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Cognitive-Motor Dissociation in Patients Admitted to ICUs After Acute Brain Injuries
In a large, prospective, single-center study, more than one in six patients with acute brain injuries may have cognitive-motor dissociation (CMD) (e.g., they harbor capacity to modulate their brain activity in response to motor commands while remaining behaviorally unresponsive at the bedside). Some acute CMD patients were found to have a much higher chance for recovery of neurological functions and for reaching independent levels of activities of daily living by 12 months after brain injury.
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Neuropathy After Total Knee Arthroplasty
In a large series of cases from the Mayo Clinic, 54 cases of new neuropathy occurred in 14,450 total knee arthroplasties. Most were isolated peroneal neuropathies. No specific risk factors were identified in this series.
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Prevalence of Refractory Juvenile Myoclonic Epilepsy
Juvenile myoclonic epilepsy (JME) is a common form of generalized epilepsy. Although the prognosis of JME is not clear, it is assumed to have a good response to treatment. The authors of this meta-analysis found a higher than expected prevalence of refractoriness in JME, which will affect how neurologists counsel patients with JME.
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Common Foot Problems
Foot problems are a common chief complaint. Patients may present to the ED when they do not have access to other sources of care or when an exacerbation becomes painful enough. Although these foot problems rarely are considered emergencies, it is useful for the emergency physician to be knowledgeable about these conditions to provide sound advice to patients and appropriate referral.
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Reader Survey Available
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Infectious Disease Alert Updates
Surgeons Really Are Different; Short-Course Atovaquone/Proguanil for Malaria Prophylaxis; The High Cost of Chronic Lyme Treatment
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Trimethoprim Sulfamethoxazole Plus Clindamycin for Treatment of Staphylococcus aureus Endocarditis
A before-and-after intervention study compared 170 patients treated with either oxacillin IV or vancomycin IV for six weeks (plus gentamicin IV given during the first five days) to 171 patients who were treated with TMP/SMZ IV plus clindamycin IV for the first week followed by TMP/SMZ PO (without clindamycin) to complete a six-week course. Mortality and hospital length of stay were significantly less in the TMP/SMZ-treated patients.
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Checkpoint Inhibitors: The First Effective Therapy for Progressive Multifocal Leukoencephalopathy?
Enhancing the immune response with checkpoint inhibitors may be beneficial in the management of progressive multifocal leukoencephalopathy, a viral disease previously recalcitrant to therapy.
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Significance of Pyuria in Children With Neurogenic Bladder
Pyuria is common in asymptomatic children with neurogenic bladders, especially after bladder surgery. The simple presence of pyuria does not necessarily indicate a need for antibiotic treatment.
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Babesiosis — Increase in Reported Cases in the United States
The number of cases reported to the CDC from 2011-2015 has increased and there is concern about expansion of the areas in which it is transmitted.