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Molenaar RJ, Dijkman R, Ter Veen C, Heuvelink A, van Kaam F, Augustijn M, Feberwee A. A Salmonella Pullorum outbreak with neurological signs in adult layers and outbreak investigation using whole genome sequencing. Avian Pathol 2024; 53:44-55. [PMID: 37800359 DOI: 10.1080/03079457.2023.2268027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/03/2023] [Indexed: 10/07/2023]
Abstract
RESEARCH HIGHLIGHTS Cerebral granulomas are associated with nervous signs in Salmonella Pullorum outbreak.Bone marrow is also a recommended tissue for isolation of Salmonella Pullorum.Rapid plate agglutination test detects Pullorum antibodies in a vaccinated flock.Phylogenetic analysis showed clonality of isolates within the outbreak.
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Abha Mishra KM, Podili R, Pathlavath TS, Sethi KK. A critical review on brain and heart axis response in COVID-19 patients: Molecular mechanisms, mediators, biomarkers, and therapeutics. J Biochem Mol Toxicol 2023; 37:e23409. [PMID: 37341157 DOI: 10.1002/jbt.23409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023]
Abstract
Since the outbreak of highly virulent coronaviruses, significant interest was assessed to the brain and heart axis (BHA) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-affected patients. The majority of clinical reports accounted for unusual symptoms associated with SARS-CoV-2 infections which are of the neurological type, such as headache, nausea, dysgeusia, anosmia, and cerebral infarction. The SARS-CoV-2 enters the cells through the angiotensin-converting enzyme (ACE-2) receptor. Patients with prior cardiovascular disease (CVD) have a higher risk of COVID-19 infection and it has related to various cardiovascular (CV) complications. Infected patients with pre-existing CVDs are also particularly exposed to critical health outcomes. Overall, COVID-19 affected patients admitted to intensive care units (ICU) and exposed to stressful environmental constraints, featured with a cluster of neurological and CV complications. In this review, we summarized the main contributions in the literature on how SARS-CoV-2 could interfere with the BHA and its role in affecting multiorgan disorders. Specifically, the central nervous system involvement, mainly in relation to CV alterations in COVID-19-affected patients, is considered. This review also emphasizes the biomarkers and therapy options for COVID-19 patients presenting with CV problems.
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Affiliation(s)
- K M Abha Mishra
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Runesh Podili
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Teja S Pathlavath
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Kalyan K Sethi
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
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Gabba L, Iannucci C, Vigani A. Hemodialysis as emergency treatment of a severe baclofen intoxication in a 3 kg dog. Vet Med Sci 2022; 9:43-46. [PMID: 36516306 PMCID: PMC9857140 DOI: 10.1002/vms3.1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To describe the clinical efficacy and drug removal kinetics of hemodialysis (HD) as emergency treatment in a small size dog with severe baclofen intoxication. CASE DESCRIPTION A 2-year-old dog was presented in stupor to the emergency service a few hours after ingestion of up to 25 mg of baclofen. Medical stabilisation was attempted but was unsuccessful in improving the neurological condition and the patient rapidly progressed to coma. A 4-h session of HD was performed in emergency with near complete resolution of neurological signs and only mild disorientation by the end of the treatment. No adverse side effects occurred during HD. Baclofen concentration was measured serially during the session. Drug extraction ratio, clearance and mass removal by the dialyser were calculated. Dialytic elimination rate constant (Kd ) was seven times higher than the intrinsic elimination rate constant (Kintr ) and the half-life (t½) during HD was nearly nine times shorter than the endogenous one. NEW OR UNIQUE INFORMATION PROVIDED This is the first case report providing pharmacokinetic data associated with HD treatment of severe baclofen intoxication in a dog.
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Affiliation(s)
- Linda Gabba
- Division of Small Animal Emergency and Critical CareDepartment of Clinical Veterinary MedicineVetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Claudia Iannucci
- Division of Small Animal Emergency and Critical CareDepartment of Clinical Veterinary MedicineVetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Alessio Vigani
- Division of Small Animal Emergency and Critical CareDepartment of Clinical Veterinary MedicineVetsuisse FacultyUniversity of ZurichZurichSwitzerland
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Szlago M. [Practical approach to the diagnosis of inherited metabolic diseases]. Medicina (B Aires) 2022; 82 Suppl 3:40-45. [PMID: 36054856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Inborn errors of metabolism constitute a growing group of rare diseases with usual neurological impact. Heterogeneous in clinical and biochemical aspects, its diagnosis and treatment are difficult. Advances in its knowledge, in diagnostic methods and in its treatments, highlight the importance of a timely diagnosis, the gateway to access to early medical intervention. The neuropediatrician's suspicion in different clinical situations is very relevant. This article aims to be a practical contribution to facilitate their recognition.
