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The article examines the influence of the diet on the quality of buffalo carcasses of crossbred Murrah and Mediterranean, concentrate fed on traditional or on agro-industrial residues. The researchers noted differences in the percentage of fat in the carcass fat thickness and coverage. They also reported that the animals supplemented with palm oil cake had better carcass conformation and fat trim.

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Copyright of Brazilian Journal of Biology is the property of Instituto Internacional de Ecologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Neuromyelitis optica spectrum disorders (NMOSD) are severe, inflammatory, immune-mediated disorders of the central nervous system that predominantly affect the optic nerves and the spinal cord. Longitudinally extensive transverse myelitis (LETM) is the most suggestive sign of NMOSD, although it may occur in a number of other conditions. The human T-lymphotropic virus type-I (HTLV-1) infection has a worldwide distribution but is highly prevalent in Latin America, the Middle East and Africa. Its associated myelopathy or tropical spastic paraparesis (HAM/TSP) is the most common neurological complication of the viral infection. HAM/TSP usually has a slow onset with chronic progression, but an acute and more severe form of the disease, characterized by rapid progression, may involve an extensive length of the spinal cord with swelling and vacuolization mimicking the longitudinally extensive transverse myelitis (LETM), associated with anti-aquaporin-4 autoimmunity. Cases of LETM with a rapid progressive course have been reported in post-transfusion and post-transplantation patients. We report a previously healthy anti-AQP4-IgG seronegative patient who developed relapsing LETM, associated with HTLV-1 infection. Materials and Methods: Case report. ResuIts: A 41-year-old mulatto female was in good health until 2004, when a slight weakness of the left lower limb was noticed. She denied any sensation or sphincter disturbance in association with the weakness. No work-up was done. She did well with no progression of her symptom until 2011, when she developed severe paraparesis and dysesthesia in both legs. A spinal MRI disclosed severe atrophy of the spinal cord between the T1-T10 vertebral segments. A brain MRI was unrevealing. A search for serum aquapo-rin-4-IgG by cell-based assay was negative, whereas an ELISA test detected HTLV I-II serum antibodies. Discussion and Conclusion: Very rarely HAM/TSP may manifest as relapsing LETM in previously healthy patients and should be included in the differential diagnosis of NMOSD, mainly in countries where infection by HTLV-1 is highly prevalent. [ABSTRACT FROM AUTHOR]

Introduction: Neuromyelitis optica (NMO) is a central nervous system disorder mainly mediated by the anti-aquaporin-4 antibody. Although the disease has been of continuous interest to neuroscientists since its early description, there has been a non-linear growth in the publication rate of articles over the course of its history. A search of publications related to NMO was conducted in order to analyze some of their properties and qualities, which could provide insights into the global involvement and trends regarding knowledge of the disease. Materials and Methods: A search of the Web of ScienceTM, Science Citation Index, Version 2006, was carried out up to 31st May 2014 for publications related to NMO. The following terms were used: neuromyelitis optica, Devic's syndrome, Devic's disease, neuro-optic myelitis, neuropticomielitis aguda, neuropticomielitis, opthalmoneuromyelite, oftalmomielitis, mielitis oftalmica, optic neuritis and myelitis, NMO. The documents were refined to better understand trends in global research, affiliations, categories of contribution, research areas, societies/committees, year of publication, languages, organization-enhanced, and funding agencies. Results: A total of 2746 indexed documents were found. The first authors were most frequently associated with institutions in the USA (24%). Brazil was ranked #10 in the world and #1 in Latin America. Types of indexed documents included original papers (n 1338, 48%), meeting abstracts (n 818, 30%) and reviews (n 287,10%). A tremendous increment was observed in the yearly distribution of number of publications in the last decade, from 17 in 2000 to 487 in 2013. The publications were in the English language in 95% of cases. The most frequent funding agencies or companies included the Guthy-Jackson Charitable Foundation, Merck Serono, NIH, Biogen Idee, and National Multiple Sclerosis Society. Discussion and Conclusion: There has been an increasing global interest in NMO in the last decade. Institutions in the USA and Japan have contributed the most to research in this field. [ABSTRACT FROM AUTHOR]

