bluuebunny/crossref_metadata_2025 huggingface dataset:
“The childhood I was meant to be in”: The Queer Time of Reading
Authors: Pyke Sarah
Published: July 2023

How can attention to queer adults’ childhood reading illuminate the complex temporalities of queer experience—and of reading itself? Developing existing critical work on non-linear time, reading and book use, this article proposes queerness as a mode and oral history as a method for provoking new thinking about reading-in-time and how the manipulation of the material book might facilitate time unfolding differently. Analyzing the Textual Preferences archive, in which ten LGBTQ+ adults reflect on their formative reading, the article shows how recalling and rereading key books from childhood enables readers to produce belatedly legible aspects of their “protoqueer” child-selves. Through encounters with texts by Laura Ingalls Wilder, Ruby Ferguson, Louisa May Alcott, Enid Blyton, Kenneth Grahame, Susan Coolidge and Joanna Trollope, these readers use books to negotiate growing up, to disrupt and defend against the progress of chronological time, and to reshape their past experiences, both in life and in reading.
Detection of Leptomeningeal Carcinomatosis by Cerebrospinal Fluid in a Dog with a Negative MRI
Authors: Al Kafaji Tania , Cantile Carlo , Tocco Fabio , Gallucci Antonella
Published: July 2023

An 11 yr old female French bulldog was presented for acute onset of seizures and a 2 wk history of disorientation. On physical examination, a nodular mass at the fourth mammary gland level was observed. Neurological evaluation showed obtundation and compulsive behavior. Brain MRI study did not reveal any abnormalities. Cerebrospinal fluid (CSF) collected from the cerebellomedullary cistern showed a marked increase of total nucleated cell count (400 cells/μL). Cytological evaluation identified the presence of a monomorphic round cell population characterized by large cell bodies, a single eccentrical located nucleus with high nuclear:cytoplasmatic ratio, and marked atypia with anisocytosis, anisokaryosis, and multiple nucleoli. Leptomeningeal carcinomatosis (LC) was suspected. The dog was euthanatized for worsening of clinical signs. Post-mortem examination identified an anaplastic mammary carcinoma in the nodular mammary mass. Infiltration by neoplastic cells exhibiting the same morphological features was detected along leptomeninges of the telencephalon and cerebellum associated with cortical and subcortical parenchymal micrometastases. To our knowledge, this is the first case of LC in a dog detected by CSF evaluation but without any MRI abnormalities. This finding emphasizes the usefulness of CSF cytology in patients with suspected LC even in the absence of any MRI identifiable lesions.
Fluoroscopy-Guided Surgical Removal of a Microchip from the Spinal Canal of Two Cats
Authors: Mergl Justin , Nutt Laura , Pareja Augusto
Published: July 2023

Two cats were presented with acute left-sided paresis after implantation of a microchip at the referring veterinary clinic. Neurological examinations were consistent with left-sided lesions between spinal cord segments C1 and C5. Orthogonal radiographs of the cervical spine showed a microchip dorsoventrally oriented, partially embedded in the cervical vertebral canal. Fluoroscopy was used to localize and retrieve the foreign body from the cervical spinal cord in each case. Improvement in clinical condition and return to ambulation was observed in both cats within 48 hr of surgical removal of the implant. No significant perioperative adverse events were noted during the surgical retrieval of the microchip. Two previously reported cases of intraspinal canal microchip placement had been treated surgically by hemilaminectomy. This approach carries a risk of complications, including hemorrhage from the venous sinus, iatrogenic damage to the spinal cord, and improper identification of the surgical site, requires advanced surgical training, and typically has an extended surgical time. The use of fluoroscopy to assist intraoperative localization of a spinal canal foreign body may lessen the requirement for more invasive surgical procedures.
Schistosomal myeloradiculopathy: a case report of a disease that still exists
Authors: Novais Aurea Maria Lago , Reis Jerusa Ataides , Oliveira Jayne Carvalho de , Branco Renan Carvalho Castello
Published: July 2023

Introduction: Schistosomiasis affected 164 individuals during 2022, of which 56% were from Northeast region, being a disease of public concern. One of atypical presentations is the myeloradiculopathy, that can evolve — if without adequate treatment and eradication — with incapacity. Case report: 44-years-old patient, with no previous comorbidities, artisanal fisherman, positive epidemiology for schistosomiasis. Admitted in emergency with backache (lumbar and sacral regions), evolving with paraparesy of lower members associated to progressive (two months) fecal and urinary hesitation. Physical examination showed an alert patient, oriented in time and space, no alteration in cranial nerves and coordenation exams. Flacid paraparesy in lower limbs (muscular force III/V), fasciculations and hypoesthesia in L3/L4 myotomes. Positive Lasegue, cremasteric reflex absent. Metabolic, inflammatory and sorologies negatives. Oriented to proceed with pulsotherapy and methylprednisolone (1 g) during five day and, after, praziquantel 50 mg/kg twice a day, during three days, and after, prednisolone 60 mg/day. Two months later, patient returned with positive sorology to schistosomiasis (1:128) and evolved with partial improvement of paraparesy (muscular force IV/V) and fecal/urinary hesitation, although maintained hypoesthesia (L3/L4) and lumbar pain. Considering the persistence of symptoms, a new cicle of praziquantel and corticoid was done, just as motor physiotherapy and eradication actions. Conclusion: Antihelmintic treatment associated with corticoid use is still an adequate strategy to this disease, but it is a problem of public health, demanding major measures to its erradication.
Congenital myasthenic syndrome due rapsyn mutation presenting with predominant ocular symptoms and good therapeutic response with salbutamol
Authors: Santiago Mayhara Rosany da Silva , Andrade Renata Amaral , Simeão Ana Caroline Paiva , Galvão Heloisy Maria Nunes
Published: July 2023

