Prevalence Of Neurological Symptoms Research Articles

Neurological Manifestations in Hospitalized Geriatric Patients With COVID-19 at King Abdulaziz Medical City in Jeddah, Western Region, Saudi Arabia From 2020 to 2021: A Cross-Sectional Study.

Introduction COVID-19 involvement in the nervous system has been reported in many cases.Viral neuroinvasion has multiple routes of entry.Neurological manifestations of COVID-19 can be divided into ones of the central nervous system (CNS), such as headache, dizziness, altered mental status, ataxia, and seizure, and of theperipheral nervous system (PNS), including ageusia, anosmia, acute illness demyelinating polyneuropathy, and neuralgia. Aim and objectives This study aims to observe and report the neurological manifestations in geriatric patients who were diagnosed with COVID-19 at KAMC-J and report the duration of admission to the in-patient and ICU wards. Methods This was a cross-sectional study conducted on admitted geriatric patients with PCR-confirmed COVID-19 from April 1, 2020 to June 30, 2021 at KAMC-J. Using Raosoft®, the sample size was estimated with a CI of 95% and a 36.4%prevalence of neurological symptoms in COVID-19 patients to be 289. Convenience sampling was used, and the data were collected from BESTCare EMRs. IBMSPSSStatistics for Windows, Version 20 (Released 2011) was used for descriptive and inferential statistical analysis. Results In this study, a total of 290 patients' data were collected, 161 (55.5%) of which were males. In addition, the median age was 71 (Q1-Q3: 65-78) years; furthermore, the median body mass index (BMI) was 30(Q1-Q3: 25-34) kg/m2. In descending order, the most prevalent comorbidities were hypertension (HTN) (70.3%), diabetes mellitus (DM) (68.6%), cardiac disease (42.1%), chronic kidney disease(26.6%), neurological disease (23.6%), cancer malignancy (13.1%), and finally chronic respiratory disease (11.4%).Regarding typical COVID-19 manifestations, 181 patients claimed to have experienced cough(62.4%), dyspnea by 164 (56.7%), fever by 154 (53.5%), fatigue by 93 (32.3%), a reading of anoxia by 68 (23.4%), abdominal pain by 58 (20.0%), diarrhea by 56 (19.4%), and finally throat pain by 19 (6.6%). Manifestations and pathologies of the CNS included headache (25.4%), dizziness (21.5%), impaired consciousness (17.2%), delirium (6.6%), ischemic stroke (4.1%), focal cranial nerve dysfunction(2.8%), seizure (2.8%), intracerebral hemorrhage (ICH) (0.3%), and ataxia (0.3%). Moreover, pathologies of the PNS manifested as taste impairment in 46 patients (15.9%), smell impairment in 33 (11.4%), nerve pain in 7 (24%), visual impairment in 5 (1.7%), Bell's palsy in 2 (0.7%), and Guillain-Barre syndrome in 1 (0.3%). Moreover, the majority of patients who developed an ischemic stroke or ICH, or required admission to the ICU had either DM or HTN. In addition, 17 (25.4%) of the 67 patients admitted to the ICU developed impaired consciousness. All-cause mortality in our study was 31 (10.71%) cases. Conclusion Neurological manifestations of COVID-19 are common and can result in serious complications if not detected and managed early, especially in the elderly. These complications are mostly seen in severely ill patients and may be the only symptoms in COVID-19 patients. In addition,patients' clinical conditions could deteriorate rapidly and result in significant morbidity and mortality. Therefore, a high index of suspicion is required among healthcare providers when dealing with such cases. Moreover, we recommend systematically collecting data on the short- and long-term neurological complications of COVID-19 globally and documenting the functional long-term outcomes after these complications.

Neurologic symptoms among solar greenhouse workers and field workers in China.

