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1.
Int J Environ Res Public Health ; 19(7)2022 Mar 31.
Article in English | MEDLINE | ID: covidwho-1785644

ABSTRACT

OBJECTIVES: To compare neurologists' knowledge, practice, and barriers of pharmacovigilance (PV) process among patients with epilepsy in Poland and Egypt. METHODS: It was an international study that used an online questionnaire e-mailed to neurologists registered to practice in Poland and Egypt. RESULTS: Most of the neurologists were familiar with the definition of PV and adverse drug reactions (ADRs), but relatively few neurologists knew where to report ADRs, especially the Egyptian neurologists. Only 31.11% of the neurologists from Egypt and 39.90% neurologists from Poland declared that they had reported ADRs at least once during their professional practice, and few of them declared the regular reporting of such incidents. The main reason for the neurologists not reporting ADRs was the lack of time and a conviction that reporting ADRs would be an additional burden that would generate extra work. CONCLUSION: The standards of pharmacovigilance process, safety control, and quality are not the same throughout the world. System-regulated PV stabilization in a country translates into the practice of maintaining PV. Monitoring the safety of pharmacotherapy and knowledge of risks associated with ADRs should be included in the academic curricula of physician courses.


Subject(s)
Drug-Related Side Effects and Adverse Reactions , Epilepsy , Adverse Drug Reaction Reporting Systems , Cross-Sectional Studies , Egypt , Epilepsy/drug therapy , Health Knowledge, Attitudes, Practice , Humans , Neurologists , Pharmacovigilance , Poland
2.
J Telemed Telecare ; 28(3): 213-223, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1775070

ABSTRACT

Access to paediatric neurology care is complex, resulting in significant wait times and negative patient outcomes. The goal of the American Academy of Pediatrics National Coordinating Center for Epilepsy's project, Access Improvement and Management of Epilepsy with Telehealth (AIM-ET), was to identify access and management challenges in the deployment of telehealth technology. AIM-ET organised four paediatric neurology teams to partner with primary-care providers (PCP) and their multidisciplinary teams. Telehealth visits were conducted for paediatric epilepsy patients. A post-visit survey assessed access and satisfaction with the telehealth visit compared to an in-person visit. Pre/post surveys completed by PCPs and neurologists captured telehealth visit feasibility, functionality and provider satisfaction. A provider focus group assessed facilitators and barriers to telehealth. Sixty-one unique patients completed 75 telehealth visits. Paired t-test analysis demonstrated that telehealth enhanced access to epilepsy care. It reduced self-reported out-of-pocket costs (p<0.001), missed school hours (p<0.001) and missed work hours (p<0.001), with 94% equal parent/caregiver satisfaction. Focus groups indicated developing and maintaining partnerships, institutional infrastructure and education as facilitators and barriers to telehealth. Telehealth shortened travelling distance, reduced expenses and time missed from school and work. Further, it provides significant opportunity in an era when coronavirus disease 2019 limits in-person clinics.


Subject(s)
COVID-19 , Epilepsy , Neurology , Pediatrics , Telemedicine , Child , Epilepsy/therapy , Humans , Telemedicine/methods
3.
Eur J Paediatr Neurol ; 36: 57-68, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1757300

ABSTRACT

INTRODUCTION: The evidence relating vaccination to febrile seizures and epilepsy is evaluated with an emphasis on febrile seizures (FS), Dravet syndrome (DS), West syndrome, and other developmental and epileptic encephalopathies. METHODS: A systematic literature review using search words vaccination/immunization AND febrile seizures/epilepsy/Dravet/epileptic encephalopathy/developmental encephalopathy was performed. The role of vaccination as the cause/trigger/aggravation factor for FS or epilepsies and preventive measures were analyzed. RESULTS: From 1428 results, 846 duplicates and 447 irrelevant articles were eliminated; 120 were analyzed. CONCLUSIONS: There is no evidence that vaccinations cause epilepsy in healthy populations. Vaccinations do not cause epileptic encephalopathies but may be non-specific triggers to seizures in underlying structural or genetic etiologies. The first seizure in DS may be earlier in vaccinated versus non-vaccinated patients, but developmental outcome is similar in both groups. Children with a personal or family history of FS or epilepsy should receive all routine vaccinations. This recommendation includes DS. The known risks of the infectious diseases prevented by immunization are well established. Vaccination should be deferred in case of acute illness. Acellular pertussis DTaP (diphtheria-tetanus-pertussis) is recommended. The combination of certain vaccine types may increase the risk of febrile seizures however the public health benefit of separating immunizations has not been proven. Measles-containing vaccine should be administered at age 12-15 months. Routine prophylactic antipyretics are not indicated, as there is no evidence of decreased FS risk and they can attenuate the antibody response following vaccination. Prophylactic measures (preventive antipyretic medication) are recommended in DS due to the increased risk of prolonged seizures with fever.