Introduction: Rapsyn mutations are found in Congenital Myasthenic Syndromes (CMS), usually described with early onset, hypotonia and respiratory insufficiency. Late onset phenotypes had already been described, with mild limb weakness and semiptosis. Episodic respiratory symptons and lack of ophthalmoparesis are considered hallmarks of rapsyn – CMS. The aim is to describe an unusual phenotype of a commom mutation of Rapsyn CMS and therapeutic response with salbutamol. Case report: A 29-year-old female patient was referred complaining of diplopia and fatigable assymmetrical semiptosis during the last six years. She pratices physical exercise, with no fatigue or weakness in limbs. Her past medical history was unremarkable except for drop neck episodes triggered by viral infectons during childhood, with first episode taking place around two years of age. Her parents were consaguinous, howeve no similar clinical picture was reported in family members. In clinical examination besides assymetrical semiptosis and ophthalmoparesis, was noted winged scapula, with normal muscle trofism and strength in four limbs. Laboratory investigation showed negative acetylcholine receptor antibodies (anti-AChR), and negative muscle-specific kinase antibodies (anti-MuSK). Single fiber electromyography revealed abnormal jitter. Genetic panel found a pathogenic homozygous mutation in the RAPSN gene (chr11:47.448.079G>T; p.Asn88Lys). She was treated with pyridostigmine and showed poor response. We opted to start salbutamol with marked clinical improvement. Conclusion: Rapsyn-CMS may present as late episodic diplopia, with semiptosis and ophthalmoparesis, and no limb or respiratory muscle weakness. That diagnosis possibility should be also considered in patients with late onset ocular symptons, incomplete response to pyridostigmine and negative assays for auto antibodies.
Cerebral tuberculoma as a differential diagnosis for extraaxial lesions in immunocompetent patient: case report
Authors: Dunga Lucas Medeiros , Lucena Renner Cassio Nunes de , Medeiros Matheus Araújo de , Benvenuto Brendo Bezerra , Silva Tiago Lameque de Sousa e , Martins Maria Eduarda Medeiros , Almeida Fabricia dos Santos , Silva Diógenes Emanuel Dantas da , Guimarães Matheus Procópio , Carvalho Pedro Henrick Guimarães , Dias Tereza Cristina Batista , Dantas Iury Hélder Santos
Published: July 2023

Introduction: Cerebral tuberculomas are a rare and serious form of tuberculosis, representing 0.2% of intracranial expansive processes. In the absence of conclusive diagnostic tests, doctors often make treatment decisions based on clinical judgment, cerebrospinal fluid (CSF) profile, and radiological findings. Magnetic resonance imaging (MRI) commonly shows discrete lesions with ring enhancement, with perilesional edema, being a relevant differential diagnosis in ring lesions, as their clinical and imaging can mimic brain tumors. The aim to report a case of cerebral tuberculoma in an immunocompetent patient. This is a case report study. The information of this work was obtained through review of the medical record. Case report: G.L.F, female, 26 years old, immunocompetent, with a history of generalized tonic-clonic seizure. MRI showed a right temporal extra-axial lesion, with heterogeneous contrast enhancement and adjacent dural thickening, associated with vasogenic edema. CSF was collected for investigation of inflammatory disease, without any significant findings. Excisional biopsy for anatomopathological analysis revealed an epithelioid granulomatous process (complete tuberculoid granulomas) with central caseous necrosis. Based on clinical, laboratory, and imaging data correlation, the conclusion was reached that it was a cerebral tuberculoma. Treatment followed the standard tuberculosis regimen for one year. Conclusion: Mycobacterium tuberculosis infection in the central nervous system, manifested as tuberculoma, although extremely rare, should be considered as a differential diagnosis for expansive brain lesions, especially in regions with a higher prevalence of the disease.
Partial involvement of the upper division of the oculomotor nerve of microvascular etiology: a case report
Authors: Canzian Kássia Braga
Published: July 2023

A 70-year-old woman with uncontrolled hypertension woke up with a vertical binocular diplopia worsened when looking upward, without pain during ocular movements. After two days, she presented with left eyelid ptosis. She denied any history of trauma. At admission in hospital, was ruled out macular and/or retinal pathologies. Upon neurologic examination, she had restricted upward gaze in the left eye and eyelid ptosis, without pupillary involvement or other cranial nerve deficits, consistent with involvement of the upper division (UD) of the left third cranial nerve (CN III). The patient underwent extensive investigation for cranial nerve syndrome, including magnetic resonance imaging (MRI), cerebrospinal fluid analysis, and laboratory tests. All of these exams had normal results, and microvascular (MV) etiology was then considered. Ischemic involvement of the CN III often presents with limitation of extrinsic eye movement of all muscles innervated by this nerve. When the limitation is restricted to the UD of the CN III, the most common etiologies are related to extrinsic mechanical compression of the orbit, mainly due to neoplastic and infiltrative processes, in addition to skull base trauma. MV etiology due to involvement of the vasa-nervorum should be considered a diagnosis of exclusion in patients with high cardiovascular risk. In these cases, structural causes should be initially investigated with Orbital MRI and the image should be carefully evaluated for mechanical compression. After ruling out such etiology, MV disease responsible for the irrigation of the CN III should be considered, actively searching for risk factors such as hypertension and diabetes mellitus, which, if present, should be promptly controlled with lifestyle changes and appropriate medication treatment.
Cerebral venous thrombosis (CVT) and its interface with arboviroses
Authors: Dantas Iury Hélder Santos , Dantas Iony Santana Santos , Dias Tereza Cristina Batista , Dunga Lucas Medeiros , Fernandes Lucca Ferdinando Queiroz , Almeida Fabricia Santos , Araujo Ana Luiza Bezerra de
Published: July 2023

