MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Neurologic Clinics' source. Sun, 21 Mar 2010 15:31:27 +0100 http://www.medworm.com/index.php?rid=3020835&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909001005%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020835 Tue, 24 Nov 2009 14:50:25 +0100 3020835 http://www.medworm.com/index.php?rid=3020834&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000577%2Fabstract%3Frss%3Dyes Neurologic complications of bacterial endocarditis have been observed for centuries but its management has remained challenging at all times. The cerebrovascular complications of this disorder are the most feared and difficult to address. The management of mycotic aneurysms, recent ischemic/hemorrhagic strokes with and without brain abscesses, and mechanical valve patients continues as an ongoing challenge. Literature continues to appear, providing new alternatives in treatment and hope for improved therapy. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020834 Tue, 24 Nov 2009 14:50:25 +0100 3020834 http://www.medworm.com/index.php?rid=3020833&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000693%2Fabstract%3Frss%3Dyes This article provides an overview of the clinical features and laboratory findings of the major mycoses affecting the CNS and a focus on their neurologic presentations. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020833 Tue, 24 Nov 2009 14:50:25 +0100 3020833 http://www.medworm.com/index.php?rid=3020832&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000656%2Fabstract%3Frss%3Dyes Only two spirochetal infections are known to cause nervous system infection and damage: neurosyphilis and neuroborreliosis (nervous system Lyme disease). Diagnosis of both generally relies on indirect tools, primarily assessment of the host immune response to the organism. Reliance on these indirect measures poses some challenges, particularly as they are imperfect measures of treatment response. Despite this, both infections are known to be readily curable with straightforward antimicrobial regimens. The challenge is that, untreated, both infections can cause progressive nervous system damage. Although this can be microbiologically cured, the threat of permanent resultant neurologic damage, often severe in neurosyphilis and usually less so in neuroborreliosis, leads to considerable concer... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020832 Tue, 24 Nov 2009 14:50:25 +0100 3020832 http://www.medworm.com/index.php?rid=3020831&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000747%2Fabstract%3Frss%3Dyes This article reviews the HIV-associated neurologic syndromes, which can be classified as primary HIV neurologic disease (in which HIV is both necessary and sufficient to cause the illness), secondary or opportunistic neurologic disease (in which HIV interacts with other pathogens, resulting in opportunistic infections and tumors), and treatment-related neurologic disease (such as immune reconstitution inflammatory syndrome). (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020831 Tue, 24 Nov 2009 14:50:25 +0100 3020831 http://www.medworm.com/index.php?rid=3020830&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386190900067X%2Fabstract%3Frss%3Dyes Neurologic complications affect posttransplant recovery of more than 20% of transplant recipients. Etiology is usually related to surgical procedure of transplantation, primary disorders causing failure of transplanted organ, opportunistic infections, and neurotoxicity of immunosuppressive medications. Risk of opportunistic infections and immunosuppressant neurotoxicity is greatest within the first six months, but it persists along with long-term maintenance immunosuppression required to prevent graft rejection. Neurotoxicity may require alteration of immunosuppressive regimen, and prompt therapy of opportunistic infections improves outcomes. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020830 Tue, 24 Nov 2009 14:50:25 +0100 3020830 http://www.medworm.com/index.php?rid=3020829&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000644%2Fabstract%3Frss%3Dyes This article focuses on the clinical features, diagnosis, and management options for patients with radiation neurotoxicity. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020829 Tue, 24 Nov 2009 14:50:25 +0100 3020829 http://www.medworm.com/index.php?rid=3020828&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000668%2Fabstract%3Frss%3Dyes This article explains the general nature of drug abuse, identifies the physiologic effects of certain drugs, and briefly describes the neurobiology of addiction. This article also reviews available treatment options for those addicted to substances of abuse, and clarifies common misconceptions, including the differences between tolerance, abuse, and addiction. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020828 Tue, 24 Nov 2009 14:50:25 +0100 3020828 http://www.medworm.com/index.php?rid=3020827&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000681%2Fabstract%3Frss%3Dyes Neurosarcoidosis is a diagnostic consideration in diverse clinical settings. Efforts should be made to secure pathologic confirmation of systemic sarcoidosis; only rarely is central nervous system (CNS) pathologic confirmation available. CNS infection and malignancy should be reasonably excluded before making a diagnosis of CNS sarcoidosis. Corticosteroid therapy alone may not be sufficient to treat neurosarcoidosis; adjunct immunosuppressive agents are increasingly used to achieve an optimal clinical outcome. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020827 Tue, 24 Nov 2009 14:50:25 +0100 3020827 http://www.medworm.com/index.php?rid=3020826&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000711%2Fabstract%3Frss%3Dyes Vasculitis or angiitis refers to a group of inflammatory disorders of the blood vessels that cause structural damage to the affected vessel, including thickening and weakening of the vessel wall, narrowing of its lumen, and, usually, vascular necrosis. Systemic vasculitis is classified according to the vessel size and histopathologic and clinical features. Vasculitides with small vessel involvement typically include Henoch-Schönlein purpura and cryoglobulinemia. Polyarteritis nodosa and Wegener granulomatosis are small- and medium-sized vessel vasculitides, whereas temporal arteritis and Takayasu arteritis involve large vessels. In this article, the authors provide a review of the neurologic presentations of the major systemic vasculitides. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020826 Tue, 24 Nov 2009 14:50:25 +0100 3020826 http://www.medworm.com/index.php?rid=3020825&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000620%2Fabstract%3Frss%3Dyes Optimal functioning of the central and peripheral nervous system is dependent on a constant supply of appropriate nutrients. The first section of this review discusses neurologic manifestations related to deficiency of key nutrients such as vitamin B12, folate, copper, vitamin E, thiamine, and others. The second section addresses neurologic complications related to bariatric surgery. The third sections includes neurologic presentations caused by nutrient deficiencies in the setting of alcoholism. The concluding section addresses neurologic deficiency diseases that have a geographic predilection. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020825 Tue, 24 Nov 2009 14:50:24 +0100 3020825 http://www.medworm.com/index.php?rid=3020824&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000723%2Fabstract%3Frss%3Dyes This article discusses the most recent developments in understanding the pathophysiology of HE and its diagnosis and management. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020824 Tue, 24 Nov 2009 14:50:24 +0100 3020824 http://www.medworm.com/index.php?rid=3020823&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000632%2Fabstract%3Frss%3Dyes This article focuses on some of those disease processes. Illnesses primarily targeting the GI tract are addressed and examples of primary esophageal, gastric, and intestinal disease processes are described. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020823 Tue, 24 Nov 2009 14:50:24 +0100 3020823 http://www.medworm.com/index.php?rid=3020822&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000607%2Fabstract%3Frss%3Dyes Among the collagen vascular diseases neurologic manifestations have been most commonly recognized and well-studied in systemic lupus erythematosus (SLE, lupus). Neurologic manifestations are less prevalent in other systemic inflammatory and autoimmune disorders. This review focuses on the clinical presentation, pathophysiology, and treatment strategies of neuropsychiatric lupus (NPSLE) in children and adults. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020822 Tue, 24 Nov 2009 14:50:24 +0100 3020822 http://www.medworm.com/index.php?rid=3020821&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000590%2Fabstract%3Frss%3Dyes Renal diseases-related metabolic abnormalities cause diverse CNS disturbances, namely uremic encephalopathy, seizures, stroke, movement disorders, sleep alterations, and peripheral nervous system involvement comprising polyneuropathy, mononeuropathies, and myopathy. Some inherited and acquired renal diseases present with concomitant or precedent neurologic syndromes. Several mechanisms involved include toxic metabolic accumulation, hyperkalemia, hypercoagulability, immunologic disturbances, and tubular acido-basic disequilibrium. Clinical symptoms usually indicate severe renal dysfunction, but subtle abnormalities may occur. Judiciously tailored renal replacement therapy may avoid these complications, whereas others may emerge from these very therapies with overlapping clinical pictures. T... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020821 Tue, 24 Nov 2009 14:50:24 +0100 3020821 http://www.medworm.com/index.php?rid=3020820&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000619%2Fabstract%3Frss%3Dyes This article deals with the effects of abnormal ventilation on the nervous system. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020820 Tue, 24 Nov 2009 14:50:24 +0100 3020820 http://www.medworm.com/index.php?rid=3020819&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386190900070X%2Fabstract%3Frss%3Dyes Cardiac evaluation as part of the assessment of neurologic presentations is very much reflective of the diligence in the pursuit of the mechanism. Newer and more aggressive techniques as part of the evaluation process can enhance the diagnostic yield. The detection and management of cardioembolic disease remains an evolutionary process. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020819 Tue, 24 Nov 2009 14:50:24 +0100 3020819 http://www.medworm.com/index.php?rid=3020818&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000589%2Fabstract%3Frss%3Dyes This article focuses on key neurologic presentations of respiratory and metabolic acid-base derangements and potentially life-threatening endocrinopathies. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020818 Tue, 24 Nov 2009 14:50:24 +0100 3020818 http://www.medworm.com/index.php?rid=3020817&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000759%2Fabstract%3Frss%3Dyes Neurology and internal medicine are two closely connected branches of medical science. In many cases, systemic diseases initially present with neurologic manifestations. Therefore, neurologists should have a thorough understanding of systemic diseases to better diagnose their neurologic complications. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020817 Tue, 24 Nov 2009 14:50:24 +0100 3020817 http://www.medworm.com/index.php?rid=3020816&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000991%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020816 Tue, 24 Nov 2009 14:50:24 +0100 3020816 http://www.medworm.com/index.php?rid=3020815&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386190900098X%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3020815 Tue, 24 Nov 2009 14:50:20 +0100 3020815 http://www.medworm.com/index.php?rid=2921971&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000760%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921971 Sat, 24 Oct 2009 13:25:57 +0100 2921971 http://www.medworm.com/index.php?rid=2921970&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000553%2Fabstract%3Frss%3Dyes This article addresses aspects of sudden unexpected death in epilepsy, reflecting on current knowledge and questions that need answers to quantify, monitor, and reduce risk. A brief overview is followed by a discussion of definitions, drug treatment, genetic susceptibility, mechanisms in relation to seizure monitoring units and supervision, with some suggestions for the way forward. