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NEWS - Neurology

Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 – The Lancet Neurology (free)

Invited Commentary: Statistics on the burden of dementia: need for stronger data – The Lancet (free)

“In 2016, globally, 43·8 million individuals lived with dementia, increased from 20.2 million in 1990; dementia was the fifth leading cause of death globally (2·4 million) and more women than men had dementia” (via @TheLancet see Tweet with infographic)

 


Antipsychotic drug use and pneumonia: Systematic review and meta-analysis – Journal of Psychopharmacology (link to abstract – $ for full-text)

Commentary: Antipsychotics May Increase Risk of Pneumonia, Meta-Analysis Suggests – Psychiatric News Alert (free)

“Although antipsychotic use was associated with a higher risk of pneumonia, the researchers stopped short of claiming causality, citing a lack of data from randomized, controlled trials and a failure of observational studies to control for relevant confounders like tobacco use and weight.” (from Psychiatric News Alert)

 


Global, regional, and national burden of Parkinson’s disease, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 – The Lancet Neurology (free)

Invited Commentary: The burden of Parkinson’s disease: a worldwide perspective (free)

“In 2016, 6·1 million people worldwide had Parkinson’s disease, 2·9 million (48%) women & 3·2 million (52%) men; the increase in burden since 1990 was not exclusively explained by an increasing number of older people” (via @TheLancet see Tweet)

 


Modifying the consistency of food and fluids for swallowing difficulties in dementia – Cochrane Library (free for a limited period)

Summary: Modifying the consistency of food and fluids for swallowing difficulties in dementia (free)

“We are uncertain about the immediate and long-term effects of modifying the consistency of fluid for swallowing difficulties in dementia”

 


Antidepressants for treating depression in dementia – Cochrane Library (free for a limited period)

Summary: Antidepressants for treating depression in dementia – Cochrane Library (free)

“On the only measure of efficacy for which we had high-quality evidence (depression rating scale scores), antidepressants showed little or no effect.”

 


Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women’s Health Initiative – Journal of the American Heart Association (free)

Commentaries: Breastfeeding linked to lower stroke risk – Reuters (free) AND Breastfeeding may help protect mothers against stroke – AHA News (free)

“…ultimately, the study is observational, which means that it can only prove that breast feeding is associated with lower risk of stroke as opposed to being the cause of the lowered risk.” (from Reuters)

 


Association of Retinal Nerve Fiber Layer Thinning With Current and Future Cognitive Decline: A Study Using Optical Coherence Tomography – JAMA Neurology (free for a limited period)

Commentaries: Eye Sign of Dementia Risk? Thinning of Retinal Nerve Fiber Layer – MedicalResearch.com (free) AND Are the Eyes Windows to Early Dementia? – MedPage Today (free registration required)

“A thinner Retinal Nerve Fiber Layer is associated with worse cognitive function in individuals without a neurodegenerative disease as well as greater likelihood of future cognitive decline”.

 


Association of Antidepressant Use With Drug-Related Extrapyramidal Symptoms: A Pharmacoepidemiological Study – Journal of Clinical Psychopharmacology (link to abstract – $ for full-text)

Commentaries: Incidence of Extrapyramidal Symptoms Higher With Certain Antidepressants – MPR (free) AND Antidepressants tied to Parkinson’s-like symptoms – Univadis (free registration required)

“Observational study: Incidence of EPSs with antidepressants. RRs: duloxetine, 5.68; mirtazapine, 3.78; citalopram, 3.47; escitalopram, 3.23; paroxetine, 3.07; sertraline, 2.57; venlafaxine, 2.37; bupropion, 2.31; and fluoxetine, 2.03 (all significant)” (via @psychopharmacol see Tweet)

 


Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs – American Academy of Neurology and the American Epilepsy Society

Part I: Treatment of new-onset epilepsy (free PDF)

Part II: Treatment-resistant epilepsy (free PDF)

Commentary: New Epilepsy Guidelines Shed Light on Explosion of New Drugs – MedPage Today (free registration required)

 


Continuous low-dose antibiotic prophylaxis to prevent urinary tract infection in adults who perform clean intermittent self-catheterisation: the AnTIC RCT – Health Technology Assessment (free)

“The results of this large randomised trial, conducted in accordance with best practice, demonstrate clear benefit for antibiotic prophylaxis in terms of reducing the frequency of UTI for people carrying out CISC”.

