Neuroimaging techniques including magnetic resonance spectroscopy

James C. Johnston, MD, JD, is a board-certified neurologist and attorney whose current work focuses on global health issues in sub-Saharan Africa. He serves as an Honorary Professor in the Department of Neurology, Addis Ababa University, Ethiopia. In his quest to advance neurological care across the globe, Dr. James C. Johnston also serves as a Partner in Global Neurology Consultants and is the Founder and Director of Global NeuroCare, an NGO with UN Special Consultative Status.

Neuroimaging is an integral part of neurological practice for Dr. James C Johnston, whether in the United States or Africa. Neuroimaging entails the use of various techniques to directly or indirectly investigate the status of the brain or spine, and may include CT scans, MRI (magnetic resonance imaging), PET (positron emission tomography), ultrasonography, and functional imaging modalities. These tests are crucial for the accurate diagnosis and treatment of many patients with neurological diseases or disorders.

Magnetic resonance spectroscopy (MRS) is a non-invasive diagnostic test used to detect biochemical or metabolic changes in the brain, particularly for brain tumors as well as to detect tissue changes during strokes or epilepsy and evaluate Alzheimer’s disease and other conditions. This testing is typically performed in conjunction with more conventional studies in order to provide the most accurate diagnosis. For example, MRI may delineate the anatomical position of a brain tumor, while MRS detects the difference in chemical composition between normal brain tissue and the tumor which may, for example, allow differentiation of low grade from high grade gliomas, or distinguish recurrent brain tumor from radiation induced necrosis.

A conventional MRI machine is used to conduct MRS, which aims to analyze molecules such as protons or hydrogen ions. Proton MRS is the most common type of test. The spectroscopy consists of an additional series of tests to measure various metabolites of the metabolic processes, in order to differentiate between the various types of tissue and allow the most accurate diagnosis.

Many of these neuroimaging techniques including MRI are available globally, although scarce in the low resource nations. There are, for example, numerous CT machines and several MRI facilities in Addis Ababa, Ethiopia, but availability in the rural areas is limited to nonexistent, which precludes the accurate diagnosis and treatment of many patients. Dr. James C Johnston and one of his Ethiopian colleagues Dr. Mehila Zebenigus work through Global Neurocare to raise these concerns with various professional organizations, university medical centers, the World Health Organization and the United Nations.

Basic Tips for Avoiding COVID-19

James C. Johnston MD, JD is a Consultant Neurologist with particular expertise in global health. As founder and director of Global NeuroCare, Dr. James C. Johnston has addressed a number of questions regarding SARS-CoV-2 (also called COVID-19 or the Wuhan virus) including the neurological complications of this infection and methods for minimizing the risk of becoming infected.

An obvious step to take in avoiding the infection is to refrain from unnecessary travel, particularly to public areas with high concentrations of people or regions that are seeing a spike in reported cases. Similarly, individuals should avoid direct contact with people who have recently traveled extensively or to destinations like those described above, though social distancing measures should be observed in all person to person encounters and public spaces.

Basic social distancing and hygiene measures include standing at least six feet from other people at all times and frequently and thoroughly washing hands. Hands should be washed with soap and water for at least 20 seconds, especially after being in a public space, after handling a face covering, and before touching the face, handling food or eating. A face cover is recommended when in public. It is also important to clean and disinfect frequently touched areas daily.

Finally, a person demonstrating symptoms of the virus, especially with reason to believe he or she may have been exposed to someone who could be carrying it already, should immediately begin taking the necessary precautions and steps towards isolation and testing, as well as contact his or her physician and employer. Be alert to symptoms including fever, cough, shortness of breath, gastrointestinal symptoms, loss of smell or taste, and virtually any other of a broad array of symptoms as outlined on the CDC website: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html.

Global NeuroCare in Ethiopia

A neurologist with more than three decades of experience, James C. Johnston, MD, JD, has driven operations at Global NeuroCare in the role of director since founding the 501(c)(3) organization in 2008. Under the guidance of Dr. James C. Johnston, the organization works toward enhancing the standards and availability of neurological offerings in university and hospital settings throughout developing countries.

