Aspirin withdrawal: A risk factor for ischemic stroke severity.

INTRODUCTION: Acetylsalicylic acid (ASA) cessation, is suggestive of a rebound phenomenon laying the ground for ischemic stroke (IS) re-occurrence but nothing is known about its implication for IS severity (ISS). Thus, the aim of our study is to examine whether or not aspirin withdrawal is a risk factor for ISS. PATIENTS AND METHODS: This study, recruited patients having presented an IS in the following 2 weeks of ASA withdrawal, matched with treatment free cases. ISS was evaluated in all patients at admission using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin scale (mRS) at 3 months' follow-up. FINDINGS: Fifty cases were included in this study and fifty, manually matched, controls. ISS analysis found that the case group had a more severe stroke at admission (mean NIHSS: 12.76 (±7.319) in cases vs 10.04 (±5.562) in controls, P=0.039), with ASA discontinuation judged as a risk factor directly related to ISS regardless of the underlying cardiovascular risk factors (using the multivariate analysis). CONCLUSION: Our study's findings suggest that aspirin interruption over a 15-days period could result in a more severe IS in the acute phase. To our knowledge, no study has ever discussed this outcome, shedding the light on the pressing need for larger studies with various withdrawal periods to support these data.

No impact of confinement during COVID-19 pandemic on anxiety and depression in Parkinsonian patients.

BACKGROUND: Governments around the world have imposed varied containment measures to curb the spread of the COVID-19 infection. The psychological impact could be highly negative in patients with neurologic condition like Parkinson's Disease (PD). METHODS: We prospectively evaluated symptoms of depression and anxiety in 50 (26 females; mean age at 60.4) non demented Moroccan PD patients, using Hospital Anxiety and Depression Scale (HADS), at the beginning and after 6 weeks of a full confinement. RESULTS: At the first evaluation, 28% of patients had depression while 32% had anxiety. After 6 weeks of confinement, some patients got worse and others got better scores but no significant statistical difference for both troubles was seen. CONCLUSION: Our results show that there is no significant impact of 6 weeks of confinement on overall anxiety and depression scores. However, confinement could have an unexpected positive psychological impact on a significant number of PD patients.

Othello syndrome in Parkinson's disease: A diagnostic emergency of an underestimated condition.

Othello syndrome (OS) is a type of delusional jealousy, characterized by the false absolute certainty of the infidelity of a partner. This syndrome is not uncommon in Parkinson's Disease (PD), appearing as side effect of Dopaminergic Agonists (DA) therapy. We analyze the observations of five patients with OS, diagnosed in a series of 250 consecutive PD patients during two years. All patients are men, with a particularly young age at onset of PD. The mean duration of DA therapy at OS onset was 3 years. One patient had hypersexuality and another had punding. Significant cognitive impairment was present in two patients. All patients were treated with DA: two with Pramipexol and three with Piribedil. At the time of the management of the OS, three patients had already divorced their spouse. It is imperative for clinicians to know this underestimated syndrome in order to identify it early and approach it adequately to avoid irreversible negative prejudice.