Neurology
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Apolipoprotein E and CSF Levels in Men and Women With Alzheimer’s Disease
Apolipoprotein E epsilon 4 (APOE4) genotype, the stronger genetic risk factor for late-onset Alzheimer’s disease, negatively affects cerebrospinal levels of tau protein in a sex-dependent manner, whereby the effect of APOE4 is stronger in women than men.
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Revefenacin Oral Inhalation (Yupelri)
Revefenacin should be used to help patients with COPD.
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Antipsychotics Do Not Shorten the Duration of ICU Delirium
In this randomized, placebo-controlled trial, neither haloperidol nor ziprasidone altered the duration of delirium when compared to placebo.
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PCSK9 Inhibitors in Acute Coronary Syndrome Patients
Compared to adding placebo, using the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab in post-acute coronary syndrome patients on maximally tolerated, high-intensity statins with low-density lipoprotein (LDL) cholesterol levels higher than 70 mg/dL lowered LDL and reduced the number of major adverse cardiac events.
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Caregivers and Mindfulness-Based Stress Reduction Interventions
A Cochrane Review regarding efficacy of mindfulness-based stress reduction (MBSR) for family caregivers of dementia patients revealed low-quality evidence that MBSR reduces short-term anxiety and depressive symptoms in this population.
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Hormone Therapy and Mortality: No Overall Effect?
An evaluation of outcomes of users and nonusers of postmenopausal hormonal therapy followed longitudinally in the Danish database showed no overall difference in mortality.
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Precise Localization of Focused Ultrasound Thalamotomy Determines Clinical Benefit
Lesioning of the posterior portion of the VIM thalamus is most efficacious. Lesions extending beyond this portion can lead to adverse side effects in those with essential tremor treated with MRI-guided focused ultrasound.
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Miller Fisher Syndrome: Atypical Features
Other than the classic triad of neurological signs that define Miller Fisher syndrome, it also is common to see delayed facial palsy, loss of taste, and weakness of pharyngeal and cervical muscles.
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Treatment of Acute Migraine With Ginger
Ginger extract has a long anecdotal history as a treatment for migraine headaches in traditional Chinese medicine. This well-designed study provides evidence that adding ginger to a standard nonsteroidal anti-inflammatory medication improves outcomes of migraine treatment by all measured parameters.
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Proceedings From the International Stroke Conference, Honolulu, February 2019
The following reviews of studies presented at the 2019 International Stroke Conference were written after my personal attendance at the presentations, followed by review of the simultaneous publications in The New England Journal of Medicine and The Lancet. All comments and opinions are solely those of this editor. — Matthew E. Fink, MD