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Affiliation(s)
- Marina Szlago
- Errores Congénitos del Metabolismo, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina. E-mail:
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Li J, He Y, Ren B, Zhang Z, Meng F, Zhang X, Zhou Z, Li B, Li F, Liu L, Shen H. The Thyroid Condition and Residual Clinical Signs in 31 Existing Endemic Neurological Cretins After 42 Years of Iodine Supplementation in China. Front Endocrinol (Lausanne) 2022; 13:911487. [PMID: 35898470 PMCID: PMC9309213 DOI: 10.3389/fendo.2022.911487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUD Endemic cretinism is the most severe manifestation among the iodine deficiency-related disorders. The clinical status of the cretins may be modified subsequently by the duration and severity of the disease. We aimed to reassess the clinical status and thyroid function of 31 surviving "neurological cretins" after 42 years of iodine supplementation in a historically severely iodine deficiency area of China. METHODS It was a cross-sectional study in design and we investigated all 31 surviving neurological cretins and 85 controls. A detailed neurological examination was conducted on each patients. All the participants were given a questionnaire and underwent B-mode ultrasonography of the thyroid. The serum levels of thyroid hormones, thyroid antibodies, serum iodine concentration (SIC) and urine iodine concentration (UIC) were measured. RESULTS The neurological cretins had shorter stature than that of the control. Neurological damage is still present in patients with cretinism. The prevalence of subclinical hypothyroidism and thyroid nodule in the cretins was significantly higher (χ2 =4.766, P=0.029 and χ2 =17.077, P<0.0001, respectively) compared with the control. After adjusting for confounding factors, endemic neurocretinism was found to be an independent risk factor for subclinical hypothyroidism (OR=4.412; 95% CI: 1.358-14.334; P=0.014) and thyroid nodule (OR=6.433; 95% CI: 2.323-17.816; P<0.0001). CONCLUSIONS Iodine supplementation after birth does not reverse the neurological damage that results from maternal/foetal hypothyroidism in utero and is subsequently manifested as neurological cretinism. There is a cross-sectional association between endemic neurocretinism and subclinical hypothyroidism and thyroid nodule.
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Affiliation(s)
- Jianshuang Li
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- College of Medical Laboratory Science and Technology, Harbin Medical University (Daqing), Daqing, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
| | - Yanhong He
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
| | - Bingxuan Ren
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
| | - Zhaojun Zhang
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
| | - Fangang Meng
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
| | - Xiaoye Zhang
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
| | - Zheng Zhou
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
| | - Baoxiang Li
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
| | - Fan Li
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
| | - Lixiang Liu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
- *Correspondence: Hongmei Shen, ; Lixiang Liu,
| | - Hongmei Shen
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin City, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China
- *Correspondence: Hongmei Shen, ; Lixiang Liu,
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Snyman J, Koekemoer O, van Schalkwyk A, Jansen van Vuren P, Snyman L, Williams J, Venter M. Epidemiology and Genomic Analysis of Equine Encephalosis Virus Detected in Horses with Clinical Signs in South Africa, 2010-2017. Viruses 2021; 13:398. [PMID: 33801457 DOI: 10.3390/v13030398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/23/2022] Open
Abstract
Equine encephalosis virus (EEV) is a neglected virus endemic to South Africa and is considered to generally result in mild disease in equines. Specimens were analyzed from live horses that presented with undefined neurological, febrile, or respiratory signs, or sudden and unexpected death. Between 2010 and 2017, 111 of 1523 (7.3%) horse samples tested positive for EEV using a nested real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Clinical signs were reported in 106 (7.2%) EEV positive and 1360 negative horses and included pyrexia (77/106, 72.6%), icterus (20/106, 18.9%) and dyspnea (12/106, 11.3%). Neurological signs were inversely associated with EEV infection (OR < 1, p < 0.05) relative to EEV negative cases despite a high percentage of animals presenting with neurological abnormalities (51/106, 48.1%). Seventeen of the EEV positive horses also had coinfections with either West Nile (5/106, 4.7%), Middelburg (4/106, 3.8%) or African Horse sickness virus (8/106, 7.6%). To investigate a possible genetic link between EEV strains causing the observed clinical signs in horses, the full genomes of six isolates were compared to the reference strains. Based on the outer capsid protein (VP2), serotype 1 and 4 were identified as the predominant serotypes with widespread reassortment between the seven different serotypes.
