Category Archives: Neurology

Here some excerpts from the 2012 review of hirsutism in women in the journal American Family Physician:

Hirsutism is excess terminal hair that commonly appears in a male pattern in women.

Although hirsutism is generally associated with hyperandrogenemia, 50% of women with mild symptoms have normal androgen levels.

Causes of hirsutism

The most common cause of hirsutism is polycystic ovary syndrome (PCOS), which accounts for 3 out of every 4 cases.

Many medications can also cause hirsutism.

In patients whose hirsutism is not related to medication use, evaluation is focused on testing for endocrinopathies and neoplasms, such:

- polycystic ovary syndrome (PCOS)
- adrenal hyperplasia
- thyroid dysfunction
- Cushing syndrome
- androgen-secreting tumors

Symptoms of hirsutism

Symptoms and findings suggestive of neoplasm include rapid onset of symptoms, signs of virilization, and a palpable abdominal or pelvic mass.

Patients without these findings who have mild symptoms and normal menses can be treated empirically.

For patients with moderate or severe symptoms, an early morning total testosterone level should be obtained, and if elevated, it should be followed by a plasma free testosterone level.

A total testosterone level greater than 200 ng per dL (6.94 nmol per L) should prompt evaluation for an androgen-secreting tumor.

Diagnosis of hirsutism

Laboratory workup may include:

- early morning total testosterone level
- plasma free testosterone level
- thyroid function tests
- prolactin level
- 17-hydroxyprogesterone level
- corticotropin stimulation test

Treatment of hirsutism

Treatment includes hair removal and pharmacologic measures.

Shaving is effective but needs to be repeated often. Evidence for the effectiveness of electrolysis and laser therapy is limited.

Laser treatment does not result in complete, permanent hair reduction, but it is more effective than other methods such as shaving, waxing, and electrolysis. It produces hair reduction for up to 6 months. The effect is enhanced with multiple treatments.

In patients who are not planning a pregnancy, first-line pharmacologic treatment should include oral contraceptives. Topical agents, such as eflornithine, may also be used.

Treatment response should be monitored for at least six months before making adjustments.

References:

Hirsutism in women. Bode D, Seehusen DA, Baird D. Am Fam Physician. 2012 Feb 15;85(4):373-80.

Management of Hirsutism (Excess Hair)

Image source: Skin layers. Wikipedia, public domain.

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Public release date: 18-Jul-2012 [ | E-mail | Share ]

Contact: Rachel Seroka rseroka@aan.com 612-928-6129 American Academy of Neurology

MINNEAPOLIS Higher levels of a certain fat in the blood called ceramides may increase a person's risk of developing Alzheimer's disease, according to a study published in the July 18, 2012, online issue of Neurology, the medical journal of the American Academy of Neurology.

"Our study identifies this biomarker as a potential new target for treating or preventing Alzheimer's disease," said study author Michelle M. Mielke, PhD, an epidemiologist with the Mayo Clinic in Rochester, Minn. Mielke was with Johns Hopkins University at the time of the research.

For the study, 99 women between the ages of 70 and 79 and free of dementia in the Women's Health and Aging Study II had their blood tested for levels of serum ceramides, a fatty compound found throughout the body that is associated with inflammation and cell death. The participants were placed into three groups: high, middle and low levels of ceramides. They were then followed for up to nine years. Of the 99 participants, 27 developed dementia and 18 of those were diagnosed with probable Alzheimer's disease.

The study found that women who had the highest levels of the biomarker were 10 times more likely to develop Alzheimer's disease than women with the lowest levels. Those with middle levels of the biomarker were nearly eight times more likely to develop the disease than those with the lowest levels.

"These findings are important because identifying an accurate biomarker for early Alzheimer's that requires little cost and inconvenience to a patient could help change our focus from treating the disease to preventing or delaying it," said Valory Pavlik, PhD, with the Alzheimer's Disease and Memory Disorders Center of Baylor College of Medicine in Houston and a member of the American Academy of Neurology, in an accompanying editorial.

According to Pavlik, "While a larger, more diverse study is needed to confirm these findings, projections that the global prevalence of Alzheimer's disease will double every 20 years for the foreseeable future have certainly increased the sense of urgency among researchers and health care agencies to identify more effective screening, prevention and treatment strategies."

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The study was supported by the National Institute on Aging, the National Institute of Neurological Disorders and Stroke and the Johns Hopkins Older Americans Independence Center.

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New biomarker in the blood may help predict Alzheimer's disease

Newswise MINNEAPOLIS A new guideline released by the American Academy of Neurology recommends several treatments for people with Huntingtons disease who experience choreajerky, random, uncontrollable movements that can make everyday activities challenging. The guideline is published in the July 18, 2012, online issue of Neurology, the medical journal of the American Academy of Neurology.

Chorea can be disabling, worsen weight loss and increase the risk of falling, said guideline lead author Melissa Armstrong, MD, MSc, with the University of Maryland School of Medicine Department of Neurology and a member of the American Academy of Neurology.

