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April 2008 Briefing - Neurology

Here are what the editors at HealthDay consider to be the most important developments in Neurology for April 2008. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Blood Substitutes May Raise Risk of Heart Attack, Death

TUESDAY, April 29 (HealthDay News) -- Using hemoglobin-based blood substitutes increases the risk of death by 30 percent and the risk of myocardial infarction by 2.7 times, according to a report published online April 28 in the Journal of the American Medical Association.

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Receptors Increase in Brain of Mouse Stroke Model

TUESDAY, April 29 (HealthDay News) -- The expression of mineralocorticoid receptors increases in the brain in a mouse model of non-fatal stroke, and a drug that blocks the receptor is neuroprotective, according to study findings published online April 24 in Endocrinology.

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Physicians Lack Feedback on Accuracy of Diagnoses

TUESDAY, April 29 (HealthDay News) -- Clinical diagnosis is a largely open-loop system in which there is no systematic way for clinicians to obtain feedback on the outcome of their diagnoses, according to an article published in a supplement to the May issue of The American Journal of Medicine.

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Phenytoin Accelerates Bone Loss in Premenopausal Women

TUESDAY, April 29 (HealthDay News) -- In premenopausal women with epilepsy, phenytoin monotherapy is associated with a significant loss of bone mineral density over a one-year period, according to the results of a study published in the April 29 issue of Neurology.

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Endocannabinoid Pathway Activated by Nerve Agents

TUESDAY, April 29 (HealthDay News) -- Organophosphorus nerve agents augment the endocannabinoid pathway in the brain, resulting in clinical effects such as that caused by the exogenous cannabinoid, marijuana. Selective activation of this pathway could be used to obtain desirable therapeutic effects such as analgesia, while avoiding unwanted side effects such as hypomotility and cognitive dysfunction, according to research findings published online April 27 in Nature Chemical Biology.

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Hormone Therapy Increases Stroke Risk Despite Timing

TUESDAY, April 29 (HealthDay News) -- In postmenopausal women, hormone therapy is associated with a significantly increased risk of stroke regardless of the type of regimen or the timing of therapy initiation, according to a report published in the April 28 issue of the Archives of Internal Medicine.

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Palliative Care Can Improve Patient Care Most, Poll Finds

MONDAY, April 28 (HealthDay News) -- In an international poll conducted by BMJ to determine which area of health care would enable doctors to make the greatest difference to patients, palliative care for non-malignant disease received the most votes, the BMJ Group announced at the International Forum on Quality and Safety in Health Care in Paris this week.

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Triglycerides May Explain Cognition Problems in Obesity

FRIDAY, April 25 (HealthDay News) -- Experiments with mice suggest that triglycerides play a major role in obesity-related cognitive disturbance and that lowering triglycerides can improve such impairment, according to research published in the May issue of Endocrinology.

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Tethered Inhibitor More Effective for Alzheimer's

FRIDAY, April 25 (HealthDay News) -- An inhibitor of an Alzheimer's disease target that is tethered to the cell membrane is more effective than the free inhibitor, and the approach could be used to design more effective inhibitors, according to a study in the April 25 issue of Science.

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Wealth Can Predict Stroke Among Middle-Aged

FRIDAY, April 25 (HealthDay News) -- Among people aged 50 to 64, wealth is an independent predictor of stroke, but it cannot be used to predict stroke among the elderly, according to a study published online April 24 in Stroke.

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Protein State Affects Behavior of Alzheimer's Protein

THURSDAY, April 24 (HealthDay News) -- In neurodegenerative diseases such as Alzheimer's disease that involve abnormalities in the tau protein (tauopathies), a tau-regulating protein has opposite effects on tauopathy in mice depending on whether the tau is normal or mutant, according to a study published online April 22 in The Journal of Clinical Investigation.

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Endoscopic Lumbar Discectomy Safe and Effective

THURSDAY, April 24 (HealthDay News) -- Full-endoscopic interlaminar and transforaminal lumbar discectomy produces results similar to those of conventional microsurgery without the same risk of damage due to trauma, according to a study published in the April 20 issue of Spine.

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Spinal Fracture Outcome Same With or Without Surgery

THURSDAY, April 24 (HealthDay News) -- Over the medium to long term, operative and nonoperative treatment for traumatic thoracic and lumbar spinal fractures result in similar overall outcomes, according to a study published in the April 20 issue of Spine.

