Wilson disease: copper deficiency and iatrogenic neurological complications with zinc therapy

A 17‐year‐old female was diagnosed with Wilson disease and commenced on oral zinc therapy. She re‐presented 6 months later with a fall and had classical signs of subacute combined degeneration of the spinal cord confirmed on nerve conduction studies, as a result of zinc‐induced copper deficiency. After 6 months of copper therapy, she made a complete recovery with no residual neurological deficits. Early detection of zinc‐induced copper deficiency and stringent follow‐up mechanisms are crucial. Early initiation of copper replacement may both limit and completely reverse neurological deficits.     

Increased serum level of soluble receptor for advanced glycation end products (sRAGE) in type 2 diabetic patients with nephropathy

Activation of the receptor for advanced glycation end products (RAGE) has been implicated in the development of diabetic vascular complications. Soluble RAGE (sRAGE) could act as a decoy for the RAGE ligands and may thus exert a cytoprotective effect. Since RAGE is upregulated by advanced glycation end products (AGEs), the same could be implied for sRAGE. We aimed to investigate the role of sRAGE as a marker of early diabetic nephropathy. Forty-eight type 2 diabetic patients, further subdivided into group 1 without renal affection (10 patients), group 2 with microalbuminuria (25 patients), and group 3 with proteinuria (13 patients), and age-matched control group 4 (17 subjects) were included. Serum sRAGE, urea, creatinine, plasma glycated hemoglobin (HBA1c), and urinary albumin excretion (albumin/creatinine ratio) were measured. sRAGE levels were significantly higher in groups 2 and 3when compared to groups 1 and 4. No significant difference was found on comparing groups 2 and 3 together or on comparing groups 1 and 4. There was a significant positive correlation between sRAGE level and all the studied parameters (p?<?0.05) as well as a significant association between the sRAGE positivity within the three diabetic groups and the degree of proteinuria. Although sRAGE level was found to be significantly higher in the microalbuminuria group when compared to both the control and diabetics with normal kidney groups, the absolute value did not differ significantly from the proteinuria group. So we say that sRAGE can be used as a marker of diabetic nephropathy; however, its absolute level cannot be used to distinguish different degrees of renal affection.     

Central projections of lagenar primary neurons in the chick

Perception of linear acceleration and head position is the function of the utricle and saccule in mammals. Nonmammalian vertebrates possess a third otolith endorgan, the macula lagena. Different functions have been ascribed to the lagena in arboreal birds, including hearing, equilibrium, homing behavior, and magnetoreception. However, no conclusive evidence on the function of the lagena in birds is currently available. The present study is aimed at providing a neuroanatomical substrate for the function of the lagena in the chicken as an example of terrestrial birds. The afferents from the lagena of chick embryos (E19) to the brainstem and cerebellum were investigated by the sensitive lipophilic tracer Neuro Vue Red in postfixed ears. The results revealed that all the main vestibular nuclei, including the tangential nucleus, received lagenar projections. No lagenar terminals were found in auditory centers, including the cochlear nuclei. In the cerebellum, the labeled terminals were found variably in all of the cerebellar nuclei. In the cerebellar cortex, the labeled fibers were found mostly in the uvula, with fewer afferents in the flocculus and paraflocculus. None was seen in the nodulus. The absence of lagenar afferent projections in auditory nuclei and the presence of a projection pattern in the vestibular nuclei and cerebellum similar to that of the utricle and saccule suggest that the primary role of the lagena in the chick lies in the processing of vestibular information related to linear acceleration and static head position. J. Comp. Neurol. 521:3524‐3540, 2013. © 2013 Wiley Periodicals, Inc.     

Rhino-orbito-cerebral mucormycosis during the COVID-19 third wave in 2021: an Egyptian preliminary report from a single tertiary hospital

Neurological Sciences - COVID-19 is a pandemic disease which predominantly affects the respiratory system with high critical care mortality and morbidity; however, it also causes multi-organ...