Neurology India
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To assess the risk of perioperative stroke on in-hospital morbidity and mortality following combined coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA). ⋯ A strong association was found to exist between perioperative stroke and in-hospital mortality and morbidity after combined CABG and CEA. CEA procedures are thought to mitigate the high stroke rate of 3-5% post-CABG, but our study found that combined procedures exhibit a similar stroke risk undercutting their effectiveness. Further investigative studies on combined CABG+CEA are needed to assess risk-stratification for better patient selection and examine other preventative strategies to minimize the risk of ischemic strokes.
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Letter Case Reports
Unexpected cause of leg pain in a patient with lower back pain.
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Randomized Controlled Trial
A randomized placebo-controlled trial of progesterone with or without hypothermia in patients with acute severe traumatic brain injury.
Among newer neuroprotectant modalities, hypothermia and progesterone have shown a beneficial role in preliminary studies enrolling patients with severe traumatic brain injury (sTBI). The primary objective of this study was to evaluate the efficacy of progesterone with or without prophylactic hypothermia in acute sTBI patients. ⋯ A strong evidence for prophylactic hypothermia and a weak evidence for progesterone therapy was observed for a better primary outcome at 6 months as compared to the placebo. A similar trend was observed at a 1-year follow-up. Contrary to our hypothesis, prophylactic hypothermia therapy suppressed the beneficial effects of progesterone therapy in sTBI patients. The complex cascades of factors responsible for such interactions are still unknown and need to be further determined.
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Diffusion tensor imaging (DTI) allows for noninvasive, in vivo visualization of white matter fiber tracts in the central nervous system by measuring the diffusion of water molecules. It provides both quantitative and qualitative (i.e., tractography) means to describe a region-of-interest. ⋯ Although structural magnetic resonance imaging (MRI) has long been the gold standard for noninvasive imaging of soft tissues, DTI provides additional tissue characteristics not found in the conventional MRI. We place emphasis on the unique characteristics of DTI, its potential value as an adjunct imaging modality, and its impact on clinical practice.
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Multicenter Study
Bilateral anterior capsulotomy for patients with refractory obsessive-compulsive disorder: A multicenter, long-term, follow-up study.
The objectives of this retrospective study were to analyze the short-term and long-term effects and complications of stereotactic anterior capsulotomy for patients with refractory obsessive-compulsive disorder (OCD). The advantages and disadvantages of stereotactic anterior capsulotomy have been discussed. ⋯ Using MRI guidance, stereotactic treatment of refractory OCD via bilateral anterior internal capsulotomy significantly improved several OCD symptoms such as compulsive behavior, depression, and anxiety. In addition, the assessment of the effects and complications of this treatment was most accurate at 6 months postoperatively.