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Headache in the Older Population: Causes, Diagnoses, and Treatments
AbstractPurpose of ReviewPrimary headaches are less common and differ in presentation in older versus younger individuals. Secondary headaches become more common among older patients.Recent FindingsDiagnosis and management of headaches in those>  65 years are discussed. Migraine and tension-type headaches are rarely new onset in this age group and should be a diagnosis of exclusion. In older individuals, migraine is more likely to be bilateral with less sensory sensitivities. Migraine aura may present without headache; careful assessment is needed to exclude stroke. Other primary headaches discussed include cough, hy...
Source: Current Pain and Headache Reports - May 28, 2020 Category: Neurology Source Type: research

Patient Perspectives on the Therapeutic Profile of Botulinum Neurotoxin Type A in Spasticity
Conclusions: Patients with spasticity can expect a characteristic profile of BoNT-A effects, namely time lag to onset and peak effect followed by a gradual decline in the symptomatic benefits. Symptom re-emergence is common and has significant impact on quality of life. Greater patient/clinician awareness of this therapeutic profile should lead to better level of overall satisfaction with treatment, informed therapeutic discussions and treatment schedule planning.
Source: Frontiers in Neurology - May 6, 2020 Category: Neurology Source Type: research

Evidence Base of Clinical Studies on Qi Gong: A Bibliometric Analysis.
CONCLUSIONS: Qigong research publications have been increasing gradually. Reports on study types, participants, Qigong Intervention, and outcomes are diverse and inconsistent. There is an urgent need to develop a set of reporting standards for various interventions of Qigong. Further trials of high methodological quality with sufficient sample size and real world studies are needed to verify the effects of Qigong in health and disease management. PMID: 32444061 [PubMed - as supplied by publisher]
Source: Complementary Therapies in Medicine - April 30, 2020 Category: Complementary Medicine Authors: Zhang YP, Hu RX, Han M, Lai BY, Liang SB, Chen BJ, Robinson N, Chen K, Liu JP Tags: Complement Ther Med Source Type: research

Diagnosis and management of acute aortic syndromes in the emergency department
AbstractAcute aortic syndromes (AASs) are deadly cardiovascular emergencies involving the thoracic aorta. AASs are relatively rare conditions, have unspecific signs and symptoms (including truncal pain, syncope, neurologic deficit and limb ischemia) and require contrast-enhanced tomography angiography (CTA) of the chest and abdomen for conclusive diagnosis and subsequent therapeutic planning. In the Emergency Department (ED), most patients with potential signs/symptoms of AASs are finally found affected by other alternative diagnoses. Hence, misdiagnosis and delayed diagnosis of AASs are major concerns. In critically ill p...
Source: Internal and Emergency Medicine - April 30, 2020 Category: Emergency Medicine Source Type: research

Landmark Phase 3 VOYAGER PAD Study of XARELTO ® (rivaroxaban) Plus Aspirin Shows Significant Benefit in Patients with Symptomatic Peripheral Artery Disease (PAD) after Lower-Extremity Revascularization
RARITAN, NJ, March 28, 2020 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced the VOYAGER PAD study met its primary efficacy and principal safety endpoints, demonstrating the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily) plus aspirin (100 mg once daily) was superior to aspirin alone in reducing the risk of major adverse limb and cardiovascular (CV) events by 15 percent in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization, with similar rates of TIMI[1] major bleeding. VOYAGER PAD is the only study to show a significant benefit using...
Source: Johnson and Johnson - March 28, 2020 Category: Pharmaceuticals Tags: Innovation Source Type: news

European Headache Federation recommendations for neurologists managing giant cell arteritis
ConclusionThe present article will outline recent advances made in the diagnosis and management of GCA.
Source: The Journal of Headache and Pain - March 16, 2020 Category: Neurology Source Type: research

Complex regional pain syndrome: A case report and review of the literature
Conclusion: A multidisciplinary approach is needed for effective management of CRPS, and refractory disease may respond to intrathecal baclofen with morphine.
Source: Annals of African Medicine - March 12, 2020 Category: African Health Authors: Nura H Alkali Abdulrahman M Al-Tahan Mohammad Al-Majed Husam Al-Tahan Source Type: research

