Review on Acute Relapse of Spinal Cord Infarction: A Case Report

Objective: To present a case of relapsed spinal cord infarction (SCI) as an acute spinal emergency in an in-patient elderly male patient. Methods: This report presents a case of an in-patient 84 years-old man who was admitted due to acute paraparesis with urge incontinence and sudden worsening after initial improvement. To assess his condition, spine magnetic resonance was performedResults: The spine magnetic resonance confirmed relapse of spinal cord infarction, which also involved the medullar conus.Conclusion: This case report presents a very rare event that is poorly described in literature. A strict follow up of risk factors and regular neurological evaluations during ihospitalization are recommended, especially in older patients

A multiregion operator-splitting CFD approach for coupling microkinetic modeling with internal porous transport in heterogeneous catalytic reactors

We propose a multiregion approach to allow for the computational fluid dynamic simulation of heterogeneous fixed bed reactors with a microkinetic description of the surface reactivity and the concomitant account for intraphase transport. A partitioned approach has been considered for the coupling between the different regions. The computational domain is split in different regions, which are characterized by different phenomena. The governing equations in the different regions of the domain are solved separately, followed by the achievement of the convergence at the boundaries through an iterative procedure. Overall, the resulting numerical framework allows for the dynamic solution of reacting flows over solid porous catalysts of arbitrary complex geometries with surface reactivity described by detailed microkinetic mechanisms. The capabilities of the numerical framework are tested through the analysis of complex geometries and large heterogeneous microkinetic models and the simulation of experimental data of H2 combustion on Rh in conditions where internal mass transfer limitations are controlling

Urinalysis parameters for predicting severity in coronavirus disease 2019 (COVID-19)

Urinalysis Parameters for Predicting Severity in Coronavirus Disease 2019 (COVID-19

Laboratory predictors of death from coronavirus disease 2019 (COVID-19) in the area of Valcamonica, Italy

Background Comprehensive information has been published on laboratory tests which may predict worse outcome in Asian populations with coronavirus disease 2019 (COVID-19). The aim of this study is to describe laboratory findings in a group of Italian COVID-19 patients in the area of Valcamonica, and correlate abnormalities with disease severity. Methods The final study population consisted of 144 patients diagnosed with COVID-19 (70 who died during hospital stay and 74 who survived and could be discharged) between March 1 and 30, 2020, in Valcamonica Hospital. Demographical, clinical and laboratory data were collected upon hospital admission and were then correlated with outcome (i.e. in-hospital death vs. discharge). Results Compared to patients who could be finally discharged, those who died during hospital stay displayed significantly higher values of serum glucose, aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), urea, creatinine, high-sensitivity cardiac troponin I (hscTnI), prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time (APTT), D-dimer, C reactive protein (CRP), ferritin and leukocytes (especially neutrophils), whilst values of albumin, hemoglobin and lymphocytes were significantly decreased. In multiple regression analysis, LDH, CRP, neutrophils, lymphocytes, albumin, APTT and age remained significant predictors of in-hospital death. A regression model incorporating these variables explained 80% of overall variance of in-hospital death. Conclusions The most important laboratory abnormalities described here in a subset of European COVID-19 patients residing in Valcamonica are highly predictive of in-hospital death and may be useful for guiding risk assessment and clinical decision-making

Global uncertainty in the diagnosis of neurological complications of SARS-CoV-2 infection by both neurologists and non-neurologists: An international inter-observer variability study

Introduction: Uniform case definitions are required to ensure harmonised reporting of neurological syndromes associated with SARS-CoV-2. Moreover, it is unclear how clinicians perceive the relative importance of SARSCoV-2 in neurological syndromes, which risks under- or over-reporting. Methods: We invited clinicians through global networks, including the World Federation of Neurology, to assess ten anonymised vignettes of SARS-CoV-2 neurological syndromes. Using standardised case definitions, clinicians assigned a diagnosis and ranked association with SARS-CoV-2. We compared diagnostic accuracy and assigned association ranks between different settings and specialties and calculated inter-rater agreement for case definitions as "poor" (kappa <= 0.4), "moderate" or "good" (kappa > 0.6). Results: 1265 diagnoses were assigned by 146 participants from 45 countries on six continents. The highest correct proportion were cerebral venous sinus thrombosis (CVST, 95.8%), Guillain-Barre ' syndrome (GBS, 92.4%) and headache (91.6%) and the lowest encephalitis (72.8%), psychosis (53.8%) and encephalopathy (43.2%). Diagnostic accuracy was similar between neurologists and non-neurologists (median score 8 vs. 7/10, p = 0.1). settings with few neurologists. However, encephalopathy, encephalitis, and psychosis were often misdiagnosed