摘要： Since February 2020, SARS-COV 2 pandemic in Lombardy (Italy) progressively limited the access of patients to hospitals because of the risk of contagion. Noteworthy, 6.1% of 1072 MS patients treated with disease-modifying drugs in our MS Center had a SARS-COV-2 infection, with an exponential increase since February 26 till March 26 (from 0.37% to 5.78% of the patients' cohort). MS patients, post-stroke, and post-traumatic brain-injured patients with cognitive impairment were tested. [Extracted from the article]

摘要： Objectives Describe what is known about illness trajectory and risk for mortality in children with SNI who have LTV. Analyze the differences between parents' recollection of clinician counseling regarding LTV between parents of children with SNI and without SNI. Importance. Decisions around long-term ventilation (LTV) in children should consider the child's illness trajectory. Data suggest that children with severe neurologic impairment (SNI) are at increased risk of LTV being lifelong once placed (permanent) and have increased mortality compared to those without SNI due to their underlying medical complexity. Objective(s). To evaluate whether parents of children with SNI perceive clinician counseling regarding LTV differently than parents of children without SNI. Method(s). We interviewed parents from three academic centers who were faced with a decision about LTV for their child within the last 5 years. Interviews were audio recorded and transcribed. Content analysis was performed within and across groups of parents according to their child's SNI status. Results. A total of 37 parents were interviewed; 24 with children with SNI and 13 with children without SNI. Among children with SNI, 46% had LTV and 83% were alive. Among children without SNI, 69% had LTV and 85% were alive. Parents of children with SNI perceived less certainty from clinicians regarding LTV permanence than parents of children without SNI. Despite this, mortality related to LTV was discussed with both groups and honesty about

摘要： [...]the diagnosis of the patient was an acute left hemispheric MCA ischemic stroke with severe left internal carotid artery (ICA) stenosis. The results were that messages before 15:00 had normal writing, but after 15:00 the messages started to contain incoherent and incomprehensible words. [...]it was established that the onset of stroke was at 15:00, so thrombolytics could be administered at 18:35 because he still was in therapeutic window (4.5 h) of acute cerebral infarction. [...]these modern symptoms could be presented in the onset of stroke, and most of the time these may be the only ones reported. [...]if a person presents an abnormal keyboard typing or sends incoherent text messages everyone should communicate immediately to the emergency service, because it maybe suggests a cerebral infarction.

摘要： A new pathogenic virus, COVID-19, appeared in 2019, in Wuhan, China, typically causing fever, cough, diarrhea and fatigue and significant mortality (Mao, 2020). From mid-January to mid-February in 2020, 214 patients with both non-severe and severe COVID-19 infections confirmed by nucleic acid tests, were examined by a panel of neurologists. Seventy-eight patients (36.4%) displayed neurological symptoms, including central nervous system symptoms of dizziness, headache, impaired consciousness, acute cerebrovascular disease with either ischemic stroke or cerebral hemorrhage, ataxia, seizures; peripheral nervous system symptoms of taste impairment, smell impairment, vision impairment, and nerve pain; and skeletal muscle injury (Mao, 2020).

摘要： Leonardo da Vinci may be most famous for his paintings 'Mona Lisa' and 'Last Supper' but he was more than just an artist. Although he was not a medical doctor, his contributions to neuroanatomy are so significant that - on the occasion of the 500th anniversary of his death - it is worthwhile remembering and celebrating Leonardo da Vinci's achievements in neuroanatomy. Leonardo da Vinci's early childhood was humble; he was born out-of-wedlock in the small town of Vinci in 1452 and received no formal education. [Extracted from the article]

关键词： RNA   small molecules   nucleic acids   neurological disorders  

摘要： Aberrant RNA structure and function operate in neurological disease progression and severity. As RNA contributes to disease pathology in a complex fashion, that is, via various mechanisms, it has become an attractive therapeutic target for small molecules and oligonucleotides. In this review, we discuss the identification of RNA structures that cause or contribute to neurological diseases as well as recent progress toward the development of small molecules that target them, including small molecule modulators of pre-mRNA splicing and RNA repeat expansions that cause microsatellite disorders such as Huntington's disease and amyotrophic lateral sclerosis. The use of oligonucleotide-based modalities is also discussed. There are key differences between small molecule and oligonucleotide targeting of RNA. The former targets RNA structure, while the latter prefers unstructured regions. Thus, some targets will be preferentially targeted by oligonucleotides and others by small molecules.