Introduction: Cerebral venous thrombosis (CVT) is a rare condition. The presence of headache, papilledema, alteration of the VI cranial nerve, focal deficits and changes in consciousness are highlighted. Attention is needed for the interface between arboviruses, and their impact on the Central Nervous System to better understand the disease. This aim is to report a case of CTV, addressing how the arboviroses affect the Central Nervous System. The information contained in this work was obtained through review of the medical record. Case report: A 50-year-old, female, previously healthy sought medical attention due to progressive, squeezing, diffuse headache associated with persistent fever (38 °C), arthralgia and myalgia. Admission exams revealed platelets of 20.000 mm³, positive polymerase chain reaction for dengue and positive immunoglobulin M and negative immunoglobulin G serology. However, during hospitalization, headache intensity worsened, associated with nausea, vomiting, visual blurring and unprecedented tonic-clonic seizures in four limbs. Due to clinical worsening, underwent cranial resonance and angioresonance which revealed venous thrombosis in the transverse and left sigmoid sinus. Absence of changes in the electroencephalogram, lumbar puncture with opening pressure of 25 cmH2O, 10 cells (90% of lymphocytes), no changes in glucose, increase in proteins: 60 mg/dL. On this occasion the platelets were 175.000 mm³. Hematological and rheumatological examinations were normal. Anticoagulation was started with low-molecular-weight heparin and later warfarin 5 mg/day. The patient was discharged without complaints, with oral anticoagulation and follow-up at the CVT outpatient clinic. Conclusion: It is essential to be aware of the alarm signals (red flags) as a form of suspected secondary causes of headache as the TVC, especially in women with persistent headache in the context of arboviroses.
Pure motor-variant CIDP associated with immune checkpoint inhibitor therapy
Authors: Yamaguchi Laís Ciribelli , Damasceno Jéssica Cristina Silveira , Vieira Bruna Queiróz , Campos Laura Altomare Fonseca , Mendonça Marcelo Sobrinho , Vale Thiago Cardoso
Published: July 2023

Introduction: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune disease with many possible etiologies. There are only a few reports of CIDP secondary to the use of immune checkpoint inhibitor therapy. The aim is to describe a case of CIDP secondary to the treatment of metastatic melanoma with immune checkpoint inhibitors (ipilimumab and nivolumab). Case report: A 52-year-old male patient, with arterial hypertension and hypothyroidism, presented with paresthesia and pain in the hands and forearms in November/22, that progressively spread and affected the feet in a one-month period. He then presented proximal and distal tetraparesis in January/23, leading him to depend on a wheelchair. At the time, he was being treated with immunotherapy for metastases in the pectoral muscles due to a melanoma. Symptoms’ onset and progression coincided with the therapy infusions. On examination, there were a grade 4 strength in flexion, extension, abduction and adduction of the thighs and grade 5 in other movements, with global areflexia and tactile hypoesthesia in the feet. Cerebrospinal fluid examination (CSF) showed 11 cells, predominantly with lymphocytes, and 283 mg/dL of proteins. Electromyographic studies revealed focal demyelinating neuropathy of the medians at the wrist level, with moderate to severe intensity on the right and moderate on the left, suggestive of pure motor-variant CIDP. Methylprednisolone 1g/day was given for five days with significant improvement of the condition. Results: The 2021 EFNS/PSN criteria provide diagnostic guidelines for CIDP based on clinical, electromyographic and CSF studies. Conclusion: CIDP secondary to the use of immune checkpoint inhibitors has distinct characteristics such as lymphocytic pleocytosis with slightly increased CSF cellularity and severe neuropathic pain as an initial symptom.
Neurosarcoidosis as a differential diagnosis of tolosahunt syndrome: a case report
Authors: Guimarães Matheus Procópio , Carvalho Pedro Henrick Guimarães , Fernandes Lucca Ferdinando Queiroz , Silva Diógenes Emanuel Dantas da , Dantas Iury Hélder Santos , Lima Junior Daniel Vicente de Siqueira , Villarim Luíza Alves Monteiro Torreão , Oliveira Bianca Etelvina Santos de
Published: July 2023

Introduction: Neurosarcoidosis (NS) is a rare and often underdiagnosed manifestation of sarcoidosis, which is an inflammatory disorder that can affect multiple organs, including the nervous system. The main clinical feature is cranial neuropathy, especially involvement of the optic nerve and facial nerve. These alterations make a differential diagnosis with Tolosa-Hunt syndrome. The aim is to report a case of neurosarcoidosis. This is a case report study. The information of this work was obtained through review of the medical record. Case report: Female, 39-year-old. In 2005, she started pain and paralysis of the lateral movement of the left eye, which was resolved with mucocele removal surgery. Presented three similar cases in 2010, 2015, and 2020, resolved with the use of anti-inflammatory drugs. In 2021, she presented left facial paralysis, left eyelid ptosis, visual blurring and headache. During hospitalization, the possibility of Tolosa-Hunt syndrome was investigated. Imaging exams and laboratory tests were performed without significant alterations. In 2022, she presented a similar clinical manifestation. Magnetic resonance imaging with angiography were performed, which showed thickening and enhancement of the pachymeninges in the occipital regions and cerebellar hemispheres, suggesting the possibility of meningeal granulomatous involvement. A biopsy with histopathological and immunohistochemical analysis was performed, confirming the diagnosis of neurosarcoidosis. Conclusion: This case report highlights the importance of considering neurosarcoidosis as a differential diagnosis in cases of multiple cranial neuropathy, such as in Tolosa-Hunt syndrome. Early recognition and diagnosis can lead to timely treatment and improved outcomes for patients.
Syringomyelia in children: a case report
Authors: Teixeira Elaine Calumby , Morais Thulio Carvalho , Rodrigues Thiago , Rocha Cristiane Maria da
Published: July 2023

