Public release date: 12-Feb-2012
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Contact: Rachel Seroka
rseroka@aan.com
651-695-2738
American Academy of Neurology

NEW ORLEANS ? New research suggests that consuming between 2,100 and 6,000 calories per day may double the risk of memory loss, or mild cognitive impairment (MCI), among people age 70 and older. The study was released today and will be presented at the American Academy of Neurology's 64th Annual Meeting in New Orleans April 21 to April 28, 2012. MCI is the stage between normal memory loss that comes with aging and early Alzheimer's disease.

"We observed a dose-response pattern which simply means; the higher the amount of calories consumed each day, the higher the risk of MCI," said study author Yonas E. Geda, MD, MSc, with the Mayo Clinic in Scottsdale, Arizona and a member of the American Academy of Neurology.

The study involved 1,233 people between the ages of 70 and 89 and free of dementia residing in Olmsted County, Minn. Of those, 163 had MCI. Participants reported the amount of calories they ate or drank in a food questionnaire and were divided into three equal groups based on their daily caloric consumption. One-third of the participants consumed between 600 and 1,526 calories per day, one-third between 1,526 and 2,143 and one-third consumed between 2,143 and 6,000 calories per day.

The odds of having MCI more than doubled for those in the highest calorie-consuming group compared to those in the lowest calorie-consuming group. The results were the same after adjusting for history of stroke, diabetes, amount of education, and other factors that can affect risk of memory loss. There was no significant difference in risk for the middle group.

"Cutting calories and eating foods that make up a healthy diet may be a simpler way to prevent memory loss as we age," said Geda.

###

The co-authors of the study include Ronald C. Petersen, MD, Fellow of the American Academy of Neurology, and other investigators of the Mayo Clinic Study of Aging in Rochester, Minn.

Learn more about Alzheimer's disease at http://www.aan.com/patients.

The study was supported by the National Institutes of Health, the Robert Wood Johnson Foundation and the Robert H. and Clarice Smith and Abigail van Buren Alzheimer's Disease Research Program.

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease and multiple sclerosis. For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

Media Contacts:
Rachel Seroka, rseroka@aan.com, (651) 695-2738
Angela Babb, APR, ababb@aan.com, (651) 695-2789

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Overeating may double risk of memory loss

08-02-2012 18:05 Sam Stuart - A case Study of a Neurological Physiotherapy patient, who had a burst fracture of L1, vertebroplasty of L4 and neuropathic pain in the Right leg.

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Neurological physiotherapy case study - Sam Stuart - Video

08-08-2011 14:52

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Neurology 14 Amyotrophic Lateral Sclerosis ALS - Video

What is it?

Patients with osteoarthritis of the thumb carpometacarpal joint, or base of the thumb, commonly seek help for their symptoms. Arthritis at the base of the thumb causes functional disability and pain, particularly with “pinching” actions.

A hand with arthritic changes. Image source: Cicadas, a Creative Commons license.

How common is osteoarthritis of the thumb?

The prevalence of this condition increases with age and is greatest in postmenopausal women. It ranges between 15% prevalence in adults in Finland and a 33% prevalence in postmenopausal women. This is likely to increase as populations age and people stay active for longer.

How to diagnose it?

Pain reproduced on the axial grind test localizes pathology to the base of the thumb.

Trapeziometacarpal and scaphotrapeziotrapezoid joints should be assessed with plain radiographs (X-rays) that typically show degenerative changes. However, X-rays may underestimate the extent of the disease.

What to do?

Non-operative treatments can ameliorate symptoms and delay surgery in most patients with osteoarthritis of the thumb:

- behaviour modification
- pain relief
- splinting
- corticosteroid injections

No single operative procedure has been shown to be superior:

- simple trapeziectomy has the lowest complication rate
- arthrodesis may be the best option for patients who value pain relief and reliable strength and stability more than mobility (such as younger manual workers)

Piano lesson: "Rachmaninov had big hands". See how one gets 4 million views on YouTube:

References:

Osteoarthritis at the base of the thumb. BMJ, 2011.

