Here are what the editors at HealthDay consider to be the most important developments in Neurology for February 2009. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.
Fampridine Boosts Mobility in Multiple Sclerosis
FRIDAY, Feb. 27 (HealthDay News) -- Fampridine, an investigational potassium-channel blocker, improves walking ability and reduces ambulatory disability in patients with multiple sclerosis, according to research published in the Feb. 28 issue of The Lancet.
Ischemic Strokes Rise Steeply with Age Even in Young
FRIDAY, Feb. 27 (HealthDay News) -- Modifiable risk factors for stroke, such as high cholesterol and hypertension, were common in a group of younger stroke patients, according to research published online Feb. 26 in the journal Stroke.
Novel Drugs May Help Prevent Cerebral Palsy
THURSDAY, Feb. 26 (HealthDay News) -- In high-risk pregnancies, the use of selective neuronal nitric oxide synthase inhibitors could help prevent cerebral palsy, according to research published online Feb. 20 in the Annals of Neurology.
Drug-Resistant Meningitis Present in North America
WEDNESDAY, Feb. 25 (HealthDay News) -- Ciprofloxacin-resistant meningitis has appeared in North America, although the bacteria remain susceptible to other antibiotics, according to a report in the Feb. 26 issue of the New England Journal of Medicine.
Insurance Essential for Good Health, Well-Being
TUESDAY, Feb. 24 (HealthDay News) -- Having health insurance is vital for health and well-being, and when rates of uninsurance are high, even insured people are more likely to struggle to obtain necessary care, according to a new report from the Institute of Medicine released online Feb. 24.
US Health Spending May Have Hit $2.4 Trillion in 2008
TUESDAY, Feb. 24 (HealthDay News) -- Health spending in the United States was estimated to be $2.4 trillion last year, and is expected to account for an unprecedented share of the economy this year, according to a report published online Feb. 24 in Health Affairs.
Workers' Comp Linked to Poor Back Surgery Outcomes
TUESDAY, Feb. 24 (HealthDay News) -- Workers' compensation patients who undergo lumbar discectomy may have a greater risk of poor outcomes than non-compensated patients, according to study findings published in the March issue of The Spine Journal.
Global Burden of Stroke Varies Widely
TUESDAY, Feb. 24 (HealthDay News) -- The burden of stroke mortality varies widely around the world, and the incidence of stroke in high-income countries has declined in the last four decades, while it has doubled in low- and middle-income countries over the same time period, according to two articles published online Feb. 20 in The Lancet Neurology.
Long-Term Epilepsy Risk High After Traumatic Brain Injury
MONDAY, Feb. 23 (HealthDay News) -- In children and young adults with traumatic brain injury, the risk of epilepsy persists for 10 years or longer, according to a report published online Feb. 23 in The Lancet.
Medicaid Patients May Travel Long Distance for Spine Care
MONDAY, Feb. 23 (HealthDay News) -- Medicaid patients may have less access to local spine care than patients with private, commercial health insurance, according to a report published in the March issue of The Spine Journal.
Brain Surgery Shows Benefit in Pediatric Stroke Patients
MONDAY, Feb. 23 (HealthDay News) -- Periinsular hemispherotomy may be useful in treating stroke-induced refractory epilepsy in children, according to research published in the February issue of the Journal of Neurosurgery: Pediatrics.
FDA Issues Exemption for Device That Treats OCD
FRIDAY, Feb. 20 (HealthDay News) -- The U.S. Food and Drug Administration has issued a human device exemption for a system that uses electrical therapy in the brain to suppress severe obsessive-compulsive disorder (OCD) symptoms, according to a release issued by the agency Feb. 19.
Vertebroplasty May Protect Osteoporotic Vertebrae
FRIDAY, Feb. 20 (HealthDay News) -- Prophylactic vertebroplasty may protect adjacent intact vertebrae from fatigue injury in some patients with osteoporosis, according to a biomechanical study in the Feb. 15 issue of Spine.
