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IntroductionTo the best of our knowledge, here we present two post-COVID19 longitudinally extensive transverse myelitis (LETM) with atypical presentationsCase presentationsA 44-year-old male who did not have any previous medical condition and a 73-year-old male foreigner who did not have any disease other than type 2 diabetes mellitus were admitted to our neurology clinic in the same period with similar clinical presentations of transverse myelitis. Upon admission, paraplegia and urinary-fecal incontinence were observed in their neurological examination. Neurological complaints had started within approximately 3–4 weeks following the resolution of the COVID-19 infection. Thoracic lower segment LETM was observed on spinal magnetic resonance imaging (MRI) in one of the patients, and long segment myelitis extending from the lower thoracic segment to the conus medullaris was observed in the other one. No significant diagnostic positivity was present in their diagnostic evaluation. In both cases, we assume a post-infectious etiology in terms of secondary immunogenic overreaction following COVID-19.ConclusionOur patients improved with multiple treatments such as methylprednisolone, intravenous immunoglobulin, and plasmapheresis. Whether post-infectious myelitis behaves differently from other viral infections after COVID-19 is currently unclear. Long lag times appear to be a post-infectious neurological complication resulting from the host response to the virus.

Cigarette smoking has been associated with increased occurrence of multiple sclerosis (MS), as well as clinical disability and disease progression in MS. We aimed to assess the effects of smoking on the white matter (WM) in patients with clinically isolated syndrome (CIS) using diffusion tensor imaging. Smoker patients with CIS (n=16), smoker healthy controls (n=13), nonsmoker patients with CIS (n=17) and nonsmoker healthy controls (n=14) were included. Thirteen regions-of-interest including nonenhancing T1 hypointense lesion and perilesional WM, and 11 normal-appearing white matter (NAWM) regions were drawn on color-coded fractional anisotropy (FA) maps. Lesion load was determined in terms of number and volume of WM hyperintensities. A tendency towards greater lesion load was found in smoker patients. T1 hypointense lesions and perilesional WM had reduced FA and increased mean diffusivity to a similar degree in smoker and nonsmoker CIS patients. Compared with healthy smokers, smoker CIS patients had more extensive NAWM changes shown by increased mean diffusivity. There was no relationship between diffusion metrics and clinical disability scores, duration of the disease and degree of smoking exposure. Smoker patients showed a tendency towards having greater number of WM lesions and displayed significantly more extensive NAWM abnormalities.

This article focuses on images of walking in Agnès Varda's films -  Cléo de 5 à 7 (1962), Sans toit ni loi (1985), and Les Plages d' Agnès (2008). The activity of walking (as urban flânerie, circular travelling or walking backwards) is central to these films, and can be seen as a corporeal practice that not only interweaves striated and smooth spaces but also offer a gender-sensitive, political contemplation on the forces of striation and smoothing as well as a re-invention of space. The women in movement in Varda's films embody a transgression of stratified territories such as the image-oriented society of the spectacle in Cléo , myths of adolescence and settled living in Sans toit ni loi , or the boundaries of aging in Les Plages d'Agnès .

Teriflunomide is a once-daily oral immunomodulatory disease-modifying treatment for multiple sclerosis (MS). Skin reactions are an infrequent side effect of teriflunomide. Here, we present the case of a 52-year-old female patient with ankylosing spondylitis who was consulted for demyelinating lesions and limb weakness. She was diagnosed with multiple sclerosis and started treatment with teriflunomide. Palmoplantar pustular psoriasis developed after three weeks of treatment initiation. It is a rare side effect related to teriflunomide.