Introduction: Syringomyelia or hydromyelia is a rare neurological disorder of cerebrospinal fluid circulation caused by a pathologically dilated central spinal canal, manifested as dissociated sensory loss, chronic pain and motor deficits. The pathogenesis is not completely understood, usually being a diagnostic challenge. The authors describe a case of syringomyelia in a ten-year-boy associated with depression, as a challenging condition, emphasizing diagnostic difficulties and the multidisciplinary approach. Clinical case: The patient was admitted to the emergency room with pain, gait abnormality, arthralgia and dysesthesia in limbs with subacute onset. Neurological examination revealed tetraparesis with hypoesthesia and hypopallesthesia in limbs, associated with emotional lability. Feelings of worthlessness and abandonment in psychiatric evaluation resulted in diagnosis of depression. For persistent pain assessment, a magnetic resonance imaging of the spinal cord showed dilatation of the central canal, compatible with hydromyelia. To establish if the sensitive symptoms were secondary to damage of spinothalamic pathway, a laser evoked potential was performed, demonstrating integrity of Aδ-fibers, excluding, therefore, impairment of the nociceptive pathways only in the segments analyzed. In view of the findings, the patient was discharged from the hospital, still with some gait impairment, taking selective serotonin reuptake inhibitors for depression and carbamazepine for chronic pain with progressive improvement. Conclusion: This report explores the complexity of diagnosis of hydromyelia in children, which are difficult to examine accurately, particularly on sensitive examination, whose objective alteration in this case made us consider this rare disease. We believe that rigorous clinical follow-up, with multidisciplinary intervention, is extremely important to achieve the best response to treatment.
Pediatric onset multiple sclerosis: defying disability – a case report
Authors: Cunha Vinícius Gonçalves Portilho , Mendonça Alda Maria de Sousa , Dias Amanda Selvátici dos Santos , Rodrigues Ketteny de Lima
Published: July 2023

Introduction: Multiple sclerosis (MS) is the main demyelinating disturbance of the central nervous system in childhood and, compared to adulthood, the disease presents in a more inflammatory way and with greater probability of younger disability if not well managed in adequate time. Objectives: Case report of a patient with pediatric onset multiple sclerosis (POMS) and high lesions burden in need of high efficacy medications in early time. Methods: The present case report was based on data collected through literature review and medical records. Results: We found the case of a 12-year-old girl presenting with monoparesis of right leg and being first diagnosed with acute disseminated encephalomyelitis due to lesions with a demyelinating character in a skull magnetic resonance (MRI) in January 2022 after COVID-19 vaccination. After six months, she presented with diplopia and ataxia, besides worsening of radiological pattern of the previous lesions and evidence of spinal involvement, being submitted to therapy with methylprednisolone. Further, the diagnosis of POMS was stablished due to oligoclonal bands in cerebrospinal fluid and negativity to serum anti aquaporin 4 and serum antibody against myelin oligodendrocyte glycoprotein; treatment with natalizumab was started. After four months, she presented with worsening of previous neurological deficits and progression of disease was seen in a new skull and neuroaxis MRI, being submitted to a new cycle of methylprednisolone and five sessions of plasmapheresis. After these therapies, she went home with an expanded disability status scale of 4 and rituximab was the chosen drug to continue treatment according to literature and the neurological state. Conclusion: Early intervention in pediatric onset multiple sclerosis is necessary to avoid the maximum of future disability and high inflammatory level frequently demands high efficacy therapies to control the disease.
Ataxia unit of the Federal University of São Paulo: 16 years of experience and a description of frequency and etiology
Authors: Massuyama Breno Kazuo , Gama Maria Thereza Drumond , Silva Thiago Yoshinaga Tonholo , Braga-Neto Pedro , Pedroso José Luiz , Barsottini Orlando Graziani Povoas
Published: July 2023

Introduction: Cerebellar ataxias are a heterogeneous group of diseases comprising genetic and non-genetic etiologies. Sporadic ataxias are a group of neurological disorders with no family history for ataxia or its related symptoms and signs. Hereditary cerebellar ataxias and hereditary spastic paraplegias (HSP) are rare genetic neurodegenerative disorders with considerable clinical overlap. Objectives: To report a descriptive analysis of the frequency of different forms of cerebellar ataxias evaluated over 16 years in the Ataxia Unit, Federal University of São Paulo, Brazil. Methods: We reviewed charts of patients who were being followed at the Ataxia Unit at Federal University of São Paulo, from January 2007 to December 2022. We used descriptive statistics to present our results as frequencies and percentages of the overall analysis. Patients were classified into the following 8 groups: sporadic ataxias, autosomal dominant cerebellar ataxias, autosomal recessive cerebellar ataxias (ARCA), mitochondrial ataxias, congenital ataxias, X-linked ataxias, HSP, and others. Results: Overall, 1225 Brazilian patients with ataxias or spastic paraplegias. There were 683 patients with a definite diagnosis, which 89 were sporadic ataxias, 322 autosomal dominant cerebellar ataxias, 169 ARCA, 4 congenital ataxias, 6 X-linked ataxias, 16 autosomal dominant HSP, and 35 autosomal recessive HSP. Conclusion: This study describes the frequency of cerebellar ataxias
Etiological evaluation of hypertrophic pachymeningitis in a tertiary general neurology department
Authors: Moraes Marianna , Abrantes Fabiano , Pedroso José Luiz , Barsottini Orlando Graziani Povoas
Published: July 2023

