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Although there are no approved medications to treat levodopa-induced dyskinesias, several strategies are commonly used. Reducing the interval and amount of each dose of levodopa, maximizing the dose
of dopamine agonists, and even liquefying the daily levodopa and giving it in small hourly increments are useful in selected patients. The present study evaluates clozapine in a double-blind, placebo-controlled trial as a treatment for levodopa-induced dyskinesias.
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Although infectious agents are not widely believed to be the primary cause of Alzheimers disease (AD), some evidence implicates certain neurotrophic viruses and bacteria as possible contributing factors. Canadian investigators Loeb and colleagues suggest that Chlamydia pneumonia infection might play a role in AD. They carried out a randomized, blinded, and placebo-controlled trial testing whether antichlamydial antibiotics (rifampin/doxycycline) could serve as a potential therapy for patients with mild-to-moderate AD.
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Six patients are the focus of this report defining the neuropathic side effects of thalidomide treatment in multiple myeloma. All patients developed a pure or predominant sensory polyneuropathy while on thalidomide. Thalidomide can induce an axonal sensory neuropathy or, infrequently, a ganglionopathy.
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Thrombolysis with intravenous rt-PA (IVrt-PA) is an effective treatment for strokes due to acute cerebral ischemia. This analysis of pooled data confirms that the sooner rt-PA is given to stroke patients, the greater the benefit, especially if started within 90 minutes. The results suggest a potential benefit beyond 3 hours but with a potential for an increased risk of death.
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The dose of aspirin after discharge for acute coronary syndromes may affect the 6-month clinical course.
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Long-term treatment with aspirin is associated with a progressive diminution in platelet sensitivity to the drug.
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This second and final part of a series covers the topics of differential diagnosis that must be considered when a patient presents with symptoms consistent with PE, treatment, and considerations for prevention of this disease state.