scholarly journals The Biosafety and Risk Management in Preparation and Processing of Cerebrospinal Fluid and Other Neurological Specimens With Potential Coronavirus Infection

2021 ◽  
Vol 11 ◽  
Author(s):  
Chien-Chin Chen ◽  
Pei-Chun Chiang ◽  
Tsung-Hsien Chen

The recent outbreak of coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2, has become a global threat. Due to neurological manifestations presented throughout the coronavirus disease process, the potential involvement of COVID-19 in central nervous system has attracted considerable attention. Notably, the neurologic system could be widely affected, with various complications such as acute cerebrovascular events, encephalitis, Guillain-Barré syndrome, and acute necrotizing hemorrhagic encephalopathy. However, the risk assessment of exposure to potential biohazards in the context of the COVID-19 pandemic has not been clearly clarified regarding the sampling, preparation, and processing neurological specimens. Further risk managements and implantations are seldom discussed either. This article aims to provide current recommendations and evidence-based reviews on biosafety issues of preparation and processing of cerebrospinal fluid and neurological specimens with potential coronavirus infection from the bedside to the laboratory.

2021 ◽  
Vol 12 ◽  
Author(s):  
Francisco J. Gonzalez-Gonzalez ◽  
Mary Rodriguez Ziccardi ◽  
Mark D. McCauley

In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as a virally transmitted disease. Three months later, SARS-CoV-2 became one of the largest pandemics in recent times, causing more than 235 million cases globally, and accounting for at least 4.8 million deaths to date. SARS-COV-2 infection was initially classified as a respiratory tract infection, but later was recognized as a multisystemic disease compromising gastrointestinal, hematological, cardiac, and neurological systems. With this Review, we aim to describe the epidemiology, risk factors, mechanisms, and management of cerebrovascular events in patients infected with COVID-19. Neurological manifestations related to thromboembolic cerebrovascular events in patients infected with COVID-19 have been frequent and associated with poor prognosis in the majority of cases. A better understanding of the mechanisms of thrombosis and etiologies of this new disease process are necessary to determine how to prevent and treat patients to reduce their length of stay, morbidity, and mortality.


2021 ◽  
pp. 1-19
Author(s):  
Nina Lindblom ◽  
Lars Lindquist ◽  
Jacob Westman ◽  
Mikael Åström ◽  
Roger Bullock ◽  
...  

Background: Accumulating data suggest infectious agents are involved in Alzheimer’s disease (AD). The two primary aims of this trial were to assess safety and efficacy of an antiviral drug combination on AD progression. Objective: The trial evaluated whether Apovir, a combination of two antiviral agents, pleconaril (active on enteroviruses) and ribavirin (active on several viruses), could slow AD progression. Methods: Sixty-nine patients 60–85 years were treated with Apovir or placebo for 9 months and followed until 12 months after end of treatment. Cognitive tests, safety, biomarkers, drug plasma, and cerebrospinal fluid concentrations were assessed. Results: The tolerability of Apovir was compromised as demonstrated by the large drop-out rate and increased frequency and severity of adverse events. The primary endpoint, demonstrating a difference in change from baseline to 9 months between groups in ADAS-cog total score, was not met (p = 0.1809). However, there were observations indicating potential effects on both ADAS-cog and CDR-SB but these effects need to be verified. Also, there was a decrease in cerebrospinal fluid amyloid-β in Apovir at 9 months (p = 0.0330) but no change in placebo. Conclusion: This was the first randomized, placebo controlled clinical trial exploring antiviral treatment on AD progression. The trial is considered inconclusive due to the large drop-out rate. New trials are needed to verify if the indications of effect observed can be confirmed and which component(s) in Apovir contributed to such effects. Pleconaril alone may be studied to improve the tolerability and to verify if enterovirus is involved in the disease process.


2016 ◽  
Vol 23 (6) ◽  
pp. taw062 ◽  
Author(s):  
Emily S. Jentes ◽  
R. Ryan Lash ◽  
Michael A. Johansson ◽  
Tyler M. Sharp ◽  
Ronnie Henry ◽  
...  

