#GBS Associated With #Zika Virus #Infection: A Prospective Case Series From #Mexico (Front Neurol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Front Neurol. 2019 Apr 30;10:435. doi: 10.3389/fneur.2019.00435. eCollection 2019.

Guillain-Barré Syndrome Associated With Zika Virus Infection: A Prospective Case Series From Mexico.

Soto-Hernández JL1, Ponce de León Rosales S2, Vargas Cañas ES3, Cárdenas G1, Carrillo Loza K4, Díaz-Quiñonez JA5,6, López-Martínez I5, Jiménez-Corona ME7, Ruiz-Matus C7, Kuri Morales P6.

Author information: 1 Department of Infectious Diseases National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico. 2 Programa Universitario de Investigación en Salud UNAM, Mexico City, Mexico. 3 Neuromuscular Clinic, Department of Neurology, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico. 4 Department of Neurology, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico. 5 Instituto de Diagnóstico y Referencia Epidemiológicos “Dr. Manuel Martínez Báez”, Mexico City, Mexico. 6 División de Estudios de Postgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico. 7 Dirección General de Epidemiología, Mexico City, Mexico.

 

Abstract

Background:

On May 2016, anticipating the rainy season from June to October in Mexico, we expected an increase in cases of Zika virus (ZIKV) infections. With the goal of identifying cases of GBS associated with ZIKV infection, a prospective joint study was conducted by a reference center for neurological patients and the Secretary of Health in Mexico City from July 2016 to November 2016.

Methods:

Serum, cerebrospinal fluid, urine, and saliva were tested by RT-PCR for ZIKV, dengue virus, and chikungunya virus in patients referred from states with reported transmissions of ZIKV infection, and with clinical symptoms of GBS according to the Brighton Collaboration criteria. Clinical, electrophysiological, and long-term disability data were collected.

Results:

In the year 2016 twenty-eight patients with GBS were diagnosed at our institute. In five hospitalized patients with GBS, RT-PCR was positive to ZIKV in any collected specimen. Dengue and chikungunya RT-PCR results were negative. All five patients had areflexic flaccid weakness, and cranial nerves affected in three. Electrophysiological patterns were demyelinating in two patients and axonal in three. Three patients were discharged improved in 10 days or less, and two patients required intensive care unit admission, and completely recovered during follow-up.

Conclusion:

Our results are similar to those reported from the state of Veracruz, Mexico, in which out of 33 samples of urine of patients with GBS two had a positive RT-PCR for ZIKV. Simultaneous processing of serum, CSF, urine, and saliva by RT-PCR may increase the success of diagnosis of GBS associated to ZIKV.

KEYWORDS: Guillain–Barré Syndrome; RT-PCR; Zika virus; cranial neuropathies multiple; flavivirus infection

PMID: 31114537 PMCID: PMC6502985 DOI: 10.3389/fneur.2019.00435

Keywords: Zika Virus; GBS; Neurology; Mexico.

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Relationship Between Poor #Olfaction and #Mortality Among Community-Dwelling Older #Adults: A Cohort Study (Ann Intern Med., abstract)

[Source: Annals of Internal Medicine, full page: (LINK). Abstract, edited.]

Relationship Between Poor Olfaction and Mortality Among Community-Dwelling Older Adults: A Cohort Study

Bojing Liu, PhD *; Zhehui Luo, PhD *; Jayant M. Pinto, MD; Eric J. Shiroma, ScD; Gregory J. Tranah, PhD; Karin Wirdefeldt, MD, PhD; Fang Fang, MD, PhD; Tamara B. Harris, MD, MSc; Honglei Chen, MD, PhD

 

Abstract

Background:

Poor olfaction is common among older adults and has been linked to higher mortality. However, most studies have had a relatively short follow-up and have not explored potential explanations.

Objective:

To assess poor olfaction in relation to mortality in older adults and to investigate potential explanations.

Design:

Community-based prospective cohort study.

Setting:

2 U.S. communities.

Participants:

2289 adults aged 71 to 82 years at baseline (37.7% black persons and 51.9% women).

Measurements:

Brief Smell Identification Test in 1999 or 2000 (baseline) and all-cause and cause-specific mortality at 3, 5, 10, and 13 years after baseline.