It has been widely reported that the farmers were at increased risk of neurologic disorders, which probably be related with agricultural risk factors. The intensity of agricultural risk factors was rather high in the solar greenhouse than those in the agricultural farm, while the risk and prevalence of neurologic symptoms among solar greenhouse workers are unclear, which may provide evidence of neurologic dysfunction before clinically measurable signs are evident. This study aimed to evaluate the association among solar greenhouse working, field working, and neurologic symptoms. A cross-sectional study was conducted in China, and 986 Chinese Han population consisting 711 solar greenhouse workers (greenhouse worker group) and 275 field farmers (field worker group) were included. Participants provided information on demographic information, number of solar greenhouses owned (only solar greenhouse workers), working lifetime, and neurologic symptoms through an established questionnaire Q16 to assess the impact of occupational exposure to neurotoxicants, and the total scores were calculated. Multiple linear regression models were used to analyze the association among solar greenhouse working, field working, and neurologic symptoms. The total scales of the neurologic symptoms were higher in the solar greenhouse worker group (20.29 ± 4.79) than those in the field worker group (19.44 ± 4.22) (p < 0.05). Multivariate multiple linear regression showed that solar greenhouse working was positively associated with the scales of the neurologic symptoms (β = 0.248, 95% CI: (0.112, 0.383)). And the age, working lifetime, and current smoking were also positively associated with the scores of the neurologic symptoms, β = 0.007, 0.006 and 0.485 respectively (All p < 0.05). Solar greenhouse workers probably be at an increased risk of neurologic symptoms scores, and the age, working lifetime, and current smoking were also risk factors.

Neurologic symptoms and signs observed in critical COVID-19 patients may be precursors of existing cerebrovascular disease

Introduction: Although COVID-19 disease often includes respiratory system findings, that affects the gastrointestinal system, circulatory system, coagulation system and neurological system. In this study, we identified the neurological signs and symptoms observed in critical COVID-19 patients.&#x0D; Material and Method: This retrospective study reviewed 595 COVID-19 patients admitted to our intensive care unit (ICU) between January to June 2020. Patients with neurologic symptoms that were divided into two groups were diagnosed neurological disease (group ND) and non-neurological disease (group non-ND). Clinical signs and symptoms, radiological findings, demographic data (age, gender, presence of comorbidities), white blood cell (WBC), lymphocyte, platelet, lactic acid, glucose, and D-dimer levels, length of hospitalization, requirement of mechanical ventilation, and mortality were recorded for each patient.&#x0D; Results: Neurologic symptoms were observed in 148 (24.8%) patients. Of these, 44 patients were diagnosed neurological disease and 104 patients were non- neurological disease. The prevalence of neurologic symptoms was significantly higher in group ND. The rate of acute ischemic cerebrovascular disease in 595 critical COVID-19 patients was 6.2%.&#x0D; Conclusion: Presence of cerebrovascular diseases should be suspected in COVID-19patients with paresis, altered consciousness, numbness, taste/smell disorders, and plegia. The rate of ischemic cerebrovascular disease was approximately seven times higher than the rate of hemorrhagic cerebrovascular disease in critically COVID-19 patients.