Subject(s)
Epilepsies, Myoclonic , Epilepsy , Seizures, Febrile , Spasms, Infantile , Child , Epilepsy/etiology , Epilepsy/prevention & control , Humans , Infant , Seizures, Febrile/etiology , Vaccination/adverse effects
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 122(2): 101-106, 2022.
Article in Russian | MEDLINE | ID: covidwho-1737453

ABSTRACT

To compare an impact of coronavirus disease and Sputnik V COVID-19 vaccine on the dynamics of epilepsy. The study is part of the ongoing «Epilepsy and COVID-19¼ independent research which recruited patients with epilepsy into two groups: group 1 - COVID-19 survivors and group 2 - patients vaccinated with a COVID-19 vaccine. The study compares two clinical cases: seizure recurrence with COVID-19 disease in a young patient and good tolerability of vaccination in a female elderly patient following surgical management of pharmacoresistant epilepsy with concomitant pathology. In group 1, a 32-year-old patient with idiopathic generalized epilepsy and 3-year seizure remission had generalized seizure recurrence with electroencephalographic deterioration against the backdrop of mild COVID-19. In group 2, a 59-year-old patient, with focal pharmacoresistant epilepsy, and 3-year seizure remission after surgical management, and comorbid endocrine dysfunction showed no side-effects with Sputnik V COVID-19 vaccination and maintained clinical and electroencephalographic remission. The study revealed that the Sputnik V vaccine was well tolerated, and that seizure remission was maintained after epilepsy surgery in an elderly patient with comorbidity, as well as there was the possibility of seizure recurrence in younger patients with mild COVID-19. The findings will aid practitioners in making decisions on how to manage epilepsy patients. More study into the impact of the disease and COVID-19 vaccination on epilepsy dynamics in a larger sample is required.


Subject(s)
COVID-19 , Epilepsy , Adult , Aged , Anticonvulsants/therapeutic use , COVID-19 Vaccines , Epilepsy/complications , Epilepsy/drug therapy , Epilepsy/surgery , Female , Humans , Middle Aged , SARS-CoV-2 , Vaccines, Synthetic
5.
Curr Opin Neurol ; 35(2): 169-174, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1722760

ABSTRACT

PURPOSE OF REVIEW: Epilepsy is a common, chronic neurologic disease with continued disparities in care. The COVID-19 pandemic and recent social movements have drawn greater attention to social determinants of health and our progress (or lack thereof) toward delivering more equitable care. RECENT FINDINGS: Recent studies continue to document racial and economic disparities in diagnosis, treatment, and overall care of epilepsy and associated conditions. Notably, an increasing number of studies are attempting to design healthcare pathways and other interventions to improve access and equity in epilepsy care. SUMMARY: The present literature highlights the importance of identifying and addressing the particular needs of vulnerable persons with epilepsy. Practitioners and researchers should continue to develop interventions aimed at improving care for all patients and, crucially, measure the impact of their changes to ensure that any interventions are truly advancing health equity.


Subject(s)
COVID-19 , Epilepsy , COVID-19/epidemiology , Epilepsy/diagnosis , Epilepsy/epidemiology , Epilepsy/therapy , Healthcare Disparities , Humans , Pandemics , SARS-CoV-2 , Socioeconomic Factors
6.
J Med Chem ; 65(5): 3706-3728, 2022 03 10.
Article in English | MEDLINE | ID: covidwho-1699705

