Neurological soft signs and cognition among inpatients with schizophrenia.

Introduction: Evidence has shown that neurological soft signs are strongly associated with neurocognitive dysfunction. Therefore, the primary objective of this study was to assess the association between NSS and cognitive impairments in a sample of inpatients with schizophrenia. The secondary objective was to explore the association between NSS total scores and functioning.Methods: The study enrolled 95 inpatients diagnosed with schizophrenia disorders and 45 healthy controls. The neurological evaluation scale (NES) was used to assess neurological soft sign while the Brief Assessment of Cognition in Schizophrenia (BACS) was used to evaluate cognitive functioning in patients with schizophrenia.Results: Patients with schizophrenia had significantly higher mean scores on the NES total test and subtests than the control group. Higher cognition was significantly associated with lower NES total and subtest scores. Higher functional independence was significantly associated with a lower NES total score (Beta = -.25), lower motor coordination subtest score (Beta = -.04), and lower others subtest (Beta = -.12). When taking the functional independence scale as the dependent variable, a higher NES total score was significantly associated with lower functioning (Beta = -0.03).Conclusion: NSS were associated to neurocognitive impairments in almost every domain among patients with schizophrenia. Further prospective research is still needed to confirm this role.

Imaging-Based Deep Learning for Predicting Desmoid Tumor Progression.

Desmoid tumors (DTs) are non-metastasizing and locally aggressive soft-tissue mesenchymal neoplasms. Those that become enlarged often become locally invasive and cause significant morbidity. DTs have a varied pattern of clinical presentation, with up to 50-60% not growing after diagnosis and 20-30% shrinking or even disappearing after initial progression. Enlarging tumors are considered unstable and progressive. The management of symptomatic and enlarging DTs is challenging, and primarily consists of chemotherapy. Despite wide surgical resection, DTs carry a rate of local recurrence as high as 50%. There is a consensus that contrast-enhanced magnetic resonance imaging (MRI) or, alternatively, computerized tomography (CT) is the preferred modality for monitoring DTs. Each uses Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), which measures the largest diameter on axial, sagittal, or coronal series. This approach, however, reportedly lacks accuracy in detecting response to therapy and fails to detect tumor progression, thus calling for more sophisticated methods. The objective of this study was to detect unique features identified by deep learning that correlate with the future clinical course of the disease. Between 2006 and 2019, 51 patients (mean age 41.22 ± 15.5 years) who had a tissue diagnosis of DT were included in this retrospective single-center study. Each had undergone at least three MRI examinations (including a pretreatment baseline study), and each was followed by orthopedic oncology specialists for a median of 38.83 months (IQR 44.38). Tumor segmentations were performed on a T2 fat-suppressed treatment-naive MRI sequence, after which the segmented lesion was extracted to a three-dimensional file together with its DICOM file and run through deep learning software. The results of the algorithm were then compared to clinical data collected from the patients' medical files. There were 28 males (13 stable) and 23 females (15 stable) whose ages ranged from 19.07 to 83.33 years. The model was able to independently predict clinical progression as measured from the baseline MRI with an overall accuracy of 93% (93 ± 0.04) and ROC of 0.89 ± 0.08. Artificial intelligence may contribute to risk stratification and clinical decision-making in patients with DT by predicting which patients are likely to progress.

Human herpesvirus-7 meningitis in an immunocompetent adult patient: a case report.

Aim: The underlying pathological mechanisms of CNS human herpesvirus-7 (HHV-7) related infections are still unknown, especially among immunocompetent adults. Although HHV-7 meningitis in immunocompetent adults is usually uncommon, serious consideration for possible HHV-7 involvement should be taken when assessing CNS infection of unknown etiology. Case presentation: We report a 53-year-old female who presented for fever and progressive headaches. Cerebrospinal fluid (CSF) analysis was compatible with a viral meningitis. CSF cultures were negative and HHV-7 DNA was the only strain detected in the CSF analysis. The patient died 1 month later following complications and cardiac arrest. Conclusion: HHV-7 CNS infection in immunocompetent patient can be a serious infection. Prompt diagnosis and treatment management are essential for better outcome.

