Neurology
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Fecal Microbiota Transplantation: Patients Need No Convincing
Relapsing and refractory Clostridium difficile infection has become a real challenge for clinicians and affected patients alike. Some patients wind up in a seemingly never-ending cycle of illness, gradual improvement, followed by a prolonged vancomycin taper, and eventual relapse.
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Intracerebral Hemorrhages Associated with Non-vitamin K Oral Anticoagulants Appear to Be Smaller than Those Associated with Warfarin
This small prospective observational study suggests that warfarin-associated intracerebral hemorrhages may be larger and have worse clinical outcomes then hemorrhages associated with the newer anticoagulant agents.
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Blood Transfusion in Cardiac Disease Patients
An observational study confirms the hypothesis that ischemic heart disease patients may do better with higher hemoglobin levels as compared to ICU patients without heart disease.
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Symptomatic Carotid Artery Stenosis Requires Urgent Revascularization
Johansson et al identified a significant early risk of recurrent stroke in patients with symptomatic carotid artery stenosis, and advise a prospective randomized trial to determine when the optimal time for revascularization should take place.
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Early Chest CT Can Improve Treatment for Community-acquired Pneumonia
In patients with suspected community-acquired pneumonia, early chest CT significantly changed management decisions.
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The Opioids Just Keeping Coming
Most opioid prescriptions are continued after a patient overdoses accidentally. Those patients are also at risk for a recurrent overdose.
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Overdiagnosis of Idiopathic Intracranial Hypertension
Idiopathic intracranial hypertension is over-diagnosed because of a lack of physician expertise in performing accurate ophthalmoscopy. When considering the diagnosis, referral to a neuro-ophthalmologist is strongly recommended.
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Isolated Dizziness and Vertigo Are Rarely Caused by Stroke
The rate of stroke in patients discharged from the ED with a diagnosis of peripheral vestibular disorder is extremely low, and unless there are associated neurological symptoms and signs, there is no need for extensive ED evaluation.
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Tranexamic Acid-associated Seizures: Features, Mechanisms, and Treatment
Tranexamic acid is a commonly used antifibrinolytic drug that has been associated with increased risk of postoperative seizures. The authors reviewed the incidence, risk factors, and clinical features of these seizures, as well as potential mechanisms. They also proposed treatments and interventions for preventing Tranexamic acid-related seizures.
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Does Rivastigmine Prevent Falls in Parkinson’s Disease?
A randomized, double-blind, placebo-controlled Phase II clinical trial of oral rivastigmine in 130 patients with moderate-stage Parkinson’s disease demonstrated improved gait stability as measured by accelerometry, and suggested an association with lower rate of falls.