What can the neurological manifestations of COVID-19 tell us: a meta-analysis

BackgroundCovid-19 became a global pandemic in 2019. Studies have shown that coronavirus can cause neurological symptoms, but clinical studies on its neurological symptoms are limited. In this meta-analysis, we aimed to summarize the various neurological manifestations that occurred in COVID-19 patients and calculate the incidence of various neurological manifestations. At the same time, we further explored the mechanism of nervous system injury and prognosis in COVID-19 patients in combination with their nervous system manifestations. This study provides a reference for early clinical identification of COVID-19 nervous system injury in the future, so as to achieve early treatment and reduce neurological sequelae.MethodsWe systematically searched all published English literature related to the neurological manifestations of COVID-19 from January 1, 2020, to April 30, 2021, in Pubmed, Embase, and Cochrane Library. The keywords used were COVID-19 and terminology related to the nervous system performance. All included studies were selected by two independent reviewers using EndNote and NoteExpress software, any disagreement was resolved by consensus or by a third reviewer, and the selected data were then collected for meta-analysis using a random-effects model.ResultsA total of 168 articles (n = 292,693) were included in the study, and the meta-analysis showed that the most common neurological manifestations of COVID-19 were myalgia(33%; 95%CI 0.30–0.37; I2 = 99.17%), smell impairment(33%; 95%CI 0.28–0.38; I2 = 99.40%), taste dysfunction(33%; 95%CI 0.27–0.39; I2 = 99.09%), altered mental status(32%; 95%CI 0.22–0.43; I2 = 99.06%), headache(29%; 95%CI 0.25–0.33; I2 = 99.42%), encephalopathy(26%; 95%CI 0.16–0.38; I2 = 99.31%), alteration of consciousness(13%; 95%CI 0.08–0.19; I2 = 98.10%), stroke(12%; 95%CI 0.08–0.16; I2 = 98.95%), dizziness(10%; 95%CI 0.08–0.13; I2 = 96.45%), vision impairment(6%; 95%CI 0.03–0.09; I2 = 86.82%), intracerebral haemorrhage(5%; 95%CI 0.03–0.09; I2 = 95.60%), seizure(4%; 95%CI 0.02 -0.05; I2 = 98.15%), encephalitis(2%; 95%CI 0.01–0.03; I2 = 90.36%), Guillan-Barré Syndrome (GBS) (1%; 95%CI 0.00–0.03; I2 = 89.48%).ConclusionsNeurological symptoms are common and varied in Covid-19 infections, and a growing number of reports suggest that the prevalence of neurological symptoms may be increasing. In the future, the role of COVID-19 neurological symptoms in the progression of COVID-19 should be further studied, and its pathogenesis and assessment methods should be explored, to detect and treat early neurological complications of COVID-19 and reduce mortality.

Neurological symptoms and findings in COVID-19: a prospective clinical study

ABSTRACT Objective We sought to evaluate neurologic symptoms and findings in patients with COVID-19 infection hospitalized in a ward and intensive care unit (ICU). Methods This study was designed as a prospective study. Hospitalized COVID-19 rRt-PCR positive patients in the ward and ICU were included in the study. A 54-item questionnaire was used to evaluate the patients. Patients were examined within 3 hours of hospitalization. Results A total of 379 patients were included in the study. The mean age of the patients was 56.1 ± 17.8. 89 of the patients were in intensive care. At least one general symptom was recorded in 95.5% of patients. The most common neurologic symptoms were myalgia (48.5%), headache (39.6%), anosmia (34.8%), and dysgeusia (34%). Neurological symptoms in ICU patients were higher than in the ward. 53.6% of patients had comorbidities. Discussion This study indicated that the prevalence of neurological symptoms was very high in patients with COVID-19. The percentage of neurological symptoms and findings was higher in patients hospitalized in ICU.

Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management.

Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome (STEC-HUS) is a form of thrombotic microangiopathy secondary to an infection by an enterohemorrhagic E. coli. Historically considered a pediatric disease, its presentation has been described as typical, with bloody diarrhea at the forefront. However, in adults, the clinical presentation is more diverse and makes the early diagnosis hazardous. In this review, we review the epidemiology, most important outbreaks, physiopathology, clinical presentation and prognosis of STEC-HUS, focusing on the differential features between pediatric and adult disease. We show that the clinical presentation of STEC-HUS in adults is far from typical and marked by the prevalence of neurological symptoms and a poorer prognosis. Of note, we highlight knowledge gaps and the need for studies dedicated to adult patients. The differences between pediatric and adult patients have implications for the treatment of this disease, which remains a public health threat and lack a specific treatment.

Application of the French TMA Reference Center Score and the mortality in TTP Score in de novo and relapsed episodes of acquired thrombotic thrombocytopenic purpura at a tertiary care facility in Spain.

