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The Controversies Concerning the Prevalence of the Neurodevelopmental Conditions ADHD and Autism 关于神经发育障碍ADHD和自闭症患病率的争议
Pub Date : 2021-06-15 DOI: 10.31038/jnnc.2021421
P. Gustafsson
J Neurol Neurocrit Care, Volume 4(2): 1–2, 2021 The neurodevelopmental disorders ADHD and autism are among the most important diagnoses in Child and Adolescent Psychiatry and are also important diagnoses in adult psychiatry [1]. The prevalence of diagnosed ADHD varies considerably between countries and regions and one region can report more than twice the prevalence in another region [2,3]. ADHD and autism have been found to have very high heritabilities which implies that environmental factors, although of importance, are not completely decisive for the prevalence of these conditions [4,5]. Studies of ADHD in different countries have shown approximately the same prevalence when using the same strict criteria [6]. The prevalence of ADHD in childhood has been estimated to be in the order of 5 to 6% [7].
神经发育障碍ADHD和自闭症是儿童和青少年精神病学中最重要的诊断之一,也是成人精神病学的重要诊断[1]。诊断为ADHD的患病率在国家和地区之间差异很大,一个地区报告的患病率可能是另一个地区的两倍以上[2,3]。ADHD和自闭症被发现具有很高的遗传性,这意味着环境因素虽然很重要,但对这些疾病的流行并不是完全决定性的[4,5]。不同国家对ADHD的研究表明,在使用同样严格的标准时,ADHD的患病率大致相同[6]。据估计,儿童时期ADHD的患病率约为5%至6%[7]。
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引用次数: 1
Quantitative Sensory Testing to Assessment Objective Changes by Spinal Cord Stimulation In-Patient with Complex Regional Pain Syndrome 定量感觉测试评估复杂局部疼痛综合征患者脊髓刺激的客观变化
Pub Date : 2021-06-08 DOI: 10.31038/jnnc.2021413
Nino Ninidze, S. Sator-Katzenschlager
The “complex regional pain syndrome” (CRPS) is characterized by continued pain, debilitating affliction, sensory abnormalities, vaso- and sudomotor disturbances as well as trophic changes. CRPS is often difficult to treat. Spinal cord stimulation (SCS) as a measure to provide adequate pain relief, improve the quality of life and physical function has been employed for that purpose. The sensory profile of the patients with CRPS, including sensory signs: hyperalgesia, allodynia, or hypoesthesia may be linked with the damage and surviving afferent nerve fibres, ectopic impulse generation, peripheral and central sensitization. For comprehensive assessing, the sensory profiles of a patient and results of treatment were verified with quantitative sensory testing (QST) in accordance with the protocol of the German Research Network on Neuropathic Pain (DFNS).
“复杂局部疼痛综合征”(CRPS)的特征是持续疼痛、使人衰弱的痛苦、感觉异常、血管和sudomotor紊乱以及营养改变。CRPS通常难以治疗。脊髓刺激(SCS)作为一种提供足够的疼痛缓解,改善生活质量和身体功能的措施已被用于这一目的。CRPS患者的感觉特征,包括感觉症状:痛觉过敏、异常性疼痛或感觉减退,可能与传入神经纤维的损伤和存活、异位冲动产生、外周和中枢致敏有关。为了进行综合评估,根据德国神经性疼痛研究网络(DFNS)的协议,用定量感觉测试(QST)验证患者的感觉特征和治疗结果。
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引用次数: 0
Theoretical Basements for a Clinical Trial on COVID-19 Patients with Systemic Ozone Therapy 系统臭氧治疗新冠肺炎临床试验的理论基础
Pub Date : 2021-02-12 DOI: 10.31038/jnnc.2021411
F. Tallón, Silvia Menéndez-Cepero, J. Baeza-Noci, G. Carrasco
Due to the extreme world situation caused by COVID19 pandemic we consider unethic not to try any treatment option with a justified rationale. We have explained that medical ozone therapy has a clear scientific basement thanks to all preclinical investigation already published. It can be classified as chemical stressor that produces a modulation of the redox balance and immunity. Moreover, it is easy and safe to administer [1]. The efficacy in viral diseases have been published together the modulation of IL-6 and other proinflammatory cytokines that could potentially help in COVID19 patients. We proposed to carry out a randomized control trial to evaluate the safety and efficacy of systemic ozone (indirect endovenous and rectal) in these patients.
