Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality / 대한뇌졸중학회지

Background@#and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. @*Methods@#We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). @*Results@#There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. @*Conclusions@#During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.

Multiple sclerosis in East Azerbaijan, North West Iran

Background and Objective: Multiple sclerosis (MS) is variable in its prevalence and manifestations in different regions of the world. Iran is one of the most populous countries in Middle East, it is important to have a better understanding of the epidemiology and clinical pattern of MS in different parts of Iran. Although Iran is said to be located in the low-risk area, recent studies have shown that the prevalence of MS in Iran may be much higher than what was previously thought. This study determines the current prevalence and clinical features of MS in East Azerbaijan province, North West Iran. Methods: All patients for this study were MS cases listed in the Committee for Diagnosis and Treatment of MS (CDTMS) registry. The study patients were all residents of East Azerbaijan Province who were diagnosed with MS by neurologists. Results: Out of one thousand cases, 269 were males (26.9%) and 731 females (73.1%).The female/male ratio was 2.7. The crude prevalence of MS in East Azerbaijan was 27.7/100,000 population. The mean age (SD) of patients was 33.4 (8.9) years. The relapse-remitting form of disease was seen in 67.7% of patients; primary-progressive disease in 2.8%; and secondary progressive disease in 11.2%. Conclusion: Our study suggests that MS prevalence in North West Iran lies in the medium frequency range.

Campylobacter jejuni infection and childhood guillain-barre syndrome

Guillain-Barre syndrome [GBS], acute postinfectious polyneuritis, is the most common cause of acute neuromuscular paralysis. Infection with Campylobacter jejuni is recognized as a common antecedent of the GBS. This study aimed to determine the frequency of this infection in children with GBS and, the clinical and epidemiologic features of this association. We performed a prospective case-control study on a cohort of 47 children with GBS admitted to Tabriz Childrens Hospital in the northwest of Iran between July 2006 and July 2008. Serologic investigations were used to diagnose preceding C. jejuni infection. We found evidence of recent C. jejuni infection in 40.4% of the patients with GBS, as compared with 6.1% in household controls [odds ratio 10.5, 95% CI: 2.2-49.2, P<0.001]. Duration to achieve independent walking was longer in C. jejuni-associated patients [P<0.013]. However 95% of C. jejuni-associated GBS patients achieved independent walking at end of one year. The patients with preceding C jejuni infection were more likely to have axonal neuropathy [P<0.05]. Campylobacter jejuni infection is an important antecedent illness in childhood Guillain-Barre syndrome in Iranian children, and is associated with good prognosis

Comparison of immunoblotting and ELISA for detection of anti-ganglioside antibodies in children with Guillain-Barre Syndrome

Anti-ganglioside antibody assays are widely used for diagnosis of auto-immune peripheral neuropathies. This study aimed to determine serum levels of anti-ganglioside antibodies in children with Guillain-Barre syndrome by immunoblotting technique and compare the results with those obtained by ELISA method. In this investigation, 50 children with Guillain-Barre syndrome [GBS] who were admitted from July 2006 to July 2008, to Tabriz Children's hospital in the north-west of Iran were studied. 30 children admitted for various other reasons than GBS were randomly selected as a control group. The levels of anti-ganglioside antibodies in serum were measured by ELISA and immunoblotting methods using commercial kits. Anti-ganglioside antibodies [IgG] were detected in 16 [32%] GBS patients and in 1 [3.3%] control using ELISA assay. However, by employing immunoblotting technique, antibodies against seven gangliosides were found positive in 28 [56%] GBS patients and none in the control group. The sensitivities of immunoblotting and ELISA methods were 56% and 32% and their specificities were 100% and 97%, respectively [p<0.001]. According to the clinical criteria of GBS, the specificity and sensitivity of immunoblotting was better than those of ELISA. It is important to notice that the immunoblotting method is able to measure the seven types of antibodies [GM1, GM2, GM3, GD1a, GD1b, GT1b, and Gq1b] simultaneously and it is an easy, routine method with a lower cost