Multiple randomized clinical trials have demonstrated that carotid endarterectomy is beneficial in patients who have symptomatic carotid stenosis, and currently, that is the recommendation for such patients. However, in the intervening years, advances in medical therapy, as well as significant improvement in the management of blood pressure, diabetes, diet, and exercise, have been shown to reduce stroke rate. Therefore, it is currently controversial whether carotid endarterectomy is still beneficial in asymptomatic patients with carotid artery stenosis compared to current medical management.
Following ischemic stroke in patients with non-valvular atrial fibrillation, the timing to restart anticoagulation treatment is uncertain and controversial. In addition, there is little data available regarding timing to restart anticoagulation following reperfusion therapy with either systemic thrombolysis and/or mechanical thrombectomy.
A retrospective, single-center cohort study among 201 adults admitted with COVID-19 pneumonia revealed that risk factors associated with the development of acute respiratory distress syndrome (ARDS) and progression from ARDS to death included older age, neutrophilia, organ dysfunction, and coagulation derangement. Treatment with methylprednisolone may be beneficial for these patients.
Patients with acute basilar artery occlusion treated by endovascular therapy within 24 hours of occlusion time had better functional outcomes and reduced mortality compared to those treated with medical therapy alone.
The NYU Grossman School of Medicine’s working group on Pediatric Gene Therapy and Medical Ethics formed in the fall of 2019 to address and propose recommendations to issues involving gene-based therapies in pediatric populations, including research activities.
Bright light therapy (10,000 lux intensity for 30 minutes twice daily) and a low intensity control light showed similar efficacy in treatment of depression associated with Parkinson’s disease; the bright light therapy showed some advantages in improving subjective quality of sleep.
Longer lifetime exposure to endogenous estrogen and menopausal estrogen replacement were associated with better cognitive status in older adult women. Women who initiated estrogen therapy early (within five years of the onset of menopause) showed higher cognitive test scores than those who started later.
In a randomized clinical trial conducted at 27 hospitals in four countries, researchers found that the addition of an antistaphylococcal beta-lactam to vancomycin or daptomycin (99% received vancomycin) did not lead to improved outcomes in MRSA bacteremia. The trial was stopped early because of safety concerns, including a higher risk of acute kidney injury in the combination group.