由于covid - 19大流行造成的极端世界局势,我们认为不尝试任何有正当理由的治疗方案是不道德的。我们已经说明,由于所有已发表的临床前研究,医用臭氧疗法具有明确的科学基础。它可以被归类为化学应激源,产生氧化还原平衡和免疫的调节。此外,[1]的管理既简单又安全。在病毒性疾病中的疗效已被发表,同时还发表了IL-6和其他促炎细胞因子的调节,这些细胞因子可能有助于covid - 19患者。我们建议进行一项随机对照试验,以评估系统臭氧(间接静脉内和直肠)在这些患者中的安全性和有效性。
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引用次数: 1
mRNA Vaccines for SARS-CoV-2 are “95% Effective”: What Does That Mean? SARS-CoV-2 mRNA疫苗“95%有效”:这意味着什么?
Pub Date : 2021-01-15 DOI: 10.31038/jnnc.2020344
Colin A. Ross
J Neurol Neurocrit Care, Volume 3(4): 1–1, 2020 In a recent paper, Polack et al. [1], who are members of the C4591001 Clinical Trial Group, stated that the Pfizer vaccine for SARS-CoV-2 is 95% effective. The Clinical Trial Group and their paper are funded by BioNTech and Pfizer. The statement that the mRNA vaccines for SARS-CoV-2 manufactured by Pfizer and Modern are 95% effective has been made countless times in the media and by the heads of the CDC and NIAID and other physicians and public health authorities. But what does “95% effective” actually mean? It is a relative risk number. What are the raw data reported by Polack et al. [1]? In their trial, 21,720 participants received the active vaccine and 21,728 received placebo. Altogether, 162 participants in the placebo group developed COVID-19 illness compared to 8 in the vaccine group; 9 participants in the placebo group developed severe COVID-19 disease compared to 1 in the vaccine group. This is a reduction in COVID-19 illness of 95% (the rate of illness in the vaccine group was 8/162 = 5% of the rate in the placebo group). There were no deaths in either group. This means that there is no evidence that mRNA vaccines reduce the risk of death from COVID-19 illness.
C4591001临床试验组成员Polack等[1]在最近的一篇论文中指出,辉瑞公司的SARS-CoV-2疫苗有效率为95%。临床试验组和他们的论文由BioNTech和辉瑞公司资助。辉瑞公司和现代制药公司生产的新型冠状病毒mRNA疫苗有效率达95%的说法,在媒体和美国疾病控制与预防中心(CDC)、NIAID等医生和公共卫生当局的负责人中被无数次提及。但“95%有效”到底是什么意思呢?这是一个相对的风险数字。Polack等人[1]报告的原始数据是什么?在他们的试验中,21720名参与者接种了活性疫苗,21728名参与者接种了安慰剂。安慰剂组总共有162名参与者患上了COVID-19疾病,而疫苗组只有8名;安慰剂组有9名参与者患上了严重的COVID-19疾病,而疫苗组只有1名。这意味着COVID-19发病率降低了95%(疫苗组的发病率为8/162 =安慰剂组的5%)。两组均无死亡病例。这意味着没有证据表明mRNA疫苗可以降低COVID-19疾病的死亡风险。
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引用次数: 1
Differences in Evaluation of Hydroxychloroquine and Face Masks for SARS-CoV-2 羟氯喹与口罩对SARS-CoV-2的评价差异
Pub Date : 2020-12-31 DOI: 10.31038/jnnc.2020342
C. Ross
In a recent opinion piece in JAMA, Saag [1] defined the criteria for evaluating scientific medical evidence, and specifically for evaluating potential interventions for treatment and prevention of coronavirus infections. His comments included the statement that: “First, a single report based on a small, nonrandomized study must be considered preliminary and hypothesis generating, not clinically actionable. Likewise, anecdotal case reports and case series that include several cases likewise must be considered anecdotal and preliminary.” (p. 2162) These criteria are undisputed in medicine. They should be applied to all public health, pharmacological, vaccine and other preventive and treatment interventions for SARS-CoV-2. Saag applied these criteria in evaluating the effectiveness of hydroxychloroquine for the treatment of SARS-CoV-2 and concluded that: 1) based on the highest level of evidence, randomized controlled trials (RCTs), hydroxychloroquine is ineffective and should not be used, and 2) enthusiasm for hydroxychloroquine was not based on science or data, but instead was due to the politization of the pandemic: “However, the politicization of the treatment was a more important factor in promoting interest in use of this drug. On April 4, the US president, “speaking on gut instinct,” promoted the drug as a potential treatment and authorized the US government to purchase and stockpile 29 million pills of hydroxychloroquine for use by patients with COVID-19. Of note, no health official in the US government endorsed use of hydroxychloroquine owing to the absence of robust data and concern about adverse effects.” (p. 2162).