Acquired thrombotic thrombocytopenic purpura (aTTP) is still associated with a 10% to 20% death rate and its clinical course is characterized by recurrent episodes in up to 50% of cases. Over the last decade, mortality predicting models like the French TMA Reference Center Score and the Mortality In TTP Score (MITS) have been developed in an attempt to personalize treatment. The objective of the present study was to compare the results in both scores of de novo and relapsed aTTP episodes. For such purpose, a total of 29 episodes of aTTP (16 de novo and 13 relapses) were analyzed. All patients were homogeneously diagnosed and treated. First episodes had a higher score in both models in comparison with relapsed aTTP, (MITS median, 1 r: 1-4 vs 0 r: 1-2, P=.038 and French TMA Reference Center Score median, 2 r: 1-3 vs 1 r: 0-1, P=.006). The prevalence of neurological symptoms was significantly higher in the first episodes (P=.001) and patients >60 years old were more common in this group (P=.013), which may have been related to the results. Platelet count at presentation was higher in recurrences than in the first disease episode (P=.016) and ADAMTS13 activity <5% was more frequent in the last group (P=.016). There was no significant difference in the rate of refractoriness or exacerbations. In conclusion, first aTTP episodes had a higher probability of short-term mortality compared to relapsed aTTP episodes according to the MITS and French TMA Reference Center Score.

Characteristics of Neurological Symptoms in Adult Japanese Patients with Fabry Disease.

Objective Fabry disease (FD) is a hereditary lysosomal storage disease that has been highlighted as a possible etiology of stroke at a young age and presents with other various neurological symptoms. Since FD is rare, limited information is currently available on the prevalence of neurological symptoms in Japanese patients with FD. Therefore, we examined the characteristics of neurological symptoms and brain magnetic resonance imaging (MRI) findings in adult Japanese patients with FD. Methods This was a retrospective, single-center study. We reviewed neurological symptoms and brain MRI findings in the medical records of 12 adult Japanese patients with FD diagnosed by a gene analysis of the α-galactosidase gene. Results Ten out of 12 patients with FD presented with the following neurological symptoms: acroparesthesia (n=6), headache (n=5) [migraine (n=4)], hypohidrosis (n=5), and cerebral infarction (n=3). Two and three of the patients with migraine were complicated by ischemic stroke and coronary spastic angina, respectively. Five and 10 patients presented with periventricular hyperintensity and deep white matter hyperintensity, respectively, on brain MRI. Two out of eight patients had cerebral microbleeds. Seven out of 11 patients had a dilated basilar artery diameter on magnetic resonance angiography. There were no patients with the pulvinar hyperintensity sign. Conclusion Patients with FD present with various neurological symptoms. Headache, particularly migraine, might be a major neurological symptom in patients with FD. Since migraine, ischemic stroke, and coronary spastic angina might occur together in FD, caution is needed when administering triptan to FD patients with migraine.

Neurotropism of SARS-CoV 2 and others Coronavirus in Children: Mechanisms and Clinical Manifestations

Neurotropism of SARS-CoV 2 and others Coronavirus in Children: Mechanisms and Clinical Manifestations

Dental amalgam risks in dental staff: systematic review

Mercury is an essential constituent of dental amalgams, several studies have shown that dental personnel who work with dental amalgams are chronically exposed to mercury vapors. The World Health Organization considers that inhaling mercury vapors can have harmful effects on the nervous, immune, pulmonary and renal systems. The objective of this review was to collect and analyze data relating to the exposure of dental personnel to mercury and the possible harmful effects on human health. All biomonitoring studies published between 2002 and 2019 measuring mercury in hair, blood, urine and nails were included. Dentists reported higher levels of mercury in their biomarkers compared to control groups. These levels reflected occupational exposures to chronic low levels of elemental mercury in dental amalgam fillings. Some studies have shown a high prevalence of neurological symptoms and memory deficit in dental staff compared to controls. Studies based on genes involved in mercury metabolism have shown associations between sources of mercury exposure and single nucleotide polymorphisms in these genes. It is important that preventive measures are strengthened to reduce exposure to mercury and that a biomonitoring program for dental professionals exposed to mercury vapors is implemented.