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02-02-2012 10:21 How is Depression linked to the brain and how can we treat this as Chiropractic Neurologists

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Chiropractic "Functional" Neurology and Depression(1/2) - Video

06-02-2012 23:17 I went and saw a Neurologist Monday Morning lots of news to share 🙂

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Neurology Update - Video

This is another recent review from Am Fam Physician:

Chronic kidney disease (CKD) affects 27 million adults in the U.S. It increases risk of cardiovascular disease and stroke.

Patients should be assessed annually to determine whether they are at increased risk of developing chronic kidney disease (CKD).

Risk factors for CKD include:

- diabetes mellitus
- hypertension
- older age
- cardiovascular disease
- family history of chronic kidney disease
- ethnic and racial minority status

Tests for CKD:

- Serum creatinine levels can be used to estimate the glomerular filtration rate (GFR)
- Spot urine testing can detect proteinuria

Staging of CKD is based on estimated glomerular filtration rate (GFR). Evaluation should focus on the specific type of CKD and identifying complications related to the disease stage.

When to refer to a nephrologist?

The patients with the following characteristics should be referred to a nephrologist:

- estimated glomerular filtration rates less than 30 mL per minute per 1.73 m2
- significant proteinuria
- rapid loss of kidney function

References:

Chronic Kidney Disease: Detection and Evaluation. Baumgarten M, Gehr T. Am Fam Physician. 2011 Nov 15;84(10):1138-1148.
Nephrology Cases

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Public release date: 6-Feb-2012
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Contact: Rachel Seroka
rseroka@aan.com
651-695-2738
American Academy of Neurology

ST. PAUL, Minn. ? A new scoring method can help doctors quickly decide which stroke patients will respond well to the clot-busting drug alteplase, according to a study published in the February 7, 2012, print issue of Neurology?, the medical journal of the American Academy of Neurology.

The DRAGON score was 86 percent accurate in predicting the outcome three months after people had the stroke and received the drug within four-and-a-half hours after their first stroke symptoms.

"The DRAGON score is simple and fast to perform, it has no cost, and it consists solely of factors that are known when the patient is admitted to the hospital or soon after," said study author Daniel Strbian, MD, PhD, of Helsinki University Central Hospital in Finland. "We found that we could determine the score in less than a minute. This can help the doctor, the patient, and the family to evaluate the situation, make choices and give the most relevant treatment with the greatest speed."

Strbian said the score can help with the decision to try additional therapies when the likelihood is high that alteplase alone will not provide a good outcome.

The study involved 1,319 people with ischemic stroke with an average age of 69 who were treated with alteplase. Participants were given a score of zero to 10 based on their age, glucose level, time since stroke symptoms started, the severity of the stroke and other factors. The higher the score was, the more likely the person was to have a bad outcome three months later. A bad outcome was defined as being dead or being bedridden, incontinent and requiring constant nursing care and attention.

A total of 96 percent of those with scores of zero to two had a good outcome three months later. A good outcome was defined as being independent in daily activities. None of the people with DRAGON scores of eight to 10 had good outcomes three months later.

The score was also tested on a second group of 333 people at a hospital in Switzerland, with similar results.

###

The study was supported by Helsinki University Central Hospital, the Sigrid Juselius Foundation, the Finnish Medical Foundation and the Yrj? Jahnsson Foundation.

Learn more about stroke at http://www.aan.com/patients.

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease and multiple sclerosis.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

Media Contacts:
Rachel Seroka, rseroka@aan.com, (651) 695-2738
Angela Babb, APR, ababb@aan.com, (651) 695-2789

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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

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Who will benefit from stroke drug? New score can help decide

Chronic diarrhea is defined as a decrease in stool consistency (loose BM) for more than 4 weeks (Am Fam Physician, 2011).

It can be divided into 3 categories:

- watery
- fatty (malabsorption)
- inflammatory

Watery diarrhea

Watery diarrhea may be subdivided into:

- osmotic
- secretory
- functional, e.g. IBS

Watery diarrhea includes irritable bowel syndrome (IBS), which is the most common cause of functional diarrhea. Another example of watery diarrhea is microscopic colitis, which is a secretory diarrhea affecting older persons.