ABSTRACT

Glucose, the primary substrate for ATP synthesis, is catabolized during glycolysis to generate ATP and precursors for the synthesis of other vital biomolecules. Opportunistic viruses and cancer cells often hijack this metabolic machinery to obtain energy and components needed for their replication and proliferation. One way to halt such energy-dependent processes is by interfering with the glycolytic pathway. 2-Deoxy-d-glucose (2-DG) is a synthetic glucose analogue that can inhibit key enzymes in the glycolytic pathway. The efficacy of 2-DG has been reported across an array of diseases and disorders, thereby demonstrating its broad therapeutic potential. Recent approval of 2-DG in India as a therapeutic approach for the management of the COVID-19 pandemic has brought renewed attention to this molecule. The purpose of this perspective is to present updated therapeutic avenues as well as a variety of chemical synthetic strategies for this medically useful sugar derivative, 2-DG.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , Deoxyglucose/chemistry , Adenosine Triphosphate/metabolism , Antiviral Agents/chemistry , Antiviral Agents/metabolism , Antiviral Agents/pharmacology , COVID-19/diagnosis , COVID-19/virology , Deoxyglucose/metabolism , Deoxyglucose/pharmacology , Deoxyglucose/therapeutic use , Epilepsy/diagnosis , Epilepsy/drug therapy , Epilepsy/pathology , Glycolysis/drug effects , Humans , Isotope Labeling , Mitochondria/metabolism , Neoplasms/diagnosis , Neoplasms/drug therapy , Neoplasms/pathology , Positron-Emission Tomography , SARS-CoV-2/isolation & purification , SARS-CoV-2/physiology , Structure-Activity Relationship , Virus Replication/drug effects
7.
Am J Emerg Med ; 53: 284.e1-284.e3, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1682857

ABSTRACT

Valproic acid (VPA) and derivatives are effective anticonvulsants that are also used for numerous mood disorders. VPA toxicity can cause central nervous system (CNS) depression, dose related hyperammonemia, and eventually hepatotoxicity. While traditional treatment of VPA toxicity often includes l-carnitine, activated charcoal, and hemodialysis; an interaction with carbapenem class antibiotics has been well established in literature and may offer a different avenue of treatment. This case describes a 38 year-old female with a past medical history of epilepsy effectively treated with meropenem to rapidly and safely lower toxic VPA levels after an acute ingestion. A review of four VPA poisoning case reports and the interaction with carbapenem class antibiotics is also included.


Subject(s)
Drug Overdose , Epilepsy , Adult , Anti-Bacterial Agents/therapeutic use , Anticonvulsants , Carbapenems/therapeutic use , Drug Overdose/drug therapy , Drug Overdose/therapy , Epilepsy/drug therapy , Female , Humans , Meropenem/therapeutic use , Valproic Acid
8.
Expert Rev Neurother ; 22(2): 145-153, 2022 02.
Article in English | MEDLINE | ID: covidwho-1662065

ABSTRACT

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic represented a relevant issue for people with epilepsy (PwE). Medical care and social restrictions exposed PwE to a high risk of seizure worsening. Medical institutions answered to the pandemic assuring only emergency care and implementing a remote assistance that highlighted the technological obsolescence of the medical care paradigms for PwE. AREA COVERED: We reviewed the literature on the COVID-19-related factors influencing the epilepsy course, from the evidence of seizure risk in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infected PwE to anti-Sars-Cov-2 drugs interactions with antiseizure medications and the perceived changes of seizures in PwE. EXPERT OPINION: COVID-19 pandemic was a problematic experience for PwE. We must make treasure of the lessons learned during this period of social restrictions and employ the recent technological advances to improve PwE assistance, in particular telemedicine and electronic media for patients' education.


Subject(s)
COVID-19 , Epilepsy , Communicable Disease Control , Epilepsy/drug therapy , Epilepsy/therapy , Humans , Pandemics , SARS-CoV-2
9.
Epilepsy Behav ; 128: 108569, 2022 03.
Article in English | MEDLINE | ID: covidwho-1655243

ABSTRACT

BACKGROUND: Effectiveness of different tele-medicine strategies varies in different medical conditions. Use of basic tele-medicine strategy like mobile health (m-health) can be an effective option in different medical conditions in a resource-poor setting. AIMS: To study effectiveness and satisfaction of tele-medicine among persons with epilepsy (PWE) in a developing nation during COVID-19 pandemic. METHODS: Persons with epilepsy aged 18 years or more who have attended epilepsy clinic at least once physically and were asked for regular follow-up were included. A cross-sectional telephonic survey was conducted to assess effectiveness of tele-medicine over past 1 year. Satisfaction was assessed by tele-medicine satisfaction questionnaire. RESULT: 31.9% of PWE have used tele-medicine facility in last 1 year and 58.2% were unaware of the availability of such a facility. Among those who utilized tele-medicine, 95.3% were able to explain their concerns satisfactorily during tele-consultation and change in prescription was done in 42.8%. None experienced any new adverse event. Overall, more than 95% were satisfied with tele-consultation and more than 80% wanted to use it again. CONCLUSION: Even basic tele-medicine strategies can be a very effective and satisfactory mode of follow-up for PWE in resource-poor settings. Steps should be undertaken to make people aware of the availability of such a facility.