Introduction: Hypertrophic pachymeningitis (HP) is the thickening of the cranial or spinal dura. This process causes cranial nerve palsy, vascular events (stroke and venous thrombosis), and intracranial hypertension. The diagnosis of HP is disclosed by magnetic resonance imaging, showing dural thickening and contrast enhancement. Several etiologies are possible for HP, but infection and autoimmune diseases are the most frequent. The gold standard for diagnosis is the dural biopsy, but cerebrospinal fluid (CSF), blood and other tissues analysis are essential guides to the correct diagnosis. A quick diagnosis is crucial to early treatment and this avoid permanent deficits. However, the diagnostic approach can be a complicated process, which could delay the beginning of the treatment. Objectives: This study aims to analyze the population of patients with magnetic resonance imaging showing HP. Methods: Its epidemiological, clinical and radiological aspects was evaluated through a retrospective and descriptive study to elucidate the etiological diagnosis. Results: A total of 45 patients was included with some different etiologies: granulomatosis with polyangiitis (n = 7); idiopathic (n = 14); probable neurosarcoidosis (n = 9); seronegative rheumatoid arthritis (n = 1); neurotuberculosis (n = 1); plaque meningioma (n = 2); IgG4 related disease (n = 4); Inflammatory myofibloblastic tumor (n = 1); neurosyphilis (n = 1); diffuse B-cell lymphoma (n = 1); Erdheim-Chester disease (n = 1); iatrogenic secondary to radiotherapy (n = 1) and cryopyronopathy (n = 1). Conclusion: The diversity of etiologies found in this study demonstrates the complexity of HP and how important it is to follow a diagnostic algorithm in order to institute appropriate and early therapy for a better clinical outcome for patients.
Giant cell glioblastoma: a case report of a long-term survival
Authors: Teixeira Hennan Salzedas , Catito Murillo Silva , Santos Adrialdo José , Batistella Gabriel Novaes de Rezende , Pazini Andreia Martini , Andrade Thays Neri
Published: July 2023

Glioblastoma (GBM) is the most common primary brain tumor in adults, classified as grade 4 by World Health Organization, with a mean overall survival of 15–18 months. The histopathological subtype described as giant cell GBM corresponds to < 1% of this tumor, more frequent in young patients, affecting the temporal and parietal lobes in a more circumscribed and subcortical way. We present a case report of a woman diagnosed with GBM giant cell (GC). Data was collected through electronic medical record. A 19-years-old woman, healthy, during investigation of headache with visual and speech alteration, a cranial tomography was performed in January 2009, demonstrating a supratentorial lesion. Cranial magnetic resonance imaging showed a solid-cystic, infiltrative lesion with perilesional edema, located in the left parietal region and heterogeneous peripheral enhancement. Subtotal resection of the lesion was performed in February 2010. The anatomopathological study was compatible with GC, and adjuvant treatment was performed with radiotherapy (60 Gy, in 30 fractions) and concomitant chemotherapy, temozolamide (TMZ), followed by adjuvant TMZ, monthly for seven cycles. The patient developed osteomyelitis and it was necessary to suspend the adjuvant chemotherapy in November 2010. Clinical and radiological follow-up showed stability of the lesion and staying functionally independent, with progression-free survival >13 years. This is an atypical case of a patient with glioblastoma with prolonged survival. Some studies suggest that the dominant presence of giant cells, extent of surgical resection in addition to some molecular may be predictors of long-term survival. Besides the rarity of this malignancy and heterogeneity response with the treatment, it’s important to recognize this subtype of GBM and to treat aggressively for the possible of achieve better outcomes, until better therapeutic data are available.
Evaluation of the NINDS-CSN 5-minutes protocol as a cognitive screening test to detect Parkinson’s disease dementia: a study of a Brazilian sample
Authors: Teixeira Igor de Lima e , Souza Vanessa Pereira de Alencar , Borges Vanderci , Ferraz Henrique Ballalai
Published: July 2023

Introduction: Many cognitive screening tests have been investigated for the diagnosis of Parkinson’s disease dementia (PDD), due to its prevalence and its interference in the evolution of the disease, quality of life and in the treatment response of the patients with Parkinson’s disease (PD). Therefore, more effective and faster cognitive screening tests are needed. Objectives: To evaluate the usefulness of the NINDS-CSN 5-minutes protocol assessment (NC5MPA) in PD patients as screening test for the detection of PDD, as well as to test if the association with the cube drawing test (CDT) can increase the test accuracy. Methods: A total of 98 patients with PD were evaluated using the NC5MPA, combined with the CDT, Mini Mental State Examination and the Montreal Cognitive Assessment (MoCA). These patients were also evaluated for mild cognitive impairment (MCI) and dementia by the Clinical Dementia Rating Scale (CDR). Results: There was a good correlation (with P value < 0.00) between the test scores and PDD, but the results of the 3 tests for MCI was > 0.05. The NC5MPA test has had sensitivity of 78.5%, specificity of 85.7%, accuracy of 82.6%, positive predictive value of 80.4% and negative predictive value of 84.2%, in addition to demonstrate an average performance time of 3.2 minutes (3.08–3.31). The association with the CDT has led to a little significant increase in sensitivity and has showed a decrease in specificity and accuracy, besides increase the test performance time. In assessing the interference of education level, the results were influenced by the small sample size of the 5 to 8 years of education group. Conclusion: The NC5MPA test has proven up to be a good screening test for PDD, being even faster and easier to perform, but more tests with larger populations are necessary to assess the accuracy of this test for MCI and to assess if there is interference of education level in the test accuracy.
Poems syndrome: report of a rare disease with often neurologic presentation
Authors: Nery Julia Pio Fernandes , Martins Aldrin Pedroza , Alvares Rafael Elian , Vieira Cintia Alvarenga Pereira , Resende Glaucia Lara
Published: July 2023

