Calixto Machado

Calixto Machado
Institute of Neurology and Neurosurgery Havana Cuba · Department of Clinical Neurophysiology

MD, PhD, FAAN

About

565
Publications
141,973
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3,893
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Introduction
Calixto Machado currently works at the Department of Clinical Neurophysiology, Institute of Neurology and Neurosurgery, Havana, Cuba. Dr. Machado is a Senior Professor and Researcher in neurology and clinical neurophysiology. Their current projects are "Disorders of consciousness", "Brain Death", Autism, 'Heart Rate Variability in Autonomic Function Assessment in different neurological diseases.
Additional affiliations
January 1976 - present
Instituto de Neurología y Neurocirugía
Position
  • Senior Professor and Researcher
Education
- July 1976
University of Havana
Field of study
  • Medical career

Publications

Publications (565)
Article
Full-text available
Introduction: Recent evidence on distinguishing patients with dis- orders of consciousness (DOC) showed that heartbeat-evoked responses (HERs) could be more accurate than using generic EEG features. Here we aim to illustrate HERs in an independent cohort of DOC patients and provide qualitative differences that may help to complement bedside diagnos...
Article
Full-text available
Calixto Machado, Senior Professor and Researcher in Neurology, Institute of Neurology and Neurosurgery, Department of Clinical Neurophysiology, Havana, Cuba Submitted July 13, 2022 Frontera et al. found that less than 20% of patients in their cohort had normal metrics scores at 12 months after severe COVID-19 onset. The patients with neurologic co...
Article
Full-text available
Dickerman et al. developed a cohort study to compare the head-to-head safety regarding the risk of adverse events between the Pfitzer (BNT162b2) and the Moderna (mRNA-1273) using the health care databases of the US Department of Veterans Affairs.1 Many studies have compared the safety and effectiveness of vaccines against the SARS-CoV-2 virus.2 Non...
Article
Full-text available
We provide evidence to support the contention that many aspects of Autistic Spectrum Disorder (ASD) are related to interregional brain functional disconnectivity associated with maturational delays in the development of brain networks. We think a delay in brain maturation in some networks may result in an increase in cortical maturation and develop...
Preprint
Full-text available
Houry et al. discussed that the COVID-19 pandemic led to community-law enforcement tensions and social and structural factors that have potentially contributed to increased risks for homicide and suicide in the US. The authors emphasized that possession of firearms was the most frequent method of injury in suicides and homicides during the pandemic...
Article
Full-text available
Background: New controversies have raised on brain death (BD) diagnosis when lesions are localized in the posterior fossa. Objective: The aim of this study was to discuss the particularities of BD diagnosis in patients with posterior fossa lesions. Materials and Methods: The author made a systematic review of literature on this topic. Results and C...
Article
Full-text available
Calixto Machado, MD, PhD, FAAN | Institute of Neurology and Neurosurgery, Havana, Cuba The Omicron variant led to exponential increases in cases and a sharp rise in hospital admissions, completely displacing the Delta variant within weeks. Nonetheless, some authors have emphasized that disease severity is less, and that symptoms associated with Omi...
Article
Full-text available
Calixto Machado, Full Professor and Researcher in Neurology, Institute of Neurology and Neurosurgery, Department of Clinical Neurophysiology, Havana, Cuba Submitted February 13, 2022 Young and Bernat remark in this report that neurologists are facing novel ethical and philosophical issues "by virtue of the privileged relationship between personhood...
Article
Full-text available
The SARS-CoV-2 variant B.1.1.529 (Omicron) has rapidly spread worldwide. The Omicron variant has led to an exponential increase in cases and a sharp rise in hospital admissions. The COVID-19 vaccine's protection is still under study for the Omicron variant. However, a third vaccine dose seems to boost neutralizing antibodies, although less efficien...
Article
Full-text available
Background: New controversies have raised on brain death (BD) diagnosis when lesions are localized in the posterior fossa. Objective: The aim of this study was to discuss the particularities of BD diagnosis in patients with posterior fossa lesions. Materials and methods: The author made a systematic review of literature on this topic. Results...
Preprint
Full-text available
Wijdicks wrote a remarkable historical article revisiting the Transatlantic discussion on the British-American (UK-US) divide on brain death-determination of death by neurological criteria (BD/DNC) by approaching the original contributions of two main inspiring pioneers in this field: Christopher Pallis and Julius Korein. I had the opportunity of m...