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921970 Sat, 24 Oct 2009 13:25:57 +0100 2921970 http://www.medworm.com/index.php?rid=2921969&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000516%2Fabstract%3Frss%3Dyes Genetic factors play an increasingly recognized role in idiopathic epilepsies. Since 1995, positional cloning strategies in multi-generational families with autosomal dominant transmission have revealed 11 genes (KCNQ2, KCNQ3, CHRNA4, CHRNA2, CHRNB2, SCN1B, SCN1A, SCN2A, GABRG2, GABRA1, and LGI1) and numerous loci for febrile seizures and epilepsies. To date, all genes with the exception of LGI1 (leucine-rich glioma inactivated 1), encode neuronal ion channel or neurotransmitter receptor subunits. Molecular approaches have revealed great genetic heterogeneity, with the vast majority of genes remaining to be identified. One of the major challenges is now to understand phenotype–genotype correlations. This review focuses on the current knowledge on the molecular basis of these rare Mendeli... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921969 Sat, 24 Oct 2009 13:25:56 +0100 2921969 http://www.medworm.com/index.php?rid=2921968&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000486%2Fabstract%3Frss%3Dyes This article concentrates on clinical studies of DBS for epilepsy. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921968 Sat, 24 Oct 2009 13:25:56 +0100 2921968 http://www.medworm.com/index.php?rid=2921967&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000541%2Fabstract%3Frss%3Dyes Pharmacologic therapy represents the first line of treatment of epilepsy and is effective in most patients. However, about 20% to 30% of cases develop intractable seizures that cannot be controlled by medication alone. In such cases, surgical intervention is considered for therapeutic, often curative purposes. Dynamic spatiotemporal variability in the epileptic focus renders seizure localization a challenge to the clinician. Many diagnostic modalities have been developed to identify different aspects of the epileptic focus. Older techniques are being increasingly supplemented by a variety of anatomic and functional imaging modalities that can help clarify discrepancies. Invasive electroencephalography remains the gold standard for identifying epileptic foci and guiding the surgeon to succe... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921967 Sat, 24 Oct 2009 13:25:56 +0100 2921967 http://www.medworm.com/index.php?rid=2921966&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000449%2Fabstract%3Frss%3Dyes There is no single definition of pharmacoresistant (intractable, refractory) epilepsy. Prospective identification of pharmacoresistance is complicated by the variability of its appearance across different types of epilepsy and the variability of seizure control within a given patient over time. Failure of informative trials of two appropriate antiepileptic drugs has been recommended as a threshold that should trigger referral for evaluation at a comprehensive epilepsy center. Maximizing seizure control is imperative for reducing the risks and consequences of epilepsy, including the cognitive and psychiatric comorbidities and even sudden death. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921966 Sat, 24 Oct 2009 13:25:56 +0100 2921966 http://www.medworm.com/index.php?rid=2921965&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000498%2Fabstract%3Frss%3Dyes During the last few years epilepsy and pregnancy registries and other large scale observational studies have provided new information on the teratogenic effects of the most frequently used antiepileptic drugs (AEDs). The prevalence of major congenital malformations associated with exposure to carbamazepine or lamotrigine appears to be only marginally increased from the expected, while malformation rates with valproate have been reported to be 2 to 4 times higher. Recent studies also suggest that compared with carbamazepine, lamotrigine and phenytoin, exposure to valproate in utero may be associated with poorer postnatal cognitive development. However, adverse outcomes with valproate appear to be dose-related, and doses below 800-1,000 mg/day might not be associated with worse outcome than ... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921965 Sat, 24 Oct 2009 13:25:56 +0100 2921965 http://www.medworm.com/index.php?rid=2921964&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000504%2Fabstract%3Frss%3Dyes This article explores the rationale for treatment selection in adults with epilepsy. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921964 Sat, 24 Oct 2009 13:25:56 +0100 2921964 http://www.medworm.com/index.php?rid=2921963&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000565%2Fabstract%3Frss%3Dyes The interactions between hormones, epilepsy, and the medications used to treat epilepsy are complex, with tri-directional interactions which affect both men and women in various ways. Abnormalities of baseline endocrine status occur more commonly in people with epilepsy, and are most often described for the sex steroid hormone axis. Common symptoms include sexual dysfunction, decreased fertility, premature menopause, and polycystic ovarian syndrome. Antiepileptic drugs (AEDs) and hormones have a bidirectional interaction, with a decrease in the efficacy of hormonal contraceptive agents with some AEDs and a decrease in the concentration and efficacy of other AEDs with hormonal contraceptives. Endogenous hormones can influence seizure severity and frequency, resulting in catamenial patterns ... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921963 Sat, 24 Oct 2009 13:25:56 +0100 2921963 http://www.medworm.com/index.php?rid=2921962&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000450%2Fabstract%3Frss%3Dyes This article reviews the clinical evidence for seizure prediction. The epilepsy cycle is considered, including the interictal, preictal, ictal, and postictal phases. Evidence suggesting that the preictal phase can sometimes be identified based on neurophysiologic signals, premonitory features, the presence of trigger factors, or self-report is discussed. Diary studies have shown that seizures are not randomly distributed in time and that a subgroup of persons with epilepsy can predict an impending seizure. Paper diary data and preliminary analysis of electronic diary data suggest that seizure prediction is feasible. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921962 Sat, 24 Oct 2009 13:25:56 +0100 2921962 http://www.medworm.com/index.php?rid=2921961&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000474%2Fabstract%3Frss%3Dyes This article summarizes current knowledge about the etiology of PNES. Through describing the interactions of predisposing, precipitating, perpetuating, and triggering factors, an integrated biopsychosocial model of a complex disorder is developed. PNES emerge as a dissociative response to a range of different stressors in vulnerable individuals. Once established, maintaining factors turn a temporary disturbance into a chronically disabling disorder. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921961 Sat, 24 Oct 2009 13:25:56 +0100 2921961 http://www.medworm.com/index.php?rid=2921960&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000528%2Fabstract%3Frss%3Dyes A new literature is now under way, one linking cognitive abnormalities directly to indices of structural, functional, metabolic, and other neurobiologic markers of cerebral integrity, independent of their association with clinical epilepsy characteristics. These trends are reviewed in this article. The focus is on temporal lobe epilepsy (TLE) as a model with which to address the core points because this form of localization-related epilepsy has been very carefully studied from both a cognitive and imaging standpoint. Some pertinent historical issues are touched on first, followed by more detailed reviews of the cognitive and neuroimaging abnormalities that have been found in TLE, followed by an overview of studies examining direct structure-function relationships in TLE and other epilepsie... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921960 Sat, 24 Oct 2009 13:25:56 +0100 2921960 http://www.medworm.com/index.php?rid=2921959&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386190900053X%2Fabstract%3Frss%3Dyes This article reviews these data, the clinical manifestations of depressive disorders in PWE, and their significant impact on the suicidal risk and quality of life. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921959 Sat, 24 Oct 2009 13:25:56 +0100 2921959 http://www.medworm.com/index.php?rid=2921958&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000462%2Fabstract%3Frss%3Dyes This article reviews evidence of quality of life (QOL) determinants in people affected by epilepsy, including detractors and promoters. Emerging factors of particular significance for QOL are highlighted, including seizure frequency, medication side effects, psychological comorbidity, and stigma and discrimination. This article also examines the role of resilience, interpreted in its widest sense, for promoting good QOL, even in the presence of poorly controlled seizures. The importance of addressing both clinical and wider psychosocial issues is highlighted and some possible directions for future research into QOL in epilepsy are suggested. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921958 Sat, 24 Oct 2009 13:25:56 +0100 2921958 http://www.medworm.com/index.php?rid=2921957&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000735%2Fabstract%3Frss%3Dyes The diagnosis and management of patients who have epilepsy have greatly evolved over recent years. This issue of Neurologic Clinics presents state-of-the-art reviews by renowned experts of critical issues that illustrate this evolution and underscore their importance in the care of patients. The first six papers focus on the interrelationships between seizures and psychological, neuropsychological, and hormonal factors. The next five papers discuss pharmacologic treatment selection, drug resistance, approaches to localizing seizure onset, and deep brain stimulation as a possible non-pharmacological intervention. The final two papers present an update on the genetics of idiopathic epilepsies and a thought-provoking approach to sudden, unexpected death in epilepsy. (Source: Neurologic Clinic... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921957 Sat, 24 Oct 2009 13:25:55 +0100 2921957 http://www.medworm.com/index.php?rid=2921956&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000838%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921956 Sat, 24 Oct 2009 13:25:55 +0100 2921956 http://www.medworm.com/index.php?rid=2921955&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000826%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2921955 Sat, 24 Oct 2009 13:25:55 +0100 2921955 http://www.medworm.com/index.php?rid=2808957&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000395%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808957 Fri, 31 Jul 2009 23:00:00 +0100 2808957 http://www.medworm.com/index.php?rid=2808956&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000243%2Fabstract%3Frss%3Dyes Peripherally induced movement disorders may be defined as involuntary or abnormal movements triggered by trauma to the cranial or peripheral nerves or roots. Although patients often recall some history of trauma before the onset of a movement disorder, determining the true relationship of the disorder to the earlier trauma is often difficult. The pathophysiology of these disorders is reviewed. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808956 Fri, 31 Jul 2009 23:00:00 +0100 2808956 http://www.medworm.com/index.php?rid=2808955&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000279%2Fabstract%3Frss%3Dyes Psychogenic movement disorders (PMDs) represent a challenging dilemma for the treating neurologist. The terminology to classify this disorder is confusing and making the diagnosis is difficult. Once the diagnosis has been established, treatment options are limited, and the patient generally does not accept the diagnosis. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808955 Fri, 31 Jul 2009 23:00:00 +0100 2808955 http://www.medworm.com/index.php?rid=2808954&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000267%2Fabstract%3Frss%3Dyes Restless legs syndrome (RLS) affects many people. General population prevalence surveys usually range from 1% to 12%, but most European ancestry studies suggest 10%. The development of validated rating scales and standardized diagnostic criteria have vastly improved the quality of RLS treatment trials. Although multiple medications have shown outstanding efficacy, all of them are felt to provide only symptomatic relief, rather than any “curative” effect. Dopamine agonists are clearly the best investigated and probably the most effective treatments for RLS. