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Determinants of Long-Term Outcome After Concussion
This cohort study of U.S. veterans found that mild traumatic brain injuries occurring alongside psychological trauma are associated with long-term post-concussive symptoms and disability. The authors postulate that the traumatic context contributes to the development of post-traumatic stress disorder, which may in turn potentiate long-term sequelae.
Transcranial Magnetic Stimulation and Tai Chi for Older Adults with Sleep Disorders and MCI
This study showed improvement in sleep and cognitive endpoints in patients with sleep disorders and mild cognitive impairment (MCI) treated with a combination of repetitive transcranial magnetic stimulation and tai chi chuan.
Transfusion Therapy in Aneurysmal Subarachnoid Hemorrhage
The SAHARA trial evaluated liberal vs. restrictive red blood cell transfusion strategies in aneurysmal subarachnoid hemorrhage (SAH) patients with anemia. No significant difference in neurological outcomes at 12 months was found. Findings add to existing uncertainty regarding transfusion thresholds in SAH, highlighting the need for further research.
Diagnosis and Outcome of Reversible Cerebral Vasoconstriction Syndrome
Reversible cerebral vasoconstriction syndrome (RCVS) is a rare disorder characterized by thunderclap headaches and cerebral vasoconstriction resolving within 90 days. A retrospective study of 80 patients found favorable outcomes, with most treated using calcium channel blockers. However, challenges in RCVS diagnosis and classification may affect reported outcomes.
From Glucocentricity to a Multi-Risk Strategy: An Updated Approach to Managing Chronic Kidney Disease
This article discusses an important microvascular complication of diabetes mellitus, chronic kidney disease (CKD), which affects more than one-third of patients with diabetes. There is substantial evidence that early diagnosis and management can delay or prevent the progression of CKD, making its prevention, diagnosis, and treatment a priority for the primary care clinician.
Stroke in Young Adults
Although stroke once was considered primarily a disease of older adults, recent epidemiological data underscore a rising incidence in younger populations worldwide. This article will define the scope of young adult stroke, discuss its epidemiology and pathophysiology, highlight the wide etiological spectrum, delve into clinical diagnostic steps, offer a practical framework for management, and conclude with a summary that emphasizes the persistent practice gap.
Researchers Face Many Ethical Challenges with HEALthy Brain and Child Development Study
The HEALthy Brain and Child Development study is looking at the effect of various prenatal and postnatal exposures on pediatric brain and behavioral development. To answer important questions about early life influences on developmental trajectories, researchers are recruiting a large cohort of pregnant individuals. Some participants have substance use disorders.
Policies for Vulnerable Research Participants Vary at U.S. Academic Institutions
When conducting clinical trials involving vulnerable participants, researchers are ethically and legally obligated to protect them from harm. But what policies do academic institutions have for protecting vulnerable human research subjects?
Ethical Concerns if Surrogates Report Decisional Conflict
Surrogates face challenging decisions on life-sustaining treatments in the intensive care unit setting. Those with decisional conflict reported poor medical understanding, suboptimal support, and lack of clarity about patients’ treatment preferences.
Who Is the ‘Correct’ Decision-Maker? Legal, Ethical Definitions May Conflict
From an ethical standpoint, it may be clear to everyone concerned that a particular individual is the correct surrogate decision-maker. However, from a legal standpoint, it can be a different story.