Subject(s)
COVID-19 , Epilepsy , Telemedicine , Adolescent , Cross-Sectional Studies , Epilepsy/epidemiology , Epilepsy/therapy , Follow-Up Studies , Humans , Pandemics , Personal Satisfaction , SARS-CoV-2
10.
Curr Neurol Neurosci Rep ; 22(1): 11-17, 2022 01.
Article in English | MEDLINE | ID: covidwho-1653759

ABSTRACT

PURPOSE OF REVIEW: Seizures, including status epilepticus, have been reported in association with acute COVID-19 infection. People with epilepsy (PWE) have suffered from seizure exacerbations during the pandemic. This article reviews the data for clinical and electrographic seizures associated with COVID-19, technical EEG considerations for reducing risk of transmission, and factors contributing to seizure exacerbations in PWE as well as strategies to address this issue. RECENT FINDINGS: An increasing number of studies of larger cohorts, accounting for a variety of variables and often utilizing EEG with standardized terminology, are assessing the prevalence of seizures in hospitalized patients with acute COVID-19 infections, and gaining insight into the prevalence of seizures and their effect on outcomes. Additionally, recent studies are evaluating the effect of the pandemic on PWE, barriers faced, and the usefulness of telehealth. Although there is still much to learn regarding COVID-19, current studies help in assessing the risk of seizures, guiding EEG utilization, and optimizing the use of telehealth during the pandemic.


Subject(s)
COVID-19 , Epilepsy , Status Epilepticus , COVID-19/epidemiology , Epilepsy/complications , Epilepsy/epidemiology , Epilepsy/therapy , Humans , Pandemics , Seizures/complications , Seizures/epidemiology , Seizures/therapy , Status Epilepticus/epidemiology , Status Epilepticus/etiology , Status Epilepticus/therapy
11.
Epilepsy Behav ; 129: 108581, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1648820

ABSTRACT

INTRODUCTION: In 2020, Coronavirus Disease 2019 (COVID-19) was declared as a global pandemic. Self-reported stress, anxiety, and insomnia, which are believed to be common triggers for epilepsy, are more likely to occur. We aimed to establish the influence of COVID-19 pandemic itself on changes in the daily life routine related to pandemic on epilepsy course in pediatric patients. The unique form of clinical care which is telemedicine was also taken into consideration. We wanted to evaluate patients' satisfaction with telemedicine and if changing stationary visits into telemedicine influenced epilepsy course in our patients. METHODS: Patients, who attended developmental neurology outpatient clinic in the period March-December 2020 were collected. As patients were minors, legal guardians were asked to fill out the questionnaire. Patients were divided according to the outcome into three groups: those with a worsened, stable, or improved course of epilepsy during the pandemic. Appropriate statistical tests for two-group and multi-group comparisons have been implemented. Post hoc p values were also calculated. RESULTS: Four hundred and two questionnaires were collected. Most of the patients had a stable course of epilepsy during the pandemic; in 13% of participants an improvement has been observed, worsening of the disease was seen in 16% of patients. Age, sex, type of epilepsy, number of seizure incidents before pandemic, and duration of the disease had no statistically significant connection with changes in the course of the disease. Behavioral changes and altered sleep patterns were found to be more common in the worsened group. Fifty-eight percent of patients were satisfied with telemedicine. Poorer satisfaction was connected with less frequent visits, cancellation of scheduled appointments, and lack of help in case of need in an emergency situation. CONCLUSION: Epilepsy course in pediatric patients seems to be stable during COVID-19 pandemic. Sleep disturbances and changes in a child's behavior may be related to increase in seizure frequency. Telemedicine is an effective tool for supervising children with epilepsy. Patients should be informed about possible ways of getting help in urgent cases.


