Neurofilament-light in former athletes: a potential biomarker of neurodegeneration and progression.

BACKGROUND/OBJECTIVE: This study aimed to evaluate serum neurofilament light chain (NF-L) levels in former professional contact sports athletes with multiple concussions (ExPro) as a potential biomarker of neurodegeneration and predictor of white-matter (WM) abnormality progression. METHODS: Concentrations of NF-L in the serum of fifty-two cognitively normal ExPro and twenty-one healthy controls (HC) with no history of concussions were measured using single molecule array (Simoa) technology. Both groups underwent neuroimaging at the time of serum collection. Eighteen of the participants in the ExPro underwent follow-up imaging after 2 years. RESULTS: Levels of serum NF-L were not significantly different between the ExPro and HC. However, in the ExPro group, NF-L levels were positively correlated with the mean diffusivity (MD) of corpus callosum (CC) and fornix, and total ventricular volume. Moreover, NF-L levels in the ExPro group at the first visit were positively correlated with the amount of increase in CC MD at the 2-year follow-up. CONCLUSIONS: NF-L levels reflect neuronal changes in the ExPro group and predict the extent of decrease in white matter integrity over time. Serum NF-L might be a biomarker of neurodegeneration and WM abnormality progression in ExPro.

Irreversible unilateral visual loss due to acute sinusitis.

Extension of sphenoethmoiditis into the orbital apex may result in visual loss and ophthalmoplegia, but minimal signs of orbital pathology such as proptosis, chemosis, or lid edema. This entity is termed orbital apex syndrome. The case of a 74-year-old woman with orbital apex syndrome and irreversible unilateral visual loss secondary to bacterial sphenoethmoiditis is presented. This case, and our review of the literature, suggest that patients with symptomatic acute sphenoethmoiditis are at a relatively higher risk of permanent visual loss than those with sinusitis not involving the posterior ethmoid and/or sphenoid sinuses.

Eating utensil foreign bodies of the esophagus.

Large foreign bodies of the esophagus are uncommon. We report two unusual cases of eating utensil, esophageal, foreign bodies that occurred unintentionally following self-instrumentation of the oropharynx. The histories, radiographs, and clinical management of these cases are presented and discussed.

Cerebrospinal fluid rhinorrhea: an unusual presentation of domestic violence.

The incidence of "battered woman syndrome" is increasing over the past few years affecting as many as one in every four families. Most of these cases present to the emergency room with mostly head and maxillofacial injuries. We are describing three cases of battered women with cerebrospinal fluid rhinorrhea as the only presenting symptom of domestic violence. The different etiologies, work up and treatment strategies are all discussed and reviewed.

Impact of depression and disability on quality of life in Iranian patients with multiple sclerosis.

Multiple sclerosis (MS) can influence all aspects of a patient's health. This study determines the main factors affecting quality of life (QoL) in Iranian MS patients. QoL (Multiple Sclerosis Impact Scale; MSIS-29), disability (Expanded Disability Status Scale; EDSS) and depression (Beck Depression Inventory; BDI) were assessed in 106 MS patients. EDSS, clinical course and MS duration significantly correlated with physical MSIS-29. Depression highly correlated with both physical and psychological MSIS-29. Regression analyses showed that depression and EDSS predicted physical health. Psychological health was predicted by depression. These findings highlight that depression and physical disability strongly influence QoL in Iranian MS patients.

Laryngeal tuberculosis: presentation of 16 cases and review of the literature.

Tuberculosis of the larynx was quite common in the past and usually associated with advanced pulmonary cavitations with an overall mortality of approximately 70% before the advent of chemotherapy. Its incidence was on the decline in the last two decades; however, it seems to be on the increase in the last few years. During the past 30 years, 16 patients with laryngeal tuberculosis were investigated at the American University of Beirut, Medical Centre. Around 20% of our patients had isolated laryngeal tuberculosis with no apparent pulmonary involvement. Four patients (25%) presented with stridor and had a tracheotomy performed for the relief of their upper airway obstruction. In contrast to earlier studies, our series showed great variations as far as location and appearance of the laryngeal lesions.

Case report: aspiration from delayed radiation fibrosis of the neck.

An unusual case of delayed severe fibrosis of the soft tissues of the neck following radiation therapy for squamous cell carcinoma of the oropharynx resulting in dysphagia and recurrent aspiration is reported. The patient's case history, radiographic findings, and speech-language pathologic evaluation are presented.