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Madrid M, Brianza-Padilla M, Echeverría JC, Rivera-González R, Bojalil R. The Severity of Neurological Dysfunction in Preschool Children, Secondary to Damage Generated During the Perinatal Period, is Associated With a Pro-Inflammatory Pattern of Serum Molecules. Front Immunol 2021; 11:595309. [PMID: 33584663 PMCID: PMC7876313 DOI: 10.3389/fimmu.2020.595309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 12/11/2020] [Indexed: 11/17/2022] Open
Abstract
Disorders in the child’s neurological development caused by perinatal risks can lead to long-term altered neurological signs that begin at an early age and involve persistent functional disorders. Recent data suggest that tissue dysfunction, not just acute damage, may initiate or perpetuate an inflammatory response. The aim of this study was to find out if any neurological dysfunction in preschool children secondary to damage generated during the perinatal period is associated with the magnitude of perinatal risks and long-term modifications in the serum concentrations of inflammatory molecules. The participants, aged 1–4 years, were on neurodevelopmental follow-up and rehabilitation therapy from the first three months of life and had no acute disease data. We classified the children into three groups according to the importance of their perinatal risks: low, medium, and high. The results show that 1) the magnitude of perinatal risks correlated with the severity of neurological dysfunction; 2) the greatest changes in the concentrations of the molecules of the inflammatory process were associated with the most altered neurological signs. This suggests that persistent nervous system dysfunction keeps inflammatory responses active even in the absence of an acute process of infection or damage.
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Affiliation(s)
- Miriam Madrid
- Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | | | - Juan C Echeverría
- Department of Electric Engineering, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, Mexico
| | - Rolando Rivera-González
- Neurodevelopment Monitoring Laboratory, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Rafael Bojalil
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
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Felten S, Matiasek K, Leutenegger CM, Sangl L, Herre S, Dörfelt S, Fischer A, Hartmann K. Diagnostic Value of Detecting Feline Coronavirus RNA and Spike Gene Mutations in Cerebrospinal Fluid to Confirm Feline Infectious Peritonitis. Viruses 2021; 13:186. [PMID: 33513683 DOI: 10.3390/v13020186] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Cats with neurologic feline infectious peritonitis (FIP) are difficult to diagnose. Aim of this study was to evaluate the diagnostic value of detecting feline coronavirus (FCoV) RNA and spike (S) gene mutations in cerebrospinal fluid (CSF). METHODS The study included 30 cats with confirmed FIP (six with neurological signs) and 29 control cats (eleven with neurological signs) with other diseases resulting in similar clinical signs. CSF was tested for FCoV RNA by 7b-RT-qPCR in all cats. In RT-qPCR-positive cases, S-RT-qPCR was additionally performed to identify spike gene mutations. RESULTS Nine cats with FIP (9/30, 30%), but none of the control cats were positive for FCoV RNA in CSF. Sensitivity of 7b-RT-qPCR in CSF was higher for cats with neurological FIP (83.3%; 95% confidence interval (95% CI) 41.8-98.9) than for cats with non-neurological FIP (16.7%; 95% CI 6.1-36.5). Spike gene mutations were rarely detected. CONCLUSIONS FCoV RNA was frequently present in CSF of cats with neurological FIP, but only rarely in cats with non-neurological FIP. Screening for spike gene mutations did not enhance specificity in this patient group. Larger populations of cats with neurological FIP should be explored in future studies.
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Morelli S, Marruchella G, Passarelli A, Diakou A, Di Cesare A, Colombo M, Frangipane di Regalbono A, Frate A, Traversa D. An Unusual Case of Mixed Respiratory Capillariosis in a Dog. Pathogens 2021; 10:pathogens10020117. [PMID: 33498766 PMCID: PMC7911517 DOI: 10.3390/pathogens10020117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 11/16/2022] Open
Abstract
Nematodes belonging to the genus Capillaria infect a range of domestic and wild animals. Capillaria aerophila and Capillaria boehmi cause respiratory parasitoses in dogs and wild carnivores, e.g., foxes and mustelids, although they are often overlooked in canine clinical practice. The present report describes an unusual case of a severe and mixed infection by C. aerophila and C. boehmi in a privately housed dog that showed acute and life-threatening respiratory and neurological signs. Clinic-pathologic and epizootiological implications are described and discussed.
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Affiliation(s)
- Simone Morelli
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (G.M.); (A.D.C.); (M.C.); (D.T.)
- Correspondence:
| | - Giuseppe Marruchella
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (G.M.); (A.D.C.); (M.C.); (D.T.)
| | | | - Anastasia Diakou
- Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Angela Di Cesare
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (G.M.); (A.D.C.); (M.C.); (D.T.)
| | - Mariasole Colombo
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (G.M.); (A.D.C.); (M.C.); (D.T.)
| | | | - Alessandro Frate
- Clinica Veterinaria Città di Bari, 70125 Bari, Italy; (A.P.); (A.F.)
| | - Donato Traversa
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (G.M.); (A.D.C.); (M.C.); (D.T.)
