Neurology
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Celery Seed-Derived Compound: A Legitimate Neuroprotectant for Acute Ischemic Stroke?
A Phase III double-blind, placebo-controlled, randomized controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.
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Brain Atrophy and Type 1 Diabetes
In a long-term longitudinal study of people with type 1 diabetes, excessive brain atrophy and cognitive dysfunction were noted compared to healthy controls. The investigators calculated that type 1 diabetes resulted in six years of accelerated brain aging and brain atrophy that was separate and distinct from Alzheimer’s disease.
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ICU Admission Means Trouble for Alzheimer's and Dementia Patients
If they are released, such patients are twice as likely to die soon after discharge.
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Alcohol: Double-Edged Sword, or Hatchet?
Researchers reported consuming two to 14 alcoholic drinks per week was associated with fewer major adverse cardiovascular events, which the authors noted could be explained in part by less stress-related neural activity demonstrated on PET and CT scans.
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New Research Suggests Treating Traumatic Brain Injury as a Chronic Illness
The road to recovery might be longer than initially thought.
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Prescribing the Internet to Prevent Dementia
In an ongoing longitudinal survey of a nationally representative sample of dementia-free adults age 50 to 64.9 years, regular internet users experienced approximately half the risk of dementia compared with non-regular users.
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A Primer on Excessive Daytime Sleepiness and Narcolepsy
Many new drugs are coming on the market to treat daytime sleepiness, as well as insomnia, as the prevalence of sleep disorders continues to grow in modern society. Clinicians should familiarize themselves with these disorders and the various ways to treat them safely.
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Glycoprotein IIb/IIIa Receptor Inhibitor Tirofiban for Ischemic Stroke
Glycoprotein IIb/IIIa receptor inhibitors are potent, rapidly acting antiplatelet agents that have been tried in pilot studies to treat acute ischemic stroke, without significant benefit. Tirofiban is fast-acting, highly selective, and has a short half-life that allows bleeding time to return to normal within three hours after administration is stopped. The investigators proposed that this medication may be of benefit in patients with acute ischemic stroke who arrived within 24 hours after stroke onset but are not eligible for thrombolysis or thrombectomy or have progression of stroke symptoms after receiving thrombolysis.
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Endovascular Thrombectomy for Large Ischemic Core Strokes
Endovascular thrombectomy has been rapidly adopted throughout the world for the treatment of patients with acute ischemic stroke and large vessel occlusion. This approach has achieved strong recommendations in stroke guidelines. However, the trials that form the basis of the recommendations have strict imaging recruitment criteria.
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Is Dexamethasone Effective in the Treatment of Chronic Subdural Hematomas?
Chronic subdural hematomas are common disorders and may occur after minor trauma or no trauma. For decades, nonsurgical therapies have been tried and proposed, including the use of corticosteroids. Various case series and nonrandomized trials of treatment with corticosteroids have been reported to show benefit, but efficacy of steroid therapy has been uncertain.