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Hugh J Willison, Bart C Jacobs, Pieter A van Doorn
Guillain-Barré syndrome is the most common and most severe acute paralytic neuropathy, with about 100,000 people developing the disorder every year worldwide. Under the umbrella term of Guillain-Barré syndrome are several recognisable variants with distinct clinical and pathological features. The severe, generalised manifestation of Guillain-Barré syndrome with respiratory failure affects 20-30% of cases. Treatment with intravenous immunoglobulin or plasma exchange is the optimal management approach, alongside supportive care...
August 13, 2016: Lancet
Graeme J Hankey
In the past decade, the definition of stroke has been revised and major advances have been made for its treatment and prevention. For acute ischaemic stroke, the addition of endovascular thrombectomy of proximal large artery occlusion to intravenous alteplase increases functional independence for a further fifth of patients. The benefits of aspirin in preventing early recurrent ischaemic stroke are greater than previously recognised. Other strategies to prevent recurrent stroke now include direct oral anticoagulants as an alternative to warfarin for atrial fibrillation, and carotid stenting as an alternative to endarterectomy for symptomatic carotid stenosis...
September 13, 2016: Lancet
Yaejin Moon, Jacob J Sosnoff
OBJECTIVE: To systematically synthesize information on safe landing strategies for a fall and quantitatively examine the effects of the strategies to reduce risk of injury from a fall. DATA SOURCES: PubMed, Web of science, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library STUDY SELECTION: Databases were searched using the combinations of keywords of "falls", "strategy", "impact" and "load". Randomized control trials, cohort studies, pre-post studies, or cross-sectional studies were included...
August 31, 2016: Archives of Physical Medicine and Rehabilitation
Renata Terra de Oliveira, Lilian Assunção Felippe, Lilian Teresa Bucken Gobbi, Fabio Augusto Barbieri, Gustavo Christofoletti
OBJECTIVE: We have made a 3-arm trial (group vs. individual exercise vs. no treatment) to test the effects of a 6-month exercise program upon the executive functions in participants with Parkinson disease. METHODS: Twenty-four subjects were randomly allocated in 3 groups and undertook individualized exercises (G1, n = 8), group exercises (G2, n = 8), or monitoring (G3, n = 8). Executive functions were evaluated by means of the Wisconsin card sorting test and the Raven colored matrices, both assessed at the beginning of the program and after 6 months...
August 31, 2016: American Journal of Physical Medicine & Rehabilitation
Maarten A Röling, Nina M C Mathijssen, Rolf M Bloem
Groin pain is a frequent cause of discomfort in patients and highly prevalent in active patients. One of the diagnoses causing groin pain is femoroacetabular impingement (FAI). However, the incidence of FAI in the general population is unknown. This study aimed to identify the incidence of groin pain suggestive of FAI in a cohort of 31 451 patients in the Netherlands during 1 year. A cooperation of 16 general practitioners (GPs) participated in this prospective registry. All GPs were educated in the clinical manifestation of FAI and the physical examination for FAI...
August 2016: Journal of Hip Preservation Surgery
Shane A Shapiro, Shari E Kazmerchak, Michael G Heckman, Abba C Zubair, Mary I O'Connor
BACKGROUND: Bone marrow aspirate concentrate (BMAC) is increasingly used as a regenerative therapy for musculoskeletal pathological conditions despite limited evidence-based support. HYPOTHESIS: BMAC will prove feasible, safe, and efficacious for the treatment of pain due to mild to moderate degenerative joint disease of the knee. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2. METHODS: In this prospective, single-blind, placebo-controlled trial, 25 patients with bilateral knee pain from bilateral osteoarthritis were randomized to receive BMAC into one knee and saline placebo into the other...
August 26, 2016: American Journal of Sports Medicine
Matthew F Glasser, Timothy S Coalson, Emma C Robinson, Carl D Hacker, John Harwell, Essa Yacoub, Kamil Ugurbil, Jesper Andersson, Christian F Beckmann, Mark Jenkinson, Stephen M Smith, David C Van Essen
Understanding the amazingly complex human cerebral cortex requires a map (or parcellation) of its major subdivisions, known as cortical areas. Making an accurate areal map has been a century-old objective in neuroscience. Using multi-modal magnetic resonance images from the Human Connectome Project (HCP) and an objective semi-automated neuroanatomical approach, we delineated 180 areas per hemisphere bounded by sharp changes in cortical architecture, function, connectivity, and/or topography in a precisely aligned group average of 210 healthy young adults...
August 11, 2016: Nature
Fiona Aspinal, Jon Glasby, Tine Rostgaard, Hanne Tuntland, Rudi G J Westendorp
As the overwhelming majority of older people prefer to remain in their own homes and communities, innovative service provision aims to promote independence of older people despite incremental age associated frailty. Reablement is one such service intervention that is rapidly being adopted across high-income countries and projected to result in significant cost-savings in public health expenditure by decreasing premature admission to acute care settings and long-term institutionalisation. It is an intensive, time-limited intervention provided in people's homes or in community settings, often multi-disciplinary in nature, focussing on supporting people to regain skills around daily activities...
September 2016: Age and Ageing
Kenneth W Lyles, Cathleen S Colón-Emeric, Jay S Magaziner, Jonathan D Adachi, Carl F Pieper, Carlos Mautalen, Lars Hyldstrup, Chris Recknor, Lars Nordsletten, Kathy A Moore, Catherine Lavecchia, Jie Zhang, Peter Mesenbrink, Patricia K Hodgson, Ken Abrams, John J Orloff, Zebulun Horowitz, Erik Fink Eriksen, Steven Boonen
BACKGROUND: Mortality is increased after a hip fracture, and strategies that improve outcomes are needed. METHODS: In this randomized, double-blind, placebo-controlled trial, 1065 patients were assigned to receive yearly intravenous zoledronic acid (at a dose of 5 mg), and 1062 patients were assigned to receive placebo. The infusions were first administered within 90 days after surgical repair of a hip fracture. All patients (mean age, 74.5 years) received supplemental vitamin D and calcium...
November 1, 2007: New England Journal of Medicine
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