Introduction: Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome is a rare monoclonal lambda plasma cell disorder, with multisystem presentation leading to a challenging diagnosis. The aim is to report a case of a rare hematologic disease, with neurologic manifestation widely seen in daily practice. Case report: Male, 35-year-old, with a history of distal weakness of the lower limbs, symmetrical, subacute onset and progressive worsening, associated with ascending numbness, lower back pain and fatigue. Neurological examination showed motor deficit in extremities (plantar flexion and extension), hypoactive reflexes of lower limbs, in addition to distal sensory deficit (tactile and painful). Electroneuromyography confirmed axonal sensory-motor neuropathy in both lower limbs. Biochemical testing revealed a monoclonal gammaglobulin peak with a predominance of lambda chains and an elevated serum vascular endothelial growth factor (VEGF) concentration. Magnetic resonance imaging detected sclerotic lesions in vertebral bodies of thoracic and lumbar spine. Furthermore, patient also had mild pigmentary changes in the skin of the extremities of lower limbs and polycythemia. Accordingly with the evaluation was possible to make POEMS diagnosis and patient is currently in preparation for an autologous bone marrow transplant. Conclusion: Polineuropathy is a neurological hallmark of the disease and should lead to evaluation for POEMS, when associated with a monoclonal protein detected. Elevated serum VEGF can be a biomarker that supports the diagnosis. In summary, early recognition is essential, because enables adequate treatment, which contributes to stop progressive worsening of symptoms, especially debilitating neurologic ones.
Meningeal sporotrichosis in an immunocompetent host: case report
Authors: Paiva Lara Teixeira , Ribeiro Victor Teatini , Alves Kaisy Nagella , Christo Paulo Pereira , Gomes Antônio Pereira
Published: July 2023

Endemic in Brazil, sporotrichosis usually presents in its cutaneous form. Meningeal involvement is rare and generally affects immunocompromised hosts. Here we describe a case of meningeal sporotrichosis in an immunocompetent patient without concurrent skin lesions. A 78-year-old woman, previously healthy, developed cognitive deficits with fluctuating mental confusion over the course of three months, until she went to the emergency department with fatigue and stupor. Laboratory workup showed severe hyponatremia due to inappropriate ADH secretion. She was treated with fluid restriction and discharged. Two months later, she was referred to a neurologist because of persistent mental confusion in spite of controlled sodium. She had no headache, fever, seizures, or focal deficits. Cerebrospinal fluid (CSF) analysis revealed chronic meningitis: 232 cells (95% lymphocytes), elevated protein (3.021 mg/dl) and low glucose; cultures and polymerase chain reaction (PCR) for Mycobacterium were negative. Brain magnetic resonance imaging (MRI) revealed basal meningeal enhancement. She was hospitalized and empirically treated for meningeal tuberculosis, with no clinical nor CSF improvement after one month. In a careful history review, we found out that one year earlier she had been exposed to cats who died from sporotrichosis. One month after that, she had had a single skin lesion which spontaneously disappeared, followed by polyarthritis, which also resolved. At the time of our evaluation, she had no cutaneous lesion nor arthritis; CTs of the chest and abdomen were normal. PCR for Sporothrix in the CSF came out positive. She received liposomal amphotericin for 1 month, followed by a 6-months use of itraconazole. She fully recovered her cognitive capacities; follow-up MRI showed no alterations; her late CSF was nearly normal (5 cells, protein 55 mg/dl, no glucose consumption). Our report draws the attention to atypical neurological presentations of sporotrichosis, a treatable condition that may unrecognized.
PRES in the context of an infectious insult
Authors: Lemos Ana Flavia Andrade Ana Flavia Andrade , Gomes Helio Aquaroni Farão , Santos Patrick Emanuell Mesquita Sousa , Foloni Maria Clara , Sousa Rebeca Aranha Barbosa , Frigo Yasmim Nadime José , Alvarenga Tarcísio Nunes , Baston Ana Beatriz Marangoni , Longo José Eduardo Trentim , Dantas Gabriela Rossini , Rocha Fernando Coronetti Gomes da
Published: July 2023

Introduction: Posterior reversible leukoencephalopathy syndrome is an acute/subacute clinical-radiological syndrome characterized by headache, changes in consciousness, seizures, focal neurological deficits, visual deficits and that may be preceded by uncontrolled blood pressure in the day before. It does not commonly occur concomitantly with prolonged infectious conditions. The most typical imaging finding is white matter edema in the posterior cerebral hemispheres. Treatment is based on adequate control of blood pressure and epileptic seizures, as well as metabolic and electrolyte control. The prognosis in most cases is excellent with significant improvement and complete reversal over days to weeks. Case report: Female, 37-year-old, after one month of underwent an endoscopic retrograde cholangiopancreatography was hospitalized due to a perirenal abscess, and treatment with antibiotics was initiated. During this treatment, she developed a sudden onset of bilateral amaurosis, continuous horizontal nystagmus, mental confusion, right upper limb weakness and hyperreflexia, in addition to an epileptic seizure and fencing response posture requiring intravenous phenytoin. Brain tomography demonstrated hypodensity in the occipital hemispheres and magnetic resonance imaging identified signal alteration in the white matter diffuse without diffusion restriction compatible with posterior reversible leukoencephalopathy syndrome. She evolved with adequate control of blood pressure and epileptic seizures, progressive improvement in visual acuity and muscle strength, until he returned to normality 10 days after the onset of symptoms. The antiepileptic drug was suspended, and she was discharged with antihypertensive medication. Conclusion: Posterior reversible leukoencephalopathy syndrome is an important differential diagnosis in conditions of sudden deficits and seizures, especially in this infectious context, because it is a reversible clinical condition with a good prognosis.
Thyroid dysfunction with the continued use of beta interferon in the treatment of multiple sclerosis
Authors: Dunga Lucas Medeiros , Pinto Bruna Emanuelle Alves , Fernandes Lucca Ferdinando Queiroz , Medeiros Matheus Araújo de , Oliveira Bianca Etelvina Santos
Published: July 2023

