Refusal of care is a frequent occurrence in geriatric medicine, especially among people with neurocognitive diseases, particularly in the advanced stages. These refusals of care are a daily burden, not only for the patients themselves, but also for their carers and caregivers. Although they can be prevented, the absence of a single, simple strategy for overcoming them is a real challenge for professionals and carers alike. Their management calls for an approach that is essentially non-pharmacological, always interdisciplinary, humanistic and ethically grounded.

Childhood is recognised as a period of immense physical and emotional development, and this, in part, is driven by underlying neurophysiological transformations. These neurodevelopmental processes are unique to the paediatric brain and are facilitated by augmented rates of neuroplasticity and expanded neural stem cell populations within neurogenic niches. However, given the immaturity of the developing central nervous system, innate protective mechanisms such as neuroimmune and antioxidant responses are functionally naïve which results in periods of heightened sensitivity to neurotoxic insult. This is highly relevant in the context of paediatric cancer, and in particular, the neurocognitive symptoms associated with treatment, such as surgery, radio- and chemotherapy. The vulnerability of the developing brain may increase susceptibility to damage and persistent symptomology, aligning with reports of more severe neurocognitive dysfunction in children compared to adults. It is therefore surprising, given this intensified neurocognitive burden, that most of the pre-clinical, mechanistic research focuses exclusively on adult populations and extrapolates findings to paediatric cohorts. Given this dearth of age-specific research, throughout this review we will draw comparisons with neurodevelopmental disorders which share comparable pathways to cancer treatment related side-effects. Furthermore, we will examine the unique nuances of the paediatric brain along with the somatic systems which influence neurological function. In doing so, we will highlight the importance of developing in vitro and in vivo paediatric disease models to produce age-specific discovery and clinically translatable research.

Sexual dimorphisms exist in multiple domains, from learning and memory to neurocognitive disease, and even in the immune system. Male sex has been associated with increased susceptibility to infection, as well as increased risk of adverse outcomes. Sepsis remains a major source of morbidity and mortality globally, and over half of septic patients admitted to intensive care are believed to suffer some degree of sepsis-associated encephalopathy (SAE). In the short term, SAE is associated with an increased risk of in-hospital mortality, and in the long term, has the potential for significant impairment of cognition, memory, and acceleration of neurocognitive disease. Despite increasing information regarding sexual dimorphism in neurologic and immunologic systems, research into these dimorphisms in sepsis-associated encephalopathy remains critically understudied. In this narrative review, we discuss how sex has been associated with brain morphology, chemistry, and disease, sexual dimorphism in immunity, and existing research into the effects of sex on SAE.

Neurocognitive disorders are a group of disorders characterized by an impaired cognition which has not been present since birth or very early life and represents a decline from a previous attained level of functioning. The case we studied is M.E., a 62 years female, married, from rural area, working as a tailor, without any psychiatric history. She develops psychiatric symptoms during Covid-19 infection and treatment, in November 2020. The patient has been admitted in psychiatric care, in that time, for about one month, for a persistent confusion state during and after this event. These symptoms diminish the patient\'s level of functioning and seemed to be related with the Covid-19 infection or treatment. Psychological investigation underlines a MMSE 14, severe impairment in attention, short-term and long-term memory. CT evaluation presents normal relation except a moderate general atrophy, according with patient\'s age. Differential diagnosis will be discussed. The treatment has proven its effectiveness, the patient regaining her ability to orientate, could do housework, good improvement in attention and short-term memory. We emphasize that there is correlation between the Covid-19 infection and confusive state and delirium in patients, as a comorbidity, followed in many cases by chronic progressive neurocognitive disorder, especially in elderly.

The awareness of the global trends in neuroscience study, especially in the cognitive neuroscience field, should be increased. One notable approach is the use of transcranial magnetic stimulation (TMS) not only as a research tool but also as a choice for treatment and rehabilitation in neurological disorders, such as post-stroke hemiplegia, visuospatial neglect syndrome, Alzheimer\'s disease (AD) and psychiatric conditions such as major depression and schizophrenia. All of these occur in significant numbers in highly populated regions. This paper briefly discusses the basic protocols and potential benefits of using TMS with the aim of providing insight that is useful in the design of future public health strategies in highly populated regions with a large neurocognitive burden of disease where this technique is currently underemployed.