Neurological Disorders

Background: Vertebral compression fractures (VCFs) occur most commonly on the thoracolumbar junction, which are the most vulnerable biomechanical
regiments at the thoracolumbar junction between the thoracic kyphosis and lumbar lordosis. Percutaneous vertebroplasty and kyphoplasty are currently
the primary minimally invasive surgical treatments for thoracolumbar VCFs. The principal aim of this study is to compare the clinical efficacies of percutaneous
balloon kyphoplasty (BKP) and SpineJack^® (SJ) techniques in the treatment of thoracolumbar VCFs by evaluating the risk factors for early-onset adjacent level
fractures (ALFs) over a 6 month follow-up.
Methods: A total of 106 patients with thoracolumbar (T11-L2) VCFs, treated with kyphoplasty techniques (64 with BKP and 42 with SJ), were enrolled in
this retrospective study. Patterns of preoperative, postoperative day 1, and postoperative 6 month thoracolumbar spine images and discrepancies of
long-term kyphosis correction functions were compared using two different kyphoplasty procedures.
Results: A total of 19 new early-onset ALFs were found within one month postoperatively (9 in BKP and 10 in SJ groups), and all presented as anterior
vertebral endplate fractures. The early-onset ALFs in the BKP group were anterior inferior endplate fractures at the superior vertebral levels mainly. The
preoperative anterior-type and severe VCFs were the statistically significant risk factors for early-onset ALFs. The timing of kyphoplasty intervention for
acute VCFs within 1 month and patients with advance age were also presented risk factors to developed early-onset ALFs in our study (p=0.018; p<0.001).
Conclusion: There was no superiority in the occurrence rate of early-onset ALFs and kyphosis correction effects of BKP or SJ techniques in the treatment of
thoracolumbar VCFs. The factors, including pre-OP anterior-type and severe VCFs, patients with advance ages, and kyphoplasty timing within one month
since the appearance of symptoms, are the primary risk factors for subsequent early-onset ALFs after kyphoplasty to thoracolumbar VCFs.

The globe faces a serious threat coming from the increase in greenhouse gases (GHG) and the damage caused by it. As emissions depend on the performance and efficiency of manufacturing companies as well as on individual lifestyles, the performance of each individual should be taken into consideration. Herein, the susceptibility to the global emission rate can be linked to a mental state of the population. Therefore, an increasing trend in depressive disorders among individuals was shown. It was described the mental state of individuals can affect their decision-making and performance in resource management, including material handling, inventory control, finance, and losses in time and energy. Secondly, major industrial accidents caused by human error, fatigue, and losses of concentration coming from the mental state were shown. Additionally, the way depression affects individuals in terms of consumption of certain products, indifference to an economy of utilities, and how it might lead to compulsive buying was also described. The results of this study can help to highlight growing problem worldwide, so that better studies supported by private sector as well as a government could be done. Consequently, the risk of unanticipated growth in emissions and environmental damage can be prevented.

Background: According to WHO statistics for 2020, the risk of acute infection, which can lead to death, increases with age. The median age of patients with COVID-19 is 61 years. Mortality-after 80 years of life is 15%. The literature discusses the difficulties of timely diagnosis of Covid-19 in the elderly, which in most of them are associated with asymptomatic disease and its atypical course.

Goal and tasks: To assess the symptoms, the nature of the course of the pathology and clinical diagnostic data and mortality rates in people aged 90 years and older hospitalized with a diagnosis of COVID-19 in a repurposed emergency hospital in the city of Sochi. Moscow from April 12 to August 3, 2020 Material and methods: We retrospectively analyzed the clinical diagnostic data of 108 patients, including 23 men and 85 women aged 90-98 years,

Material and methods: We retrospectively analyzed the clinical diagnostic data of 108 patients, including 23 men and 85 women aged 90-98 years, on average 92.2 ± 1.7, admitted to the hospital for diagnosis and treatment in the period from 04/12/2020 to 12.04.2020. Until 08/03/2020 with diagnoses according to ICD-10: U07.1 U07.1 Coronavirus infection caused by the COVID-19 virus, virus identified (confirmed by laboratory testing regardless of the severity of clinical signs or symptoms); J12.9 J12.9 Community acquired pneumonia. Patients' data were archived in the city computer system DZM KIS EMIAS of the Department of Health of the city of Moscow.

