Saturday, August 30, 2014

'Brain Training' May Cut Risk for Cognitive Decline

'Brain Training' May Cut Risk for Cognitive Decline
Medscape NeurologyHeadlines

Participating in divided-attention training programs can increase activation of the brain region involved in multitasking in healthy adults, which may help reduce the risk for cognitive decline.
Medscape Medical News

Original Article: http://www.medscape.com/viewarticle/830703?src=rss
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Marijuana compound shows promise for treating Alzheimer's disease in preclinical study

Marijuana compound shows promise for treating Alzheimer's disease in preclinical study
Neurology News & Neuroscience News from Medical News Today

Extremely low levels of the compound in marijuana known as delta-9-tetrahydrocannabinol, or THC, may slow or halt the progression of Alzheimer's disease, a recent study from neuroscientists at the...

Original Article: http://www.medicalnewstoday.com/releases/281658.php
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Friday, August 29, 2014

Escrito em letra de medico - iBook, kindle e Android

ESCRITO EM LETRA DE MÉDICO

Check out this book on iBooks:

Cover Art

ESCRITO EM LETRA DE MÉDICO

Júlio Pereira

Category: Medical
5 Ratings



iBooks
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Copyright © 2014 Apple Inc. All rights reserved
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Thoughts from the hospital - iBook, Kindle and Android

THOUGHTS FROM THE HOSPITAL

Check out this book on iBooks:

Cover Art

THOUGHTS FROM THE HOSPITAL

Júlio Pereira

Category: Medical



iBooks
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Copyright © 2014 Apple Inc. All rights reserved
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Potential treatments for absence seizures

Potential treatments for absence seizures
Neurology News & Neuroscience News from Medical News Today

Absence seizures are believed to be elicited by T-type calcium channels in the thalamic reticular nucleus of the brain that regulate influxes of calcium.

Original Article: http://www.medicalnewstoday.com/releases/281420.php
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Adult stroke risk after growth hormone treatment in childhood: First do no harm

Adult stroke risk after growth hormone treatment in childhood: First do no harm
Neurology recent issues

Childhood precursors of adult diseases are increasingly identified by studies that span the period from birth to senescence. This is particularly relevant for cerebrovascular disease, for which links have been discovered with childhood obesity and adolescent-onset hypertension.1 In this issue of Neurology®, Poidvin et al.2 report an increased risk of stroke in adults treated with growth hormone (GH) during childhood. This report has been much anticipated by the endocrinology community because it extends and clarifies findings in a 2012 study showing increased mortality in adults treated in childhood with GH from the prospective European cohort study—the Safety and Appropriateness of Growth Hormone Treatments in Europe (SAGhE).3



Original Article: http://www.neurology.org/cgi/content/short/83/9/776?rss=1
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Judgment is not ignorance

Judgment is not ignorance
Neurology recent issues

We disagree with the statement that "There would be little justification for using RNS or DBS prior to VNS."1 In fact, the efficacy of both deep brain stimulation (DBS) and responsive neurostimulation (RNS) was superior to that of vagus nerve stimulation (VNS) in the respective pivotal clinical trials, an important result given that trials of the DBS and RNS were properly blinded and had strict entry criteria requiring proof that enrolled participants had epileptic seizures. Additionally, patient subgroups with bilateral independent temporal onsets did better than participants as a whole in both the RNS and DBS trials, suggesting that cranially implanted devices may be preferred to VNS in specific clinical situations.



Original Article: http://www.neurology.org/cgi/content/short/83/9/847?rss=1
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Yes, neurostimulation has a role in the management of epilepsy

Yes, neurostimulation has a role in the management of epilepsy
Neurology current issue

The treatment of epilepsy involves 4 modalities: medications, neurostimulation, diet, and surgery. The proportion of medically refractory patients remains around 30%, despite new medications, justifying the need for nondrug treatments. In fact, the use of nondrug treatments is one of the key roles of a comprehensive epilepsy center.



