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Approximately 10% of all patients with middle cerebral artery (MCA) territory cerebral infarction suffer progressive deterioration due to cerebral edema, increased intracranial pressure, and brain herniation. In these patients with malignant MCA territory infarction aggressive decompressive craniectomy has been reported to improve overall prognosis.
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Chronic inflammation is now a well-recognized cause of atherosclerotic vascular disease, including coronary artery disease and stroke. Asymptomatic individuals harboring the common bacterium Chlamydia pneumoniae have been shown to have an elevated incidence of plaque in both the coronary and carotid arteries.
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Huntingtons disease is a progressive neurodegenerative disease with onset generally in midlife. Insoluble huntingtin protein aggregates have been seen in vitro in mammalian cells, as well as in transgenic mouse models and in brain tissues from patients with Huntingtons disease. The relationship between the presence of the insoluble protein aggregates and Huntingtons disease pathogenesis has been controversial.
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As discussed previously in Neurology Alert, there is increasing evidence that a number of dietary manipulations may significantly affect the risk of dementia and Alzheimers disease (AD). Three studies in 2002 indicated that dietary intake of vitamins E and C lowered the risk of getting AD. However, there appeared to be no association with intake from dietary supplements. This is an important point since it is much easier to take dietary supplements than to increase ones dietary intake of antioxidant vitamins.
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Correction
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The editors of the prestigious British medical journal Lancet recently issued a public statement acknowledging a failure to disclose conflict-of-interest concerns about a 1998 study they published connecting autism to childhood vaccines.
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New IRBs and new IRB members, as well as those who have been working in the field of human research protection for years, often have questions regarding the use of the exempt category when research protocols are reviewed.
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As IRB staff and members find their workload increasing more quickly than their resources, some may consider using a centralized IRB model as a way to allow them to spend their time and energy where it is most needed.
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