Multiple sclerosis (MS) is characterized as an immune-mediated central nervous system disease marked by chronic inflammation, demyelination, and progressive neurodegeneration. In this study, we evaluated the contribution of low-frequency and rare genetic variants to MS susceptibility within one of the largest family-based MS cohorts to date, comprising 215 individuals from 59 Turkish multiplex MS families. Whole exome sequencing was conducted on all samples including affected and unaffected members, followed by investigation of the effect of well-established human leukocyte antigen loci for MS on the elevated MS risk observed in our families. Subsequently, a gene-based burden analysis was performed on candidate genes identified through both our segregation analysis and existing literature. To prioritize the genes and pathways that are potentially associated with MS, a segregation-based analysis of the variants was conducted and complemented by gene-based pathway enrichment analysis. Our results highlighted the significance of the extracellular matrix in MS pathogenesis, as we identified laminin-related genes including LAMA5 and LAMB1 from both the segregation analysis and gene-based burden test. Hemidesmosome assembly emerged as a key pathway in our analysis, primarily driven by the identification of DST and PLEC as significant genes in the gene-based segregation analysis. Finally, we identified two rare coding variants passing our allele frequency and deleteriousness score-based filters, rs41266745 (C> T) in the CD109 gene with CADD phred score 24 and rs143093165 (T> G) in the ITPR1 gene with CADD phred score 22 and LOEUF 0.325, segregating within more than one family. Overall, this is one of the first and largest family-based MS studies from Turkey that features a unique cohort from an admixed population that enabled the detection of novel low-frequency and rare variants associated with MS. The findings from this study offer valuable insights that could guide future research aimed at further exploring and understanding the factors contributing to MS risk.

This study compared trunk exercises based on the Bobath concept with routine neurorehabilitation approaches in multiple sclerosis (MS). Bobath and routine neurorehabilitation exercises groups were evaluated. MS cases were divided into two groups. Both groups joined a 3 d/wk rehabilitation program for 8 wk. The experimental group performed trunk exercises based on the Bobath concept, and the control group performed routine neurorehabilitation exercises. Additionally, both groups performed balance and coordination exercises. All patients were evaluated with the Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), International Cooperative Ataxia Rating Scale (ICARS), and Multiple Sclerosis Functional Composite (MSFC) before and after the physiotherapy program. In group analysis, TIS, BBS, ICARS, and MSFC scores and strength of abdominal muscles were significantly different after treatment in both groups (p < 0.05). When the groups were compared, no significant differences were found in any parameters (p > 0.05). Although trunk exercises based on the Bobath concept are rarely applied in MS rehabilitation, the results of this study show that they are as effective as routine neurorehabilitation exercises. Therefore, trunk exercises based on the Bobath concept can be beneficial in MS rehabilitation programs.

Amac: Primer progresif multipl skleroz (PPMS) ve progresif relapsing multipl skleroz (PRMS) baslangictan beri olan progresyon ile karakterize MS tipleridir. Nadir gorulmelerinden dolayi, literaturde diger MS formlarina gore daha az bilgi bulunmaktadir. Bu calismanin amaci progresif baslangicli MS (PBMS) hastalarinda klinik ve laboratuvar ozelliklerini ortaya koymaktir. Yontem: PBMS hastalari 2010-2014 yillari arasinda degerlendirilip demografik, klinik ozellikleri ve beyin omurilik sivisi (BOS) bulgulari belirlendi. Bulgular: Otuz iki PBMS hastasi ile ilgili veriler degerlendirildi. Hastalik seyri 24 hastada relaps olmadan (PPMS), sekiz hastada ise relapsli progresifti (PRMS). Kadin/erkek orani tum grupta 1'di. Ortalama baslangic yasi tum grup icin 40 (23-55) yasti. Gruplar arasinda hastalik baslangic yasi ortancasi anlamli farkli bulunmadi (p=0,053). En sik prezantasyon belirtisi motor bozukluklardi. Relapslar tum hastalarda hastaligin ilk 10 yilinda goruldu. BOS analizinde oligoklonal bant pozitifligi ve artmis IgG indeksi acisindan gruplar arasinda fark saptanmadi (p=0,938, p=0,058). Hastalik suresi her iki grupta da benzer oldugu halde, PPMS grubunda degerlendirme sirasinda ortanca EDSS skoru daha yuksek bulundu (p=0,020). Sonuc: Calismamiz Turk PBMS hastalarinin klinik seyir ve laboratuvar bulgularina odaklanmis ilk calismadir. Iki grubun klinik ve laboratuvar bulgularinin karsilastirilmasi benzer sonuclar gostermistir. Gruplar arasinda hastalik baslangic yasi ve artmis IgG indeksi acisindan farklilik olup olmadigini netlestirmek icin gelecekte daha genis orneklemli calismalar yapilmasi gerekmektedir. Anahtar Kelimeler: kronik progresif multiple skleroz, multipl skleroz, primer progresif multiple skleroz, beyin omurilik sivisi

