The North American Fetal Therapy Network consensus statement: prenatal surveillance of uncomplicated monochorionic gestations.

Because they share a common placenta, monochorionic gestations are subject to unique pregnancy complications that can threaten the life and health of both fetuses and therefore impose a disproportionate disease burden on overall perinatal morbidity and mortality. Early detection of these unique disease processes may allow for prompt referral to a regional treatment center, comprehensive counseling, and better patient outcomes. The North American Fetal Therapy Network is a consortium of 30 medical institutions in the United States and Canada with established expertise in fetal surgery and other forms of multidisciplinary care for complex fetal disorders.

A pooled analysis of two phase 3 clinical trials of dalfampridine in patients with multiple sclerosis.

Background: Two phase 3 clinical trials demonstrated that dalfampridine extended-release 10-mg tablets (D-ER), twice daily, significantly improved walking relative to placebo in patients with multiple sclerosis (MS). The objective of this study was to evaluate the efficacy and safety of D-ER in patients with MS using pooled data from the two phase 3 trials.

Methods: Data were pooled from the two trials, and D-ER was compared with placebo for timed-walk responder rate, changes in walking speed, and the 12-item Multiple Sclerosis Walking Scale (MSWS-12).

Lower plasma apolipoprotein A1 levels are found in Parkinson's disease and associate with apolipoprotein A1 genotype.

The discovery of novel plasma-based biomarkers could lead to new approaches in the treatment of Parkinson's disease (PD). Here, we explore the role of plasma apolipoprotein A1 (ApoA1) as a risk marker for PD and evaluate the influence of APOA1 promoter variation on plasma ApoA1 levels. Plasma ApoA1 and the single-nucleotide polymorphism, rs670, were assayed in a discovery cohort (cohort 1) of 301 PD patients, 80 normal controls (NCs), and 165 subjects with other neurodegenerative diseases, as well as a cohort (cohort 2) of 158 PD patients from a second clinical site.

People with Parkinson's disease and normal MMSE score have a broad range of cognitive performance.

Cognitive impairment, including dementia, is common in Parkinson's disease (PD). The Mini-Mental State Examination (MMSE) has been recommended as a screening tool for Parkinson's disease dementia (PDD), with values below 26 indicative of possible dementia. Using a detailed neuropsychological battery, we examined the range of cognitive impairment in PD patients with an MMSE score of 26 or higher.

Endoscopic diagnosis of cervical esophageal heterotopic gastric mucosa with conventional and narrow-band images.

Aim: To compare the diagnostic yield of heterotopic gastric mucosa (HGM) in the cervical esophagus with conventional imaging (CI) and narrow-band imaging (NBI).

Methods: A prospective study with a total of 760 patients receiving a CI examination (mean age 51.6 years; 47.

Association mapping of the PARK10 region for Parkinson's disease susceptibility genes.

Background: Previous studies indicate that as many as six genes within the PARK10 region (RNF11, UQCRH, HIVEP3, EIF2B3, USP24, ELAVL4) might modify susceptibility or age at onset in Parkinson's disease (PD).

Methods: We sought to identify new PD susceptibility genes and to validate previously nominated candidate genes within the PARK10 region using a two-stage design. We used data from a large, publicly-available genome-wide association study (GWAS) in the discovery stage (n = 2000 cases and 1986 controls) and data from three independent studies for the replication stage (total n = 2113 cases and 2095 controls).

Pilot trial of onabotulinumtoxina (Botox) in moderate to severe restless legs syndrome.

Objective: To evaluate the potential of onabotulinum toxin A (Botox®, Allergan, Inc., Irvine, California) in the treatment of restless legs syndrome (RLS).

Methods: A single-arm, open-label pilot trial of onabotulinum toxin A was conducted to determine its usefulness as an injectable treatment for RLS.

Survey of neurohospitalists: subspecialty definition and practice characteristics.

Neurohospitalists represent an emerging neurological subspecialty focusing on inpatient neurological disease. Little data exists regarding neurohospitalist practice information and clinical activity. A survey among neurohospitalists was performed to help define the subspecialty, yield demographic information, practice characteristics, and understand clinical and non-clinical activities.

Physical therapy as conservative management for cervical pain and headaches in an adolescent with neurofibromatosis type 1: a case study.

Background And Purpose: : Neurofibromatosis is a group of genetic disorders that affect the development and growth of nerve cell tissues. These disorders include tumors of myelin-producing supportive cells that grow on nerves and can cause changes in bone formation, skin integrity, and nerve transmission. Common musculoskeletal impairments associated with neurofibromatosis type 1 (NF 1) include cervical pain, muscle weakness, muscle stiffness, headaches, and postural deviations.

Time from decision to incision for cesarean deliveries at a community hospital.

Objective: To compare decision-to-incision times of cesarean deliveries for various indications, estimate the percentage of cesarean deliveries initiated within 30 minutes (defined as "efficient"), and assess the effect of performance improvement projects over time.

Methods: In 2004 (n=291) and 2006 (n=574) cesarean deliveries were prospectively tracked for decision-to-incision time. Information collected included indication, urgency, and reason for delay.

Deep brain stimulation hardware complications: the role of electrode impedance and current measurements.

Deep brain stimulation (DBS) is an effective therapy for advanced Parkinson's disease patients. Successful DBS outcomes depend on appropriate patient selection, surgical placement of the lead, intact hardware systems, optimal programming, and medical management. Despite its importance, there is little guidance in reference to hardware monitoring, hardware troubleshooting, and patient management.

Gadolinium MR Arthrography of the Rotator Cuff.

Conventional magnetic resonance imaging (MRI) of the rotator cuff has not done well in distinguishing partial-thickness tears from tendonitis or small, full-thickness tears. However, these are important distinctions for orthopedic surgeons who are deciding whether to operate and what type of surgery to perform on a patient with suspect rotator cuff pathology. Gadolinium magnetic resonance arthrography (MRA) involves injecting dilute gadolinium into the shoulder under fluoroscopy.

Postpartum follow-up care in a hospital-based clinic: an update on an expanded program.

The Postpartum Care Center, an outpatient, in-hospital follow-up clinic began in 1991 in response to shortening maternity stays and the resulting need to provide follow-up care to mothers, infants, and families. This innovative model of postpartum follow-up care is cost effective and allows one nurse to see two to three times as many families in a clinic day as could be seen at home. Support services including the laboratory, pharmacy, social service, and anesthesia service are in close proximity to the clinic.

CT angiography of the carotid artery.

CT angiography shows promise as a noninvasive method to display carotid vascular pathology. This article discusses technique, stenosis measurements, pitfalls, strengths, and weaknesses of CT imaging of the carotid artery.

Mothers' reports of the outcome of nipple shield use.

Although nipple shields have undergone significant design improvements in recent years, many lactation consultants are reluctant to use them to assist with breastfeeding challenges. This article shares the experience of lactation consultants and their clients in the Breastfeeding Center at Evergreen Hospital with the use of ultrathin, silicone nipple shields. Fifty-one clients who used ultra-thin nipple shields were interviewed by telephone to determine patterns of use and client satisfaction.