Articles Tagged With:
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Clinical Insights on Managing DPN and PAD in Patients with Diabetes
Given the significant prevalence of diabetes in the population, it is important for the primary care clinician to be familiar with the many types of neuropathies commonly affecting people living with diabetes. By far the most prevalent type is chronic diabetic peripheral sensorimotor neuropathy, affecting up to 50% of people with diabetes. Peripheral arterial disease (PAD) refers to partial or complete occlusion of peripheral vessels of the lower extremities. The underdiagnosis of PAD in the primary care setting may be a major issue because of many patients presenting without the typical claudication symptoms described in medical textbooks. The ability of primary care clinicians to diagnose PAD in asymptomatic patients still has a significant clinical effect because PAD acts as a marker for systemic atherosclerosis.
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Stroke 2025 Is Here!
Stroke 2025: Optimizing Outcomes with Clinical Approaches provides evidence-based, cutting edge, clinical information on treating stroke and other neurological problems in a concise, accurate, and clinically relevant format. Written and edited by leading experts in the fields of neurology and emergency medicine, Stroke 2025 is an unbiased resource for any physician or nurse working in an emergency department or stroke center. Healthcare providers can earn all of the Joint Commission-required stroke credits at one time through this electronic publication.
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Clinical Consequences of Alzheimer’s and Lewy Body Co-Pathologies
This large study of patients with cognitive impairment-assessed cerebrospinal fluid biomarkers, positron emission tomography imaging, and cognitive tests showed that those with evidence of both Alzheimer’s and Lewy body pathologies had greater cognitive dysfunction and faster progression than those with either pathology alone.
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Long-Term Efficacy of Ocrelizumab as First-Line Treatment for Relapsing-Remitting Multiple Sclerosis
Nine-year follow-up data from open-label extension of the Phase III clinical trials of ocrelizumab show that, although the efficacy of ocrelizumab was maintained throughout the duration of the study, patients who were treated with ocrelizumab from the beginning of the Phase III trials did better than the patients who were on subcutaneous (SC) interferon β-1a initially and were switched to ocrelizumab at the onset of the open-label extension period.
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Small Fiber Neuropathy in Post-COVID Patients with Chronic Fatigue Syndrome
This study examines small fiber neuropathy (SFN) in post-COVID patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). While ME/CFS patients reported more SFN symptoms, objective testing showed limited diagnostic value beyond heat/cold detection differences.
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Should Thrombolytic Drugs Be Added to Mechanical Thrombectomy in Acute Stroke?
Two recent trials from China studied the effect of post-thrombectomy, intra-arterial thrombolysis on neurological outcomes. One study used tenecteplase and the other used urokinase. Both studies showed a trend toward improvement that was not statistically significant, and there was an increase in brain hemorrhage. The benefit of adjunctive thrombolysis with mechanical thrombectomy is uncertain and requires more study.
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Infectious Disease Updates
COVID Monoclonals Needed for PrEP; Oral Camostat Ineffective in COVID-19; Mpox: Lessons Learned from Rio
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Cardiovascular Risk with mRNA COVID Vaccines
A large, nationwide population study in Sweden of the risk of adverse cardiovascular events after messenger ribonucleic acid (mRNA) COVID-19 vaccinations has shown that, except for rare cases of myopericarditis, severe cardiovascular events, such as myocardial infarction, heart failure, and stroke, are reduced, probably because of the prevention of COVID infection.
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Death Due to the ‘No Name’ Virus in Santa Fe
There is no specific treatment for hantavirus infection and no vaccine. Prevention consists of control and avoidance of rodents and their body fluids and excreta.
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New Insights into the Antimicrobial Susceptibility of Stenotrophomonas maltophilia
Stenotrophomonas maltophilia is an opportunistic gram-negative bacillus with intrinsic resistance to a variety of antibiotics. Since clinical trial data are lacking, the optimal antimicrobial regimen is unknown. These factors make S. maltophilia increasingly challenging for the treating clinician. A recent study by Sader and colleagues analyzed the antimicrobial susceptibility of 1,400 S. maltophilia isolates collected from U.S. medical centers between 2019 and 2023. Aztreonam-avibactam, which inhibited 99.6% of isolates at ≤ 8 mcg/mL, was found to have the highest levels of in vitro activity. Trimethoprim-sulfamethoxazole, which has historically been a preferred agent, had slightly lower activity (96.9% susceptible), followed by minocycline (89.2%) and levofloxacin (78.9%). The results from this in vitro study suggest that aztreonam-avibactam may be a highly effective option for treating S. maltophilia infections, especially in multidrug-resistant cases.