Laxative-induced diarrhea is often osmotic.

Malabsorptive diarrhea

Malabsorptive diarrhea is characterized by excess gas, steatorrhea, or weight loss. Giardiasis is a classic infectious example of malabsorptive diarrhea.

Celiac disease (gluten-sensitive enteropathy) is also malabsorptive, and typically results in weight loss and iron deficiency anemia.

Inflammatory diarrhea

Inflammatory diarrhea, such as ulcerative colitis (UC) or Crohn disease, is characterized by blood and pus in the stool and an elevated fecal calprotectin level.

Invasive bacteria and parasites also produce inflammation. Infections caused by Clostridium difficile (C. diff.) subsequent to antibiotic use have become increasingly common and virulent.

Image source: Escherichia coli, Wikipedia, public domain.

Not all chronic diarrhea is strictly watery, malabsorptive, or inflammatory, because some categories overlap.

References:

Evaluation of Chronic Diarrhea. Juckett G, Trivedi R. Am Fam Physician. 2011 Nov 15;84(10):1119-1126.
Skin patch vaccine to prevent travelers' diarrhea
Image source: Colon (anatomy), Wikipedia, public domain.

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Heath Frisby lands the first snowmobile front flip in competition:

This is what happens when the things don't go as planned: Colten Moore flies 120 feet into the air and then hits the snow hard in Snowmobile Freestyle Finals... (video below). He not only survived but went on to win Winter X Games Gold later.

Not all extreme winter sport champions are so lucky though, and some of them have barely escaped death, with life-altering injuries: Kevin Pearce reflects on Sarah Burke's death (USA Today).

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30-01-2012 11:09 University of Colorado School of Medicine Neurology Grand Rounds 12.16.2011

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CU School of Medicine Neurology Grand Rounds 12.16.2011 - Video

Newswise — Dr. Jeffrey L. Saver, professor of neurology at the David Geffen School of Medicine at UCLA and director of the UCLA Stroke Center, received the William Feinberg Award for Excellence in Clinical Stroke at the American Stroke Association’s 2012 International Stroke Conference in New Orleans on Feb. 2.

The Feinberg Award recognizes a Stroke Council Fellow actively involved in patient-based research who has made significant contributions to clinical stroke research.

Saver, a stroke physician and scientist for nearly 20 years, has been a principal investigator or co-investigator in numerous national and international trials spanning a spectrum of stroke care.

He has made many pioneering contributions including advancing the pre-hospital identification and treatment of stroke; modernizing the definition of transient ischemic attack; developing methods to analyze the whole range of post-stroke deficits in clinical trials; showing that rapid restoration of blood flow can reverse acute stroke brain injury; and developing clot retrieval devices to reopen blocked cerebral arteries in acute stroke.

Saver’s masterwork may be as the principal investigator of National Institute of Health FAST-MAG trial in which paramedics are giving potentially brain protective magnesium to patients within the first minutes after stroke onset.

In addition, Saver has trained more than 20 neurology fellows and created the UCLA Visiting Scholars Program for international vascular neuroscientists to perform clinical research within the UCLA Stroke Center.

Saver has been an active member of the American Heart Association’s Stroke Council, serving on executive and planning committees and guideline and statement writing groups. He has been an editor for more than 10 journals and currently serves on numerous journal editorial boards.

The UCLA Stroke Center, recognized as one of the world's leading centers for the management of cerebral vascular disease, treats simple and complex vascular disorders by incorporating recent developments in emergency medicine, stroke neurology, microneurosurgery, interventional neuroradiology, stereotactic radiology, neurointensive care, neuroanesthesiology and rehabilitation neurology. The program is unique in its ability to integrate clinical and research activities across multiple disciplines and departments. Founded in 1994, the UCLA Stroke Center is designated as a certified Primary Stroke Center by the national Joint Commission on Accreditation of Healthcare Organizations.