Results:

During follow-up, 1211 participants died by year 13. Compared with participants with good olfaction, those with poor olfaction had a 46% higher cumulative risk for death at year 10 (risk ratio, 1.46 [95% CI, 1.27 to 1.67]) and a 30% higher risk at year 13 (risk ratio, 1.30 [CI, 1.18 to 1.42]). Similar associations were found in men and women and in white and black persons. However, the association was evident among participants who reported excellent to good health at baseline (for example, 10-year mortality risk ratio, 1.62 [CI, 1.37 to 1.90]) but not among those who reported fair to poor health (10-year mortality risk ratio, 1.06 [CI, 0.82 to 1.37]). In analyses of cause-specific mortality, poor olfaction was associated with higher mortality from neurodegenerative and cardiovascular diseases. Mediation analyses showed that neurodegenerative diseases explained 22% and weight loss explained 6% of the higher 10-year mortality among participants with poor olfaction.

Limitation:

No data were collected on change in olfaction and its relationship to mortality.

Conclusion:

Poor olfaction is associated with higher long-term mortality among older adults, particularly those with excellent to good health at baseline. Neurodegenerative diseases and weight loss explain only part of the increased mortality.

Primary Funding Source:

National Institutes of Health and Michigan State University.

Keywords: Neurology; USA.

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#Brain ventricular #volume changes induced by long-duration #spaceflight (Proc Natl Acad Sci USA, abstract)

[Source: Proceedings of the National Academy of Sciences of the United States of America, full page: (LINK). Abstract, edited.]

Brain ventricular volume changes induced by long-duration spaceflight

Angelique Van Ombergen, Steven Jillings, Ben Jeurissen, Elena Tomilovskaya, Alena Rumshiskaya, Liudmila Litvinova, Inna Nosikova, Ekaterina Pechenkova, Ilya Rukavishnikov, Olga Manko, Sergey Danylichev, R. Maxine Rühl, Inessa B. Kozlovskaya, Stefan Sunaert, Paul M. Parizel, Valentin Sinitsyn, Steven Laureys, Jan Sijbers, Peter zu Eulenburg, and Floris L. Wuyts

PNAS first published May 6, 2019 / DOI: https://doi.org/10.1073/pnas.1820354116

Edited by Marcus E. Raichle, Washington University in St. Louis, St. Louis, MO, and approved April 17, 2019 (received for review December 5, 2018)

 

Significance

Long-duration spaceflight induces detrimental changes in human physiology due to microgravity. One example is a cephalic fluid shift. Here, we prospectively investigated the quantitative changes in cerebrospinal fluid (CSF) volume of the brain ventricular regions in space crew by means of a region of interest, observer-independent analysis on structural brain MRI scans. MRI scans were collected before the mission, shortly after and 7 mo after return to Earth. We found a significant increase in lateral and third ventricles at postflight and a trend to normalization at follow-up, but still significantly increased ventricular volumes. The observed spatiotemporal pattern of CSF compartment enlargement and recovery points to a reduced CSF resorption in microgravity as the underlying cause.

 

Abstract

Long-duration spaceflight induces detrimental changes in human physiology. Its residual effects and mechanisms remain unclear. We prospectively investigated the changes in cerebrospinal fluid (CSF) volume of the brain ventricular regions in space crew by means of a region of interest analysis on structural brain scans. Cosmonaut MRI data were investigated preflight (n = 11), postflight (n = 11), and at long-term follow-up 7 mo after landing (n = 7). Post hoc analyses revealed a significant difference between preflight and postflight values for all supratentorial ventricular structures, i.e., lateral ventricle (mean % change ± SE = 13.3 ± 1.9), third ventricle (mean % change ± SE = 10.4 ± 1.1), and the total ventricular volume (mean % change ± SE = 11.6 ± 1.5) (all P < 0.0001), with higher volumes at postflight. At follow-up, these structures did not quite reach baseline levels, with still residual increases in volume for the lateral ventricle (mean % change ± SE = 7.7 ± 1.6; P = 0.0009), the third ventricle (mean % change ± SE = 4.7 ± 1.3; P = 0.0063), and the total ventricular volume (mean % change ± SE = 6.4 ± 1.3; P = 0.0008). This spatiotemporal pattern of CSF compartment enlargement and recovery points to a reduced CSF resorption in microgravity as the underlying cause. Our results warrant more detailed and longer longitudinal follow-up. The clinical impact of our findings on the long-term cosmonauts’ health and their relation to ocular changes reported in space travelers requires further prospective studies.

spaceflight – microgravity – brain – ventricles – CSF

Keywords: Neurology; Microgravity; Spaceflight.

