Background: Schizophrenia is a chronic heterogeneous mental disorder that often has debilitating long-term outcomes. Our aim in this study is to survey history of psychiatric disorders in first-degree relatives of schizophrenia patients and its association with the disease clinical and demographic profile. Methods: In this retrospective study the hospital records of all schizophrenia patients that had been admitted in Ibn Sina Psychiatric Hospital from March 2018 to March 2019 were surveyed. Histories of any psychiatry disorders in the first-degree relatives of the schizophrenia patients were searched. The patients with positive family history were compared with those with negative family history in regard to age of onset, sex, negative symptoms, substance abuse and education level. Results: Of 250 files that were studied, 62 (24.2%) patients had family history of psychiatry disorders. Schizophrenia (10.8%), schizoaffective disorder (7.2%) and bipolar disorder (4.2%) were the most common psychiatry disorders in first-degree relatives of schizophrenia patients. Male sex, lower age at onset, substance abuse, negative symptoms, and lower education were more frequently observed in schizophrenia patients with positive family history. Conclusions: Our study demonstrated that family histories of schizophrenia, schizoaffective and bipolar disorder were higher in family history of schizophrenia patients than normal population. Furthermore, positive family history for psychiatric disorder is associated with worse prognosis in schizophrenia patients. J Neurol Res. 2020;10(6):231-234 doi: https://doi.org/10.14740/jnr631
{"title":"Study Family History of Psychiatry Disorders in Schizophrenia Patients","authors":"A. Mowla, S. Bahrami","doi":"10.14740/jnr631","DOIUrl":"https://doi.org/10.14740/jnr631","url":null,"abstract":"Background: Schizophrenia is a chronic heterogeneous mental disorder that often has debilitating long-term outcomes. Our aim in this study is to survey history of psychiatric disorders in first-degree relatives of schizophrenia patients and its association with the disease clinical and demographic profile. Methods: In this retrospective study the hospital records of all schizophrenia patients that had been admitted in Ibn Sina Psychiatric Hospital from March 2018 to March 2019 were surveyed. Histories of any psychiatry disorders in the first-degree relatives of the schizophrenia patients were searched. The patients with positive family history were compared with those with negative family history in regard to age of onset, sex, negative symptoms, substance abuse and education level. Results: Of 250 files that were studied, 62 (24.2%) patients had family history of psychiatry disorders. Schizophrenia (10.8%), schizoaffective disorder (7.2%) and bipolar disorder (4.2%) were the most common psychiatry disorders in first-degree relatives of schizophrenia patients. Male sex, lower age at onset, substance abuse, negative symptoms, and lower education were more frequently observed in schizophrenia patients with positive family history. Conclusions: Our study demonstrated that family histories of schizophrenia, schizoaffective and bipolar disorder were higher in family history of schizophrenia patients than normal population. Furthermore, positive family history for psychiatric disorder is associated with worse prognosis in schizophrenia patients. J Neurol Res. 2020;10(6):231-234 doi: https://doi.org/10.14740/jnr631","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86829328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. S. A. Rumeh, T. Shaikh, A. Lari, Abdullah Muharib, W. Shakweer
Several syndromes are associated with an increased incidence of intracranial tumors. Among these is enchondromatosis. It is a rare, nonhereditary condition. The common subtypes of enchondromatosis are Ollier’s disease (OD) and Maffucci syndrome. It has been distinguished between them by the presence of vascular malformation and non-skeletal neoplasm in Maffucci syndrome. The emergence of malignant neoplasms, including gliomas is a well-recognized complication in Maffucci syndrome, but over the past few years there has been an increasing number of reported cases of patients with intracranial tumors and OD. In our case report we discuss a 23-year-old female recently diagnosed with World Health Organization (WHO) grade II diffuse astrocytoma and found to have OD. J Neurol Res. 2020;10(6):240-244 doi: https://doi.org/10.14740/jnr580
