Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Nov 2016
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of the diagnostic utility of physician-diagnosed with algorithm-defined stroke-associated pneumonia.
Diagnosing stroke-associated pneumonia (SAP) is challenging and may result in inappropriate antibiotic use or confound research outcomes. This study evaluates the diagnostic accuracy of algorithm-defined versus physician-diagnosed SAP in 1088 patients who had dysphagic acute stroke from 37 UK stroke units between 21 April 2008 and 17 May 2014. ⋯ Algorithm-based approaches can standardise SAP diagnosis for clinical practice and research.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2016
Statins are underused in recent-onset Parkinson's disease with increased vascular risk: findings from the UK Tracking Parkinson's and Oxford Parkinson's Disease Centre (OPDC) discovery cohorts.
Cardiovascular disease (CVD) influences phenotypic variation in Parkinson's disease (PD), and is usually an indication for statin therapy. It is less clear whether cardiovascular risk factors influence PD phenotype, and if statins are prescribed appropriately. ⋯ Over 60% of recent-onset PD patients have high or medium cardiovascular risk (meriting statin usage), which is associated with a worse motor and cognitive phenotype. Statins are underused in these patients, compared with those with vascular disease, which is a missed opportunity for preventive treatment.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2016
Influence of cigarette smoking on ALS outcome: a population-based study.
To assess the prognostic influence of premorbid smoking habits and vascular risk profile on amyotrophic lateral sclerosis (ALS) phenotype and outcome in a population-based cohort of Italian patients. ⋯ This study has demonstrated in a large population-based cohort of patients with ALS that cigarette smoking is an independent negative prognostic factor for survival, with a dose-response gradient. Its effect is not related to the presence of COPD or to respiratory status at time of diagnosis. The understanding of the mechanisms, either genetic or epigenetic, through which exogenous factors influence disease phenotype is of major importance towards a more focused approach to cure ALS.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2016
Randomized Controlled Trial Multicenter Study Comparative Study Pragmatic Clinical TrialPeer support and reminiscence therapy for people with dementia and their family carers: a factorial pragmatic randomised trial.
The objective of this study was to evaluate peer support and reminiscence therapy, separately and together, in comparison with usual care for people with dementia and their family carers. ⋯ There is no evidence from the trial that either peer support or reminiscence is effective in improving the quality of life.