Are We Aware of the Neurological Manifestations of Cytomegalovirus Infection in Immunocompetent Individuals?

BACKGROUND: While cytomegalovirus (CMV) infection usually causes disease in immunosuppressed individuals, it mostly progresses as an asymptomatic infection in healthy adults. However, very rarely, immunocompetent individuals may also suffer from encephalitis and stroke. METHODS: Nine patients who were admitted to the Neurology Clinic of Abant Izzet Baysal University Faculty of Medicine from 2016 to 2020 who had various neurological symptoms and were diagnosed with CMV infection were retrospectively analyzed. Symptoms, examination findings, laboratory results, radiologic imaging, and treatments were recorded and evaluated. RESULTS: Although severe infections because of CMV generally occur in newborns and immunosuppressed adults, it is estimated that the disease is more common in immunocompetent adults than known. This may be associated with unrecognized risks, in part because of immune dysfunction or comorbidities such as renal failure or diabetes mellitus. Also, CMV replication in arterial endothelial cells can restrict blood flow, inducing an atherosclerotic environment and causing stroke. Diagnosis is based on clinical suspicion and serology. Ganciclovir is administered for treatment. CONCLUSION: CMV infection should be considered in the differential diagnosis of patients presenting with neurological symptoms, even among immunocompetent individuals, because of the high possibility that patients can greatly benefit from antiviral treatment at the early stage.

Could Artesunate Have a Positive Effect on the Neurological Complications Related to Infection When It Is Used in the Treatment of COVID-19?

Artesunate is a safe noncytotoxic drug with low side effects which is used in the treatment of chloroquine-resistant malaria. In addition to being an antimalarial drug, artesunate also has immunomodulatory, anticarcinogenic, and antiviral activity. There are in vivo and in vitro studies reporting that artesunate may have a positive effect on the treatment of COVID-19. Artesunate may be effective based on its effect on the anti-inflammatory activity, chloroquine-like endocytosis inhibition mechanism, and nuclear factor kappa B (NF-κB) signal pathway. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may cause neurological complications in addition to targeting the respiratory system. In this study, we have discussed the possible neuroprotective action mechanisms of artesunate. We think that systemic and intranasal topical artesunate administration may have a positive effect on neurological complications resulting from COVID-19.

Investigation of a 6-year seropositivity of Toxoplasma gondii in Abant Izzet Baysal University Educational Research Hospital.

OBJECTIVE: The aim of the present study was to determine the prevalence of Toxoplasma gondii IgG and IgM antibodies in patients who were admitted in Abant Izzet Baysal University Education and Research Hospital between January 2010 and December 2016 with a suspicion of toxoplasmosis. METHODS: Anti-T. gondii IgM and IgG antibodies and IgG avidity test determined by ELISA method in 14,262 serum samples belonging to the Abant Izzet Baysal University Education and Research Hospital were retrospectively investigated. RESULTS: IgG was detected in 4079 serum samples with 78% negative, 21% positive, and 0.8% gray zone. IgM was detected in 13,671 cases with 98% negative, 1.2% positive, and 0.5% gray zone. (3.8%, n=540) and neurology (3.4%, n=478) patients who were referred to the Obstetrics and Gynecology Clinic (88.3%, n=12,588) for the majority of the cases requested for the detection of T. gondii antibodies. It has been found that a request has been made. CONCLUSION: The seropositivity of T. gondii has been found to be so large that it should not be ignored. It has come to the conclusion that the events in the risk group should be taken into consideration for this parasite, and awareness should be established. In recent years, this awareness has been observed, especially in neurology clinics.

Optical coherence tomography findings in Parkinson's disease.

The aim of this study is to compare optical coherence tomography (OCT) findings of retinal thickness (RT) and retinal nerve fiber layer thickness (RNFLT) of idiopathic Parkinson's disease (IPD) patients to those of healthy subjects, and to investigate whether there is any relationship between the severity of the disease and the RNFLT values. This prospective study was included 25 IPD patients and 29 healthy controls. In the IPD group, the Hoehn and Yahr (H&Y), Unified Parkinson's Disease Rating Scale (UPDRS), and Mini-Mental State Exam (MMSE) were performed. Intraocular pressure (IOP), visual acuity (VA), spherical equivalent, axial length (AL), and central corneal thickness (CCT) were measured using OCT in both groups. The RT was measured in the central retinal (RTc), nasal (RTn), and temporal (RTt) segments. Nasal (RNFLTn), nasal superior (RNFLTns), nasal inferior (RNFLTni), temporal (RNFLTt), temporal superior (RNFLTts), and temporal inferior (RNFLTti) measurements were made and mean RTFLT was calculated (RNFLTg) for each individual. In the patient group, IOP and VA values were statistically significantly lower The RTn and RNFLTg were significantly thinner in the patient group. There was no statistically significant relationship between the severity of IPD and these findings. In our study, RNFLTg and RTn were found to be thinner in the IPD group, which may have caused lower VA scores. The effects of retinal dopamine depletion on RT and RNFLT, and lower IOP values in the non-glaucomatous IPD patients should be further investigated.