{"title":"Diffuse Astrocytoma and Ollier’s Disease","authors":"A. S. A. Rumeh, T. Shaikh, A. Lari, Abdullah Muharib, W. Shakweer","doi":"10.14740/jnr580","DOIUrl":"https://doi.org/10.14740/jnr580","url":null,"abstract":"Several syndromes are associated with an increased incidence of intracranial tumors. Among these is enchondromatosis. It is a rare, nonhereditary condition. The common subtypes of enchondromatosis are Ollier’s disease (OD) and Maffucci syndrome. It has been distinguished between them by the presence of vascular malformation and non-skeletal neoplasm in Maffucci syndrome. The emergence of malignant neoplasms, including gliomas is a well-recognized complication in Maffucci syndrome, but over the past few years there has been an increasing number of reported cases of patients with intracranial tumors and OD. In our case report we discuss a 23-year-old female recently diagnosed with World Health Organization (WHO) grade II diffuse astrocytoma and found to have OD. J Neurol Res. 2020;10(6):240-244 doi: https://doi.org/10.14740/jnr580","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82019787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: This study focuses on gender-based trends in psychotropic agent poisoning across a 17-year span. The goal of the study was to determine whether there are statistically significant differences in the characteristics of male and female hospital stays for psychotropic agent poisoning. Methods: We used the Healthcare Cost and Utilization Project (HCUP) national database to perform a retrospective cohort study analyzing trends for poisoning by psychotropic agents in males and females between 1997 and 2014. Results: Between 1997 and 2014, HCUP recorded a total of 1,368,649 psychotropic agent poisoning discharges. The overall number of discharges increased from 62,148 to 82,905 (P < 0.001). The average age at discharge increased from 37.36 to 40.85 years (P < 0.001). As the average length of stay increased from 2.3 to 3.2 days (P < 0.001), hospital charges increased from $6,357 to $27,892 (P < 0.001). Across the study period, the number of in-hospital deaths increased from 468 to 755 (P < 0.001). In each year of the study, both number of discharges and average age were found to be greater for females than for males (P < 0.001). Conclusions: Female discharges were consistently higher than male discharges, suggesting that female patients were more likely to experience psychotropic poisoning than male patients. This may possibly be due to a greater number of women being prescribed psychotropic medications, in concordance with higher rates of mood and anxiety disorders. Additionally, there exist notable differences in drug metabolism that should be considered to prevent overprescribing. J Neurol Res. 2020;10(6):220-225 doi: https://doi.org/10.14740/jnr640
{"title":"Gender and Psychotropic Poisoning in the USA","authors":"Aleena Vargas, George Ormseth, A. Seifi","doi":"10.14740/jnr640","DOIUrl":"https://doi.org/10.14740/jnr640","url":null,"abstract":"Background: This study focuses on gender-based trends in psychotropic agent poisoning across a 17-year span. The goal of the study was to determine whether there are statistically significant differences in the characteristics of male and female hospital stays for psychotropic agent poisoning. Methods: We used the Healthcare Cost and Utilization Project (HCUP) national database to perform a retrospective cohort study analyzing trends for poisoning by psychotropic agents in males and females between 1997 and 2014. Results: Between 1997 and 2014, HCUP recorded a total of 1,368,649 psychotropic agent poisoning discharges. The overall number of discharges increased from 62,148 to 82,905 (P < 0.001). The average age at discharge increased from 37.36 to 40.85 years (P < 0.001). As the average length of stay increased from 2.3 to 3.2 days (P < 0.001), hospital charges increased from $6,357 to $27,892 (P < 0.001). Across the study period, the number of in-hospital deaths increased from 468 to 755 (P < 0.001). In each year of the study, both number of discharges and average age were found to be greater for females than for males (P < 0.001). Conclusions: Female discharges were consistently higher than male discharges, suggesting that female patients were more likely to experience psychotropic poisoning than male patients. This may possibly be due to a greater number of women being prescribed psychotropic medications, in concordance with higher rates of mood and anxiety disorders. Additionally, there exist notable differences in drug metabolism that should be considered to prevent overprescribing. J Neurol Res. 2020;10(6):220-225 doi: https://doi.org/10.14740/jnr640","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74518154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Ceramides are implicated in sphingolipid signaling. Elevated ceramide levels have been associated with increased cardiovascular risk, but information on their role in acute ischemic stroke (AIS) is limited. The purpose of this study is to investigate the temporal dynamics of ceramide levels in AIS and assess their prognostic utility for long-term outcomes. Methods: This is a prospective pilot study of patients with AIS admitted to Mayo Clinic within 12 h of last known well (LKW). Ceramides were assessed by liquid chromatography mass spectrometry at two time points: T1 (within 12 h of LKW) and T2 (1 - 7 days from LKW). Wilcoxon signed rank test was used to compare paired ceramide levels and ratios. Ordinal logistic regression was used for assessment of associations with long-term outcomes. Results: Twenty-three patients met inclusion criteria (median (range)): age (76 years (45 - 95)); body mass index (25.6 (20.5 - 46.6)); National Institutes of Health Stroke Scale (NIHSS) score (5 (0 - 27)); infarct volume (1.4 cm 3 (0.0 - 36.5)). Long-chain ceramides increased between T1 and T2 whereas very-long chain ceramides decreased, P < 0.05. Upon stratification of patients by prior statin exposure, increase in long-chain ceramide level was present only in statin-naive patients. Greater neurological disability at follow-up was associated with higher ceramide score, C(18:0)/C(24:0) ratio and higher levels of glycated hemoglobin. Conclusions: Long-chain and very-long-chain ceramide are actively implicated in pathologic processes in acute and subacute phases of stroke, with their dynamics being inversely related and potentially modulated by statin therapy. Ceramide levels and ratios might be useful for prognosis of long-term neurological outcomes. J Neurol Res. 2020;10(6):209-219 doi: https://doi.org/10.14740/jnr633
{"title":"Ceramide Dynamics and Prognostic Value in Acute and Subacute Ischemic Stroke: Preliminary Findings in a Clinical Cohort","authors":"Marina Buciuc, V. Vasile, G. Conte, E. Scharf","doi":"10.14740/jnr633","DOIUrl":"https://doi.org/10.14740/jnr633","url":null,"abstract":"Background: Ceramides are implicated in sphingolipid signaling. Elevated ceramide levels have been associated with increased cardiovascular risk, but information on their role in acute ischemic stroke (AIS) is limited. The purpose of this study is to investigate the temporal dynamics of ceramide levels in AIS and assess their prognostic utility for long-term outcomes. Methods: This is a prospective pilot study of patients with AIS admitted to Mayo Clinic within 12 h of last known well (LKW). Ceramides were assessed by liquid chromatography mass spectrometry at two time points: T1 (within 12 h of LKW) and T2 (1 - 7 days from LKW). Wilcoxon signed rank test was used to compare paired ceramide levels and ratios. Ordinal logistic regression was used for assessment of associations with long-term outcomes. Results: Twenty-three patients met inclusion criteria (median (range)): age (76 years (45 - 95)); body mass index (25.6 (20.5 - 46.6)); National Institutes of Health Stroke Scale (NIHSS) score (5 (0 - 27)); infarct volume (1.4 cm 3 (0.0 - 36.5)). Long-chain ceramides increased between T1 and T2 whereas very-long chain ceramides decreased, P < 0.05. Upon stratification of patients by prior statin exposure, increase in long-chain ceramide level was present only in statin-naive patients. Greater neurological disability at follow-up was associated with higher ceramide score, C(18:0)/C(24:0) ratio and higher levels of glycated hemoglobin. Conclusions: Long-chain and very-long-chain ceramide are actively implicated in pathologic processes in acute and subacute phases of stroke, with their dynamics being inversely related and potentially modulated by statin therapy. Ceramide levels and ratios might be useful for prognosis of long-term neurological outcomes. J Neurol Res. 2020;10(6):209-219 doi: https://doi.org/10.14740/jnr633","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87167830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas G Pederson, Yimage Ahmed, J. Maddry, Nurani M. Kester
