The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.

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Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association

The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating, and categorizing indications for the evidence-based use of therapeutic apheresis in human disease. Since the 2007 JCA Special Issue (Fourth Edition), the Committee has incorporated systematic review and evidence-based approaches in the grading and categorization of apheresis indications. This Seventh Edition of the JCA Special Issue continues to maintain this methodology and rigor to make recommendations on the use of apheresis in a wide variety of diseases/conditions. The JCA Seventh Edition, like its predecessor, has consistently applied the category and grading system definitions in the fact sheets. The general layout and concept of a fact sheet that was used since the fourth edition has largely been maintained in this edition. Each fact sheet succinctly summarizes the evidence for the use of therapeutic apheresis in a specific disease entity. The Seventh Edition discusses 87 fact sheets (14 new fact sheets since the Sixth Edition) for therapeutic apheresis diseases and medical conditions, with 179 indications, which are separately graded and categorized within the listed fact sheets. Several diseases that are Category IV which have been described in detail in previous editions and do not have significant new evidence since the last publication are summarized in a separate table. The Seventh Edition of the JCA Special Issue serves as a key resource that guides the utilization of therapeutic apheresis in the treatment of human disease. J. Clin. Apheresis 31:149-162, 2016. © 2016 Wiley Periodicals, Inc.

Guidelines on the Use of Therapeutic Apheresis in Clinical Practice—Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Sixth Special Issue

https://www.ahajournals.org/doi/pdf/10.1161/STR.0000000000000375

2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association

Unified Parkinson's Disease Rating Scale

Objective: To provide updated evidence-based recommendations for the preventive treatment of migraine headache The clinical question addressed was: What pharmacologic therapies are proven effective for migraine prevention? Methods: The authors analyzed published studies from June 1999 to May 2009 using a structured review process to classify the evidence relative to the efficacy of various medications available in the United States for migraine prevention Results and Recommendations: The author panel reviewed 284 abstracts, which ultimately yielded 29 Class I or Class II articles that are reviewed herein Divalproex sodium, sodium valproate, topiramate, metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered to patients with migraine to reduce migraine attack frequency and severity (Level A) Frovatriptan is effective for prevention of menstrual migraine (Level A) Lamotrigine is ineffective for migraine prevention (Level A)

https://n.neurology.org/content/neurology/78/17/1337.full.pdf

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society

While REM sleep behavior disorder (RBD) is typically observed among older adults, with characteristic clinical and polysomnographic features and risk for future neurodegenerative disease in the majority, it has also been reported among children and adolescents. The clinical presentation, associated conditions, and clinical course have not been studied in detail in childhood, however. Insights into the pathogenesis, clinical manifestations, diagnosis and directions for future research related to childhood-onset RBD and its polysomnographic signature, REM sleep without atonia (RSWA), are presented. An illustrative case report has been included, and details of published case reports and case series have been tabulated. Differential diagnosis and clues for recognition of RBD among the young are also discussed.

RBD in Childhood and Adolescence

Prevention of new vascular events in patients with obstructive sleep apnea and stroke, using CPAP: A randomized controlled trial

Background:Rapid eye movement (REM) sleep behavior disorder (RBD) and REM sleep without atonia (RWA) have assumed much clinical importance with long-term data showing progression into neurodegenerative conditions among older adults However, much less is known about RBD and RWA in younger populations This study aims at comparing clinical and polysomnographic (PSG) characteristics of young patients presenting with RBD, young patients with other neurological conditions, and normal age-matched subjectsMethods:A retrospective chart review was carried out for consecutive young patients (<25 years) presenting with clinical features of RBD; and data were compared to data from patients with epilepsy, attention deficit hyperactivity disorder (ADHD), and autism, as well as normal subjects who underwent PSG during a 2-year-periodResults:Twelve patients fulfilling RBD diagnostic criteria, 22 autism patients, 10 with ADHD, 30 with epilepsy, and 14 normal subjects were included Eight patients with autism (30%), three with ADHD (30%), one with epilepsy (33%), and six patients who had presented with RBD like symptoms (50%) had abnormal movements and behaviors during REM sleep Excessive transient muscle activity and/or sustained muscle activity during REM epochs was found in all patients who had presented with RBD, in 16/22 (72%) autistic patients, 6/10 (60%) ADHD patients compared to only 6/30 (20%) patients with epilepsy and in none of the normal subjectsConclusion:We observed that a large percentage of young patients with autism and ADHD and some with epilepsy demonstrate loss of REM-associated atonia and some RBD-like behaviors on polysomnography similar to young patients presenting with RBD

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Rapid Eye Movement (REM) Sleep Behavior Disorder and REM Sleep with Atonia in the Young - ADDENDUM.

Tremor in spinocerebellar ataxia type12 (SCA-12) mimics essential tremor (ET)

Objective: One of the factors that possibly account for conflicting results from research studies examining sleep problems in children with attention-deficit hyperactivity disorder (ADHD) is sleep lab adaptation. The aim of the present study was to study sleep quality in children with ADHD and investigate the presence of a first night effect in children with ADHD using polysomnography (PSG) in a sleep lab.

/pdf/sleep-quality-in-children-with-attention-deficit-23guwwchhk.pdf

Garima Shukla

Papers

RBD in Childhood and Adolescence

Prevention of new vascular events in patients with obstructive sleep apnea and stroke, using CPAP: A randomized controlled trial

Rapid Eye Movement (REM) Sleep Behavior Disorder and REM Sleep with Atonia in the Young - ADDENDUM.

Tremor in spinocerebellar ataxia type12 (SCA-12) mimics essential tremor (ET)

Sleep quality in children with attention deficit hyperactivity disorder: Is one night polysomnography as good as two nights?