Introduction: The treatment of multiple sclerosis (MS) with beta interferon has been shown to be effective in reducing the number of relapses and the inflammatory activity of the disease, as well as slowing its progression. Although there are controversies in the literature, recent studies have pointed to the possibility of thyroid dysfunction as a side effect of prolonged use of beta interferon. Objectives: To analyze the presence of thyroid dysfunction due to the use of beta-interferon in patients with multiple sclerosis. Methods: That is a documentary, observational, and analytical study, with a quantitative, retrospective, and cross-sectional approach. Sociodemographic variables, thyroid function laboratory tests, and medication usage time present in medical records were analyzed. Results: From 118 medical records evaluated, after applying the exclusion and inclusion criteria, 35 were included in the study. 80% of the sample were female, mean age was 32.43. The mean values for TSH and free T4 before starting treatment with beta-interferon were 1.66 mIU/L and 0.96 ng/dL, respectively. After 6 months, the values for TSH and free T4 were 2.20 mIU/L and 0.91 ng/dL, respectively. It can be concluded that the continuous use of beta-interferon did not lead to significant changes in TSH and free T4 levels compared to baseline (P = 0.061 and P = 0.102, respectively). It is worth noting that there were two cases of subclinical hypothyroidism developed during the study. Conclusion: MS patients using beta-interferon are mostly young women. No significant changes in their thyroid function were observed. Therefore, based on this information, the need for routine periodic laboratory tests to evaluate thyroid function in patients using beta-interferon is questioned. Further studies are needed with a larger sample size to definitively clarify this topic.
Effect of different spectral processing methods on the quantitative model of Astragalus polysaccharides detected by NIR spectroscopy
Authors: ZHAO Fan , ZHANG Jiawei , ZHI Jihao , YAN Zhaoru
Published: July 2023

Quality control of Chinese herbal medicines requires reliable and rapid detection techniques, Many scholars have used NIR spectroscopy for research in Chinese herbal medicine industry. The aim of this study was to evaluate the feasibility of combining NIR spectroscopy and machine learning to predict the adulteration content of Astragalus polysaccharides. The astragalus polysaccharide and rice flour were mixed to form astragalus polysaccharide adulterant with different concentration. the Quantitative prediction models are built using the support vector machine (SVM). Different pre-processing methods of SG, SNV, WT, SG+SNV, SG+WT were used to process the spectra, and then the continuous projection algorithm (SPA) and uninformative variable elimination (UVE) were used to select the characteristic wavelengths. The SVM prediction model based on SG+SNV+SPA is optimal with an RPD of 2.653, indicating that the model has good predictive ability. The results showed that NIR technique could be used for quantitative analysis of Astragalus polysaccharides.
A Dataset of Social-Psychological and Emotional Reactions During the COVID-19 Pandemic Across Four European Countries
Authors: Abadi David , Arnaldo Irene , Fischer Agneta
Published: July 2023

In April 2020, only a few weeks after the COVID-19 pandemic had erupted, we conducted an online survey and collected data from 2031 individuals in four European countries (Germany, the Netherlands, Spain and the United Kingdom) using a cross-sectional design. Participants recruited on Cint completed new and pre-existing measures of socio-political and populist attitudes perceived threats, appraisals (anger at the government, anger at transgressors of hygiene measures, anxiety about coronavirus via the appraisals of health-related threats), conspiracy mentality, moral reasoning, threat estimation (coronavirus, climate, symbolic material/safety), news consumption, support for and compliance with governmental hygiene measures, subjective social status and demographics. The dataset is stored on figshare repository. It can be used to study social-psychological, emotional, socio-political and socio-economic factors of the COVID-19 pandemic.
Association between MPV and Cerebral Vascular Ischemic Burden in Mild to Moderate Alzheimer’s Disease
Authors: ERKOÇ ATAOĞLU Esra , UÇAR Murat
Published: July 2023

Title: Association between MPV and Cerebral Vascular Ischemic Burden in Mild to Moderate Alzheimers’s Disease

Running Title: MPV and Ischemic Burden in AD

ABSTRACT

Objective: Vascular pathologies and chronic neuroinflammation play an important role in Alzheimer's Disease(AD). Increased platelet activity, which underlies the pathophysiology of atherosclerosis and systemic inflammation, has been reported several times in the setting of AD. However, the relationship between this increase and neuroimaging correlates has not been studied yet. This study aims to evaluate the relationship between mean platelet volume (MPV), as a reliable indicator of platelet activity, and vascular ischemic burden in neuroimaging of AD. Material- Method: Medical records of mild-moderate AD cases diagnosed in our dementia outpatient clinic between 2021-2022 were retrospectively reviewed. Patients were classified as having "mild" or "severe" vascular ischemic burden on MRI. Clinical findings and platelet markers were compared between the groups. Multivariate regression was applied for potential confounders regarding vascular ischemic burden. Results: Out of 59 patients, 36 had 'mild' and 23 had 'severe' ischemic burden. Demographic and clinical features were similar; however, MPV was significantly higher in the group with severe ischemia (p:0.013). Multivariate analysis revealed an independent association between MPV and ischemic burden. An MPV value of ≥8.7 fL had a sensitivity of 69.6% and a specificity of 61% for the presence of severe burden.