What Are Some Risk Factors for Cerebral Palsy?
Discussion The term, cerebral palsy, or CP has gone through many iterations with the first description in 1861 by W.J. Little who described it as “The condition of spastic rigidity of the limbs of newborn children.” The most recent definition is from Rosenbaun et al. in 2007 which states it is “a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cog...
Source: PediatricEducation.org - March 9, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Management of Left Ventricular Thrombi with Direct Oral Anticoagulants: Retrospective Comparative Study with Vitamin K Antagonists
ConclusionsThis retrospective observational study found a similar efficacy between DOAC and VKA agents in patients with LV thrombi (70.6% vs. 71.5%); however, when the thrombus remains, VKAs are still the standard of care as it is possible to control INR levels (3 –4) with them.
Source: Clinical Drug Investigation - March 5, 2020 Category: Drugs & Pharmacology Source Type: research

What to Expect in Neuromodulation This Year
The spinal cord stimulation (SCS) market growth should improve in 2020 as leaders in the space launch new products and benefit from recent acquisitions and invest in potential indication expansions, according to Needham & Co.'s Mike Matson. The medtech analyst published a report Monday sharing his takeaways from the North American Neuromodulation Society (NANS) meeting in Las Vegas, NV over the weekend. Matson noted that SCS device market growth should continue to improve in 2020 and beyond, thanks to a number of factors. The analyst estimates that SCS currently represents about $2.5 billion, wh...
Source: MDDI - January 27, 2020 Category: Medical Devices Authors: Amanda Pedersen Tags: Business Source Type: news

Axillary Peripheral Nerve Stimulation for Chronic Shoulder Pain: A Retrospective Case Series
ConclusionsThis retrospective case series provides level IV evidence supporting the use of axillary PNS therapy for the management of chronic shoulder pain. Additional, higher ‐level studies are required to further support its use.
Source: Neuromodulation: Technology at the Neural Interface - January 12, 2020 Category: Biotechnology Authors: John Taylor Mansfield, Mehul J. Desai Tags: Case Series Source Type: research

Diagnostic strategy of pulmonary embolism in the cardiology department of Ibn Rochd University hospital, Casablanca, Morocco
ConclusionManagement of pulmonary embolism in our cardiology department is characterized by the frequent use of non-invasive techniques on the diagnostic view and appeal to heparin on the therapeutic view.
Source: Archives of Cardiovascular Diseases Supplements - January 7, 2020 Category: Cardiology Source Type: research

Sonographic features of carotid artery dissection due to extension of aortic dissection: a case report
ConclusionsBedside carotid ultrasound enables rapid, sensitive and safe hemodynamic assessment, especially in critically ill patients.
Source: Critical Ultrasound Journal - December 1, 2019 Category: Radiology Source Type: research

Pre ‐hospital management protocols and perceived difficulty in diagnosing acute heart failure
ConclusionsThe prevalence of AHF protocols is rather high but the contents seem to vary. Difficulty of diagnosing suspected AHF seems to be moderate compared with other pre ‐hospital conditions.
Source: ESC Heart Failure - November 7, 2019 Category: Cardiology Authors: Pia Harjola, Òscar Miró, Francisco J. Martín‐Sánchez, Xavier Escalada, Yonathan Freund, Andrea Penaloza, Michael Christ, David C. Cone, Said Laribi, Markku Kuisma, Tuukka Tarvasmäki, Veli‐Pekka Harjola, on behalf of the EMS‐AHF Study Tags: Original Research Article Source Type: research

Diagnosis and treatment of hypertensive emergencies and urgencies among Italian emergency and intensive care departments. Results from an Italian survey: Progetto GEAR (Gestione dell'Emergenza e urgenza in ARea critica).
Abstract Hypertensive emergencies (HE) and urgencies (HU) are frequent causes of patients referral to Emergency Department (ED) and the approach may be different according to local clinical practice. Our aim was to explore awareness, management, treatment and counselling after discharge of HE and HU in Italy, by mean of an on-line survey. The young investigator research group of the Italian Society of Hypertension developed a 23-item questionnaire spread by e-mail invitation to the members of Italian Scientific societies in the field of Hypertension. 665 questionnaires were collected from EDs, Emergency and Urgenc...
Source: European Journal of Internal Medicine - November 1, 2019 Category: Internal Medicine Authors: Saladini F, Mancusi C, Bertacchini F, Spannella F, Maloberti A, Giavarini A, Rosticci M, Bruno RM, Pucci G, Grassi D, Pengo M, Muiesan ML Tags: Eur J Intern Med Source Type: research

