The Infectious Headache- A Case of Neurocysticercosis

A 50-year-old Hispanic female presented to her primary care physician with a progressively worsening headache over a week, associated with visual disturbances, prosopagnosia and episodes of disorientation. Outpatient workup with head CT showed abnormality in the ventral aspect of the left thalamus showing 1.2 × 1 cm low density cyst with approximately 2-3 mm right-left midline shift locally. Left basal ganglia showed multiple well-defined foci of low density measuring up to 3 mm reflecting edema. On admission, pertinent physical exam findings were left sided nystagmus, positive deep tendon reflexes (DTRs) in the right lower extremity (RLE), positive Babinski on the right foot, and mild endpoint tremor dysmetria. MRI showed multiple cystic structures (Figure 1) with eccentric nodularity suggesting a scolex, with calcifications and surrounding edema (Figure 2). The largest was localized near the left anterior aspect of the third ventricle measuring 15 mm with vasogenic edema extending to left temporal lobe (Figure 3). EEG showed focal cortical disturbance (transient triphasic sharp morphology) on the left hemisphere localizing to the central temporal region, corresponding with the area of vasogenic edema and potential for epileptogenesis (Figure 4). Travel history was significant for a family vacation in Punta Cana 3 years prior, where they ate at local restaurants and street vendors. Family members also lived in close proximity, often preparing meals together. Serum antibody detection ELISA assays for Taenia solium cysticercosis (T. solium) was negative. Serum testing for Toxoplasmosis, HIV and CMV were also unrevealing. A diagnosis [1] of Neurocysticercosis (NCC) was established based on 2 Major Neuroimaging criteria: presence of cystic lesions and enhancing lesions paired with 1 Minor criteria: Clinical presentation. Treatment [2] was started as per IDSA guidelines with albendazole, praziquantel (though delayed due to lack of supply in hospital), anti-epileptic and dexamethasone. Recommendation was given for family members to be evaluated and treated upon discharge. Repeat MRI brain after one month of treatment initiation, showed a decrease to 13 mm for the largest cyst. Patient was instructed to follow up with her PCP and ID specialist for monitoring

Superior Short-Term Patency of Stents Over Balloons in Infrapopliteal Artery Disease

Purpose The optimal strategy for revascularization in below-the-knee (BTK) chronic limb-threatening ischemia (CLTI) remains debatable. High restenosis rates of percutaneous transluminal angioplasty (PTA) often warrants re-intervention or amputations. Novel devices such as drug-eluting (paclitaxel) balloons (DEB), stents, and atherectomy devices- directional (HawkOne, SilverHawk, TurboHawk)™ or orbital (DiamondBack 360) ™ are used infrequently as therapy when BTK. We aim to compare the rate of total re-occlusion between these interventions. Material & Methods A retrospective chart review of 97 patients who underwent BTK percutaneous intervention in 2015-2020 at our hospital. Descriptive statistics were used to assess the distribution of variables; continuous variables (time to readmissions) were summarized as mean values with standard deviations, and categorical variables were summarized as counts and percentages. Results Out of the 97 patients, 73.4% met documented Rutherford category V-VI on initial admission, 53.6% patients were readmitted to our facility with Rutherford category IV-VI at 8 +/- 8 months from initial intervention, 79.7% were diabetic and 62.5% were hypertensive. Interventions performed on the 208 arteries were plain balloon angioplasty 57.7%, DEB 2.9%, atherectomy with adjunctive PTA (A+PTA) 28.8%, stent 8.7% and atherectomy with adjunctive stent (A+S) 2.9%. Of the stents placed, 13 were bare-metal stent (BMS) and 11 drug-eluting (everolimus) stent (DES). Within 12 months from initial intervention, total re-occlusion post PTA occurred at 4 (+/-3) months, A+PTA 3.7 (+/-2) months, and stents 8 (+/-3) months (p= 0.015, F= 4.6). Comparing stents, restenosis was 53.8% in BMS versus 18.2% in DES (p= 0.09) at 6 (+/-3) months readmission. Re-occlusion rates 30 months from initial intervention were 58.1% for uncoated balloons, 33.3% A+PTA, 60% DEB, 50% stents and 50% A+S (p= 0.27). 22 patients were not readmitted again for any reason. Of the 17 patients who underwent major amputation (below or above the knee), 10 had triple-vessel involvement below the knee, 4 had osteomyelitis. Restoring straight-line flow in angioplasty was unsuccessful in 10 cases. Conclusion These preliminary data suggest superior short term (\u3c 1-year) patency of stents over PTA and A+PTA BTK. Re-occlusion in A+PTA may be lower than PTA alone. DES seems to have better patency than BMS. Further studies needed to compare clinical outcomes

In Support of the Matrix Language Frame Model: Evidence from Igbo-English Intrasentential Codeswitching

This paper explores the morphosyntactic features of mixed nominal expressions in a sample of empirical Igbo-English intrasentential codeswitching data (i.e. codeswitching within a bilingual clause) in terms of the Matrix Language Frame (MLF) model. Since both Igbo and English differ in the relative order of head and complement within the nominal argument phrase, the analysed data seem appropriate for testing the veracity of the principal assumption underpinning the MLF model: the notion that the two languages (in our case Igbo and English) participating in codeswitching do not both contribute equally to the morphosyntactic frame of a mixed constituent. As it turns out, the findings provide both empirical and quantitative support for the basic theoretical view that there is a Matrix Language (ML) versus Embedded Language (EL) hierarchy in classic codeswitching as predicted by the MLF model because both Igbo and English do not simultaneously satisfy the roles of the ML in Igbo-English codeswitching

African Linguistics in Central and Eastern Europe, and in the Nordic Countries

Non peer reviewe

The Synthesis and Characterization of a Diruthenium Complexe-diruthenium Tetra ETHYL-4-[(PYRIDIN-3-YL] AMINO) Benzoate Chloride- A Potential Chemotherapeutic Agent.

Platinum and Ruthenium complexes show prospective as an antitumor and antimetastasis agent. The lower toxicity found with ruthenium compared to platinum and the advantages of ruthenium\u27s geometric shape made it more advantageous for my antitumor research. Reaction of metal-metal bonded complex diruthenium tetraacetate chloride (RU2(02CCH3)4Cl and ethyl-4-[(pyridine-3-yl) amino] benzoate leads to the synthesis of diruthenium tetraethyl-4-[(pyridine-3-yl) amino] benzoate chloride. The complex was examined using infrared spectroscopy and thermal gravitational analysis. The infrared spectroscopy allowed comparison with original compound and synthesized complexes to see new bonds and functional groups that were formed, which helped in identifying the formation of ethyl-4-[(pyridine-3-yl) amino] benzoate. Thermal gravimetric analysis indicates that the complex synthesized had two ruthenium atoms. It also helped determine that four ethyl-4-[(pyridine-3-yl) amino] benzoate were bonded to 1 2 two ruthenium\u27s which were originally attached to four acetate chloride\u27s. Similarities with functional group\u27s (such as the NH2, Cl and arene groups) within the synthesized diruthenium complex and ruthenium complexes which are currently being researched and/ or in clinical trial stages show antitumor and antimetatasis potential in the synthesized comple