Journal of the neurological sciences
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Cognitive impairment is frequent in multiple sclerosis (MS). Tissue-specific atrophy measures have been shown to correlate with cognitive performance in several studies. Voxel-based morphometry (VBM) aims to identify regional differences in the local composition of brain tissue and makes possible to correlate these findings with cognitive impairment patterns. ⋯ Quantitative tissue-specific atrophy measures may display better correlations with patients' variables than regional grey matter atrophy distribution obtained using VBM methodology. These results should be confirmed in larger samples.
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Stroke centers and intravenous tissue plasminogen activators (tPA) are effective management for acute ischemic stroke. This study aimed to analyze stroke center characteristics on the administration of thrombolytic therapy. A national survey of stroke centers in academic medical centers and regional teaching hospitals in Taiwan was conducted. ⋯ The frequency of thrombolytic therapy administration significantly correlated with stroke center criteria (Spearman's rho=0.731, P<0.001). Multivariate analysis showed routine intravenous tPA protocol in the emergency room (odds ratio=4.6, P=0.042) and supervision by the stroke center director (odds ratio=3.7, P=0.031) significantly influenced the administration of thrombolytic therapy. Well-organized stroke centers, routine use of thrombolytic therapy protocols in the emergency room, and guidance by a stroke center director are important for enhancing thrombolytic therapy in patients with acute ischemic stroke.
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Fluoroquinolones has been rarely associated with exacerbation of myasthenia gravis (MG). We present a case of MG following a treatment with prulifloxacin, a new broad-spectrum oral fluoroquinolone. Fluoroquinolones of any generation may interfere with neuromuscular transmission and should be avoided in patients with MG.
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Randomized Controlled Trial
Longitudinal one-year study of levels and stoichiometry of neurofilament heavy and light chain concentrations in CSF in patients with multiple system atrophy.
Two cerebrospinal fluid (CSF) biomarkers specific for neurodegeneration have recently emerged - the neurofilament light (NfL, 68 kDa) and heavy (NfH, 190-210 kDa) chains. This study investigated whether the CSF NfH and NfL levels or their stoichiometric relationship changed over time in a neuroprotective treatment trial. ⋯ These results indicate that CSF levels of both NfL and NfH on their own are not useful markers of disease progression in MSA, at least over a 12-month period. Future work is needed to elucidate whether the CSF stoichiometry and dynamics of Nf subunits in individual patients are a feature of the underlying pathology and of diagnostic or prognostic value.
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Celecoxib is a potent anti-inflammatory drug with a safety profile that has been well-demonstrated in several human diseases and is reported to have beneficial effects in a rat model of intracerebral hemorrhage (ICH). We investigated the efficacy and safety of celecoxib treatment in patients with primary ICH. We retrospectively collected clinical data of patients admitted within 48 h after the onset of primary ICH. ⋯ The incidences of adverse events during the admission were not different between the groups. These results suggest that celecoxib may be safe and efficacious in patients with primary ICH. To confirm this notion, a large-sized prospective study should be performed.