A BS TRACT: Background: Despite experimental evidence implicating oxidative stress in the pathogenesis of PD, epidemiological studies have provided inconsistent associations between dietary antioxidants and risk of developing PD. Furthermore, no study has been done in any Asian population. Objectives: We examined the associations for intake levels of dietary carotenoids (α-carotene, β-carotene, lycopene, β-cryptoxanthin, and lutein) and vitamins (vitamin A, C and E) and the risk of developing PD. Methods: We used data from the Singapore Chinese Health Study, a population-based prospective cohort of 63,257 men and women aged 45 to 74 years during enrollment in 1993-1998. Antioxidant intake was derived from a validated semiquantitative food frequency questionnaire. Incident cases were identified through followup interviews, hospital records, or PD registries through 31 July 2018. Hazard ratios and corresponding 95% confidence intervals were derived from multivariable Cox proportional hazard regression models with adjustment for other lifestyle and dietary factors. Results: During an average 19.4 years of follow-up, 544 incident PD cases were identified. No association was found for dietary carotenoids, individually or summed. Hazard ratio comparing highest to lowest quartile for total carotenoids was 0.98 (95% confidence interval: 0.76-1.28; P trend = 0.83). There were also no clear dose-dependent associations of dietary vitamins A, C, and E with risk of developing PD (all P trend ≥ 0.10). Sensitive analyses with lag time and excluding supplement use did not materially alter results. Conclusions: Intake of dietary antioxidants, such as carotenoids and vitamins, was not associated with the risk of developing PD in Singaporean Chinese.
<b><i>Introduction:</i></b> Sporadic Creutzfeldt-Jakob disease (sCJD) is a transmissible disorder of the central nervous system caused by the transformation of normal prion protein into an abnormal misfolded form. The process begins spontaneously and runs a vicious cycle to cause spongiform encephalopathy, rapidly resulting in death. Amply described in the western literature, CJD is scarcely reported in Asia due to certain limitations including missed diagnosis, under-reporting, and rarity of the disease. Brain MRI, electroencephalogram, cerebrospinal fluid testing, and biopsy of the infected brain tissue support the diagnosis in cases of clinical suspicion. However, the diagnosis can still be made with limited available resources in developing countries. <b><i>Method:</i></b> A review of CJD cases evaluated in the neurology department of a tertiary care hospital in Pakistan was done from 2002 to 2018. <b><i>Results:</i></b> Eleven cases labeled as sCJD are identified based on the European MRI-CJD consortium criteria. This is the first study on CJD from Pakistan, which includes both the typical and atypical presentations. <b><i>Conclusion:</i></b> Even with limited testing available, the diagnosis of CJD can be made with confidence in the developing countries, provided the suspicion is kept high in cases of rapid onset dementia and acute behavioral changes.
The Centers for Disease Control and Prevention reported 8,916 cases of tuberculosis in 2019. Reducing the number of cases of active tuberculosis requires identification of patients with latent tuberculous infections (LTBI). Optimal screening for LTBI requires information about the demographics and characteristics of people who are more likely to have had tuberculous infection. Information from the 2011–2012 National Health and Nutrition Examination Survey (NHANES) was used to determine the number and characteristics of adults from a representative sample of the United States who had LTBI. Latent tuberculous infection was identified either by a positive skin test or by a positive QuantiFERON blood test. Information about the number of patients with active tuberculosis in Texas was determined from reports from the Texas State Department of Health Services. The NHANES database for the years 2011-2012 included 5,684 adults. Participants with a positive QuantiFERON blood test were more likely in the age group 45-64, male, foreign born, and have less than a high school education. Participants with a positive skin test had similar characteristics. Participants who had both a positive skin test and positive QuantiFERON test were more likely to be in the age group 45-64, males, foreign born, and Hispanic. In addition, they had diabetes, self-reported fair/poor health, and an educational level less than high school. In the State of Texas tuberculosis occurred more frequently in individuals older than 75 who were male and were not US born Texas residents. Important clinical diagnoses included diabetes, alcohol abuse, correctional facility residence, non-injection drug use, positive HIV status, and homelessness. Information from the NHANES study and from the State Department of Health Services in Texas provides information needed to develop screening programs for latent tuberculosis and active tuberculosis.
Objective. e success of clinical research and tissue donation programs are highly dependent on recruitment of willing volunteers. A comprehensive survey of patient preferences and attitudes can help identify and address barriers hindering the recruitment for research. Method. is is a cross-sectional study on 105 Parkinson's disease patients who completed an interviewer-administered questionnaire. Results. Out of 105 respondents, 48% of patients had either already participated in clinical research or were keen to participate. About 80% believed clinical research to be safe for their health and privacy. More than 70% of participants were willing to donate blood, urine, or stool, while 16% were agreeable for cerebrospinal fluid sample donation. Motivating factors for clinical research included altruism (64%) and contribution to advance medical knowledge (64%). Common reasons for unwillingness towards clinical research included the risks involved (43%), time constraints (33%), and mobility challenges (24%). Conclusion. e attitude of Singaporean Parkinson patients toward clinical research and tissue donation is encouraging with about half of the participants willing to support clinical research. ree-quarters of patients would support tissue donations. Participation in research may be further increased with greater patient and public education to overcome misconceptions and also by limiting the demands of studies.
Background: Acute encephalopathy is a common neurological manifestation in coronavirus disease 2019 (COVID-19) patients and presents with confusion, delirium, or poor responsiveness. Non-convulsive status epilepticus (NCSE) is an important differential diagnosis in this situation. The electroencephalography (EEG) patterns in COVID-19 patients remain largely unknown. Method: A literature search was conducted on MEDLINE, EMBASE, and Cochrane database. Eligibility criteria included case series and case reports of COVID-19 patients with neurological complication who underwent EEG. Two authors screened all resulting studies and extracted the data independently. Results: Four retrospective case control studies and eleven case reports were identified. Background diffuse slow activity were seen in most of the COVID-19 patients. Other EEG patterns reported included status epilepticus, focal slow activity, rhythmic periodic discharges, and interictal epileptiform discharges. Imaging and CSF studies were available in only a few patients. Conclusions: Acute encephalopathy is common in the context of COVID-19. There is no specific EEG pattern found in these patients. Keywords: COVID-19, coronavirus, SAR-CoV-2, electroencephalogram, EEG
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