Preprint
Full-text available
The Omicron variant led to exponential increases in cases and a sharp rise in hospital admissions. The wave increased faster than previous waves, completely displacing the Delta variant within weeks, creating worldwide worries about the final pandemic control. Omicron is the fifth variant to be named as a variant of concern (VOC) by the World Healt...
Chapter
Full-text available
The main characteristics and challenging symptoms of COVID-19, caused by the novel coronavirus SARS-CoV-2, are related to respiratory distress. Although most patients have mild symptoms such as fever, headache, cough, myalgia, and anosmia, some develop acute respiratory distress syndrome, leading to death in many cases. Human coronavirus (CoVs) wer...
Chapter
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The most accepted theory of PRES is a loss of autoregulation in cerebral blood flow —usually associated with hypertension or arterial pressure fluctuations, with a subsequent increase in vascular permeability and leakage of blood plasma and erythrocytes— producing vasogenic edema. Other theories have been proposed in the pathogenesis of PRES, but t...
Chapter
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A perplexing clinical aspect of COVID-19 is presentation of patients with pronounced hypoxemia without expected signs of respiratory distress or dyspnea, even when cyanotic. Nonetheless, these patients frequently leapfrog clinical evolution stages and suffer acute respiratory distress syndrome (ARDS), with concomitant cardiorespiratory arrest and d...
Chapter
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Related to my earlier publications on central nervous system involvement in COVID-19, I would like to stress the importance of diagnosing obstructive sleep apnea syndrome (OSAS) in infected patients, prompting early use of continuous positive air pressure (CPAP) to prevent hypoxemia. OSAS is commonly related to obesity, which is considered an impor...
Chapter
Full-text available
(…) SARS-CoV-2 can reach CNS through hematogenous or neural propagation. Direct endothelial damage and thrombo-inflammation, loss of blood-brain barrier function with a consequent microvascular leak, and maladaptation of ACE2-related pathways might be possible mechanisms to explain patients’ clinical findings. Nonetheless, another conceivable mecha...
Chapter
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The authors argued that a virus-mediated immune response was a possible mechanism to explain patients’ symptoms as reported in cases of Guillain-Barré syndrome (GBS) associated with SARS- CoV-2 infection. The authors also considered the possibility of a direct virus infection mechanism. Timing in the appearance of symptoms is crucial to discuss the...
Chapter
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The article on the care of stroke preservation during Covid-19 by Leira and colleagues is quite informative. The authors have well-elaborated about the care of patients and families, the safety of health care workers, quality of care, ethical considerations, logistics, and research. As the pandemic lengthens, we don’t know how long it will run, so...
Chapter
Full-text available
Early reports of COVID-19 have demonstrated respiratory predominant symptomatology, but an increasing number of studies have highlighted SARS-CoV-2 capacity to cause neurologic complications. An important route for coronavirus to invade the brain is via the olfactory bulb, which explains why anosmia can be the first and/or a unique COVID-19 symptom...
Chapter
Full-text available
SARS-CoV-2 (CoV-2) is a coronavirus which is causing the actual COVID-19 pandemic. The disease caused by the 2019 new coronavirus (2019-nCoV) was named coronavirus disease-19 (COVID-19) by the World Health Organization in February 2020. Primary non-specific reported symptoms of 2019-nCoV infection at the prodromal phase are malaise, fever, and dry...
Chapter
Full-text available
Background: New controversies have been raised on brain death (BD) diagnosis when lesions are localized in the posterior fossa. Objective: To discuss the particularities of diagnosis BD in patients with posterior fossa lesions. Methods: The author made a systematic review of the literature on this topic. Results and Conclusions: A supratentorial br...
Chapter
Full-text available
Lewis et al. published an important and timely necessary article about the determination of death by neurological criteria, revising the Uniform Determination of Death. The acceptance of brain death (BD) has been progressively accepted beginning in the late 1950s. Nonetheless, contentious brain-dead cases have recently raised new controversies abou...
Chapter
Full-text available
(…) SARS-CoV-2 can reach CNS through hematogenous or neural propagation. Viral dissemination through neural pathways—retrograde or antegrade—is facilitated by proteins called dinein and kinesin, which can be targets of viruses. Hence, SARS-CoV-2 can even invade the CNS coming from peripheral nerves. The immune response mechanism has been discussed...
