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https://www.readbyqxmd.com/read/29783067/motor-retraining-more-for-functional-movement-disorders-outcomes-from-a-one-week-multidisciplinary-rehabilitation-program
#1
Alexandra Jacob, Darryl Kaelin, Abbey Roach, Craig Ziegler, Kathrin LaFaver
BACKGROUND: Functional Movement Disorders (FMD) are conditions of abnormal motor control thought to be caused by psychological factors. These disorders are commonly seen in neurological practice and prognosis is often poor. No consensus treatment guidelines have been established, however the role of physical therapy in addition to psychotherapy has increasingly been recognized. This study reports patient outcomes from a multidisciplinary FMD treatment program using motor retraining (MoRe) strategies...
May 18, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29781051/prehospital-prediction-of-large-vessel-occlusion-in-suspected-stroke-patients
#2
REVIEW
Kevin J Keenan, Charles Kircher, Jason T McMullan
PURPOSE OF REVIEW: Recent advances in endovascular thrombectomy have made acute ischemic stroke due to a large vessel occlusion more treatable than ever. Rapid access to treatment remains paramount and multiple large vessel occlusion prediction scales have been created to enhance prehospital identification and triage of these patients. This review summarizes the current state of large vessel occlusion prediction scales, proposes a set of ideal scale features, and discusses the future of these scales and prehospital neurological emergency response systems...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29775977/-rehabilitation-after-traumatic-fracture-of-thoracic-and-lumbar-spine
#3
Hartmut Bork, Stefan Simmel, Eckhardt Böhle, Ulrich Ernst, Klaus Fischer, Bernd Fromm, Jean-Jacques Glaesener, Bernhard Greitemann, P Krause, S Panning, V Pullwitt, J Schmidt, Andreas Veihelmann, Lutz Vogt
On the basis of the S2-k guideline "Rehabilitation after traumatic fractures of the thoracic und lumbar spine without neurologic disorder", this article gives an overview of target-oriented rehabilitation of patients with minor fractures or those with column stability and unstable spinal fractures which are stabilised by surgery. To obtain early social and job related reintegration, outpatient or inpatient rehabilitation has to start immediately after treatment in hospital. Rehabilitation must be orientated towards the biopsychosocial model of ICF and has to be adapted for the patient...
May 18, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29770929/two-cases-of-sarcoidosis-presenting-as-longitudinally-extensive-transverse-myelitis
#4
REVIEW
Amanda Mary Scott, Janeth Yinh, Timothy McAlindon, Robert Kalish
Neurosarcoidosis is uncommon with an incidence of approximately 5 to 15%. Central nervous system involvement can be divided into brain and spinal cord neurosarcoidosis. Spinal cord sarcoidosis is extremely rare, occurring in less than 1% of all sarcoidosis cases. Its manifestations may include cauda equina syndrome, radiculopathy, syringomyelia, cord atrophy, arachnoiditis, and myelopathy or transverse myelitis. We highlight two cases of spinal cord sarcoidosis, each presenting with longitudinally extensive transverse myelitis, that demonstrate the dilemmas that physicians face with regard to diagnosis and treatment...
May 17, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29769180/factors-associated-with-delay-in-carotid-endarterectomy-for-patients-with-symptomatic-severe-internal-carotid-artery-stenosis-a-case-control-study
#5
Daniel Meyer, Erwin Karreman, David Kopriva
BACKGROUND: The Canadian Best Practice Recommendations for Stroke Care (2008 update) recommend that patients with neurologic symptoms secondary to severe internal carotid artery stenosis undergo carotid endarterectomy within 14 days of symptom onset to prevent stroke. The purpose of this study was to identify patient and system factors associated with meeting, or failing to meet, the guideline. METHODS: In this case-control study, potential study participants were identified through an electronic search of the Discharge Abstract Database...
