Neurology
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Ambulatory Autonomic Testing in Multiple System Atrophy and Parkinson’s Disease
A comparison of ambulatory blood pressure monitoring with tilt-table testing in 23 patients with multiple system atrophy, 18 with Parkinson’s disease and autonomic dysfunction, and 33 with Parkinson’s disease alone demonstrated 82% sensitivity and 100% specificity in detecting orthostatic hypotension. This suggests ambulatory monitoring provides valuable information on these patients’ function.
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Does Therapeutic Hypothermia Improve Functional Outcomes After Convulsive Status Epilepticus?
In a multicenter trial in France, patients admitted to the ICU from 2011-2015 for convulsive status epilepticus were randomly assigned to receive standard therapy (control group) or hypothermia plus standard therapy (treatment group). The primary outcome measure was an absence of functional impairment at 90 days after seizure onset, as measured by the Glasgow Outcome Scale (score of 5). There was no significant difference in outcomes between the two groups.
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Imaging of Glial Cell Activation in the Brains of Professional Football Players
In this case-controlled study, PET scanning reflective of microglial activation and diffusion-tensor imaging assessing white matter integrity was performed on 14 National Football League players (four current, 10 retired) and compared to 16 matched controls, suggesting significant ongoing localized brain injury and repair along with subtle white matter changes in professional football players.
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Polyneuropathy in the Metabolic Syndrome
The metabolic syndrome, independent of the diagnosis of diabetes, is associated with the development of polyneuropathy.
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Sacubitril/Valsartan Associated with Reduced Risk of Hyperkalemia
\In a secondary analysis of the PARADIGM-HF trial, the risk of severe hyperkalemia in heart failure patients taking a mineralocorticoid receptor antagonist was lower among patients treated with sacubitril/valsartan compared to those receiving enalapril.
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Zika Virus Infection and Guillain-Barré Syndrome: The Evidence Grows
A recent Zika outbreak in Colombia was associated with a significant increase in Guillain-Barré syndrome (GBS) rates, with laboratory evidence of definite or probable Zika infection in more than half of the GBS cases.
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Early Initiation of Continuous Renal Replacement Therapy May Reduce Mortality in Patients Who Require Dialysis
Initiation of continuous renal replacement therapy for patients with Kidney Disease: Improving Global Outcomes stage 2 renal failure reduced 90-day all-cause mortality.
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Bezlotoxumab Injection (Zinplava)
The FDA has approved a selective, fully human monoclonal antibody directed at Clostridium difficilie toxin B. Binding of toxin B neutralizes its toxic effect. Bezlotoxumab is marketed as Zinplava.
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Fecal Transplant vs. Oral Vancomycin Taper for Recurrent Clostridium difficile Infection
In a small randomized, controlled trial that compared fecal microbiota transplant (FMT) administered by enema to a six-week oral vancomycin taper, FMT was not more effective for patients with recurrent Clostridium difficile infection. -
Clinical Briefs
In this section: dietary supplement trends, new tools for glucose monitoring, and placebo for osteoarthritis pain.