scholarly journals Prevalence of syphilis reactivity in patients with stroke, cognitive impairment and extrapyramidal syndromes: a retrospective study.

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Giulia Ciccarese ◽  
Francesco Drago ◽  
Bianco Drago ◽  
Aurora Parodi
Keyword(s):  
Cognitive Impairment ◽  
Neurological Diseases ◽  
Treponema Pallidum ◽  
Epidemiological Data ◽  
Routine Screening ◽  
Serological Screening ◽  
Extrapyramidal Syndromes ◽  
Neurology Clinic ◽  
Syphilis Serology ◽  
Reporting Data

In the last two decades, there has been a resurgence of syphilis worldwide. However, epidemiological data on neurosyphilis are inconsistent for the lack of reporting data and diagnostic gold standard tests. The aim of the present study was to estimate the prevalence of syphilis reactivity in a cohort of patients with neurological diseases of our hospital. We retrospectively analyzed the medical records of the patients hospitalized at the Stroke Unit of the Neurology Clinic and those suffering from cognitive impairment hospitalized at the acute ward of the Geriatrics Clinic between January 2017 and December 2019. Also the patients who attended the Movement disorder outpatient clinic during the same study period were examined. To detect syphilis reactivity a qualitative specific treponemal test on patient’s serum was performed: the Treponema pallidum haemagglutination assay (TPHA). A total of 652 patients were admitted and 315 of them (52%) were submitted to a routine screening for syphilis: 307 (97%) were negative while 8 (3%) had a positive syphilis serology. The TPHA-positive patients (4 males, 4 females) were 2 patients with stroke, 5 with cognitive impairment and 1 with Parkinsonism with a mean age of 83 years, suffering from multiple comorbidities. Although the patients we have retrospectively studied have not undergone lumbar puncture to confirm the diagnosis of neurosyphilis, the not negligible syphilis reactivity rate found in our series suggests that serological screening for syphilis should be reviewed as a routine screening test in neurology and geriatrics departments, especially if the clinical presentation of the neurological diseases is atypical.

scholarly journals Sweet Syndrome and Secondary Syphilis in a Person with Acute Necrotizing Tonsillitis

2021 ◽  
Vol 13 (1) ◽  
pp. 216-221
Author(s):  
Joseph Mishal ◽  
Igor Viner ◽  
Alexandro Livoff ◽  
Shlomo Maayan ◽  
Eli Magen
Keyword(s):  
Unusual Case ◽  
Treponema Pallidum ◽  
Cervical Lymphadenopathy ◽  
Secondary Syphilis ◽  
Neutrophilic Dermatosis ◽  
Sweet Syndrome ◽  
Acute Febrile Neutrophilic Dermatosis ◽  
Acute Necrotizing ◽  
The Right ◽  
Syphilis Serology

Syphilis has received its classical designation as one of “the great imitators,” reflecting a wide variety of symptoms and presentations, which can cause difficulties in diagnosis. Here we report an unusual case of secondary syphilis in a person with acute necrotizing tonsillitis and Sweet syndrome. A 33-year-old female presented with fever, bilateral cervical lymphadenopathy, tonsillar enlargements with ulcerated pus-filled lesions on the right tonsil, and multiple pseudovesicular, mammillated, edematous plaques on her neck, face, and extremities. Syphilis serology was positive and a skin biopsy demonstrated a neutrophil-rich dermatitis characteristic of Sweet syndrome. The association of <i>Treponema pallidum</i> infection with Sweet syndrome may be a coincidence; nevertheless, our case serves as a reminder that secondary syphilis should remain in the differential diagnosis of the acute febrile neutrophilic dermatosis.

scholarly journals HUBUNGAN NILAI P300 DENGAN MOCA-INA PADA PASIEN DENGAN GANGGUAN KOGNITIF VASKULAR PASCASTROKE ISKEMIK

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Susilo Susilo ◽  
Yudy Goysal ◽  
Abdul Muis ◽  
Muhammad Akbar ◽  
Andi Kurnia Bintang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Human Life ◽  
Strong Predictor ◽  
Vascular Cognitive Impairment ◽  
P300 Amplitude ◽  
P300 Latency ◽  
Cross Sectional ◽  
Neurology Clinic ◽  
Cross Sectional Design