Original Article: http://www.neurology.org/cgi/content/short/83/9/845?rss=1
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Neurostimulation for the treatment of epilepsy: The skeptical view

Neurostimulation for the treatment of epilepsy: The skeptical view
Neurology current issue

Great debates erupted in the late 19th century over the therapeutic value of electrotherapy to the brain before interest eventually waned.1 We now have 3 electrical stimulation devices for the treatment of epilepsy (2 approved in the United States, a third in Europe). What do they offer and when should we consider their use?



Original Article: http://www.neurology.org/cgi/content/short/83/9/847-a?rss=1
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How neurons respond to sequences of familiar objects

How neurons respond to sequences of familiar objects
Neurology News & Neuroscience News from Medical News Today

The world grows increasingly more chaotic year after year, and our brains are constantly bombarded with images.

Original Article: http://www.medicalnewstoday.com/releases/281490.php
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Upcoming election could rekindle health debate in Brazil.

Upcoming election could rekindle health debate in Brazil.
Unbound MEDLINE | Lancet journal articles



Original Article: http://www.unboundmedicine.com/medline/citation/25157388/Upcoming_election_could_rekindle_health_debate_in_Brazil_
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What is ALS? What causes ALS?

What is ALS? What causes ALS?
Neurology News & Neuroscience News from Medical News Today

Amyotrophic lateral sclerosis (ALS) is a fatal degenerative neurological condition, also referred to as Lou Gehrig's disease. It weakens the muscles and impacts body functioning.

Original Article: http://www.medicalnewstoday.com/articles/281472.php
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TMS Improves Memory via Brain Surface Networks

TMS Improves Memory via Brain Surface Networks
Medscape NeurologyHeadlines

Repetitive transcranial magnetic stimulation improves memory by targeting surface regions connected with the much deeper center of memory, the hippocampus.
Medscape Medical News

Original Article: http://www.medscape.com/viewarticle/830610?src=rss
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Friday, August 22, 2014

Are patient preferences for end-of-life care socially influenced? Examining racial disparities in advance care planning

Are patient preferences for end-of-life care socially influenced? Examining racial disparities in advance care planning
Cancer

Future research should continue empirical investigations into the social influences and additional factors responsible for the modification of preferences among racially/ethnically diverse patients with terminal cancer, because these factors would be informative for the development of a culturally sensitive, patient-centered advance planning intervention for such patients. Advance care planning interventions have the potential to significantly challenge current clinical and research practice paradigms pertaining to the provision of end-of-life care to terminal cancer patients, with particular relevance to racial and ethnic minorities who are disproportionately more likely to receive aggressive life-sustaining care.



Original Article: http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002/cncr.28969
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Study reveals 'suicide tourism' has doubled in Switzerland

Study reveals 'suicide tourism' has doubled in Switzerland
Neurology News & Neuroscience News from Medical News Today

Assisted suicide is not clearly regulated in Switzerland, so non-residents flock to the country seeking help with dying. A new study shows these numbers have doubled in 4 years.

Original Article: http://www.medicalnewstoday.com/articles/281339.php
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Cervical sensory axonal dysfunction in radiculopathy: A novel concept!

Cervical sensory axonal dysfunction in radiculopathy: A novel concept!
JNNP blog

Cervical radiculopathy is a common issue for neurologists. While motor dysfunction has been traditionally assessing using needle EMG techniques, thereby confirming the diagnosis, frequently only sensory symptoms may be evident. In such cases, the diagnostic time may be protracted.
In an upcoming issue of JNNP (ON-LINE FIRST) Lin and colleagues tackle this issue in a novel manner assessing sensory axonal excitability distal to the site of dysfunction. Interestingly, distal axonal hyperpolarisation was noted even in the presence of normal sensory nerve conduction studies, as traditionally expected. This provides a novel pathophysiological insight into this disorder.