Rare Brain Infection Confirmed in Patients on Efalizumab
FRIDAY, Feb. 20 (HealthDay News) -- Three cases of progressive multifocal leukoencephalopathy (PML) have been confirmed in patients taking the psoriasis drug efalizumab (Raptiva), according to a public health advisory issued by the U.S. Food and Drug Administration on Feb. 19.
Eltrombopag Increases Platelet Counts in Purpura
FRIDAY, Feb. 20 (HealthDay News) -- In patients with chronic idiopathic thrombocytopenic purpura, eltrombopag -- an oral, non-peptide, thrombopoietin-receptor agonist -- may help manage thrombocytopenia, according to a study published in the Feb. 21 issue of The Lancet.
Healthy Lifestyle Behaviors Lower Risk of Stroke
FRIDAY, Feb. 20 (HealthDay News) -- In middle-aged and older adults, a combination of four healthy lifestyle behaviors may significantly reduce the risk of stroke, according to a study published online Feb. 20 in the British Medical Journal.
Proposed Changes to Health Care Would Reduce Costs
THURSDAY, Feb. 19 (HealthDay News) -- Simultaneous gains in universal health coverage, improved health outcomes and slowed spending growth would have a major impact on the development of public policy, according to a perspective published in the Feb. 26 issue of the New England Journal of Medicine.
Transparency, Globalization Growing in Clinical Research
THURSDAY, Feb. 19 (HealthDay News) -- All clinical trial data and the U.S. Food and Drug Administration database should be publicly available, and global clinical research should be conducted in relevant populations for potential applications of the intervention, according to two articles published in the Feb. 19 issue of the New England Journal of Medicine.
IDH1, IDH2 Mutations Linked to Malignant Glioma
WEDNESDAY, Feb. 18 (HealthDay News) -- Mutations in the isocitrate dehydrogenase genes IDH1 and IDH2 appear to play a role in the pathogenesis of malignant gliomas, according to research published in the Feb. 19 issue of the New England Journal of Medicine.
Repairing Heart Defect May Relieve Migraines
WEDNESDAY, Feb. 18 (HealthDay News) -- Patent foramen ovale closure can greatly reduce the frequency and severity of migraines, according to study findings published in the February issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.
Implementing a Quality Improvement Faculty Path
WEDNESDAY, Feb. 18 (HealthDay News) -- A new career pathway in academic medicine, termed clinicians in quality improvement, is a justified concept to achieve and recognize excellence in patient safety, according to a commentary published in the Feb. 18 issue of the Journal of the American Medical Association.
Ads Featuring 'Drug Facts Box' Help Educate Consumers
TUESDAY, Feb. 17 (HealthDay News) -- Replacing the brief summary in direct-to-consumer ads with a "drug facts box" may result in improved consumer knowledge and judgment about medication benefits and side effects, according to study findings released online Feb. 17 in advance of publication in the Apr. 21 issue of the Annals of Internal Medicine.
Sleep Problems, Headaches May Influence Each Other
MONDAY, Feb. 16 (HealthDay News) -- The use of sleep as a method of headache relief may help promote insomnia in women with tension-type headaches, according to research published in the Feb. 15 issue of the Journal of Clinical Sleep Medicine.
Drug May Help Erase Scary Memories
MONDAY, Feb. 16 (HealthDay News) -- Treatment with the beta-adrenergic receptor antagonist propranolol can erase scary memories by blocking memory reconsolidation, a process where fear memories change when recalled, according to research published online Feb. 15 in Nature Neuroscience.
Motor Cortex Stimulation Has Good Results in Chronic Pain
FRIDAY, Feb. 13 (HealthDay News) -- Motor cortex stimulation may lead to a significant improvement in symptoms for patients who experience severe chronic neuropathic pain resistant to medical treatment, according to research published in the February issue of the Journal of Neurosurgery.
