Neurology
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Mechanisms of Tissue Hypoxia and Cerebral Ischemia in Traumatic Brain Injury
Tissue hypoxia after traumatic brain injury occurs in a widespread manner in the brain, including areas that appear structurally normal. Moreover, cerebral tissue hypoxia appears to occur independent of ischemia with areas of no overlap, implying a microvascular etiology.
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Sleep Disorders Associated with Traumatic Brain Injury
Patients with traumatic brain injuries need longer sleep times to heal the injured brain, and persistent pleiosomnia at 18 months implies that ongoing abnormalities are producing an increased need for sleep.
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Eating Behavior in Frontotemporal Dementias
In a prospective, controlled study of 49 patients with dementia and 25 healthy controls, marked hyperphagia is restricted to behavioral-variant frontotemporal dementia patients that is likely due to differing neural networks, while increased sucrose preference is likely controlled by a similar network in both behavioral-variant frontotemporal dementia and semantic dementia patients.
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Migraine with Aura and Systemic Right-to-Left Shunt: Risk for Stroke?
Right-to-left shunts, as detected by transcranial Doppler, are more common in patients with migraine with aura, but are not correlated with increased risk of silent posterior circulation infarcts or white matter lesions on MRI.
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Clinical Briefs
In this section: watching carefully for suicide risk; tackling chronic cough; and a new treatment for Peyronie's disease.
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Reslizumab Injection (Cinqair)
Reslizumab is indicated for add-on maintenance treatment of adult patients with severe asthma with eosinophilic phenotype.
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Longer Course Therapy for Lyme Disease Is Not Beneficial
A randomized, placebo-controlled clinical trial from the Netherlands found that longer-term antibiotic therapy for Lyme disease did not improve health-related quality of life compared to a standard course of treatment.
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Predicting Seizure Recurrence with Routine EEG After First Unprovoked Seizure
Using positive likelihood ratios, an adult and child with epileptiform discharges on electroencephalography were estimated to have a 77% and 66% probability, respectively, of recurrent seizures.
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Too Much of a Good Thing
In the United States in 2010 and 2011, an estimated 30% of outpatient oral antibiotic prescriptions may have been inappropriate, a finding that supports the need for establishing a goal for outpatient antibiotic stewardship.
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ECG Review: SVT in a 13-Year-Old Patient
The ECG in the figure below was obtained from an otherwise healthy 13-year-old boy. He was alert and hemodynamically stable at the time this ECG was recorded. How should one interpret this tracing?