Chapter
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(…) I read Dr. Nath’s editorial with interest. The COVID-19 pandemic has pushed scientists to in- investigate if this new disease can affect the central nervous system (CNS). The most challenging symptoms of COVID-19 are related to respiratory distress, and most patients admitted to intensive care units cannot breathe on their own. Therefore, a cru...
Chapter
Full-text available
Serious medical complications have been reported in COVID-19 related to severe hypoxia and car- diac arrest, leading to post-anoxic coma. Other complications like encephalitis and stroke might also be the cause of profound disturbances of consciousness. These conditions are not easy to handle when it is necessary to confirm BD, eliminating possible...
Book
Full-text available
(…) An increasing amount of reports demonstrate that neurotropism is a common feature of SARS-CoV-2, and that acute respiratory failure in COVID-19 could be related to infection of the brainstem. Thus, the early prediction of brain damage with a rapidly accessible biomarker could prove useful to detect patients at higher risks of complications. Blo...
Article
Full-text available
Muchos se han preguntado si la afección directa del sistema nervioso por el SARS-CoV-2 puede tener una participación como causa de muerte. En este sentido, investigadores del Instituto Nacional de Neurología y Neurocirugía de Cuba, liderados por el profesor Calixto Machado, publicaron en la revista Neurology India, valoraciones relacionadas con la...
Preprint
Full-text available
According to MacLaren et al., using ECMO for severe COVID-19 has been considered by clinicians because the disease process appeared similar to ARDS from other etiologies.1 Nevertheless, the role of ECMO has been unverified, and there is a lack of evidence to treat refractory ARDS in this disease.1,2 These authors defend that several advances in the...
Preprint
Full-text available
Objectives: Recent evidence on distinguishing patients with disorders of consciousness (DOC) showed that heartbeat-evoked responses (HERs) could be more accurate than using generic EEG features. We aim to illustrate HERs in an independent cohort of DOC patients and provide qualitative differences that may help to complement bedside diagnosis in cli...
Chapter
Full-text available
The disorders of consciousness (DOC) discussions are actual and permanent subjects for debate in the media and scientific discussion in any forum. Controversies exist in the use of present-day clinical terminology, including terms that may be pejorative in describing patients. The European Task Force on Disorders of Consciousness has proposed a new...
Preprint
Full-text available
Newsome et al. concluded that among the patients with neuromyelitis optica spectrum disorders (NMOSD) complaining COVID-19, a high mortality rate was observed. There were no deaths reported in the patients with myelin oligodendrocyte glycoprotein antibody disease (MOGAD). Most NMOSD patients were treated rituximab, and those taking rituximab with f...
Article
Full-text available
The main contradiction in the analysis of cerebral venous sinus thrombosis (CVST), occurring after the COVID-19 vaccination, is that shortly after the emergence of the SARS-CoV-2 pandemic, it became ostensible that individuals infected with the virus exhibited a high risk of thromboembolic events. Hence, the crucial question is: Was CVST only relat...
Preprint
Full-text available
Several reports have been published over recent years about Zolpidem's paradoxical arousing effect in unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) patients. During Zolpidem pharmacological intervention, we emphasized the importance of using the heart rate variability (HRV) methodology to assess the autonomic in a UWS...
Preprint
Full-text available
Newsome et al. concluded that among the patients with neuromyelitis optica spectrum disorders (NMOSD) complaining COVID-19, a high mortality rate was observed. There were no deaths reported in the patients with myelin oligodendrocyte glycoprotein antibody disease (MOGAD). Most NMOSD patients were treated rituximab, and those taking rituximab with f...
Article
Full-text available
We read with interest the study by Suh et al.1 The authors concluded that muscle and nerve damage was secondary to inflammatory response and cytokine storm, rather than direct viral infection. Nonetheless, the authors did not perform histopathologic examinations in symptomatic patients. Consequently, viral RNA may have been cleared from muscle and n...
Article
Full-text available
The paper discusses and provides support for diverse processes of brain plasticity in visual function after damage in infancy and childhood in comparison with injury that occurs in the adult brain. We provide support and description of neuroplastic mechanisms in childhood that do not seemingly exist in the same way in the adult brain. Examples incl...