      ASSOCIATION OF P300 VALUE WITH MOCA-INA IN VASCULAR COGNITIVE IMPAIRMENT POST-ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: Stroke is a major threat in human life because it can cause disability and mortality. Cognitive impairment in early stroke is strong predictor for long term vascular cognitive impairment while neuropsychology method is superior than conventional method to diagnose cognitive impairment, especially P300.Aim: To identify the association between P300 values and MoCA-Ina in vascular cognitive impairment post ischemic stroke patients.Methods: It is a cross sectional design study for ischemic stroke patients who suffered from vascular cognitive impairment during April to June 2018 in Neurology Clinic of Dr. Wahidin Sudirohusodo Hospital, Makassar. The statistical analysis was performed by Pearson’s correlation test.Result: There were 20 samples, male (60%) and female (40%). The average MoCA-Ina score was 19.35±6.06; the average P300 latency in Fz, Cz, and Pz were 370.22±49.01ms, 360.78±38.27ms, and 361.02±44.45ms, respectively; the average P300 in Fz, Cz, and Pz amplitude were 6.09±3.10µV, 5.67±3.49µV, and 6.10±2.77µV, respectively. The Pearson’s showed that P300 latency had significantly correlation  with MoCA-Ina score while no correlation between the P300 amplitude and MoCA-Ina.Discussion: There was correlation between P300 latency with MoCA-Ina in vascular cognitive impairment post ischemic stroke patients.Keywords: Ischemic stroke, MoCA-Ina, P300 value, vascular cognitive impairment.ABSTRAKPendahuluan: Stroke merupakan suatu ancaman terbesar di kehidupan manusia karena dapat menimbulkan kecacatan dan kematian. Gangguan kognitif pada awal stroke merupakan prediktor kuat untuk gangguan kognitif vaskular jangka panjang dan metode neuropsikologi lebih unggul daripada metode konvensional untuk mendiagnosis gangguan kognitif, terutama P300.Tujuan: Untuk mengetahui hubungan nilai P300 dengan MoCA-Ina pada pasien gangguan kognitif vaskular pascastroke iskemik.Metode: Desain studi potong lintang terhadap pasien stroke iskemik yang mengalami gangguan kognitif vaskular selama bulan April sampai Juni 2018 di Poliklinik Saraf RSUP Dr. Wahidin Sudirohusodo, Makassar. Data diolah menggunakan uji korelasi Pearson’s.Hasil: Didapatkan 20 orang sampel laki-laki (60%) dan perempuan (40%). Nilai MoCA-Ina rata-rata 19,35±6,06; hasil rata-rata latensi gelombang P300 di Fz, Cz, dan Pz   masing-masing adalah 370,22±49,01, 360,78±38,27, dan 361,02±44,45; rata-rata tinggi amplitudo P300 di Fz masing-masing adalah 6,09±3,10, 5,67±3,49, dan 6,10±2,77. Hasil uji korelasi Pearson’s menunjukkan latensi P300 berkorelasi signifikan terhadap MoCA-Ina, sedangkan amplitudo P300 tidak.Pembahasan: Ada hubungan antara latensi gelombang P300 dengan MoCA-Ina pada pasien gangguan kognitif vaskular pascastroke iskemik.Kata kunci: Gangguan kognitif vaskular, MoCA-Ina, nilai P300, stroke iskemik  

An Analysis of Disorders Presenting at a Pediatric Neurology Outpatient Clinic: A Report from Turkey

2021 ◽  
Author(s):  
Emre Sarıkaya ◽  
Halûk Yavuz
Keyword(s):  
Outpatient Clinic ◽  
Neurological Diseases ◽  
Child Neurology ◽  
Pediatric Neurology ◽  
Number Of Patients ◽  
The Family ◽  
Neurology Clinic ◽  
Similar Disease ◽  
Male Patients ◽  
First Time

AbstractNeurological problems constitute an important part of diseases in children. Studies evaluating neurological diseases in children collectively and reporting their types and rates are very few. We report the clinical and laboratory spectra of children presenting with neurological diseases to our clinic. The charts of patients who presented for the first time to the only pediatric neurology outpatient clinic in the region during a year were evaluated retrospectively. A total of 88,785 patients were seen at the Meram Faculty of Medicine pediatric outpatient clinics in 1 year; 5.5% (4,904) of these patients were seen at the child neurology clinic and 1,807 patients (36.8%) were seen for the initial evaluation. Medical charts of 1,685 (93.2%) patients were reviewed: 952 (56.5%) were male patients and 733 were females. The mean age was 5.77 ± 4.92 years; 30.9% of the patients had a similar disease in the family. The top three presenting complaints that led to hospital seen were seizures (12.2%), paroxysmal events (10%), and headaches (9.2%). The most common diagnoses were epilepsy (18%), headache (8.6%), and developmental delay (7.8%). Our study describes the characteristics of the large number of patients seen for the first time in the child neurology outpatient clinic.

