Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Sep 2009
Randomized Controlled TrialEfficacy and safety of two 5 day insulin dosing regimens to achieve strict glycaemic control in patients with acute ischaemic stroke.
In patients with acute ischaemic stroke and hyperglycaemia, prolonged strict glycaemic control may improve clinical outcome. The question is how to achieve this prolonged strict glycaemic control. In this study, the efficacy and safety of two regimens with different basal to meal related insulin ratio are described. ⋯ In intermittently fed ischaemic stroke patients, strict glycaemic control between day 2 and day 5 with two different basal bolus regimens did not result in lower glucose profiles due to postprandial hyperglycaemia. Continuous enteral feeding may therefore be needed to achieve prolonged strict glycaemic control in acute stroke patients.
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J. Neurol. Neurosurg. Psychiatr. · Sep 2009
Review Meta AnalysisCSF phosphorylated tau in the diagnosis and prognosis of mild cognitive impairment and Alzheimer's disease: a meta-analysis of 51 studies.
To evaluate the accuracy and clinical utility of phosphorylated tau (p-tau) for the diagnosis and prognosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI). ⋯ CSF p-tau is a good diagnostic biomarker of probable AD, a satisfactory diagnostic biomarker of MCI, a satisfactory prognostic biomarker for progression of MCI but was less adequate in separating AD from other dementias.
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J. Neurol. Neurosurg. Psychiatr. · Sep 2009
Randomized Controlled TrialPilot randomised controlled trial of occupational therapy to optimise independence in Parkinson's disease: the PD OT trial.
To perform a pilot trial of occupational therapy (OT) to optimise functional independence in Parkinson disease (PD) to assess accrual/withdrawal rates, acceptability, outcome measures, and inform sample-size calculation. ⋯ Randomisation to a trial of OT in PD is feasible. NEADL and PDQ-39 are relevant outcomes and provided data to inform sample size for an adequately powered randomised trial for which there is pressing need.
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J. Neurol. Neurosurg. Psychiatr. · Sep 2009
Frequency and predictors for the risk of stroke recurrence up to 10 years after stroke: the South London Stroke Register.
Data estimating the risk of, and predictors for, long-term stroke recurrence are lacking. ⋯ Very-long-term risk of stroke recurrence is substantial. Different predictors for stroke recurrence were identified throughout the follow-up period. Risk factors prior to initial stroke have a significant role in predicting stroke recurrence up to 10 years.
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J. Neurol. Neurosurg. Psychiatr. · Sep 2009
Therapeutic efficacy of unilateral subthalamotomy in Parkinson's disease: results in 89 patients followed for up to 36 months.
Stereotactic thermocoagulative lesions of the subthalamic nucleus (STN) have been shown to induce significant motor improvement in patients with Parkinson's disease (PD). ⋯ Unilateral subthalamotomy was associated with significant and sustained motor benefit contralateral to the lesion. Further work is needed to ascertain what factors led to severe, persistent chorea-ballism in a subset of patients. Subthalamotomy may be considered an option in circumstances when deep brain stimulation is not viable.