Hot off the press is a way for you to read some quick medical news.

Choosing Wisely is an international initiative launched in Ann Arbor, Michigan, which has resulted in a number of recommendations for various specialties. In Neurology there are findings like the use of imaging, which is over-rated, and of interferon beta and glatiramer acetate in secondary progressive multiple sclerosis, a scenario in which the drugs not only do not work but may worsen the situation. In low back pain not complicated by a neurological déficit, the use of complex arthrodesis will be discontinued in view of recommendations by Choosing Wisely Australia (Neurology Today December 21st 2017).

Brain death guidelines have come under a storm due to controversies hot off the press, “most arisen from sudden, unfortunate tragedies involving young people, where the family had absolutely no expectation that things woud go awry”. The response from the American Academy of Neurology and other bodies has been a call to make more uniform the use of the presente guidelines, as well as to make an effort for better public education (Neurology Today February 22 2018)

Dementia is a chronic disease amenable to measures during the life of everyone that may prevent one third of the cases. These are early child education, exercise, treatment of hypertension, cessation of smoking, prevention of diabetes and obesity, and decreasing depression and social isolation.

Nursinersen is effective in children with early onset spinal muscular atrophy, more son in infants with a shorter disease duration

Alteplase, or rTPA, improves survival but not function in people who had intraventricular hemorrage

Erenumab and fremanezumab are effective for prevention of migraine in early trials with many hundreds of patients but very severe cases were excluded

Physician burn-out, another very hot off the press subject, is heavily related to excessive administrative and other remediable work conditions (Neurology Today January 25 2018)

Dr Paulo Bittencourt

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