Articles Tagged With:
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Interprofessional Meetings Can Prepare Caregivers of Brain Injury Patients
Brain injury patients and their caregivers face difficult care transitions after leaving an inpatient setting. But care teams with case management can help caregivers by assessing their readiness and engaging with them in interprofessional meetings early.
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Should Endovascular Thrombectomy Be Performed With or Without Intravenous Alteplase?
With the widespread adoption of endovascular thrombectomy for the treatment of acute ischemic stroke caused by large vessel occlusion, a debate has raged about the role of intravenous thrombolysis. None of the clinical trials published to date have given us a clear evidence-based answer regarding the relative risks and benefits of this approach.
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Long-Term Outcome in Patients with Intracerebral and Intraventricular Hemorrhage
Intracerebral hemorrhage continues to be a major cause of mortality and long-term disability. Early in the course of this severe disease prognosis is based on early characteristics, and care may be withdrawn at an early stage. The natural history and long-term recovery of survivors is uncertain because of withdrawal of care at an early time, resulting in a “self-fulfilling prophecy.”
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Benefits and Risks of Dual Antiplatelet Therapy After Acute Ischemic Stroke or TIA
Secondary prevention of acute ischemic stroke is continuing to evolve with great interest in the use of dual antiplatelet treatment early in the course. A complicating factor has been the role of the CYP2C19 loss-of-function gene that interferes with the conversion of clopidogrel to its active antiplatelet metabolite.
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COVID-19 Vaccination in Patients with Autoimmune Neuromuscular Diseases
In a population-based, self-reporting survey of patients with immune-mediated myopathy and myasthenia gravis, the frequency of both mild and severe acute adverse events appeared to be no more frequent than in the general population. COVID-19 vaccinations are safe for this population of patients.
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Magnetic Resonance Imaging Evaluation of Perivascular Space Abnormalities in Neuromyelitis Optica
Perivascular space (PVS) abnormalities were demonstrated in two cohorts of patients with neuromyelitis optica spectrum disorder (NMOSD) as compared to healthy controls. Magnetic resonance imaging provided visualization of PVS enlargement, and quantification of reduced flow in NMOSD patients, both of which were found to be associated with disease outcomes.
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Improvement of Memory with Transcranial Electrical Brain Stimulation in Patients with Alzheimer’s Disease
The authors showed that gamma frequency transcranial alternating current stimulation targeting the precuneus in patients with Alzheimer’s disease improved measures of immediate and delayed verbal memory as well as associative memory for faces. Additionally, neurophysiological measurements of cholinergic transmission improved. Apolipoprotein E genotype and baseline cognitive performance were correlated with treatment response. Memory improvement was correlated both with increases in gamma frequency power in posterior cortical regions and spatial overlap between the modeled electric field distribution and the precuneus target site.
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A Guide to Change: Modifying Unhealthy Behaviors in Patients
Motivational interviewing is an evidence-based, empathic approach to the patient interview incorporating techniques that encourage patients to self-reflect and voice reasons for change, while recognizing underlying ambivalence. This article presents approaches recommended for use in a primary care office when the clinical interview indicates a need for behavioral change.
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Updates on Syncope
Syncope is a common ED chief complaint that often results in over-ordering of tests and unnecessary admission to the hospital, with significant economic impact. The main focus of the emergency medicine physician is to risk stratify the patient based on the history and physical exam.
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Nurses at Rural Facilities Explain Barriers to End-of-Life Care
Family members often disagree with one another and misunderstand the meaning of “lifesaving measures.”