Curing hemoglobinopathies: challenges and advances of conventional and new gene therapy approaches.
Inherited hemoglobin disorders, including beta-thalassemia (BT) and sickle-cell disease (SCD) are the most common monogenic diseases worldwide, with a global carrier frequency of over 5%. With migration they are becoming more common worldwide, making their management and care an increasing concern for health care systems.BT is characterized by an imbalance in the α/β-globin chain ratio, ineffective erythropoiesis, chronic hemolytic anemia, and compensatory haemopoietic expansion. Globally, there are over 25,000 births each year with transfusion-dependent thalassemia (TDT). The current available treatment f...
Source: Mediterranean Journal of Hematology and Infectious Diseases - October 30, 2019 Category: Hematology Source Type: research

Risk of PE significantly raised well beyond six weeks post-surgery
Postoperative pulmonary embolism risk still elevated 7-12 weeks later, regardless of the type of procedure Related items fromOnMedica Prescribe higher dose opioids for shorter time after surgery Poor pain management - a major cause of opioid crisis Statin use after stroke not linked to bleeds Don ’t delay young children’s surgery for fear of GA harms Earlier thrombolysis improves stroke outcomes
Source: OnMedica Latest News - October 9, 2019 Category: UK Health Source Type: news

Human Urinary Kallidinogenase Reduces Lipopolysaccharide-Induced Neuroinflammation and Oxidative Stress in BV-2 Cells.
Abstract Migraine is one of the most common neurological disorders which poses significant socioeconomic burden worldwide. Neuroinflammation and oxidative stress both play important roles in the pathogenesis of migraine. Human urinary kallidinogenase (UK) is a tissue kallikrein derived from human urine. Increasing evidence suggests that UK may protect against ischemic stroke, but UK's treatment potential against migraine remains to be explored. Immortal BV-2 murine microglial cells were treated with UK (125 nM, 250 nM, and 500 nM) and then given lipopolysaccharides (LPS, 1000 ng/mL). Cell viability of BV-2...
Source: Pain Research and Management - August 21, 2019 Category: Anesthesiology Authors: Zhao Z, Xu Z, Liu T, Huang S, Huang H, Huang X Tags: Pain Res Manag Source Type: research

Do chronic pain and comorbidities affect brain function in sickle cell patients? A systematic review of neuroimaging and treatment approaches
Sickle cell disease (SCD) is a medical condition in which chronic pain is common and negatively impacts psychosocial function and quality of life. Although the brain mechanisms underlying chronic pain are well studied in other painful conditions, the brain mechanisms underlying chronic pain and the associated psychosocial comorbidities are not well established in SCD. A growing literature demonstrates the effect of treatment of chronic pain, including pharmacological and nonpharmacological treatments, on brain function. The present systematic review aimed to (1) determine the effects of chronic pain and psychosocial comorb...
Source: Pain - August 21, 2019 Category: Anesthesiology Tags: Systematic Reviews and Meta-Analyses Source Type: research

Efficacy of Biofeedback for Medical Conditions: an Evidence Map
We present our findings in the form of evidence maps.ResultsWe included 16 good-quality systematic reviews examining biofeedback alone or as an adjunctive intervention. We found clear, consistent evidence across a large number of trials that biofeedback can reduce headache pain and can provide benefit as adjunctive therapy to men experiencing urinary incontinence after a prostatectomy. Consistent evidence across fewer trials suggests biofeedback may improve fecal incontinence and stroke recovery. There is insufficient evidence to draw conclusions about effects for most conditions including bruxism, labor pain, and Raynaud ...
Source: Journal of General Internal Medicine - August 13, 2019 Category: Internal Medicine Source Type: research