We do not fully understand how human herpesvirus-7 (HHV-7) brain infections affect healthy individuals. We share a case of a 53-year-old woman who presented with fever and worsening headaches. In her cerebrospinal fluid analysis, only HHV-7 DNA was found. She received treatment with acyclovir initially and later with ganciclovir for a total of 4 weeks. Unfortunately, the patient passed away 1 month later due to complications and cardiac arrest. We highlight the need for robust guidelines for effectively treating HHV-7 brain infections in healthy individuals.

Parental alienation in Lebanon: a case report.

BACKGROUND: Parental alienation is a relatively newly described disorder, with a growing prevalence, as divorce and custody battles are becoming more and more complex with increased difficulty of joint custody. In parental alienation, one parent, the alienating parent, forms an alliance with the child involved in the custody dispute and manages to effectively alienate the targeted parent completely. The child and the alienating parent manifest a form of folie à deux and, hence, are in complete synchrony in the hatred and denigration of the targeted parent. Issues, such as potentially false allegations of sexual, physical, and emotional abuse of the child by the targeted parent, arise. The child and the alienating parent become mutually convinced of the targeted parent's transgressions. Consequently, it becomes difficult for the courts and psychiatric professionals to differentiate true abuse from parental alienation. CASE PRESENTATION: In this case study, we aimed to conduct an in-depth psychological and psychiatric evaluation of a Lebanese family (white race) where a father was wrongly accused by the mother and his 11-year-old white boy of both physical and sexual abuse. The data for this study were collected through unstructured and semi-structured interviews, observations, and psychological tests (Rorschach test for the parents and Blacky test for the child), and through the analysis of documented evidence presented in the trial. CONCLUSION: This case manifested most criteria set forth for the diagnosis of parental alienation and created serious doubt regarding the validity of the allegations set forth by the mother and the child. Uncovered parental alienation often misleads mental health professionals at the expense of the child's mental health .

Religious hallucinations in Lebanese patients with schizophrenia and their association with religious coping.

PURPOSE: to evaluate the relationship between religious hallucinations and religious coping among Lebanese patients with schizophrenia. METHODS: We have studied the prevalence of religious hallucinations (RH) among 148 hospitalized Lebanese patients suffering from schizophrenia or schizoaffective disorder in November 2021 exhibiting religious delusions (RD), and their relationship with religious coping using the brief Religious Coping Scale (RCOPE). The PANSS scale was used to evaluate psychotic symptoms. RESULTS: After adjustment over all variables, more psychotic symptoms (higher total PANSS scores) (aOR = 1.02) and more religious negative coping (aOR = 1.11) were significantly associated with higher odds of having religious hallucinations, whereas watching religious programs (aOR = 0.34) was significantly associated with lower odds of having religious hallucinations. CONCLUSION: This paper highlights the important role of religiosity that has to play in the formation of religious hallucinations in schizophrenia. Significant association was found between negative religious coping and the emergence of religious hallucinations.

Oseltamivir-induced behavioral changes in a female Lebanese adolescent: a case report of a usual drug with unusual side effect.

Neuropsychiatric symptoms, including abnormal behavior, after oseltamivir use among influenza patients have been of concern. In recent years, many case reports of neuropsychiatric events during or after oseltamivir treatment were reported; however, literature review revealed no such cases in Lebanon. Oseltamivir is the most widely prescribed medication against influenza and is generally well tolerated, causing random gastrointestinal disturbances, including nausea, vomiting, diarrhea and abdominal pain. However, in rare instances, it has been reported to stimulate behavioral activities in adolescents. We report herein a case of an oseltamivir-related neuropsychiatric event in a female adolescent in Lebanon, which resolved 2 days after stopping the drug.