Introduction: Neuromyelitis optica spectrum disorders (NMOSD) comprise of a group of inflammatory immune-mediated disorders of the central nervous system whose hallmark is involvement of the optic nerves and spinal cord. Cerebral and brainstem symptoms may occur at disease onset or during the course of the disease, usually in association with one of the index events. Occurrence of brainstem symptoms as the sole clinical manifestation of NMOSD has been rarely reported. Herein we report an aquaporin 4-IgG seropositive patient with brainstem symptoms and no clinical evidence of optic nerve or spinal cord abnormality. Materials and Methods: Case report. Results: A 31-year-old black female was examined at the CIEM MS Research Center because of dysgeusia and a loss of sensation in the right teeth and over most of the right facial area. She gained partial recovery of the sensation deficit over a 15 day period, however, she also developed diplopia, ptosis of the right upper lid, bilateral loss of hearing, dysarthria and dysphagia over this time. Examination revealed no visual deficit and no motor or sensation abnormality in her upper and lower limbs. Brain MRI revealed a large periepen-dymal lesion around the 4th ventricle and aqueduct. Spinal MRI was normal. Cerebrospinal fluid analysis was unrevealing. Serum anti-aquaporin-4 IgG (AQP4- IgG) was negative by indirect immunofluorescence but a repeated search using cell-based assay yielded a positive result. The patient was given pulses of IV methylprednisolone and put on prophylactic treatment with oral prednisone and azathioprine. Discussion and Conclusion: This patient had brainstem symptoms as the sole clinical manifestation of NMOSD. The diagnosis of the disease was confirmed by AQP4-IgG seropositivity as the antibody is highly specific for NMOSD. Clinicians should include NMOSD in the differential diagnosis of isolated brainstem syndrome and use more sensitive assays for the detection of AQP4-IgG, rather than indirect immunofluorescence. [ABSTRACT FROM AUTHOR]

