Neurology
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Dual Antibiotic Therapy Is Not Routinely Necessary for Uncomplicated Cellulitis
A randomized, multicenter, placebo-controlled clinical trial that enrolled patients presenting to emergency departments with uncomplicated cellulitis found the addition of trimethoprim-sulfamethoxazole to cephalexin did not lead to better outcomes.
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Is This 4:1 Flutter?
The rhythm in the figure was diagnosed as atrial flutter with 4:1 AV conduction. Do you agree? How would you confirm your answer?
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Clinical Briefs
In this section: treating hypothyroidism in seniors; revisiting penicillin allergies; and new diverticulitis guidance.
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Sofosbuvir, Velpatasvir, and Voxilaprevir Tablets (Vosevi)
Vosevi is indicated for the treatment of adult patients with chronic hepatitis C infection without cirrhosis or with compensated cirrhosis who are infected with genotype 1, 2, 3, 4, 5, or 6, and have been treated previously with a hepatitis C regimen containing an NS5A inhibitor.
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Eat Right, and Live
An improvement in diet over 12 years in middle-aged nurses and other health professionals resulted in a decreased risk of death.
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Glucose Self-monitoring Not Helpful for Non-insulin-treated Type 2 Diabetes
In this pragmatic randomized trial, self-monitoring blood glucose did not lead to lower hemoglobin A1c levels or improvement in health-related quality-of-life measures.
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Optimizing Electromyography in ALS
In the appropriate clinical setting, electromyography studies of multiple, distal muscle groups in three separate spinal regions showing acute and chronic denervation, are pathognomonic for the diagnosis of amyotrophic lateral sclerosis.
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EEG-based Metrics After Severe Brain Injury
In this cohort study of 104 patients with disorders of consciousness, the authors demonstrated a strong correlation between EEG-based metrics and clinical diagnosis using quantitative behavioral scales, brain metabolism as measured by PET, and clinical outcomes at one year.
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Risk Factors for Seizures in Critically Ill Patients Monitored by Continuous EEG
Investigators prospectively analyzed 72-hour continuous electroencephalograms to identify clinical and electroencephalogram risk factors for having seizures and developed a model for “time-dependent” seizure risk. Electrographic seizures occurred in 23% of all patients. The only significant clinical predictors of seizures were presence of coma and prior clinical seizure history.
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P-syn in Nerve Fibers on Skin Biopsy May Help Diagnose Dementia with Lewy Bodies
This study compared 18 subjects diagnosed with dementia with Lewy bodies (DLB), 23 with nonsynucleinopathy dementia, and 25 healthy controls and demonstrated that phosphorylated alpha-synuclein was found only in the skin nerve fibers of DLB subjects, helping distinguish this type of dementia from other types.