Teledermatology in the time of COVID-19.

AIMS: The enormous spread of the novel Corona virus disease (COVID-19) represents a challenge to dermatological practice. Accumulating evidence has suggested a possible role of teledermatology in facing this challenge. In this article, we aimed to give a general overview of teledermatology in terms of models of practice, modes of delivery, advantages, limitations, ethical considerations and legislative challenges as well as discussing, using examples from literature, how dermatological practice can benefit from teledermatology during the time of the COVID-19 pandemic. DISCUSSION AND CONCLUSION: Teledermatology could be an accessible, accurate and cost-effective substitute for conventional face-to-face dermatological consultations during the COVID-19 pandemic. However, teledermatology practice needs updated legislation and guidelines. More efforts should be done to encourage dermatologists, especially in underserved communities, to provide teledermatology services. Ethical issues and data security related to teledermatology have to be considered.

Knowledge and attitude of Egyptian parents toward childhood mental disorders.

BACKGROUND: Parents' awareness of childhood mental disorders can help in early detection and management. This study aimed to assess the knowledge of parents about childhood mental disorders and their attitudes toward children with mental disorders. SUBJECTS AND METHODS: Parents of children attending two public primary schools in Beni-Suef city in southern Egypt were invited to participate in this cross-sectional study during the first semester of the academic year 2017/2018. Knowledge and attitude of parents toward childhood mental disorders in addition to their socio-demographic characteristics were evaluated using a self-administered questionnaire. RESULTS: A total of 468 parents (41.5% fathers and 58.5% mothers) participated in this study. Only 21.6% of parents had optimal knowledge of risk factors, 33.3% of manifestations/screening, 58.8% of types and 47.6% of treatment, while 42.7% of parents held a positive attitude toward impressions, 43.4% toward social distance, 63.7% toward spiritual treatment, and 59.4% toward chemotherapy and psychotherapy of childhood mental disorders. The multivariable-adjusted regression analyses showed that optimal knowledge associated with urban residence [odds ratio (OR) 1.56, 95% confidence interval (CI) 1.05-2.30)] and knowing someone with a mental disorder (OR 1.62, 95% CI 1.08-2.41). The positive attitude was associated with urban residence (OR 1.80, 95% CI 1.18-2.74) and higher education (OR 2.14, 95% CI 1.32-3.48). Knowledge of parents correlated positively with their attitude toward childhood mental disorders (r = 0.258, p < 0.001). CONCLUSION: A significant portion of parents in southern Egypt have suboptimal knowledge of childhood mental disorders and hold a negative attitude toward children with mental disorders. Future studies should focus on the possibility of including parents in screening for childhood mental disorders.

Neuropsychological performance changes following subthalamic versus pallidal deep brain stimulation in Parkinson's disease: a systematic review and metaanalysis.

BACKGROUND: Studies comparing subthalamus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) for the management of Parkinson's disease in terms of neuropsychological performance are scarce and heterogeneous. Therefore, we performed a systematic review and metaanalysis to compare neuropsychological outcomes following STN DBS versus GPi DBS. METHODS: A computer literature search of PubMed, the Web of Science, and Cochrane Central was conducted. Records were screened for eligible studies, and data were extracted and synthesized using Review Manager (v. 5.3 for Windows). RESULTS: Seven studies were included in the qualitative synthesis. Of them, four randomized controlled trials (n=345 patients) were pooled in the metaanalysis models. The standardized mean difference (SMD) of change in the Stroop color-naming test favored the GPi DBS group (SMD=-0.31, p=0.009). However, other neuropsychological outcomes did not favor either of the two groups (Stroop word-reading: SMD=-0.21, p=0.08; the Wechsler Adult Intelligence Scale (WAIS) digits forward: SMD=0.08, p=0.47; Trail Making Test Part A: SMD=-0.05, p=0.65; WAIS-R digit symbol: SMD=-0.16, p=0.29; Trail Making Test Part B: SMD=-0.14, p=0.23; Stroop color-word interference: SMD=-0.16, p=0.18; phonemic verbal fluency: bilateral DBS SMD=-0.04, p=0.73, and unilateral DBS SMD=-0.05, p=0.83; semantic verbal fluency: bilateral DBS SMD=-0.09, p=0.37, and unilateral DBS SMD=-0.29, p=0.22; Boston Naming Test: SMD=-0.11, p=0.33; Beck Depression Inventory: bilateral DBS SMD=0.15, p=0.31, and unilateral DBS SMD=0.36, p=0.11). CONCLUSIONS: There was no statistically significant difference in most of the neuropsychological outcomes. The present evidence does not favor any of the targets in terms of neuropsychological performance.

Evidence for association between hepatitis C virus and Parkinson's disease.

Parkinson's disease (PD) is a globally prevalent neurodegenerative disorder, characterized by progressive neuronal loss in the substantia nigra and formation of Lewy bodies. These pathological characteristics are clinically translated into motor symptoms, such as bradykinesia, rigidity, resting tremors, and postural instability. Emerging data from epidemiological studies suggest a possible association between PD and hepatitis C virus (HCV) infection, which affects up to 71 million individuals worldwide. Preclinical studies have shown that HCV can penetrate and replicate within the brain macrophages and microglial cells, increasing their production of pro-inflammatory cytokines that can directly cause neuronal toxicity. Other studies reported that interferon, previously used to treat HCV infection, can increase the risk of PD through inhibition of the nigrostriatal dopaminergic transmission or induction of neuroinflammation. In this article, we provide a comprehensive review on the possible association between HCV infection and PD and highlight recommendations for further research and practice in this regard.