Introduction: Although the characterization of neuromyelitis optica (NMO) as a nosological entity was credited to the works of Devic and Gault in 1894, reports on the association of optic nerve and spinal cord abnormalities date from the early 19th century. Knowledge on NMO remained mostly dormant for about a century. Significant interest in the study of the disease was boosted following the description of its immunohistopathology, and identification of NMO-IgG and aquaporin-4 as the targeted antigen in 2002,2004 and 2005, respectively. This study examined the growth rates of scientific publications related to NMO and correlated them with the milestones in the understanding of the disease. Materials and Methods: A search of the MEDLINE/PubMed database for scientific articles was conducted up to 31st May 2014, using key MeSH terms for NMO. The following publications were considered as milestones: the Devic and Gault publications (1894); creation of the eponym "Devic's disease" (1907); the review of 70,200 and 300 cases (1927,1949,1958); identification of a high frequency of NMO in Japan (1950); the nationwide survey of demyelinating diseases in Japan (1975); Mandler's diagnostic criteria (1993); review of the Mayo Clinic cohort (1999); the immunohistopathology description (2002); identification of NMO-IgG and its targeted antigen (2004,2005); the Wingerchuk et al. revised diagnostic criteria and definition of neuromyelitis optic spectrum disorder (2006,2007). The references of papers for publications prior to 1913 were also searched. Results: A total of 2766 scientific papers were found, 2744 in the MEDLINE/PubMed database and 22 from the reference lists of papers published prior to 1913. There were 12 descriptions of NMO patients preceding Devic's case report. The highest increases in growth rate for NMO related articles was found in the decades of the 1930s, 1950s, 1970s and 2000s, and in 2001, 2004,2006, and 2007. Discussion and Conclusion: A tremendous increase was found in the growth of scientific publications related to NMO. Growth rates were seen to be higher following publication of the most significant advances in the understanding of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Although acute longitudinally extensive transverse myelitis (LETM) is a key diagnostic component of neuromyelitis optica (NMO), it may also occur in other conditions, such as multiple sclerosis, sarcoidosis and infectious diseases. Schistosomiasis is a human trematode infection affecting at least 200 million people in endemic areas in Africa, South America and Asia. Involvement of the spinal cord may cause severe lumbar pain followed by paraparesis associated with sensation and sphincter disturbances. Such a clinical picture is frequently seen as the first index event in NMO. The finding of a tumefactive longitudinally extensive lesion on a spinal MRI may further confound the diagnosis. We report on three patients with schistosomal myelitis and LETM. Materials and Methods: Case reports. Results: Patients were a 21-year-old black female, a 23-year-old indian male, and a 70-year-old mulatto male. All had lived for years in endemic areas for schistosomiasis and had been in contact with contaminated water. The clinical presentation of the disease was similar in all cases and was characterized by lumbar pain, followed by paraparesis, dysesthesia in the lower limbs, and sphincter disturbances. Patient 3 was the only one with a previous diagnosis of intestinal and hepatic schistosomiasis. All patients had a positive stool examination and rectal biopsy for schistosoma mansoni ova. Spinal MRI disclosed tumefactive T2-weighted isointense or hyperintense, and T1-weighted hypointense gadolinium-enhanced longitudinally extensive lesions in all three patients. Lesions extended from T4 to the conus medullaris in Patient 1; from T1 to T12 in Patient 2; and from T7 to T11 in Patient 3. Brain MRI was unrevealing. Patients 1 and 2 did not respond to treatment and remained wheelchair-bound, whereas Patient 3 made a full recovery. Discussion and Conclusion: In endemic areas schistosomal myelitis should be included in the differential diagnosis of LETM. Neurologic outcome may depend on the immune response of the host but prompt diagnosis and treatment may favor recovery. [ABSTRACT FROM AUTHOR]

Introduction: Neuromyelitis optica spectrum disorders (NMOSD) are a group of inflammatory immune-mediated disorders of the central nervous system that may be triggered by viral infections. Although dengue fever is highly prevalent in some areas where NMOSD have been more frequently identified, to our knowledge there is just one reported case of presumed NMOSD related to dengue infection, in which information related to the anti-aquaporin-4 (AQP4) antibody is not provided. Materials and Methods: Case report. Results: A previously healthy 45-year-old white female presented with dengue fever in February 2010. During the acute phase of the disease she developed transient diplopia for about a week, followed three months later by incoercible nausea and vomiting associated with vertigo, tinnitus and diplopia. New attacks occurred 6 and 12 months later with diplopia, vertigo, dysesthesia in the right fingers, ataxia, paraparesis, and sphincter disturbance, with poor response to treatment. The visual acuity and fundi examinations were normal. Pupils measured 4/3 mm and there was bilateral paresis of the horizontal gaze. Moderate paraparesis, brisk deep tendon reflexes, bilateral Babinski sign, ataxia, and decreased vibration sense in the limbs were noted. Serum IgG and IgM anti-dengue antibodies were detected by ELISA. Brain MRI showed lesions adjacent to the lateral ventricles, in the corpus callosum, cerebellar peduncles, posterior limbs of the internal capsule, periaqueductal ependymal surface and surrounding the fourth ventricle. Spinal MRI was normal. Cerebrospinal fluid analysis showed 138 cells/mm3; protein content 93.9 mg%; IgG index 0.66. A search for serum AQP4-IgG by indirect immunofluorescence was negative but a repeated test using cell-based assay yielded a positive result. Discussion and Conclusion: This patient developed recurring signs of brainstem involvement that started at the acute phase of dengue fever. Although she did not have optic neuritis and her spinal MRI was normal, the diagnosis of NMOSD could be confirmed by her AQP4-IgG seropositive status. [ABSTRACT FROM AUTHOR]