关键词： cauda equina syndrome   functional neurological disorders  

摘要： Background and purpose Cauda equina syndrome (CES) is a neurosurgical emergency which warrants lumbar magnetic resonance imaging (MRI). Many patients with suggestive symptoms of CES have no radiological correlate. A functional (non-organic) aetiology has been proposed in some, but currently little is known about this patient group and their clinical outcomes. Methods At a tertiary referral centre, 155 adult patients underwent urgent lumbar MRI for suspected CES in 1 year from December 2014. Data regarding clinical symptoms and follow-up were obtained from records. Patients were divided into CES (n = 25), radiculopathy (n = 68) and scan-negative (SN) groups (n = 62) from scans. Up to 3 years post-discharge, postal questionnaires were sent to patients with Oswestry Disability Index, Pain Catastrophizing score, Patient Health Questionnaire (PHQ) 9, Generalized Anxiety Disorder (GAD) 7, PHQ 15 and Work and Social Adjustment Scale measures. Results No clinical symptoms were found to differentiate CES from SN patients. Functional comorbidities were significantly more common in SN patients but mental health diagnosis frequency did not differ. Follow-up was variable with no consistent referral pathways, particularly for the SN group. 33% (n = 47) responded to the postal questionnaires;high levels of pain, symptom chronicity and disability were ubiquitous but self-reported mental health diagnoses and PHQ 15 were higher for SN patients. Conclusions Conflicting data suggest further research is needed to investigate the prevalence of mental illness and somatic symptoms in SN cases. SN patients have higher rates of comorbid functional disorders and inconsistent referral pathways. Self-report measures indicate impaired quality of life across all groups. The low response rate limits the generalizability of findings but neuropsychiatric assessment and care pathway optimization should be considered.

关键词： Cerebral palsy   child   deglutition   microcephaly   nursing diagnosis  

摘要： OBJECTIVE To investigate the clinical indicators of the nursing diagnosis impaired swallowing in children with neurological disorders. METHODS An integrative review was performed on the Scopus, Web of Science, PubMed, Lilacs and Cinahl databases;by crossing the terms impaired degluition, dyphagia, deglutition disorders, cerebral palsy, microcephaly, which resulted in 45 articles. RESULTS Eighteen indicators were identified in the oral phase, ten in the pharyngeal phase, and nine in the esophageal phase. There was a percentage of 80.4% of the indicators cited in NANDA-International, especially those referring to the oral phase. CONCLUSIONS There are clinical indicators in both phases of impaired swallowing in children with neurological dysfunctions presenting heterogeneous distribution.

关键词： Basic life support   Cardiopulmonary resuscitation   Bystander CPR   Automated external defibrillator   Out-of-hospital cardiac arrest  

摘要： Aim: To assess the current situation and neurologically favourable outcomes after out-of-hospital cardiac arrest (OHCA) with respect to the type of witness. Methods: This retrospective observational study used data from the All-Japan Utstein Registry of the Fire and Disaster Management Agency collected between January 1, 2016, and December 31, 2016. Patients with cardiogenic OHCA aged >= 18 years who were witnessed by bystanders were included. The primary outcome measure was a neurologically favourable outcome 1 month after the OHCA. Results: Among the 123,554 patients with OHCA registered between January 1, 2016, and December 31, 2016, 24,856 patients were included. Of them, 15,139 were witnessed by family, and 9717 were witnessed by non-family (friends, 1306;colleagues, 951;passers-by, 997;others, 6463). When witnessed by family, the rate of neurologically favourable outcomes was significantly lower than that when witnessed by non-family (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.41-0.49, P < 0.001). After adjusting for potential confounders, the rate of neurologically favourable outcomes remained lower when OHCA was witnessed by family (OR = 0.88, 95% CI = 0.79-0.99, P = 0.03). However, in subgroup analysis, adjusted ORs for neurologically favourable outcomes were slightly greater for 65-84-year-old women and >= 85-year-old women with family witnesses than for those with non-family witnesses. For all other groups, non-family witnesses outperformed family witnesses. Conclusion: Family-witnessed OHCA events had fewer neurologically favourable outcomes before and after adjusting for confounders. BLS education for family members may lead to improved prognosis of witnessed cardiogenic OHCAs.