Journal of the neurological sciences
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Facioscapulohumeral muscular dystrophy (FSHD) is one of the most frequent forms of muscular dystrophy. The aims of this study were: 1) to evaluate the prevalence of sleep disordered breathing (SDB) in patients with FSHD; 2) to define the sleep-related respiratory patterns in FSHD patients with SDB; and 3) to find the clinical predictors of SDB. Fifty-one consecutive FSHD patients were enrolled, 23 women, mean age 45.7+/-12.3 years (range: 26-72). ⋯ The presence of SDB does not depend on the clinical severity of the disease. SDB is often asymptomatic, and no clinical or physical measure can reliably predict its occurrence. A screening of SDB should be included in the clinical assessment of FSHD.
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The purpose of the study is to investigate the embolic potential as well as ultrasonic characteristics of plaques in patients presenting with severe unilateral restenosis at least 1 year after carotid endarterectomy (CEA), compared with patients with severe unilateral primary carotid stenosis. ⋯ Carotid plaques in patients with severe unilateral carotid restenosis at least 1 year after surgery and in patients with primary lesions are similar in their embolic potential and ultrasonic characteristics.
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Antiplatelet therapy is an integral component of effective secondary prevention after non-cardioembolic ischemic stroke. Numerous clinical trials have tested the efficacy and safety of different antiplatelet regimens, including aspirin monotherapy, clopidogrel monotherapy, the combination of aspirin plus clopidogrel, and the combination of aspirin plus dipyridamole, in patients with a history of arterial ischemic stroke and transient ischemic attack (TIA). Although competing, head-to-head comparisons between aspirin plus dipyridamole and clopidogrel were not previously available, various professional societies have outlined evidence-based recommendations for antiplatelet therapy in patients with ischemic stroke or TIA. ⋯ The results of PRoFESS thus highlight the pitfalls of making conclusions of relative therapy efficacy in the absence of head-to-head comparisons. This article presents an overview of the factors that differ between clinical trials and "real-world" patient populations, as well as factors that differ among clinical trials themselves. The article also addresses the potential impact these differences may have on clinical trial results and subsequent clinical decision making.
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Intracranial bleeding is an important and dangerous complication associated with thrombolytic therapy for acute ischemic stroke. Spinal hemorrhage has been reported after systemic thrombolysis for various conditions other than acute ischemic stroke. Our patient presented with an acute ischemic stroke and showed significant clinical recovery during intravenous thrombolysis. ⋯ She was treated conservatively and showed a satisfactory recovery. We report, probably the first case of spinal epidural hemorrhage after systemic thrombolysis for acute ischemic stroke. Spinal hemorrhage should be considered as a differential diagnosis for neurological worsening after intravenous thrombolysis for acute ischemic stroke, especially when the brain imaging studies do not reveal an appropriate intracranial pathology.