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Szôts M, Péterfi A, Geröly J, Nagy F. [Covid-19 associated neurological disorders]. Ideggyogy Sz 2020; 73:427-430. [PMID: 33264532 DOI: 10.18071/isz.73.0427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The clinical signs of SARS-CoV-2 infection has become more recognisable in recent times. In addition to common symptoms such as fever, cough, dyspnea, pneumonia and ageusia, less common complications can be identified, including many neurological manifestations. In this paper, we discuss three Covid-19 associated neurological disorders (Case 1: Covid-19 encephalitis, Case 2: Covid-19 organic headache, Case 3: SARS-CoV-2-infection and ischaemic stroke). We emphasize in our multiple case study that during the present pandemic, it is especially important for neurologists to be aware of the nervous system complications of the virus infection, thus saving unnecessary examinations and reducing the frequency of patients' contact with health care personnel.
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Affiliation(s)
- Mónika Szôts
- Somogy Megyei Kaposi Mór Oktató Kórház, Neurológiai Osztály, Kaposvár
| | - Anna Péterfi
- Somogy Megyei Kaposi Mór Oktató Kórház, Neurológiai Osztály, Kaposvár
| | - Júlia Geröly
- Somogy Megyei Kaposi Mór Oktató Kórház, Neurológiai Osztály, Kaposvár
| | - Ferenc Nagy
- Somogy Megyei Kaposi Mór Oktató Kórház, Neurológiai Osztály, Kaposvár
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Ferruccio NP, Tosato S, Lappin JM, Heslin M, Donoghue K, Giordano A, Lomas B, Reininghaus U, Onyejiaka A, Chan RCK, Croudace T, Jones PB, Murray RM, Fearon P, Doody GA, Morgan C, Dazzan P. Neurological Signs at the First Psychotic Episode as Correlates of Long-Term Outcome: Results From the AESOP-10 Study. Schizophr Bull 2020; 47:118-127. [PMID: 32656567 PMCID: PMC7824991 DOI: 10.1093/schbul/sbaa089] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Minor neurological signs are subtle deficits in sensory integration, motor coordination, and sequencing of complex motor acts present in excess in the early stages of psychosis. Still, it remains unclear whether at least some of these signs represent trait or state markers for psychosis and whether they are markers of long-term disease outcome of clinical utility. We examined the relationship between neurological function at illness onset assessed with the Neurological Evaluation Scale and subsequent illness course in 233 patients from AESOP-10 (Aetiology and Ethnicity in Schizophrenia and Other Psychoses), a 10-year follow-up study of a population-based cohort of individuals recruited at the time of their first episode of psychosis in the United Kingdom. In 56 of these patients, we also explored changes in neurological function over time. We included a group of 172 individuals without psychosis as controls. After 10 years, 147 (63%) patients had developed a non-remitting course of illness, and 86 (37%) a remitting course. Already at first presentation, patients who developed a non-remitting course had significantly more primary, motor coordination, and total signs than both remitting patients and healthy controls. While Motor Coordination signs did not change over time, rates of Primary, Sensory Integration, and Total signs increased, independently of illness course type. These findings suggest that motor coordination problems could be a useful early, quick, and easily detectable marker of subsequent clinical outcome. With other motor abnormalities, a measure of motor incoordination could contribute to the identification of the most vulnerable individuals, who could benefit from targeted and more assertive treatment approaches.
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Affiliation(s)
- Naika P Ferruccio
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sarah Tosato
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Julia M Lappin
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Margaret Heslin
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Kim Donoghue
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Annalisa Giordano
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ben Lomas
- Department of Psychiatry, University of Nottingham, Nottingham, UK
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Adanna Onyejiaka
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Tim Croudace
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Peter B Jones
- University of Cambridge, and Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paul Fearon
- Discipline of Psychiatry, School of Medicine, Trinity College, Dublin, Ireland
| | - Gillian A Doody
- Department of Psychiatry, University of Nottingham, Nottingham, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK,To whom correspondence should be addressed; tel: +44-(0)207-848-0700, fax: +44-(0)207-848-0287, e-mail:
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Bereczki D, Stang R, Böjti P, Kovács T. [Neurological aspects of the COVID-19 pandemic caused by the SARS-CoV-2 coronavirus]. Ideggyogy Sz 2020; 73:171-175. [PMID: 32579306 DOI: 10.18071/isz.73.0171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
By the spring of 2020 the COVID-19 outbreak caused by the new SARS-CoV-2 coronavirus has become a pandemic, requiring fast and efficient reaction from societies and health care systems all over the world. Fever, coughing and dyspnea are considered the major signs of COVID-19. In addition to the involvement of the respiratory system, the infection may result in other symptoms and signs as well. Based on reports to date, neurological signs or symptoms appear in 30-50% of hospitalized COVID-19 patients, with higher incidence in those with more severe disease. Classical acute neurological syndromes have also been reported to associate with COVID-19. A drop in the volume of services for other acute diseases has been described in countries with healthcare systems focusing on COVID-19. During the COVID-19 epidemic it is also important to provide appropriate continuous care for those with chronic neurological disorders. It will be the task of the future to estimate the collateral damage caused by the COVID-19 epidemic on the outcome of other neurological disorders, and to screen for the possible late neurological complications of the SARS-CoV-2 coronavirus infection.
