Diffusion tensor imaging of the cervical spinal cord of patients with Neuromyelitis Optica

Background: Previous studies have demonstrated a correlation between Expanded Disability Status Scale (EDSS) and Diffusion Tensor Imaging (DTI) metrics, but the conclusions were based on evaluations of the entire cervical spinal cord.Objectives: the purpose of this study was to quantify the FA and MD values in the spinal cord of NMO patients, separating the lesion sites from the preserved sites, which has not been previously preformed. in addition, we attempted to identify a correlation with EDSS.Methods: DTI was performed in 11 NMO patients and 11 healthy individuals using a 1.5-T MRI scanner. We measured the FA and MD at ROIs positioned along the cervical spinal cord. the mean values of FA and MD at lesion, preserved and spinal cord sites were compared with those of a control group. We tested the correlations between the mean FA and MD with EDSS.Results: FA in NMO patients was significantly reduced in lesion sites (0.44 vs. 0.55, p = 0.0046), preserved sites (0.46 vs. 0.55, p = 0.0015), and all sites (0.45 vs 0.55, p = 0.0013) while MD increased only in lesion sites (1.03 x 10(-3) mm(2)/s vs. 0.90 x 10(-3) mm(2)/s, p = 0.009). the FA demonstrated the best correlation with EDSS (r = -0.7603, p = 0.0086), particularly at lesion sites.Conclusions: the results reinforce the importance of the FA index and confirm the hypothesis that NMO is a diffuse disease. (C) 2014 Elsevier Inc. All rights reserved.TEVA Pharmaceutical (Brazilian branch)Universidade Federal de São Paulo UNIFESP, Dept Diagnost Imagem, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Neurol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Diagnost Imagem, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Neurol, BR-04024002 São Paulo, BrazilWeb of Scienc

Association between demyelinating disease and autoimmune rheumatic disease in a pediatric population

Introduction: Multiple sclerosis (MS) and neuromyelitis optica (NMO) are demyelinating diseases of the central nervous system. Autoimmunity in patients with demyelinating disease and in their families has been broadly investigated and discussed. Recent studies show a higher incidence of rheumatic autoimmune diseases among adult patients with MS or NMO and their families, but there are no studies in the pediatric population. Objective: To evaluate an association of MS and NMO with autoimmune rheumatic diseases in pediatric patients. Method: 22 patients younger than 21 years old with MS or NMO diagnosed before the age of 18 years were evaluated regarding epidemiological data, clinical presentation, association with autoimmune diseases, family history of autoimmune diseases, laboratory findings, imaging studies and presence of auto-antibodies. Results: Among the patients studied, there was a prevalence of females (68.1%). The mean age of symptoms onset was 8 years and 9 months and the mean current age was 16 years and 4 months. Two patients (9%) had a history of associated autoimmune rheumatic disease: one case of juvenile dermatomyositis in a patient with NMO and another of systemic lupus erythematosus in a patient with MS. Three patients (13%) had a family history of autoimmunity in first-degree relatives. ANA was found positive in 80% of patients with NMO and 52% of patients with MS. About 15% of ANA-positive patients were diagnosed with rheumatologic autoimmune disieses. Conclusion: Among patients with demyelinating diseases diagnosed in childhood included in this study there was a high frequency of ANA positivity but a lower association with rheumatologic autoimmune diseases than that observed in studies conducted in adults. (C) 2016 Elsevier Editora Ltda.Univ Fed Sao Paulo Unifesp, Dept Pediat, Setor Reumatol Pediat, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Dept Neurol & Neurocirurgia, Setor Doencas Desmielinizantes, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Dept Pediat, Setor Reumatol Pediat, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Dept Neurol & Neurocirurgia, Setor Doencas Desmielinizantes, Sao Paulo, SP, BrazilWeb of Scienc

Neuromyelitis Optica With Onset in Childhood and Adolescence

BACKGROUND: Neuromyelitis optica with onset before the age of 18 years is a relatively rare, yet potentially devastating condition. the objective of the present study was to contribute to the study of early-onset neuromyelitis optica with a case series. PATIENTS: Data were collected from medical records of Brazilian neurologists caring for patients with neuromyelitis optica occurring in childhood and adolescence. RESULTS: Twenty-nine patients with neuromyelitis optica occurring before the age of 18 years and fulfilling the diagnostic criteria were identified. the average age at disease onset was 13 years and the patients had had an average disease duration of 6 years. the expanded disability scale score at the latest consultation was, on average, 4.7, and one patient had died from the disease. the 29 patients had had an average 4.5 relapses during the disease, accounting for 0.75 relapses per year, irrespective of the medication used. All patients were using one or more of the following medications: azathioprine, prednisone, immunoglobulin, and glatiramer acetate. CONCLUSIONS: Neuromyelitis optica with onset in childhood and adolescence is a poorly understood condition that is often disabling and difficult to manage.Univ Metropolitana Santos, Santos, BrazilHosp Restauracao, Recife, PE, BrazilUniv Fed Estado São Paulo, São Paulo, BrazilSanta Casa Vitoria, Fac Ciencias Saude, Vitoria, BrazilUniv Fed Goias, Goiania, Go, BrazilUniv Fed Santa Catarina, Florianopolis, SC, BrazilUniv Fed Rio de Janeiro, Macae, BrazilHosp Beneficencia Portuguesa, São Paulo, BrazilHosp Paulistano, São Paulo, BrazilHosp Sirio Libanes, São Paulo, BrazilUniv Fed Estado São Paulo, São Paulo, BrazilWeb of Scienc

Swine and Poultry Pathogens: the Complete Genome Sequences of Two Strains of Mycoplasma hyopneumoniae and a Strain of Mycoplasma synoviae

This work reports the results of analyses of three complete mycoplasma genomes, a pathogenic (7448) and a nonpathogenic (J) strain of the swine pathogen Mycoplasma hyopneumoniae and a strain of the avian pathogen Mycoplasma synoviae; the genome sizes of the three strains were 920,079 bp, 897,405 bp, and 799,476 bp, respectively. These genomes were compared with other sequenced mycoplasma genomes reported in the literature to examine several aspects of mycoplasma evolution. Strain-specific regions, including integrative and conjugal elements, and genome rearrangements and alterations in adhesin sequences were observed in the M. hyopneumoniae strains, and all of these were potentially related to pathogenicity. Genomic comparisons revealed that reduction in genome size implied loss of redundant metabolic pathways, with maintenance of alternative routes in different species. Horizontal gene transfer was consistently observed between M. synoviae and Mycoplasma gallisepticum. Our analyses indicated a likely transfer event of hemagglutinin-coding DNA sequences from M. gallisepticum to M. synoviae