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#H1N1 #hemagglutinin-specific HLA-DQ6-restricted CD4+ T cells can be readily detected in #narcolepsy type 1 patients and healthy controls (J Neuroimmunol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Neuroimmunol. 2019 Apr 17;332:167-175. doi: 10.1016/j.jneuroim.2019.04.009. [Epub ahead of print]

H1N1 hemagglutinin-specific HLA-DQ6-restricted CD4+ T cells can be readily detected in narcolepsy type 1 patients and healthy controls.

Schinkelshoek MS1, Fronczek R2, Kooy-Winkelaar EMC3, Petersen J4, Reid HH4, van der Heide A5, Drijfhout JW3, Rossjohn J6, Lammers GJ2, Koning F3.

Author information: 1 Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Sleep Wake Centre SEIN, Achterweg 5, 2103 SW Heemstede, the Netherlands. Electronic address: M.S.Schinkelshoek@lumc.nl. 2 Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Sleep Wake Centre SEIN, Achterweg 5, 2103 SW Heemstede, the Netherlands. 3 Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands. 4 Infection and Immunity Program, The Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, VIC 3800, Australia; Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, VIC 3800, Australia. 5 Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands. 6 Infection and Immunity Program, The Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, VIC 3800, Australia; Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, VIC 3800, Australia; Institute of Infection and Immunity, Cardiff University School of Medicine, Heath Park, Cardiff CF14 4XN, UK.

 

Abstract

Following the 2009 H1N1 influenza pandemic, an increased risk of narcolepsy type 1 was observed. Homology between an H1N1 hemagglutinin and two hypocretin sequences has been reported. T cell reactivity to these peptides was assessed in 81 narcolepsy type 1 patients and 19 HLA-DQ6-matched healthy controls. HLA-DQ6-restricted H1N1 hemagglutinin-specific T cell responses were detected in 28.4% of patients and 15.8% of controls. Despite structural homology between HLA-DQ6-hypocretin and -H1N1 peptide complexes, T cell cross-reactivity was not detected. These results indicate that it is unlikely that cross-reactivity between H1N1 hemagglutinin and hypocretin peptides presented by HLA-DQ6 is involved in the development of narcolepsy.

Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.

KEYWORDS: Cross-reactivity; H1N1; Hypocretin; Narcolepsy; T cells

PMID: 31048269 DOI: 10.1016/j.jneuroim.2019.04.009

Keywords: Pandemic Influenza; H1N1pdm09; Narcolepsy; Neurology.

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#Congenital #Zika Syndrome: The Main Cause of #Death and Correspondence Between #Brain #CT and Postmortem #Histological Section Findings From the Same Individuals (Top Magn Reson Imaging, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Top Magn Reson Imaging. 2019 Feb;28(1):29-33. doi: 10.1097/RMR.0000000000000194.

Congenital Zika Syndrome: The Main Cause of Death and Correspondence Between Brain CT and Postmortem Histological Section Findings From the Same Individuals.

de Fatima Viana Vasco Aragão M1,2, van der Linden V3, Petribu NC3, Valenca MM4, Parizel PM5,6, de Mello RJV4.

Author information: 1 Multimagem, Recife, Brazil. 2 Catholic University of Pernambuco, Recife, Brazil. 3 Barão de Lucena Hospital, Recife, Brazil. 4 Federal University of Pernambuco, Recife, Brazil. 5 Royal Perth Hospital (RPH), Perth, WA, Australia. 6 University of Western Australia (UWA) Medical School, Perth, WA, Australia.