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Affiliation(s)
- Dániel Bereczki
- Semmelweis Egyetem, Neurológiai Klinika, Budapest.,MTA-SE Neuroepidemiológiai Kutatócsoport, Budapest.,European Academy of Neurology, EANcore COVID-19 Taskforce
| | - Rita Stang
- Semmelweis Egyetem, Neurológiai Klinika, Budapest
| | - Péter Böjti
- Semmelweis Egyetem, Neurológiai Klinika, Budapest
| | - Tibor Kovács
- Semmelweis Egyetem, Neurológiai Klinika, Budapest.,MTA-SE Neuroepidemiológiai Kutatócsoport, Budapest
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13
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Zaccaria G, Lorusso A, Hierweger MM, Malatesta D, Defourny SV, Ruggeri F, Cammà C, Ricci P, Domenico MD, Rinaldi A, Decaro N, D'Alterio N, Petrini A, Seuberlich T, Marcacci M. Detection of Astrovirus in a Cow with Neurological Signs by Nanopore Technology, Italy. Viruses 2020; 12:E530. [PMID: 32403368 DOI: 10.3390/v12050530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/07/2020] [Accepted: 05/09/2020] [Indexed: 01/16/2023] Open
Abstract
In this study, starting from nucleic acids purified from the brain tissue, Nanopore technology was used to identify the etiological agent of severe neurological signs observed in a cow which was immediately slaughtered. Histological examination revealed acute non-suppurative encephalomyelitis affecting the brainstem, cerebrum, cerebellum, and medulla oblongata, while by using PCR-based assays, the nucleic acids of major agents for neurological signs were not detected. By using Nanopore technology, 151 sequence reads were assigned to Bovine Astrovirus (BoAstV). Real-time RT-PCR and in situ hybridization (ISH) confirmed the presence of viral RNA in the brain. Moreover, using the combination of fluorescent ISH and immunofluorescence (IF) techniques, it was possible to detect BoAstV RNA and antigens in the same cells, suggesting the active replication of the virus in infected neurons. The nearly whole genome of the occurring strain (BoAstV PE3373/2019/Italy), obtained by Illumina NextSeq 500, showed the highest nucleotide sequence identity (94.11%) with BoAstV CH13/NeuroS1 26,730 strain, an encephalitis-associated bovine astrovirus. Here, we provide further evidence of the role of AstV as a neurotropic agent. Considering that in a high proportion of non-suppurative encephalitis cases, which are mostly indicative of a viral infection, the etiologic agent remains unknown, our result underscores the value and versatility of Nanopore technology for a rapid diagnosis when the PCR-based algorithm gives negative results.
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14
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Basile JK, Vigani A. Treatment of phenobarbital intoxication using hemodialysis in two dogs. J Vet Emerg Crit Care (San Antonio) 2020; 30:221-225. [PMID: 31975513 DOI: 10.1111/vec.12908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 02/21/2018] [Accepted: 03/22/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the use of hemodialysis in 2 dogs with severe clinical signs from phenobarbital intoxication. SERIES SUMMARY Two dogs ingested a toxic dose of phenobarbital, leading to severe neurological dysfunction and a comatose state. Both dogs received a 3-hour session of hemodialysis with complete resolution of clinical signs and returned to normal mentation by the end of the therapy. No negative side effects occurred and phenobarbital concentrations returned to therapeutic range during treatment. NEW INFORMATION PROVIDED This is the first report on the utility and safety of using hemodialysis for phenobarbital intoxication in dogs.