 


Effect of Fremanezumab Compared With Placebo for Prevention of Episodic Migraine: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

Commentary: Fremanezumab effective in preventing episodic migraine – 2 Minute Medicine (free)

“Among patients with episodic migraine in whom multiple medication classes had not previously failed, subcutaneous fremanezumab, compared with placebo, resulted in a statistically significant 1.3- to 1.5-day reduction in the mean number of monthly migraine days over a 12-week period”. (from JAMA)

“The small effect size in terms of reduction in number of days with migraine dampens enthusiasm for this medication, though without head-to-head comparison against other prophylactics, this is hard to assess” (from 2 Minute Medicine)

 


Rapid Recommendations: Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline – The BMJ (free)

We issue a strong recommendation for use of atraumatic needles in all patients (adults and children) undergoing lumbar puncture because they decrease complications and are no less likely to work than conventional needles”

 


Support for midlife anxiety diagnosis as an independent risk factor for dementia: a systematic review – BMJ Open (free)

Commentaries: Moderate to severe mid-life anxiety may be linked to later life dementia – BMJ Open Blog (free) AND Anxiety in middle age linked to dementia later – Reuters (free) AND Expert reaction to a review of the association between mid-life anxiety and later life dementia – Science Media Centre (free)

“The current study isn’t designed to explain how anxiety and dementia might be connected, Iadecola added.

“We cannot say with confidence that anxiety is a cause (risk factor), an early manifestation of the dementia, or only coincidentally associated with it,”” (from Reuters)

 


Anticholinergic drugs and risk of dementia: case-control study – The BMJ (free)

Editorial: Anticholinergic drugs and dementia in older adults (free)

Commentaries: Expert reaction to study investigating the association between different types of anticholinergic drugs and risk of dementia – Science Media Centre (free) AND Anticholinergic drugs may be linked to increased risk of dementia – OnMedica (free)

“The effect of anticholinergic therapy is relatively small (odds ratio 1.1 – 1.2) and establishing an association does not prove a causal link. Nevertheless, the paper may act as a useful guide for future research and clinical practice”. (by Prof Les Iversen, in Science Media Centre)

 


Case managers improve outcomes for people with dementia and their carers – NIHR Signal (free)

Original Article: The effectiveness of community-based coordinating interventions in dementia care: a meta-analysis and subgroup analysis of intervention components – BMC Health Services Research (free)

“The review suggests that nurses may be particularly well placed to act as case managers for people with dementia, perhaps because they have the skills to perform the broad range of tasks associated with the role.” (via @NIHR_DC see Tweet)

 


Non-invasive brain stimulation techniques for chronic pain – Cochrane Library (free)

“There is a lack of high-quality evidence to support or refute the effectiveness of non-invasive brain stimulation techniques for chronic pain”

 


Time to Endovascular Treatment and Outcome in Acute Ischemic Stroke: MR CLEAN Registry Results – Circulation (link to abstract – $ for full-text)

Commentary: Time to endovascular therapy predicted functional outcome after stroke in registry study – ACP Hospitalist (free)

“Every hour of delay from stroke onset to the start of endovascular therapy resulted in a 5.3% decreased probability of functional independence” (from ACP Hospitalist)

 


Increased coronary heart disease and stroke hospitalisations from ambient temperatures in Ontario – Heart (free)

Related study: Big Swings in Daily Temperatures Linked to Spikes in MI Rates – TCTMD (free)

“Cold and hot weather associated with risk of cardiovascular disease hospitalization” (via @kamleshkhunti see Tweet)

 


Patent foramen ovale closure vs. medical therapy for cryptogenic stroke: a meta-analysis of randomized controlled trials – European Heart Journal (free)

“5-study EHJ meta analysis confirms value of PFO closure after cryptogenic stroke. “Number Needed to Close”: 178 pts to prevent one stroke over 1 year. Size matters (no effect for small shunts, “NNC” 96 for large shunts)” (via @Steph_Achenbach see Tweet)

 


Endovascular treatment for acute ischaemic stroke in routine clinical practice: prospective, observational cohort study (MR CLEAN Registry) – The BMJ (free)

Related guideline: 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association / American Stroke Association (free PDF) AND Summary for ED-relevant care: 2018 AHA/ASA Ischemic Stroke Updates – emDocs (free)

“In routine clinical practice, endovascular treatment for patients with acute ischemic stroke is at least as effective and safe as in the setting of a randomized controlled trial”.

 


Socioeconomic disparities in first stroke incidence, quality of care, and survival: a nationwide registry-based cohort study of 44 million adults in England – The Lancet Public Health (free)

Invited commentary: Preventing stroke on the street where you live, work, and play (free)

Patients from the lowest socioeconomic groups had first stroke a median of 7 years earlier than those from the highest and a 26% higher adjusted risk of 1-year mortality.

 


Outcomes, experiences and palliative care in major stroke: a multicentre, mixed-method, longitudinal study – Canadian Medical Association Journal (free)

““Palliative care” had connotations of treatment withdrawal and imminent death… practicing the principles of palliative care is needed, but the term “palliative care” should be avoided or reframed”.

See related articles on this subject: Palliative care: renaming as supportive care and integration into comprehensive cancer care – CMAJ (free) AND Perceptions of palliative care among patients with advanced cancer and their caregivers (free)

 


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