Brain fog and non-coeliac gluten sensitivity: Proof of concept brain MRI pilot study.

AimsNon-Coeliac Gluten Sensitivity (NCGS) is poorly understood, particularly in terms of its neurological outcomes. We initially conducted a prospective postal survey to investigate its neurological presentation and symptom course. Results from this then motivated a follow-up pilot study utilising brain MRI to characterise potential diagnostic biomarkers for future research.MethodsPatients with NCGS were recruited from a specialist centre and completed a prospective postal questionnaire (N = 125). This summarised symptoms experienced, their severity and their course. Onset time was compared by Chi-squared analysis to data from the same centre concerning coeliac disease patients (N = 224). Five respondents on a strict gluten-free diet who self-reported brain fog then attended a pilot study, completing MR brain imaging/questionnaires before/after a gluten challenge. “Baseline” data were assessed for abnormalities, while symptom severity and cerebral blood flow (CBF) were compared before/after challenge.ResultsSurvey participants were aged 47 (85% female). Prevalence of neurological symptoms were: headaches (51%), brain fog (48%), balance issues (31%), tingling (19%). Median symptom resolution time was 48 hours, while onset was 90 minutes; onset pattern was not significantly different compared to CD patients (p = 0.322). Extra-intestinal symptoms worsened by 37%(±28) during a typical reaction. Predominantly non-statistical observations from the brain imaging study are discussed.ConclusionsNeurological symptoms in NCGS are common, and onset time is comparable to that in CD. Brain imaging may be a useful future means of investigating physiological injury and responses to gluten in further study.

126 Neurological symptoms prevalence in hypertensive pregnancy disorders in a tertiary hospital in Southern Brazil.

Introduction Hypertensive disorders are the most prevalent disorders in pregnancy representing a major role in maternal morbidity in pregnancy in developing countries. Neurological symptoms are useful tools in clinical practice as red flags of complications such as preeclampsia and eclampsia. Objective To describe the prevalence of neurological symptoms in pregnancy disorders with gestational induced hypertension (GH) and chronic arterial hypertension (CAH). Methods We conducted a 5 years retrospective study with hospital reports of pregnant women diagnosed with GH and CAH based on the cases of a Southern Brazil Hospital (Complexo Hospital de Clinicas – UFPR). The statistical analysis was expressed in percentage. Results 452 pregnancies were included in our study. 54% in the GH group and 46% the CAH group. Table shows the neurological symptoms prevalence found in the prenatal period of pregnancy hypertensive disorders. Data presented as n (%). Download : Download high-res image (300KB) Download : Download full-size image Others neurological symptoms observed were focal weakness (0.8% in GH; 0.5% in CAH), aphasia (0.4% in GH; 1% in CAH), psychosis (0.4% in GH; 0.5% in CAH), hemiparesis and facial nerve palsy (both 1% in CAH). Conclusion The most prevalent neurological symptoms found in this study were headache, nuchal pain and visual scotomas. These symptoms are related with high risk of complications in hypertensive disorders.

Desidratação hipernatrémica no recém-nascido

Hypernatremia occurred frequently erstwhile when infant formula with high sodium concentration were given to neonates. Today, the most common cause of hypernatremic dehydration in the healthy term newborn is the low volume intake of breast milk. The diagnosis is usually performed accidentally in cases of important weight loss in the newborn. Other clinical manifestations, when present, are usually nonspecific, with prevalence of neurologic symptoms that reflect intracellular dehydration. Some complications, especially seizures, occur most frequently during treatment. Therefore, the management and treatment of this condition should be cautious and requires a thorough understanding of the underlying hydroelectrolytic disorder to prevent the brain cells´ overhydration. The practitioners should continue to recommend breastfeeding as the best method of nourishing healthy infants. There should be a high level of suspicion and early recognition of the underlying breastfeeding problems before the onset of serious and sometimes life-threatening dehydration.

