Neuroelectric assessment of HIV: EEG, ERP, and viral load.

The effects of the human immunodeficiency virus (HIV) infection on the central nervous system function were studied with electroencephalographic (EEG) and auditory event-related brain potentials (EPRs) in patients infected with HIV and unaffected young adult control subjects (n=10/group). All subjects were assessed once every 15 min for four trial blocks at the same time of day to assess EEG/ERP changes with time on task-induced fatigue. Spectral analysis was applied to the pre- and post-stimulus EEG segments. ERP values were evaluated with respect to group differences for component amplitude and latency measures. Spectral analysis demonstrated that HIV patients evinced greater pre-stimulus delta power over frontal areas compared to control subjects, and less post-stimulus spectral power for the delta, theta, and alpha bands over the central/parietal areas. P300 amplitude was smaller, and latency was marginally longer for the HIV patients compared to control subjects. P300 latency correlated positively with increases in the patient HIV viral load. Time-on-task generally did not affect EEG or ERP measures for either group other than contributing to an overall decrease in neuroelectric responsivity. Group spectral power effects were consistent with differences in arousal/fatigue level. P300 group differences were consistent with declines in cognitive capability, and P300 latency increased with increased viral load. HIV infection negatively affected central nervous system function as measured by EEG and cognitive ERPs in a manner that suggests decreased arousal and increased fatigue in HIV patients.     

Diffuse malignant peritoneal mesothelioma in a 31-year-old patient--case report

This is a case report of a diffuse malignant peritoneal mesothelioma in a 31-year-old woman. The patient presented with pains in the small pelvis followed by abdominal distension. By pelvic ultrasonography a tumorous mass of cystic architecture was verified in the small pelvis. She was submitted to laparoscopy. The diagnosis of the disease was established by histopathological examination of the material sample taken during laparoscopy. The patient was subsequently submitted to laparotomy upon which peritonectomy, omentectomy and appendectomy were performed. Postoperative combined chemotherapy was given. The patient has been well since completion of the treatment.     

Ipsilateral Malignant Axillary Lymphadenopathy and Contralateral Reactive Lymph Nodes in a COVID-19 Vaccine Recipient With Breast Cancer

Vaccine-related axillary nodal enlargement is a common benign condition that many mRNA vaccine receivers experience. However, a false attribution of axillary swelling to vaccination may result in delay in cancer care and potential disease progression, particularly in breast cancer patients presenting with ipsilateral axillary lymphadenopathy. We report the case of a 41-year-old pre-menopausal female who presented with suspicious axillary nodal enlargement and a right breast lump (triple-negative invasive ductal carcinoma) after recent administration of the second dose of Moderna mRNA coronavirus disease 2019 (COVID-19) vaccine. On imaging, bilateral axillary lymph nodes were detected. The ipsilateral right-sided node was proven to be metastatic, whereas contralateral nodes were related to a recent mRNA COVID-19 vaccination. Right-sided lymph node had intense uptake (maximum standardized uptake value [SUVmax] = 5), while the contralateral reactive nodes were mildly avid (SUVmax = 2.6). On magnetic resonance imaging, the right-sided node revealed asymmetric cortical thickening and marked cortical enhancement as opposed to normal-appearing left-sided nodes.     

Supracardiac Total Anomalous Pulmonary Venous Return Repair in a 7-Month-Old Infant

Total anomalous pulmonary venous return is a congenital heart malformation characterized by anomalous pulmonary venous inflow to the right atrium. Surgical repair typically occurs during the first month of life, and survival beyond that age in untreated patients is unlikely. We report an extreme case of supracardiac total anomalous pulmonary venous return in an infant who survived 7 months despite atypical anomalous inflow without atrial-level communication and with right-to-left shunting only through a patent ductus arteriosus. We stabilized the patient''s left-sided heart function before surgically repairing the anomalous venous return 2 months later. Three years postoperatively, the patient was well.     

