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There is little doubt that cerebrovascular disease is a major contributor to cognitive decline in the elderly. Recurrent symptomatic strokes affecting cortical or subcortical function inevitably result in a stepwise burden of accumulating damage and disability.
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Confavreux and colleagues studied 1844 multiple sclerosis (MS) patients enrolled in a large European database up until 1997. Clinical variables were identified early in the course of the disease, and their continued prognostic significance was determined after the first stages of irreversible neurological disability.
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Currently, there are no medications specifically approved in the United States for treatment of the advanced stages of Alzheimers disease (AD). Results of the first US large-scale, prospective, double-blind study of memantine in the treatment of moderate-to-severe AD indicate that memantine-treated advanced AD patients fare better than those who received placebo, with no significant treatment-related side effects.
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Synopsis: When RALES and EPHESUS are considered together, one clearly can recommend the use of an aldosterone receptor blocker for all very ill patients with congestive heart failure and significant LV dysfunction, whether or not related to acute myocardial infarction.
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In one of the more bizarre stories of the year, the FDA has uncovered files of counterfeit Procrit (epoetin alfaJohnson & Johnson) in routine surveillance. To make matters worse, the fake vials have been contaminated with bacteria and many contain no active ingredient.
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Editors Note: The following reports from the annual scientific sessions of the American College of Cardiology held March 30 to April 2, 2003, were obtained by handwritten notes, press releases, and news reports.
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Detection of Alzheimers Disease and Dementia in the Preclinical Phase; Shoe Design and Plantar Pressures in Neuropathic Feet; Serum Thyroid Stimulating Hormone in Assessment of Severity of Tissue Hypothyroidism in Patients with Overt Primary Thyroid Failure.
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A high intake of nondairy protein may accelerate renal function decline in women with mild renal insufficiency.
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Adding continuous positive airway pressure (CPAP) to medical therapy in patients who have obstructive sleep apnea and congestive heart failure both improves systolic function and lowers blood pressure.