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UCLA Stroke Researcher Honored by American Stroke Association

31-01-2012 05:28 History Taking and Neurology Symptoms Clinical Neurology Series Prof.Dr.Abdel Latef Osman Professor of Neurology, Azhar University

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Dr.Abdel Latef Osman | History Taking

NEW YORK & PETACH TIKVAH, Israel--(BUSINESS WIRE)-- BrainStorm Cell Therapeutics Inc. (OTCBB: BCLI.OB - News), a leading developer of adult stem cell technologies and therapeutics, announced today that the prestigious Experimental Neurology Journal, published an article indicating that preclinical studies using cells that underwent treatment with Brainstorm’s NurOwn™ technology show promise in an animal model of Huntington’s disease. The article was published by leading scientists including Professor Melamed and Professor Offen of the Tel Aviv University.

In these studies, bone marrow derived mesenchymal stem cells secreting neurotrophic factors (MSC-NTF), from patients with Huntington’s disease, were transplanted into the animal model of this disease and showed therapeutic improvement.

“The findings from this study demonstrate that stem cells derived from patients with a neurodegenerative disease, which are processed using BrainStorm’s NurOwn™ technology, may alleviate neurotoxic signs, in a similar way to cells derived from healthy donors. This is an important development for the company, as it confirms that autologous transplantation may be beneficial for such additional therapeutic indications,” said Dr. Adrian Harel, BrainStorm’s CEO.

"These findings provide support once again that BrainStorm’s MSC-NTF secreting cells have the potential to become a platform that in the future will provide treatment for various neuro-degenerative diseases," says Chaim Lebovits, President of BrainStorm. "This study follows previously published pre-clinical studies that demonstrated improvement in animal models of neurodegenerative diseases such as Parkinson’s, Multiple Sclerosis (MS) and neural damage such as optic nerve transection and sciatic nerve injury. Therefore, BrainStorm will consider focusing on a new indication in the near future, in addition to the ongoing Clinical Trials in ALS.”

BrainStrom is currently conducting a Phase I/II Human Clinical Trial for Amyotrophic Lateral Sclerosis (ALS) also known as Lou Gehrig’s disease at the Hadassah Medical center. Initial results from the clinical trial (which is designed mainly to test the safety of the treatment), that were announced last week, have shown that the Brainstorm’s NurOwn™ therapy is safe and does not show any significant treatment-related adverse events and have also shown certain signs of beneficial clinical effects.

To read the Article entitled ‘Mesenchymal stem cells induced to secrete neurotrophic factors attenuate quinolinic acid toxicity: A potential therapy for Huntington's disease’ by Sadan et al. please go to:

http://www.sciencedirect.com/science/article/pii/S0014488612000295

About BrainStorm Cell Therapeutics, Inc.

BrainStorm Cell Therapeutics Inc. is a biotech company developing adult stem cell therapeutic products, derived from autologous (self) bone marrow cells, for the treatment of neurodegenerative diseases. The company, through its wholly owned subsidiary Brainstorm Cell Therapeutics Ltd., holds rights to develop and commercialize the technology through an exclusive, worldwide licensing agreement with Ramot at Tel Aviv University Ltd., the technology transfer company of Tel-Aviv University. The technology is currently in a Phase I/II clinical trials for ALS in Israel.

Safe Harbor Statement

Statements in this announcement other than historical data and information constitute "forward-looking statements" and involve risks and uncertainties that could cause BrainStorm Cell Therapeutics Inc.'s actual results to differ materially from those stated or implied by such forward-looking statements, including, inter alia, regarding safety and efficacy in its human clinical trials and thereafter; the Company's ability to progress any product candidates in pre-clinical or clinical trials; the scope, rate and progress of its pre-clinical trials and other research and development activities; the scope, rate and progress of clinical trials we commence; clinical trial results; safety and efficacy of the product even if the data from pre-clinical or clinical trials is positive; uncertainties relating to clinical trials; risks relating to the commercialization, if any, of our proposed product candidates; dependence on the efforts of third parties; failure by us to secure and maintain relationships with collaborators; dependence on intellectual property; competition for clinical resources and patient enrollment from drug candidates in development by other companies with greater resources and visibility, and risks that we may lack the financial resources and access to capital to fund our operations. The potential risks and uncertainties include risks associated with BrainStorm's limited operating history, history of losses; minimal working capital, dependence on its license to Ramot's technology; ability to adequately protect its technology; dependence on key executives and on its scientific consultants; ability to obtain required regulatory approvals; and other factors detailed in BrainStorm's annual report on Form 10-K and quarterly reports on Form 10-Q available at http://www.sec.gov. The Company does not undertake any obligation to update forward-looking statements made by us.