Botulinum Neurotoxin Injections in Childhood Opisthotonus

Opisthotonus refers to abnormal axial extension and arching of the trunk produced by excessive contractions of the paraspinal muscles. In childhood, the abnormal posture is most often related to dystonia in the setting of hypoxic injury or a number of other acquired and genetic etiologies. The condition is often painful, interferes with ambulation and quality of life, and is challenging to treat. Therapeutic options include oral benzodiazepines, oral and intrathecal baclofen, botulinum neurotoxin injections, and deep brain stimulation. Management of opisthotonus within the pediatric population has not been systematically reviewed. Here, we describe a series of seven children who presented to our institution with opisthotonus in whom symptom relief was achieved following administration of botulinum neurotoxin injections.     

Are golden jackals (Canis aureus) definitive hosts for Angiostrongylus vasorum?

Angiostrongylosis caused by Angiostrongylus vasorum is an emerging disease in Europe. Recent reports have shown that, besides the red fox (Vulpes vulpes) recognized as the main definitive host and reservoir for the parasite, the role of the definitive host can be taken by a range of mammals. We considered that, due to the rapid large‐scale expansion of its populations in Europe, the golden jackal (Canis aureus) could assume an important role in the epidemiology of the disease. The aim of the investigations was to explore the role of the golden jackal as the definitive host for A. vasorum. Sixty‐three golden jackals, legally hunted in lowlands around the Danube River in Serbia recognized as the core area of the species' distribution in Europe, were subjected to patho‐morphological and parasitological examination. The adult forms of A. vasorum were detected in the pulmonary arteries in six golden jackals with gross lesions manifested in the lungs. The finding of first stage larvae (L1) of A. vasorum in microscopic smears of the lung tissue altered by infection, which was consistent with the presence of adult parasites and manifestation of gross lesions in the lungs, confirms the successful reproduction of the parasite in the golden jackal. Migration of L1 from the blood vessels to the airways was confirmed by histopathology and, subsequently, their shedding was demonstrated by the Baermann method. The results support the hypothesis that the golden jackal acts as a suitable definitive host for A. vasorum. As a definitive host with a large‐scale expansion of its populations in Europe, the golden jackal may be an important part of the parasite's host repertoire by spreading the parasite into previously non‐endemic areas and by being an additional definitive host in endemic areas of vulpine angiostrongylosis.     

Self-injurious behavior in Tourette syndrome

Journal of Neurology - Tourette syndrome (TS) is characterized by the presence of motor and phonic tics, as well as a variety of behavioral co-morbidities. Self-injurious behavior (SIB) is one of...     

TLR2, TLR3, TLR4 and CD14 gene polymorphisms associated with oral lichen planus risk

The aim of this study was to assess whether polymorphisms in toll‐like receptor (TLR) and cluster of differentiation 14 (CD14) genes are associated with oral lichen planus (OLP) risk and clinical course of the disease. The study group consisted of 101 patients with confirmed OLP and 104 healthy blood donors without systemic or oral mucosal diseases. Single nucleotide polymorphisms of TLR2 (rs3804099), TLR3 (rs3775291 and rs5743312), TLR4 (rs4986790 and rs4986791), and CD14 (rs2569190) genes were genotyped using real‐time PCR or PCR‐restriction fragment length polymorphism (PCR‐RFLP). The rs5743312 TLR3 gene polymorphism was associated with increased OLP risk in comparison with the wild type genotype (OR = 15.984, P = 0.011). No association with OLP risk was observed for the polymorphisms studied in TLR2, TLR4 and CD14 genes or for the rs3775291 polymorphism of the TLR3 gene. The polymorphisms of the TLR3 gene were in linkage disequilibrium (D′ = 1, r² = 0.1). Identified haplotypes were not associated with the risk of OLP. The findings of the current study suggest that the TT genotype of the rs5743312 TLR3 gene polymorphism may play a significant role in the aetiology of OLP.