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Magnetic Resonance Images of Herniated Disc Reliable

THURSDAY, April 24 (HealthDay News) -- Readers of magnetic resonance images of intervertebral disc herniation are able to accurately and reliably assess disc morphology, according to a study published in the April 20 issue of Spine.

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Chemotherapy Drug Damages Mouse Central Nervous System

TUESDAY, April 22 (HealthDay News) -- The chemotherapeutic drug 5-fluorouracil causes acute and delayed damage to progenitor cells and myelin in the mouse central nervous system (CNS), which may explain the cognitive problems experienced by some cancer patients, according to a study published online April 22 in the Journal of Biology.

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Migraine Sufferers Are Most At Risk for Allodynia

TUESDAY, April 22 (HealthDay News) -- Cutaneous allodynia is more common in people who have migraine headaches than it is among people with other types of severe or chronic headaches, according to a study published in the April 22 issue of Neurology.

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Cesarean is Independent Risk Factor for Postpartum Stroke

MONDAY, April 21 (HealthDay News) -- Women who undergo cesarean delivery have a higher risk of postpartum stroke than those who deliver vaginally, according to research published in the April issue of the American Journal of Obstetrics & Gynecology.

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Epilepsy's Effect on Brain Aging Poorly Understood

MONDAY, April 21 (HealthDay News) -- Although there is a paucity of data examining the effect of chronic epilepsy on cognitive and brain aging, available evidence suggests that individuals with chronic epilepsy may be at increased risk for dementia, according to an article published in the current issue of Epilepsia.

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Vioxx Court Documents Show Minimized Mortality Risk

TUESDAY, April 15 (HealthDay News) -- Court documents related to Vioxx (rofecoxib) litigation and published clinical trials have shown that Merck minimized mortality risk and often recruited academically affiliated investigators as first authors even though the manuscripts were written by Merck employees, according to two studies published in the April 16 issue of the Journal of the American Medical Association.

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Single Question Can Help Evaluate Over-Sleepy Patients

TUESDAY, April 15 (HealthDay News) -- Asking patients to rate their daytime sleepiness on a scale from zero (none) to 10 (high) is an effective screening tool that can be easily implemented in a non-specialist setting, researchers report in the April 15 issue of the Journal of Clinical Sleep Medicine.

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Higher Pulse Pressure Linked to Lower Headache Risk

TUESDAY, April 15 (HealthDay News) -- A study investigating the association between blood pressure and headache reports that a high pulse pressure appears to protect against both migraine and non-migraine headaches. The research is published in the April 15 issue of Neurology.

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Mutations Linked to Higher Parkinson's Disease Risk

MONDAY, April 14 (HealthDay News) -- Relatives of early-onset Parkinson's disease patients who carry a mutation in the Parkin gene have a significantly higher risk of developing the disease before 65 years of age, according to study findings published in the April issue of the Archives of Neurology.

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Individualized Health Care Budgets Improve Care

FRIDAY, April 11 (HealthDay News) -- The U.K.'s National Health Service (NHS) should allow patients individual control of their health care budgets, an approach that has been shown in pilot studies to improve outcomes and patient satisfaction in a cost-effective manner, according to an analysis published April 12 in BMJ.

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Lumbar Decompression Doesn't Lead to Weight Loss

THURSDAY, April 10 (HealthDay News) -- After successful lumbar decompression surgery, most overweight and obese patients either maintain or gain body weight despite significant improvements in physical function and symptoms such as neurogenic claudication, according to a study published in the April issue of the Journal of Bone & Joint Surgery.

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Impaired Insulin Secretion Increases Alzheimer's Risk

THURSDAY, April 10 (HealthDay News) -- An impaired insulin response at 50 years of age is associated with an increased risk of developing Alzheimer's disease, according to research published online April 9 in Neurology.

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Surgical Technique Prevents Nerve Pain After Back Surgery

THURSDAY, April 10 (HealthDay News) -- Postoperative nerve pain after posterior lumbar interbody fusion surgery (PLIF) can be prevented with careful surgical technique, according to an article published in the March/April issue of the Spine Journal.