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Experimental Neurology Journal: BrainStorm's NurOwn™ Stem Cell Technology Shows Promise for Treating Huntington's ...

26-01-2012 22:47

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Connecticut Tutorials Examination Neurology - Video

30-01-2012 11:05 University of Colorado School of Medicine Neurology Grand Rounds 12.7.2011

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CU School of Medicine Neurology Grand Rounds 12.7.2011 - Video

SALISBURY -- You don't have to be a brain surgeon to figure out that Chelsea Simon is an exemplary student.

Planning to go into neurology, the James M. Bennett High School senior said she was inspired to enter the field after taking an Advanced Placement psychology course. Having also been laid up in the hospital early last fall with what turned out to be dehydration, she said her interest in medicine was also boosted by that experience.

Describing herself as a "people person," Simon had previously considered becoming a lawyer.

"The neuroscience unit in my psychology course was just so compelling," she said, noting there was an overlap in the interests. "I love being around people and seeing what goes into the way they think."

Recognized by her teachers for her dedication, her AP English teacher Kathryn Wilde was impressed with the way Simon maintained high grades in her classes while in the hospital.

"She's strong athletically and academically," Wilde said. "She is the kind of student that one marks 'exceeds expectations' for on reference forms."

Remarking on her work in her class, Wilde said Simon "loves to write and has a strong voice; she likes to push herself to be creative."

Simon, a strong field hockey player, had considered trying out for a varsity team in college. But with her plans to attend a large Division I school, she said it would likely take too much time away from studies.

Also a competitive cheerleader when she was younger, she currently serves as one of the dance captains for JMB's legendary "Rock 'n' Roll Revival" musical shows.

Frequently practicing with other dancers after school, she said she usually only has time when she gets home to finish her homework and get to bed.

She is taking five AP classes this year alone and she said she has gotten used to her busy schedule. She thinks she can handle the rigor of medical school if she decides to stick with that plan.

As vice president of the senior class, among several other school leadership positions, she said listening, communication and being able to help people are important parts of life for her.

ABOUT CHELSEA SIMON

School: James M. Bennett High School

School related activities: VP of class, Grades 11-12; SGA, Grades 9-12; president of National Honor Society, Grade 12; National Honor Society, Grades 10-12; Mu Alpha Theta, Grade 12; French Honor Society, Grades 11-12; varsity field hockey, Grades 9-12, captain, Grades 11-12; Mock Trial Grades 10-11; Rock 'n' Roll Revival, Grades 9-12, dance captain, Grades 11-12; Environmental Club, Grades 11-12; French Club, Grades 9-12.

Community-based activities: Appalachia Service Project, volunteer coach for Salisbury Middle School field hockey team

Personal achievements: Futures Field Hockey; senior ambassador for Sanders Photography; Minds in Motion Scholar Athlete Award, Grades 9-12; James M. Bennett nominee for the Jefferson Scholarship for the University of Virginia; Academic Letter; Lamp of Knowledge; National Young Leaders Scholar Nominee; Circuit Champion for the 2011 Maryland State Bar Association High School Mock Trial; Honorable Mention for Bayside Hockey, Grade 11; Second Team All Bayside Hockey, Grade 12; Senior All-Star Game, Grade 12.

If you could choose your age, what would it be? I think I would be the age I am now. I am at the point where I know who I am and what I want to do. I have great friends and family support. I enjoy my classes and activities. Life is seemingly perfect.

What is your greatest fear? My greatest fear is failure. I strive to always do my best and achieve my goals no matter the circumstance. I know who I want to be and where I want to go, thus I couldn't imagine not reaching my goals. I don't think this is something I should particularly concern myself with because I don't give up. I would just be innovative and find a new way to reach my goals.