在《美国医学会杂志》最近的一篇评论文章中,Saag[1]定义了评估科学医学证据的标准,特别是评估治疗和预防冠状病毒感染的潜在干预措施的标准。他的评论包括:“首先,基于小型非随机研究的单一报告必须被认为是初步的和假设产生的,而不是临床可操作的。同样,轶事案例报告和包括若干案例的案例系列也必须被认为是轶事和初步的。(第2162页)这些标准在医学界是无可争议的。它们应适用于SARS-CoV-2的所有公共卫生、药理学、疫苗和其他预防和治疗干预措施。Saag将这些标准应用于评价羟氯喹治疗SARS-CoV-2的有效性,并得出结论:1)基于最高水平的证据,随机对照试验(RCTs),羟氯喹无效,不应使用;2)对羟氯喹的热情不是基于科学或数据,而是由于大流行的政治化;“然而,治疗的政治化是促进使用这种药物的一个更重要的因素。4月4日,美国总统“凭直觉发言”,宣传这种药物是一种潜在的治疗方法,并授权美国政府购买和储存2900万粒羟氯喹,供COVID-19患者使用。值得注意的是,由于缺乏可靠的数据和对不良反应的担忧,美国政府没有卫生官员支持使用羟氯喹。(第2162页)。
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引用次数: 4
Stroke Survivors’ Experiences of Early Person- Centered Rehabilitation at Home – Living in Sparsely Populated Areas 居住在人口稀少地区的中风幸存者在家中早期以人为中心的康复经验
Pub Date : 2020-10-20 DOI: 10.31038/jnnc.2020331
B. Nordström, Ann-Charlotte Kassberg, S. W. Axelsson
negative psychosocial effects because of the body being unreliable and the patient’s self-identity, role and social relations may also be negatively affected [14,15]. A person with stroke may have an altered life instead of going back to life as it was before the stroke. The altered life may have an impact on the person’s capacity to learn and adapt to a change in the environment [16]. Overall, a person-centred rehabilitation needs to include biopsychosocial and spiritual aspects, preferences, experience’s and the right to make decisions about one´s treatment [17,18]. It is about respecting, differences and deviation and having an inclusive attitude to the ways people view their own embodiment [19]. Living in a sparsely populated area, includes specific challenges such as long distances to receive rehabilitation. These conditions place high demands on the person, family members and their social network. Rehabilitation at home enables adaptation of the environment and provides opportunities for the patient to practice skills that are important for them. There are no studies regarding stroke patient’s own perspective, of undergoing home-based rehabilitation in sparsely populated areas from true person-centred perspective [20]. Such knowledge may support health care providers to develop individual interventions at home and support transition from rehabilitation units to the home in this specific area. Abstract Aim : The aim was to illuminate the situation of patients with stroke in sparsely populated areas and their experience of person-centred rehabilitation at home. Methods : Fourteen persons with stroke who had received Early Supported Discharge home- rehabilitation following stroke were interviewed. The data were analyzed with a qualitative content analysis method. Results: The analysis resulted in one overall theme: Living a life with a new version of me 2.0, built up from three categories: A new strengthen sense of self, Being at home creates trust and self-management and Environmental factors essential for rehabilitation at home . Conclusion: The results exposed that early home rehabilitation in sparsely populated area following stroke influences the person’s possibilities to return to the life they lived before. Living a life with the new version of me 2.0 includes conditions related to prerequisites of own empowerment and the importance of both relativities and professionals.