Subject(s)
COVID-19 , Epilepsy , Telemedicine , COVID-19/epidemiology , Child , Epilepsy/complications , Epilepsy/epidemiology , Humans , Pandemics , Seizures
12.
Rev Med Suisse ; 18(764-5): 51-55, 2022 Jan 19.
Article in French | MEDLINE | ID: covidwho-1644191

ABSTRACT

In 2021, we assisted to the publication of new diagnostic criteria, classifications, and guidelines (CIDP, brain tumors, auto-immune encephalitis). Several studies helped to define the pharmacological management of focal and generalized epileptic seizures and epilepsy in pregnant women. The availability of biomarkers and the approval of immunotherapies are modifying the landscape of dementia management. Endovascular interventions without previous thrombolysis seems to be effective in anterior circulation acute ischemic stroke (AIS) and severe posterior circulation AIS. Neurologic complications of Sars-CoV-2 infection were further studied, as well as the efficacy of vaccines in immunosuppressed patients. New molecules and techniques show promising results for the treatment of migraine and cluster headache.


L'année 2021 a été marquée par la publication des nouveaux critères diagnostiques, classifications et guidelines (polyradiculonévrite inflammatoire démyélinisante chronique, tumeurs cérébrales, encéphalites autoimmunes). L'attitude thérapeutique dans les épilepsies focales ou généralisées et l'épilepsie chez la femme enceinte a été mieux définie. Les marqueurs biologiques et les immunothérapies modifient le paysage de la prise en charge des démences. Le traitement endovasculaire des AVC de la circulation antérieure semble efficace indépendamment d'une thrombolyse préalable, ainsi qu'en cas d'AVC sévère de la circulation postérieure. Les complications neurologiques du SARS-CoV-2 ont été éclaircies et l'efficacité des vaccins étudiée chez les patients immunosupprimés. Plusieurs nouvelles molécules et techniques montrent des résultats prometteurs pour les migraines et céphalées en grappe.


Subject(s)
Brain Ischemia , COVID-19 , Endovascular Procedures , Epilepsy , Neurology , Stroke , Female , Humans , Pregnancy , SARS-CoV-2 , Stroke/diagnosis , Stroke/therapy
13.
J Headache Pain ; 23(1): 13, 2022 Jan 21.
Article in English | MEDLINE | ID: covidwho-1643106

ABSTRACT

BACKGROUND: After the initiation of the COVID-19 vaccination program in Thailand, thousands of patients have experienced unusual focal neurological symptoms. We report 8 patients with focal neurological symptoms after receiving inactivated virus vaccine, CoronaVac. CASE SERIES: Patients were aged 24-48 years and 75% were female. Acute onset of focal neurological symptoms occurred within the first 24 h after vaccination in 75% and between 1-7d in 25%. All presented with lateralized sensory deficits, motor deficits, or both, of 2-14 day duration. Migraine headache occurred in half of the patients. Magnetic resonance imaging of the brain during and after the attacks did not demonstrate any abnormalities suggesting ischemic stroke. All patients showed moderately large regions of hypoperfusion and concurrent smaller regions of hyperperfusion on SPECT imaging while symptomatic. None developed permanent deficits or structural brain injury. DISCUSSIONS: Here, we present a case series of transient focal neurological syndrome following Coronavac vaccination. The characteristic sensory symptoms, history of migraine, female predominant, and abnormal functional brain imaging without structural changes suggest migraine aura as pathophysiology. We propose that pain related to vaccine injection, component of vaccine, such as aluminum, or inflammation related to vaccination might trigger migraine aura in susceptible patients.


Subject(s)
Brain Ischemia , COVID-19 , Epilepsy , Ischemic Stroke , Migraine Disorders , Migraine with Aura , Stroke , Adult , Brain Ischemia/diagnostic imaging , Brain Ischemia/etiology , COVID-19 Vaccines , Female , Humans , Male , Middle Aged , SARS-CoV-2 , Stroke/diagnostic imaging , Stroke/etiology , Vaccination/adverse effects , Young Adult
14.
Brain Behav ; 12(1): e2461, 2022 01.
Article in English | MEDLINE | ID: covidwho-1640675