If you had $10,000 to donate to a charity, which one would you give it to? Why? If I had $10,000 I would first set aside money for college. College is extremely expensive and proves to be such a financial burden. I would then donate money toward the organizations who create feel-good bags for children in the hospital. I experienced being cooped up in a hospital bed, wondering when I would be normal again. One day I was given a feel-good bag. Since I was still underage, I was admitted to the pediatric floor. The bag contained notebooks, crayons, a teddy bear, and a blanket. I couldn't possibly imagine what life would be like for those kids who experience hospital life frequently. I know for me, I was scared and lonely, thus I would love to give a child something to comfort them. Comfort and happiness honestly does help the situation improve and I would love to help donate to such a fantastic cause.

What is the best piece of advice you have ever received? Who gave it to you? The best advice I was given was actually expressed to me recently by one of my friends. The friend told me to simply do what I want to do. I am one of those people who always analyze situations and I recently realized that all that does is create unnecessary stress and worry. If I would simply just do what I want and not think too far into things, I could just sit back and enjoy life day by day. Life is too short for stress.

How do you know when someone is a true friend? I would say that a true friend is someone that you can share everything with. Someone who has your back no matter what. Someone who is loyal and trustworthy. Someone who you can be yourself around. Someone who isn't afraid to tell you when you are wrong but supports you when you are right. Someone who pushes you towards your goals and is genuinely happy when you achieve them. That is a true friend.

If you could have lunch with any person or thing, living or from the past, who or what would you choose? If I could have lunch with one person I think it would have to be Oliver Sacks. I am taking an AP psychology course and we have discussed his immense influence on psychological development. He was one of the first people to actually analyze psychological situations based on his own gut feelings. Sacks wasn't afraid to share his ideas and express them. He contributed not only an immense knowledge of medicine but a genuine care for the health of his patients. I want to pursue neurology in such a way that can be similarly juxtaposed with Sacks' ideals and motivations toward changing seemingly disastrous diseases.

If you could be an animal, which animal would you choose to be? If I could be an animal, I would be a dolphin. I have always admired their freedom and free-spirited lifestyle. I have always loved the ocean and the feeling of excitement and wonder that comes with it. I think being able to relax all day among the waves and yet still be surround by wonders would be a perfect balance in life.

Where would you like to be in five years? In five years I would like to be pursuing my pre-med aspirations. I would absolutely love to become involved with child neurology. I think the brain is one of the most interesting topics. The brain is completely wondrous and presents new discoveries and challenges each and every day. I would love to be able to change a child's life by discovering and curing brain diseases that diminish their abilities to live the life they desire.

What is your goal for this school year? My goal for this school year is to have fun. I obviously will strive to achieve good grades and excel in my classes but at the same time I want to enjoy my life here before I leave for school. I want to enjoy my friends and family. I think my ultimate goal is to never stop smiling. I want the rest of the year to create some of the best times of my life.

What makes you angry? I wouldn't say that I get angry easy. The one thing that does bother me, though, would have to be those who pick on others. I truly believe that everyone has something wonderful to contribute and that each person can express a new way to assess a situation. Individuals provided various ideas that when combined create the most magnificent effects.

What current issue concerns you the most? I think a current issue that is important to those of my generation is the lack of choice within their education. It is sad when a student taking higher level classes cannot take classes that they are interested in because their schedule has to be worked around the few choices available. If the student isn't taking classes in which they find interesting, then they will not learn. I just find it sad that we cannot overcome this educational struggle. Look at other countries who push student interests: the students who are college bound attend a college bound high school and the students with the goal of working in mechanics go to a school similar to the CTE program provided at Parkside. This encompasses all types of learning styles and motivations. Personally, if the Board of Education wants higher school attendance, then they need to re-establish activities of interest. I know that the monetary situation is becoming increasingly worse, but yet we spend money on buying things we don't need. What will happen to those kids who are motivated by their eligibility to play sports? Do you really think those kids will still try as hard once the funding for sports disappears? No, of course not. Those kids will lose their desire to try in school. I feel that we are losing touch of the fun in schools and focusing on stupid test scores. Let the kids study what interests them and support their goals; that will create a better future.