Huntingtons disease is a complex disease with physical, cognitive and behavioral symptoms. The new guideline addresses only one aspect of the disease that may require treatment.

The guideline found that the drugs tetrabenazine (TBZ), riluzole and amantadine can be helpful and the drug nabilone may also be considered to treat chorea. The medications riluzole, amantadine and nabilone are not often prescribed for Huntingtons disease.

People with Huntingtons disease who have chorea should discuss with their doctors whether treating chorea is a priority. Huntingtons disease is complex with a wide range of sometimes severe symptoms and treating other symptoms may be a higher priority than treating chorea, said Armstrong.

Armstrong adds that it is important for patients to understand that their doctors may try drugs not recommended in this guideline to treat chorea. More research is needed to know if drugs such as those used for psychosis are effective; however, doctors may prescribe them on the basis of past clinical experience.

Learn more about the guideline at http://www.aan.com/guidelines or Huntingtons disease 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 Alzheimers disease, stroke, migraine, multiple sclerosis, brain injury, Parkinsons disease and epilepsy.

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

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AAN: New Guideline on How to Best Treat Involuntary Movements in Huntington's Disease

From Mayo Clinic YouTube channel:

Vernon Smith, M.D., an emergency room physician at Mayo Clinic in Arizona, discusses the benefits of the computerized YES Board patient tracking system which he developed over the course of several years and input from hundreds of doctors, nurses and emergency room staff while he worked at Mayo Clinic in Rochester, Minn.

According to Mayo Clinic, "the YES board reduces the time required to translate data, allowing physicians to forecast the needs of their patients and track progress. It has the capacity to walk physicians through current and past information for each patient — in addition to all patients collectively. Additionally, the YES Board helps to secure usable space and resources and detect the most at-risk patients and also helps forecast the needs of the patients in the emergency department. Plus, the YES Board can be viewed through any approved computer with an internet connection."

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EmergencyLink is a free service that provides medical information and personal contacts to emergency responders - Mossberg for WSJ:

Here is the URL: http://www.emergencylink.com

The company explains how it can help if:

- You Are In An Accident. A first responder locates the EmergencyLink ID and calls EmergencyLink as instructed. EmergencyLink provides the first responder with your emergency medical information and contacts your “Emergency Contacts” as you have instructed.

- Your Child Is Missing. You can quickly create a a Missing Person report and forward it to the police. The police can immediately act on the information maximizing their chances of locating your child quickly and safely.

- Sharing Information with a Caregiver. You are able to electronically share all of the information the caregiver will need in case of an emergency. Whenever your child's profile is updated, everyone with whom you are sharing the information will be updated, no need to constantly update everyone.

- A Friend is in an Accident. If your friend is an EmergencyLink Member and is "sharing" their info with you, you can access their emergency medical information (allergies, medications, medical insurance) and forward them to the first responder.

- Co-Workers Are On A Project Away From Home. Each Member in the group agrees to share their emergency contact information with each other. If there is an emergency situation, the group has the information needed to reach each others emergency contacts.

EmergencyLink is a free 24-Hour Emergency Response Service that helps you store your important information in one location, share emergency information with family and friends and has a 24-Hour Emergency Response center to aid you in an emergency:

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DUBLIN--(BUSINESS WIRE)--

Research and Markets (http://www.researchandmarkets.com/research/zgk4p5/sweden_neurology_d) has announced the addition of GlobalData's new report "Sweden Neurology Devices Market Outlook to 2018 - Interventional Neurology, Neurological Diagnostic Equipment, Neurostimulation Devices and Others" to their offering.

This report provides key market data on the Sweden Neurology Devices market. The report provides value (USD million), volume (units) and average price (USD) data for each segment and sub-segment within six market categories - CSF Management, Interventional Neurology, Neurological Diagnostic Equipment, Neurostimulation Devices, Neurosurgical Products and Radiosurgery. The report also provides company shares and distribution shares data for each of the aforementioned market categories. The report is supplemented with global corporate-level profiles of the key market participants with information on company financials and pipeline products, wherever available.

This report is built using data and information sourced from proprietary databases, primary and secondary research and in-house analysis by GlobalData's team of industry experts.

Scope:

- Market size and company share data for Neurology Devices market categories - CSF Management, Interventional Neurology, Neurological Diagnostic Equipment, Neurostimulation Devices, Neurosurgical Products and Radiosurgery.

- Annualized market revenues (USD million), volume (units) and average price (USD) data for each of the segments and sub-segments within six market categories. Data from 2004 to 2011, forecast forward for 7 years to 2018.

- 2011 company shares and distribution shares data for each of the six market categories.

- Global corporate-level profiles of key companies operating within the Sweden Neurology Devices market.

- Key players covered include Medtronic, Inc., Stryker Corporation, DePuy, Inc., St. Jude Medical, Inc., Covidien plc, B. Braun Melsungen AG and others.

More:
Research and Markets: Sweden Neurology Devices Market Outlook to 2018 - Interventional Neurology, Neurological ...