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Affiliation(s)
- Jessica Kielb Basile
- Emergency and Critical Care Service, North Carolina State Veterinary Hospital, Raleigh, NC
| | - Alessio Vigani
- Emergency and Critical Care Service, North Carolina State Veterinary Hospital, Raleigh, NC
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15
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Mudji J, Benhamou J, Mwamba-Miaka E, Burri C, Blum J. The Flipside of Eradicating a Disease; Human African Trypanosomiasis in a Woman in Rural Democratic Republic of Congo: A Case Report. Trop Med Infect Dis 2019; 4:E142. [PMID: 31835660 DOI: 10.3390/tropicalmed4040142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/06/2019] [Accepted: 12/07/2019] [Indexed: 11/16/2022] Open
Abstract
Human African Trypanosomiasis (HAT) is a neglected disease caused by the protozoan parasites Trypanosoma brucei and transmitted by tsetse flies that progresses in two phases. Symptoms in the first phase include fever, headaches, pruritus, lymphadenopathy, and in certain cases, hepato- and splenomegaly. Neurological disorders such as sleep disorder, aggressive behavior, logorrhea, psychotic reactions, and mood changes are signs of the second stage of the disease. Diagnosis follows complex algorithms, including serological testing and microscopy. Our case report illustrates the course of events of a 41-year old woman with sleep disorder, among other neurological symptoms, whose diagnosis was made seven months after the onset of symptoms. The patient had consulted two different hospitals in Kinshasa and was on the verge of being discharged from a third due to negative laboratory test results. This case report highlights the challenges that may arise when a disease is on the verge of eradication.
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16
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Martin-Giménez T, Cruz AM, Barragán A, Montero E, Sanchez PG, Caballero G, Corradini I. Delayed onset vagus nerve paralysis after occipital condyle fracture in a horse. J Vet Intern Med 2019; 33:2780-2785. [PMID: 31556150 PMCID: PMC6872609 DOI: 10.1111/jvim.15581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 07/15/2019] [Indexed: 11/30/2022] Open
Abstract
Occipital condylar fractures (OCFs) causing delayed onset lower cranial nerve paralysis (LCNPs) are rare. We present a 7‐year‐old Friesian horse with delayed onset dysphagia caused by vagus nerve (CNX) paralysis and suspicion of glossopharyngeal nerve (CNIX) paralysis developed several days after a minor head injury. Endoscopic examination revealed right laryngeal hemiplegia and intermittent dorsal displacement of the soft palate. An area of submucosal hemorrhage and bulging was appreciated over the dorsal aspect of the medial compartment of the right guttural pouch. Radiological examination of the proximal cervical region showed rotation of the atlas and the presence of a large bone fragment dorsal to the guttural pouches. Occipital condyle fracture with delayed onset cranial nerve paralysis was diagnosed. Delayed onset cranial nerve paralysis causing dysphagia might be a distinguishable sign of OCF in horses. Delayed onset dysphagia after head injury should prompt equine clinicians to evaluate the condition of the atlanto‐occipital articulation and skull base.
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Affiliation(s)
- Tamara Martin-Giménez
- Veterinary Teaching Hospital, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
| | - Antonio M Cruz
- Veterinary Teaching Hospital, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain.,Department of Animal Medicine and Surgery, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
| | - Agustín Barragán
- Pathological Anatomy Service. Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
| | - Estefanía Montero
- Pathological Anatomy Service. Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
| | - Pedro G Sanchez
- Veterinary Teaching Hospital, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
| | - Guillermo Caballero
- Veterinary Teaching Hospital, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
| | - Ignacio Corradini
- Veterinary Teaching Hospital, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain.,Department of Animal Medicine and Surgery, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
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17
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Golender N, Bumbarov V, Assis I, Beer M, Khinich Y, Koren O, Edery N, Eldar A, Wernike K. Shuni virus in Israel: Neurological disease and fatalities in cattle. Transbound Emerg Dis 2019; 66:1126-1131. [PMID: 30864252 DOI: 10.1111/tbed.13167] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 02/15/2019] [Accepted: 03/01/2019] [Indexed: 11/29/2022]
Abstract
The insect-transmitted Shuni virus (SHUV) belongs to the Simbu serogroup of orthobunyaviruses and it is known to induce abortions, stillbirths and severe congenital malformations in ruminants and may cause neurological signs in infected horses. Here, SHUV was detected in brain samples of two Israeli cattle, which suffered from severe neurological signs that led to the deaths of the animals. During histopathological examination of the first case, a 5-month-old calf, small perivascular cuffs, composed mainly of neutrophils with few lymphocytes were observed in the brain stem and cerebrum. Similar infiltrates were also found to a lesser extent in the cerebellar meninges leading to the diagnosis of acute-subacute meningoencephalitis. The histological examination of the brainstem from the second case, a 16-month-old heifer, revealed perivascular infiltration composed of equal numbers of macrophages and neutrophils associated with cerebral and meningeal haemorrhages. In this case encephalitis was diagnosed. Viral RNA was extracted from brain samples of both cattle that suffered from severe neurological signs and was subsequently tested by a polymerase chain reaction PCR assay specific for Simbu serogroup viruses and found positive. The presence of SHUV was subsequently confirmed by the isolation of the virus from one sample and sequence analysis of both brain samples. The comparison of the complete sequences of the coding regions of all three genome segments from both cases revealed a close relationship to Shuni viruses detected in tissue samples of aborted or malformed calves or lambs born during the last years in Israel.
