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  • Clinical Briefs in Primary Care Supplement

  • Fascicular Phenomena

    How does one physiologically explain ulnar neuropathies at the elbow that clinically localize to the wrist? Why do proximal sciatic neuropathies sometimes masquerade clinically as peroneal neuropathies at the knee? In this lucid, well-articulated review, Stewart thoroughly and evenhandedly comments on the literature going back to 1913, convincingly arguing that nerve fibers do not randomly intertwine as they progress distally in nerve bundles.
  • Clozapine for Dyskinesias in Parkinson’s Disease

    Although there are no approved medications to treat levodopa-induced dyskinesias, several strategies are commonly used. Reducing the interval and amount of each dose of levodopa, maximizing the dose of dopamine agonists, and even liquefying the daily levodopa and giving it in small hourly increments are useful in selected patients. The present study evaluates clozapine in a double-blind, placebo-controlled trial as a treatment for levodopa-induced dyskinesias.
  • Antibiotics for Alzheimer’s?

    Although infectious agents are not widely believed to be the primary cause of Alzheimers disease (AD), some evidence implicates certain neurotrophic viruses and bacteria as possible contributing factors. Canadian investigators Loeb and colleagues suggest that Chlamydia pneumonia infection might play a role in AD. They carried out a randomized, blinded, and placebo-controlled trial testing whether antichlamydial antibiotics (rifampin/doxycycline) could serve as a potential therapy for patients with mild-to-moderate AD.
  • Thalidomide Neuropathy

    Six patients are the focus of this report defining the neuropathic side effects of thalidomide treatment in multiple myeloma. All patients developed a pure or predominant sensory polyneuropathy while on thalidomide. Thalidomide can induce an axonal sensory neuropathy or, infrequently, a ganglionopathy.
  • rt-PA Stroke Trials: Pooled Analysis and Opinion

    Thrombolysis with intravenous rt-PA (IVrt-PA) is an effective treatment for strokes due to acute cerebral ischemia. This analysis of pooled data confirms that the sooner rt-PA is given to stroke patients, the greater the benefit, especially if started within 90 minutes. The results suggest a potential benefit beyond 3 hours but with a potential for an increased risk of death.
  • Correction

  • Once Upon a (Medium-Firm) Mattress

    The virtues of a firm mattress are generally espoused by the medical and lay community alike despite the utter lack of scientific evidence to support it. In an attempt to shed light on this poorly understood subject, Kovacs and associates assess the effect of the firmness of a mattress on low back pain.
  • Clinical Briefs in Primary Care Supplement

    St Johns Wort and Drug Interactions; Serum Potassium and Stroke Risk Among Hypertensive Adults; Skin Cancer Prevention and Detection Practices Among Siblings of Patients with Melanoma, TZDs and HF in People with Type 2 Diabetes; Exercise Plus Behavioral Management in Patients with AD; Spironolactone in Resistant HBP
  • Pharmacology Watch: Vioxx Might Control Postoperative Knee Pain

    Oral rofecoxib (Vioxx) may have a role in controlling postoperative pain patients undergoing knee surgery.