Must read more at:  http://jnnp.bmj.com/content/early/2014/08/20/jnnp-2014-308088.abstract

 

J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2014-308088
  • Neuromuscular
  • Research paper

Sensory axonal dysfunction in cervical radiculopathy



Original Article: http://blogs.bmj.com/jnnp/2014/08/22/cervical-sensory-axonla-dysufnction-in-radiculoapthy-a-novel-concept/
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Thursday, August 21, 2014

Arterial Blood Pressure and Neurologic Outcome After Resuscitation From Cardiac Arrest*

Arterial Blood Pressure and Neurologic Outcome After Resuscitation From Cardiac Arrest*
Critical Care Medicine - Most Popular Articles

imageObjectives: Guidelines for post–cardiac arrest care recommend blood pressure optimization as one component of neuroprotection. Although some retrospective clinical studies suggest that postresuscitation hypotension may be harmful, and laboratory studies suggest that a postresuscitation hypertensive surge may be protective, empirical data are few. In this study, we prospectively measured blood pressure over time during the postresuscitation period and tested its association with neurologic outcome. Design: Single center, prospective observational study from 2009 to 2012. Patients: Inclusion criteria were age 18 years old or older, prearrest independent functional status, resuscitation from cardiac arrest, and comatose immediately after resuscitation. Measurements and Main Results: Our research protocol measured blood pressure noninvasively every 15 minutes for the first 6 hours after resuscitation. We calculated the 0- to 6-hour time-weighted average mean arterial pressure and used multivariable logistic regression to test the association between increasing time-weighted average mean arterial pressures and good neurologic outcome, defined as Cerebral Performance Category 1 or 2 at hospital discharge. Among 151 patients, 44 (29%) experienced good neurologic outcome. The association between blood pressure and outcome appears to have a threshold effect at time-weighted average mean arterial pressure value of 70 mm Hg. This threshold (mean arterial pressure > 70 mm Hg) had the strongest association with good neurologic outcome (odds ratio, 4.11; 95% CI, 1.34–12.66; p = 0.014). A sustained intrinsic hypertensive surge was relatively uncommon and was not associated with neurologic outcome. Conclusions: We found that time-weighted average mean arterial pressure was associated with good neurologic outcome at a threshold of mean arterial pressure greater than 70 mm Hg.

Original Article: http://journals.lww.com/ccmjournal/Fulltext/2014/09000/Arterial_Blood_Pressure_and_Neurologic_Outcome.15.aspx
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Carpal Tunnel Syndrome Is Associated With High Fibrinogen and Fibrinogen Deposits

Carpal Tunnel Syndrome Is Associated With High Fibrinogen and Fibrinogen Deposits
Neurosurgery - Current Issue

imageBACKGROUND: Idiopathic carpal tunnel syndrome (ICTS) is a common entrapment neuropathy. Some cases of ICTS are linked to mutations of the transthyretin gene, whereas others are associated with systemic amyloidosis. The majority of ICTS cases are of unknown etiology. OBJECTIVE: To study molecular mechanisms of ICTS development. METHODS: A total of 71 ICTS patients and 68 control subjects were included in the study. The fibrinogen level was determined before surgery and its deposition in the transversal carpal ligament (TCL) was detected by immunohistochemistry, Western blot, and mass spectrometry. Fibrinogen interaction with other proteins was studied by immunoprecipitation assay. RESULTS: Plasma levels of the proinflammatory and hemostatic protein fibrinogen are elevated in ICTS patients. Other measured systemic inflammatory markers were not affected, and local inflammatory responses in TCL were absent. ICTS patients have shorter bleeding times, probably because of the elevated plasma levels of fibrinogen. Polymorphisms of the fibrinogen B promoter region were previously associated with increased plasma fibrinogen, but this association was not observed among patients with ICTS. Interestingly, we detected fibrinogen deposits in the TCL, whereas transcriptional activity of the fibrinogen genes was low. Amyloidogenic proteins, including transthyretin and α-synuclein, were also found in the TCL, whereas their local transcriptional activity was rather high. Finally, we demonstrated that fibrinogen interacts with transthyretin and α-synuclein in TCL lysates. CONCLUSION: Our data indicate that fibrinogen and other aggregation-prone proteins have potentially important roles in the pathogenesis of ICTS. ABBREVIATIONS: CTS, carpal tunnel syndrome ENG, electroneurography ICTS, idiopathic carpal tunnel syndrome PCR, polymerase chain reaction SNP, single-nucleotide polymorphism TCL, transversal carpal ligament TTR, transthyretin

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/09000/Carpal_Tunnel_Syndrome_Is_Associated_With_High.9.aspx
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DNA methylation in brain 'linked to Alzheimer's disease'

DNA methylation in brain 'linked to Alzheimer's disease'
Neurology News & Neuroscience News from Medical News Today

Analyzing samples from 708 donated brains, researchers have discovered that changes to the human genome caused by DNA methylation may contribute to onset of Alzheimer's disease.

