Neurology
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A ‘Normal’ Initial ECG?
The ECG in the figure was obtained from a 30-year-old man who was admitted to the hospital to “rule out myocardial infarction.” His symptoms of chest discomfort were thought to be atypical and unlikely to be due to a cardiac etiology. His initial ECG (not shown) was interpreted as normal. Evaluation, including serial troponins and stress testing, were deemed normal. Before sending the patient home, the ECG in the figure was obtained.
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Peanut (Arachis hypogaea) Allergen Powder-dnfp (Palforzia)
This is the first FDA-approved oral immunotherapy for desensitizing peanut allergy in children to help reduce the risk of allergic reactions.
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The Safety and Effectiveness of Pyrethroid Insecticides as the Battle Against Mosquitoes Continues
There is a statistical association between a urine test suggestive of exposure to pyrethroid insecticides and increased mortality over the subsequent 14 years.
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Optimal Antithrombic Therapy After PCI for Atrial Fibrillation Patients
In three subgroups of coronary artery disease patients with atrial fibrillation, apixaban plus a P2Y12 inhibitor provided superior safety and similar efficacy outcomes as treatment with warfarin, aspirin, or both for six months.
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Heart Failure-Exacerbating Medications
In a large, diverse cohort of Medicare patients hospitalized for heart failure exacerbations, almost half were on medications known to exacerbate heart failure; more than one-third were on these agents at discharge.
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Are Epidural Steroid Injections Cost-Effective?
In a retrospective review of patients treated for low back pain and lumbar radiculopathy at the Cleveland Clinic, at three- and six-month follow-up, epidural steroid injections were no better than conservative therapies in quality of life measures or overall cost of medical care.
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Cavum Septum Pellucidum and Cavum Vergae: Markers of Chronic Brain Injury?
A cohort study assessing participants from the Professional Fighters Brain Health Study found that the presence of cavum septum pellucidum and cavum vergae is associated with lower regional brain volumes and lower cognitive performance.
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Intravenous Immunoglobulin for Treatment of Autoimmune Epilepsies
Patients with LGI1 and CASPR2 IgG-associated autoimmune epilepsy were identified and randomized to treatment with intravenous immunoglobulin (IVIG) vs. placebo. The authors hypothesized that IVIG would show superiority over placebo, with a primary endpoint of 50% or greater seizure reduction.
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Rituximab for the Treatment of MOG and AQP4 Antibody Diseases
Based on an observational prospective study of 16 patients with anti-myelin oligodendrocyte protein (MOG) disease and 29 anti-aquaporin-4 disease, the authors report lesser efficacy of rituximab in anti-MOG patients, characterized by higher occurrence of relapses in the anti-MOG group, even while the biological effect of rituximab on memory B-cell suppression was sustained.
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Neurofilament Light Correlates With Postoperative Delirium Severity
Measurement of postoperative plasma neurofilament light protein (NfL) in plasma appears to have a dose-dependent correlation with delirium severity, independent of inflammation. This observation provides evidence of neuronal injury from delirium.