What is your favorite song? I am such an indecisive person! I probably have a new song every day. Right now, I would have to say I play Adele's song "Set Fire to the Rain" over and over. I really like all types of music. Country has been a big genre for me lately as well.

What was the last movie you watched? The last movie I watched was actually last Saturday when I had a mommy daughter movie night! I have been so busy that I am honestly home long enough for homework and bed. The movies we watched are two of my favorites, "The Notebook" and "A Walk to Remember." I am such a romantic!

What is your favorite place to eat away from home? I actually love sushi and Sakura Japan Sushi & Grill has the best banana rolls! So yummy!

cmckinney@dmg.gannett.com

410-845-4639

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Teen's thinking of neurology

Lexington Clinic is notifying 1,018 patients of a privacy breach involving a stolen laptop containing patients' names, contact information, and diagnoses.

Someone stole the laptop from Lexington Clinic's Neurology Department located in the St. Joseph Office Park at 1401 Harrodsburg Road on December 7. All of the patients affected were receiving services within the neurology department.

According to a release from Lexington Clinic, the stolen laptop did not contain the personal financial information of patients, such as Social Security Numbers, credit card numbers and bank account numbers.

The company says it immediately notified law enforcement authorities once it learned of the theft, and all door locks to the neurology department were changed. Lexington Clinic is actively working with the St. Joseph security officials to further assess security of offices located in the St. Joseph Office Park.

Lexington Clinic is notifying, by letter, all patients who may be affected by this theft. If you have been or currently are a patient of the Lexington Clinic Neurology Department, and you did not receive a letter regarding this incident, your information was not included on the stolen laptop. There is no evidence thus far that any patient information has been misused, however, Lexington Clinic advises patients to follow the steps recommended by the Federal Trade Commission to prevent misuse of personal information:

Lexington Clinic advises patients to stay alert for signs of identity theft, such as accounts they didn't open and debts on their accounts that they can't explain; fraudulent or inaccurate information on credit reports, including accounts and personal information, such as your Social Security number, address(es), name or initials and employers; failing to receive bills or other mail; receiving credit cards that you didn't apply for; being denied credit, or being offered less favorable credit terms, like a high interest rate, for no apparent reason; and getting calls or letters from debt collectors or businesses about merchandise or services you didn't buy.

For additional information Lexington Clinic patients are encouraged to call toll-free at 1 (877) 851-2562. Local patients may call (859) 258-5888.

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Lexington Clinic warns patients of stolen laptop with medical information

Initial evaluation of chronic cough (defined as more than 8 weeks' duration in adults and 4 weeks in children) should include a chest radiography (CXR) in most adult patients.

Patients who are taking an angiotensin-converting enzyme inhibitor (ACEi) should switch to a medication from another drug class.

Differential diagnosis of cough, a simple mnemonic is GREAT BAD CAT TOM. Click here to enlarge the image: (GERD (reflux), Laryngopharyngeal Reflux (LPR), Rhinitis (both allergic and non-allergic) with post-nasal drip (upper airway cough syndrome), Embolism, e.g. PE in adults, Asthma, TB (tuberculosis), Bronchitis, pneumonia, pertussis, Aspiration, e.g foreign body in children, Drugs, e.g. ACE inhibitor, CF in children, Cardiogenic, e.g. mitral stenosis in adults, Achalasia in adults, Thyroid enlargement, e.g. goiter, "Thoughts" (psychogenic), Other causes, Malignancy, e.g. lung cancer in adults).

The most common causes of chronic cough in adults are:

- upper airway cough syndrome (post-nasal drip)
- asthma
- gastroesophageal reflux disease (GERD)
- any combination of the above

If upper airway cough syndrome is suspected, a trial of a decongestant and an antihistamine is warranted.

The diagnosis of asthma can be confirmed with a clinical response to empiric therapy with inhaled bronchodilators or corticosteroids (spirometry is generally preferred though).