Article
Full-text available
Bartley et al. concluded that pediatric patients with COVID-19 and prominent subacute neuropsychiatric symptoms may have anti–SARS-CoV-2 and antineural antibodies in their CSF and may respond to immunotherapy.1 Although several authors have reported in some neurologically impaired adults with COVID-19 the presence of intrathecal antineural autoanti...
Preprint
Full-text available
In COVID-19, an exaggerated pro-inflammatory response, known as cytokine storm (CS). The anti-inflammatory system's CS–mediated response is an ineffective immunological control, leading to tissue damage, multiorgan failure, acute respiratory distress syndrome (ARDS), and death. Cytokine-mediated lung endothelial and epithelial cell injury may damag...
Preprint
Full-text available
Le May et al. conducted a randomized clinical trial including 367 adults with out-of-hospital cardiac arrest, concluding that a target temperature of 31 °C did not significantly reduce the rate of death or predict poor neurologic outcome at 180 days compared with a target temperature of 34 °C.1 Hypothermia is the best-known method to protect the b...
Preprint
Full-text available
Several reports have been published over recent years about Zolpidem's paradoxical arousing effect in unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) patients. During Zolpidem pharmacological intervention, we emphasized the importance of using the heart rate variability (HRV) methodology to assess the autonomic in a UWS...
Article
Full-text available
Spyropoulos et al. ran a randomized clinical trial concluding that LMWH therapeutic dose in patients with COVID-19 with very elevated D-dimer levels reduced major thromboembolism and death compared with standard heparin thromboprophylaxis.1 Early reports during the COVID-19 pandemic described elevated D-dimer levels, high venous thromboembolism (V...
Article
Full-text available
The World Health Organization (WHO) reported that since March 2021, cases of thromboses associated with thrombocytopenia in subjects vaccinated with the Oxford-AstraZeneca (ChAdOx1-S) and Johnson & Johnson (J&J) Janssen (Ad26.COV2-S) COVID-19 vaccines. National and international bodies currently recognize the vaccine-induced immune thrombotic throm...
Article
Full-text available
Since the vaccination programs for COVID-19 began, clinicians were primarily concerned whether multiple sclerosis (MS) patients should be vaccinated or not. Clinicians were also particularly worried about COVID-19's effects on people with MS treated with a disease-modifying therapy (DMT). One of the central queries was whether MS patients treated w...
Article
Full-text available
Since the vaccination programs for COVID-19 began, clinicians were primarily concerned whether multiple sclerosis (MS) patients should be vaccinated or not. Clinicians were also particularly worried about COVID-19's effects on people with MS treated with a disease-modifying therapy (DMT). One of the central queries was whether MS patients treated w...
Article
Full-text available
The paper discusses and provides support for diverse processes of brain plasticity in visual function after damage in infancy and childhood in comparison with injury that occurs in the adult brain. We provide support and description of neuroplastic mechanisms in childhood that do not seemingly exist in the same way in the adult brain. Examples incl...
Thesis
Full-text available
Se realizó un estudio transversal descriptivo a 62 pacientes ingresados en la Unidad de Cuidados Intensivos del Instituto Nacional de Neurología y Neurocirugía con el diagnostico de Infarto Cerebral en fase aguda en el período correspondiente entre Abril de 1997 y Abril de 1999, con el objetivo de identificar las variables clínicas que mostraron ma...
Article
Full-text available
Curiously, Kimura et al. did not mention the possibility of SARS-CoV-2 infection to discuss the conceivable etiology of their patient’s encephalitis, considering the worldwide spread of the pandemic.1 Several authors have found an association between anti-NMDA receptors and COVID-19 encephalitis.2 Confirming the clinical diagnosis of anti-NMDA rece...
Article
Full-text available
Abdo et al. described a series of COVID-19 cases who showed a prolonged comatose state with full consciousness recovery after weeks of clinical evolution. Their patients showed a typical evolution from coma to unresponsive wakefulness syndrome, to PVS, to conscious state. MRI findings showed diffuse restricted diffusion in the corona radiata and su...
Preprint
Full-text available
La muerte encefálica (ME) se basa en un diagnóstico clínico, y se acepta como sinónimo de muerte del individuo.1-6 Se llega a este estado cuando una lesión catastrófica provoca un coma irreversible, con ausencia de reflejos de tronco encefálico y apnea, aunque puede ocurrir con lesiones primarias del tronco encefálico sin una elevación importante d...
