Internal Medicine
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Saffron and Depression: What Do We Know and Where Do We Go?
Saffron studies, while still preliminary, show potential for use of this ancient spice in combatting mild-moderate depression.
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Treatment of Intracerebral Hemorrhage Guided by the ‘Spot Sign’
Although the “spot sign” is a predictor of early hematoma expansion, selective treatment of this group with aggressive antihypertensive therapy did not alter hematoma size or neurological outcome.
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Direct DNA Sequencing of Dominant Cerebellar Ataxias
Current genetic testing techniques with DNA sequencing can diagnose the molecular-genetic causes for the majority of dominantly inherited cerebellar ataxias.
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Severe Olfactory Impairment Is Associated With Preclinical Alzheimer’s Disease
In this cross-sectional, population-based, cohort study of 829 cognitively normal participants, abnormal neuroimaging biomarkers known to be associated with Alzheimer’s disease were associated with severe olfactory impairment.
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Plasma α-Synuclein Is a Leading Candidate Biomarker in Parkinson’s Disease
In this cross-sectional study, plasma alpha-synuclein levels were higher in individuals with Parkinson’s disease than controls, and correlated with cognitive decline.
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Tacrolimus for Treatment of Myasthenia Gravis
A large observational study performed in Korea suggests that tacrolimus is an effective immunomodulating, steroid-sparing medication for the treatment of myasthenia gravis.
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Prediction of Survival After Cardiac Arrest Using Pupillometry
Automated infrared pupillometry holds promise as a quantitative, reproducible measure that aids in determining neurological prognosis after cardiac arrest and coma.
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Distinguishing Ischemic from Non-ischemic Cardiomyopathy Clinically
SYNOPSIS: This cardiac catheterization-based study of patients with newly diagnosed reduced left ventricular ejection fraction of unknown etiology showed that 15% had ischemic cardiomyopathy and they could be identified by clinical characteristics and an ECG-based risk score.
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B-type Natriuretic Peptide Is Less Useful in Elderly Patients with Dyspnea
SYNOPSIS: Among patients ≥ 80 years of age presenting with acute dyspnea, B-type natriuretic peptide level was not useful for differentiating cardiac vs. respiratory etiologies when added to a model of clinical predictors.
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Sepsis Management: What We Think We Know
SYNOPSIS: In the Protocolized Resuscitation in Sepsis Meta-Analysis (PRISM), 3,723 patients’ outcomes from the ProCESS, ARISE, and ProMISe randomized, controlled trials of early goal-directed therapy (EGDT) were evaluated. EGDT did not result in better outcomes than usual care and was associated with higher costs. The authors of a second study looked at outcomes of 49,331 patients with sepsis treated in New York from April 2014 to June 2016. More rapid completion of the three-hour sepsis bundle and antibiotic administration (but not rapid bolus administration of IV fluids) was associated with reduced in-hospital mortality.