Turning alterations detected by mobile health technology in idiopathic REM sleep behavior disorder

Idiopathic REM sleep Behavior Disorder (iRBD) is a condition at high risk of developing Parkinson's disease (PD) and other alpha-synucleinopathies. The aim of the study was to evaluate subtle turning alterations by using Mobile health technology in iRBD individuals without subthreshold parkinsonism. A total of 148 participants (23 persons with polysomnography-confirmed iRBD without subthreshold parkinsonism, 60 drug-naïve PD patients, and 65 age-matched controls were included in this prospective cross-sectional study. All underwent a multidimensional assessment including cognitive and non-motor symptoms assessment. Then a Timed-Up-and-Go test (TUG) at normal and fast speed was performed using mobile health technology on the lower back (Rehagait®, Hasomed, Germany). Duration, mean, and peak angular velocities of the turns were compared using a multivariate model correcting for age and sex. Compared to controls, PD patients showed longer turn durations and lower mean and peak angular velocities of the turns in both TUGs (all p ≤ 0.001). iRBD participants also showed a longer turn duration and lower mean (p = 0.006) and peak angular velocities (p < 0.001) compared to controls, but only in the TUG at normal speed. Mobile health technology assessment identified subtle alterations of turning in subjects with iRBD in usual, but not fast speed. Longitudinal studies are warranted to evaluate the value of objective turning parameters in defining the risk of conversion to PD in iRBD and in tracking motor progression in prodromal PD.

Joint laxity in canine hip dysplasia assessed using the hip flexed not distracted ventrodorsal view

OBJECTIVES

The ventrodorsal hip extended standard view is conventionally used for radiographic screening of canine hip dysplasia. However, because the ventrodorsal hip extended standard view minimises hip joint laxity, several alternative views have been proposed. Our aim was to evaluate a new ventrodorsal hip flexed and not distracted view to assess joint laxity, by comparing it with the ventrodorsal hip extended standard and ventrodorsal hip flexed and distracted views.

MATERIALS AND METHODS

Between April 2013 and March 2017, all dogs referred to the University of Naples "Federico II" for the diagnosis of canine hip dysplasia were studied using the ventrodorsal hip extended standard, ventrodorsal hip flexed and not distracted and ventrodorsal hip flexed and distracted views. The Norberg angle and the laxity index were measured for each view.

RESULTS

Overall, 102 dogs, 67 males and 35 females, mean age 15 months, were included. The mean (±standard deviation) Norberg angles were 99.77° (±10.42°), 89.29° (±14.32°) and 91.80° (±13.50°) for the ventrodorsal hip extended standard, ventrodorsal hip flexed and not distracted and ventrodorsal hip flexed and distracted views, respectively. The mean (± standard deviation) laxity indices were 0.19 (± 0.14), 0.39 (± 0.25) and 0.36 (± 0.21), respectively. The ventrodorsal hip flexed and distracted and ventrodorsal hip flexed and not distracted views had lower Norberg angle and higher laxity index values compared with the ventrodorsal hip extended standard view. The ventrodorsal hip flexed and distracted and ventrodorsal hip extended standard views are in strong agreement for the measurement of both Norberg angle and laxity index, as confirmed by Bland-Altman analysis and the intraclass correlation coefficient.

CLINICAL SIGNIFICANCE

The ventrodorsal hip flexed and distracted and ventrodorsal hip flexed and not distracted views obtained with the hip in a neutral position reveal joint laxity better than the ventrodorsal hip extended standard view. Unlike the ventrodorsal hip flexed and distracted view, the ventrodorsal hip flexed and not distracted view does not require human operators or special devices for positioning the dog. The wide age range of the dogs enrolled might have influenced the laxity index measurements, since capsular fibrosis in older dogs reduces laxity.

Steroid-Responsive Encephalitis in Coronavirus Disease 2019

Coronavirus disease 2019 (COVID-19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been described in patients with severe respiratory distress. Here, we described the case of a 60-year-old patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but only mild respiratory abnormalities who developed an akinetic mutism attributable to encephalitis. Magnetic resonance imaging was negative, whereas electroencephalography showed generalized theta slowing. Cerebrospinal fluid analyses during the acute stage were negative for SARS-CoV-2, positive for pleocytosis and hyperproteinorrachia, and showed increased interleukin-8 and tumor necrosis factor-α concentrations. Other infectious or autoimmune disorders were excluded. A progressive clinical improvement along with a reduction of cerebrospinal fluid parameters was observed after high-dose steroid treatment, thus arguing for an inflammatory-mediated brain involvement related to COVID-19. ANN NEUROL 2020;88:423-427.