Global NeuroCare maintains a strict set of criteria when it comes to identifying the most in-need regions in which to work. Ethiopia represents one such region, burdened, along with other sub-Saharan African nations, by 24 percent of all global disease but just 3 percent of the world’s healthcare workers. These dire circumstances profoundly impact the more than 100 million people inhabiting the Horn of Africa, at the center of which is Ethiopia.

The complexities of Ethiopia’s medical landscape cannot be understated. Decades of considerable political, social, and economic challenges have left the nation as arguably the most medically underserved region in the world, a situation frequently exacerbated by outbreaks of infectious diseases. Neurological conditions are particularly challenging in the region, as the country has fewer than 40 neurologists, or one for every four to five million individuals.

Global NeuroCare is accredited by the World Health Organization and holds Special Consultative Status with the United Nations ECOSOC which allows James C. Johnston, MD, JD to serve as a Delegate at UN meetings where he focuses recommendations on advancing neurological services in Ethiopia and other developing regions. Please visit www.globalneurocare.org for more information.

Global Neurocare Works with the UN to Combat Neurological Disorders

A prominent neurologist and medical law specialist, Dr. James C. Johnston has been in private practice for nearly 30 years. In addition to his work as a neurologist, James C. Johnston, MD, JD, also serves as a partner with Global Neurology Consultants, where he is mostly concerned with improving health care quality and access in developing regions. To further this vision, Dr. Johnston founded Global Neurocare, a nonprofit organization dedicated to advancing patient care and increasing medical training and research in developing countries such as Ethiopia.

Neurologists are scarce and resources limited in these developing regions, resulting in the needless deaths of those suffering from neurological disorders every day. Global Neurocare was granted Special Consultative Status with the United Nations in 2013, the highest status granted to a non-governmental organization. The Economic and Social Council (ECOSOC) Committee at the United Nations looks at numerous applications to find non-governmental organizations that coincide with the aims and purposes of other United Nations programs.

Members of organizations granted Special Consultative Status are able to serve as UN delegates at sessions in various locations around the world. Global Neurocare’s status with the UN allows it to raise public awareness, implement international trade agreements, and provide expert analysis on relevant issues, among other benefits. Neurological disorders are recognized by the World Health Organization as one of the greatest threats to public health, and organizations such as Global Neurocare are poised to help with the crisis.

“Electronic Fetal Monitoring, Cerebral Palsy, and Medical Ethics”

A Consultant Neurologist in private practice, Dr. James C Johnston holds an MD from the University of Texas Health Science Center, is a Diplomate of the American Board of Psychiatry and Neurology, and an Attorney and Counselor at Law. Dr. James C Johnston is also an accomplished clinical researcher and medical author.

Among Dr. James C Johnston’s numerous peer-reviewed articles on cerebral palsy and electronic fetal monitoring, he published “Electronic Fetal Monitoring, Cerebral Palsy, and Medical Ethics: Nonsense of a High Order” with coauthors Berna Arda and Thomas P Sartwelle. This article appeared on May 2, 1017 in the medical law, health governance, and bioethics journal Medical Law International.

Electronic fetal monitoring (EFM) is employed to monitor the heart activity of unborn babies during the labor process. The inventors of EFM saw great benefits for the prevention of cerebral palsy (CP), believing that the technology could predict CP and allow physicians the time to prevent CP by ordering immediate C-sections.

“Electronic Fetal Monitoring, Cerebral Palsy, and Medical Ethics” demonstrates that EFM has done nothing to combat CP since the technology became the standard of care almost half a century ago. Furthermore, the article describes how EFM harms mothers and babies alike and discusses how physicians relying on EFM violate the fundamental bioethical principles of autonomy, beneficence, and nonmaleficence.

James C. Johnston, MD, JD and his colleagues have also published an article in the 2018 Surgery Journal highlighting the failed arguments of a typical EFM advocate. This article, “Continuous Electronic Fetal Monitoring During Labor: A Critique and Reply to Contemporary Proponents” is freely available in the open access journal or through the following link on Researchgate.net:

https://www.researchgate.net/publication/323614188_Continuous_Electronic_Fetal_Monitoring_during_Labor_A_Critique_and_a_Reply_to_Contemporary_Proponents

The Medical Law International article is also open access and available through Researchgate.net under Dr. James C. Johnston: https://www.researchgate.net/publication/316693326_Electronic_fetal_monitoring_cerebral_palsy_medical_ethics_Nonsense_of_a_high_order.