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In the absence of definitive treatment, vaccination against COVID-19 emerged as an effective solution to the spread of the pandemic. This study aimed to investigate the factors impacting the rates of COVID-19 vaccine acceptance in Jordan, in addition to examining the relationship between COVID-19 risk perception and vaccine acceptance among the Jordanian population.This cross-sectional study was conducted among a sample of adults (aged ≥18) residing in Jordan. Data were collected using an online questionnaire disseminated using social media platforms between December 2nd and December 29th, 2020.A total of 2,268 (72.3%) participants demonstrated willingness to receive the COVID-19 vaccine. The mean COVID-19 risk perception score among the participants was 4.65 out of 10 (median 5; IQR 3-6). Higher risk perception scores were significantly associated with being female (COVID-19 risk perception and certain sociodemographic characteristics (i.e., being male, being young, and having children aged under 18 years) were found to be significantly associated with vaccine acceptance. Policymakers are recommended to develop public educational campaigns to enhance people's trust in and willingness to take the COVID-19 vaccine.

Introduction. Health care providers are at high risk of becoming infected when taking care of patients who have COVID-19, especially while attending aerosol generating procedures. Protective personal equipment must be used in the correct manner to prevent transmission of the disease. Published protocols on protective personal equipment (PPE) donning and doffing have been issued by disease control agencies. Methods. A questionnaire-based cross-sectional study was designed. An online anonymous questionnaire, which was validated and tested for reliability, focused on PPE related knowledge, donning and doffing practices of healthcare providers across the eastern region of Saudi Arabia. Results. A total of 312 healthcare providers across the eastern region of Saudi Arabia participated in the study, 208 physicians (66.7%) and 104 non-physicians (33.3%). Results indicate poor practice regarding PPE donning (13.8% reported the correct sequence) and PPE doffing (3.5% reported the correct sequence) among participants. In addition, practice and confidence scores regarding other issues with PPE were analyzed. Based on questionnaire responses, being male (T=2.825; p=0.008), being a non-physician (T=-2.120; p=0.014) and being an allied medical professional (F=5.379; p=0.003) were significantly associated with higher confidence levels. Also, being a consultant was significantly associated with higher practice scores (F=4.774; p=0.008). Conclusion. The study demonstrates deficiencies among healthcare providers in following the recommended practices for correctly using PPE during the pandemic. Poor practice in PPE donning and doffing necessitates additional educational and training programs focused on infection control practices., Journal of Preventive Medicine and Hygiene, Vol. 62 No. 4 (2021): 2021624

As previously reported, intention-to-treat findings from our phase III randomized clinical trial found that a supplement of 600 mg docosahexaenoic acid (DHA)/day during the last half of pregnancy reduced the incidence of early preterm birth (ePTB

Background:The goal of the study was to analyze the factors associated with quality of life (QoL) in institutionalized older adults with dementia, based on self and proxy ratings, and if these characteristics differ by dementia severity.Methods:Cross-sectional study of 525 people with dementia (PwD) and their caregivers (professional or family caregivers). Two different QoL questionnaires, leading to three measures, were used: QoL in Alzheimer's disease scale (QOL-AD), self and proxy-rated, and QoL in late-stage dementia scale (QUALID), proxy-rated. Multivariate linear regression models were tested for each QoL measure and for mild/moderate and severe stages of dementia.Results:Multiple regression analyses showed a significant association between the three QoL measures and depression. Functional ability was significantly associated with QoL when assessed by proxy. Other factors such as education level, leisure activities and frequency of visits were significantly related with QOL-AD by proxy. The associated factors that differed by dementia severity were education level for moderate dementia, and frequency of visits and who answered the questionnaire (professional vs. family member) for severe dementia.Conclusions:QoL was consistently associated with depressive symptoms independently of the measures as well as functional ability and social leisure activities when the QoL questionnaire was rated by proxy. Treating depressive symptoms, increasing social activities and maintaining the functional ability may decrease the deterioration of QoL in institutionalized older adults with dementia.

From 1983 to 1990, 234 patients with one or several cerebral arterial aneurysms were surgically treated in our department. Since 1983, we have been performing surgery as early as possible. As soon as the subarachnoid hemorrhage diagnosis is confirmed by computed tomography (or if unconfirmed, by lumbar puncture), we assume that each patient may have an aneurysm. Between 1987 and 1990, 111 patients were treated by vascular volume expansion (maintenance of central venous pressure above 5 cm H2O with 4% albumin or Ringer-lactate or, if necessary, with 20% albumin), which we supplemented with calcium antagonists (nimodipine in 60 patients and nicardipine in 51 patients). Two months after being discharged, each patient is examined by a neurosurgeon and, on the same day, is subjected to a neuropsychological evaluation and a computed tomographic scan of the brain. A few months after this consultation, a working-position/family-activities questionnaire is issued to the patient. All of the results studied on the basis of postoperative mortality, second-month computed tomographic scan ischemia, neuropsychological evaluation, and return to work show no significant difference between the groups with or without calcium antagonists or between the nimodipine and nicardipine subgroups.

