{"title":"Coronaviruses: HCoV, SARS-CoV, MERS-CoV, and COVID-19","authors":"M. Ison","doi":"10.2310/neuro.1422","DOIUrl":"https://doi.org/10.2310/neuro.1422","url":null,"abstract":"Coronaviruses (CoVs) are a group of viral pathogens that infect mammals and birds. The presentation in humans is typically that of a mild upper respiratory tract infection, similar to the common cold. However, in recent years, dramatic attention has arisen for more lethal members of this viral family (e.g., severe acute respiratory syndrome [SARS-CoV], Middle East respiratory syndrome [MERS-CoV], and coronavirus disease 2019 [COVID-19]). The epidemiology, clinical presentation, diagnosis, and management of these viruses are discussed in this review. Importantly, new guideline tables from the Centers for Disease Control and Prevention, as well as the World Health Organization are provided at the conclusion of the review.\u0000This review contains 12 tables, 3 figure and 48 references.\u0000Keywords: Coronavirus, severe acute respiratory distress syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19, respiratory infection, antiviral, real-time polymerase chain reaction","PeriodicalId":142272,"journal":{"name":"DeckerMed Neurology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114589081","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}
{"title":"Diagnosis of Dyslipidemia","authors":"J. Brunzell, R. Failor","doi":"10.2310/NEURO.1161","DOIUrl":"https://doi.org/10.2310/NEURO.1161","url":null,"abstract":"Disorders of lipoprotein metabolism, in conjunction with the prevalence of high-fat diets, obesity, and physical inactivity, have resulted in an epidemic of atherosclerotic disease in the United States and other developed countries. The interaction of common genetic and acquired disorders of lipoproteins with these adverse environmental factors leads to the premature development of atherosclerosis. In the United States, mortality from coronary artery disease (CAD), particularly in persons younger than 60 years, has been declining since 1970; however, atherosclerotic cardiovascular disease remains the most common cause of death among both men and women.\u0000\u0000This review contains 6 figures, 12 tables, and 47 references.\u0000Keywords: dyslipoproteinemias, hepatic lipase, hyperlipoproteinemia, hypoalphalipoproteinemia, lipoprotein, ","PeriodicalId":142272,"journal":{"name":"DeckerMed Neurology","volume":"68 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125964216","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}
{"title":"Ataxias","authors":"Hélio A G Teive, O. Barsottini","doi":"10.2310/neuro.6351","DOIUrl":"https://doi.org/10.2310/neuro.6351","url":null,"abstract":"<jats:p />","PeriodicalId":142272,"journal":{"name":"DeckerMed Neurology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130229427","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}
{"title":"Neurobiology of Anxiety Disorders","authors":"E. Hollander, P. Palkar","doi":"10.2310/NEURO.13021","DOIUrl":"https://doi.org/10.2310/NEURO.13021","url":null,"abstract":"In recent years, advances in the fields of neuroimaging and experimental psychology increased our understanding of the basic mechanisms of classical conditioning and learning, contributing to our knowledge of the neurobiology of anxiety disorders. Research has shown that the amygdala is the cornerstone of fear circuitry and that abnormalities in amygdala pathways can affect the acquisition and expression of fear conditioning. Activation of the amygdala in response to disorder-relevant stimuli has been observed in anxiety disorders. The roles of the hippocampus, nucleus accumbens, periaqueductal gray, and insular and medial prefrontal cortices in response to fear have been identified as well. Neurotransmitters such as serotonin, dopamine, γ-aminobutyric acid, glutamate, and some neurosteroids play an important part in the neurobiology of anxiety disorders. Neuropeptides such as oxytocin, neuropeptide Y, galanin, and cholecystokinin have been shown to modulate stress response. Drugs such as N-methyl-d-aspartate (NMDA) antagonists and blockers of voltage-gated calcium channels in the amygdala are anxiolytic. Fear extinction, which entails new learning of fear inhibition, is the mechanism of effective antianxiety treatments such as d-cycloserine, a partial NMDA agonist. Extinction is thought to occur by the medial prefrontal cortex, which inhibits the lateral amygdala under hippocampal modulation. Harnessing extinction to delink neutral stimuli from aversive responses is an important goal of the psychotherapy and pharmacotherapy of anxiety disorders. Discovery of the role of microRNAs in the etiology of anxiety disorders and their possible utility as targets to treat these disorders is fascinating. In this review, we discuss the neurobiology of anxiety disorders, which will help us better manage them clinically.\u0000This review contains 5 figures, 6 tables, and 39 references.\u0000Key words: Amygdala, anxiety disorders, neurobiology, fear conditioning, neurocircuitry, neurotransmitters, neuropeptides, neurosteroids, endogenous opioids.","PeriodicalId":142272,"journal":{"name":"DeckerMed Neurology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132815418","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}