Inflammatory Myopathy in Horses With Chronic Piroplasmosis

Horses affected by chronic piroplasmosis may develop poor performance and muscle atrophy. Here we investigate the pathological and immunopathological aspects of myopathy occurring in chronic equine piroplasmosis. The study included 16 horses serologically positive for equine piroplasms presenting with clinical signs and supporting serum biochemical evidence of a myopathy. Skeletal muscle was evaluated by histopathology, immunohistochemistry, indirect immunofluorescence, and molecular detection of piroplasms and inflammatory cytokines in skeletal muscle. Histologic lesions included muscle fiber atrophy (100% of cases), degenerative changes (13/16, 81%), and perivascular perimysial and endomysial lymphocytic infiltrates (81% of cases). In 15 cases (94%), muscle fibers had strong immunostaining for major histocompatibility complex classes I and II. T lymphocyte populations were mainly CD3+, CD8+, and CD4+ in equal proportions, with a lower number of CD79α+ cells. The serum from affected horses was tested by indirect immunofluorescence for binding of IgG, IgM, or IgA to sections of normal equine muscle to detect circulating autoantibodies against muscle antigen(s). In all cases, distinct sarcolemmal staining was detected in sections incubated with serum from affected horses, in contrast to sections incubated with phosphate-buffered saline or equine control sera. Reverse transcription polymerase chain reaction (RT-PCR) testing of muscles from affected animals revealed a significant increase of interferon-γ, interleukin-12, and tumor necrosis factor-α gene expression compared to healthy controls. Theileria equi or Babesia caballi was not detected in samples of affected muscle by RT-PCR. Thus, inflammatory myopathy associated with equine piroplasmosis may involve an autoimmune pathogenesis with upregulation of inflammatory cytokines that may cause myofiber atrophy and degeneration.

Myopathy with Central Cores in a Foal

Central core disease is a nonprogressive or slowly progressive congenital myopathy with a variable degree of hypotonia and axial and proximal muscle weakness that is histologically characterized by areas devoid of oxidative enzyme activity, resulting from an absence or low numbers of mitochondria in these regions (central core). A 10-month-old, male, pony foal was examined because of stiff gait, marked contractures of the distal portion of the limbs, flexion deformities of the hooves, and moderate hypotonia that had been present from birth. The foal had increased creatine kinase (282 U/ liter; reference interval 10-135 U/liter), lactate dehydrogenase (1,188 U/liter; reference interval 150–450 U/liter), and aspartate transaminase (377 U/liter; reference interval <290 U/liter) activities, suggesting muscle disease. Muscle biopsy was performed. In cytochrome oxidase-, succinate dehydrogenase-, and reduced nicotinamide adenine dinucleotide tetrazolium reductase-reacted sections, the dominant morphologic feature was the absence of oxidative enzyme activity in the cores. By use of immunohistochemical technique with a monoclonal antibody against desmin, the cores were clearly delineated and a desmin network was present within the cores. Ultrastructurally, the core areas were characterized by preserved sarcomeres with irregular Z-lines, with some streaming or zigzag appearance and abnormal sarcoplasmic reticulum profiles and T-tubules. Lack of mitochrondria within central cores was observed. Diagnosis of myopathy with central cores was made.

Mature teratoma arising from an undescended testis in a horse: comparison between ultrasonographic and morphological features

Scant information is available on the ultrasonographic appearance of different testicular tumours in the stallion. Preoperative ultrasound imaging and gross and microscopic features of a testicular teratoma in a horse is described. An asymptomatic 4 years old cryptorchid Arabian horse was admitted for orchiectomy. Combined transabdominal and inguinal ultrasound examination revealed a large complex ovoid mass, containing both solid and cystic elements with internal echoes, located dorsally to the superficial inguinal ring. Two main hypoechoic cavities divided by a linear hyperechoic septum were evident, with a hyperechoic circular structure inside the lumen of the largest one. A tumour of the undescended testis was suspected. Ultrasound findings guided a provisional diagnosis of teratoma that was confirmed by histology following surgical removal of the tumour. Due to the correspondence between ultrasonographic and morphological features, trans-abdominal ultrasonography was conclusive in the preoperative planning.