Secondhand Smoke Linked to Cognitive Impairment
FRIDAY, Feb. 13 (HealthDay News) -- Secondhand smoke exposure may be associated with an increased risk of developing cognitive impairment, according to research published online Feb. 12 in BMJ.
Thrombolysis Window May Be Longer Than Thought
THURSDAY, Feb. 12 (HealthDay News) -- Patients with acute stroke may have a diffusion-perfusion mismatch after nine hours of stroke onset, particularly those with proximal arterial occlusion, suggesting the treatment window for stroke may be extended in some cases, according to the results of a study published in the March issue of Radiology.
Stroke Risk in Women Needs More Research
WEDNESDAY, Feb. 11 (HealthDay News) -- Women account for the majority of stroke deaths in the United States, yet there are major gaps in awareness of risk factors specific to women, and in the knowledge of the causes and treatment of strokes in women, according to several reports published a special themed issue of Stroke released online Feb. 10 and dedicated to the epidemic of stroke among women.
Better Visual Field Sight with Vigabatrin During Infancy
WEDNESDAY, Feb. 11 (HealthDay News) -- Administration of the anti-epileptic drug vigabatrin during infancy compared with later ages may reduce the risk of vigabatrin-attributed visual field loss, according to research published in the February issue of Epilepsia.
Brain Atrophy Pattern May Predict Cognitive Decline
WEDNESDAY, Feb. 11 (HealthDay News) -- A pattern of brain atrophy can discriminate between people with mild Alzheimer's disease and healthy individuals, according to research published online Feb. 6 in Radiology.
Parkinsonism Induced by Deep Brain Stimulation
WEDNESDAY, Feb. 11 (HealthDay News) -- Bilateral deep vein stimulation of the globus pallidus internus (GPi) for craniocervical dystonia induced reversible parkinsonism in a patient who did not have pre-existing bradykinesia, according to a case report published in the February issue of the Journal of Neurosurgery.
Surgery Helps Amputees Control Complex Artificial Arms
TUESDAY, Feb. 10 (HealthDay News) -- Patients with arm amputations may have improved control of artificial arms that use electromyogram signals after undergoing targeted muscle reinnervation surgery that transfers remaining arm nerves to the chest or upper-arm muscles, according to research published in the Feb. 11 issue of the Journal of the American Medical Association.
Care Coordination Programs Don't Benefit Medicare Patients
TUESDAY, Feb. 10 (HealthDay News) -- For Medicare beneficiaries with chronic illnesses, most care coordination programs have little impact on reducing hospitalizations and costs or improving quality of care, according to a report published in the Feb. 11 issue of the Journal of the American Medical Association.
Spine Surgeons Receptive to Total Disc Arthroplasty
TUESDAY, Feb. 10 (HealthDay News) -- Spine surgeons are generally enthusiastic about cervical and lumbar disc replacement, but are also concerned about long-term outcomes and reimbursement issues, according to research published in the February issue of the Journal of Spinal Disorders & Techniques.
Study Examines Factors Related to Post-Traumatic Epilepsy
TUESDAY, Feb. 10 (HealthDay News) -- Long-term outcome of post-traumatic epilepsy following war-related brain injury, including persistence of seizures, is significantly impacted by whether or not a sphincter disturbance occurred during injury and the number of shrapnel pieces involved in the injury, according to research published in the February issue of the Journal of Neurosurgery.
Migraines Impose Substantial Societal and Economic Burden
TUESDAY, Feb. 10 (HealthDay News) -- Although migraines and their associated disabilities are prevalent and carry a high societal and economic burden, they are not generally considered a serious medical condition, according to a report published in the January/February issue of Value in Health.
Tests Can Spot Alzheimer's Patients Who Can Safely Drive
TUESDAY, Feb. 10 (HealthDay News) -- Cognition, vision and motor skills tests can help identify Alzheimer's disease patients who can safely drive, according to study findings published in the Feb. 10 issue of Neurology.