scholarly journals Obesity-induced Cognitive Impairment in Older Adults: a Microvascular Perspective

2020 ◽  
Author(s):  
Priya Balasubramanian ◽  
Tamas Kiss ◽  
Stefano Tarantini ◽  
Ádám Nyúl-Tóth ◽  
Chetan Ahire ◽  
...  
Keyword(s):  
United States ◽  
Cognitive Impairment ◽  
Molecular Mechanisms ◽  
Epidemiological Data ◽  
The Elderly ◽  
The United States ◽  
Potential Contribution ◽  
Blood Brain Barrier Disruption ◽  
Brain Barrier Disruption ◽  
Microvascular Rarefaction

Over two thirds of individuals aged 65 and older are obese or overweight in the United States. Epidemiological data show an association between the degree of adiposity and cognitive dysfunction in the elderly. In this review, the pathophysiological roles of microvascular mechanisms, including impaired endothelial function and neurovascular coupling responses, microvascular rarefaction and blood-brain barrier disruption in the genesis of cognitive impairment in geriatric obesity are considered. The potential contribution of adipose-derived factors and fundamental cellular and molecular mechanisms of senescence to exacerbated obesity-induced cerebromicrovascular impairment and cognitive decline in aging are discussed.

scholarly journals Chemokine Ligand 13 (CXCL13) in Neuroborreliosis and Neurosyphilis as Selected Spirochetal Neurological Diseases: A Review of Its Diagnostic Significance

2020 ◽  
Vol 21 (8) ◽  
pp. 2927
Author(s):  
Monika Gudowska-Sawczuk ◽  
Barbara Mroczko
Keyword(s):  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Neurological Diseases ◽  
Treponema Pallidum ◽  
High Sensitivity ◽  
Borrelia Burgdorferi Sensu Lato ◽  
Laboratory Diagnostics ◽  
Diagnostic Significance ◽  
Pubmed Database ◽  
Chemokine Ligand

Neuroborreliosis (NB) and neurosyphilis (NS) are abnormal conditions caused by spirochetal bacteria which affect the nervous system. Diagnosis of neuroborreliosis and neurosyphilis is determined by clinical examination of visible symptoms, serum and cerebrospinal fluid (CSF) analysis, and serological detection of antibodies against Borrelia burgdorferi sensu lato and Treponema pallidum, respectively. Establishing a diagnosis may sometimes pose a number of diagnostic difficulties. A potential role of chemokine ligand 13 (CXCL13) as an accurate diagnostic biomarker of intrathecal inflammation has been suggested. In this review, we focused on changes in serum and cerebrospinal fluid concentration of chemokine ligand 13 in selected spirochetal neurological diseases neuroborreliosis and neurosyphilis reported in the available literature. We performed an extensive search of the literature relevant to our investigation via the MEDLINE/PubMed database. It has been proven that CXCL13 determination can provide rapid information regarding central nervous system inflammation in patients with selected spirochetosis. We described that neuroborreliosis and neurosyphilis are associated with an elevated CXCL13 concentration, mainly in the cerebrospinal fluid. Moreover, literature data suggest that CXCL13 determination is the most interesting additional marker for diagnosis and monitoring of neuroborreliosis and neurosyphilis thanks to its high sensitivity. Based on these published findings, we suggest that CXCL13 has high diagnostic utility and may be applied in laboratory diagnostics as a potential diagnostic marker in human spirochetal neurologic diseases.

scholarly journals Difficult case of a rare form of familial Alzheimer’s disease with PSEN1 P117L mutation

2018 ◽  
Vol 11 (1) ◽  
pp. e226664
Author(s):  
Ana Luísa Rocha ◽  
Andreia Costa ◽  
Maria Carolina Garrett ◽  
Joana Meireles
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
De Novo ◽  
Spastic Paraparesis ◽  
Difficult Case ◽  
Diagnostic Challenge ◽  
Subsequent Investigation ◽  
Neurology Clinic ◽  
Upper Limb Paresis