Discussion: Our results highlight the role of platelet activation in the vascular pathogenesis of AD. During the early evaluation of AD, increased MPV can serve as a marker to determine the high-risk group in terms of cerebral ischemic burden. This might enable close monitoring and timely management of high-risk patients regarding the development of vascular morbidities. Keywords: Alzheimer's Disease, mean platelet volume, MPV, vascular ischemic burden, inflammation
Rezension von: Pyta, Wolfram (Hrsg.), Krieg und Revolution
Authors: Mährle Wolfgang , Pyta Wolfram
Published: July 2023

Wolfram Pyta (Hg.), Krieg und Revolution. Historische Konstellationen seit der Französischen Revolution (Geschichte in Wissenschaft und Forschung). Stuttgart: Kohlhammer 2022. 250 S. ISBN 978-3-17-039908-2. € 45,–
Rezension von: Hirbodian, Sigrid; Jörg, Christian; Wegner, Tjark (Hrsg.), Zwischen Region, Nation und Europa
Authors: Schneidmüller Bernd , Hirbodian Sigrid , Jörg Christian , Wegner Tjark
Published: July 2023

Sigrid Hirbodian / Christian Jörg / Tjark Wegner (Hg.), Zwischen Region, Nation und Europa. Landesgeschichte in europäischer Perspektive (Landesgeschichte, Bd. 4). Ostfildern: Thorbecke 2022. VI, 189 S. ISBN 978-3-7995-1384-5. € 30,–
Rezension von: Gut, Franz (Bearb.), Registerband der Forschungen zur Rechtsarchäologie und rechtlichen Volkskunde sowie Signa Ivris
Authors: Weber Raimund J. , Gut Franz
Published: July 2023

Franz Gut (Bearb.), Registerband der Forschungen zur Rechtsarchäologie und Rechtlichen Volkskunde sowie SIGNA IURIS, zu 40 Jahren Rechts- und Kulturgeschichte in 40 Bänden, mit 378 Beiträgen der Rechtlichen Volkskunde, der Rechtsarchäologie und der Rechtsikonographie (SIGNA IURIS, Beiträge zur Rechtsikonographie, Rechtsarchäologie und Rechtlichen Volkskunde, Bd. 17). Halle an der Saale: Junkermann 2021. 176 S., Abb. ISBN 978-3-941226-36-2. Geb. € 85,–
Rezension von: Jehn, Alexander; Kirschner, Albrecht; Wurthmann, Nicola (Hrsg.), IG Farben zwischen Schuld und Profit
Authors: Leise Britta , Jehn Alexander , Kirschner Albrecht , Wurthmann Nicola
Published: July 2023

Alexander Jehn / Albrecht Kirschner / Nicola Wurthmann (Hg.), IG Farben zwischen Schuld und Profit. Abwicklung eines Weltkonzerns (Veröffentlichungen der Historischen Kommission für Hessen 91). Marburg: Historische Kommission für Hessen 2022. 407 S. ISBN 978-3-942225519. € 32,–
Rezension von: Kleinschmidt, Christian (Hrsg.), Seuchenbekämpfung, Wissenschaft und Unternehmensstrategien
Authors: Bacher Frederick , Kleinschmidt Christian
Published: July 2023

Christian Kleinschmidt (Hg.), Seuchenbekämpfung, Wissenschaft und Unternehmensstrategien. Die Behringwerke und die Philipps-Universität Marburg im 20. Jahrhundert (Quellen und Forschungen zur hessischen Geschichte, Bd. 187). Darmstadt und Marburg: Hessische Historische Kommission Darmstadt und Historische Kommission für Hessen 2021. 284 S., 52 Abb. ISBN 978-3-88443- 342-3. € 28,–
Rezension von: Petershagen, Wolf-Henning, Die Ulmer Donauschifffahrt im 19. Jahrhundert
Authors: Lang Stefan , Petershagen Wolf-Henning
Published: July 2023

Wolf-Henning Petershagen, Die Ulmer Donauschifffahrt im 19. Jahrhundert (Forschungen zur Geschichte der Stadt Ulm, Reihe Dokumentation, Bd. 17). Stuttgart: Kohlhammer 2021. 195 S. ISBN 978-3-17-041966-7. Geb. € 25,–
Rezension von: Hirbodian, Sigrid; Holtz, Sabine; Steymans-Kurz, Petra (Hrsg.), Zwischen Mittelalter und Reformation
Authors: Regenbogen Clemens , Hirbodian Sigrid , Holtz Sabine , Steymans-Kurz Petra
Published: July 2023

Sigrid Hirbodian / Sabine Holtz / Petra Steymans-Kurz (Hg.), Zwischen Mittelalter und Reformation. Religiöses Leben in Oberschwaben um 1500 (Oberschwaben. Forschungen zu Landschaft, Geschichte und Kultur, Bd. 6). Stuttgart: Kohlhammer 2021. 348 S. mit zahlr. farb. Abb. ISBN 978-3-17-039342-4. Geb. € 29,–
Rezension von: Gassert, Philipp; Nieß, Ulrich; Stockert, Harald (Hrsg.), Zusammenleben in Vielfalt
Authors: Harter Hans , Gassert Philipp , Nieß Ulrich , Stockert Harald
Published: July 2023

Philipp Gassert / Ulrich Nieß / Harald Stockert (Hg.), Zusammenleben in Vielfalt. Zuwanderung nach Mannheim von 1607 bis heute (Veröffentlichungen zur Mannheimer Migrationsgeschichte, Bd. 1). Ubstadt-Weiher: verlag regionalkultur 2021. 319 S., zahlr. Abb. und Grafiken. ISBN 978-3-95505-311-6. Brosch. € 24,80