Dacryocystography in a cat with orbital pneumatosis

A 2-year-old neutered male European short-haired cat was presented for a persistent discharge from the scar of previous left eye enucleation, performed 6 months prior by the referring veterinarian. A surgical exploration of the orbit was performed and retained nictitating membrane glandular and conjunctival tissues were removed. Eleven days later, the cat developed an orbital pneumatosis caused by retrograde movement of air through a patent nasolacrimal system and diagnosed by survey radiographic examination of the skull. Nasolacrimal system patency was assessed by dacryocystography performed by injection of iodinated contrast medium under pressure into the orbital cavity. Computed tomography dacryocystography confirmed the radiographic findings. The condition resolved following dacryocystography, possibly as an inflammatory response to the contrast medium. To our knowledge, this is the first case of orbital pneumatosis reported in a cat.

A multicancer-like syndrome in a dog characterized by p53 and cell cycle-checkpoint kinase 2 (CHK2) mutations and sirtuin gene (SIRT1) down-regulation

INTRODUCTION

We have investigated SIRT1, p53 and cell cycle-checkpoint kinase 2 (CHK2) gene dysfunction in a dog with a multicancer syndrome-like in order to evaluate their potential role in the determinism of the disease and to establish a possible correlation between SIRT1 transcript level and p53 expression status.

MATERIAL AND METHODS

Blood sample and tumour samples from a pure breed English Setter dog with different tumours were used for this study. Nucleotide sequence analysis was performed with a DNA autosequencer in order to examine p53 and CHK2 mutations. In addition, the expression level of SIRT1 was quantified by Southern Blot analysis of Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR).

RESULTS

Cytological examination revealed five different tumours: a cutaneous sebaceous epithelioma, a cutaneous mast cell tumour, a testicular Sertoli cell tumour, an oral malignant melanoma, and a cutaneous squamous cell carcinoma. Sequencing analysis revealed the presence of a nucleotide substitution, (CGG>CAG) exon 7 of the p53 gene in DNA from peripheral blood mononuclear cells (PBMCs) as well as in the melanoma; whereas the other four cancers showed the loss of the wild-type allele. Furthermore, CHK2 mutation at codon 311 has been identified in the melanoma and sebaceous epithelioma. In addition, SIRT1 cDNA expression decreased in all tumour samples compared to cDNA SIRT1expression level in peripheral blood mononuclear cells (PBMCs) in the same dog.

CONCLUSIONS

These results suggest that the germ line mutation of the p53 gene at codon 248 might be, at least, one cause of the multicancer syndrome-like in our dog; furthermore, we show a possible correlation between SIRT1 transcript level and p53 mutations status. The regulatory role of SIRT1 in tumour suppressor pathways suggests that the net effect seen may represent both direct and indirect downstream regulation and it is likely to depend on the presence or absence of functional p53.

Effect of sod (superoxide dismutase) protein supplementation in semen extenders on motility, viability, acrosome status and ERK (extracellular signal-regulated kinase) protein phosphorylation of chilled stallion spermatozoa

New studies are underway to find new methods for supporting longer storage of cooled stallion semen. It is known that high concentrations of reactive oxygen species (ROS) cause sperm pathology. The metalloprotein superoxide dismutase (SOD) is responsible for H(2)O(2) and O(2) production, by dismutation of superoxide radicals. The aim of this study is to assess the quality of chilled stallion semen processed with extenders containing SOD at different concentrations as antioxidant additives. A total of 80 ejaculates collected from 5 standardbred stallions was divided into 5 aliquots treated as: native semen (control 1); native semen diluted 1:3 with Kenney semen extender (control 2); spermatozoa diluted after centrifugation in extender without (control 3) or with SOD at 25 IU/ml (experimental 1) or 50 IU/ml (experimental 2). Each sample was analyzed for motility, viability and acrosome status, immediately after semen preparation and again after storage at 5 °C for 24 h, 48 h and 7 2h. Acrosome integrity was evaluated by Chlortetracycline (CTC) and Fluorescent-labeled peanut lectin agglutinin (PNA-FITC conjugated staining). A proteomic approach of quantifying extracellular signal regulated kinase (ERK) was also evaluated as an indirect indicator of oxidative stress. In all samples sperm progressive motility and sperm acrosomal integrity showed a significant reduction between fresh and cooled spermatozoa at 24 h, 48 h and 72 h. Quality parameters of sperm were significantly higher (Progressive Motility P < 0.01; Viability P < 0.001) in aliquots supplemented with SOD. ERK phosphorylation was statistically higher (P < 0.01) in aliquots without SOD. The Authors concluded that addition of SOD to semen extenders improves the quality of chilled equine semen and reduces ERK activation.