The Prevalence of Neurological Symptoms among Chinese Older Adults in the Greater Chicago Area

Background: Neurological symptoms influence health and well-being among older adults. However, Chinese older adults are underrepresented in most studies on neurological symptoms. This study aims to examine the prevalence of neurological symptoms among U.S. Chinese older adults. Methods: Data were drawn from the PINE study, a population-based survey of U.S Chinese older adults in the greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. Clinical review of system (ROS) was used to assess the presence of dizziness, syncope/fainting, fall, seizures, weakness, numbness, tingling, tremor, and stiffness. Results: Neurological symptoms were commonly experienced by U.S Chinese older adults (50.6%). Symptoms as dizziness (31.0%), numbness (19.0%), and falls (14.8%) were commonly reported. Participants were more likely to report any neurological symptom if they were older , less educated, low income, with poorer self-perceived health status, poorer quality of life, and worsened health change over last year. Conclusions: Neurological symptoms are common among Chinese older adults in the U.S. Future longitudinal research is needed to examine risk factors and health outcomes associated with neurological symptoms.

OR06-1 * NEUROLOGICAL SYMPTOMS, DEPENDENCE AND BEHAVIOR CHANGES ASSOCIATED WITH KHAT CHEWING IN JAZAN REGION, KINGDOM OF SAUDI ARABIA

BACKGROUND: Khat chewing is highly prevalent among males (up to 37.7%) at Jazan region in the far southwest of Saudi Arabia. Most of Khat quitters showed some withdrawal symptoms and better health after quitting. However, Khat chewers consider khat chewing as a social habit and deny khat dependence. OBJECTIVES: To assess neurological symptoms associated with khat chewing, evaluate the behavior of khat chewers towards the chewing practice, measure psychological dependence among khat chewers. METHODS: A male volunteer study was conducted in Jazan region, Saudi Arabia. Seventy two khat chewers and seventy five non-chewers were recruited in the study. All participants filled a structured questionnaire asking about the neurologic symptom that was developed from the Lundberg Q16 questionnaire. Behaviors related to khat chewing were evaluated using modified questionnaire from Fagerstorm; 1978, Griffiths; 1998 and Kassim and Croucher; 2006 questionnaires. Khat dependence was measured using Severity of Dependence Scale (SDS) of khat lastly modified by Kassim et al; 2010. RESULTS: Khat chewers showed higher prevalence of neurological symptoms than non-chewers. The main neurological symptoms were loss of appetite, nausea and vomiting, feeling irritable, fast heart rate, and difficulty with balance. 52% of khat chewers were dependant with median SDS score of 4.5. Most of chewers (70%) were behaviorally low on the behavior scale. Dependant chewers showed higher frequency of neurological symptoms, mainly; dizziness, nausea and vomiting, being abstained and inability to sleep by night. CONCLUSION: Khat chewing is associated with disturbance in behavior. Around half of khat chewers are dependent on khat. OBJECTIVE evaluation is required to measure khat dependency. Language: en

