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Three recent studies have provided further evidence linking elevated homocysteine levels to brain atrophy and cognitive dysfunction, as well as a decline in physical function.
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The publication of the ALLHAT trial received much publicity not only in medical circles but was also front-page news in the Wall Street Journal. This trial was a significant blow to the pharmaceutical industry, and it convincingly showed that inexpensive diuretic medications had superiority over highly marketed ACE inhibitors and calcium channel blockers for the treatment of hypertension.
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In this randomized, double-blind trial, a total of 213 patients with relapsing-remitting or relapsing secondary progressive multiple sclerosis were assigned to 1 of 3 groups: natalizumab at 3 or 6 mg/kg (68 and 74 patients, respectively), or placebo (71 patients), by infusion every month for 6 months.
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Overlap of symptomatology can make differentiation of myasthenia gravis (MG) from Lambert Eaton myasthenic syndrome (LEMS) challenging. Among 101 patients with MG and 38 with LEMS, clinical features allowing more accurate differential diagnosis are noted.
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Among patients undergoing epilepsy surgery for pharmacologically refractory seizures, detection and excision of a structural lesion congruent with the electroencephalographic ictal onset is a strong predictor of a seizure-free outcome.
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Synopsis: There was no overall benefit to a rhythm control strategy. Therefore, rate control should be considered a primary therapeutic option, and rhythm control, if elected, may be abandoned early if not fully satisfactory.
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