{"title":"Ethical and Social Issues in Medicine","authors":"R. Loewy, E. Loewy, Faith T. Fitzgerald","doi":"10.2310/neuro.1222","DOIUrl":"https://doi.org/10.2310/neuro.1222","url":null,"abstract":"So rapidly has the field of health care ethics continued to grow that, when recently “googled,” the term produced 28.2 million hits. The challenge is to address the ethical and social issues in medicine in this very limited article space. It remains an impossible task to present more than a superficial discussion of these complex issues and the complicated cases in which they are to be found. Like good medicine, good ethics cannot be practiced by algorithm. The authors have opted to provide an operational guide to help clinicians sort through the ethical and social quandaries they must face on a daily basis. To that end, the authors have chosen to divide this chapter into the following sections: 1. A brief description of the biopsychosocial nature of ethics and how it differs from personal morality 2. A method for identifying and dealing with ethical issues 3. A discussion of the role of bioethicists and ethics committees 4. The professional fiduciary role of clinicians 5. Listings of some of the common key bioethical and legal terms (online access only) 6. A very brief discussion of the terms cited in the above listings (online access only)\u0000This reviews contains 4 tables, 8 references, 1 appendix, and 20 additional readings.\u0000Keywords: Ethical, social, right, wrong, good, bad, obligation, moral authority, critically reflective, and multiperspectival activity, Curiosity, Honesty, Patience, Open-mindedness","PeriodicalId":142272,"journal":{"name":"DeckerMed Neurology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130689434","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}
{"title":"Brain Failure and Brain Death","authors":"S. Taghavi, A. Salim","doi":"10.2310/surg.2159","DOIUrl":"https://doi.org/10.2310/surg.2159","url":null,"abstract":"Brain failure consists of a wide spectrum of central nervous system pathologies with many different neurologic manifestations. The causes of brain failure include several disease processes that result in decreased supply of blood and oxygen to the brain or metabolic derangements that affect the central nervous system. Brain failure usually results in some altered level of consciousness. Brain failure and brain death result in several pathophysiologic changes. The definition of brain death is controversial and evolving. However, clear guidelines to determine brain death have been established. These guidelines state that three cardinal findings be present to establish brain death: (1) coma or unresponsiveness, (2) absence of brainstem reflexes, and (3) apnea. Several clinical parameters must be met when these findings are made. Adjunctive studies such as four-vessel cerebral angiography, electroencephalography, and nuclear brain scintigraphy can help make a diagnosis of brain death. When brain death is established, suitability for organ transplantation should be evaluated. After obtaining consent, potential organ donation should be optimized for possible donation.\u0000\u0000This review contains 2 figures, 3 tables, and 69 references.\u0000Key Words: brain failure, brain death, consciousness, coma, death, delirium, organ donation\u0000\u0000","PeriodicalId":142272,"journal":{"name":"DeckerMed Neurology","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125183491","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}
{"title":"Chronic Pelvic Pain: The Neuropathic Pain Basis","authors":"Stanley J. Antolak Jr","doi":"10.2310/neuro.15034","DOIUrl":"https://doi.org/10.2310/neuro.15034","url":null,"abstract":"Chronic pelvic pain (CPP) in both genders has been chiefly the province of surgical subspecialists. Morphologic end-organ processes have been studied for decades without significant advances in understanding the etiology of CPP or developing adequate therapeutic outcomes. The neurogenic basis of CPP has received little attention. Several peripheral nerves may be the source. The largest of these is a pudendal nerve and is the most important because it is a mixed nerve and affects sensory and motor symptoms in both the somatic and autonomic nervous systems. Nerve compression and stretch are the two most important etiologic factors.\u0000Practitioners can diagnose these painful neuropathies by a careful symptom history and physical examination. The most important diagnostic tool is sensory examination of the pudendal territory using pinprick. Various neurophysiologic tests can confirm pudendal neuropathy. The smaller peripheral nerves affect CPP.\u0000Because pudendal neuropathy is a tunnel syndrome related to cumulative, repetitive microtrauma, it can be treated accordingly. Treatment options include nerve protection, medications (analeptics, tricyclic amines), perineural infiltrations of local anesthetics with or without corticosteroids, and, in a significant minority, decompression of the pudendal nerves. The smaller nerves often respond to a program of postural correction and perineural anesthetic blockades. All patients require attention to central sensitization. Treatment success depends on the duration of symptoms, etiology, and severity of nerve damage. The last item can only be evaluated at surgery. Complete cures of CPP, treated using each modality, can be measured by validated symptom scores for as long as 13 years.\u0000To progress in the diagnosis and treatment of CPP, interspecialty studies are needed that distinctly separate neurogenic from nonneurogenic CPP. To date, this has not been done. Thus, diagnostic, etiologic, and treatment conclusions are quite limited. CPP provides a rich foundation for clinical research for neurologists.\u0000Key Words: abdominal cutaneous neuropathy, chronic pelvic pain, interstitial cystitis, irritable bowel syndrome, middle cluneal neuropathy, neurogenic pelvic pain, pudendal neuropathy, sexual dysfunction, thoracolumbar junction syndrome ","PeriodicalId":142272,"journal":{"name":"DeckerMed Neurology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127627342","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}
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