Introduction: Although brainstem symptoms (BSS) have been increasingly recognized as a frequent component within neuromyelitis optica spectrum disorders (NMOSD), their exact frequency and time of onset are not known. A number of BSS have been reported, but those related to trigeminal nucleus/nerve dysfunction are rare. Herein we report a patient who presented trigeminal neuralgia 19 months prior to simultaneously developing bilateral optic neuritis and longitudinally extensive transverse myelitis. Materials and Methods: Case report. Results: A 20-year-old mulatto female began experiencing jolts of severe, paroxysmal and lancinating pain in her right face, most frequently located inside her right ear or shooting from the angle of the mandible, and triggered by jaw movement. The pain typically faded over a few seconds but the patient remained with a burning sensation in the affected area for some minutes. A variable number of attacks were experienced, ranging from 2/week to more than 10/day. A presumptive diagnosis of trigeminal neuralgia was made and the patient received gabapentin, with relief from the pain occurring after three months. Two years following the onset of the facial pain, the patient simultaneously developed bilateral loss of sight, weakness and sensation disturbances to the left lower limb. The patient was treated with IV methylpred-nisolone for 3 days, then IV cyclophosphamide for five days and followed by plasma exchange, resulting in partial recovery. Subsequent examination after three months revealed visual acuity 20/400 OD and 20/50 OS. No motor deficit was observed, however, touch and vibration sense were decreased in the left limbs. Brain MRI showed periependymal T2-hyperintense lesions surrounding the third ventricles and cerebral aqueduct and edematous gadolinium-enhancing lesions in the parieto-occipital lobes. Spinal cord MRI showed a gadolinium-enhanced lesion extending from C4 to C7. The AQP4-IgG was negative. The patient was given a diagnosis of neuromyelitis optica. Discussion and Conclusion: The present report shows that NMOSD should be included as a cause of trigeminal neuralgia occurring mainly in young individuals. [ABSTRACT FROM AUTHOR]

Introduction: Neuromyelitis optica (NMO) combined with large vessel abnormalities has been reported only once in the literature in a patient with Sjögren syndrome. Materials and Methods: Case report. Results: A 30-year-old woman was diagnosed with optic neuritis in her left eye. She was treated with intravenous methylprednisolone and made a full recovery. Seven months later she was readmitted with a 20-day-history of incoercible vomiting, associated with hiccups and diarrhea, followed by dysesthesia in the lower limbs and left arm, and deterioration of vision in her left eye. Brain MRI disclosed lesions in the left optic nerve, periependymal surface of the fourth ventricle, dorsolateral aspect of the medulla oblongata and pons, and hypothalamic region, with some enhanced by gadolinium. Brain MRA revealed segmental stenosis and irregularity of the vertebral and basilar artery walls, and stenosis of the left posterior cerebral artery. Hypoplasia of a segment of the right carotid artery was also observed. An analysis of cerebrospinal fluid revealed an increased protein concentration and IgG index. The remaining laboratory work-up, including indirect immunofluorescence assay for serum NMO-IgG was negative. A presumptive diagnosis of primary vasculitis of the central nervous system was made. Examination disclosed normal visual function in the right eye. In the left eye the visual acuity was counting fingers; there was an inferior altitudinal field defect and a pale optic disc. Pyramidal signs were also present. Serum aquaporin-4-IgG (AQP4-IgG) was detected by cell-based assay. A further brain MRI showed similar lesions as previously seen. Brain MRA showed minimal irregularities of the walls of the vertebral arteries with no abnormalities in the basilar and posterior cerebral arteries. Discussion and Conclusion: Transient vascular abnormalities of large cerebral arteries are rarely found in NMOSD and their mechanisms remain to be determined. Anti-AQP4-IgG seropositive status is helpful to differentiate NMOSD from other causes of stenosis and irregularities of the vessel walls. [ABSTRACT FROM AUTHOR]

Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is an immune-mediated disorder in which aquaporin-4-IgG (AQP4-IgG) plays a major role. The high prevalence of associated autoimmune disorders and other autoantibodies in NMOSD suggests a genetic predisposition to autoimmunity. Herein are presented two case reports demonstrating that NMOSD and Sjögren syndrome (SS) co-exist in a common milieu of autoimmunity, irrespective of the AQP4-IgG serostatus of the patient. Materials and Methods: We report on two patients who met the current diagnostic criteria for SS and NMOSD. A review of the PubMed database up to December 2013 was also conducted for similar case reports in the English language. Results: Case 1: 45-year-old white female presented four attacks of optic neuritis since the age of 22 years with full recovery. She was diagnosed with SS at 30 years. Work-up disclosed positive serum anti-SSA, anti-SSB, ANA, anti-thyroglobulin, anti-AchR, and anti-AQP4 antibodies. Brain MRI showed lesions in the left optic nerve and the right frontal cortex. The Schirmer's test, Rose Bengal test, and salivary gland scintigraphy were positive. One year later she developed myelitis. Spinal MRI showed lesions in C2 and from T4 to T10. Case 2: 44-year-old white female with SS since childhood developed myelitis. Spinal MRI showed T2 to T7 lesion. Brain MRI showed lesions in the midbrain, and supratentorial small patches. Tire patient made a full recovery. One month later, she developed bilateral optic neuritis and myelitis. Serum anti-SSB-Ab was positive but anti-AQP4-Ab was negative (cell-based assay). Biopsy of the salivary glands was positive for SS. Adding our patients, a total of 49 cases meet the diagnostic criteria for both SS and NMOSD (42 female; mean age at onset of NMOSD: 36.2 years (10-74 years); full NMO: 27 patients, limited NMO: 13 patients). Discussion and Conclusion: The AQP4-IgG serostatus was positive for the first patient and negative for the second. The present cases, together with those previously reported, suggest that SS and NMOSD coexist in an autoimmune milieu, and are not necessarily dependent on the presence of AQP4 autoimmunity. [ABSTRACT FROM AUTHOR]

Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory autoimmune disease that predominantly affects the optic nerves and spinal cord. The spinal inflammation preferentially locates in the central portion of the cord and characteristically involves an extension equal to or longer than three vertebral segments. Shorter lesions in NMOSD have been rarely reported, either in the very early phases of inflammation or later in chronic phases following treatment and partial remission. Herein we report on an aquaporin-4 (AQP4) seropositive NMOSD patient who presented a short dorsolateral transverse myelitis at disease onset, which has persisted mostly unchanged for months. Materials and Methods: Case report. Results: A 61-year-old white female presented optic neuritis in her right eye. Three months later she developed a recurrent attack of optic neuritis in the left eye, associated with dysesthesia in the right arm and Lhermitte's sign. At this time she was treated with IV pulses of methylprednisolone, with partial recovery. Laboratory work-up was unrevealing except for a positive anti-AQP4-IgG serostatus. Cerebro-spinal fluid analysis disclosed 19 leukocytes/mm3 (100% lymphocytes); a protein content of 38 mg%, and a negative result for restricted oligoclonal bands. Brain MRI was normal, whereas the spinal MRI showed a T2-hyperintense signal in the dorsolateral aspect of the spinal cord C2 segment. The patient was put on prophylactic treatment with oral prednisone and azathioprine and has had no further attack. An additional spinal MRI ten months later revealed persistence of the short C2 lesion. Discussion and Conclusion: The patient met the diagnostic criteria for NMOSD as she presented recurrent optic neuritis and a positive anti-AQP4-IgG serostatus. Additionally, she developed clinical signs of myelitis in association with a persistent short dorsolateral spinal cord lesion. To our knowledge, short non-central spinal lesions occurring at disease onset and persisting for months have not been reported in NMOSD. [ABSTRACT FROM AUTHOR]

