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AAN 2015

AAN 2015

New research was presented at AAN 2015, the American Academy of Neurology’s annual meeting, from April 18 to 25 in Washington, DC. The features below highlight some of the studies that emerged from the conference. LOS & Return ED Visits in Stroke Patients The Particulars: The initial hospitalization for patients with acute, mild ischemic stroke can impact long-term outcomes. However, few studies have assessed whether hospital length of stay (LOS) is related to clinical characteristics, in-hospital care processes, and long-term clinical outcomes in this patient population. Data Breakdown: For a study, adults diagnosed with acute ischemic stroke were grouped according to their LOS. Despite no significant differences between patients, researchers found that inpatient therapy evaluations took place later in those with a LOS longer than 1 day. Patients with an LOS longer than 1 day were more likely to return to the ED within 1 year. Take Home Pearls: Among ischemic stroke patients, time to therapy evaluation appears to be associated with LOS and risk for return ED visits. Coordination of inpatient care processes, along with assessment and treatment of comorbidities, may impact hospital LOS. Mental Illness, Substance Abuse, & Children The Particulars: Understanding outcomes among groups of patients at higher risk of primary and medication-induced psychiatric illness, such as those with neurological conditions, may help reduce the burden of mental illness. Data Breakdown: Study investigators compared mental health and substance abuse diagnosis patterns and length of stay (LOS) in children with epilepsy, cerebral palsy, and Tourette syndrome with those of the general pediatric population. Depression was the most common psychiatric diagnosis in the general population as well as...
An Update on Managing IBS & CIC

An Update on Managing IBS & CIC

IBS and chronic idiopathic constipation (CIC) are among the most common functional gastrointestinal (GI) disorders, with studies estimating that between 5% and 15% of the general population experiences IBS symptoms, whereas CIC symptoms occur in about 14% of people. Recently, the American College of Gastroenterology (ACG) released a monograph—published in the American Journal of Gastroenterology—that updated prior monographs on approaches to treating IBS and CIC. To develop the monograph, the ACG’s Institute for Clinical Research & Education conducted a systematic review and meta-analysis of randomized clinical trials that assessed several types of interventions for IBS and CIC. “We looked back at previous monographs from recent years,” explains Eamonn M.M. Quigley, MD, FACG, a co-author of the update. “The last monograph on constipation came out in 2005, whereas the last one on IBS was released in 2009. Since then, there have been significant developments that warranted an update.” Diet & Fiber An important addition to the ACG guidelines is new information on the relationship between diet and IBS (Table 1). “Research has shown that diet has emerged as a major issue, especially for patients with IBS,” says Dr. Quigley. “This isn’t new for patients because they’ve known for years about certain foods upsetting their GI tract. For clinicians, however, we now have good evidence that diet is a major factor in the precipitation of IBS attacks.” The guidelines note that specialized diets may improve IBS symptoms for some, but the recommendation was labeled as weak because of a low quality of evidence. Current data show that gluten-free diets and diets low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols—also known as...
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