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CARPHOLOGY by Rajendra

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DRUG TREATMENT OF DEMENTIA

Treatment of dementia with cholinesterase inhibitors (donepezil, galantamine, rivastigmine, tacrine) and memantine can result in statistically significant but clinically only marginal improvement in measures of cognition and global assessment of dementia. This is the conclusion reached in the guideline developed by the American College of Physicians and American Academy of Family Physicians, based on a review of 59 trials. However, these trials had several limitations such as short duration, inclusion of only patients with mild to moderate Alzheimer’s disease, poor reporting of adverse events, lack of clear definitions for statistical significance, limited evaluation of behaviour and quality-of-life outcomes, and few direct comparison of different treatments.

Ann Intern Med 2008;148:370–8.

SURVIVAL AFTER STROKE

Functional status six months after an ischaemic stroke is associated with long-term survival. This is the finding of a prospective study based on three cohorts with a total of 7710 patients registered between 1981 and 2000 and followed up for a maximum of 19 years. Among patients who survived to assessment six …

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