Introduction: Brainstem, hypothalamic and cerebral symptoms may occur in neuromyelitis optica spectrum disorders (NMOSD). However, pathologic yawning has not been previously described in NMOSD patients. Materials and Methods: Patients with NMOSD who complained of excessive yawning spells initially drew our attention to this symptom. The diagnosis of neuromyelitis optica (NMO) was performed on the basis of the revised criteria of Wingerchuk et al. (2006), and the term NMOSD was used as defined by Wingerchuk et al. (2007). Serum AQP4-IgG was determined using cell-based assay (Takahashi et al., 2006). Pathologic yawning was defined as a frequency higher than 3 yawns/15 minute, or 28 yawns/day (Singer et al, 2007). Results: Nine AQP4-IgG seropositive NMOSD patients experienced excessive yawning unrelated to sleep deprivation or fatigue. Patients were female, aged 19-57 years (median, 39 years) at disease onset. Excessive yawning spells were the presenting symptom of the disease in five patients, lasting 2-16 weeks and usually occurring in association with nausea, vomiting and hiccups. Brain MRI was abnormal in all patients and most frequently showed brainstem and hypothalamic lesions. Discussion and Conclusion: Pathologic yawning maybe a neglected, although not rare, symptom in NMOSD. [ABSTRACT FROM AUTHOR]

Introduction: Inflammatory bowel disease (IBD) is a group of immune-mediated disorders of the gastrointestinal tract, which includes Crohn's disease (CD), ulcerative colitis (UC), and intermediate conditions. CD can affect any part of the gastrointestinal tract with inflammation involving the whole bowel wall, whereas UC is restricted to the colon and rectum and only involves the intestinal mucosa. Optic neuropathy in patients with IBD may be demyelinating (due to the increased association risk for demyelinating disease in these patients or a complication of infliximab therapy); ischemic or in association with intracranial hypertension (due to increased coagulopathy); or toxic (due to infliximab). Materials and Methods: Herein we report five patients with optic neuropathy occurring in association with IBD and unrelated to infliximab therapy. Results: Of the five IBD patients who developed optic nerve involvement, only one had bilateral sequential anterior ischemic optic neuropathy (AION). This patient was a 66-year-old white male who awoke one morning with unilateral loss of vision. A similar episode occurred one year later in the fellow eye. Visual acuity was 20/200 OU and there were altitudinal field defects in both eyes. Full recovery was not made. The remaining four IBD patients were female with bilateral recurring demyelinating optic neuritis (DON), aged 22-50 years (mean 39.7 years) at onset of the optic nerve involvement. Visual loss was mild in two patients who made a good recovery. One patient had a partial recovery and residual vision of OD 20/70 and OS 20/40, whereas one patient had severe impairment with no light perception in one eye and hand movement in the fellow eye. Discussion and Conclusion: Patients with IBD may develop AION and DON as a result of different abnormalities that occur in association with the disease. DON has been more frequently reported in association with IBD than AION, although it usually occurs during anti-TNF-alpha therapy. None of our patients had been receiving anti-TNF-alpha therapy. [ABSTRACT FROM AUTHOR]

Introduction: Neuromyelitis optica (NMO) is an immune-mediated disease of the central nervous system, often associated with the presence of organ-specific and non-organ specific autoantibodies. It has been observed that NMO patients who also have other autoimmune conditions are at higher risk of developing clinical relapses during the course of their disease. Herein we report an anti-AQP4-IgG seropositive NMO patient whose disease was associated with systemic lupus erythematosus (SLE), myasthenia gravis (MG), hypothyroidism and Sjögren syndrome (SS). During her 29-year follow-up the patient presented 40 attacks of the disease. To our knowledge a case with such a high number of relapses has not been previously reported in the scientific literature. Materials and Methods: Case Report. Results: A 25-year-old mulatto female presented three recurrent attacks of optic neuritis in a period of three years, which resulted in permanent left eye amaurosis. At 28 years she developed the first attack of myelitis, characterized by dysesthesia and pain in the left lower limb and decreased sensation below the level of T6. During the 29-year follow-up period the patient developed 40 relapses (6 acute attacks of optic neuritis and 34 of transverse myelitis). No further attack occurred of optic neuritis in association with transverse myelitis. The patient met the diagnostic criteria for SLE at age 27 years, MG at 50 years, hypothyroidism at 53 years and SS at 55 years. She tested serum positive for anti-AQP4-IgG by cell-based assay. Discussion and Conclusion: The present report demonstrates that NMO may occur in association with multiple autoimmune conditions. In such circumstances, patients may develop a high number of acute disease attacks. [ABSTRACT FROM AUTHOR]