ObjectivesBehçet disease (BD) is a complex vasculitis with both autoimmune and autoinflammatory features. Despite specific clinical features, no laboratory tests are available for the diagnosis of BD. We recently found that BD sera exhibited immunoreactivity against neurofilament medium protein (NF-M). This study aimed to replicate this finding in an independent cohort and to assess the specificity and sensitivity of NF-M immunoreactivity in serum samples obtained from BD, systemic lupus erythematosus (SLE), multiple sclerosis (MS), psoriatic arthritis (PsA) and non-Behçet uveitis (NBU) patients as well as healthy donors.MethodsSerum samples from 76 patients (33 BD, 16 MS, 15 SLE, 9 PsA and 3 NBU) and 22 healthy donors (totalling 98 sera) were analysed. Mouse brain tissue sections were immunolabelled with the sera and examined using confocal microscopy.Results97% (32/33) of BD patient sera exhibited a distinct fine filamentous staining pattern consistent with NF-M protein immunolabelling in axons, while sera from healthy controls and patients with SLE, MS, PsA and NBU showed no similar staining. Conversely, MS patient sera displayed a thick filamentous staining pattern attributed to oligodendrocytes and their myelin-forming processes. SLE patient sera intensely labelled all cell nuclei, conforming to immunoreactivity against nuclear antigens.ConclusionsThese findings reveal the ubiquitous presence of NF-M immunoreactivity, reportedly cross-reacting with bacterial heat shock protein 65, in BD sera. This common and specific immunoreactivity may serve as a valuable tool for diagnosing BD. Additionally, the data confirm the unique potential of connective tissue-poor brain sections for identifying sero-immunoreactivity.

Logo design is the most powerful visual instrument that indicates how brands seem to their stakeholders and determines the brand's reputation. In the past, corporations focused only on the graphic design of logos, and this situation has changed over time and included many intangible features such as the institution's culture, stance goals, and the position that individuals want to be in the content of the logo. In this context, the current research looks for similarities of linear effects in logo designs belonging to brands with strong corporate reputations. It investigates the relationship between the character traits and emotions reflected by these effects and the perception of reputation. We employed an artificial intelligence-based “Psychophysiological Data Harvesting” technique for this research and used a multi-method. While conducting the research, the visual identities of the world's top 10 brands with the strongest corporate reputation (2016-2020), according to the Global RepTrak® 100 Research, were examined. As part of the Psychophysiological Data Harvesting technique, participants' logos, facial expression analyses, and eye-tracking data were compared with the participant's responses to the survey questions. Thirty-nine people participated in the research. As a result, valuable findings were obtained about which linear effects and emotions should be applied for a strong perception of corporate reputation. It is thought that the results of the linear effect, character traits and emotional states in the logo production processes will be beneficial and will guide the designers to create the strength of the corporate reputation in the dimension of visual identity.

Background: Systemic lupus erythematosus (SLE) is one of the autoimmune diseases, which is rarely reported with Myasthenia Gravis (MG). In the literature, the clinical features of MG in these patients were not mentioned in detail. Here, we want to present our five patients with MG and SLE. Methods: Between 2000 and 2010, 132 MG patients were evaluated and have been followed up in our institution. Five patients had MG with SLE and eleven patients had antinuclear antibody (ANA) positivity without SLE symptoms. The clinical, laboratory findings and treatment responses were reviewed. Results: All patients had generalized MG and four of five patients experienced at least one myasthenic crisis. The response to corticosteroid was poor; consequently, they needed immunosuppressive treatments, IVIg or plasmapheresis. Although in the literature thymectomy was accused of the precipitation of SLE, in our series SLE symptoms preceded thymectomy. Conclusion: We would like to point out that MG and SLE being two autoimmune diseases may coexist. This coexistence might cause a more severe myasthenic course compared to MG alone; therefore, these patients need a close and frequent follow-up.