 

Abstract

In the present case series, the cause of death of infants diagnosed with congenital Zika syndrome (CZS) was lung disease (pneumonia and sepsis with massive pulmonary aspiration), probably secondary to dysphagia and reflux. The main findings in infants with a confirmed diagnosis of CZS who died were as follows: (1) calcification and hypoplasia of the lentiform nuclei, hypoplasia of the caudate nuclei, and calcification at the cortical-subcortical junction was noted in all cases (100%) and calcification of the caudate nuclei was noted in 66.7% of cases; (2) calcification in the brainstem and along the lateral wall of the lateral ventricles was noted in only the case with arthrogryposis (33.3%); and (3) lesions in the posterior fossa (hypoplasia of the brainstem and cerebellum) were noted in two cases (66.7%), including the case with arthrogryposis. The findings concerning calcifications and brain malformations obtained from non-contrast computed tomography (CT) demonstrated good agreement with findings obtained from the postmortem pathological analysis; however, CT failed to detect discontinuity of the pia mater with heterotopia, invasion of the cerebral tissue into the subarachnoid space, and discontinuity of the ependyma in the lateral ventricles with gliosis; this last feature was only imaged in the most severe case of extreme microcephaly with a simplified gyral pattern. Only histopathology showed grouped calcifications associated with scattered calcifications suggestive of the neuron morphology.

PMID: 30817678 DOI: 10.1097/RMR.0000000000000194 [Indexed for MEDLINE]

Keywords: Congenital Zika Syndrome; Zika Virus; Microcephaly; Histopathology; Neurology; Neuroimaging.

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Detection of #clinical and #neurological signs in apparently asymptomatic #HTLV1 infected carriers: Association with high proviral load (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Detection of clinical and neurological signs in apparently asymptomatic HTLV-1 infected carriers: Association with high proviral load

Michel E. Haziot , M. Rita Gascon, Tatiane Assone, Luiz Augusto M. Fonseca, Olinda do Carmo Luiz, Jerusa Smid, Arthur M. Paiva, Rosa Maria do N. Marcusso, A. C. Penalva de Oliveira , Jorge Casseb

Published: May 1, 2019 / DOI: https://doi.org/10.1371/journal.pntd.0006967 / This is an uncorrected proof.

 

Abstract

Several studies suggest that HTLV-1 infection may be associated with a wider spectrum of neurologic manifestations that do not meet diagnostic criteria for HAM/TSP. These conditions may later progress to HAM/TSP or constitute an intermediate clinical form, between asymptomatic HTLV-1 carriers and those with full myelopathy. Our aim was to determine the prevalence of HTLV-1-associated disease in subjects without HAM/TSP, and the relationship between these findings with HTLV-1 proviral load (PVL).

Methods: 175 HTLV-1-infected subjects were submitted to a careful neurological evaluation, during their regular follow up at the HTLV outpatient clinic of the Institute of Infectious Diseases “Emilio Ribas”, São Paulo city, Brazil. Clinical evaluation and blinded standardized neurological screening were performed for all the subjects by the same neurologist (MH).

Results:

After the neurological evaluation, 133 patients were classified as asymptomatic and 42 fulfilled the criteria for intermediate syndrome (IS). The mean age of the enrolled subjects was 46.3 years and 130 (74.3%) were females. Clinical classification shows that neurological symptoms (p<0.001), visual disorders (p = 0.001), oral conditions (p = 0.001), skin lesions (p<0.001), bladder disorders (p<0.001), and rheumatological symptoms (p = 0.001), were strongly associated to IS, except for disautonomy (p = 0.21). A multivariate analysis revealed that HTLV-1 proviral load, oral conditions, bladder disorders and rheumatological symptoms were independently associated with the IS.

Conclusions:

We found some early alterations in 42 patients (24%), particularly the presence of previously not acknowledged clinical and neurological symptoms, among subjects previously classified as “asymptomatic”, who we reclassified as having an intermediate syndrome.

 

Author summary

At least 5–10 million people live with the Human T-Cell Lymphotropic Virus type 1 (HTLV-1) worldwide, and around 0.25–5% of them may develop HTLV-1-associated myelopathy/Tropical spastic paraparesis (HAM/TSP), which is associated with chronic inflammation. In this study, involving 175 HTLV-1-infected subjects originally classified as asymptomatic, we found that 42 of them in reality presented some early clinical conditions, including alterations related not only to the neurological system, but also to the eyes and the skin. We called such conditions intermediate syndrome. Thus, it seems reasonable to suggest that all HTLV-1-infected subjects should be monitored for symptoms that may arise earlier in the course of their infection.

