Prospective Cohort Study

Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(00)02490-9.pdf

The importance of selenium to human health

The essential trace mineral, selenium, is of fundamental importance to human health. As a constituent of selenoproteins, selenium has structural and enzymic roles, in the latter context being best-known as an antioxidant and catalyst for the production of active thyroid hormone. Selenium is needed for the proper functioning of the immune system, and appears to be a key nutrient in counteracting the development of virulence and inhibiting HIV progression to AIDS. It is required for sperm motility and may reduce the risk of miscarriage. Deficiency has been linked to adverse mood states. Findings have been equivocal in linking selenium to cardiovascular disease risk although other conditions involving oxidative stress and inflammation have shown benefits of a higher selenium status. An elevated selenium intake may be associated with reduced cancer risk. Large clinical trials are now planned to confirm or refute this hypothesis. In the context of these health effects, low or diminishing selenium status in some parts of the world, notably in some European countries, is giving cause for concern.

The importance of selenium to human health.

Because depression and painful symptoms commonly occur together, we conducted a literature review to determine the prevalence of both conditions and the effects of comorbidity on diagnosis, clinical outcomes, and treatment. The prevalences of pain in depressed cohorts and depression in pain cohorts are higher than when these conditions are individually examined. The presence of pain negatively affects the recognition and treatment of depression. When pain is moderate to severe, impairs function, and/or is refractory to treatment, it is associated with more depressive symptoms and worse depression outcomes (eg, lower quality of life, decreased work function, and increased health care utilization). Similarly, depression in patients with pain is associated with more pain complaints and greater impairment. Depression and pain share biological pathways and neurotransmitters, which has implications for the treatment of both concurrently. A model that incorporates assessment and treatment of depression and pain simultaneously is necessary for improved outcomes.

https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/216320/ira30040_2433_2445.pdf

Depression and pain comorbidity: a literature review.

Results In the acute treatment experiment, rats receiving LEV 400mg/kg/d (8.4 ± 1.0) had fewer CSDs per hour than those receiving vehicle (12.9 ± 1.7, p < 0.001) and LEV 200mg/kg/d (12.5 ± 1.2, p<0.001). In the chronic treatment experiment, rats receiving LEV 400mg/kg/d (11.4 ± 0.6) had fewer hourly CSD events than those receiving vehicle (14.3 ± 0.3, P < 0.001) and LEV 200mg/kg/d (13.6 ± 0.4, p < 0.001), and rats treated LEV 200mg/kg/d had less CSDs than those in the vehicle group (p = 0.049). Conclusion LEV had a modest effect on reducing CSD susceptibility at a dose of 400mg/kg/d, and the effects on CSD susceptibility were comparable when administered acutely or chronically. Conflict of interest.

/pdf/ehmti-0140-the-potential-role-of-levetiracetam-in-migraine-3jxkm18z2j.pdf

EHMTI-0140. The potential role of levetiracetam in migraine treatment: an animal study

Chronic daily headache

Contents Vol. 13, 2002

Hiccups-functional or pathological?

Stroke is a major cause of morbidity and mortality worldwide in both developed and undeveloped countries. In 2012, it was the third leading cause of death and the leading cause of disability in elderly individuals in Taiwan. Stroke constitutes a major public health problem that poses a tremendous socioeconomic burden on society. About 70% of acute stroke events result in hospitalization. The duration of hospitalization is longer and rates of readmission, medical comorbidities, and expenditures are higher for stroke patients than for patients with other chronic illnesses. After discharge following acute hospitalization, stroke survivors usually experience persistent neurological symptoms that require ongoing medical attention. Additionally, they are at a high risk for new illness (including recurrent stroke), aggravation of known disease, and functional decline, all of which ultimately lead to a high risk of rehospitalization. Readmission rates show the ongoing challenges that stroke survivors face: 18e28% are readmitted within the first 3 months, 26e44% within 6 months, and 50% within 1 year; less than 15% of survivors remain admission-free for 5 years. Stroke is the second leading cause of hospital admission in elderly individuals. Age, stroke severity, recurrent vascular events (e.g., stroke, cardiovascular events), other comorbidities (e.g., diabetes, hypertension), and infection were the most common reasons for readmission. Nonvascular complications are common reasons for rehospitalization in stroke survivors. Infection (e.g., pneumonia or respiratory distress, urinary tract infection) is among the most common reasons for readmission, particularly during the early period after discharge. These complications may be related to neurological sequelae, such as dysphagia, sphincter dysfunction, and limited motor function, as well as poor quality of care and nutritional status after discharge. Dysphagia is especially common among stroke patients with pneumonia, and it is a leading cause of nonvascular death after stroke in acute and chronic settings. Although dysphagia is frequently encountered in stroke patients, it is not an independent predictor for stroke survival. However, other factors such as advanced age, stroke severity, and other comorbidities might play important roles in predicting stroke outcome. The importance of recurrent stroke is well recognized in terms of clinical outcome and high healthcare cost. In addition, recurrent stroke remains a leading cause for readmission after stroke. Many clinical guidelines and several

Jong Ling Fuh

Papers

EHMTI-0140. The potential role of levetiracetam in migraine treatment: an animal study

Chronic daily headache

Contents Vol. 13, 2002

Hiccups-functional or pathological?

Readmission after stroke: Recurrence or infection?