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How experienced community neurologists make diagnoses during clinical encounters
We describe 3 core domains of diagnosis: 1) clinical (C), 2) laboratory and electrodiagnostics (L), and 3) neuroimaging (N). Neurologists were uniform in their practices across these domains except within the clinical domain, where the physical examination varied considerably among clinicians. All neurologists coordinated findings from the 3 domains to arrive at a final diagnosis. This practice of coordination varied across common disease categories (e.g., meningitis vs dementia). To codify this variance, we developed a provisional model of diagnostic practice derived from the data consisting of a 3-point coordinate shorth...
Source: Neurology - October 14, 2013 Category: Neurology Authors: Dhand, A., Engstrom, J., Dhaliwal, G. Tags: Cost effectiveness/economic, Decision analysis, All Clinical Neurology, Methods of education CONTEMPORARY ISSUES Source Type: research

Study of audiovestibular dysfunction in children with systemic lupus erythematosus
Conclusion: Silent audiovestibular dysfunction is prevalent among systemic lupus erythematosus children especially those positive for antiphospholipid antibodies necessitating routine regular evaluation.
Source: International Journal of Pediatric Otorhinolaryngology - September 1, 2013 Category: ENT & OMF Authors: Ghada Ibrahim Gad, Somaia Tawfik Mohamed, Khaled Salah Awwad, Rehab Fetoh Mohamed Tags: Research papers Source Type: research

Strokes Tied to Tainted Steroid Injections (CME/CE)
(MedPage Today) -- There should be a "high index of suspicion for possible fungal meningitis" when ischemic stroke occurs in the posterior circulation and patients have a history of epidural spinal injections, according to researchers who reported a small series of case studies.
Source: MedPage Today Cardiovascular - July 24, 2013 Category: Cardiology Source Type: news

Stroke in paediatric pneumococcal meningitis: a cross-sectional population-based study
Before routine infant pneumococcal immunisation and improved access to neuroimaging, around 25% of children with pneumococcal meningitis (PM) suffered ischaemic stroke (IS).1 2 In a population-based retrospective audit (UHS ZAUD2053), we investigated the postimmunisation prevalence of stroke/cerebrovascular disease (CVD), and compared features of children with and without IS/CVD. We included all cases of PM in children <18 years old with a Wessex postcode admitted to our tertiary centre, University Hospital Southampton (UHS) and the eight hospitals in our referral catchment area of Hampshire and Dorset (2001 childh...
Source: Archives of Disease in Childhood - July 11, 2013 Category: Pediatrics Authors: Pryde, K., Walker, W. T., Hollingsworth, C., Haywood, P., Baird, J., Hussey, M., Freeman, A., Gawne-Cain, M., Harms, B., Kirkham, F. J., Faust, S. N. Tags: PostScript Source Type: research

Adjunctive dexamethasone in adults with meningococcal meningitis
In the article by Heckenberg et al.,1 the authors conclude that dexamethasone did not similarly improve the unfavorable outcome in meningococcal meningitis as was seen in their previous pneumococcal cohort study.2 The difference in the incidence of meningitis-related stroke between these meningitis populations may explain the difference in the cohorts' Glasgow Outcome Scale results.
Source: Neurology - May 6, 2013 Category: Neurology Authors: Boelman, C. G., Brouwer, M. C., van de Beek, D. Tags: WRITECLICK: EDITOR ' S CHOICE Source Type: research

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