Shoulder pain after recent stroke (SPARS): hemiplegic shoulder pain incidence within 72hours post-stroke and 8 –10 week follow-up (NCT 02574000)
This study aimed to identify very early incidence of hemiplegic shoulder pain within 72hours (HSP), how clinical assessment was related to pain at 8 –10 week follow-up and explore current standard therapy/management.
Source: Physiotherapy - August 8, 2019 Category: Physiotherapy Authors: Martine Nadler, Mathilde Pauls, Gillian Cluckie, Barry Moynihan, Anthony C. Pereira Source Type: research

Shoulder Pain after Recent Stroke (SPARS): Hemiplegic shoulder pain incidence within 72 hours post-stroke and 8-10 week follow-up (NCT 02574000)
This study aimed to identify very early incidence of hemiplegic shoulder pain within 72  hours (HSP), how clinical assessment was related to pain at 8-10 week follow-up and explore current standard therapy/management.
Source: Physiotherapy - August 8, 2019 Category: Physiotherapy Authors: Martine Nadler, Mathilde Pauls, Gillian Cluckie, Barry Moynihan, Anthony C. Pereira Source Type: research

Characteristics of arterial hypertension in menopausal diabetic women
ConclusionHigh blood pressure is a public health problem most often associated with other cardiovascular risk factors. An evaluation of cardiovascular risk is necessary in postmenopausal hypertensive diabetic women and effective management of risk factors is recommended.
Source: Archives of Cardiovascular Diseases Supplements - July 24, 2019 Category: Cardiology Source Type: research

Need for prehospital management of hypertensive peaks
ConclusionIn the management of hypertension, it is necessary to rely more on clinical tolerance than on the level of blood pressure to guide treatment. It is necessary to know how to diagnose a true hypertensive emergency associating generally very high blood pressure and a threatening clinical context justifying the use of an immediate treatment whose benefit must be greater than the risks incurred by a rapid fall in blood pressure.
Source: Archives of Cardiovascular Diseases Supplements - July 24, 2019 Category: Cardiology Source Type: research

Zynex Expands Executive Team, Appoints Joseph Papandrea Chief Operating Officer
ENGLEWOOD, Colo., July 22, 2019 -- (Healthcare Sales & Marketing Network) -- Zynex, Inc. (NASDAQ: ZYXI), an innovative medical technology company specializing in the manufacture and sale of non-invasive medical devices for pain management, stroke rehabili... Devices, Personnel Zynex, NeuroMove
Source: HSMN NewsFeed - July 22, 2019 Category: Pharmaceuticals Source Type: news

Surgical interventions for symptomatic mild to moderate knee osteoarthritis.
CONCLUSIONS: The review found no placebo-or sham-controlled trials of surgery in participants with symptomatic mild to moderate knee osteoarthritis. There was low quality evidence that there may be no evidence of a difference between arthroscopic partial meniscectomy surgery and a home exercise program for the treatment of this condition. Similarly, low-quality evidence from a few small trials indicates there may not be any benefit of arthroscopic surgery over other non-surgical treatments including saline irrigation and hyaluronic acid injection, or one type of surgery over another. We are uncertain of the risk of adverse...
Source: Cochrane Database of Systematic Reviews - July 18, 2019 Category: General Medicine Authors: Palmer JS, Monk AP, Hopewell S, Bayliss LE, Jackson W, Beard DJ, Price AJ Tags: Cochrane Database Syst Rev Source Type: research

Treating and managing diabetic neuropathic foot ulcers
  A study by the Centers for Disease Control and Prevention reports that diabetes rates are at a steady growth, with more than 100 million people in the country living with diabetes or prediabetes as of 2017. This condition has a major impact on overall health and wellness and can cause serious complications involving vision loss, heart disease, stroke, and even toe, foot or leg amputation due to ulcers. Defining diabetic foot ulcers According to the American Podiatric Medical Association, a diabetic foot ulcer is an open wound or sore that occurs in those who have diabetes. Diabetic patients are more likely to develo...
Source: Advanced Tissue - July 1, 2019 Category: Dermatology Authors: AdvancedTissue Tags: Wound Care diabetic foot ulcers Source Type: news