Less than 10% of Alzheimer’s disease (AD) cases are familial. Presenilin-1 (PSEN1) mutations are the most frequent aetiology and may be associated to atypical neurological manifestations. We report the case of a 27-year-old right-handed man, ensuing with mild cognitive impairment, motor discoordination and axial myoclonus after a parachute accident. At age 32 he was referred to our neurology clinic, presenting cognitive impairment, cerebellar syndrome, axial myoclonus and hypomimia, without other signs of parkinsonism. Because of absence of family history, he was worked up along the line of spinal ataxic disorders. Later, he developed pseudobulbar affect, cognitive deterioration, right upper limb paresis and spastic paraparesis. Subsequent investigation identified a PSEN1 P117L mutation and the diagnosis of autosomal dominant AD was made. This case illustrates the diagnostic challenge imposed by atypical presentation of de novo PSEN1 mutation, leading to unnecessary investigation. Genetic study might be essential for defining the diagnosis.

Post-stroke depression, obstructive sleep apnea, and cognitive impairment: Rationale for, and barriers to, routine screening

2016 ◽  
Vol 11 (5) ◽  
pp. 509-518 ◽  
Author(s):  
Richard H Swartz ◽  
Mark Bayley ◽  
Krista L Lanctôt ◽  
Brian J Murray ◽  
Megan L Cayley ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cognitive Impairment ◽  
Sleep Apnea ◽  
Routine Screening ◽  
Screening Tools ◽  
Stroke Recurrence ◽  
Post Stroke ◽  
Obstructive Sleep ◽  
Post Stroke Depression ◽  
The Impact

Stroke can cause neurological impairment ranging from mild to severe, but the impact of stroke extends beyond the initial brain injury to include a complex interplay of devastating comorbidities including: post-stroke depression, obstructive sleep apnea, and cognitive impairment (“DOC”). We reviewed the frequency, impact, and treatment options for each DOC condition. We then used the Ottawa Model of Research Use to examine gaps in care, understand the barriers to knowledge translation, identification, and addressing these important post-stroke comorbidities. Each of the DOC conditions is common and result in poorer recovery, greater functional impairment, increased stroke recurrence and mortality, even after accounting for traditional vascular risk factors. Despite the strong relationships between DOC comorbidities and these negative outcomes as well as recommendations for screening based on best practice recommendations from several countries, they are frequently not assessed. Barriers related to the nature of the screening tools (e.g., time consuming in high-volume clinics), practice environment (e.g., lack of human resources or space), as well as potential adopters (e.g., equipoise surrounding the benefits of treatment for these conditions) pose challenges to routine screening implementation. Simple, feasible approaches to routine screening coupled with appropriate, evidence-based treatment protocols are required to better identify and manage depression, obstructive sleep apnea, and cognitive impairment symptoms in stroke prevention clinic patients to reduce the impact of these important post-stroke comorbidities. These tools may in turn facilitate large-scale randomized controlled treatment trials of interventions for DOC conditions that may help to improve cardiovascular outcomes after stroke or TIA.

Relationship of respiratory disorders of sleep with cognitive impairment and neurological diseases

2020 ◽  
Author(s):  
Marcos Alejandro Escobar Penagos ◽  
Fernanda Margarita Nuñez Gómez ◽  
Marely Bravo Muñoz
Keyword(s):  
Cognitive Impairment ◽  
Neurological Diseases ◽  
Respiratory Disorders ◽  
Relationship Of

An oral fluid test for syphilis

2005 ◽  
Vol 16 (4) ◽  
pp. 299-301 ◽  
Author(s):  
S D K Baguley ◽  
P J Horner ◽  
P A C Maple ◽  
L Stephenson
Keyword(s):  
Sensitivity And Specificity ◽  
Oral Fluid ◽  
Treponema Pallidum ◽  
Fluorescence Immunoassay ◽  
Time Resolved Fluorescence ◽  
Time Resolved ◽  
Screening Clinic ◽  
Syphilis Serology ◽  
Outbreak Situation ◽  
Fluid Test

We have developed a time-resolved fluorescence immunoassay to detect antibodies to Treponema pallidum recombinant antigens in oral fluid specimens. Using an 'Oracol' swab, oral fluid was collected from 34 subjects with a serological diagnosis of syphilis and 97 seronegative controls. Using a cut-off of three standard deviations over control mean, the sensitivity and specificity of the assay in all subjects with positive syphilis serology was 76.5% and 97.9%, respectively. In those with early syphilis, the sensitivity and specificity of the assay was 100% and 97.9%. In a non-outbreak situation, screening clinic attendees for syphilis using oral fluid specimens is potentially useful when collection of blood is not practicable. In addition, it may have much to offer in outreach projects and epidemiological investigations.

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