Acta neurologica Scandinavica
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Acta Neurol. Scand. · Sep 2016
Randomized Controlled Trial Comparative StudyBotulinum toxin-A injections vs radiotherapy for drooling in ALS.
Botulinum neurotoxin (BoNT) injections in the salivary glands and radiotherapy (RT) on these glands are commonly used to alleviate severe drooling in patients with amyotrophic lateral sclerosis (ALS). This study compares BoNT type A with RT based on patient-rated evaluations. ⋯ This pilot study showed no significant difference in the burden of drooling between the treatments. However, with RT more saliva reduction was achieved, including negative experiences directly after treatment, but without the risk of decreasing oropharyngeal function. In addition, patients with very severe dysphagia do not seem to benefit from either treatment.
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Acta Neurol. Scand. · May 2016
Case ReportsSpinal epidural abscess following treatment with rituximab.
To describe spinal epidural abscess after treatment with rituximab. ⋯ Spinal epidural abscess is a rare complication with potential severe morbidity, and continued vigilance is needed as timely intervention may prevent severe morbidity and potentially fatal outcome.
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Behavioural/functional disturbances, characteristic of frontotemporal dementia (FTD), are also a feature of amyotrophic lateral sclerosis (ALS) and patients with combined ALS and FTD (FTD-ALS). ⋯ Motor disturbance is the primary marker of disease severity in ALS, but behavioural and functional impairment are common, and may decline independently of motor function. As such, the FTDFRS may provide valuable information in the assessment and monitoring of ALS.
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Acta Neurol. Scand. · Apr 2016
Predicting risk of symptomatic intracerebral hemorrhage and mortality after treatment with recombinant tissue-plasminogen activator using SEDAN score.
The most feared complication after treatment with recombinant tissue-plasminogen activator (rt-PA) is the occurrence of symptomatic intracerebral hemorrhage (sICH). The aims of the study were to predict the risk of sICH (ECASS II definition) after a therapy with rt-PA and to examine whether associations exist between SEDAN score and the early mortality in patients with acute ischemic stroke in a monocenter study. ⋯ Higher SEDAN score was associated with an increased risk of sICH and early mortality in this monocenter study.
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Clinical deterioration and death among patients with acute stroke are often preceded by detrimental changes in physiological parameters. Systematic and effective tools to identify patients at risk of deterioration early enough to intervene are therefore needed. The aim of the study was to investigate whether the aggregate weighted track and trigger system early warning score (EWS) can be used as a simple observational tool to identify patients at risk and predict mortality in a population of patients with acute stroke. ⋯ Early warning score is a simple and valid tool for identifying patients at risk of dying after acute stroke. Readily available physiological parameters are converted to a single score, which can guide both nurses and physicians in clinical decision making and resource allocation.