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808954 Fri, 31 Jul 2009 23:00:00 +0100 2808954 http://www.medworm.com/index.php?rid=2808953&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000218%2Fabstract%3Frss%3Dyes Myoclonus is defined as sudden, brief, shock-like, involuntary movements caused by muscular contractions or inhibitions. Etiologic classification organizes the myoclonus disorders and provides major categories of clinical presentation. However, classifying myoclonus according to its source provides insight about its pathophysiology. The best strategy for symptomatic treatment is derived from defining the pathophysiology by way of source physiologic classification. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808953 Fri, 31 Jul 2009 23:00:00 +0100 2808953 http://www.medworm.com/index.php?rid=2808952&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000309%2Fabstract%3Frss%3Dyes Tourette syndrome (TS) is a neuro-developmental disorder of childhood that is often associated with various psychiatric morbidities. Timely diagnosis and appropriate management can significantly impact psychosocial functioning. Morbidities may be a major source of disability, and may determine ultimate prognosis, although most children will experience significant improvement or resolution of symptoms by adulthood. Additional management considerations must be made in those with TS symptoms persisting into adulthood. The mainstay of therapy remains dopamine receptor blocking drugs, but new therapies are emerging. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808952 Fri, 31 Jul 2009 23:00:00 +0100 2808952 http://www.medworm.com/index.php?rid=2808951&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000206%2Fabstract%3Frss%3Dyes Chorea is defined as a syndrome characterized by brief, abrupt involuntary movements resulting from a continuous flow of random muscle contractions. There are genetic and non-genetic causes of chorea. The most common genetic cause of chorea is Huntington's disease (HD). Non-genetic forms of chorea include vascular choreas, auto-immune choreas, metabolic and toxic choreas, and drug-induced choreas. This chapter provides an overview of clinical features, pathogenesis and management of HD, other important genetic causes of chorea, Sydenham's chorea, other autoimmune choreas and vascular choreas. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808951 Fri, 31 Jul 2009 23:00:00 +0100 2808951 http://www.medworm.com/index.php?rid=2808950&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000292%2Fabstract%3Frss%3Dyes The torsion dystonias encompass a broad collection of etiologic subtypes, often divided into primary and secondary classes. Tremendous advances have been made in uncovering the genetic basis of dystonia, including discovery of a gene causing early onset primary torsion dystonia—a GAG deletion in exon 5 of the DYT1 gene that encodes torsinA. Although the exact function of torsinA remains elusive, evidence suggests aberrant localization and interaction of mutated protein; this may result in an abnormal response to stress or interference with cytoskeletal events and the development of neuronal brain pathways. Breakthroughs include the discovery of a genetic modifier that protects against clinical expression in DYT1 dystonia and the identification of the gene causing DYT6, THAP1. The authors... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808950 Fri, 31 Jul 2009 23:00:00 +0100 2808950 http://www.medworm.com/index.php?rid=2808949&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386190900022X%2Fabstract%3Frss%3Dyes Tremor is not understood completely, and pharmacotherapy for all tremor disorders is inadequate. Fortunately, deep brain stimulation is effective for the most common and disabling tremor disorders. Our understanding of pathologic tremors has increased at an accelerating pace during the past 30 years, and this will hopefully lead to improved pharmacotherapy in the near future. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808949 Fri, 31 Jul 2009 23:00:00 +0100 2808949 http://www.medworm.com/index.php?rid=2808948&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000255%2Fabstract%3Frss%3Dyes Surgical approaches are an important consideration in the management of many movement disorders, particularly for patients refractory to medications. In this article, we review the history, pathophysiology, risks and indications for surgical treatment. Summaries of case studies, case series and clinical trials performed using deep brain stimulation are provided for Parkinson's disease, dystonia, essential tremor and other movement disorders. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808948 Fri, 31 Jul 2009 23:00:00 +0100 2808948 http://www.medworm.com/index.php?rid=2808947&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000280%2Fabstract%3Frss%3Dyes The cardinal characteristics of Parkinson disease (PD) include resting tremor, rigidity, and bradykinesia. Patients may also develop autonomic dysfunction, cognitive changes, psychiatric symptoms, sensory complaints, and sleep disturbances. The treatment of motor and non-motor symptoms of Parkinson disease is addressed in this article. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808947 Fri, 31 Jul 2009 23:00:00 +0100 2808947 http://www.medworm.com/index.php?rid=2808946&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000231%2Fabstract%3Frss%3Dyes The etiology of Parkinson disease (PD) is multifactorial and is likely to involve different causes in different patients. Several different genes have been identified as causes of familial PD, including alpha-synuclein gene mutations and multiplications, and mutations of parkin, PINK1, DJ1, and LRRK2. The biochemical consequences of these mutations have served to reinforce the relevance of the pathways to pathogenesis previously characterized, for example, mitochondrial dysfunction, oxidative stress, and protein misfolding and aggregation. The recognition that glucocerebrosidase mutations represent a significant risk factor for PD has focused attention on lysosomal function and autophagy as relevant to PD. Several environmental factors have also been shown to influence the risk for PD, alt... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808946 Fri, 31 Jul 2009 23:00:00 +0100 2808946 http://www.medworm.com/index.php?rid=2808945&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000310%2Fabstract%3Frss%3Dyes Few neurologic disorders have attracted more attention from the scientific and lay communities than Parkinson disease and related neurodegenerative diseases. Advances in basic research into mechanisms of neuronal death, physiology of the basal ganglia, and biochemistry and pharmacology are now being translated into clinical practice. Despite extraordinary therapeutic advances during the recent past, Parkinson disease continues to be among the most common causes of disability, particularly among the elderly. In this issue of Neurologic Clinics, dedicated entirely to movement disorders, two articles, one by Dr. Schapira and another by Dr. Stacy, focus on the pathogenesis and medical treatment of Parkinson disease. Dr. Kluger and colleagues provide an update on surgical treatment, particular... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808945 Fri, 31 Jul 2009 23:00:00 +0100 2808945 http://www.medworm.com/index.php?rid=2808944&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000383%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808944 Fri, 31 Jul 2009 23:00:00 +0100 2808944 http://www.medworm.com/index.php?rid=2808943&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000371%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2808943 Fri, 31 Jul 2009 23:00:00 +0100 2808943 http://www.medworm.com/index.php?rid=2651933&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000627%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651933 Thu, 30 Jul 2009 11:19:17 +0100 2651933 http://www.medworm.com/index.php?rid=2651932&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000445%2Fabstract%3Frss%3Dyes In this era of cost-consciousness and containment, it is imperative to examine not only treatment outcomes but also cost of these treatments. With improvements of in vitro fertilization outcome and continued development of less-invasive sperm retrieval methods, physicians and couples must examine all options available after surgical sterilization. Vasectomy reversal remains the gold standard of treatment; however, certain situations may be present in which sperm acquisition/in vitro fertilization may be a better option. A physician's responsibility is to present all options with the pros and cons of each, including cost, to help arrive at an informed decision. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651932 Thu, 30 Jul 2009 11:19:17 +0100 2651932 http://www.medworm.com/index.php?rid=2651931&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000512%2Fabstract%3Frss%3Dyes This article systematically reviews each of these phases of decision-making and management. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651931 Thu, 30 Jul 2009 11:19:17 +0100 2651931 http://www.medworm.com/index.php?rid=2651930&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000524%2Fabstract%3Frss%3Dyes This article details the contemporary preoperative preparation, microsurgical techniques, and postoperative care recommended for vasectomy reversal. The two-layer vasovasostomy and intussuscepted epididymovasostomy techniques are presented in detail. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651930 Thu, 30 Jul 2009 11:19:17 +0100 2651930 http://www.medworm.com/index.php?rid=2651929&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000421%2Fabstract%3Frss%3Dyes Vasectomy reversal has come a long way since the first anastomosis of the vas deferens and epididymis. Although its history is not as politically charged as that of vasectomy, the progress of reversal surgery has had its share of brilliant discoveries and missteps. In the early part of the twentieth century, vasovasostomy and vasoepididymostomy were esoteric procedures, but by the 1970s, a majority of urologists had some experience with reversal surgery. With the advent of microsurgical technique, reversal surgery has become once more a specialist's undertaking. The history of vasectomy reversal is an excellent case study in the evolution of surgery. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651929 Thu, 30 Jul 2009 11:19:17 +0100 2651929 http://www.medworm.com/index.php?rid=2651928&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000433%2Fabstract%3Frss%3Dyes This article explores why the national court system has seen a steady influx of claims alleging practitioners' failure properly to perform vasectomy or ensure sterilization and the manner in which that influx has caused physicians to reassess their methods of practicing medicine in an increasingly litigious environment and make the appropriate and necessary accommodations. Through their experiences as medical malpractice litigators and through the analysis of reported cases, national jury verdicts, and insurance claims made and paid in lawsuits arising from claims regarding the performance of vasectomy, the authors enlighten the reader as to the legal theories and hurdles applicable to such claims and the medical theories most often elucidated and litigated by the patients who bring them. ... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651928 Thu, 30 Jul 2009 11:19:17 +0100 2651928 http://www.medworm.com/index.php?rid=2651927&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000457%2Fabstract%3Frss%3Dyes This article reviews the literature surrounding each of these purported health concerns. Because the ultimate findings have important ramifications for both informed consent of vasectomy patients and for public health, the reported health risks in question should be critically evaluated. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651927 Thu, 30 Jul 2009 11:19:17 +0100 2651927 http://www.medworm.com/index.php?rid=2651926&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000500%2Fabstract%3Frss%3Dyes Vasectomy is a safe and effective procedure for permanent contraception. Vasectomy is 30 times less likely to fail and 20 times less likely to have postoperative complications than its gynecologic counterpart. Complications from vasectomy are rare and minor in nature. Immediate risks include infection, hematoma, and pain. Complications seldom lead to hospitalization or aggressive medical management. Technique is surgeon dependent; however, certain techniques, such as fascial interposition, seem to decrease rates of vasectomy failure. Despite myriad vasectomy techniques, failure rates are less than those seen with tubal ligation. Available data suggest that vasectomized men do not seem at increased risk for immune-complex diseases. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651926 Thu, 30 Jul 2009 11:19:17 +0100 2651926 http://www.medworm.com/index.php?rid=2651925&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000494%2Fabstract%3Frss%3Dyes The effectiveness of various vasectomy techniques is reviewed, with a focus on methods used for vas occlusion. Spontaneous recanalization of the vas is more common than generally recognized and is often transient. Simple ligation and excision has an unacceptably high risk for failure. Techniques that include cautery seem to have a lower risk for failure than techniques that do not include cautery. There is insufficient evidence to recommend a particular standardized cautery technique, but adding fascial interposition to cautery seems to be associated with the lowest risk for failure. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651925 Thu, 30 Jul 2009 11:19:17 +0100 2651925 http://www.medworm.com/index.php?rid=2651924&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000469%2Fabstract%3Frss%3Dyes Vasectomy remains a safe and effective method of contraception for men. Many variations in surgical technique currently are used by surgeons in the United States, each with its own benefits and drawbacks. Regardless of the surgical method used, the most important factor for successful vasectomy remains the experience and skill of the surgeon. The amount of evidence-based literature on the rationale for the different techniques for vasectomy remains limited. Careful study and innovation of vasectomy techniques will ensure that the most commonly performed urologic surgical procedure remain an excellent form of contraception in the future. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651924 Thu, 30 Jul 2009 11:19:17 +0100 2651924 http://www.medworm.com/index.php?rid=2651923&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000470%2Fabstract%3Frss%3Dyes Vasectomy is safer, simpler, less expensive, and equally as effective as female sterilization—yet it remains one of the least known and least used methods of contraception. Worldwide, an estimated 33 million of married women ages 15 to 49 (less than 3%) rely on their partner's vasectomy for contraception. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651923 Thu, 30 Jul 2009 11:19:17 +0100 2651923 http://www.medworm.com/index.php?rid=2651922&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000482%2Fabstract%3Frss%3Dyes Vasectomy as a medical term is a misnomer because only part of the vas deferens is excised during the procedure. Vas deferens as an anatomic structure was not a subject of significant clinical and research interest until the nineteenth century. It is difficult to find another surgical procedure as simple as vasectomy that has sparked so much medical and social controversies for more than a century. Vasectomy is a historical, social, philosophic, medical, demographic, and legal phenomenon. It is not surprising that the history of this procedure combines not only a constant quest for ideal technique and better results but also misconceptions, false beliefs, and erroneous indications. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651922 Thu, 30 Jul 2009 11:19:17 +0100 2651922 http://www.medworm.com/index.php?rid=2651921&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000536%2Fabstract%3Frss%3Dyes Vasectomy is a safe and effective method of contraception that should be viewed as permanent. In the United States, it is employed by nearly 11% of all married couples and is performed on approximately one-half million men each year. Thus, vasectomies are carried out more often than any other urologic surgical procedure. Worldwide, however, far fewer vasectomies are performed than female sterilizations by tubal ligation, even though vasectomy is less expensive and is associated with less morbidity and mortality than tubal ligation. This apparent underutilization of a safe procedure is caused, in part, by concerns of men and their partners. Some men fear pain and complications; others falsely equate vasectomy with castration or loss of masculinity. It is important to recognize that these mi... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651921 Thu, 30 Jul 2009 11:19:17 +0100 2651921 http://www.medworm.com/index.php?rid=2651920&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000615%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651920 Thu, 30 Jul 2009 11:19:17 +0100 2651920 http://www.medworm.com/index.php?rid=2651919&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000603%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2651919 Thu, 30 Jul 2009 11:19:17 +0100 2651919 http://www.medworm.com/index.php?rid=2393658&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000251%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393658 Fri, 01 May 2009 04:00:00 +0100 2393658 http://www.medworm.com/index.php?rid=2393657&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000032%2Fabstract%3Frss%3Dyes This article reviews the unique features, mechanism of action, safety profile, and prototypical applications of the agents most commonly used in urologic surgery. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393657 Fri, 01 May 2009 04:00:00 +0100 2393657 http://www.medworm.com/index.php?rid=2393656&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000147%2Fabstract%3Frss%3Dyes This article discusses the current state of miniature robotics and novel robotic surgical platforms and the development of future robotic technology for general surgery and urology. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393656 Fri, 01 May 2009 04:00:00 +0100 2393656 http://www.medworm.com/index.php?rid=2393655&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000111%2Fabstract%3Frss%3Dyes In this article, the authors describe the evolution of urologic robotic systems and the current state-of-the-art features and existing limitations of the da Vinci S HD System (Intuitive Surgical, Inc.). They then review promising innovations in scaling down the footprint of robotic platforms, the early experience with mobile miniaturized in vivo robots, advances in endoscopic navigation systems using augmented reality technologies and tracking devices, the emergence of technologies for robotic natural orifice transluminal endoscopic surgery and single-port surgery, advances in flexible robotics and haptics, the development of new virtual reality simulator training platforms compatible with the existing da Vinci system, and recent experiences with remote robotic surgery and telestration. (S... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393655 Fri, 01 May 2009 04:00:00 +0100 2393655 http://www.medworm.com/index.php?rid=2393654&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000123%2Fabstract%3Frss%3Dyes Laparoendoscopic single site (LESS) surgery is a recently coined term that refers to a group of techniques that perform laparoscopic intervention through a single abdominal incision often hidden within the umbilicus. The relative ease and swiftness of early success of LESS surgery is in large part because of the familiarity of current practitioners with advanced laparoscopic techniques and the advent of several technologic advances in the areas of instrumentation, camera systems, and access devices. As ongoing advancements in instrumentation and future robotics platforms are incorporated, the scope and application of LESS surgery is likely to expand. Ultimately, prospective studies that compare the safety and effectiveness of this new approach with the standard conventional laparoscopic ap... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393654 Fri, 01 May 2009 04:00:00 +0100 2393654 http://www.medworm.com/index.php?rid=2393653&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS009401430900007X%2Fabstract%3Frss%3Dyes This article focuses on advances in intraoperative imaging and tissue characterization for various urologic procedures. Each modality is presented with its corresponding applications in urology. The following techniques are covered: optical coherence tomography, confocal fluorescent microscopy, near infrared fluorescence imaging, elastography, intraoperative ultrasonography, and a neurovascular bundle surgical mapping aid. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393653 Fri, 01 May 2009 04:00:00 +0100 2393653 http://www.medworm.com/index.php?rid=2393652&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000068%2Fabstract%3Frss%3Dyes Tissue engineering efforts are currently being undertaken for every type of tissue and organ within the urinary system. Most of the effort expended to engineer genitourinary tissues has occurred within the past decade. Tissue engineering techniques require a cell culture facility designed for human application. Personnel who have mastered the techniques of cell harvest, culture, and expansion in addition to polymer design are essential for the successful application of this technology. Before these engineering techniques can be applied to humans, further studies need to be performed in many of the tissues described. Recent progress suggests that engineered urologic tissues and cell therapy may have clinical applicability. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393652 Fri, 01 May 2009 04:00:00 +0100 2393652 http://www.medworm.com/index.php?rid=2393651&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000056%2Fabstract%3Frss%3Dyes This article details laser developments in each of these areas. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393651 Fri, 01 May 2009 04:00:00 +0100 2393651 http://www.medworm.com/index.php?rid=2393650&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS009401430900010X%2Fabstract%3Frss%3Dyes This article summarizes some of the emerging applications of nanomedicine in urology. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393650 Fri, 01 May 2009 04:00:00 +0100 2393650 http://www.medworm.com/index.php?rid=2393649&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000044%2Fabstract%3Frss%3Dyes Driven by patient preference and a more favorable oncologic prognosis at diagnosis, there has been a paradigm shift in the treatment of urologic cancers. Although the standard of care for most urologic malignancies continues to be surgical extirpation, ablation, in the form of needle-based or extracorporeal approaches, is quickly establishing itself as a viable primary treatment option. If there is anything to be learned from pioneering studies, it is that there must be strict adherence to inclusion criteria for patient enrollment and that there are real limitations with each approach. It is only with this awareness that we can achieve maximal benefit while limiting the number of unnecessary complications and poor oncologic outcomes. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393649 Fri, 01 May 2009 04:00:00 +0100 2393649 http://www.medworm.com/index.php?rid=2393648&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000020%2Fabstract%3Frss%3Dyes This article describes some novel flexible robotic platforms that may enhance the capabilities of flexible endoscopy and provides a rationale for robotic technology's further development and future use. It also reviews some recent experimental and clinical usages of flexible robotic technology to perform ureterorenoscopy and to provide treatment of stones. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393648 Fri, 01 May 2009 04:00:00 +0100 2393648 http://www.medworm.com/index.php?rid=2393647&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000159%2Fabstract%3Frss%3Dyes This article presents a fair and balanced review of natural orifice translumenal endoscopic surgery. The article chronicles the history and technical aspects of natural orifice translumenal endoscopic surgery with particular emphasis on its application in urology. It is hoped that this article serves as a straightforward and pragmatic reference for practicing and academic urologists. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393647 Fri, 01 May 2009 04:00:00 +0100 2393647 http://www.medworm.com/index.php?rid=2393646&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000093%2Fabstract%3Frss%3Dyes This article focuses on the potential clinical applications of recent advances in US technology in oncologic urology. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393646 Fri, 01 May 2009 04:00:00 +0100 2393646 http://www.medworm.com/index.php?rid=2393645&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000081%2Fabstract%3Frss%3Dyes This article reviews current and emerging molecular imaging technologies relevant to urologic surgery. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393645 Fri, 01 May 2009 04:00:00 +0100 2393645 http://www.medworm.com/index.php?rid=2393644&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000135%2Fabstract%3Frss%3Dyes Computer-aided surgical navigation systems with fusion or overlaying capability, coupled with newer position tracking systems, can provide new opportunities to improve the precision of minimally invasive urology. Three-dimensional feedback of spatial position of surgical targets, and the predictive ability to guide laparoscopic dissection along the ideal surgical plane, with built-in safety checks and balances may help to lay the foundation for automated surgery in the future. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393644 Fri, 01 May 2009 04:00:00 +0100 2393644 http://www.medworm.com/index.php?rid=2393643&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000160%2Fabstract%3Frss%3Dyes Technological advances have affected the scope and practice of medicine over centuries. However, the speed and magnitude of technological change over the past few decades are unparalleled in the history of medical science. Urology, long at the forefront of innovation, evaluation, and incorporation of technology, remains at the forefront in the twenty-first century. This issue of the Urologic Clinics of North America, comprising contributions by expert innovators, is devoted to important recent technological advances likely to influence urologic practice for years to come. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393643 Fri, 01 May 2009 04:00:00 +0100 2393643 http://www.medworm.com/index.php?rid=2393642&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS009401430900024X%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393642 Fri, 01 May 2009 04:00:00 +0100 2393642 http://www.medworm.com/index.php?rid=2393641&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.urologic.theclinics.com%2Farticle%2FPIIS0094014309000238%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2393641 Fri, 01 May 2009 04:00:00 +0100 2393641 http://www.medworm.com/index.php?rid=2360906&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000140%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360906 Fri, 24 Apr 2009 14:19:49 +0100 2360906 http://www.medworm.com/index.php?rid=2360905&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386190900005X%2Fabstract%3Frss%3Dyes This article reviews “other primary headaches,” a classification of the International Headache Society that includes primary stabbing headaches, primary cough headache, primary exertional headache, primary headache associated with sexual activity, hypnic headache, primary thunderclap headache, and new daily persistent headache. Clinicians should be aware that these headaches may be symptomatic to structural lesions and therefore usually require careful neuroimaging evaluation. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360905 Fri, 24 Apr 2009 14:19:49 +0100 2360905 http://www.medworm.com/index.php?rid=2360904&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861908001783%2Fabstract%3Frss%3Dyes The trigeminal autonomic cephalalgias (TACs) are a group of primary headache syndromes all marked by headache and associated autonomic features. The TACs include cluster headache, paroxysmal hemicrania, hemicrania continua, and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing syndrome. Diagnosis is made after looking at headache frequency, duration, and accompanying symptoms. Each TAC has its own unique treatment modality, which is discussed in depth. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360904 Fri, 24 Apr 2009 14:19:49 +0100 2360904 http://www.medworm.com/index.php?rid=2360903&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861908001734%2Fabstract%3Frss%3Dyes The substantial societal and individual burdens associated with tension-type headache (TTH) constitute a previously overlooked major public health issue. TTH is prevalent, affecting up to 78% of the general population, and 3% suffer from chronic TTH. Pericranial myofascial nociception probably is important for the pathophysiology of episodic TTH, whereas sensitization of central nociceptive pathways seems responsible for the conversion of episodic to chronic TTH. Headache-related disability usually can be reduced by identification of trigger factors combined with nonpharmacologic and pharmacologic treatments, but effective treatment modalities are lacking. Benefits can be gained by development of specific and effective treatment strategies. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360903 Fri, 24 Apr 2009 14:19:48 +0100 2360903 http://www.medworm.com/index.php?rid=2360902&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861908001795%2Fabstract%3Frss%3Dyes This article reviews data supporting the association of migraine with right-to-left shunt, structural heart anomalies, cardiovascular disease, and ischemic stroke. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360902 Fri, 24 Apr 2009 14:19:48 +0100 2360902 http://www.medworm.com/index.php?rid=2360901&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000036%2Fabstract%3Frss%3Dyes Of the nearly 32 million Americans with migraine, 24 million are women. It is a disorder affecting women throughout their lifetimes, from childhood and puberty through the postmenopausal years. In childhood, before puberty girls are afflicted with migraine at approximately the same rate as boys, but after puberty, there is an emerging female predominance. Estrogen plays a key role in this epidemiologic variation but is not the only factor. There are numerous times when hormonal influences have an impact on migraine and its pattern, including menarche, oral contraceptive use, pregnancy, perimenopause, and menopause. Hence practitioners treating women with migraine need to have a clear understanding of these special considerations. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360901 Fri, 24 Apr 2009 14:19:48 +0100 2360901 http://www.medworm.com/index.php?rid=2360900&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386190800176X%2Fabstract%3Frss%3Dyes Migraine headaches are common in children and adolescents, with a wide spectrum of clinical forms. The most frequent pattern in children is migraine without aura, characterized by attacks of frontal, pounding, nauseating headache lasting 1 to 72 hours. The spectrum of migraine with aura includes migraine with typical aura, hemiplegic migraine, and basilar-type migraine, all of which may manifest during early childhood and pose challenging diagnostic dilemmas. The periodic syndromes are a fascinating subset of migraine peculiar to extremely young children, which are viewed as “precursors” to more typical migraine and can be associated with frightening focal neurologic disturbances. Migraine treatment philosophy now embraces a balanced approach with biobehavioral interventions and acute ... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360900 Fri, 24 Apr 2009 14:19:47 +0100 2360900 http://www.medworm.com/index.php?rid=2360899&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000024%2Fabstract%3Frss%3Dyes Chronic daily headache (CDH) represents a therapeutic challenge for many clinicians. Treatment strategies should be aimed at correctly identifying the presence of CDH. In addition, an effective prophylactic regimen should be initiated; the presence of medication overuse must be addressed, and the offending medication being overused must be discontinued. Aside from analgesic overuse, other modifiable risk factors associated with the development of chronic migraine and CDH must be addressed including obesity and caffeine use and the effective management of comorbid conditions such as depression, anxiety, and sleep-related breathing disorders. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360899 Fri, 24 Apr 2009 14:19:47 +0100 2360899 http://www.medworm.com/index.php?rid=2360898&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000048%2Fabstract%3Frss%3Dyes This article reviews empirically supported and efficacious behavioral approaches to the treatment and management of migraine including cognitive behavioral therapy and biobehavioral training (ie, biofeedback, relaxation training, and stress management). These techniques have demonstrated efficacy when learned and practiced correctly and may be used individually or in conjunction with pharmacologic and other interventions. Data are also reviewed regarding patient education, support groups, psychological comorbidities, modifiable risk factors for headache progression, strategies for enhancing adherence and motivation, and strategies for effective medical communication. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360898 Fri, 24 Apr 2009 14:19:46 +0100 2360898 http://www.medworm.com/index.php?rid=2360897&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861908001801%2Fabstract%3Frss%3Dyes The pharmacologic treatment of migraine may be acute (abortive) or preventive (prophylactic), and patients with frequent severe headaches often require both approaches. Preventive therapy is used to try to reduce the frequency, duration, or severity of attacks. The preventive medications with the best-documented efficacy are amitriptyline, divalproex, topiramate, and the beta-blockers. Choice is made based on a drug's proven efficacy, the physician's informed belief about medications not yet evaluated in controlled trials, the drug's adverse events, the patient's preferences and headache profile, and the presence or absence of coexisting disorders. Because comorbid medical and psychologic illnesses are prevalent in patients who have migraine, one must consider comorbidity when choosing pre... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360897 Fri, 24 Apr 2009 14:19:46 +0100 2360897 http://www.medworm.com/index.php?rid=2360896&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861908001813%2Fabstract%3Frss%3Dyes The goals of acute treatment of migraine are cost-effective rapid relief, consistent reduction of disability, and reduced use of rescue medications. Key to acute treatment is matching medication to disability as a surrogate marker for disease severity with a stratified care approach. In the absence of vascular contraindications, triptans are first-line acute treatments for disabling migraine. Acute treatment success can be assessed with use of the paper tool, Migraine-ACT. Opioids and butalbital should be avoided in acute migraine treatment. Triptan type can be selected for patients by differences in speed or effect, formulation, and formulary tier. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360896 Fri, 24 Apr 2009 14:19:45 +0100 2360896 http://www.medworm.com/index.php?rid=2360895&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861908001746%2Fabstract%3Frss%3Dyes This article evaluates the reasons for diagnostic testing and the use of neuroimaging, electroencephalography, lumbar puncture, and blood testing. The use of diagnostic testing in adults and children who have headaches and a normal neurologic examination, migraine, trigeminal autonomic cephalalgias, hemicrania continua, and new daily persistent headache are reviewed. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360895 Fri, 24 Apr 2009 14:19:45 +0100 2360895 http://www.medworm.com/index.php?rid=2360894&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861908001771%2Fabstract%3Frss%3Dyes Vestibular migraine (VM) designates recurrent attacks of vertigo that are caused by migraine. VM presents with attacks of spontaneous or positional vertigo, lasting seconds to days, accompanied by migrainous symptoms. Because headache is often absent during acute attacks, other migrainous features have to be identified by thorough history taking. In contrast, vestibular testing serves mainly for the exclusion of other diagnoses. Treatment is targeted at the underlying migraine. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360894 Fri, 24 Apr 2009 14:19:45 +0100 2360894 http://www.medworm.com/index.php?rid=2360893&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861908001758%2Fabstract%3Frss%3Dyes Neurologic symptoms are a prominent and often disturbing component of the migraine syndrome in many patients. Collectively termed “aura,” migraine-related neurologic symptoms include visual, sensory, language, and motor disturbance. They occur in about one quarter of migraine patients, are classically transient, and are thought to occur as the result of cortical phenomena. Recently, motor symptoms previously included as a type of migraine aura have been reclassified as a component of hemiplegic migraine—a distinct migraine subtype. The tendency to aura is likely to be influenced by complex genetic and perhaps epigenetic factors. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360893 Fri, 24 Apr 2009 14:19:43 +0100 2360893 http://www.medworm.com/index.php?rid=2360892&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861908001710%2Fabstract%3Frss%3Dyes Migraine is a common, disabling disorder of the central nervous system. The disorder has three key features. The tendency is largely inherited, the sufferer is sensitive to exogenous and endogenous triggers that very often involve challenges to normal homeostatic biology, and the attack phenotype, when severe, is the stereotypical migraine attack. The attack itself consists of an abnormal perception of otherwise normal circumstances, such as pain without evidence of primary nociceptive activation, and light and sound sensitivity without change in ambient stimuli. The disturbance in the brain is of the subcortical aminergic sensory modulatory systems, and probably includes brainstem, hypothalamic, and thalamic changes that produce the rich clinical presentation seen in practice. (Source: Ne... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360892 Fri, 24 Apr 2009 14:19:42 +0100 2360892 http://www.medworm.com/index.php?rid=2360891&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861908001722%2Fabstract%3Frss%3Dyes We describe the epidemiology and comorbidities of migraine, which affects 12% of adults in occidental countries. Prevalence is three times higher in women, but 6% of men are affected, making it the most prevalent neurologic disorder in men. Although migraine is a remarkably common cause of temporary disability, many migraineurs have never consulted a physician for the problem. Many disorders are comorbid with migraine. For some such as depression, the association has been well described, but for others, the relationship has been recently suggested, such as in the case of clinical and subclinical vascular brain lesions and coronary heart disease. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360891 Fri, 24 Apr 2009 14:19:41 +0100 2360891 http://www.medworm.com/index.php?rid=2360890&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000061%2Fabstract%3Frss%3Dyes This issue of Neurologic Clinics reviews migraine and other primary headaches, one of the most common disorders seen by neurologists (accounting for about 20% of the general neurologist's practice), which affects 90% of the population and is the cause of 90% of all headaches. Secondary headache disorders were reviewed in Neurologic Clinics in 2004. Primary headache manifestations vary from the most mundane to among the most interesting in all of neurology. Migraine and tension-type headaches affect huge portions of the population, at times with significant impairment, with about 35 million persons yearly having attacks in the United States. Tension-type headaches have a lifetime prevalence of up to 78%. Neurologists may be particularly interested in migraine as over 50% of neurologists the... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360890 Fri, 24 Apr 2009 14:19:39 +0100 2360890 http://www.medworm.com/index.php?rid=2360889&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000139%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360889 Fri, 24 Apr 2009 14:19:38 +0100 2360889 http://www.medworm.com/index.php?rid=2360888&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909000127%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2360888 Fri, 24 Apr 2009 14:19:37 +0100 2360888 http://www.medworm.com/index.php?rid=2279123&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289217%26dopt%3DAbstract Authors: Evans RW PMID: 19289217 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279123 Sat, 21 Mar 2009 08:43:04 +0100 2279123 http://www.medworm.com/index.php?rid=2279120&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289218%26dopt%3DAbstract We describe the epidemiology and comorbidities of migraine, which affects 12% of adults in occidental countries. Prevalence is three times higher in women, but 6% of men are affected, making it the most prevalent neurologic disorder in men. Although migraine is a remarkably common cause of temporary disability, many migraineurs have never consulted a physician for the problem. Many disorders are comorbid with migraine. For some such as depression, the association has been well described, but for others, the relationship has been recently suggested, such as in the case of clinical and subclinical vascular brain lesions and coronary heart disease. PMID: 19289218 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279120 Sat, 21 Mar 2009 08:42:52 +0100 2279120 http://www.medworm.com/index.php?rid=2279117&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289219%26dopt%3DAbstract Authors: Goadsby PJ Migraine is a common, disabling disorder of the central nervous system. The disorder has three key features. The tendency is largely inherited, the sufferer is sensitive to exogenous and endogenous triggers that very often involve challenges to normal homeostatic biology, and the attack phenotype, when severe, is the stereotypical migraine attack. The attack itself consists of an abnormal perception of otherwise normal circumstances, such as pain without evidence of primary nociceptive activation, and light and sound sensitivity without change in ambient stimuli. The disturbance in the brain is of the subcortical aminergic sensory modulatory systems, and probably includes brainstem, hypothalamic, and thalamic changes that produce the rich clinical presentation seen ... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279117 Sat, 21 Mar 2009 08:42:47 +0100 2279117 http://www.medworm.com/index.php?rid=2279114&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289220%26dopt%3DAbstract Authors: Foroozan R, Cutrer FM Neurologic symptoms are a prominent and often disturbing component of the migraine syndrome in many patients. Collectively termed "aura," migraine-related neurologic symptoms include visual, sensory, language, and motor disturbance. They occur in about one quarter of migraine patients, are classically transient, and are thought to occur as the result of cortical phenomena. Recently, motor symptoms previously included as a type of migraine aura have been reclassified as a component of hemiplegic migraine-a distinct migraine subtype. The tendency to aura is likely to be influenced by complex genetic and perhaps epigenetic factors. PMID: 19289220 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279114 Sat, 21 Mar 2009 08:42:39 +0100 2279114 http://www.medworm.com/index.php?rid=2279112&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289221%26dopt%3DAbstract Authors: Neuhauser H, Lempert T Vestibular migraine (VM) designates recurrent attacks of vertigo that are caused by migraine. VM presents with attacks of spontaneous or positional vertigo, lasting seconds to days, accompanied by migrainous symptoms. Because headache is often absent during acute attacks, other migrainous features have to be identified by thorough history taking. In contrast, vestibular testing serves mainly for the exclusion of other diagnoses. Treatment is targeted at the underlying migraine. PMID: 19289221 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279112 Sat, 21 Mar 2009 08:42:30 +0100 2279112 http://www.medworm.com/index.php?rid=2279110&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289222%26dopt%3DAbstract This article evaluates the reasons for diagnostic testing and the use of neuroimaging, electroencephalography, lumbar puncture, and blood testing. The use of diagnostic testing in adults and children who have headaches and a normal neurologic examination, migraine, trigeminal autonomic cephalalgias, hemicrania continua, and new daily persistent headache are reviewed. PMID: 19289222 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279110 Sat, 21 Mar 2009 08:42:21 +0100 2279110 http://www.medworm.com/index.php?rid=2279107&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289223%26dopt%3DAbstract Authors: Tepper SJ, Spears RC The goals of acute treatment of migraine are cost-effective rapid relief, consistent reduction of disability, and reduced use of rescue medications. Key to acute treatment is matching medication to disability as a surrogate marker for disease severity with a stratified care approach. In the absence of vascular contraindications, triptans are first-line acute treatments for disabling migraine. Acute treatment success can be assessed with use of the paper tool, Migraine-ACT. Opioids and butalbital should be avoided in acute migraine treatment. Triptan type can be selected for patients by differences in speed or effect, formulation, and formulary tier. PMID: 19289223 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279107 Sat, 21 Mar 2009 08:42:12 +0100 2279107 http://www.medworm.com/index.php?rid=2279105&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289224%26dopt%3DAbstract Authors: Silberstein SD The pharmacologic treatment of migraine may be acute (abortive) or preventive (prophylactic), and patients with frequent severe headaches often require both approaches. Preventive therapy is used to try to reduce the frequency, duration, or severity of attacks. The preventive medications with the best-documented efficacy are amitriptyline, divalproex, topiramate, and the beta-blockers. Choice is made based on a drug's proven efficacy, the physician's informed belief about medications not yet evaluated in controlled trials, the drug's adverse events, the patient's preferences and headache profile, and the presence or absence of coexisting disorders. Because comorbid medical and psychologic illnesses are prevalent in patients who have migraine, one must consider c... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279105 Sat, 21 Mar 2009 08:42:04 +0100 2279105 http://www.medworm.com/index.php?rid=2279103&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289225%26dopt%3DAbstract This article reviews empirically supported and efficacious behavioral approaches to the treatment and management of migraine including cognitive behavioral therapy and biobehavioral training (ie, biofeedback, relaxation training, and stress management). These techniques have demonstrated efficacy when learned and practiced correctly and may be used individually or in conjunction with pharmacologic and other interventions. Data are also reviewed regarding patient education, support groups, psychological comorbidities, modifiable risk factors for headache progression, strategies for enhancing adherence and motivation, and strategies for effective medical communication. PMID: 19289225 [PubMed - as supplied by publisher] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279103 Sat, 21 Mar 2009 08:41:49 +0100 2279103 http://www.medworm.com/index.php?rid=2279101&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289226%26dopt%3DAbstract Authors: Vargas BB, Dodick DW Chronic daily headache (CDH) represents a therapeutic challenge for many clinicians. Treatment strategies should be aimed at correctly identifying the presence of CDH. In addition, an effective prophylactic regimen should be initiated; the presence of medication overuse must be addressed, and the offending medication being overused must be discontinued. Aside from analgesic overuse, other modifiable risk factors associated with the development of chronic migraine and CDH must be addressed including obesity and caffeine use and the effective management of comorbid conditions such as depression, anxiety, and sleep-related breathing disorders. PMID: 19289226 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279101 Sat, 21 Mar 2009 08:41:42 +0100 2279101 http://www.medworm.com/index.php?rid=2279099&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289227%26dopt%3DAbstract Authors: Lewis DW Migraine headaches are common in children and adolescents, with a wide spectrum of clinical forms. The most frequent pattern in children is migraine without aura, characterized by attacks of frontal, pounding, nauseating headache lasting 1 to 72 hours. The spectrum of migraine with aura includes migraine with typical aura, hemiplegic migraine, and basilar-type migraine, all of which may manifest during early childhood and pose challenging diagnostic dilemmas. The periodic syndromes are a fascinating subset of migraine peculiar to extremely young children, which are viewed as "precursors" to more typical migraine and can be associated with frightening focal neurologic disturbances. Migraine treatment philosophy now embraces a balanced approach with biobehavioral interv... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279099 Sat, 21 Mar 2009 08:41:32 +0100 2279099 http://www.medworm.com/index.php?rid=2279096&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289228%26dopt%3DAbstract Authors: Lay CL, Broner SW Of the nearly 32 million Americans with migraine, 24 million are women. It is a disorder affecting women throughout their lifetimes, from childhood and puberty through the postmenopausal years. In childhood, before puberty girls are afflicted with migraine at approximately the same rate as boys, but after puberty, there is an emerging female predominance. Estrogen plays a key role in this epidemiologic variation but is not the only factor. There are numerous times when hormonal influences have an impact on migraine and its pattern, including menarche, oral contraceptive use, pregnancy, perimenopause, and menopause. Hence practitioners treating women with migraine need to have a clear understanding of these special considerations. PMID: 19289228 [PubMed - ... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279096 Sat, 21 Mar 2009 08:41:26 +0100 2279096 http://www.medworm.com/index.php?rid=2279094&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289229%26dopt%3DAbstract This article reviews data supporting the association of migraine with right-to-left shunt, structural heart anomalies, cardiovascular disease, and ischemic stroke. PMID: 19289229 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279094 Sat, 21 Mar 2009 08:41:18 +0100 2279094 http://www.medworm.com/index.php?rid=2279092&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289230%26dopt%3DAbstract Authors: Bendtsen L, Jensen R The substantial societal and individual burdens associated with tension-type headache (TTH) constitute a previously overlooked major public health issue. TTH is prevalent, affecting up to 78% of the general population, and 3% suffer from chronic TTH. Pericranial myofascial nociception probably is important for the pathophysiology of episodic TTH, whereas sensitization of central nociceptive pathways seems responsible for the conversion of episodic to chronic TTH. Headache-related disability usually can be reduced by identification of trigger factors combined with nonpharmacologic and pharmacologic treatments, but effective treatment modalities are lacking. Benefits can be gained by development of specific and effective treatment strategies. PMID: 19289... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279092 Sat, 21 Mar 2009 08:41:09 +0100 2279092 http://www.medworm.com/index.php?rid=2279089&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289231%26dopt%3DAbstract Authors: Rozen TD The trigeminal autonomic cephalalgias (TACs) are a group of primary headache syndromes all marked by headache and associated autonomic features. The TACs include cluster headache, paroxysmal hemicrania, hemicrania continua, and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing syndrome. Diagnosis is made after looking at headache frequency, duration, and accompanying symptoms. Each TAC has its own unique treatment modality, which is discussed in depth. PMID: 19289231 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279089 Sat, 21 Mar 2009 08:41:01 +0100 2279089 http://www.medworm.com/index.php?rid=2279087&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19289232%26dopt%3DAbstract This article reviews "other primary headaches," a classification of the International Headache Society that includes primary stabbing headaches, primary cough headache, primary exertional headache, primary headache associated with sexual activity, hypnic headache, primary thunderclap headache, and new daily persistent headache. Clinicians should be aware that these headaches may be symptomatic to structural lesions and therefore usually require careful neuroimaging evaluation. PMID: 19289232 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2279087 Sat, 21 Mar 2009 08:40:50 +0100 2279087 http://www.medworm.com/index.php?rid=2181435&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19205880%26dopt%3DAbstract Authors: Nogueira MI, Abbas SY, Campos LG, Allemandi W, Lawson P, Takada SH, Azmitia EC S100beta is a soluble protein released by glial cells mainly under the activation of the 5-HT1A receptor. It has been reported as a neuro-trophic and -tropic factor that promotes neurite maturation and outgrowth during development. This protein also plays a role in axonal stability and the plasticity underlying long-term potentiation in adult brains. The ability of S100beta to rapidly regulate neuronal morphology raises the interesting point of whether there are daily rhythm or gender differences in S100beta level in the brain. To answer this question, the S100beta expression in adult female and male rats, as well as in adult female CD-21 and S100beta -/- female mice, were investigated. Scintillatio... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2181435 Wed, 11 Feb 2009 05:00:00 +0100 2181435 http://www.medworm.com/index.php?rid=2016058&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055972%26dopt%3DAbstract Authors: Mechtler L PMID: 19055972 [PubMed - as supplied by publisher] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016058 Sun, 07 Dec 2008 07:11:29 +0100 2016058 http://www.medworm.com/index.php?rid=2016057&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055973%26dopt%3DAbstract Authors: Moseley ME, Liu C, Rodriguez S, Brosnan T Interest in advanced neuroimaging is growing and is certain to continue; new and faster sequences, better image quality, higher magnetic fields, and improved models of diffusion, perfusion, and functional connectivity are in constant development. The purpose of this article is to highlight recent advances in neuroimaging from two aspects: (1) those advances directly benefited by increases in field strength (increased T1, signal-to-noise ratio, magnetic susceptibility-sensitivity, and chemical shift) and how the increased signal-to-noise ratio can be used to trade off for other advantages and (2) those advances made in response to attempts to try to reduce the inherent artifacts encountered at higher field strengths (eg, reducing specif... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016057 Sun, 07 Dec 2008 07:11:26 +0100 2016057 http://www.medworm.com/index.php?rid=2016056&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055974%26dopt%3DAbstract Authors: Tran T, Ross B, Lin A In this article, we review the role of MRS in neurologic diagnosis and patient care. Technical discussion focuses on the few remaining issues, localization, spectral display, and interpretation because interesting questions surrounding this widely diverse methodology have been resolved, and a single coherent diagnostic MRS protocol can be applied worldwide on clinical MRI scanners. We provide the most diagnostically useful MRS findings and discuss what is lacking for MRS to become a valuable addition to diagnostic evaluation of neurologic problems. Finally, we muse about the still-underappreciated role of MRS as a molecular neuroimaging technique and predict steady growth of this application as hyperpolarization MR technology approaches the clinic. PM... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016056 Sun, 07 Dec 2008 07:11:19 +0100 2016056 http://www.medworm.com/index.php?rid=2016055&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055975%26dopt%3DAbstract Authors: Miletich RS This short review focuses on practical, present day, clinical application of FDG PET, a technology available to practicing neurologists for managing their patients. Indications in the disease states of dementia, neuro-oncology, epilepsy, parkinsonism, and other less common settings are reviewed. Many third-party payers currently make reimbursements based on these indications. By measuring an aspect of brain function, PET provides information that often is unobtainable from other sources, thus facilitating more rationale and cost-effective management, which can only benefit the patient, the referring physician, and the health care system as a whole. PMID: 19055975 [PubMed - as supplied by publisher] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016055 Sun, 07 Dec 2008 07:11:15 +0100 2016055 http://www.medworm.com/index.php?rid=2016054&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055976%26dopt%3DAbstract Authors: Garami Z, Alexandrov AV Transcranial Doppler (TCD) is called the "doctor's stethoscope for the brain," and the use of TCD with portable carotid and vertebral duplex scanning provides structural and physiologic imaging extension of the neurologic examination. Ultrasound expands the ability of clinicians to detect, localize, and quantify disease and to evaluate hemodynamic responses, thus providing tools for a neurovascular examination at bedside. PMID: 19055976 [PubMed - as supplied by publisher] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016054 Sun, 07 Dec 2008 07:11:11 +0100 2016054 http://www.medworm.com/index.php?rid=2016053&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055977%26dopt%3DAbstract This article discusses the therapeutic benefits of endovascular procedures for commonly encountered clinical situations in cerebrovascular disease and brain tumors and then briefly discusses the advances in interventional neuroimaging modalities. Each topic is subdivided into prevalence/natural course, techniques/interventions, summary of clinical trials, and current guidelines/recommendations from professional organizations, whenever applicable. PMID: 19055977 [PubMed - as supplied by publisher] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016053 Sun, 07 Dec 2008 07:11:08 +0100 2016053 http://www.medworm.com/index.php?rid=2016052&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055978%26dopt%3DAbstract This article addresses the common stroke problems seen in an outpatient or office setting, including transient ischemic attacks (TIAs), minor strokes and carotid stenoses. Expedited, semi-emergent evaluation and prompt appropriate treatment of acute TIAs and minor strokes reduces an otherwise significant risk for stroke. Evaluation requires good-quality neuroimaging, cardiac imaging, and cardiac monitoring. Carotid stenoses may benefit from endarterectomy or stenting procedure under specific circumstances; otherwise, medical management may be more appropriate. In the evaluation and treatment of these conditions in an office setting, stroke neurologists need to be familiar with high-quality neuroimaging to best evaluate and treat these potentially life-threatening or life-altering condition... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016052 Sun, 07 Dec 2008 07:11:01 +0100 2016052 http://www.medworm.com/index.php?rid=2016051&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055979%26dopt%3DAbstract Authors: Mechtler L Neuroimaging is now entering a more mature era, whereby we can ask sophisticated questions concerning the biologic behavior of brain tumors. Multimodality imaging (CT, MRI, PET) offers the most precise information noninvasively on tumor type and grade, guides therapeutic choices, and assesses the effects of therapy. The incorporation of functional MRI (such as diffusion-weighted imaging, diffusion tensor imaging, proton MR spectroscopy, and perfusion-weighted imaging) has allowed neuro-oncologists a window of opportunity to assess the biologic behavior of brain neoplasms. These new multimodality approaches will be routinely used preoperatively, intraoperatively, and eventually, therapeutically. PMID: 19055979 [PubMed - as supplied by publisher] (Source: Neurolog... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016051 Sun, 07 Dec 2008 07:10:49 +0100 2016051 http://www.medworm.com/index.php?rid=2016050&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055980%26dopt%3DAbstract Authors: Ali EN, Buckle GJ Since its clinical introduction in the early 1980s, MRI has transformed the practice of differential diagnosis and disease monitoring for disorders affecting the central nervous system, in particular multiple sclerosis and the allied inflammatory demyelinating diseases. Widespread and dynamic inflammatory processes of the white matter that were largely invisible by CT scanning now are rendered in exquisite detail by conventional MRI, and newer techniques are providing a wealth of information regarding axonal degeneration and functional adaptation. Overuse and over-reliance on MRI by clinicians sometimes can occur, and careful interpretation and clinical judgment remain essential in the care of multiple sclerosis. PMID: 19055980 [PubMed - as supplied by pu... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016050 Sun, 07 Dec 2008 07:10:34 +0100 2016050 http://www.medworm.com/index.php?rid=2016049&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055981%26dopt%3DAbstract Authors: Schmidt R, Havas D, Ropele S, Enzinger C, Fazekas F With cognitive disorders increasingly common, clinicians urgently need faster and more accurate tools to classify such disorders and to noninvasively monitor therapeutic interventions. In this review, we provide information on MRI techniques that enable the study of the morphology, neuronal integrity, and metabolism of dementing illnesses. In addition, we explore the usefulness of such techniques as surrogate markers of these diseases. PMID: 19055981 [PubMed - as supplied by publisher] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016049 Sun, 07 Dec 2008 07:10:23 +0100 2016049 http://www.medworm.com/index.php?rid=2016048&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055982%26dopt%3DAbstract Authors: Capote HA Psychiatric neuroimaging has made great strides. PET scanning to differentiate between the dementias is clinically useful and well accepted. Understanding of the pathophysiology underlying the psychopathology of psychiatric illness also is rapidly expanding. Neuroimaging quickly is becoming an indispensable part of the day-to-day clinical management of psychiatric patients. PMID: 19055982 [PubMed - as supplied by publisher] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016048 Sun, 07 Dec 2008 07:10:10 +0100 2016048 http://www.medworm.com/index.php?rid=2016047&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055983%26dopt%3DAbstract This article provides guidance to neurologists as to when to suspect an orbital pathology and for appropriate investigative imaging. In achieving this goal, neurologically relevant anatomic structures of the orbit are discussed first. Second, some of the orbital imaging modalities are detailed, concentrating on MRI. Third, symptoms and signs that should prompt neurologists to request imaging study of the orbit are considered. Fourth, typical imaging findings in some of the most frequent neurologic diseases affecting the orbit are described, where imaging has diagnostic value. PMID: 19055983 [PubMed - as supplied by publisher] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016047 Sun, 07 Dec 2008 07:09:58 +0100 2016047 http://www.medworm.com/index.php?rid=2016046&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19055984%26dopt%3DAbstract This article provides clinical neurologists with an overview of pediatric neuroimaging. Pediatric neuroimaging is a broad subject, and its details are beyond the scope of any short review article. First this article briefly highlights different stages of brain development and explains how these stages correlate with various congenital brain anomalies. It then focuses on the safety of pediatric neuroimaging, discussing important issues in pediatric sedation and hazards of exposure of ionizing radiation. Last, it describes the advent of modern neuroimaging tools, such as diffusion tensor imaging and MR spectroscopy, and their emerging role in evaluating multiple pediatric brain disorders. PMID: 19055984 [PubMed - as supplied by publisher] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=2016046 Sun, 07 Dec 2008 07:09:40 +0100 2016046 http://www.medworm.com/index.php?rid=1989349&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026894%26dopt%3DAbstract Authors: Ruland SD, Gorelick PB PMID: 19026894 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989349 Sat, 01 Nov 2008 04:00:00 +0100 1989349 http://www.medworm.com/index.php?rid=1989348&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026895%26dopt%3DAbstract Authors: Grysiewicz RA, Thomas K, Pandey DK The epidemiology of ischemic and hemorrhagic stroke is an ongoing exploration to identify risk factors that continue to expand with the advent of technological advancements and preventative medical practices. Identification of risk factors that can or cannot be modified is a crucial step in determining stroke risk. Many of the modifiable risk factors are well established, and specific interventions to reduce stroke risk have been established. Some risk factors are less established, and intervention to reduce risk is yet to be determined by evidence-based medicine. Data from ongoing randomized clinical trials continue to enhance our ability to prevent a first stroke. PMID: 19026895 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989348 Sat, 01 Nov 2008 04:00:00 +0100 1989348 http://www.medworm.com/index.php?rid=1989347&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026896%26dopt%3DAbstract Authors: Thulborn KR Cerebrovascular disease is a heterogeneous disease that may require objective criteria for developing optimal recurrent stroke prevention strategies. MRI and magnetic resonance angiography together with magnetic resonance perfusion and functional MRI provide sufficient parameters to tailor medical and surgical interventions for each patient and to monitor disease compensation or progression. These MRI procedures are demonstrated by clinical cases of advanced cerebrovascular pathology in which treatment varied from medical management to surgical intervention. PMID: 19026896 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989347 Sat, 01 Nov 2008 04:00:00 +0100 1989347 http://www.medworm.com/index.php?rid=1989346&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026897%26dopt%3DAbstract Authors: Gorelick AR, Gorelick PB, Sloan EP The emergency department (ED) is the entry point into the health care system for many stroke victims. Rapid evaluation, diagnosis and treatment of stroke in the prehospital setting as well as the ED are integral to preventing morbidity and mortality. In some centers, emergency medicine physicians are the health care professionals most often able to provide thrombolytic therapy to stroke patients during the brief three-hour window for this therapy. An organized ED approach including implementing stroke care pathways and collaborating with specialized stroke teams in the ED enhance the ability to identify and manage stroke patients effectively. This approach has the potential to improve outcomes on a large scale. PMID: 19026897 [PubMed - in... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989346 Sat, 01 Nov 2008 04:00:00 +0100 1989346 http://www.medworm.com/index.php?rid=1989345&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026898%26dopt%3DAbstract This article discusses established and emerging therapies for acute ischemic stroke. In addition to thrombolysis, acute treatment with antiplatelet agents and other medications and neuroprotection are reviewed. The general medical management of acute ischemic stroke patients is also reviewed. PMID: 19026898 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989345 Sat, 01 Nov 2008 04:00:00 +0100 1989345 http://www.medworm.com/index.php?rid=1989344&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026899%26dopt%3DAbstract This article reviews the pathophysiology and general medical management principles of spontaneous intracerebral hemorrhage, including the acute management of elevated blood pressure and management of anticoagulant-associated intracerebral hemorrhage. PMID: 19026899 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989344 Sat, 01 Nov 2008 04:00:00 +0100 1989344 http://www.medworm.com/index.php?rid=1989343&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026900%26dopt%3DAbstract This report briefly reviews the various subtypes of hemorrhagic stroke, considers the indications for surgery, and discusses specific surgical treatment options. PMID: 19026900 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989343 Sat, 01 Nov 2008 04:00:00 +0100 1989343 http://www.medworm.com/index.php?rid=1989342&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026901%26dopt%3DAbstract This article provides an overview on the management of risk factors to prevent primary strokes, the gaps in successful management, and future directions for the research and management of stroke risk factors. The major focus is given to the management of modifiable risk factors for stroke, including hypertension, diabetes, dyslipidemia, atrial fibrillation and other cardiac conditions, carotid artery stenosis, smoking, poor diet, physical inactivity, and obesity. A brief discussion on the management of potentially modifiable risk factors, such as alcohol and drug abuse, sleep apnea, and hyperhomocysteinemia, is included, as is the use of antiplatelet therapy in primary stroke prevention. Finally, prognostic scores to assess an individual risk for a first stroke are reviewed. PMID: 1902... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989342 Sat, 01 Nov 2008 04:00:00 +0100 1989342 http://www.medworm.com/index.php?rid=1989341&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026902%26dopt%3DAbstract This article discusses antithrombotic treatment for ischemic stroke prevention, placing major emphasis on the indications for and administration of antiplatelet therapy. PMID: 19026902 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989341 Sat, 01 Nov 2008 04:00:00 +0100 1989341 http://www.medworm.com/index.php?rid=1989340&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026903%26dopt%3DAbstract Authors: Rothwell PM Recent research helped to identify which patients are likely to benefit most from carotid endarterectomy and when the intervention is most effective in patients with symptomatic stenosis. Individual risk modeling is useful in selecting patients for endarterectomy for symptomatic stenosis, although timely surgery and optimal medical treatment are of equal importance. Long-term benefit from endarterectomy for asymptomatic carotid stenosis is limited, and further research is required to identify individuals with asymptomatic stenosis who have the most to gain from surgery. PMID: 19026903 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989340 Sat, 01 Nov 2008 04:00:00 +0100 1989340 http://www.medworm.com/index.php?rid=1989339&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026904%26dopt%3DAbstract Authors: Bashir Q, Badruddin A, Aletich V The endovascular treatment of cerebral aneurysms has been shown to be a safe and effective treatment alternative to surgical management. Technologic advances in coil design, stents, and liquid embolic agents may revolutionize such treatment. Cerebral arteriovenous malformation obliteration rates have increased with the advent of newer embolic agents and devices but complications exist, related to the angioarchitecture of the arteriovenous malformations, the types of agents used, and operator experience. Therefore, a multidisciplinary approach with combination therapy should be used. As for understanding the natural history of intracranial atherosclerosis disease, it is to be hoped that the results of recently launched and future randomized clin... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989339 Sat, 01 Nov 2008 04:00:00 +0100 1989339 http://www.medworm.com/index.php?rid=1989338&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026905%26dopt%3DAbstract Authors: Freeman WD, Aguilar MI The frequency of cardioembolic stroke is expected to rise as the general population ages. Much of the increase may be attributed to atrial fibrillation, the most common cause of cardioembolic stroke and one that plays a substantial role in aging adults. Other sources of cardioembolic stroke may include ventricular thrombus from myocardial infarction, heart failure, structural heart defects such as patent foramen ovale (PFO), atrial septal aneurysm, proximal aortic atheroma, valvular heart disease, and endocarditis. Diagnostic studies, such as neuroimaging, ECG, and echocardiography, are helpful in uncovering cardioembolic sources of stroke. Medical therapy is predicated on the underlying mechanism. For example, warfarin may be indicated in certain patien... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989338 Sat, 01 Nov 2008 04:00:00 +0100 1989338 http://www.medworm.com/index.php?rid=1989337&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026906%26dopt%3DAbstract Authors: Bushnell CD Women have a one in five chance of having a stroke during their lifetime. Although the majority of strokes occur in the oldest age groups, younger women have unique risks during their childbearing years because of pregnancy, preeclampsia, and the use of oral contraceptives. Fortunately, the absolute risk of stroke in these young women is low, but a history of preeclampsia during pregnancy or postpartum may be an indication of risk that carries over into later years after childbearing. In addition, menopause represents a risk because of the potential for increasing blood pressure, low-density lipoprotein cholesterol, abdominal obesity, insulin resistance, and decreasing high-density lipoprotein cholesterol. Early identification of stroke risk in women will help to m... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989337 Sat, 01 Nov 2008 04:00:00 +0100 1989337 http://www.medworm.com/index.php?rid=1989336&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026907%26dopt%3DAbstract Authors: Trimble B, Morgenstern LB Minorities in the United States have higher stroke risks, stroke occurrence at an earlier age, and for some groups, more severe strokes than non-Hispanic whites. Factors contributing to these disparities are explored. Characteristics of African American, Hispanic, and Native American stroke risk and incidence are reviewed. The authors describe recent interventions to raise the awareness of stroke risk factors and symptoms in minorities. The importance of the problem is highlighted, and the authors suggest ways that stroke in minorities may be reduced. PMID: 19026907 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989336 Sat, 01 Nov 2008 04:00:00 +0100 1989336 http://www.medworm.com/index.php?rid=1989335&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19026908%26dopt%3DAbstract This article provides a summary of quality improvement initiatives, including those relating to hospitals, the system of care delivery infrastructure, and legislative efforts in the United States and in various countries outside of the United States. Through quality improvement initiatives, it is projected that stroke outcomes may improve and the economic burden of stroke may be reduced. PMID: 19026908 [PubMed - in process] (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=1989335 Sat, 01 Nov 2008 04:00:00 +0100 1989335