Improving the Care of Individuals With Sickle Cell Disease in the Emergency Department Using a Quality Improvement Framework: The Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS)
Sickle cell disease (SCD) is a severe chronic disease that leads to premature mortality caused by serious complications of the disease such as acute chest syndrome, stroke, and sepsis. Patients presenting to the emergency department (ED) with pain due to vaso-occlusive crisis (VOC) are at a higher risk for complications, making it imperative that emergency nurses, nurse practitioners, and physicians are knowledgeable about SCD and understand the other associated complications besides VOC. Because of the complexity of disease and misperceptions about SCD among ED nurses, physicians, and nurse practitioners, a quality improv...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Challenges of Robotic Gynecologic Surgery in Morbidly Obese Patients and How to Optimize Success
This article reviews the benefits of a minimally invasive approach in obese patients and provides a thorough guide to perioperative management of obese patients undergoing robotic gynecologic surgery. A useful set of tips and tricks to overcome many of the technical challenges in performing robotic surgery in the obese patients is included.Recent FindingsIn the USA, obesity has risen to affect 39.8% of the population, which leads to increased incidence of mortality, hypertension, diabetes, heart disease, and stroke. Moreover, obese patients are at greater risk of perioperative complications during gynecologic surgery. With...
Source: Current Pain and Headache Reports - June 30, 2019 Category: Neurology Source Type: research

Cognitive Decline in Chronic Migraine with Nonsteroid Anti-inflammation Drug Overuse: A Cross-Sectional Study.
Conclusion: The risk of cognitive decline increased in chronic migraine patients. Nonsteroid anti-inflammatory drugs overuse had no influence on cognitive performances among chronic migraine sufferers. PMID: 31198478 [PubMed - in process]
Source: Pain Research and Management - June 15, 2019 Category: Anesthesiology Authors: Cai X, Xu X, Zhang A, Lin J, Wang X, He W, Fang Y Tags: Pain Res Manag Source Type: research

What Causes Facial Nerve Palsy?
Discussion Facial nerve palsy has been known for centuries, but in 1821 unilateral facial nerve paralysis was described by Sir Charles Bell. Bell’s palsy (BP) is a unilateral, acute facial paralysis that is clinically diagnosed after other etiologies have been excluded by appropriate history, physical examination and/or laboratory testing or imaging. Symptoms include abnormal movement of facial nerve. It can be associated with changes in facial sensation, hearing, taste or excessive tearing. The right and left sides are equally affected but bilateral BP is rare (0.3%). Paralysis can be complete or incomplete at prese...
Source: PediatricEducation.org - June 3, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

A Serious Diagnosis Lacking Common Symptoms
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Pharmacy teams recruited to cut over-medication in care homes
Scheme is part of £20m programme to improve medication Related items fromOnMedica Poor pain management - a major cause of opioid crisis Guidance issued on prescribing responsibilities Clinicians need better options if we are to stop over-medication Multidisciplinary prescribing can help reduce errors Stroke survivors need more help taking medicine
Source: OnMedica Latest News - May 9, 2019 Category: UK Health Source Type: news

Major publications in critical care pharmacotherapy literature in 2018
ConclusionThis clinical review and expert commentary of impactful critical care pharmacotherapy publications in 2018 provides perspectives and insights for the critical care practitioner.
Source: Journal of Critical Care - May 2, 2019 Category: Gastroenterology Source Type: research

Interest of transcranial stimulation in pelvic and perineal disorders.
CONCLUSION: Data from the literature suggest that transcranial stimulation is a noninvasive treatment that may have a role in the management of pelvic and perineal disorders. Its promising field of action would require prospective and randomized studies on a larger scale. PMID: 31036483 [PubMed - as supplied by publisher]
Source: Progres en Urologie - May 2, 2019 Category: Urology & Nephrology Tags: Prog Urol Source Type: research

Preventable Cases of Oral Anticoagulant-Induced Bleeding: Data From the Spontaneous Reporting System
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - April 29, 2019 Category: Drugs & Pharmacology Source Type: research

Hand and Wrist Injuries in Tennis Players
AbstractPurpose of ReviewThe purpose of this article is to review common hand and wrist injuries experienced by tennis players.Recent FindingsA myriad of different wrist pathologies can be seen in tennis players ranging from metacarpal and carpal stress fractures to triangular fibrocartilage injuries and ulnar impaction. These vary depending upon the nature of the player, stroke mechanics, and time point within the season.SummaryA broad differential should guide work-up and management of wrist pain in tennis players.
Source: Current Reviews in Musculoskeletal Medicine - April 26, 2019 Category: Orthopaedics Source Type: research

