The Benefit of Mirtazapine in the Treatment of Progressive Multifocal Leukoencephalopathy in a Young HIV-positive Patient: A Case Report.

Highly active antiretroviral therapy is well-established in the treatment of human immunodeficiency virus (HIV)-positive patients. Nonadherence with therapy regimens often leads to the occurrence of opportunistic infections that further complicate treatment and challenge the treating physician. We report a young HIV-positive patient who suffered from progressive multifocal leukoencephalopathy caused by the human John Cunningham virus and showed objective clinical improvement after adding mirtazapine to the treatment regimen, an observation that is supported by the emerging literature.

Accuracy of the new ICD-9-CM code for "drip-and-ship" thrombolytic treatment in patients with ischemic stroke.

A new International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code, V45.88, was approved by the Centers for Medicare and Medicaid Services (CMS) on October 1, 2008. This code identifies patients in whom intravenous (IV) recombinant tissue plasminogen activator (rt-PA) is initiated in one hospital's emergency department, followed by transfer within 24 hours to a comprehensive stroke center, a paradigm commonly referred to as "drip-and-ship.

Stroke Prevention: The Best Outcome after a Transient Ischemic Attack. Results from the Minnesota Stroke Registry and Opportunities to Improve Care.

A transient ischemic attack (TIA) is an opportunity for stroke prevention. We examined the care of 708 TIA patients entered into the Minnesota Stroke Registry (MSR) and analyzed the extent to which they were discharged on appropriate guideline-recommended secondary prevention treatments. We calculated the overall number of strokes prevented by multiple risk factor modifying treatments.

Reliability and validity of blood pressure measurement in the Secondary Prevention of Small Subcortical Strokes study.

Rationale: The Secondary Prevention of Small Subcortical Strokes study is a multicenter, international trial funded by the National Institutes of Health testing the role of lowering systolic blood pressure to <130 mmHg in the prevention of stroke recurrence and cognitive decline in patients with recent symptomatic small subcortical stroke. Reliable and unbiased blood pressure measurement is critical to successful completion of the trial.

Methods: We looked at the reliability and validity of both the device used for blood pressure measurement and observer performance during measurement to assess the quality of blood pressure determination in the study.

What's new in stroke? The top 10 for 2004/05.

During the past decade, stroke has emerged from the dark ages of therapeutic nihilism to the current dawn of treatment activism, fueled by an unprecedented amount of high-quality clinical research. Here, the choices for the "Top 10" studies of 2004/05 influencing the management of patients with stroke and threatened stroke are reviewed. Nine are randomized, clinical trials involving a total of 61,810 participants.

Avoiding central nervous system bleeding during antithrombotic therapy: recent data and ideas.

Background: Approximately 7000 intracerebral hemorrhages (ICHs) annually in the US are caused by use of antithrombotic therapies. We review the incidence, risk factors, and predictors of ICH in patients receiving long-term anticoagulation or antiplatelet therapy.

Summary Of Review: ICH rates range from 0.