Article
Full-text available
Guillain-Barré Syndrome (GBS) is an acute, post-infectious immune-mediated polyradiculoneuropathy typically arising a few days to 6 weeks after bacterial or viral infections, including Campylobacter jejuni, Haemophilus influenzae, Mycoplasma pneumoniae, influenza, Epstein-Barr virus, cytomegalovirus, and more recently, Zika virus.1,2 The possibilit...
Article
Full-text available
Introduction: Drug-resistant extratemporal epilepsy is the second cause of referral to epilepsy surgery. Objectives: To identify factors associated with short-term seizure recurrence following extratemporal epilepsy surgery. Materials and Methods: We performed a retrospective study of 19 consecutive patients who underwent surgery for drug-resistant...
Method
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Presentamos este Informe de Trabajo como Tributo a la Memoria del Prof. PROFESOR MARIO ESTÉVEZ BÁEZ) En el transcurso de los últimos tres años este colectivo de trabajo ha logrado asimilar y aplicar de manera creadora un conjunto de métodos para el procesamiento digital de señales biológicas de alto significado clínico-fisiológico para las neuroci...
Preprint
The paper discusses and provides support for diverse processes of brain plasticity in visual function after damage in infancy and childhood in comparison with an injury that occurs in the adult brain. We provide support and description of neuroplastic mechanisms in childhood that do not seemingly exist in the same way in the adult brain. Examples i...
Article
Full-text available
Coolen et al.1 published valuable research exploring the existence of structural brain abnormalities by MRI studies in nonsurvivors of COVID-19. They described cortico-subcortical edematous changes suggestive of posterior reversible encephalopathy syndrome (PRES) in 1 decedent. The most accepted theory of PRES is a loss of autoregulation in cerebra...
Article
Full-text available
The fast Fourier transform (FFT) has been the main tool for electroencephalo-graphic (EEG) Spectral Analysis (SPA). However, as the EEG dynamics show nonlinear and non-stationary behavior, results using the FFT approach may result meaningless. A novel method has been developed for the analysis of nonlinear and non-stationary signals known as the Hi...
Article
Full-text available
In this paper, I review the case of Jahi McMath, who was diagnosed with brain death (BD). Nonetheless, ancillary tests performed nine months after the initial brain insult showed conservation of intracranial structures, EEG activity, and autonomic reactivity to the “Mother Talks” stimulus. She was clinically in an unarousable and unresponsive state...
Article
Full-text available
We read with interest the paper by Suh et al.1 The authors concluded that muscle and nerve damage was secondary to inflammatory response and cytokine storm, rather than direct viral infection. Nonetheless, the authors did not perform histopathologic examinations in symptomatic patients. Consequently, viral RNA may have been cleared from muscle and...
Article
Full-text available
The World Brain Death Project addresses discrepancies in clinical guidelines across different countries and focuses attention on the need for better education and certification of clinicians who are authorized to make this clinical diagnosis. The World Brain Death Project published an outstanding paper formulating a consensus statement of recommend...
Article
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The World Brain Death Project has formulated a consensus report of endorsements on determination of brain death by neurologic criteria (BD/DNC). We agree with the authors that substantial variability in BD/DNC protocols worldwide remains, which might partially explain why quarrelsome suspected brain dead patients have lately raised up new disputes...
Article
Full-text available
SARS-CoV-2 (CoV-2); COVID-19; coronavirus; pandemic; smell; anosmia; taste; ageusia. The disease caused by 2019 new coronavirus (2019-nCoV) was named coronavirus disease-19 (COVID-19) by the World Health Organization in February 2020. Primary non-specific reported symptoms of 2019-nCoV infection at the prodromal phase are malaise, fever, and dry co...
Article
Full-text available
I read with interest the paper by Lewis et al. to identify the countries in the Latin America/Caribbean Group of the United Nations (GRULAC) that have protocols for brain death/death by neurologic criteria (BD/DNC). Curiously, the authors don’t mention Cuba, which has been one of the most active countries in the area, since the early ’90s. The firs...
Article
Full-text available
One of the most dreadful complications that can occur during the course of COVID-19 is the cytokine storm—also known as cytokine release syndrome—a form of systemic inflammatory response syndrome triggered by SARS-CoV-2 infection. The cytokine storm is an activation cascade of auto-amplifying cytokines, which leads to excessive activation of immune...
