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Introduction: Chorea, hyperglycemia, basal ganglia syndrome (CHBG) is a rare neurological complication of nonketotic hyperglycemia which occurs more often in elderly female patients with undiagnosed or poorly controlled diabetes mellitus. Case report: We present the case of a 82-year old female, diagnosed with type 2 diabetes mellitus, but untreated, admitted with non-ketotic hyperglycemia and hemiballistic movements in her left limbs, with acute onset, that changed to choreic movements and then disappeared. Brain magnetic resonance imaging (MRI) showed characteristic hyper intensity in the right (contralateral) putamen on the T1-weighted images. Other secondary causes for ballismus and chorea were excluded. Hemiballismus/hemichorea non-ketotic hyperglycemic basal ganglia (CHBG) syndrome was considered and blood glucose was lowered using insulin. As symptomatic treatment, Haloperidol was started but, due to adverse effects, it was stopped and Clonazepam was associated. The movement disorders disappeared in two weeks after glycemic control. Signifi cance: Movement disorders, like chorea and/or ballismus (hemichorea/hemiballismus) can be a marker of uncontrolled known diabetes mellitus or a presenting sign for an undiagnosed diabetes mellitus. The chorea hyperglycemia basal ganglia (CHBG) syndrome is rare and likely undiagnosed but, being aware of it’s existence is of high importance, as normalising blood sugar values severe neurological complications can be avoided.

Spinal hydatic disease must be considered in the differential diagnosis of the spinal cord compression syndrome especially in endemic areas. The disease is highly prone to recurrence, despite the introduction of modern surgical and pharmacological therapies. The prognosis is poor, comparable to that of malignancies.

BACKGROUND Shared decision making (SDM) is very important from patients' perspective. This process has not yet been evaluated in Romania. The study aims to evaluate SDM from the patients' perspective and to evaluate patients' characteristics that associate with SDM. MATERIAL AND METHODS A cross-sectional multicentric study comprising eight recruitment centres was performed. Inpatients and outpatients who referred to Hospital Units treating autoimmune diseases or atrial fibrillation were included. Another sample consisted of members of the Autoimmune Disease Patient Society, who completed an online anonymous questionnaire. All participants completed the Romanian translated version of the 9-item Shared Decision Making Questionnaire (SDM-Q-9), as these samples were used for the validation of this questionnaire, too. Patients had to refer to the visit in which the decision concerning the antithrombotic treatment was taken (atrial fibrillation patients), or the immunosuppressive treatment was last time changed (autoimmune disease patients). Ordinal regression having the total SDM score as dependent variable was used. RESULTS A total of 665 questionnaires were filled in within the hospital setting (n = 324; 48.7%) and online (n = 341; 51.3%). The median score for SDM was 34 of 45, but it differed between hospital completion -39/45 and online completion (anonymous) -20/45 (P < .001). Patients with higher education were influenced most by the setting, giving the best marks in hospital and low marks online, while those with lower education gave lower marks in both settings. In ordinal regression with SDM score as dependent variable, hospital completion of the questionnaire (OR = 9.5, 95% confidence interval, 5.69-16), collagen disease diagnosis (OR = 2.4, 95% confidence interval, 1.39-4.14), and immunosuppressive treatment (OR = 2.16, 95% confidence interval, 1.43-3.26) were independent predictors. CONCLUSION In our study, full anonymity was associated with significantly lower scores for the SDM process. The patients with higher education were most influenced by this condition, while those with the lowest education were the most critical.

Optic nerve sheath meningiomas (ONSM) are rare, frequently unilateral, benign, slowly growing tumors, arising from the meningo-epithelial cells surrounding the optic nerve intraorbital or intercanalicular. Their localization directly impair vision and indirectly impair aesthetics, making a safe classical surgical intervention very difficult and recommending stereotactic fractionated radiotherapy. Women are more affected, the survival rate is good and imaging can sustain differential diagnosis with optic neuroglioma or orbital schwannoma, lymphoma or pseudo tumor.