Stanford type A acute aortic dissection with ischemic stroke is a rare yet highly morbid presentation of sudden onset neurological symptoms. We present a case of a 57-year-old African American male brought to the emergency department with a witnessed syncopal episode, abdominal pain, right sided gaze preference, and left side weakness. Upon initiation of the hospital’s “Code Stroke” response protocol, a computed tomography angiogram of the neck incidentally identified Stanford type A aortic dissection with extension into and occlusion of the brachiocephalic artery, occlusion of the right common carotid artery and right internal carotid artery, and dissection flap propagation into the origin of the left common carotid artery. Postoperative magnetic resonance imaging of the brain and the entire spine demonstrated multifocal cerebral infarcts, as well as T10 - L1 spinal infarct. Despite provision of multidisciplinary intensive care unit level of care, the patient failed to demonstrate clinically significant neurological recovery and was transitioned to comfort care after 3 weeks of hospitalization. This case highlights the importance of considering acute aortic dissection as a potential etiology of acute ischemic stroke through the use of computed tomography angiography, as this diagnosis carries profoundly different implications for the consideration of thrombolytic agents and other emergent treatment modalities. J Neurol Res. 2020;10(6):248-252 doi: https://doi.org/10.14740/jnr638
{"title":"Sudden Onset Hemiplegia and Neglect: A Case Report of Type A Aortic Dissection Presenting as a Code Stroke","authors":"Thomas G Pederson, Yimage Ahmed, J. Maddry, Nurani M. Kester","doi":"10.14740/jnr638","DOIUrl":"https://doi.org/10.14740/jnr638","url":null,"abstract":"Stanford type A acute aortic dissection with ischemic stroke is a rare yet highly morbid presentation of sudden onset neurological symptoms. We present a case of a 57-year-old African American male brought to the emergency department with a witnessed syncopal episode, abdominal pain, right sided gaze preference, and left side weakness. Upon initiation of the hospital’s “Code Stroke” response protocol, a computed tomography angiogram of the neck incidentally identified Stanford type A aortic dissection with extension into and occlusion of the brachiocephalic artery, occlusion of the right common carotid artery and right internal carotid artery, and dissection flap propagation into the origin of the left common carotid artery. Postoperative magnetic resonance imaging of the brain and the entire spine demonstrated multifocal cerebral infarcts, as well as T10 - L1 spinal infarct. Despite provision of multidisciplinary intensive care unit level of care, the patient failed to demonstrate clinically significant neurological recovery and was transitioned to comfort care after 3 weeks of hospitalization. This case highlights the importance of considering acute aortic dissection as a potential etiology of acute ischemic stroke through the use of computed tomography angiography, as this diagnosis carries profoundly different implications for the consideration of thrombolytic agents and other emergent treatment modalities. J Neurol Res. 2020;10(6):248-252 doi: https://doi.org/10.14740/jnr638","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80423940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Athena Michaelides, Spyridon Bekas, A. Papaioannou, A. Lazaridou, P. Nicolaides
Herein we describe a case of a 25-year-old man diagnosed with the “variant late infantile-onset” neuronal ceroid lipofuscinosis (NCL) who has a novel mutation in the CLN6 gene located on chromosome 15. The patient developed seizures at the age of 10 years along with progressive symptoms of ataxia, spasticity, cognitive decline and visual difficulties. At the age of 25 years, the seizures were drug-resistant, and the patient was put in an anesthesia-induced coma until the use of cannabis oil in combination with Food and Drug Administration (FDA)-approved anti-seizure drugs proved to be lifesaving. Treatment for NCL currently consists of symptomatic relief of seizures, and supportive therapies for associated symptoms of behavior, language and visual difficulties. Although limited, recent data on the efficacy of cannabinoids for treatment-resistant epilepsy have been published. Since cannabis oil is not currently FDA approved for most formulations, its use in drug-resistant epilepsy is anecdotal and remains highly controversial. J Neurol Res. 2020;10(6):245-247 doi: https://doi.org/10.14740/jnr626