ABSTRACT

PURPOSE: Very little is known about the knowledge and attitude of students about epilepsy at Sudanese universities. Therefore, we aimed to assess knowledge and attitude of undergraduate medical students toward epilepsy. METHODS: A 35-items standardized questionnaire was self-administered to 320 students between December 2020 and February 2021 with a recorded response rate of 61.8%. Google form was used to collect the data. The data was analyzed using R software. RESULTS: Overall, our findings showed a negative trend in the awareness and attitude towards epilepsy. While the majority of students (84.8%) had read or heard about epilepsy, only 43.9% of them had seen someone with epilepsy. Epilepsy was considered contagious and psychological by 1.7% and 56%, respectively. About 62.2% of students believed head / birth trauma is a cause of epilepsy. On the other hand, 15.7 % and 5.1 % of students thought evil eye and divine retribution are also causes of epilepsy, respectively. The latter beliefs were more uniform among participants from rural background (p < .05). Regarding attitude, 19.7% of students considered it inappropriate for a patient with epilepsy to have a child. This attitude correlates with the mother's education as the percentage was higher for students whose mothers had a lower education (pre-college education) (p < .05). The majority of students were aware that certain people with epilepsy need long-term drug treatment; this belief was more uniform among females than in males (p < .05). The vast majority of students (93.9%) thought that a child with epilepsy could succeed in a normal class. Compared to the corresponding group, this belief was found more common in students whose mothers had a higher education (university level and above) (p < .05). CONCLUSION: This study concludes that Sudanese undergraduate students' understanding of epilepsy was minimal, necessitating a well-directed educational campaign to develop a well-informed and tolerant society.


Subject(s)
Epilepsy , Health Knowledge, Attitudes, Practice , Students, Medical , Epilepsy/psychology , Female , Humans , Male , Students, Medical/psychology , Sudan , Surveys and Questionnaires , Universities
16.
J Child Neurol ; 37(2): 127-132, 2022 02.
Article in English | MEDLINE | ID: covidwho-1602856

ABSTRACT

INTRODUCTION: This study was designed to assess current recommendations from child neurologists and epileptologists on masking for school-age children with epilepsy. METHODS: A 7-item survey was created and sent out to members of the Child Neurology Society and Pediatric Epilepsy Research Consortium in August of 2021 to assess current practice and provider recommendations on masking. RESULTS: One hundred four individuals participated with representation from all regions of the United States. Masking was recommended by 95.1%, with 63.4% (n = 66) noting exception of those with severe intellectual disability, autism, and behavioral problems. Of those who write exemption letters, 54% write these <5% of the time. Only 3% reported potential adverse events associated with masking. CONCLUSION: Nearly all respondents recommended masking for school-age children with epilepsy. Potential risks of masking and adverse events were low. Improved guidance on masking is needed to ensure academic success of our patients with epilepsy.


Subject(s)
COVID-19/prevention & control , Epilepsy/physiopathology , Health Care Surveys/statistics & numerical data , Masks/statistics & numerical data , Child , Consensus , Humans , Neurologists/statistics & numerical data , SARS Virus , United States
17.
Int J Occup Med Environ Health ; 34(6): 817-819, 2021 Dec 13.
Article in English | MEDLINE | ID: covidwho-1593206

ABSTRACT

OBJECTIVES: The physiological impact of wearing personal protective equipment (PPE), in particular filtering-face-piece 3 (FFP3) masks, has increasingly been gaining importance since the outbreak of coronavirus disease 2019 (COVID-19). So far, gas exchange has been examined using transcutaneously measured partial pressure of carbon dioxide (PaCO2), ergo-spirometry and impedance cardiography. MATERIAL AND METHODS: In this structured investigation, arterial blood gas analysis in a 30-year-old female resident was carried out during a 13-hour day shift on the COVID-19 Intensive Care Unit of the University Hospital of Innsbruck, Austria. An FFP3 mask (3MTM AuraTM) with an exhalation valve was continuously worn, except for 1 break of 20 min. Arterial blood samples were obtained before putting on the PPE, and after 5 h, 9 h and 13 h of working in the contaminated area. RESULTS: During the multi-hour wearing time, an increase in PaCO2 (the baseline value: 29.3 mm Hg, the max. value: 38.9 mm Hg) and a continuous decrease in partial pressure of oxygen (PaO2, the baseline value: 102 mm Hg, the min. value: 80.8 mm Hg) was detectable. CONCLUSIONS: All measured values were within the normal range, but a trend towards an insufficient gas exchange could be suspected. Int J Occup Med Environ Health. 2021;34(6):817-9.