Background . Shared decision making (SDM) is becoming more and more important for the patient-physician interaction. There has not been a study in Romania evaluating patients’ point of view in the SDM process yet. Therefore, the present study aims to evaluate the psychometric parameters of the translated Romanian version of SDM-Q-9. Material and methods . A multicentric cross-sectional study was performed comprising eight recruitment centers. The sample consisted of in- and outpatients who referred to Hospital Units for treatment for atrial fibrillation or collagen diseases. Furthermore, patients who were members of Autoimmune Disease Patient Society were able to participate via an online survey. All participants completed the Romanian translated SDM-Q-9. Results . Altogether, 665 questionnaires were filled in within the hospital setting (n = 324; 48.7%) and online (n = 341; 51.3%). The Romanian version had good internal consistency (Cronbach α coefficient of 0.96.) Corrected item correlations were good ranging from 0.64 to 0.89 with low corrected item correlations for item 1 and item 7. PCA found a one-factorial solution (similar with previous reports) but the first item had the lowest loading. Conclusion . SDM-Q-9 is a useful tool for evaluation and improvement in health care that was validated in Romania and can be used in clinical setting in this country.

Visual acuity loss can be due to eye ball diseases or to lesions of the optic nerves, visual pathway or cortical projection of vision. The differential diagnosis can be challenging and though patients go first to the ophthalmologist, there is not always the ophthalmologist who can diagnose and treat the patient. For a great number of causes/diseases, a neurologist should also see the patient, even if there is a transient or persistent monocular or binocular visual acuity loss a disturbance of the visual field or of the perception of colours. Visual acuity loss can be more than this. It can be a symptom or a sign of a neurological or systemic disease and a rapid diagnosis and specific treatment are mandatory in order to treat the symptoms and improve the patient’s quality of life.

Traditionally, multiple sclerosis (MS) has been considered a white matter disease, but MS lesions are known to occur in grey matter. Recent immunohistochemical studies have demonstrated extensive grey matter demyelination in chronic MS, grossly underestimated by standard hystochemical myelin staining methods. Extensive cortical demyelination is associated with the progressive phases of disease, as less cortical demyelination has been detected in relapsing-remitting MS. The pathology of grey matter lesions differs from that of white matter lesions. Significant axonal transection and neuronal loss have been demonstrated in grey matter MS lesions. Current magnetic resonance imaging (MRI) methods are not sensitive for purely cortical MS lesions. Special MRI techniques permit the visualization of grey matter lesions, and in the future more sensitive MRI methods will help to characterize their clinical significance.

Multiple sclerosis (MS) is a chronic inflammatory and degenerative disease of young people, which affects life quality, with social and psychological effects. The new era of treatments in MS, with drugs influencing immunomodulatory systems made possible a new approach of these patients, in efforts to make them capable to perform their activities as much as possible. Physical rehabilitation is an important mean for making patients with MS to accept their disease and to favourise their independence longer time. Patients should be encouraged to perform daily, or at least 2-3 times a week, a programme of physical exercises under the supervision of a specialist. Performing exercises in MS leads to a lot of benefits, not only physical ones, but also psychological ones and for overall health and finally to quality of life improvement. Physical therapy should be combined with psychological support, for limitation of negative impact of a chronic disease in young people. We must not forget that depression, anxiety, and in late stages of the disease, cognitive decline can interfere with life quality, so it is necessary to manage in a correct way all these aspects.

Electrical potential oscillations were obtained across a liquid membrane composed of nitrobenzene/picric acid placed between two aqueous phases in the presence of various taste (i.e. salty, sweet and bitter) substances. The influence of these compounds on electrical oscillations was studied using Fourier analysis to establish a “fingerprint” of the substance that can be correlated with its taste index. Various concentrations of each substance were tested to obtain a Fourier spectrum with discrete peaks which can be further processed. The electrical oscillations consisted of a number of weak damped oscillators, and the Fourier spectra of these signals were found to have a number of discrete peaks of decreasing amplitude at low frequencies (0–0.5 Hz). A correlation of the frequency of the first peak of the Fourier spectrum with the taste index was found for bitter substances, whereas for salty substances the amplitude of the first two peaks of the spectrum was correlated with the taste index.