Retrospective study of bacterial isolates and their antimicrobial susceptibilities in equine uteri during fertility problems

Bacterial pathogens are a potential cause when a mare fails to conceive to a fertile stallion on a well-managed breeding farm on one or more cycles in the same season. Furthermore, emerging bacterial resistance to commonly used (topical) antibiotics has been demonstrated. In this study, a total of 586 uterine swabs from mares with fertility problems were evaluated and the bacterial isolates were identified and measured for resistance to 10 antibiotics most commonly used during bacterial equine infection. Forty-nine percent of the examined mares were positive at bacteriological investigations. Amongst 347 successful isolations, 31.7% were Streptococcus group C and 18.4% Escherichia (E.) coli, both considered frequently associated with fertility problems. Determination of the antibiotic susceptibility pattern of Streptococcus group C (110 organisms) revealed that only the amoxicillin/clavulanic acid was highly active with 82.7% of the isolates being inhibited. For E. coli, a major number of drugs displayed a high potency.

Myelography in the dog with non-ionic contrast media at different iodine concentrations

Image quality and side effects were evaluated retrospectively in a series of 183 myelographic studies performed with two non-ionic contrast media (iohexol and iopamidol) at different concentrations. Side effects during and following the procedure were recorded. Image quality was assessed using an arbitrary scoring system and statistical analysis was performed with the cross-tabulation test (4 x 2 table) by comparing two groups receiving contrast medium at higher and lower concentrations. No significant differences in side effects were observed between the two groups but the ratings for image quality were significantly higher in the group receiving contrast medium at the higher concentration than in the group receiving the lower concentration. The results suggest that a high concentration of non-ionic contrast media can safely be used in dogs and may improve image quality.

Neuropsychological assessment in patients with relapsing-remitting multiple sclerosis and mild functional impairment: correlation with magnetic resonance imaging

Forty one moderately impaired patients with clinically confirmed multiple sclerosis (MS) and a relapsing-remitting course were submitted to a neuropsychological battery and magnetic resonance imaging (MRI) to correlate the neuropsychological performances with the degree of cerebral demyelination. The neuropsychological results were indicative of a very mild overall impairment. The patients were subdivided into two groups (extensive periventricular demyelination or discrete lesions on MRI) and the results of neuropsychological tests compared. Patients with extensive periventricular demyelination had an inferior performance on concept formation, non-verbal reasoning and verbal memory tests.

Predictive value of cervical bruit for the detection of obstructive lesions of the internal carotid artery. Data from 2000 patients

Between January 1982 and June 1985, 2000 patients with either symptoms of cerebrovascular insufficiency (1873) or asymptomatic cervical bruits (127) were studied at the Surgical Department of the University of Brescia (Italy). Of these, 441 presented a mono- or bilateral cervical bruit. The value of the bruit as indicator of an obstructive pathology of the extracranial carotid artery was evaluated in comparison with the findings of Doppler spectrum analysis. A stenosis or occlusion of the internal carotid artery was present in 51% of the patients with a bruit (homolateral to the bruit in 91% of the cases) and in 9% of those without a bruit. Stenoses of a medium-high degree were those more often associated with the bruit. Both in patients with bruit and in those without bruit the age and the severity of the presenting symptoms significantly influenced the rate of association with lesions of the internal carotid artery was present in 51% of the patients with a bruit (homolateral to the bruit in 91% of the cases) and in 9% of those without a bruit. Stenoses of a medium-high degree were those more often associated with the bruit. Both in patients with bruit and in those without bruit the age and the severity of the presenting symptoms significantly influenced the rate of association with lesions of the internal carotid artery.