A Copernican Approach to Brain Advancement: The Paradigm of Allostatic Orchestration
The objective of this presentation is to explore historical, scientific, interventional, and other differences between the two paradigms, so that innovators, researchers, practitioners, policy-makers, patients, end-users, and others can gain clarity with respect to both the explicit and implicit assumptions associated with brain advancement agendas of any kind. Over the course of three decades, a series of brain-centric, evolution-inspired insights have been articulated with increasing refinement, as principles of allostasis (Sterling and Eyer, 1988; Sterling, 2004, 2012, 2014). Allostasis recognizes that the role of the ...
Source: Frontiers in Human Neuroscience - April 25, 2019 Category: Neuroscience Source Type: research

Robot-Assisted Therapy in Upper Extremity Hemiparesis: Overview of an Evidence-Based Approach
Conclusion Robotic therapy has matured and represents an embodiment of a paradigm shift in neurorehabilitation following a stroke: instead of focusing on compensation, it affords focus in ameliorating the impaired limb in line with concepts of neuroplasticity. This technology-based treatment provides intensity, interactivity, flexibility, and adaptiveness to patient's performance and needs. Furthermore, it increases the productivity of rehabilitation care. Of course, efficiency must be discussed within a local perspective. For example, following the cost containment shown in the VA ROBOTICS study (46), the UK Nati...
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

Combination of Dexmedetomidine and Ketamine for Magnetic Resonance Imaging Sedation
Conclusions: The efficacy of DEX–KET sedation was comparable to that of midazolam for MRI examination. DEX–KET was related to shorter scan time and lower occurrence of complications compared to midazolam. Introduction Neurocritically ill patients often require brain magnetic resonance imaging (MRI) in addition to conventional neurological evaluations. Brain MRI can reveal structural lesions with a high sensitivity due to its excellent spatial resolution and enhanced soft tissue contrast (1–3). To acquire MRI images, patients' cooperation is imperative. However, keeping patients with ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

A Chinese Family With Adult-Onset Leigh-Like Syndrome Caused by the Heteroplasmic m.10191T > C Mutation in the Mitochondrial MTND3 Gene
Conclusion The m.10191T>C mutation in the mtDNA of the complex I (CI) subunit of MTND3 results in the substitution of a highly conserved amino acid (p.Ser45Pro) within the ND3 protein, leading to CI dysfunction through impaired enzyme catalysis rather than impaired stability or assembly, causing a broad clinical spectrum of disorders (26). Patients with the m.10191T>C mutation are rare. In the present study, we report on a family of patients with the extremely rare adult-onset Leigh-like syndrome with the m.10191T>C mutation. Including the two patients from our reported family, the m.10191T...
Source: Frontiers in Neurology - April 17, 2019 Category: Neurology Source Type: research

Oral Cannabidiol Prevents Allodynia and Neurological Dysfunctions in a Mouse Model of Mild Traumatic Brain Injury
Conclusion In conclusion, our data demonstrate that mTBI causes late sensorial affective/cognitive deficiencies linked to altered neurotransmitter release at cortical level. Moreover, we showed that chronic CBD treatment reduces behavioral dysfunctions by restoring at least in part cortical biochemical processes. Taken together, our results suggest that CBD could represent a novel approach for the management of neuropsychiatric disorders associated with TBI. Author Contributions CB, LL, and RR conceived and designed the experiments. CB, MI, SB, FR, RI, and RM performed the experiments. GP, LS, SP, RR, LL, and IM analyze...
Source: Frontiers in Pharmacology - April 15, 2019 Category: Drugs & Pharmacology Source Type: research