Original Article: http://www.medicalnewstoday.com/articles/281192.php
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[Comment] Deep brain stimulation for cervical dystonia

[Comment] Deep brain stimulation for cervical dystonia
The Lancet Neurology

Dystonia is a movement disorder characterised by sustained or intermittent muscle contractions that cause abnormal, often repetitive, movements, postures, or both. The severity and phenomenology of dystonia vary widely and various causes have been identified. Treatment with deep brain stimulation (DBS) of the globus pallidus internus (GPi) was first announced 14 years ago for patients with inherited isolated DYT1 (also known as TOR1A) dystonia. Since then, GPi DBS has been tested successfully on various dystonia syndromes, including isolated or combined presentations and forms with different causes: idiopathic, inherited, or acquired.

Original Article: http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(14)70178-4/fulltext?rss=yes
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How #Selfie Culture is Changing Our Lives

How #Selfie Culture is Changing Our Lives
Scientific American: Mind and Brain

We've all done it: We're at an event, we take a bunch of photos with our phones, we take a selfie and maybe one with a friend, we post all the images online, and we're done.

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/blog/post/how-selfie-culture-is-changing-our-lives/
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Surgical Management of Trigeminal Neuralgia: Use and Cost-Effectiveness From an Analysis of the Medicare Claims Database

Surgical Management of Trigeminal Neuralgia: Use and Cost-Effectiveness From an Analysis of the Medicare Claims Database
Neurosurgery - Most Popular Articles

imageBACKGROUND: Trigeminal neuralgia is a relatively common neurosurgical pathology with multiple management options. Microvascular decompression (MVD) is nonablative and is considered the gold standard. However, stereotaxic radiosurgery (SRS) and percutaneous stereotaxic rhizotomy (PSR) are 2 noninvasive but ablative options that have rapidly gained support. OBJECTIVE: To use Medicare claims data in conjunction with a literature review to assess the usage, effectiveness, and cost-effectiveness of the 3 different invasive treatments for trigeminal neuralgia. METHODS: All of the claims of trigeminal neuralgia treatment were extracted from the 2011 5% Inpatient and Outpatient Limited Data Set. Current Procedural Terminology, 4th Edition/International Classification of Diseases, Ninth Revision codes for the 3 different surgical treatment modalities were used to further classify these claims. Kaplan-Meier survival curves in key articles were used to calculate quality-adjusted life years and cost-effectiveness for each procedure. RESULTS: A total of 1582 claims of trigeminal neuralgia were collected. Ninety-four (6%) patients underwent surgical intervention. Forty-eight (51.1%) surgical patients underwent MVD, 39 (41.5%) underwent SRS, and 7 (7.4%) underwent PSR. The average weighted costs for MVD, SRS, and PSR were $40 434.95, $38 062.27, and $3910.64, respectively. The quality-adjusted life years were 8.2 for MVD, 4.9 for SRS, and 6.5 for PSR. The cost per quality-adjusted life year was calculated as $4931.1, $7767.8, and $601.64 for MVD, SRS, and PSR, respectively. CONCLUSION: This study shows that the most frequently used surgical management of trigeminal neuralgia is MVD, followed closely by SRS. PSR, despite being the most cost-effective, is by far the least utilized treatment modality. ABBREVIATIONS: BNI, Barrow Neurological Institute ICD-9,International Classification of Diseases, Ninth Revision MVD, microvascular decompression PSR, percutaneous stereotaxic rhizotomy QALY, quality-adjusted life year SRS, stereotaxic radiosurgery TN, trigeminal neuralgia

