Efficacy and safety of two incobotulinumtoxinA injection intervals in cervical dystonia patients with inadequate benefit from standard injection intervals of botulinum toxin: Phase 4, open-label, randomized, noninferiority study.

Unlabelled: IntroductionSome patients with cervical dystonia (CD) receiving long-term botulinum neurotoxin (BoNT) therapy report early waning of treatment benefit before the typical 12-week reinjection interval.

Methods: This phase 4, open-label, randomized, noninferiority study (CD Flex; NCT01486264) compared 2 incobotulinumtoxinA injection schedules (Short Flex: 8 ± 2 weeks; Long Flex: 14 ± 2 weeks) in CD patients. Previous BoNT-responsive subjects who reported acceptable clinical benefit lasting < 10 weeks were recruited.

Cognitive effects of theta frequency bilateral subthalamic nucleus stimulation in Parkinson's disease: A pilot study.

Background: There is significant evidence for cognitive decline following deep brain stimulation (DBS). Current stimulation paradigms utilize gamma frequency stimulation for optimal motor benefits; however, little has been done to optimize stimulation parameters for cognition. Recent evidence implicates subthalamic nucleus (STN) theta oscillations in executive function, and theta oscillations are well-known to relate to episodic memory, suggesting that theta frequency stimulation could potentially improve cognition in Parkinson's disease (PD).

Open-label titration of apomorphine sublingual film in patients with Parkinson's disease and "OFF" episodes.

Introduction: The efficacy and safety of apomorphine sublingual film (APL-130277; APL) for the on-demand treatment of "OFF" episodes associated with Parkinson's disease (PD) was demonstrated in a double-blind trial. Herein we describe the ability of patients to receive effective and tolerable APL dose titration during the open-label titration phase.

Methods: Adult patients with levodopa-responsive PD and "OFF" episodes were enrolled.

Alcohol and the Hospitalized Patient.

Alcohol use is a common social and recreational activity in our society. Misuse of alcohol can lead to significant medical comorbidities that can affect essentially every organ system and lead to high health care costs and utilization. Heavy alcohol use across the spectrum from binge drinking and intoxication to chronic alcohol use disorder can lead to high morbidity and mortality both in the long and short term.

Evaluating the cost-effectiveness of a sequential pneumococcal vaccination compared to single-dose vaccination strategy for adults in Hong Kong.

Two vaccines, 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13), are widely available for the prevention of pneumococcal disease in adults. However, it is unclear how cost-effective these pneumococcal vaccine choices are in the Hong Kong healthcare environment. We aimed to assess the cost-effectiveness of a sequential administration of PCV13 followed by PPSV23 compared to a single dose of PPSV23 vaccination for pneumococcal disease control in Hong Kong adults aged ≥65 years and individuals aged 20-64 years with immunocompromising and chronic conditions.

Mild cognitive impairment, psychiatric symptoms, and executive functioning in patients with Parkinson's disease.

Objective: Mild cognitive impairment (MCI) and psychiatric symptoms (anxiety, depression, and apathy) are common in Parkinson's disease (PD). While studies have supported the association between psychiatric symptoms and cognitive performance in PD, it is unclear if the magnitude of link between psychiatric symptoms and cognitive health is stronger by MCI status. The purpose of this study was to examine the association between cognitive performance and psychiatric symptoms in PD and whether MCI status moderates this association.

Treadmill exercise elevates striatal dopamine D2 receptor binding potential in patients with early Parkinson's disease.

We have previously demonstrated changes in dopaminergic neurotransmission after intensive exercise in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned mouse model of Parkinson's disease (PD), including an increase in the dopamine D2 receptor (DA-D2R), using noninvasive PET imaging with the radioligand [18F]fallypride. The purpose of this feasibility and translational study was to examine whether intensive exercise leads to similar alterations in DA-D2R expression using PET imaging with [18F]fallypride in individuals with early-stage PD. In this pilot study, four patients with early-stage PD were randomized to receive intensive exercise (treadmill training sessions three times/week for 8 weeks) or no exercise.

Congenital eyelid eversion.

Congenital bilateral upper eyelid eversion is a rare, benign condition that often resolves spontaneously without permanent sequelae. The authors present an unusual case requiring multiple surgical interventions in a newborn child. A previously undescribed method that restored anatomic eyelid position in this patient is also outlined.

Primary eyelid leiomyoma.

A 10-year-old white male presented with a recurrent painful nodule of the left lateral lower eyelid margin with associated madarosis. The initial pathologic diagnosis at an outside institution was reported as chalazion. The lesion was re-excised, and histopathologic examination with immunohistochemical evaluation confirmed the diagnosis of leiomyoma.

Intubation of the ostium and nasolacrimal duct with a single self-linking silicone stent in external dacryocystorhinostomy.

Purpose: To describe a stent placement method that eliminates stent prolapse in external dacryocystorhinostomy.

Methods: A retrospective, institutional review board- approved case series of patients undergoing external dacryocystorhinostomy with an alternative stenting method. Following anastomosis of the posterior flaps, one arm of a Crawford silicone stent is passed through each canaliculus.

Outcomes of orbital implants after evisceration and enucleation in patients with endophthalmitis.

Purpose Of Review: This manuscript reviews enucleation and evisceration and primary versus secondary orbital implant placement in patients with endophthalmitis. A brief discussion of sympathetic ophthalmia is included as well.

Recent Findings: Opinions remain variable when considering enucleation versus evisceration and primary versus secondary orbital implant placement in patients with endophthalmitis.

Quantitation of Staphylococcus aureus in seawater using CHROMagar SA.

A microbiological algorithm has been developed to analyze beach water samples for the determination of viable colony forming units (CFU) of Staphylococcus aureus (S. aureus). Membrane filtration enumeration of S.

Asymptomatic nephrolithiasis detected by ultrasound.

Background And Objectives: Data from several countries suggest a recent world-wide increase in the prevalence of stone disease. However, these studies have not analyzed the effect that increases in utilization of imaging modalities have had on detection of asymptomatic stones.

Design, Setting, Participants, & Measurements: A retrospective chart review of all patients who had an abdominal or retroperitoneal ultrasound in 2005 at a Department of Veterans' Affairs Medical Center was conducted.

Efficacy of fresh versus refrigerated botulinum toxin in the treatment of lateral periorbital rhytids.

Purpose: To determine if there is a difference in the efficacy of refrigerated (previously reconstituted) versus freshly reconstituted botulinum toxin (Botox Cosmetic, Allergan, Irvine, CA, U.S.A.

Retained nuclear fragments in the anterior chamber after phacoemulsification with an intact posterior capsule.

Objective: To review the clinical features and treatment of patients with retained nuclear fragments in the anterior chamber (AC).

Design: Single-center, retrospective, noncomparative, consecutive case series.

Participants: Sixteen patients with a diagnosis of retained nuclear fragments in the AC.

Desmoplastic malignant melanoma of the lip: a report of 6 cases and review of the literature.

Desmoplastic malignant melanoma is a rare neoplasm consisting primarily of spindle-shaped melanoma cells embedded in a fibrous stroma, with approximately 6% of cases occurring in the lip. A literature search revealed that most reported cases occur in sun-exposed areas in older men. Few cases of desmoplastic malignant melanoma of the lip in young people (in their mid-twenties) have been described.