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Consensus statement for the management of incidentally found brain white matter hyperintensities in general medical practice
Med J Aust. 2023 Aug 21. doi: 10.5694/mja2.52079. Online ahead of print.ABSTRACTINTRODUCTION: There is a paradigm shift in our understanding of white matter hyperintensities (WMH) found on brain imaging. They were once thought to be a normal phenomenon of ageing and, therefore, warranted no further investigation. However, evidence now suggests these lesions are markers of poor brain and cardiovascular health, portending an increased risk of stroke, cognitive decline, depression and death. Nevertheless, no specific guidelines exist for the management of incidentally found WMH for general medical practitioners and other clin...
Source: Medical Journal of Australia - August 21, 2023 Category: General Medicine Authors: Thomas P Ottavi Elizabeth Pepper Grant Bateman Mark Fiorentino Amy Brodtmann Source Type: research

Hypotension-Avoidance Versus Hypertension-Avoidance Strategies in Noncardiac Surgery : An International Randomized Controlled Trial
CONCLUSION: In patients having noncardiac surgery, our hypotension-avoidance and hypertension-avoidance strategies resulted in a similar incidence of major vascular complications.PRIMARY FUNDING SOURCE: Canadian Institutes of Health Research, National Health and Medical Research Council (Australia), and Research Grant Council of Hong Kong.PMID:37094336 | DOI:10.7326/M22-3157
Source: Annals of Internal Medicine - April 25, 2023 Category: Internal Medicine Authors: Maura Marcucci Thomas W Painter David Conen Vladimir Lomivorotov Daniel I Sessler Matthew T V Chan Flavia K Borges Kate Leslie Emmanuelle Duceppe Mar ía José Martínez-Zapata Chew Yin Wang Denis Xavier Sandra N Ofori Michael Ke Wang Sergey Efremov Giova Source Type: research

Emergency department presentations during the COVID-19 pandemic in Queensland (to June 2021): interrupted time series analysis
CONCLUSIONS: The COVID-19 pandemic and related public restrictions were associated with profound changes in health care use. Pandemic plans should include advice about continuing to seek care for serious health conditions and health emergencies, and support alternative sources of care for less urgent health care needs.PMID:36567660 | DOI:10.5694/mja2.51819
Source: Medical Journal of Australia - December 26, 2022 Category: General Medicine Authors: Amy L Sweeny Gerben Keijzers Andrea Marshall Emma J Hall Jamie Ranse Ping Zhang Gary Grant Ya-Ling Huang Dinesh Palipana Yang D Teng Benjamin Gerhardy Jaimi H Greenslade Philip Jones Julia L Crilly Source Type: research

Correlation Between Intracranial Arterial Calcification and Imaging of Cerebral Small Vessel Disease
Conclusion: Intracranial artery calcification is common in patients with ischemic cerebrovascular disease and the intracranial carotid artery is most frequently affected. Intracranial arterial calcifications might be associated with imaging markers of SVD and are highly correlated with WMHs, lacunes, and CMBs. Quantification of calcification on CT provides additional information on the pathophysiology of SVD. Intracranial arterial calcification could act as a potential marker of SVD. Introduction Atherosclerosis is a systemic vascular process that is considered a major cause of cerebrovascular and cardiovascular di...
Source: Frontiers in Neurology - April 30, 2019 Category: Neurology Source Type: research

Acupuncture for Post-stroke Shoulder-Hand Syndrome: A Systematic Review and Meta-Analysis
Conclusions: Acupuncture therapy seems effective for motor function, pain relief and activities of daily living in stroke patients with mild SHS, when it is used in combination with rehabilitation. The low certainty of evidence downgrades our confidence in making recommendations to clinical practice. Introduction Shoulder-hand syndrome (SHS) is a common condition among people who have had a stroke, with its reported prevalence ranging from 12% to 49% (1, 2). The main symptoms of SHS include pain, hyperalgesia, joint swelling and limitations in range of motion (ROM) (3). Post-stroke SHS is also named type I complex ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Associations of Anemia With Outcomes in Patients With Spontaneous Intracerebral Hemorrhage: A Meta-Analysis
Conclusions: Anemia on admission was associated with higher mortality and an increased risk of poor outcome in patients with ICH. However, the results were limited by the high heterogeneity of included studies. Prospective, multi-center or population-based, large sample cohort studies are needed in the future. Introduction Intracerebral hemorrhage (ICH) is the second most common cause of stroke and a highly lethal disease (1), which still lacks effective therapeutic interventions (2, 3). Although age, baseline ICH volume and neurological status on admission are well-known predictors of outcome of ICH (4), none of t...
Source: Frontiers in Neurology - April 24, 2019 Category: Neurology Source Type: research

