Continued midazolam versus diphenhydramine in difficult-to-sedate patients: a randomized double-blind trial.

Background And Aims: Current guidelines recommend diphenhydramine in patients undergoing endoscopy who are not adequately sedated with a benzodiazepine and opioid combination. Because this practice has not been adequately assessed, we performed a randomized, double-blind trial comparing diphenhydramine with continued midazolam in such patients.

Methods: Patients undergoing elective colonoscopy with moderate sedation were eligible.

Cost analysis of objective resident cataract surgery assessments.

Purpose: To compare 8 ophthalmology resident surgical training tools to determine which is most cost effective.

Setting: University of Rochester Medical Center, Rochester, New York, USA.

Design: Retrospective evaluation of technology.

Interpretation of urine drug testing results in patients using transdermal buprenorphine preparations for the treatment of chronic noncancer pain.

Objective: To determine whether the prevailing liquid chromatography and tandem mass spectroscopy assay (LC-MS/MS) assay designed to monitor buprenorphine compliance of the sublingual formulation used in the substance abuse treatment setting can be extrapolated to the transdermal formulation used in the chronic pain treatment setting, which is 1000-fold less concentrated.

Design: Retrospective chart review.

Subjects: Self-reported compliant patients using the transdermal or sublingual formulations of buprenorhphine.

Neuroimaging of neurocutaneous diseases.

An in-depth knowledge of the imaging characteristics of the common neurocutaneous diseases (NCD) described in this article will help neurologists understand the screening imaging modalities in these patients. The future of neuroimaging is geared towards developing and refining magnetic resonance imaging (MRI) sequences. The detection of tumors in NCD has greatly improved with availability of high-field strength 3T MRI machines.

Spinal cord tumors: new views and future directions.

Spinal cord tumors are uncommon neoplasms that, without treatment, can cause significant neurologic morbidity and mortality. The historic classification of spine tumors is based on the use of myelography with 3 main groups: (1) extramedullary extradural, (2) intradural extramedullary, and (3) intradural intramedullary. This chapter focuses on intramedullary spinal cord tumors (ISCTs), with an emphasis on new diagnostic imaging modalities and treatment options.

MRI markers of small vessel disease in lobar and deep hemispheric intracerebral hemorrhage.

Background And Purpose: MRI evidence of small vessel disease is common in intracerebral hemorrhage (ICH). We hypothesized that ICH caused by cerebral amyloid angiopathy (CAA) or hypertensive vasculopathy would have different distributions of MRI T2 white matter hyperintensity (WMH) and microbleeds.

Methods: Data were analyzed from 133 consecutive patients with primary supratentorial ICH and adequate MRI sequences.

Interlead distance and left ventricular lead electrical delay predict reverse remodeling during cardiac resynchronization therapy.

Background: Both anatomic interlead separation and left ventricle lead electrical delay (LVLED) have been associated with outcomes following cardiac resynchronization therapy (CRT). However, the relationship between interlead distance and electrical delay in predicting CRT outcomes has not been defined.

Methods: We studied 61 consecutive patients undergoing CRT for standard clinical indications.

Effect of statins on intracerebral hemorrhage outcome and recurrence.

Background And Purpose: 3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins, have been associated with improved outcome after ischemic stroke and subarachnoid hemorrhage but an increased risk of incident intracerebral hemorrhage (ICH). We investigated (1) whether statin use before ICH was associated with functional independence at 90 days, and (2) whether survivors exposed to statins after ICH had an increased risk of recurrence.

Methods: We analyzed 629 consecutive ICH patients with 90-day outcome data enrolled in a prospective cohort study between 1998 to 2005.

Usefulness of cardiac resynchronization therapy in the management of Doxorubicin-induced cardiomyopathy.

Doxorubicin is a widely used antineoplastic agent that may cause irreversible dilated cardiomyopathy. Doxorubicin-induced cardiomyopathy (DIC) can occur several years after exposure and carries a poor prognosis. Although cardiac resynchronization therapy (CRT) is a useful intervention in end-stage heart failure unresponsive to optimal medical therapies, its efficacy in DIC remains unknown.

Feasibility of acute thrombolytic therapy for stroke.

Background: Thrombolysis is an expensive medical intervention for ischemic stroke and hence there is a need to study the feasibility of thrombolysis in rural India.

Aims: To asses the feasibility and limitations of providing thrombolytic therapy to acute ischemic stroke patients in a rural Indian set-up.

Material And Methods: The first 64 consecutive patients registered under the Acute Stroke Registry in a university referral hospital with a rural catchment area were studied as per a detailed protocol and questionnaire.