Introduction: Longitudinally extensive spinal cord lesions on magnetic resonance imaging (MRI) are observed in a variety of diseases affecting the spinal cord. In some cases, the diagnosis can only be made by pathological analysis, despite the risks of surgical complications and sequelae. Longitudinally extensive transverse myelitis (LETM) stretching over three or more vertebral segments on MRI is commonly seen in neuromyelitis optica spectrum disorders (NMOSD). The presence of antibodies against aquaporin-4 (AQP4) is an important diagnostic biomarker of NMOSD. Materials and Methods: A review of the clinical, MRI and neuropathological clues in diagnosing neuromyelitis optica spectrum disorders (NMOSD) in two cases of AQP4 antibody-positive LETM, initially biopsied due to suspected spinal cord tumors. Results: We report two female patients (aged 14 and 47 years) with acute severe transverse myelopathy. Spinal cord MRI demonstrated T2-hyperintense longitudinally extensive lesions with swelling and contrast enhancement. Spinal cord biopsies excluded tumors but precluded definitive diagnoses. Both patients were later diagnosed with NMOSD based on their AQP4-seropositivity. Pathological review of both biopsies revealed demyelinated lesions with thickened vessel walls and tissue rarefaction. Immu-nohistochemical staining demonstrated findings compatible with acute NMOSD lesions. This included astrocyte loss in the lesion center and a lack of AQP4 staining, with relatively preserved myelinated fibers in one case. The other case exhibited reactive astrogliosis that partially lacked AQP4, which is consistent with chronic NMOSD lesions. Discussion and Conclusion: A pre-biopsy differential diagnosis of longitudinally extensive spinal cord tumors should include NMOSD. Specific biopsy features, such as cystic changes with vascular wall thickening and astrocyte injury, should raise suspicion for NMOSD. [ABSTRACT FROM AUTHOR]

Introduction: Interferon beta (IFN-β) is a first line therapy for relapsing-remitting multiple sclerosis (RRMS). IFN-β is a cytokine that can contribute to the development of systemic autoimmune disease. Several studies have assessed the presence of thyroid dysfunction and anti-thyroid antibodies in RRMS patients in the course of IFN-β therapy. Herein we report the case of an RRMS patient who developed papillary thyroid carcinoma during the course of treatment with IFN-β. Materials and Methods: Case report. Results: A 46-year-old white female developed the inaugural symptoms of RRMS in 2006 and started treatment with interferon beta-la (IFN-β-la) in 2007. The medication was well tolerated and she did well with no further relapses. In 2009 increased volume of the thyroid gland was observed in a routine medical visit. Ultrasonography of the thyroid gland showed the presence of a nodule with microcalcifications in the right lobe. A biopsy of the lesion demonstrated papillary thyroid carcinoma. Treatment with IFN-β-la was stopped and the patient underwent a total thyroidectomy followed by radioiodine therapy. Past history was negative for autoimmune diseases and malignancies. Currently she has been receiving levothyroxine and glatiramer acetate with no signs of thyroid dysfunction or MS relapse. Discussion and Conclusion: Although the intimate mechanisms of IFN-induced thyroid damage have not been fully clarified, there are some evidences that they may be due to an autoimmune reaction or immune system dysregulation as a result of chronic exposure to the immunomodulator. Although the present case does not allow the link to be made between development of papillary carcinoma of the thyroid and exposure to IFN-β, it strongly enforces the recommendation to monitor the thyroid gland throughout the course of IFN-P therapy. [ABSTRACT FROM AUTHOR]