Subject(s)
COVID-19 , Epilepsy , Adult , Exhalation , Female , Humans , Masks , Medical Staff , Personal Protective Equipment , SARS-CoV-2
18.
Lancet Neurol ; 21(1): 8-10, 2022 01.
Article in English | MEDLINE | ID: covidwho-1594285
19.
J Neurol Sci ; 434: 120100, 2022 03 15.
Article in English | MEDLINE | ID: covidwho-1587195

ABSTRACT

OBJECTIVE: To study the longitudinal seizure outcomes of people with epilepsy (PWE) following the acute and chronic phases of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Consecutive PWE who were treated at the epilepsy center of Hiroshima University Hospital between 2018 and 2021 were enrolled. We evaluated the incidence of seizure frequency increase or decrease following the pandemic during observational periods in 2020 and 2021. Data between 2018 and 2019 were used as a control set. The sustainability of the altered seizure frequency condition was evaluated throughout the study period. We analyzed the clinical, psychological, and social factors associated with PWE with seizure exacerbation or amelioration. RESULTS: Among the 223 PWE who were evaluated (mean age 37.8 ± 16.3 years), seizure frequency increased for 40 (16.8%) and decreased for 34 (15.2%) after the pandemic began. While seizure exacerbation tended to be a transient episode during 2020, seizure amelioration was likely to maintain excellent status over the observation periods; the sustainability of the altered seizure frequency condition was more prominent for amelioration than exacerbation (p < 0.001). Seizure exacerbation was significantly associated with "no housemate" (odds ratio [OR] 3.37; p = 0.045) and "comorbidity of insomnia" (OR 5.80; p = 0.004). Conversely, "structural abnormality of MRI" (OR 2.57; p = 0.039) and "two-generation householding" (OR 3.70; p = 0.004) were independently associated with seizure amelioration. CONCLUSION: This longitudinal observation confirmed that seizure exacerbation and amelioration emerged during the COVID-19 pandemic. The COVID-19 pandemic has shed light on the stark difference that social support systems can make on outcomes for PWE.


Subject(s)
COVID-19 , Epilepsy , Adult , COVID-19/epidemiology , Epilepsy/complications , Epilepsy/epidemiology , Epilepsy/therapy , Humans , Middle Aged , Pandemics , Seizures/complications , Seizures/epidemiology , Young Adult
20.
Epilepsy Behav ; 126: 108487, 2022 01.
Article in English | MEDLINE | ID: covidwho-1586249

ABSTRACT

OBJECTIVE: This study aimed to investigate the factors affecting the unwillingness of physicians involved in epilepsy care to continue telemedicine during the coronavirus disease 2019 (COVID-19) pandemic in Japan. METHOD: This was a national-level cross-sectional survey initiated by Japan Young Epilepsy Section (YES-Japan) which is a national chapter of The Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES). We asked physicians who conducted telemedicine in patients with epilepsy (PWE) during the COVID-19 pandemic at four clinics and 21 hospitals specializing in epilepsy care in Japan from March 1 to April 30, 2021. The following data were collected: (1) participant profile, (2) characteristics of PWE treated by telemedicine, and (3) contents and environmental factors of telemedicine. Statistically significant variables (p < 0.05) in the univariate analysis were analyzed in a multivariate binary logistic regression model to detect the independently associated factors with the unwillingness to continue telemedicine. RESULT: Among the 115 respondents (response rate: 64%), 89 were included in the final analysis. Of them, 60 (67.4%) were willing to continue telemedicine, and 29 (32.6%) were unwilling. In the univariate binary logistic regression analysis, age (Odds ratio [OR] = 1.84, 95% confidence interval [CI] 1.10-3.09, p = 0.02), psychiatrist (OR = 5.88, 95% CI 2.15-16.08, p = 0.001), hospital (OR = 0.10, 95% CI 0.01-0.94, p = 0.04), the number of COVID-19 risk factors in the participant (OR = 2.88, 95% CI 1.46-5.69, p = 0.002), the number of COVID-19 risk factors in the cohabitants (OR = 2.52, 95% CI 1.05-6.01, p = 0.04), COVID-19 epidemic area (OR = 4.37, 95% CI 1.18-16.20, p = 0.03), consultation time during telemedicine (OR = 2.51, 95% CI 1.32-4.76, p = 0.005), workload due to telemedicine (OR = 4.17, 95% CI 2.11-8.24, p < 0.001) were statistically significant. In the multivariate binary logistic regression analysis, workload due to telemedicine (OR = 4.93, 95% CI 1.96-12.35) was independently associated with the unwillingness to continue telemedicine. CONCLUSION: This national-level cross-sectional survey found that workload due to telemedicine among physicians involved in epilepsy care was independently associated with the unwillingness to continue telemedicine.


Subject(s)
COVID-19 , Epilepsy , Physicians , Telemedicine , Cross-Sectional Studies , Humans , Japan , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
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