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Intake of Eggs Has No Impact on Cardiovascular Risk

THURSDAY, April 10 (HealthDay News) -- Although eggs are a significant source of dietary cholesterol, altering intake of eggs does not seem to have any impact on the risk of cardiovascular disease, according to the results of a study published in the April issue of the American Journal of Clinical Nutrition.

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Consider Health Literacy Level When Writing for Patients

THURSDAY, April 10 (HealthDay News) -- Giving patients clearly written educational materials that convey key messages without resorting to jargon is an important part of engaging patient compliance with treatment and can contribute to health literacy, according to an article published in the April issue of Chest.

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Carotid Stenosis Treatments Similar in High-Risk Patients

WEDNESDAY, April 9 (HealthDay News) -- Carotid artery stenting with an emboli-protection device and carotid endarterectomy result in similar three-year outcomes in high-risk patients with carotid artery stenosis, according to research published April 10 in the New England Journal of Medicine.

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Corticosteroid Use Questioned in Nerve Root Infiltration

WEDNESDAY, April 9 (HealthDay News) -- In the non-surgical treatment of lumbar disc herniation with nerve root infiltration, corticosteroids show no additional benefit when combined with a local anesthetic, according to the results of an animal study published in the April issue of Spine.

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Doctors Vote on the Ways to Make Biggest Difference

WEDNESDAY, April 9 (HealthDay News) -- The BMJ has begun accepting votes on which areas of health care allow doctors to make the biggest difference to patient care, with a shortlist of six areas each being championed by eminent doctors and researchers. The winning topic will gain special coverage in the BMJ and the BMJ Group's 24 other specialist journals and online education products.

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Parkinson's Tissue Transplant Shows Signs of Disease

WEDNESDAY, April 9 (HealthDay News) -- The embryonic stem cell graft received by a woman with Parkinson's disease 14 years ago shows characteristic signs of the disease, suggesting that the graft is as susceptible as the host neurons to the disease process, according to a report published online April 6 in Nature Medicine.

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Depressive Symptoms Not Linked to Alzheimer's Risk

TUESDAY, April 8 (HealthDay News) -- Elderly individuals with depressive symptoms or with no increase in depressive symptoms do not have an increased risk of developing Alzheimer's disease, although those with a history of depression are at increased risk, researchers report in two studies published in the Archives of General Psychiatry and Neurology in April.

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Blood Pressure Lowering in Hemorrhagic Stroke Studied

TUESDAY, April 8 (HealthDay News) -- Early intensive blood pressure-lowering therapy in patients with acute intracerebral hemorrhage appears safe and may decrease hematoma size, but more research is needed to see if this strategy improves outcomes, according to research published online April 7 in The Lancet Neurology.

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Caffeine May Protect Blood Brain Barrier in Alzheimer's

MONDAY, April 7 (HealthDay News) -- Chronic caffeine ingestion appears to protect against disruptions in the blood brain barrier caused by a cholesterol-enriched diet in rabbits, suggesting that caffeine might be useful in Alzheimer's disease and other disorders characterized by breakdown of the blood brain barrier, according to research published April 3 in the Journal of Neuroinflammation.

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Prematurity, Income Loss Studied in Relation to Autism

FRIDAY, April 4 (HealthDay News) -- A sample of toddlers who were born extremely prematurely had a high prevalence of autism spectrum behaviors, and families of children with autism tend to face a substantial loss of household income, according to two studies published in the April 1 issue of Pediatrics.

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FDA: Safety Warning Issued for Influenza Drug Relenza

THURSDAY, April 3 (HealthDay News) -- The maker of the antiviral drug Relenza (zanamivir) informed health care professionals this week of a potential risk of behavioral changes and delirium associated with the drug's use. Relenza is approved for the treatment of influenza A and B.

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Cerebral Microbleeds Prevalent in Older Adults

TUESDAY, April 1 (HealthDay News) -- In older adults, the prevalence of cerebral microbleeds may be significantly higher than commonly believed and risk factors vary according to microbleed location, according to study findings published in the April 1 issue of Neurology.

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CDC: Atlas Shows Geographic Variation in U.S. Strokes

TUESDAY, April 1 (HealthDay News) -- Among Medicare beneficiaries, blacks and individuals residing in certain parts of the southeastern United States are those most likely to be hospitalized for stroke, according to a report released March 28 by the U.S. Centers for Disease Control and Prevention in collaboration with the Centers for Medicare and Medicaid Services.

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Physician's Briefing