Neurology
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PCSK9 Inhibitors in Acute Coronary Syndrome Patients
Compared to adding placebo, using the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab in post-acute coronary syndrome patients on maximally tolerated, high-intensity statins with low-density lipoprotein (LDL) cholesterol levels higher than 70 mg/dL lowered LDL and reduced the number of major adverse cardiac events.
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Caregivers and Mindfulness-Based Stress Reduction Interventions
A Cochrane Review regarding efficacy of mindfulness-based stress reduction (MBSR) for family caregivers of dementia patients revealed low-quality evidence that MBSR reduces short-term anxiety and depressive symptoms in this population.
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Hormone Therapy and Mortality: No Overall Effect?
An evaluation of outcomes of users and nonusers of postmenopausal hormonal therapy followed longitudinally in the Danish database showed no overall difference in mortality.
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Precise Localization of Focused Ultrasound Thalamotomy Determines Clinical Benefit
Lesioning of the posterior portion of the VIM thalamus is most efficacious. Lesions extending beyond this portion can lead to adverse side effects in those with essential tremor treated with MRI-guided focused ultrasound.
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Miller Fisher Syndrome: Atypical Features
Other than the classic triad of neurological signs that define Miller Fisher syndrome, it also is common to see delayed facial palsy, loss of taste, and weakness of pharyngeal and cervical muscles.
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Treatment of Acute Migraine With Ginger
Ginger extract has a long anecdotal history as a treatment for migraine headaches in traditional Chinese medicine. This well-designed study provides evidence that adding ginger to a standard nonsteroidal anti-inflammatory medication improves outcomes of migraine treatment by all measured parameters.
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Proceedings From the International Stroke Conference, Honolulu, February 2019
The following reviews of studies presented at the 2019 International Stroke Conference were written after my personal attendance at the presentations, followed by review of the simultaneous publications in The New England Journal of Medicine and The Lancet. All comments and opinions are solely those of this editor. — Matthew E. Fink, MD
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Is There RBBB, Acute Ischemia, or Both?
The ECG in the figure was obtained from a 35-year-old man with a 20-year history of smoking. He presented to the ED with new-onset chest discomfort. He was hemodynamically stable at the time this tracing was obtained. How would one interpret his ECG? Is there right bundle branch block (RBBB)? Is there evidence of acute posterior ischemia or infarction?
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Sarecycline Tablets (Seysara)
Sarecycline is indicated for the treatment of inflammatory lesions of non-nodular moderate to severe acne in patients 9 years of age and older.
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Is Sanitizer Better Than Soap?
In day care settings, the implementation of hand hygiene programs reduced respiratory illness, absenteeism, and antibiotic use in children 0-3 years of age. Using hand sanitizer was more effective than washing with soap and water.