Empiric treatment for gastroesophageal reflux disease (GERD) should be initiated in lieu of testing for patients with chronic cough and reflux symptoms.

Patients should avoid exposure to cough-evoking irritants, such as cigarette smoke.

Further testing may be indicated if the cause of chronic cough is not identified and includes:

- high-resolution computed tomography (CT) of the chest
- referral to a pulmonologist or an allergist

In children, a cough lasting longer than 4 weeks is considered chronic.

The most common causes of chronic cough in children are:

- respiratory tract infections ("bronchitis" and pneumonia)
- asthma
- rhinitis with post-nasal drip
- gastroesophageal reflux disease (GERD)
- aspirated foreign body is relatively rare but must not be missed

Evaluation of children with chronic cough should include chest radiography (CXR) and spirometry (if older than 5 years of age). Skin prick test for environmental allergies can also be indicated.

References:

Evaluation of the patient with chronic cough. Benich Iii JJ, Carek PJ. Am Fam Physician. 2011 Oct 15;84(8):887-92.

Diagnosis of chronic cough in children

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http://feeds.feedburner.com/CasesBlog

Newswise — LOS ANGELES (Jan. 27, 2012) – Asma M. Moheet, MD,
has been named director of Cedars-Sinai Medical Center’s
Neurocritical Care Fellowship program, a two-year training
program for doctors who have completed a neurology residency
and wish to specialize in neurological intensive care.

Moheet is one of three neurointensivists who oversee patient
care in Cedars-Sinai’s highly sophisticated, 12-bed neuro ICU,
which treats a high volume of patients suffering from a range
of neurological and neurosurgical diagnoses.

“As an urban, Level 1 trauma center with a new,
state-of-the-art neuro intensive care unit and 958 licensed
beds, Cedars-Sinai offers an extraordinary learning
environment. Graduates will be prepared to function
independently as intensive care physicians and be qualified to
sit for the Neurocritical Care Board Examination,” Moheet said.

Moheet, a member of the hospital’s Code Brain team that
provides emergency stroke intervention, noted that many
Cedars-Sinai programs – including neurology and neurosurgery –
rank high in U.S. News & World Report’s annual hospital
ratings and other measures of care quality. Cedars-Sinai is a
regional stroke referral center for complicated cases. The
Stroke Program has received the Gold Award from the American
Stroke Association, is certified as a Primary Stroke Center by
The Joint Commission and is an Approved Stroke Center of Los
Angeles County’s Emergency Medical Services Agency.

The fellowship is accredited by the United Council of
Neurologic Subspecialties. Applications for the 2013 position
are being accepted now, with candidate interviews starting this
spring.

Moheet, board certified in neurology, was a clinical fellow and
instructor at the University of California, San Francisco,
before joining Cedars-Sinai in 2010. She received her medical
degree from the University of Missouri, Kansas City, in a
six-year integrated bachelor’s and medical degree program,
completing her internal medicine internship and neurology
residency at the Cleveland Clinic Foundation. She held a
courtesy faculty appointment at the Cleveland Clinic while
pursuing the fellowship in neurovascular and neurocritical care
at UCSF.

Besides caring for patients and teaching, Moheet has research
under way in drug and mechanical interventions for stroke,
brain-monitoring techniques, patient safety and medical ethics.

Cedars-Sinai’s neuro ICU is part of the Department of
Neurology, chaired by Patrick D. Lyden, MD, the Carmen and
Louis Warschaw Chair in Neurology. He is an internationally
known researcher who is leading clinical trials on therapeutic
hypothermia as a way to prevent brain injury following stroke.
He was one of the key researchers in the major clinical trial
leading to Food and Drug Administration approval in 1996 of tPA
– tissue plasminogen activator – still the only proven,
approved drug for stroke treatment.

After joining Cedars-Sinai in 2009, Lyden, an American Academy
of Neurology fellow, reinforced key existing programs and set
the department on a course to expand its research, educational
and clinical offerings. The department will relocate to the
450,000-square-foot Advanced Health Sciences Pavilion when it
opens in 2013.

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Asma M. Moheet, MD, to Direct Cedars-Sinai's Neurocritical Care Fellowship