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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 Early in the course of this severe disease prognosis is based on early characteristics, and care may be withdrawn at an early stage.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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CDC: Most Pregnancy-Related Deaths Are Preventable
Recent data indicate mental health conditions, excessive bleeding are the leading causes of pregnancy-related deaths in the United States.
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Kindergarten Vaccine Rates: Post-COVID
The COVID-19 pandemic caused disruption in healthcare delivery for everyone. Schools continue to struggle to meet the Healthy People 2030 Nationwide target of ≥ 95% coverage for measles, mumps, rubella (MMR) vaccination in kindergarteners, and COVID-19 did not help. Remarkably, the nationwide vaccine rate for children entering kindergarten in the 2020-2021 school year was decreased by only 1% for all vaccines compared with the previous year.
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Rehospitalization Common in Herpes Encephalitis
Herpes simplex encephalitis (HSE) is the most common cause of infectious encephalitis in the United States, accounting for around 30% of all causes of infectious encephalitis in the United States. With the advent of antiviral therapy and improved diagnostic measures, mortality and morbidity have improved over the past few decades, but patients remain at risk for long-term neurologic sequelae and even relapse.
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U.S. Endemic Fungal Infection Surveillance
In the United States in 2019, 29,061 cases of coccidioidomycosis were reported, as were 1,124 cases of histoplasmosis and 240 of blastomycosis.