Results: Pneumonia, which complicated the course of Covid-19 in patients aged 90 years and older, was characterized by a bilateral process-in 85% of them, involving 75-80% of the lung parenchyma-in 19.7% of cases, with the development of hydrothorax-in 53%, with a pathological decrease in oxygen saturation-in 67% of patients. In the treatment and prevention of cardiovascular complications in such patients, heparin therapy (in 70.4%), treatment with beta-blockers (in 41.7%), ACE inhibitors and blockers occupied a large place angiotensin receptors (in 31.5%), diuretics (in 27.8%). The use of antimalarial drugs (in 15.7%) and antiviral agents (in 9.3%) was limited due to the blurring of clinical symptoms, possible cardiotoxicity, and insufficiently substantiated drug efficacy. Lethality in patients with Covid-19 complicated by pneumonia, exceeded in patients aged 90 years and older-55%, which was closely associated with adverse cardiovascular premorbid background in 85.5% of them and required the initiation of inpatient diagnostics and therapy as soon as possible.

Conclusion: Covid-19 complicated by pneumonia in a group of people aged 90 years and older, proceeds with blurred clinical symptoms, with neurological manifestations in 20% and intestinal dysfunction in 6% of patients. High mortality rates at the same time require urgent diagnostic and therapeutic measures in stationary conditions.

Objective: Covid-19 patients can show various neurological symptoms. We aimed to assess the disease severity and prognosis in Covid-19 patients who experienced neurological symptoms.

Methods: In this retrospective, cross-sectional study, we evaluated 225 hospitalized Covid-19 patients with neurological symptoms. Their CURB-65 scores were measured to determine their pneumonia severity in relation to their neurological symptoms.

Results: The patients had different types of neurological symptoms, among which an altered level of consciousness was the most common (62.1%), followed by headache (50.7%). Patients with headaches had ultimately an 80% lower mortality rate (p ≤ 0.001). Patients who were conscious at the time of admission were 62% less likely to die (p=0.019). Based on the CURB-65 severity score, most patients (40.4%) were in the mild group, 33.8% were in the moderate group and 25.8% in the severe group. The presence of headache at admission was inversely related to the CURB-65 score, meaning that a patient with early-onset headache recorded a lower CURB-65 score (p ≤ 0.001; r=-0.389).

Conclusion: Neurological symptoms are a common part of the Covid-19 clinical spectrum. The severity of Covid-19 varied in patients exhibiting different neurological symptoms. A more severe disease course was observed with altered mental status and a milder course with headache at admission.

Introduction: Primary Sjogren's syndrome (pSS) is an autoimmune inflammatory disease characterized by mononuclear lymphocytic infiltration of exocrine glands (especially salivary and lacrimal) in the setting of antinuclear antibodies. These patients can also develop extraglandular manifestations within which the neurological features are frequent, especially at the peripheral level but also, less frequently, at the central nervous system (CNS).

Case presentation: We describe the case of a female patient with pSS who presented with two recurrent acute neurological events associated with CNS impairment along with radiological inflammatory lesions on MRI scans, requiring hospitalization both in 2019 and 2022.

Discussion: CNS involvement in patients with pSS shows considerable clinical variability and imposes many difficulties in its differentiation from other diseases with a similar clinical course. Knowing this entity is a crucial aspect of a correct diagnosis in order to achieve adequate treatment and reduce the risk of long-term complications and sequelae.

Background: This case emphasizes the adulthood onset of PHP with the association of new pattern of brain calcification which is exclusively falx cerebri and supratentorial.

Case presentation: A 35 year old man with 17 year history of epilepsy on Carbamazepine, referred from neurosurgical department where was diagnosed with hydrocephalus complicated by secondary severe optic atrophy and underwent Ventriculo-Peritoneal shunt. Imaging revealed Falx Cerebri, Supratentorial calcification, biochemical tests showed hypocalcemia, hypophosphatemia and elevated parathyroid hormone. Patient was given Vitamin D and Calcium in order to improve the outcome.

Conclusion: Although PHP being a rare possibility especially in adult, it has to be considered in incidental meningeal calcification and to be picked up early before complications.