由于身体不可靠,患者的自我认同、角色和社会关系也可能受到负面影响,从而产生负面的心理社会影响[14,15]。中风患者可能已经改变了生活,而不是回到中风前的生活。生活的改变可能会对个人学习和适应环境变化的能力产生影响[16]。总体而言,以人为中心的康复需要包括生物、心理、社会和精神方面、偏好、经验和决定治疗的权利[17,18]。它是对人们看待自身体现的方式的尊重、差异和偏差,以及包容的态度[19]。生活在一个人口稀少的地区,包括一些特殊的挑战,比如长距离的康复。这些情况对个人、家庭成员和他们的社会网络提出了很高的要求。家庭康复使患者能够适应环境,并为患者提供练习对他们很重要的技能的机会。目前还没有研究从真正以人为本的角度,从中风患者自身的角度,在人口稀少的地区进行家庭康复[20]。这些知识可以支持卫生保健提供者在家中制定个人干预措施,并支持从康复单位过渡到该特定地区的家庭。摘要目的:目的是阐明人口稀少地区脑卒中患者的情况和他们以人为本的家庭康复经验。方法:对14例脑卒中后接受早期支持出院家庭康复治疗的患者进行访谈。采用定性含量分析法对数据进行分析。结果:分析得出一个总体主题:与新版本的自我2.0生活,由三个类别组成:新的增强自我意识,在家创造信任和自我管理以及在家康复所必需的环境因素。结论:研究结果表明,在人口稀少的地区,中风后早期家庭康复会影响患者恢复以前生活的可能性。与新版本的自我2.0一起生活,包括与自我赋权的先决条件以及亲属和专业人士的重要性相关的条件。
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引用次数: 1
How Misinformation that Facemasks are Effective for Reducing COVID-19 is Transmitted 口罩对减少COVID-19有效的错误信息是如何传播的
Pub Date : 2020-09-12 DOI: 10.31038/jnnc.2020323
C. Ross
J Neurol Neurocrit Care, Volume 3(2): 1–3, 2020 The evidence from randomized controlled trials (RCTs) that surgical facemasks and cloth facemasks are ineffective for preventing transmission of respiratory viruses in public is conclusive [1-8]. In all the meta-analyses of all the existing RCTs [4-7], not a single trial was found in which facemasks provided any protection against virus transmission in public [1,2]. Consistent with the findings of all RCTs comparing transmission rates in public with and without facemasks, Leung et al. compared the rates of detection of three types of viruses in exhalations by infected individuals with and without facemasks: they concluded that, with facemasks, there was: “no significant reduction in detection of influenza virus in aerosols;” “For rhinovirus there were no significant differences between detection of virus with or without facemasks, both in respiratory droplets and in aerosols;” and, for coronavirus there was “no significant reduction in detection in aerosols [3].” They did observe a reduction in detection of viruses in respiratory droplets for influenza virus and coronavirus. There is no doubt that facemasks can reduce the transmission of droplets, but droplets are not the concern for transmission of viruses in public. Significant numbers of droplets are not exhaled by asymptomatic carriers because they are not coughing or sneezing in public. Symptomatic carriers who are coughing and sneezing should be quarantined. The rationale for both recommended and mandated facemasks in public is to reduce transmission by asymptomatic carriers. Since all the RCTs in the literature show no reduction in transmission of viruses in public due to facemasks, one wonders why the CDC, NIH and virtually all medical authorities are stating that there is conclusive scientific evidence that facemasks reduce viral transmission in public.