Neuroimmunology of Human T-Lymphotropic Virus Type 1-Associated Myelopathy/Tropical Spastic Paraparesis
Conclusion Recent advances in research on HTLV-1 provide better understanding of the molecular pathogenesis and mechanisms of HAM/TSP, and several clinical trials of novel therapies for patients with HAM/TSP have been initiated. However, long-term improvement of motor disability and quality of life still have not been achieved in HAM/TSP patients, and the clinical management remains challenging. Given that HAM/TSP is characterized by activated T-cells in both the periphery and CNS, studies in HAM/TSP will be highly informative for clarifying the pathogenesis of other neuroinflammatory disorders such as multiple sclerosis....
Source: Frontiers in Microbiology - April 23, 2019 Category: Microbiology Source Type: research

Harnessing the Four Elements for Mental Health
DiscussionAs detailed above, the “elements” in both a classical and a contemporary sense have effects on our mental health and are potentially modifiable aspects that can be harnessed as therapeutic interventions. The most robust interventional evidence currently available shows tentative support for several use of the elements via horticultural and nature-exposure therapy, green exercise/physical activity, sauna and heat therapy, balneotherapy, and breathing exercises. It should be noted that, in many cases, these interventions were not studied in definitive diagnosed psychiatric disorders and thus it is pre...
Source: Frontiers in Psychiatry - April 23, 2019 Category: Psychiatry Source Type: research

World-Wide Efficacy of Bone Marrow Derived Mesenchymal Stromal Cells in Preclinical Ischemic Stroke Models: Systematic Review and Meta-Analysis
Conclusions: Our results show worldwide efficacy of BM-MSCs in improving functional outcomes in pre-clinical animal models of stroke and support testing these cells in clinical trials in various ranges of time windows using different delivery routes. The continued growing number of publications showing functional benefit of BM-MSCs are now adding limited value to an oversaturated literature spanning 18 years. Researchers should focus on identifying definitive mechanisms on how BM-MSCs lead to benefit in stroke models. Introduction Ischemic stroke is the 5th leading cause of death and the leading cause of long term di...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Beta Amyloid Deposition Is Not Associated With Cognitive Impairment in Parkinson's Disease
In this study, we used a well-validated visual assessment to clinically rate scans as being amyloid positive or negative (38). As there is not an accepted threshold based on standardized centiloid reference regions, we defined an amyloid positivity centiloid cut-off threshold in our sample. Our cut-off (CL = 31.3, SUVR = 1.21) corresponds well to the estimated value proposed by Rowe and colleagues (34) in the context of AD (CL = 25–30), however our estimated threshold may be biased by the low number of Aβ positive patients. Our results suggest a lower prevalence of amyloid-positive PDD individuals than in ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

The Predictive Capacity of the Buffalo Concussion Treadmill Test After Sport-Related Concussion in Adolescents
Conclusion This study found that the ΔHR (HRt minus resting HR) correlated with duration of clinical recovery in participants who were prescribed relative rest or a placebo-stretching program but not for participants prescribed sub-threshold aerobic exercise. A ΔHR of ≤50 bpm on the BCTT was 73% sensitive and 78% specific for predicting delayed recovery in concussed adolescents prescribed the current standard of care (i.e., cognitive and physical rest). This has implications for planning team and school activities in adolescents who sustain SRC. Ethics Statement This study was carried out in acco...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Ambient Conditions Prior to Tokyo 2020 Olympic and Paralympic Games: Considerations for Acclimation or Acclimatization Strategies
This study was supported by ZonMw (Project: Thermo Tokyo: Beat the heat), Netherlands Organisation for Scientific Research (NWO) (Project: Citius, Altius, Sanius), and Heatshield, under EU Horizon 2020 grant agreement No 668786. Conflict of Interest Statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Acknowledgments The authors thank Dr. Tatsuro Amano (Niigata University, Japan) for his assistance with translating the Japanese Meteorological Agency website. Footnotes ^ https://rdrr.io/g...
Source: Frontiers in Physiology - April 23, 2019 Category: Physiology Source Type: research

Neurophysiological Analysis of Intermanual Transfer in Motor Learning
In this study, MEPs were induced during the subject’s imaged kinesthetic MI. This involves recalling muscle contraction based on a muscle sensory image and was reported to indicate the activity of brain regions similar to those involved in actual muscle contraction (Ruby and Decety, 2001). In the transfer training group, the muscle sensory image evaluation correlated to the actual task execution with the right hand. As a result, it was easy to recall the kinesthetic MI for the training task, thus affecting MI of the non-trained limbs so that MEP changes occurred in the left hand’s MI. In addition, brain exc...
Source: Frontiers in Human Neuroscience - April 17, 2019 Category: Neuroscience Source Type: research

Phagocytosis in the Brain: Homeostasis and Disease
Conclusions and Perspectives In this review we have summarized the critical role phagocytosis plays in both CNS homeostasis and disease. While much progress has been made in recent years, many unanswered questions remain. How phagocytosis in the CNS is influenced by numerous factors, such as microenvironment or phagocytic target, have yet to be fully resolved. Additionally, the utilization of novel technologies, including in vivo imaging techniques (217), iPSC-derived microglia (213) and high-throughput screens (66), will likely contribute to further identification of phagocytic pathways and consequences of phagocytosis w...
Source: Frontiers in Immunology - April 15, 2019 Category: Allergy & Immunology Source Type: research

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

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