Pine-Nut Syndrome

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Pinemouth syndrome (PMS), otherwise known as pine nut syndrome, is a relatively new condition. At least several thousand cases have now been described in the literature. The author describes the PMS toxidrome, offers a preliminary case definition, and discusses current best evidence regarding the etiology and risk factors related to the development of PMS. A clinically compatible case of PMSmust include taste disturbance, usually characterized as bitter or metallic, following the ingestion of affected pine nuts by 1 to 3 days. Affected nuts would appear to include all, or some portion, of nuts harvested from species Pinus armandii (Chinese white pine), but could include nuts from other species. The specific toxin that is apparently present in affected nuts has not yet been isolated, and the mechanism of toxicity and factors determining PMS susceptibility need to be further detailed. There are no proven therapies for PMS. The only treatment is to cease ingesting implicated nuts and to wait for symptoms to abate.

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Linee guida AAN

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"Periprocedural Management of Antithrombotic Medications in Patients with Ischemic Cerebrovascular Disease"

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EFNS review on the role of muscle biopsy in the investigation of myalgia

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An Updated Definition of Stroke for the 21st Century

http://stroke.ahajournals.org/content/early/2013/05/07/STR.0b013e318296aeca.full.pdf+html

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Xarelto

The European Commission has given its approval to the oral factor Xa inhibitor rivaroxaban (Xarelto, Bayer Pharma/Janssen Pharmaceuticals) for secondary prevention in adult patients who have had biomarker-confirmed acute coronary syndrome (ACS), The indication is for 2.5-mg twice daily in combination with standard antiplatelet therapy.

Reference: ATLAS ACS 2 TIMI 51 trial

DSM 5

La nuova "Bibbia della Psichiatria"è ufficialmente disponibile
ecco il link al sito "American Psichiatry Association"
http://www.dsm5.org/Pages/Default.aspx

FDA Drug Safety Communication: Valproate Anti-seizure Products Contraindicated for Migraine Prevention in Pregnant Women

http://www.fda.gov/downloads/Drugs/DrugSafety/UCM350748.pdf