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Affiliation(s)
- Natalia Golender
- Department of Virology, Kimron Veterinary Institute, Bet Dagan, Israel
| | - Velizar Bumbarov
- Department of Virology, Kimron Veterinary Institute, Bet Dagan, Israel
| | - Itay Assis
- "Hachaklait", Mutual Society for Veterinary Services, Caesaria, Israel
| | - Martin Beer
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany
| | - Yevgeny Khinich
- Department of Virology, Kimron Veterinary Institute, Bet Dagan, Israel
| | - Ori Koren
- "Hachaklait", Mutual Society for Veterinary Services, Caesaria, Israel
| | - Nir Edery
- Department of Pathology, Kimron Veterinary Institute, Bet Dagan, Israel
| | - Avi Eldar
- Department of Virology, Kimron Veterinary Institute, Bet Dagan, Israel
| | - Kerstin Wernike
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany
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18
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Yorifuji T, Tsuda T. Epidemiological studies of neurological signs and symptoms and blood pressure in populations near the industrial methylmercury contamination at Minamata, Japan. Arch Environ Occup Health 2016; 71:231-236. [PMID: 26299421 DOI: 10.1080/19338244.2015.1084261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Severe methylmercury exposure occurred in Minamata, Japan. Only a limited number of epidemiological studies related to that exposure have been carried out. The evidence that methylmercury is cardiotoxic is very limited, and these studies provide only minimal support for that hypothesis. We therefore analyzed the data both from an investigation in Minamata and neighboring communities in 1971 and an investigation in 1974 in another area simultaneously. We included a total of 3,751 participants. We examined the association of residential area with neurological signs or blood pressure using logistic regression or multiple linear regression models, adjusting for sex and age. We found that the prevalence of neurological signs and symptoms was elevated in the Minamata area (high-exposure), followed by the Goshonoura area (medium-exposure). Moreover, blood pressure was elevated in residents of the Minamata area.
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Affiliation(s)
- Takashi Yorifuji
- a Department of Human Ecology , Okayama University Graduate School of Environmental and Life Science , Okayama , Japan
| | - Toshihide Tsuda
- a Department of Human Ecology , Okayama University Graduate School of Environmental and Life Science , Okayama , Japan
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19
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Peralta V, Moreno-Izco L, Sanchez-Torres A, García de Jalón E, Campos MS, Cuesta MJ. Characterization of the deficit syndrome in drug-naive schizophrenia patients: the role of spontaneous movement disorders and neurological soft signs. Schizophr Bull 2014; 40:214-24. [PMID: 23256987 PMCID: PMC3885291 DOI: 10.1093/schbul/sbs152] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study aimed to characterize the deficit syndrome in drug-naive schizophrenia patients and to examine the relationship between deficit features and primary neurological abnormalities. Drug-naive schizophrenia patients (n = 102) were examined at baseline for demographics, premorbid functioning, duration of untreated illness (DUI), psychopathology, neurological signs, and deficit symptoms, and reassessed at 1-year follow-up. Neurological abnormalities were examined before inception of antipsychotic medication and included four domains of spontaneous movement disorders (SMD) and four domains of neurological soft signs (NSS). Patients fulfilling the deficit syndrome criteria at the two assessments (n = 20) were compared with nondeficit patients (n = 82) across demographic, clinical, and neurological variables. Deficit and nondeficit groups showed similar demographic characteristics and levels of psychotic, disorganization, and depressive symptoms. Compared with nondeficit patients, deficit patients showed poorer premorbid adjustment, higher premorbid deterioration, a lengthier DUI, and much poorer functional outcome. Relative to the nondeficit patients, those with the deficit syndrome showed higher levels of SMD--excepting akathisia--and NSS. This association pattern was also evident for deficit and neurological ratings in the whole sample of schizophrenia patients. Parkinsonism, motor sequencing, and release signs were all independently related to the deficit syndrome. These findings confirm that the deficit/nondeficit categorization is replicable and reliable in first-admission patients and raise the possibility that premorbid deterioration, deficit symptoms, and neurological abnormalities represent a triad of manifestations that share common underlying neurobiological mechanisms. More specifically, the data are consistent with a neurodevelopmental model of deficit symptoms involving basal ganglia dysfunction.