Mediterranean Diet Benefits Cognitive Function in Elderly
MONDAY, Feb. 9 (HealthDay News) -- In cognitively normal older adults, adherence to a Mediterranean diet is associated with a modestly reduced risk of developing mild cognitive impairment, and in older adults who already have mild cognitive impairment, adherence to the diet is associated with a significantly reduced risk of developing Alzheimer's disease, according to a report published in the February issue of the Archives of Neurology.
Lumbar Belt Improves Function in Low Back Pain Patients
MONDAY, Feb. 9 (HealthDay News) -- A lumbar belt improves function, reduces pain and decreases the need for medications in patients with low back pain, researchers report in the Feb. 1 issue of Spine.
Artificial Disc Articles Found Lacking on the Internet
MONDAY, Feb. 9 (HealthDay News) -- Because Web sites often publish potentially misleading articles about lumbar artificial disc replacement, physicians should caution patients about relying on the Internet for information about the procedure, according to a report published in the February issue of the Journal of Spinal Disorders & Techniques.
Methylphenidate Linked to Brain Neuronal Changes in Mice
FRIDAY, Feb. 6 (HealthDay News) -- The use of methylphenidate in mice was associated with neuronal changes in the brain with similarities and differences compared to the effects of cocaine, according to research published online Feb. 6 in the Proceedings of the National Academy of Sciences Early Edition.
Immediate Imaging Does Not Help Treat Low Back Pain
FRIDAY, Feb. 6 (HealthDay News) -- Clinical care without immediate imaging yields similar results as care with immediate imaging for patients with low back pain and no indication of serious underlying illness, according to an article published in the Feb. 7 issue of The Lancet.
Electromyographic Monitoring Useful During Spinal Surgery
FRIDAY, Feb. 6 (HealthDay News) -- In patients undergoing anterior cervical discectomy and fusion, intraoperative electromyography may identify the operative events leading to recurrent laryngeal nerve palsy and help reduce the risk of operative recurrent laryngeal nerve injury, researchers report in the February issue of the Journal of Spinal Disorders & Techniques.
Rapid Treatment for Minor Strokes Reduces Hospital Use
FRIDAY, Feb. 6 (HealthDay News) -- Rapid assessment and early treatment of transient ischemic attack (TIA) and minor stroke in a specialty outpatient clinic were associated with less subsequent hospital use and disability, according to research published online Feb. 5 in The Lancet Neurology.
Risk of Venous Thrombosis After Spinal Surgery Low
FRIDAY, Feb. 6 (HealthDay News) -- The risk of deep venous thrombosis after spinal surgery is relatively low, and the condition can be prevented by using compression stockings or pneumatic sequential compression devices, according to a review in the Feb. 1 issue of Spine.
Graded Exercise Program Improves Low Back Pain
THURSDAY, Feb. 5 (HealthDay News) -- A graded exercise intervention emphasizing stabilizing exercises reduces disability and improves physical health better than daily walks in patients with recurrent low back pain, researchers report in the Feb. 1 issue of Spine.
Aggressive Therapy Beneficial for Ependymoma Patients
TUESDAY, Feb. 3 (HealthDay News) -- Gross-total resection, including second surgery for patients with an incomplete first surgery, plus high-dose postoperative radiotherapy provides long-term benefits in local tumor control, event-free survival and overall survival for children with localized ependymoma, according to research published online Jan. 31 in The Lancet Oncology.
Education Does Not Impact Rate of Cognitive Decline
TUESDAY, Feb. 3 (HealthDay News) -- Although there is a clear association between the level of education attained and cognitive function, there is no parallel link to cognitive decline, according to study findings published in the Feb. 3 issue of Neurology.
Stem Cell Transplantation Shows Benefit in MS
MONDAY, Feb. 2 (HealthDay News) -- Autologous non-myeloablative hemopoietic stem cell transplantation may prevent neurological progression and improve neurological disability in relapsing-remitting multiple sclerosis, according to research published online Jan. 30 in The Lancet Neurology.
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