{"title":"Successful Treatment of Super-Refractory Status Epilepticus With Cannabis Oil in a Patient With Neuronal Ceroid Lipofuscinosis","authors":"Athena Michaelides, Spyridon Bekas, A. Papaioannou, A. Lazaridou, P. Nicolaides","doi":"10.14740/jnr626","DOIUrl":"https://doi.org/10.14740/jnr626","url":null,"abstract":"Herein we describe a case of a 25-year-old man diagnosed with the “variant late infantile-onset” neuronal ceroid lipofuscinosis (NCL) who has a novel mutation in the CLN6 gene located on chromosome 15. The patient developed seizures at the age of 10 years along with progressive symptoms of ataxia, spasticity, cognitive decline and visual difficulties. At the age of 25 years, the seizures were drug-resistant, and the patient was put in an anesthesia-induced coma until the use of cannabis oil in combination with Food and Drug Administration (FDA)-approved anti-seizure drugs proved to be lifesaving. Treatment for NCL currently consists of symptomatic relief of seizures, and supportive therapies for associated symptoms of behavior, language and visual difficulties. Although limited, recent data on the efficacy of cannabinoids for treatment-resistant epilepsy have been published. Since cannabis oil is not currently FDA approved for most formulations, its use in drug-resistant epilepsy is anecdotal and remains highly controversial. J Neurol Res. 2020;10(6):245-247 doi: https://doi.org/10.14740/jnr626","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83458938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01Epub Date: 2020-12-09DOI: 10.14740/jnr606
Casey Judge, Negar Moheb, Ramiro Castro Apolo, Joy L Dupont, Michelle L Gessner, Hussam A Yacoub
Multiple recent publications have reported numerous neurologic complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Among these is Guillain-Barre syndrome and its variants, including facial diplegia. In this case we present a patient with facial diplegia following a confirmed SARS-CoV-2 infection. The patient initially presented with respiratory symptoms and subsequently developed bilateral facial weakness approximately 3 weeks later prompting an emergency department (ED) visit. Extensive laboratory and imaging workup was negative for other etiologies. Cerebrospinal fluid (CSF) analysis was notable only for mild elevation in white blood cells and protein. Patients with acute neurologic symptoms should be evaluated carefully regarding recent infections or possible exposures to help identify and minimize late complications of this novel virus.
{"title":"Facial Diplegia as a Rare Late Neurologic Manifestation of SARS-CoV-2 Infection.","authors":"Casey Judge, Negar Moheb, Ramiro Castro Apolo, Joy L Dupont, Michelle L Gessner, Hussam A Yacoub","doi":"10.14740/jnr606","DOIUrl":"https://doi.org/10.14740/jnr606","url":null,"abstract":"<p><p>Multiple recent publications have reported numerous neurologic complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Among these is Guillain-Barre syndrome and its variants, including facial diplegia. In this case we present a patient with facial diplegia following a confirmed SARS-CoV-2 infection. The patient initially presented with respiratory symptoms and subsequently developed bilateral facial weakness approximately 3 weeks later prompting an emergency department (ED) visit. Extensive laboratory and imaging workup was negative for other etiologies. Cerebrospinal fluid (CSF) analysis was notable only for mild elevation in white blood cells and protein. Patients with acute neurologic symptoms should be evaluated carefully regarding recent infections or possible exposures to help identify and minimize late complications of this novel virus.</p>","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"10 6","pages":"235-236"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/85/jnr-10-235.PMC8040456.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38977940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01Epub Date: 2020-12-09DOI: 10.14740/jnr634
Geoffrey W Peitz, Ali Seifi
During an admission for an elective neurosurgical procedure, a patient developed hypoxia, dry cough, high grade fever, and her chest computed tomography (CT) showed ground glass opacities. As coronavirus disease 2019 (COVID-19) was gaining prevalence in the community, her neurointensivist recommended testing for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The possibility of becoming a patient under investigation and of having the disease caused the patient severe anxiety, and she refused the test. In an effort to better understand this sentiment and whether patients should have the option to refuse the test, the physician posted a description of the situation on a COVID-19 health care workers social media group, generating a lively discussion among a diverse group of people with various opinions all around the world. Posters supporting the right to refuse the test gave arguments rooted in the bioethical principles of autonomy and nonmaleficence. Meanwhile, posters opposing the right to refuse the