随机对照试验(RCTs)证实外科口罩和布质口罩对公共场所呼吸道病毒传播无效[1-8]。在所有现有随机对照试验的荟萃分析中[4-7],没有发现任何一项试验表明口罩在公共场合对病毒传播有任何保护作用[1,2]。Leung等人比较了戴口罩和不戴口罩的感染者呼出物中三种病毒的检出率,与所有比较戴口罩和不戴口罩的公共场所传播率的随机对照试验的结果一致。他们得出结论,戴口罩时:“在呼吸道飞沫和气溶胶中,戴口罩和不戴口罩检测到的鼻病毒没有显著差异”,“在气溶胶中检测到的冠状病毒没有显著减少[3]”。他们确实观察到在呼吸道飞沫中检测到流感病毒和冠状病毒的病毒有所减少。毫无疑问,口罩可以减少飞沫的传播,但飞沫不是公共场所病毒传播的担忧。无症状感染者没有呼出大量飞沫,因为他们没有在公共场合咳嗽或打喷嚏。有咳嗽和打喷嚏症状的感染者应进行隔离。建议和强制在公共场所佩戴口罩的理由是减少无症状携带者的传播。由于文献中所有的随机对照试验都显示,戴口罩并没有减少病毒在公共场所的传播,人们不禁要问,为什么美国疾病控制与预防中心、美国国立卫生研究院和几乎所有的医学权威机构都表示,有确凿的科学证据表明,戴口罩可以减少病毒在公共场所的传播。
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引用次数: 3
COVID-19 Infection Presenting as Acute Onset Focal Status Epilepticus in a Nine Year Old Boy 一名9岁男孩的COVID-19感染表现为急性发作局灶性癫痫持续状态
Pub Date : 2020-08-24 DOI: 10.31038/jnnc.2020322
Jeffrey Swarz, S. Daily, E. Niemi, Samuel G. Hilbert, H. Ibrahim, Daniela Rauch, J. Gaitanis
Estimates suggest children currently account for 1%-5% of diagnosed COVID-19 cases [1,2]. Available literature focusing on children is limited in comparison to adults but suggests the clinical spectrum of illness in the pediatric population associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes coronavirus disease 2019 (COVID-19) is distinct from and broader than that in the adults. The most frequently reported symptoms in adults with COVID-19 include fever, dry cough, fatigue, and in severe cases dyspnea is common [3]. Children, when symptomatic, also present with fever and cough, but a significant proportion present with atypical symptoms such as vomiting and diarrhea [4,5]. A large proportion of COVID-19 positive children are asymptomatic or have mild cases of disease [6,7]. This difference in presentation and severity may lead to underdiagnosis in children facilitating spread of the disease [8]. This report documents the first reported case of a COVID-19 positive child presenting with focal status epilepticus.
据估计,目前儿童占COVID-19确诊病例的1%-5%[1,2]。与成人相比,针对儿童的现有文献有限,但表明与导致2019冠状病毒病(COVID-19)的严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)相关的儿科人群的临床疾病谱与成人不同,而且比成人更广泛。成人COVID-19中最常见的报告症状包括发烧、干咳、疲劳,严重者常见呼吸困难[3]。儿童在出现症状时也会出现发烧和咳嗽,但相当大比例的儿童会出现呕吐和腹泻等非典型症状[4,5]。很大一部分COVID-19阳性儿童无症状或病情轻微[6,7]。这种表现和严重程度的差异可能导致儿童诊断不足,从而促进疾病的传播[8]。本报告记录了首例报告的COVID-19阳性儿童出现局灶性癫痫持续状态的病例。
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引用次数: 0
Facemasks are Not Effective for Preventing Transmission of the Coronavirus 口罩不能有效防止冠状病毒的传播
Pub Date : 2020-08-18 DOI: 10.31038/jnnc.2020321
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引用次数: 5
Thoughts on COVID-19 对COVID-19的思考
Pub Date : 2020-07-12 DOI: 10.31038/jnnc.2020313
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引用次数: 0
期刊
Journal of Neurology and Neurocritical Care
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