Age Is a Greater Influence on Small Saccades Than Target Size in Normal Subjects on the Horizontal Video Head Impulse Test
Conclusion: While this study suggests that target size may have a statistically significant impact on the vHIT saccade profile of normal subjects, age has a greater influence on the incidence and size of small vHIT saccades. Introduction The video head impulse test (vHIT) is a quantitative adaptation of the clinical head impulse test (1), and enables functional assessment of the high-frequency angular vestibulo-ocular reflex (VOR) in all three planes of head rotation (2, 3). Lightweight goggles worn by the subject detect head movement using an accelerometer and gyroscope, and a high frame rate video camera tracks eye...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Cochrane ' s 30 under 30: Ndi Euphrasia Ebai-Atuh
Cochrane is made up of  13,000 members and over 50,000 supporters come from more than 130 countries, worldwide. Our volunteers and contributors are researchers, health professionals, patients, carers, people passionate about improving health outcomes for everyone, everywhere.Cochrane is an incredible community of people who all play their part in improving health and healthcare globally. We believe that by putting trusted evidence at the heart of health decisions we can achieve a world of improved health for all.  Many  of our contributors are young people working with Cochrane as researchers, citizen scientists...
Source: Cochrane News and Events - April 12, 2019 Category: Information Technology Authors: Lydia Parsonson Source Type: news

Light-Induced Pupillary Responses in Alzheimer's Disease
Light-Induced Pupillary Responses in Alzheimer's Disease Pratik S. Chougule1, Raymond P. Najjar1,2, Maxwell T. Finkelstein1, Nagaendran Kandiah3,4 and Dan Milea1,2,5* 1Department of Visual Neurosciences, Singapore Eye Research Institute, Singapore, Singapore 2The Ophthalmology & Visual Sciences ACP, Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore 3Department of Neurology, National Neuroscience Institute, Singapore, Singapore 4Duke-National University of Singapore (NUS), Singapore, Singapore 5Singapore National Eye Centre, Singapore, Singapore The impact of Alzhe...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Pre-injury Comorbidities Are Associated With Functional Impairment and Post-concussive Symptoms at 3- and 6-Months After Mild Traumatic Brain Injury: A TRACK-TBI Study
Conclusions: Pre-injury psychiatric and pre-injury headache/migraine symptoms are risk factors for worse functional and post-concussive outcomes at 3- and 6-months post-mTBI. mTBI patients presenting to acute care should be evaluated for psychiatric and headache/migraine history, with lower thresholds for providing TBI education/resources, surveillance, and follow-up/referrals. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01565551. Introduction Traumatic brain injury (TBI) remains a significant cause of morbidity and mortality worldwide. In 2013 ~2.8 million TBI cases were recorded an...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Fast Intracortical Sensory-Motor Integration: A Window Into the Pathophysiology of Parkinson ’s Disease
Conclusion and Outlook In this review, we have discussed the possible contributions of the fast-afferent somatosensory pathway, the intracortical integrative component and the fast-efferent corticomotor pathway to alterations of SAI in PD. We concluded that PD-related changes in SAI are most likely caused at the cortical level, where sensory input is rapidly integrated into a motor output. This makes SAI a useful tool to probe how PD impacts on the sensorimotor integration processing at the cortical level. Studies performed on PD patients have shown variable results, ranging from reduced to normal or even enhanced SAI fi...
Source: Frontiers in Human Neuroscience - April 7, 2019 Category: Neuroscience Source Type: research

3E.1. A Multimodal Approach to Postoperative Pain Management after Spine Surgery: The Back-Up Plan
Life is not without pain. In fact, 100 million Americans suffer from chronic pain (National Institute of Health, 2011). Back pain ranks high among the offenders. According to the National Institute of Neurological Disorders and Stroke (2014), approximately 80 percent of adults will have some form of back pain. Although many may recover, others must undergo various medical treatments before surgical intervention becomes a viable solution for relief. Surgical interventions however, are not without risk.
Source: Pain Management Nursing - March 31, 2019 Category: Nursing Authors: Donna M. Mangruen Source Type: research

Electrical Stimulation in the Treatment of Hemiplegic Shoulder Pain: A Meta-Analysis of Randomized Controlled Trials
Conclusions Electrical stimulation may be an effective pain management methodology for hemiplegic shoulders and may contribute to pain-free range of external rotation as well as activities of daily living recovery. However, these results should be interpreted with caution, given the low number of selected studies and risk of potential bias.
Source: American Journal of Physical Medicine and Rehabilitation - March 21, 2019 Category: Rehabilitation Tags: Original Research Articles Source Type: research