Background Amyotrophic lateral sclerosis (ALS) is a fatal progressive motor neuron disease. People with ALS demonstrate various speech problems. Summary We aim to provide an overview of studies concerning the diagnosis of ALS based on the analysis of voice samples. The main focus is on the feasibility of the use of voice and speech assessment as an effective method to diagnose the disease, either in clinical or pre-clinical conditions, and to monitor the disease progression. Specifically, we aim to examine current knowledge on: (a) voice parameters and the data models that can, most effectively, provide robust results; (b) the feasibility of a semi-automatic or automatic diagnosis and outcomes; and (c) the factors that can improve or restrict the use of such systems in a real-world context. Key Messages: The studies already carried out on the possibility of diagnosis of ALS using the voice signal are still sparse but all point to the importance, feasibility and simplicity of this approach. Most cohorts are small which limits the statistical relevance and makes it difficult to infer broader conclusions. The set of features used, although diverse, is quite circumscribed. ALS is difficult to diagnose early because it may mimic several other neurological diseases. Promising results were found for the automatic detection of ALS from speech samples and this can be a feasible process even in pre-symptomatic stages. Improved guidelines must be set in order to establish a robust decision model.

Voice-Based Classification of Amyotrophic Lateral Sclerosis: Where Are We and Where Are We Going? A Systematic Review

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)60923-5.pdf

Chronic subdural haematoma secondary to headbanging.

BACKGROUND "Headbanging" is the slang term used to denote violent shaking of one's head in time with the music. This abrupt flexion-extension movement of the head to rock music extremely rarely causes a subdural hematoma. CASE DESCRIPTION A 24-year-old female was admitted to our department because of right sided partial seizure and acute or subacute subdural hematoma over the left cerebral convexity. She had no history of recent head trauma but performed headbanging at a punk rock concert at 3 days before admission. Since, she had a previous acute subdural hematoma on the same side after an accidental fall from a baby buggy when she was 11 months old, the present was recurrent subdural hematoma probably due to headbanging. CONCLUSIONS Headbanging has the hazardous potential to cause a subdural hematoma.

Recurrent subdural hematoma secondary to headbanging: A case report

Risk of internal carotid injury due to peritonsillar abscess drainage.

Neurodegenerative Diseases and Psychosocial Impairment

Because of advances of the fields of anesthesia and surgical techniques, pessary use has gradually decreased. Current clinical indications for using a pessary include patients awaiting surgical repairs, treatment for failure of surgical repair, treatment for women with contraindication to surgery, and individuals who prefer medical management. Uterine prolapses are clinically classified into first, second, and third degrees, with increasing severity. The cube pessary is designed for management of third-degree uterine prolapse. It should be cleaned daily because it has no drainage function. If it is not, it can easily cause urinary tract infection (UTI). Acute pyelonephritis and urosepsis caused by neglected pessaries are rare conditions of urological emergency of older women, who may forget or cannot easily recall the presence of such foreign bodies in their vaginas. A neglected pessary in the vagina may cause complications including disturbance of micturition with incomplete emptying of urinary bladder, chronic cystitis, vesicovaginal fistula, unilateral or bilateral obstructive uropathy, hydronephrosis, pyelonephritis, bacteremia, and even life-threatening urosepsis. Severity of UTI should be related to the patient’s underlying immunocompromised condition, such as diabetes mellitus and debility. Enterobacteriaceae, such as E. coli, originating from the gastrointestinal tract is the most common pathogen with hematogenous spread or ascending infection in UTI. Inability to remove and cleanse pessaries routinely (a frequent problem for older and debilitated individuals) can result in severe vaginitis. In addition to various bacterial pathogens, actinomycosis is commonly noted in association with pessary complications. MDCT is helpful in diagnosis of pyelonephritis in older adults with atypical clinical manifestations and in identifying a foreign body or a pessary in the vagina. The McGeer criteria, which were developed as surveillance criteria at a consensus conference in 1991 and have been used for surveillance, diagnostic, and treatment purposes of UTI in older adults without an indwelling catheter, are presence of any three of fever of 38°C or higher; new or increased burning on urination, frequency, or urgency; new flank or suprapubic pain or tenderness; change in character of urine; and aggravation of mental or functional status or falls, but for clinical diagnosis and treatment of UTI, a urine culture should be required. An invasive UTI, such as pyelonephritis, prostatitis, epididymitis, or secondary bacteremia from a nephrogenic source, can cause systemic nonspecific geriatric manifestations, such as falls and mental status changes. Medical imaging, such as MDCT, is required for patients with atypical clinical presentations, in those who fail to respond to conventional therapy, and in diagnosis of acute pyelonephritis and its complications such as abscess formation. Clinicians should keep in mind the possible presence of a neglected pessary in an older woman with severe UTI.

Common but critical sensation in older adults.

Slow, slurred speech as an initial complaint in amyotrophic lateral sclerosis.

https://www.annalsthoracicsurgery.org/article/S0003-4975(12)01211-8/pdf

Mediastinal Emphysema After Head-Banging in a Rock Artist: Pseudo Shaken-Baby Syndrome in Adulthood

Pitfall in the mouth caused by longevity.

The Centers for Disease Control and Prevention (CDC) alerted public health departments, health care professionals, and first responders of “a concerning acceleration of the increase in drug overdose deaths” coinciding with the emergence of the coronavirus disease 2019 (COVID-19) pandemic and said that the surge in deaths was driven primarily by a rapid rise in overdose deaths caused by synthetic opioids.1 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9040511

Do Hospital Visit Restrictions Cause Increase in the Doses of Morphine in Terminal Care? Spiritual Pain and Palliative Care in the COVID-19 Pandemic

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