May 15, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29769006/role-of-cardiac-catheterization-lab-post-resuscitation-in-patients-with-st-elevation-myocardial-infarction
#6
Sridhar Reddy, Kwan S Lee, Karl Kern, Kapildeo Lotun
BACKGROUND: Cardiac arrest remains a common and lethal condition associated with high morbidity and mortality. Even with improving survival rates, the successfully resuscitated post cardiac arrest patient is also at risk for poor neurological outcomes, functional status and long- term survival if not managed appropriately. Given that acute coronary occlusion has been found to be the leading cause of cardiac arrest, long-term prognosis is good in selected patients after successful out-of-hospital resuscitation and ST elevation myocardial infarction who are taken for immediate coronary angiography, treated with primary percutaneous coronary intervention and hypothermia when indicated...
May 16, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29766770/mri-guided-thrombolysis-for-stroke-with-unknown-time-of-onset
#7
Götz Thomalla, Claus Z Simonsen, Florent Boutitie, Grethe Andersen, Yves Berthezene, Bastian Cheng, Bharath Cheripelli, Tae-Hee Cho, Franz Fazekas, Jens Fiehler, Ian Ford, Ivana Galinovic, Susanne Gellissen, Amir Golsari, Johannes Gregori, Matthias Günther, Jorge Guibernau, Karl Georg Häusler, Michael Hennerici, André Kemmling, Jacob Marstrand, Boris Modrau, Lars Neeb, Natalia Perez de la Ossa, Josep Puig, Peter Ringleb, Pascal Roy, Enno Scheel, Wouter Schonewille, Joaquin Serena, Stefan Sunaert, Kersten Villringer, Anke Wouters, Vincent Thijs, Martin Ebinger, Matthias Endres, Jochen B Fiebach, Robin Lemmens, Keith W Muir, Norbert Nighoghossian, Salvador Pedraza, Christian Gerloff
Background Under current guidelines, intravenous thrombolysis is used to treat acute stroke only if it can be ascertained that the time since the onset of symptoms was less than 4.5 hours. We sought to determine whether patients with stroke with an unknown time of onset and features suggesting recent cerebral infarction on magnetic resonance imaging (MRI) would benefit from thrombolysis with the use of intravenous alteplase. Methods In a multicenter trial, we randomly assigned patients who had an unknown time of onset of stroke to receive either intravenous alteplase or placebo...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29765787/liver-failure-and-conjugated-hyperbilirubinemia-in-a-preterm-neonate-role-of-early-ivig-and-exchange-transfusion
#8
Jayasree Nair, Vasantha H S Kumar
Neonatal liver failure (NLF) is a rare diagnosis but carries with it significant risks of mortality and morbidity. Common etiologies for NLF include metabolic causes, gestational alloimmune liver disease (GALD or neonatal hemochromatosis), and viral infections. We report a case of liver failure in a premature infant with abnormal iron profile within 48 hours of birth. Lack of accepted guidelines for the initial management of severe jaundice with a high direct component in the first week after birth made treatment challenging...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29765166/diagnosis-of-retrocochlear-lesions-with-emphasis-on-expansion-of-the-cerebellopontine-angle
#9
Bretislav Gal, Jan Rottenberg, Marta Pazourkova, Jiri Vanicek, Ermis Vogazianos
The correct diagnosis of CPA tumours is a relatively common issue in both neurological and ENT practice, the omission of which can have serious consequences for the patient. Properly set clinical guidelines and diagnostic protocols are key aspects of good clinical practice. In the case of CPA tumours, two options are available: the first is diagnosis with the help of an ABR as the primary tool for determining the group of patients with a possible tumour; the second is an MRI scan of the posterior cranial fossa...
April 17, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29764001/hypertensive-disorders-of-pregnancy-overview-and-current-recommendations
#10
REVIEW
Diane M Folk
Hypertensive disorders of pregnancy include chronic hypertension, gestational hypertension, preeclampsia-eclampsia, and chronic hypertension with superimposed preeclampsia. These disorders are an important cause of maternal and fetal morbidity and mortality. Although advances in effective treatments have been made, current research has yet to identify a biochemical or diagnostic imaging marker to reliably predict preeclampsia. Despite current guidelines that address diagnosis and management of hypertensive disorders in pregnancy, health care providers may overlook or be unaware of signs that require immediate evaluation and treatment...