As life expectancy increases and spinal imaging techniques improve, surgery is being increasingly viewed as a therapeutic alternative for symptomatic lumbar spinal stenosis in patients older than 80 years. Thirty-four patients (21 men and 13 women) who had surgery for lumbar spinal stenosis in our department between 1979 and 1994 were studied retrospectively. The most common initial symptoms were walking-related disorders (n = 29) and sciatica or femoral neuralgia (n = 34). All 34 patients underwent laminectomy at one or more levels. Ten patients also had a herniated disk. There were no deaths and only two patients had serious complications (persistent foot drop in one and left-sided hemiplegia in the other). Results were evaluated immediately after surgery and after three and 12 months. The overall result on pain and walking-related disorders was good in 53% of cases, acceptable in 32%, and poor in 15%. Our data suggest that surgery is a reasonable alternative in symptomatic elderly patients who are in good general health. Satisfactory results can be obtained although disabling complications can occur.

While reviewing a series of 138 cerebellar tumors operated upon between 1978 and 1991, the authors could only find 2 glioblastomas and 8 anaplastic astrocytomas, occurring in 4 children (3 to 14 years old) and 6 adults (23 to 48 years old). These 10 cases represent 2% of the all malignant gliomas population observed during the same period of time. Clinically speaking, nothing makes these tumors different from other cerebellar ones. However, with an heterogenous image and an irregular contrast enhancement, the CT (scan) appearance can lead to the diagnosis. 7 lesions develop within the cerebellar vermis (vermis cerebelli) and 3 develop within the cerebellar hemisphere. Total surgical resection is performed in 9 cases and subtotal resection in 1 case (because of the extension to the floor of the fourth ventricle). Adjunctive radiotherapy on their posterior cranial fossa is achieved in 8 cases. The 2 patients with a glioblastoma present with a recurrence of their tumor at 15 months and 6 years respectively, and eventually died. Out of the patients with an anaplastic astrocytoma, 4 are still alive without recurrence and with a median follow-up of 7 years. The pathogenesis of such lesions is discussed. An aggressive therapeutic management is suggested because of the possible prolonged survival rate.

Two new cases of cauda equina metastases from visceral cancers are reported. This diagnosis is only infrequently considered in patients with intra-dural lesions visualized by magnetic resonance imaging or saccoradiculography. The diagnosis is especially difficult in patients with no known primary cancer. Diagnosis rests on surgery during which only a biopsy is performed. Treatment is symptomatic and focuses on relieving pain. Prognosis is bleak.

Two retrospective series of early operated cerebral arterial aneurysms are compared. One series involves 74 patients treated from 1983 to 1987 by vascular volume expansion only. The other series involves 75 patients treated from 1987 to 1990 by vascular volume expansion associated by calcium antagonists (nimodipine or nicardipine). The conclusion is that in our experience, calcium antagonists do not improve the outcome (mortality, cognition findings and return to work) obtained by vascular volume expansion alone. Moreover they put forward that there is no difference between the patients treated by nimodipine and those treated by nicardipine.

Early examination (3 months) of 81 patients, operated on for ruptured cerebral aneurysms, by neurosurgeons and neuropsychologists show significant differences between them both; the neuropsychological evaluation has the best predictive value as far as the outcome is concerned especially regarding the return to their initial job (69% after a year in this series). The outcome also depends on the age, the preoperative grade, and the professional qualification. The aneurysm location and the date of the operation are not so important. Early neuropsychological evaluation enable us to start a rehabilitation program for socio professional reinsertion and to improve the quality of life.

The efficiency of neuronal grafts is correlated with the differentiation of the grafted cells and the connections they establish with the host tissue. The prolonged survival of a chromaffin cell line (PC12) transplanted into an immunodepressed rat brain shows that neuronal differentiation is correlated with the amount of nerve growth factor (N.G.F.) present in the grafted structure. This result is in agreement with in vitro studies. The characterization of other factors that influence the differentiation of PC12 cells in culture could lead to an increase in the efficiency of intracerebral grafts of adrenal medulla cells in Parkinson's disease.

Recently, it has been demonstrated that symptomatic epidural calcifications represent a complication of intradiscal injection of triamcinolone hexacetonide (Hexatrione). Out of our three cases, pathological examination showed lesions of necrosis with granulomatous inflammatory reaction and bone metaplasia. Necrosis seems to be the primary cause of calcifications so we propose to call the lesion inflammatory and necrotic granuloma. The incidence of these granulomas is unknown. They are unpredictable and appear with a mean range of a year following the intradiscal injection. The treatment is surgery if they become symptomatic.

The authors report a case of sacral osteosarcoma, which is a rare and dreaded tumor. Sciatica was the first manifestation. Patients with refractory sciatica and normal plain films and computed tomography studies of the lumbar spine should undergo magnetic resonance imaging to look for a sacral lesion.