Criminology ◽  
2021 ◽  
Author(s):  
James C. Oleson

The evidence-based practice (EBP) movement can be traced to a 1992 article in the Journal of the American Medical Association, although decision-making with empirical evidence (rather than tradition, anecdote, or intuition) is obviously much older. Neverthless, for the last twenty-five years, EBP has played a pivotal role in criminal justice, particularly within community corrections. While the prediction of recidivism in parole or probation decisions has attracted relatively little attention, the use of risk measures by sentencing judges is controversial. This might be because sentencing typically involves both backward-looking decisions, related to the blameworthiness of the crime, as well as forward-looking decisions, about the offender’s prospective risk of recidivism. Evidence-based sentencing quantifies the predictive aspects of decision-making by incorporating an assessment of risk factors (which increase recidivism risk), protective factors (which reduce recidivism risk), criminogenic needs (impairments that, if addressed, will reduce recidivism risk), the measurement of recidivism risk, and the identification of optimal recidivism-reducing sentencing interventions. Proponents for evidence-based sentencing claim that it can allow judges to “sentence smarter” by using data to distinguish high-risk offenders (who might be imprisoned to mitigate their recidivism risk) from low-risk offenders (who might be released into the community with relatively little danger). This, proponents suggest, can reduce unnecessary incarceration, decrease costs, and enhance community safety. Critics, however, note that risk assessment typically looks beyond criminal conduct, incorporating demographic and socioeconomic variables. Even if a risk factor is facially neutral (e.g., criminal history), it might operate as a proxy for a constitutionally protected category (e.g., race). The same objectionable variables are used widely in presentence reports, but their incorporation into an actuarial risk score has greater potential to obfuscate facts and reify underlying disparities. The evidence-based sentencing literature is dynamic and rapidly evolving, but this bibliography identifies sources that might prove useful. It first outlines the theoretical foundations of traditional (non-evidence-based) sentencing, identifying resources and overviews. It then identifies sources related to decision-making and prediction, risk assessment logic, criminogenic needs, and responsivity. The bibliography then describes and defends evidence-based sentencing, and identifies works on sentencing variables and risk assessment instruments. It then relates evidence-based sentencing to big data and identifies data issues. Several works on constitutional problems are listed, the proxies problem is described, and sources on philosophical issues are described. The bibliography concludes with a description of validation research, the politics of evidence-based sentencing, and the identification of several current initiatives.


Author(s):  
Mohammad Enayet Hussain ◽  
Md Azharul Hoque ◽  
Md Badrul Alam ◽  
Md Abdullah Yusuf ◽  
Rajib Nayan Chowdhury ◽  
...  

Involvement of the nervous system after viral infection is common. Certain viruses show neurotropism. Recent outbreak of severe acute respiratory syndrome CoV 2 (SARSCov- 2) virus has also exhibited neurotropic properties with various neurological manifestations. The pathophysiology of their neurotropism is not yet clearly known. The details of pathophysiology, clinical manifestation and management are expected to be explored in the near future. Here we review the Neurological manifestations of COVID-19 and the early experience in the National Institute of Neurosciences and Hospital. J Bangladesh Coll Phys Surg 2020; 38(0): 122-132


2013 ◽  
Vol 54 (3) ◽  
pp. 201-208 ◽  
Author(s):  
Sidney Zisook ◽  
Joan Anzia ◽  
Ashutosh Atri ◽  
Argelinda Baroni ◽  
Paula Clayton ◽  
...  

2018 ◽  
Vol 53 (13) ◽  
pp. 806-811 ◽  
Author(s):  
Richard D Leech ◽  
Jillian Eyles ◽  
Mark E Batt ◽  
David J Hunter

The burden of non-communicable diseases, such as osteoarthritis (OA), continues to increase for individuals and society. Regrettably, in many instances, healthcare professionals fail to manage OA optimally. There is growing disparity between the strength of evidence supporting interventions for OA and the frequency of their use in practice. Physical activity and exercise, weight management and education are key management components supported by evidence yet lack appropriate implementation. Furthermore, a recognition that treatment earlier in the disease process may halt progression or reverse structural changes has not been translated into clinical practice. We have largely failed to put pathways and procedures in place that promote a proactive approach to facilitate better outcomes in OA. This paper aims to highlight areas of evidence-based practical management that could improve patient outcomes if used more effectively.


Author(s):  
Koji Nomori ◽  
Yoshifumi Nishida ◽  
Yoichi Motomura ◽  
Tatsuhiro Yamanaka ◽  
Akinori Komatsubara

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