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Affiliation(s)
- Victor Peralta
- To whom correspondence should be addressed; Psychiatry Section B, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008 Pamplona, Spain; tel: +34 848 422488, fax: +34 848 429924, e-mail:
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20
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Campistol J. [Guidelines for detection of inborn errors of metabolism based on clinical exam, analytical studies and neuroimaging techniques]. Medicina (B Aires) 2013; 73 Suppl 1:55-62. [PMID: 24072052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Neurometabolic disorders constitute an expanding and complex field in which it is difficult to diagnose and to acquire a specific education and training. This article tries to develop a practical orientation in the suspicion, clinical exam, biochemical studies and neuroimaging techniques for the detection of inborn errors of metabolism. It is very important for the neuropediatrician to suspect metabolic diseases depending on some of the most frequent unexplained neurological disturbances and symptoms as psychomotor delay, mental retardation, refractory epilepsy, dystonia, metabolic crisis or other extraneurological signs. It is important the diagnosis related to the new emergent therapeutic options, genetic counseling and prenatal diagnosis.
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Affiliation(s)
- Jaume Campistol
- Servicio de Neuropediatría, Hospital Universitario Sant Joan de Deu, Barcelona, España. E-mail:
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Abstract
Background: Snakebite is a major health problem in India. Venomous snakebite, which is an important medical hazard in several tropical countries including India, affects thousands of people per year and some of them develop acute kidney injury (AKI). Aims: This study was performed to find out 1) early clinical predictors for acute kidney injury in snakebite patients at the time of hospital admission and 2) incidence of acute kidney injury in snakebite patients. Materials and Methods: 171 consecutively admitted non-diabetic, non-hypertensive snakebite patients were examined. Multivariate linear regression analysis with 95 percent confidence interval (CI) was done for statistical analysis. Analyses were performed by software Statistical Package for the Social Sciences (SPSS) (17th version for Windows). Results: Incidence of acute kidney injury was 43.27%. Development of acute kidney injury was independently associated with 20 min whole blood clotting test (20 min WBCT) (P value = 0.029; CI 95%), dark or brown color urine (P value = 0.000; CI 95%), and time interval between snakebite and anti-snake venom administration (P value = 0.000; CI 95%). Age (P value = 0.011; CI 95%) and presence of neurological signs (P value = 0.000; CI 95%) were negatively correlated with development of acute kidney injury. Conclusion: Incidence of acute kidney injury is slightly higher in our study than previous studies. Early prediction of acute kidney injury development in snakebite patients can be done by presence of black or brown urine, 20 min WBCT > 20 min, and increased time interval between snakebite and administration of anti-snake venom at the time of hospital admission. Young age group of snakebite patients develops acute kidney injury more commonly.
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Affiliation(s)
- Jayanta Paul
- Department of General Medicine, Burdwan Medical College, West Bengal, India
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Soremekun M, Stewart R, Portet F, Artero S, Ancelin ML, Ritchie K. Neurological signs and late-life depressive symptoms in a community population: the ESPRIT study. Int J Geriatr Psychiatry 2010; 25:672-8. [PMID: 19823983 PMCID: PMC2980503 DOI: 10.1002/gps.2406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Depression in the elderly is common and often resistant to treatment. It has been suggested that late-life depression may be related to underlying neurobiological changes. However, these observations are derived from diverse clinical samples and as yet have not been confirmed in a more representative population study. Our aim was to investigate associations between neurological signs as markers of underlying brain dysfunction and caseness for depression in an elderly community sample, controlling for physical health and comorbid/past neurological disorders. METHOD A cross-sectional analysis of 2102 older people without dementia from the ESPRIT project. Depressive symptomatology was ascertained using the CES-D and abnormal neurological signs/comorbidity from a full neurological examination according to ICD-10 criteria. RESULTS Pyramidal, extrapyramidal, cranial nerve and sensory deficit signs were significantly associated with case-level depressive symptoms. However, all odds ratios were close to null values in participants who did not have previous neurological disorder. CONCLUSIONS We confirmed previous findings of an association between neurological signs and case-level depressive symptoms in late life. However, this association may simply reflect the impact of more severe comorbid neurological disorder.
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Affiliation(s)
| | - Robert Stewart
- Institute of Psychiatry
University of LondonKing's College,GB,Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR,* Correspondence should be adressed to: Robert Stewart
| | - Florence Portet
- Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR
| | - Sylvaine Artero
- Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR
| | - Marie-Laure Ancelin
- Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR
| | - Karen Ritchie
- Pathologies du système nerveux : recherche épidémiologique et clinique
INSERM : U888IFR76Université Montpellier IHôpital la colombiere 39, avenue charles flahault BP 34493 -pav 42 calixte cavalier 34093 MONTPELLIER CEDEX 5,FR
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