test gave arguments rooted in societal beneficence and justice. This article aims to discuss the psychological and ethical impacts of forcing the patients to be tested for the COVID-19. The first documented case of COVID-19 in the USA was reported in a 35-year-old man from Snohomish County, Washington on January 20, 2020. Since then, more than 78 million Americans have been tested for COVID-19 with more than 6 million positive cases in the USA [1]. Widespread testing for the disease is considered essential for managing its spread, but there are ethical and psychosocial concerns for individuals being tested. Most patients feel that coerced COVID-19 testing violates patient autonomy. Autonomy is the value that grants patients the power to decide which diagnostic tests or treatments they receive. There is precedent for violating patient autonomy, especially in the decision to accept or refuse vaccinations when vaccination refusal poses a public health threat [2]. However, as Dr. Halpern emphasized, this is an era of growing regard for patient autonomy in which removing requirements for patient consent is not straightforward [3]. Furthermore, it is difficult to justify restricting a patient’s right to refuse a treatment or test that has a significant risk of harm (i.e., when nonmaleficence is not upheld). Besides the transient discomfort from swabbing, there is virtually no expected physical harm from the COVID-19 test. However, the test can have a negative impact financially. Even if there were no cost to the test itself, a positive test prevents a patient from working unless they have a job conducive to working from home. This results in loss of paid-time-off or loss of pay for people without paid-time-off. There may also be fear that a positive COVID-19 test increases a worker’s chance of being laid off or furloughed. Besides the financial impact, a positive COVID-19 test, like human immunodeficiency virus (HIV), has a neg
{"title":"Psychological Implications of Mandatory Testing for Severe Acute Respiratory Syndrome Coronavirus 2 During the Global COVID-19 Pandemic.","authors":"Geoffrey W Peitz, Ali Seifi","doi":"10.14740/jnr634","DOIUrl":"https://doi.org/10.14740/jnr634","url":null,"abstract":"During an admission for an elective neurosurgical procedure, a patient developed hypoxia, dry cough, high grade fever, and her chest computed tomography (CT) showed ground glass opacities. As coronavirus disease 2019 (COVID-19) was gaining prevalence in the community, her neurointensivist recommended testing for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The possibility of becoming a patient under investigation and of having the disease caused the patient severe anxiety, and she refused the test. In an effort to better understand this sentiment and whether patients should have the option to refuse the test, the physician posted a description of the situation on a COVID-19 health care workers social media group, generating a lively discussion among a diverse group of people with various opinions all around the world. Posters supporting the right to refuse the test gave arguments rooted in the bioethical principles of autonomy and nonmaleficence. Meanwhile, posters opposing the right to refuse the test gave arguments rooted in societal beneficence and justice. This article aims to discuss the psychological and ethical impacts of forcing the patients to be tested for the COVID-19. The first documented case of COVID-19 in the USA was reported in a 35-year-old man from Snohomish County, Washington on January 20, 2020. Since then, more than 78 million Americans have been tested for COVID-19 with more than 6 million positive cases in the USA [1]. Widespread testing for the disease is considered essential for managing its spread, but there are ethical and psychosocial concerns for individuals being tested. Most patients feel that coerced COVID-19 testing violates patient autonomy. Autonomy is the value that grants patients the power to decide which diagnostic tests or treatments they receive. There is precedent for violating patient autonomy, especially in the decision to accept or refuse vaccinations when vaccination refusal poses a public health threat [2]. However, as Dr. Halpern emphasized, this is an era of growing regard for patient autonomy in which removing requirements for patient consent is not straightforward [3]. Furthermore, it is difficult to justify restricting a patient’s right to refuse a treatment or test that has a significant risk of harm (i.e., when nonmaleficence is not upheld). Besides the transient discomfort from swabbing, there