Unilateral Optic Neuritis Associated with SARS-CoV-2 Infection: A Rare Complication.

BACKGROUND Since the outbreak of the SARS-CoV-2 infection, extensive research has been conducted on the pulmonary implications of this novel disease. However, there has been limited data on the extrapulmonary manifestations. There have been few documented causes of optic involvement and little is understood about the pathophysiology around its presentation and the possible treatments to prevent long-term complications. Here, we describe a case of optic neuritis in a female patient concurrently infected with SARS-CoV-2. Given the plethora of evidence supporting neurological manifestations of the virus, we hypothesize that there is an association between our patient's optic neuritis and her infection with SARS-CoV-2. CASE REPORT A 21-year-old woman with no past medical history who presented with blurry vision in her left eye. Optic neuritis was suspected with physical examination and confirmed with imaging of the optic nerve. Further diagnostic evaluation was nonsuggestive of multiple sclerosis and other demyelinating diseases; however, the patient was found to be positive for SARS-CoV-2. Steroids and remdesivir treatment were started, but without the presence of any respiratory symptoms. The patient's symptoms completely resolved by day 5 of hospitalization and she was discharged home without any complications. CONCLUSIONS Optic neuritis has remained an uncommon complication of SARS-CoV-2. This rather rare complication of SARS-CoV-2 is one that clinicians should be cognizant of due to the long-term implications of optic neuritis. Furthermore, it is pertinent to consider ophthalmic involvement in SARS-CoV-2 infection to appropriately guide patient care during the pandemic, as prompt treatment can lead to improved outcomes.

[Does the written press give a fair account of a complex medical question: «the Vincent Lambert case¼?] / La presse écrite rend-elle compte d'une façon juste d'une question médicale complexe : « le cas Vincent Lambert ¼ ?

Does the written press give a fair account of a complex medical question: "The Vincent Lambert Case"? We have studid press articles referring to Mr. Vincent Lambert's situation from 2013 to 2017. Analysis using a reading grid (including 7 questions) of press articles from four French daily newspapers (Libération, Le Monde, Le Figaro and La Croix) and a specialized medical news site (Agence de presse médicale) so that they can build their own opinion. 341 articles were analyzed (61 articles from Libération, 65 articles from Le Monde, 86 articles from Le Figaro, 82 articles from La Croix, 47 articles from the APM), writing a chronology of the main facts of the patient's history from 2013 to 2017 in order to have benchmarks to estimate the accuracy of the information reported in the various articles. Articles are rarely fully explicit. Inadequate expressions ("passive euthanasia", "end-of-life procedure") are used in the majority of newspapers. Some articles present the facts in a partisan way and contribute to mask the complexity of the patient's situation. Court decisions are often shortened and therefore simplified, which does not help the reader to understand the situation in an informed way. Reflective benchmarks are sometimes found in the various newspapers from 2013 to 2016. From 2016 onwards, we notice that the articles are shorter and that they no longer give any reference points for reflection. The daily written press in its current format does not seem to be able to help the general public to obtain accurate information on complex issues involving broad areas of reflection. The difficulty of the journalist's work in addressing this type of questioning comes partly from the constraints of brevity that are often imposed on them on the one hand and from the constant evolution of the information itself on the other.

La presse écrite rend-elle compte d'une façon juste d'une question médicale complexe : « Le Cas Vincent Lambert ¼ ? Nous avons analysé des articles de presse faisant référence à « l'affaire Vincent Lambert ¼ parus de 2013 à 2017 pour comprendre la façon dont la presse quotidienne française grand public relate les questions médicales complexes à forte tonalité éthique et interroger sa capacité à informer avec justesse ses lecteurs pour qu'ils puissent se construire leur propre opinion. À l'aide d'une grille de lecture (comportant 7 questions), 341 articles de presse de 4 quotidiens français (Libération, Le Monde, Le Figaro et La Croix) et d'un site de dépêches médicales spécialisées (Agence de presse médicale) ont été analysés. Les articles apparaissent rarement entièrement explicites. Des expressions inadaptées (« euthanasie passive ¼, « procédure de fin de vie ¼) sont utilisées dans la majorité des journaux. Certains articles exposent les faits de manière partisane et participent à maquiller la complexité de la situation du patient. Les décisions de justice sont souvent raccourcies et donc simplifiées, ce qui n'aide pas le lecteur à saisir la situation de manière éclairée. Des repères réflexifs sont parfois retrouvés dans les différents journaux de 2013 à 2016. À partir de 2016, on remarque que les articles sont plus courts et ne donnent plus aucun repère de réflexion. De nos jours, la presse écrite n'est probablement plus le premier vecteur d'information choisi par le citoyen. Les articles des titres de presse étudiés dans leur format actuel ne sont peut-être pas le meilleur moyen d'aider le grand public à s'informer de manière juste sur des questions complexes englobant de vastes champs de réflexion. La difficulté du travail du journaliste pour aborder ce type de questionnement vient en partie des contraintes de brièveté qui leur sont souvent imposées d'une part, et de l'évolution constante de l'information elle-même d'autre part.

[Management of psychiatric inpatients with advanced cancer: a pilot study]. / Prise en charge de pathologie cancéreuse avancée chez des patients institutionnalisés en psychiatrie : une étude pilote.

The prevalence of cancer is not well established and probably underestimated in long-stay psychiatric inpatients. Psychiatric patients do not have the same access for cancer screening and care. Therapeutic decision-making is a real ethical problem. In this context, access to medical care should be provided by the establishment of guidelines and/or recommendations for this specific population. The aim of our study was to assess how cancer was managed among long term psychiatric inpatients. For this pilot study, we used a mixed methodology: a quantitative part with a retrospective chart review of cancer patients in a psychiatric institution and a qualitative part based on semi-structured interviews with psychiatrists with discourse analysis. Delay in cancer diagnosis can be explained by communication and behavior disorders, inadequate screening, and additional tests often refused by patients. Compliance and ethical issues (i.e. obtaining informed consent) are many pitfalls to optimal cancer care that should be explored in further research.

Medical facts to support inferencing in natural language processing.

We report on the use of medical facts to support the enhancement of natural language processing of biomedical text. Inferencing in semantic interpretation depends on a fact repository as well as an ontology. We used statistical methods to construct a repository of drug-disorder co-occurrences from a large collection of clinical notes, and this resource is used to validate inferences automatically drawn during semantic interpretation of Medline citations about pharmacologic interventions for disease. We evaluated the results against a published reference standard for treatment of diseases.