Introduction: The relationship between multiple sclerosis (MS), immunomodulation therapy and development of malignancies is yet to be fully clarified. Autoimmunity is clearly linked with some hematologic malignancies, and patients with long-term exposure to immunomodulatory treatments for MS have an elevated risk of developing some types of cancer, but less is known about the association of these factors with alimentary tract carcinogenesis. Herein we describe an MS patient who presented adeno-carcinoma of the stomach during treatment with glatiramer acetate (GA) for 7 years. To our knowledge alimentary tract cancer had not been previously reported in association with GA therapy. Materials and Methods: Case Report. Results: A 40-year-old white male developed episodes of gait ataxia, dysesthesia in the face, right hand and lower limb. Neurologic examination was normal. Brain MRI showed T2-weighted hyperintensities in the deep white matter of the left frontal and parietal lobes, periventricular regions, left internal capsule and subcortical regions. There was no gadolinium-enhanced lesion. Pattern-reversal visual evoked responses were normal bilaterally. Cerebrospinal fluid analysis was unrevealing except for increased IgG index. The patient was put on GA therapy and did well with no further relapses. Brain MRI showed a decrease in the number and intensity of lesions. Glatiramer acetate was maintained for seven years with good tolerance and then interrupted when the patient presented two episodes of gastrointestinal hemorrhage. Investigation disclosed a mass lesion in the stomach. Microscopic examination after surgical resection revealed gastric adenocarcinoma. Discussion and Conclusion: Although both autoimmunity and long-term exposure to GA have been associated with increased risk of some types of malignancies, gastric adenocarcinoma had not been reported in MS patients on GA therapy. The individual role that MS and GA have played in carcinogenesis in the present case remains to be determined. [ABSTRACT FROM AUTHOR]

Introduction: There are few epidemiological studies on neuromyelitis optica (NMO), with none having been conducted in Brazil. Prevalence studies of NMO may hold peculiar difficulties in Brazil. The disease may not be recognized by general neurologists and is frequently misdiagnosed as multiple sclerosis (MS). Ascertainment of numbers of NMO and MS patients from a reference MS center in a city can provide the NMO prevalence rate, if the prevalence of MS in that city has been previously known. This method was suggested by John Kurtzke to study MS prevalence, by comparing it with that of amyotrophic lateral sclerosis. Materials and Methods: Cases were ascertained from the CIEM MS Research Center, University of Minas Gerais, Belo Horizonte (BH). Patients were considered prevalent if alive and resident in BH city. The 2006 NMO diagnostic criteria were applied. NMO spectrum disorders (NMOSD) were defined as optic neuritis or longitudinally extensive myelitis (LETM) associated with AQP4-IgG. Serum AQP4-IgG was determined using indirect immunofluorescence assay and cell-based assay. MS was diagnosed according to the 2010 revised McDonald diagnostic criteria. Patient ethnicity, gender distribution and age at disease onset were calculated. As the prevalence of MS in the area is known, the prevalence rate of NMO was calculated by comparison of the number of cases of NMO and MS. Geographical and population data for BH were provided by the Brazilian Institute of Geography and Statistics. Results: As at 31st December 2013,85 patients (74 female, age range 2.8 - 76 years at disease onset) with NMO or NMOSD were identified as resident in BH, from a population of 2,375,171 inhabitants. The prevalence of MS in the city is 18.1 per 100,000 inhabitants, and from this, the prevalence of NMO including NMOSD, was calculated as 7.8 per 100,000 inhabitants. Discussion and Conclusion: This study shows that Belo Horizonte has a high prevalence of NMO, as compared with other populations on different continents. Further studies in Brazil are warranted to confirm the high prevalence of this disease in the country. [ABSTRACT FROM AUTHOR]