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/09000/Surgical_Management_of_Trigeminal_Neuralgia___Use.3.aspx
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Solitaire AB Stent-Assisted Coiling of Wide-Necked Intracranial Aneurysms: Mid-term Results From the SOLARE Study

Solitaire AB Stent-Assisted Coiling of Wide-Necked Intracranial Aneurysms: Mid-term Results From the SOLARE Study
Neurosurgery - Most Popular Articles

imageBACKGROUND: Endovascular treatment of intracranial aneurysms can be technically difficult when the neck is wide. The Solitaire AB stent (Covidien, Irvine, California), the only fully retrieved stent, assists in the coiling of wide-neck intracranial aneurysms. OBJECTIVE: To evaluate the mid-term angiographic follow-up of wide-necked aneurysms treated with the Solitaire AB stent. METHODS: SOLARE (SOLitaire Aneurysm Remodeling) is a consecutive, prospective study conducted in 7 European centers. A core laboratory evaluated the postoperative and mid-term (6 month ± 15 days) angiographic results by using the Raymond classification Scale. Recanalization was defined as worsening, and progressive thrombosis was defined as improvement in the Raymond scale score. RESULTS: The mean width of the aneurysm sac was 7.5 mm, and the mean diameter of the aneurysm neck was 4.7 mm. Angiographic mid-term follow-up was obtained in 55 of 65 aneurysms (85.9%). Complete occlusion was achieved in 33 aneurysms (60%); a neck remnant was seen in 16 aneurysms (29.1%) and an aneurysm remnant in 6 aneurysms (10.9%). Of 55 aneurysms, recanalization was observed in 8 aneurysms (14.5%), and progressive thrombosis was observed in 17 aneurysms (30.9%). No bleeding or rebleeding was observed during the follow-up period. CONCLUSION: Stent-assisted coiling of wide-necked intracranial aneurysms was found to be safe and effective with the Solitaire AB stent at 6-month follow-up. Angiographic results improve with time due to progressive thrombosis of the aneurysm. ABBREVIATIONS: mRS, modified Rankin Scale SAC, stent-assisted coiling

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/09000/Solitaire_AB_Stent_Assisted_Coiling_of_Wide_Necked.2.aspx
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Expert Consensus on Disease-Modifying Therapies in MS

Expert Consensus on Disease-Modifying Therapies in MS
Medscape NeurologyHeadlines

In the absence of an algorithm to make treatment decisions in multiple sclerosis, physicians should start treatment early and have access to all available disease-modifying therapies, new expert consensus concludes.
Medscape Medical News

Original Article: http://www.medscape.com/viewarticle/830205?src=rss
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Metabolism: Sugar on the brain

Metabolism: Sugar on the brain
Nature Reviews Neuroscience - Issue - nature.com science feeds

Nature Reviews Neuroscience 15, 563 (2014). doi:10.1038/nrn3812

Author: Leonie Welberg

High levels of central transforming growth factor-β1 induce hypothalamic inflammation and lead to hyperglycaemia and glucose intolerance.



Original Article: http://feeds.nature.com/~r/nrn/rss/current/~3/crWE4T70ZcY/nrn3812
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Saturday, August 16, 2014

Relationship between neurological assessments of preterm infants in the first two years and cognitive outcome at school age

Relationship between neurological assessments of preterm infants in the first two years and cognitive outcome at school age
Pediatric Neurology

The risk of cognitive disability in preterm infants is higher than in general population. The Amiel-Tison neurological assessment could be a useful tool for early identification of preterm children at risk of cognitive disability in school age. This study investigated the value of categorization of neurological signs assessed by the Amiel-Tison neurological assessment in the first two years of life in relation to cognitive performance at school age in a group of preterm children.