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Citation: Haziot ME, Gascon MR, Assone T, Fonseca LAM, Luiz OdC, Smid J, et al. (2019) Detection of clinical and neurological signs in apparently asymptomatic HTLV-1 infected carriers: Association with high proviral load. PLoS Negl Trop Dis 13(5): e0006967. https://doi.org/10.1371/journal.pntd.0006967

Editor: Joseph Raymond Zunt, University of Washington, UNITED STATES

Received: October 30, 2018; Accepted: April 8, 2019; Published: May 1, 2019

Copyright: © 2019 Haziot et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files. Any questions regarding the data should be directed to: Prof. Ester Cerdeira Sabino, Direct of the Instittute of Tropical Medicine of São Paulo – USP- Contact by email: sabinoec@usp.br; Address: Av. Dr. Eneas de Cavalho Aguiar 500, Building 1. São Paulo, SP, Brazil. Zip Code: 05403-000. Phone: + 55(11)3061-0000. Website: www.imtsp.usp.br And, Dr. Luiz Carlos Pereira Jr, Director of Infectious Diseases Emilio Ribas –IIER- Contact email: lcjunior@uol.com.br. Address: Av. Dr. Arnaldo 166, São Paulo, SP, Brazil, Zip Code: 01246-900; phone:+55(11) 3896-1200 http://www.emilioribas.sp.gov.br/.

Funding: Grant from Fundation of Support of Research of Sao Paulo State: FAPESP: 2014/22827-7 and 2016/03025-2 to JC. No. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: No. The authors have declared that no competing interests exist.

Keywords: Retrovirus; Lentivirus; HTLV1; Neurology; Brazil.

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Multi- #recombinant #Enterovirus A71 Subgenogroup C1 Isolates Associated with #Neurologic Disease, #France, 2016–2017 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 6—June 2019 / Dispatch

Multirecombinant Enterovirus A71 Subgenogroup C1 Isolates Associated with Neurologic Disease, France, 2016–2017

Stéphanie Tomba Ngangas, Alexander Lukashev, Gwendoline Jugie, Olga Ivanova, Jean-Michel Mansuy, Catherine Mengelle, Jacques Izopet, Anne-Sophie L’honneur, Flore Rozenberg, David Leyssene, Denise Hecquet, Stéphanie Marque-Juillet, David Boutolleau, Sonia Burrel, Hélène Peigue-Lafeuille, Christine Archimbaud, Kimberley Benschop, Cécile Henquell, Audrey Mirand, and Jean-Luc Bailly

Author affiliations: Université Clermont Auvergne, Clermont-Ferrand, France (S. Tomba Ngangas, G. Jugie, H. Peigue-Lafeuille, C. Archimbaud, C. Henquell, A. Mirand, J.-L. Bailly); Sechenov University, Moscow, Russia (A. Lukashev); Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products, Moscow (O. Ivanova); Centre Hospitalier Universitaire de Toulouse, Toulouse, France (J.-M. Mansuy, C. Mengelle, J. Izopet); Assistance Publique-Hôspitaux de Paris Cochin, Paris, France (A.-S. L’honneur, F. Rozenberg); Centre Hospitalier de la Côte Basque, Bayonne, France (D. Leyssene); Centre Hospitalier Universitaire Amiens, Amiens, France (D. Hecquet); Centre Hospitalier de Versailles, Le Chesnay, France (S. Marque-Juillet); Assistance Publique-Hôspitaux de Paris Pitié-Salpêtrière-Charles Foix, Paris (D. Boutolleau, S. Burrel); CHU Clermont-Ferrand, Clermont-Ferrand (H. Peigue-Lafeuille, C. Archimbaud, C. Henquell, A. Mirand, J.-L. Bailly); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (K. Benschop)

 

Abstract

In 2016, an upsurge of neurologic disease associated with infection with multirecombinant enterovirus A71 subgenogroup C1 lineage viruses was reported in France. These viruses emerged in the 2000s; 1 recombinant is widespread. This virus lineage has the potential to be associated with a long-term risk for severe disease among children.

Keywords: EV-A71; Encephalitis; Neurology; Pediatrics; France.

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