Article
Full-text available
The RUDDA affirms that the “medical standards” should be based on the AAN guidelines, (1) but it is necessary to discuss the use of ancillary tests, especially in primary posterior fossa lesions. Although Jahi McMath fulfilled clinical DNC criteria, the preservation of intracranial structures, EEG over 2 μV, conservation of HRV components, and auto...
Article
Full-text available
We read with interest the paper of Hariyanto and Kurniawan about obstructive sleep apnea (OSA) and outcomes from COVID- 19 disease. The most dreadful complication during COVID-19 is the cytokine storm (CS). Dr. Machado has emphasize about the close relationship between hypoxemia and CS, suggesting the need to prevent periods of hypoxemia in the ear...
Article
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BACKGROUND AND OBJECTIVE: This study examines the effect on third-grade students’ academic achievement and their pleasure and interest in lessons due to the incorporation of music into science classes. MATERIAL AND METHODS: Sixty-third-grade Arab school children were studied before and after listening to a Mozart Concerto. Their pleasure and inter...
Article
Full-text available
Ménière's disease (also known as Ménière's vertigo) is a condition characterized by disabling recurrent vertigo, sensorineural hearing loss, otic fullness, and tinnitus. There are various treatments to manage this entity, however, in certain cases, the lack of improvement with less aggressive strategies and the great impact on the quality of life o...
Article
Full-text available
Ménière's disease (also known as Ménière's vertigo) is a condition characterized by disabling recurrent vertigo, sensorineural hearing loss, otic fullness, and tinnitus. There are various treatments to manage this entity, however, in certain cases, the lack of improvement with less aggressive strategies and the great impact on the quality of life o...
Article
Full-text available
Intradural disc herniation is a rare entity, representing between 0.26% and 0.30% of all herniated discs. 92% of cases occur in the lumbar spine, more frequent at the L4-L5 level. The diagnostic and therapeutic conduct performed in a 61-year-old male patient who came to the office with a one-year and six-month history of dorsolumbar pain is describ...
Article
Full-text available
We read with interest the paper by Oosthuizen et al. describing a patient complaining of SARS-CoV-2 encephalitis with clinical cerebellar manifestations. CT and MRI findings showed features consistent with brainstem encephalitis, reflecting brainstem-cerebellar connection damage.1 Most anti-amphiphysin I antibodies react with the C terminus of amp...
Article
Full-text available
Matiello et al.1 discussed the use of teleneurology (TN) to offer neurologic consultations on the determination of death by neurologic criteria (DNC), a crucial topic of discussion during the current pandemic. Patients' care was mainly the responsibility of fellowship-trained intensivists, which may explain why 42% did not fulfill BD/DNC criteria....
Thesis
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En diciembre de 2019, en la ciudad de Wuhan, China comenzó la terrible pandemia de Covid-19, que hasta el día hoy ha afectado a 55,207,050 pacientes, con un total de 1,330,203 fallecidos, números que crecen cada día. Esta pandemia es sólo comparada con la llamada “Fiebre Española”, ocurrida en 1918. El virus causante de esta enfermedad es el SARS-C...
Thesis
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Nota: Estos lineamientos se publicaron en el año 1992. Como fueron las bases para que la Comisión Nacional para el Diagnósitico de la Muerte en Cuba redactara y propusiera al Ministro de Salud la "Resolución 90 de Salud", que legaliza en el territorio nacional el diagnóstico y la determinación de la muerte, creo que es importante que se conozca por...
Article
Full-text available
Frontera et al conducted a large cohort study in patients with COVID-19. These authors found that the most common diagnoses were toxic/metabolic encephalopathy, seizure, stroke, and hypoxic/ischemic injury. They affirmed that no patient suffered meningitis/encephalitis or myelopathy/myelitis ascribable to SARS-CoV-2 infection,1 although other autho...
Article
Full-text available
Lewis et al.1 developed the largest and most complete assessment ever performed for identifying similarities and differences in protocols on determination of brain death/death by neurologic criteria (BD/DNC). The authors found substantial variability in protocols, which might partially explain why quarrelsome brain-dead cases have recently raised u...
Preprint
Full-text available
Covid-19 pandemic has captivated scientists to investigate if this new disease can affect the central nervous system (CNS). The most challenging symptoms of Covid-19 are related to respiratory distress, and most patients admitted in intensive care units cannot breathe by their own. Therefore, a crucial question is if respiratory distress can be par...