Original Article: http://www.pedneur.com/article/S0887-8994(14)00453-6/abstract?rss=yes?rss=yes
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Reversible cerebral vasoconstriction syndrome following carotid stenting

Reversible cerebral vasoconstriction syndrome following carotid stenting
Neurology current issue

A 60-year-old woman on venlafaxine presented with headache and left-sided weakness 1 month after undergoing right common carotid artery stenting. Catheter-based angiogram identified new irregularities of the right anterior cerebral and right middle cerebral artery (figure, A–C). Investigations for vasculitis, including CSF studies, were unremarkable. The vessel irregularities and symptoms improved after administration of intra-arterial verapamil (figure, D–F). Unilateral reversible cerebral vasoconstriction syndrome has previously been described after carotid endarterectomy. The mechanism is unclear; however, it may be due to disturbance of cerebral autoregulation.1,2 Concomitant use of a serotonin and norepinephrine reuptake inhibitor may have been a predisposing factor.



Original Article: http://www.neurology.org/cgi/content/short/83/6/570?rss=1
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What Do Great Musicians Have in Common? DNA

What Do Great Musicians Have in Common? DNA
Scientific American: Mind and Brain

New study shows it's a myth that a lot of practice will necessarily bring greatness

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/article/what-do-great-musicians-have-in-common-dna/
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Can Acupuncture Treat Depression?

Can Acupuncture Treat Depression?
Scientific American: Mind and Brain

The alternative practice may be able to replace medication or alleviate its side effects

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/article/can-acupuncture-treat-depression/
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Recurrence Risk in Posthemorrhage Anticoagulation

Recurrence Risk in Posthemorrhage Anticoagulation
Medscape NeurologyHeadlines

A new study looks at the safety of restarting anticoagulation following intracranial hemorrhage.
Medscape Neurology

Original Article: http://www.medscape.com/viewarticle/829052?src=rss
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Discovery of potential new predictor of stress-related illnesses

Discovery of potential new predictor of stress-related illnesses
Neurology News & Neuroscience News from Medical News Today

Scientists studying depression in teens have discovered that subtle changes in a gene can predict how the brain reacts to stress, which can cause such health issues as depression, post-traumatic...

Original Article: http://www.medicalnewstoday.com/releases/280603.php
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Intelligence as we age linked to spotting things quickly

Intelligence as we age linked to spotting things quickly
Neurology News & Neuroscience News from Medical News Today

A decline in intelligence later in life has been linked to a decline in how quickly the brain is able to interpret what the eye sees, according to a new study.

Original Article: http://www.medicalnewstoday.com/articles/280714.php
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Older adults' brain functions work better in the morning

Older adults' brain functions work better in the morning
Neurology News & Neuroscience News from Medical News Today

Older adults are morning people, says a new study that suggests this group performs better on cognitive tasks when they are tested in the morning, compared with in the afternoon.

Original Article: http://www.medicalnewstoday.com/articles/280757.php
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Promising approach to restore spinal cord injury: relay strategies combined with axon regeneration

Promising approach to restore spinal cord injury: relay strategies combined with axon regeneration
Neurology News & Neuroscience News from Medical News Today

For decades, numerous investigations have only focused on axon regeneration to restore function after traumatic spinal cord injury (SCI), as interrupted neuronal pathways have to be reconnected for...

Original Article: http://www.medicalnewstoday.com/releases/280732.php
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Anticoagulant-Associated ICH: Management Still a Challenge

Anticoagulant-Associated ICH: Management Still a Challenge
Medscape NeurologyHeadlines

Mortality due to anticoagulant-associated ICH has not improved over the last 20 years, indicating that there are barriers to treatment and room for improvement, experts say.
Medscape Medical News

Original Article: http://www.medscape.com/viewarticle/829640?src=rss
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Cavernoma today: Keep the surgeon away?

Cavernoma today: Keep the surgeon away?
Neurology recent issues

Cerebral cavernous malformations (CCMs), or cavernomas, are rounded or oval lesions in the CNS consisting of dilated vascular channels with single layer of endothelium, lacking muscular and elastic layers, without normal intervening brain parenchyma. Developmental venous anomalies may coexist with CCMs in up to 30% of cases, and along with capillary telangiectasias and arteriovenous malformations, comprise 4 types of vascular malformations found in CNS.



Original Article: http://www.neurology.org/cgi/content/short/83/7/576?rss=1
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