is virtually no expected physical harm from the COVID-19 test. However, the test can have a negative impact financially. Even if there were no cost to the test itself, a positive test prevents a patient from working unless they have a job conducive to working from home. This results in loss of paid-time-off or loss of pay for people without paid-time-off. There may also be fear that a positive COVID-19 test increases a worker’s chance of being laid off or furloughed. Besides the financial impact, a positive COVID-19 test, like human immunodeficiency virus (HIV), has a neg","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"10 6","pages":"207-208"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0e/2b/jnr-10-207.PMC8040458.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38978485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01Epub Date: 2020-12-09DOI: 10.14740/jnr614
Katie Reming, Keithan Sivakumar, Negar Moheb, Ahmad Nizam, Hussam A Yacoub
Several typical and atypical neurological manifestations of viral pandemics have been reported. Neurological manifestations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have recently been reported. In this case report, we present a patient with encephalopathy as a late neurologic manifestation of SARS-CoV-2 infection. The patient initially tested positive for the novel coronavirus after presenting with fever, cough, and altered mental status. The symptoms resolved within 5 - 7 days and the patient was discharged home. He subsequently developed worsening encephalopathy in the absence of respiratory symptoms, required hospitalization, and tested positive for SARS-CoV-2. Complete workup was unrevealing otherwise. We advise clinicians to be aware of late neurological manifestations of coronavirus disease 2019 (COVID-19) including encephalopathy.
{"title":"Late-Onset Encephalopathy Associated With SARS-CoV-2 Infection.","authors":"Katie Reming, Keithan Sivakumar, Negar Moheb, Ahmad Nizam, Hussam A Yacoub","doi":"10.14740/jnr614","DOIUrl":"https://doi.org/10.14740/jnr614","url":null,"abstract":"<p><p>Several typical and atypical neurological manifestations of viral pandemics have been reported. Neurological manifestations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have recently been reported. In this case report, we present a patient with encephalopathy as a late neurologic manifestation of SARS-CoV-2 infection. The patient initially tested positive for the novel coronavirus after presenting with fever, cough, and altered mental status. The symptoms resolved within 5 - 7 days and the patient was discharged home. He subsequently developed worsening encephalopathy in the absence of respiratory symptoms, required hospitalization, and tested positive for SARS-CoV-2. Complete workup was unrevealing otherwise. We advise clinicians to be aware of late neurological manifestations of coronavirus disease 2019 (COVID-19) including encephalopathy.</p>","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"10 6","pages":"237-239"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/2e/jnr-10-237.PMC8040457.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38977943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01Epub Date: 2020-08-25DOI: 10.14740/jnr617
Satish Gaddam
The coronavirus disease 2019 (COVID-19) pandemic affected healthcare at different levels and almost all medical specialties are impacted one way or the other. In this review we try to discuss the impact of COVID-19 on neurology in particular and suggest changes that can be adopted in different neurologic diseases for navigating this pandemic without compromising the healthcare delivery to this specific patient population.
{"title":"Implications of COVID-19 in Neurological Disorders.","authors":"Satish Gaddam","doi":"10.14740/jnr617","DOIUrl":"https://doi.org/10.14740/jnr617","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic affected healthcare at different levels and almost all medical specialties are impacted one way or the other. In this review we try to discuss the impact of COVID-19 on neurology in particular and suggest changes that can be adopted in different neurologic diseases for navigating this pandemic without compromising the healthcare delivery to this specific patient population.</p>","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"10 5","pages":"160-163"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/9c/jnr-10-160.PMC8040455.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38978478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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