Article
Full-text available
BACKGROUND AND OBJECTIVE: This study examines the effect on third-grade students’ academic achievement and their pleasure and interest in lessons as a result of the incorporation of music into science classes. MATERIAL AND METHODS: Sixty, third-grade Arab school children were studied before and after listening to a Mozart Concerto. Their pleasure a...
Article
Full-text available
BACKGROUND AND OBJECTIVE: This study examines the effect on third-grade students’ academic achievement and their pleasure and interest in lessons as a result of the incorporation of music into science classes. MATERIAL AND METHODS: Sixty third grade Arab school children were studied before and after listing a Mozart Concerto. Their pleasure and int...
Article
Full-text available
BACKGROUND AND OBJECTIVE: This study examines the effect on third-grade students’ academic achievement and their pleasure and interest in lessons as a result of the incorporation of music into science classes. MATERIAL AND METHODS: Sixty third grade Arab school children were studied before and after listing a Mozart Concerto. Their pleasure and in...
Article
Full-text available
Most authors consider that the systemic expression of this disease, such as the cytokine storm, immune-mediated inflammatory syndromes, and hypercoagulability, are responsible for the majority of neurologic complications. Nonetheless, the direct invasion of the virus to the CNS is an important contributing factor (1,2). Neurotropism is a common fea...
Article
Full-text available
Young and Edlow approached a crucial dilemma, related to the development of novel neurotechnologies to assess persons with DoC, considering that pitfalls may occur in behavioral clinical bedside exploration.1 Current development of groundbreaking neuroimaging and electrophysiologic methodologies has provided a new framework to detect vestiges of aw...
Article
Full-text available
I read with interest the paper by LaRovere et al. to comprehend the variety and severity of neurologic involvement among children and adolescents with COVID-19 (1). Several papers of life-threatening neurologic involvement have appeared about children and adolescent patients developing multisystem inflammatory syndrome (MIS-C), which is a fairly in...
Article
Full-text available
Darby et al. discussed if telemedicine technology (TT) can be reliably used for the determination of brain death/death by neurologic criteria (BD/DNC).1 It is necessary to discuss several possible caveats. Of course, the remote examiners should be experienced and well-informed specialists in the BD/DNC diagnosis. To fulfill the clinical assessment...
Article
Full-text available
The authors affirm that single brain death (SBD) suffices, favoring organ donation outcomes.1 However, whether to use ancillary tests in BD/DNC confirmation raises further discussion.2 The 2010 AANPP affirmed that BD/DNC is based in a clinical diagnosis, and ancillary tests are only recommended when specific components of the clinical testing canno...
Article
Full-text available
Related to my earlier publications on central nervous system involvement in COVID-19,[1,2] I would like to stress the importance of diagnosing obstructive sleep apnea syndrome (OSAS) in infected patients, prompting early use of continuous positive air pressure (CPAP) to prevent hypoxemia. OSAS is commonly related to obesity, which is considered an...
Article
Full-text available
I read with interest the paper by Ismail and Gad. These authors demonstrated in a COVID-19 patient who developed during the recovery phase, offensive odor (cacosmia) and taste (cacogeusia). What is interesting in this case is that Magnetic resonance imaging (MRI) of the brain revealed normal findings, including the olfactory bulbs and sulci, showin...
Article
Full-text available
read with interest the paper by Nishijima et al. who described a reversible thalamic lesion in a patient with atezolizumab-induced encephalitis, before and after immunotherapy.1 This publication appears while several authors have also reported reversible encephalopathy bilateral thalamic lesions after SARS-CoV-2 infection.2,3 Acute necrotizing enc...
Article
Full-text available
Abdo et al. described a series of COVID-19 cases that showed a prolonged comatose state with full consciousness recovery after weeks of clinical evolution.1 Their patients showed a typical evolution from coma to unresponsive wakefulness syndrome, to PVS, to conscious state. MRI findings showed diffuse restricted diffusion in the corona radiata and...
Article
Full-text available
OSAS has been considered by some authors an important risk factor for severe Covid-19. Risk factors for mortality in COVID-19, such as cardiovascular and cerebrovascular complications or comorbidities, for example hypertension, heart failure, coronary artery disease, cerebrovascular diseases, diabetes mellitus, and obesity are commonly seen in OSAS...