Neurologist
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Severe sepsis has been associated with an increased risk of new-onset arrhythmias, namely atrial fibrillation (AF). Single-center and small-center studies suggest that new-onset AF is associated with higher mortality and prolonged hospitalization during severe sepsis. However, the relationship between new-onset AF in severe sepsis to prognosis is unknown. ⋯ In patients with severe sepsis, new-onset AF seems to increase the risk of in-hospital stroke and mortality compared with patients with no or preexisting AF.
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To develop future neurologists and translational neuroscientists, we created a neurosciences pathway throughout our medical school curriculum that included early exposure to clinical neurosciences decision-making and added variety to the choices of later clinical neurosciences experiences. ⋯ Our neurosciences curricular innovation increased graduating student satisfaction scores, had a mild positive impact on Step 2 Clinical Knowledge scores, and increased the number of students choosing careers in the clinical neurosciences. This model may be a consideration for other medical schools who wish to integrate neurosciences teaching throughout their curriculum.
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Traumatic brain injury (TBI) is common and confers a high rate of disability and mortality. Current treatments are primarily supportive. Therapeutic hypothermia has been proposed for severe TBI because of its ability to reduce intracranial pressure and putative neuroprotective effects. ⋯ Current cumulative evidence does not support general use of therapeutic hypothermia for acute severe TBI. However, further investigation of the role of therapeutic hypothermia may be warranted for specific TBI subgroups.
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Recently, increased attention has been paid to the association of progressive multifocal leukoencephalopathy (PML) with the use of immunomodulatory medications for autoimmune diseases. ⋯ The development of PML in this patient treated with etanercept and prednisone highlights the increased risk for opportunistic infection with JC virus in patients with autoimmune diseases on immunosuppressive therapies.
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Bilateral femoral nerve injury can occur after various surgical and nonsurgical processes, but has rarely been reported. ⋯ The patient reported is the first in the literature to have suffered from bilateral femoral nerve palsy after a suicide attempt. Half of the reported cases are secondary to a surgical process (particularly abdominopelvic surgery). If a compressive origin is most frequent, a stretch mechanism may at times explain a bilateral femoral neuropathy.