May 15, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29763271/adults-with-developmental-disabilities-a-comprehensive-approach-to-medical-care
#11
Clarissa Kripke
Developmental disabilities are attributable to a cognitive impairment, physical impairment, or both. They manifest during the developmental period from birth to early adulthood, and are likely to continue indefinitely. The life expectancy of most persons with developmental disabilities now approaches that of the general population. According to the neurodiversity model of care, developmental disability is accepted as a valued part of human neurologic diversity. The social model focuses on improving participation in society with accommodations such as adaptive equipment or improvements to the social and physical environment...
May 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29759272/pharmacologic-and-nonpharmacologic-treatment-of-restless-legs-syndrome
#12
REVIEW
Galia V Anguelova, Monique H M Vlak, Arthur G Y Kurvers, Roselyne M Rijsman
This article provides an updated practical guide for the treatment of primary restless legs syndrome (RLS). Articles that appeared after the American Academy of Neurology guideline search were reviewed according to the same evidence rating schedule. We found limited evidence for nonpharmacologic treatment options. In moderate to severe primary RLS, pharmacologic options may be considered, including iron suppletion, an α2δ ligand, a dopamine agonist, a combination of an α2δ ligand and a dopamine agonist, or oxycodone/naloxone...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29755795/double-bolus-alteplase-therapy-during-cardiopulmonary-resuscitation-for-cardiac-arrest-due-to-massive-pulmonary-embolism-guided-by-focused-bedside-echocardiography
#13
Hafiz B Mahboob, Bruce W Denney
Massive pulmonary embolism (PE) frequently leads to cardiac arrest (CA) which carries an extremely high mortality rate. Although available, randomized trials have not shown survival benefits from thrombolytic use. Thrombolytics however have been used successfully during resuscitation in clinical practice in multiple case reports and in retrospective studies. Recent resuscitation guidelines recommend using alteplase for PE related CA; however they do not offer a standardized treatment regimen. The most consistently applied approach is an intravenous bolus of 50 mg tissue plasminogen activator (t-PA) early during cardiopulmonary resuscitation (CPR)...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29755403/has-the-time-come-to-stratify-and-score-sudep-risk-to-inform-people-with-epilepsy-of-their-changes-in-safety
#14
Rohit Shankar, Craig Newman, Alistair Gales, Brendan N McLean, Jane Hanna, Samantha Ashby, Matthew C Walker, Josemir W Sander
Recent publication of the American Academy of Neurology SUDEP guidance highlighted the importance to American clinicians of making people with epilepsy aware of SUDEP risk. It is the first guideline to do this in the United States. It follows precedent set out in the UK by National Institute of Clinical Excellence in 2004. While a significant achievement, the lack of clarity of how to deliver this guidance in an enduring and person-centered manner, raises concerns on how its long-term effectiveness in risk mitigation...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29754417/teaching-paediatric-basic-life-support-in-medical-schools-using-peer-teaching-or-video-demonstration-a-prospective-randomised-trial
#15
Frederik Stephan, Hanjo Groetschel, Anja K Büscher, Deniz Serdar, Kjell A Groes, Rainer Büscher
AIM: The outcome of children with an out-of-hospital cardiac arrest is still poor, but bystander cardiopulmonary resuscitation can increase survival and minimise severe neurological sequelae. While teaching basic life support is standardised in emergency medicine classes, paediatric basic life support (PBLS) in neonates and toddlers is under-represented in paediatric curricula during university education. The appropriate mixture of E-learning and peer teaching lessons remains controversial in teaching paediatric basic skills...
May 13, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29752000/noncompliance-of-patients-with-driving-restrictions-due-to-uncontrolled-epilepsy
#16
Laurent M Willems, Philipp S Reif, Susanne Knake, Hajo M Hamer, Constantin Willems, Günter Krämer, Felix Rosenow, Adam Strzelczyk
Epilepsies are a common and chronic neurological disorder characterized by sustained risk of recurrent seizures. Because of paroxysmal and often unpredictable occurrence of seizures, patients with uncontrolled epilepsy are subject to disease-specific restrictions in daily life, such as their career choice or specific work limitations. According to German law and many other European and international guidelines, driving is strictly prohibited in patients with uncontrolled epilepsy so as to increase active and passive safety in public road traffic...
May 9, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29749575/case-report-on-the-spontaneous-resolution-of-a-traumatic-intracranial-acute-subdural-haematoma-evaluation-of-the-guidelines
#17
Isabel Charlotte Hostettler, Srinivas Murahari, Muhammad H Raza, Vassilios Kontojannis, Kevin Tsang, Haider Kareem, Brynmor Jones, Mark Wilson
Rapid spontaneous resolution of traumatic acute subdural haematomas (ASDH) can occur but is rare. We present an 88-year-old female who presents with a large left acute subdural haematoma (ASDH) measuring 18 mm in thickness with midline shift of 10.7 mm. We managed her conservatively based upon good consciousness level and absent neurological deficits. Repeat computed tomography (CT) the following day demonstrated near complete resolution of the ASDH and midline shift regression; a further CT confirmed resolution...
May 11, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29745036/non-small-cell-lung-cancer-brain-metastasis-screening-in-the-era-of-positron-emission-tomography-ct-staging-current-practice-and-outcomes
#18
Mauricio E Diaz, Maciej Debowski, Craig Hukins, David Fielding, Kwun M Fong, Catherine S Bettington
INTRODUCTION: Several clinical guidelines indicate that brain metastasis screening (BMS) should be guided by disease stage in non-small cell lung cancer (NSCLC). We estimate that screening is performed more broadly in practice, and patients undergo brain imaging at considerable cost with questionable benefit. Our aim was to quantify the use and detection rate of BMS in a contemporary cohort staged with 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT). METHODS: We conducted a retrospective review of prospectively collected data from three major lung cancer referral centres in Brisbane between January 2011 and December 2015...
May 10, 2018: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/29738616/commentary-2018-stroke-guidelines
#19
Andrew D Perron
I read with interest (and some degree of disappointment) the new 2018 Stroke Guidelines published in January of this year that are labeled prominently "Endorsed by SAEM".1 To be clear, my disappointment has nothing to do with the use of tPA in acute ischemic stroke (I am happy to let others lead that charge). I am an admitted agnostic when it comes to the use of tPA (it helps some, it harms others, and we need to be really smart in its use to maximize the former and minimize the latter). Rather, it was notable to me that while the new guidelines touch a large number of specialties (Internal Medicine, Pharmacy, Nutrition, Rehabilitation, Radiology, Neurology, and Interventionalists to name a few), only one specialty merited a new Level 1A recommendation for targeted education This article is protected by copyright...
May 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29735288/clinical-practice-guidelines-for-the-treatment-of-systemic-lupus-erythematosus-by-the-mexican-college-of-rheumatology
#20
Daniel Xibillé-Friedmann, Marcela Pérez-Rodríguez, Sandra Carrillo-Vázquez, Everardo Álvarez-Hernández, Francisco Javier Aceves, Mario C Ocampo-Torres, Conrado García-García, José Luis García-Figueroa, Javier Merayo-Chalico, Ana Barrera-Vargas, Margarita Portela-Hernández, Sandra Sicsik, Lilia Andrade-Ortega, Víctor Manuel Rosales-Don Pablo, Aline Martínez, Pilar Prieto-Seyffert, Mario Pérez-Cristóbal, Miguel Ángel Saavedra, Zully Castro-Colín, Azucena Ramos, Gabriela Huerta-Sil, María Fernanda Hernández-Cabrera, Luis Javier Jara, Leonardo Limón-Camacho, Lizbet Tinajero-Nieto, Leonor A Barile-Fabris
There are national and international clinical practice guidelines for systemic lupus erythematosus treatment. Nonetheless, most of them are not designed for the Mexican population or are devoted only to the treatment of certain disease manifestations, like lupus nephritis, or are designed for some physiological state like pregnancy. The Mexican College of Rheumatology aimed to create clinical practice guidelines that included the majority of the manifestations of systemic lupus erythematosus, and also incorporated guidelines in controversial situations like vaccination and the perioperative period...
May 4, 2018: Reumatología Clinica
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