X-linked adrenoleukodystrophy in women: a cross-sectional cohort study

X-linked adrenoleukodystrophy is the most common peroxisomal disorder. The disease is caused by mutations in the ABCD1 gene that encodes the peroxisomal transporter of very long-chain fatty acids. A defect in the ABCD1 protein results in elevated levels of very long-chain fatty acids in plasma and tissues. The clinical spectrum in males with X-linked adrenoleukodystrophy has been well described and ranges from isolated adrenocortical insufficiency and slowly progressive myelopathy to devastating cerebral demyelination. As in many X-linked diseases, it was assumed that female carriers remain asymptomatic and only a few studies addressed the phenotype of X-linked adrenoleukodystrophy carriers. These studies, however, provided no information on the prevalence of neurological symptoms in the entire population of X-linked adrenoleukodystrophy carriers, since data were acquired in small groups and may be biased towards women with symptoms. Our primary goal was to investigate the symptoms and their frequency in X-linked adrenoleukodystrophy carriers. The secondary goal was to determine if the X-inactivation pattern of the ABCD1 gene was associated with symptomatic status. We included 46 X-linked adrenoleukodystrophy carriers in a prospective cross-sectional cohort study. Our data show that X-linked adrenoleukodystrophy carriers develop signs and symptoms of myelopathy (29/46, 63%) and/or peripheral neuropathy (26/46, 57%). Especially striking was the occurrence of faecal incontinence (13/46, 28%). The frequency of symptomatic women increased sharply with age (from 18% in women <40 years to 88% in women >60 years of age). Virtually all (44/45, 98%) X-linked adrenoleukodystrophy carriers had increased very long-chain fatty acids in plasma and/or fibroblasts, and/or decreased very long-chain fatty acids beta-oxidation in fibroblasts. We did not find an association between the X-inactivation pattern and symptomatic status. We conclude that X-linked adrenoleukodystrophy carriers develop an adrenomyeloneuropathy-like phenotype and there is a strong association between symptomatic status and age. X-linked adrenoleukodystrophy should be considered in the differential diagnosis in women with chronic myelopathy and/or peripheral neuropathy (especially with early faecal incontinence). ABCD1 mutation analysis deserves a place in diagnostic protocols for chronic non-compressive myelopathy.

Prevalence of Neurologic symptoms in children of agricultural workers exposed to organophosphate pesticides in rural India

Prevalence of Neurologic symptoms in children of agricultural workers exposed to organophosphate pesticides in rural India

Neurologic symptoms associated with cattle farming in the agricultural health study.

Infection with Campylobacter jejuni, a bacterium carried by poultry and livestock, is the most frequently identified antecedent to the autoimmune neurologic condition Guillain-Barré Syndrome. We used Agricultural Health Study data to assess whether cattle farming was associated with prevalence of neurologic symptoms. Prevalence of self-reported symptoms in cattle farmers (n = 8878) was compared with farmers who did not work with animals (n = 7462), using multivariate regression. Prevalence of numbness and weakness were increased for beef and dairy farmers compared with the reference group (P < 0.0001). Of cattle farmers, 48% did not report raising other animal species, and prevalence of numbness and weakness were also increased in this subgroup compared with the reference group (P < 0.02). Occupational exposure to cattle was associated with increased prevalence of self-reported symptoms associated with peripheral neuropathy.

Abstract 3736: Applying the Carotid Atherosclerosis Score in a Clinical Environment: a Feasibility Study

Background Carotid atherosclerosis is a leading cause of stoke. Recent studies have shown that its severity can be stratified by the Carotid Atherosclerosis Score (CAS) as measured by MRI. However, these studies were performed using customized imaging sequences, coils and comprehensive plaque analysis by specialized human reviewers, which are not generally available in a clinical environment. Whether CAS can be applied for clinical risk assessment is unknown. In this study, we used clinically collected MRI data to compute CAS. We investigated the correlation between CAS and the prevalence of neurological symptoms and disrupted luminal surface (DLS), an indicator of plaque instability, to evaluate the feasibility of translating CAS for clinical use. Methods Seventy six patients with either symptomatic or asymptomatic carotid disease detected by ultrasound were recruited. All patients underwent a multi-contrast MRI with clinical sequences and a commercially available coil. The lumen and outer wall boundaries and DLS were outlined manually and the plaque components were identified automatically using histologically validated image analysis software. The maximum wall thickness (MWT) and maximum % area (100 x area/[wall area]) of lipid-rich necrotic core (LRNC) were outputted by the software to compute CAS as follows: CAS=1 with MWT&amp;lt2.0mm, CAS=2 with LRNC&amp;lt20%, CAS=3 with LRNC between 20% and 40% and CAS=4 with LRNC&amp;gt40%. Trend analysis was done to evaluate the associations between CAS and prevalence of symptoms and DLS. The area under the receiver operating characteristic (ROC) curve was used to evaluate the classification performance of CAS. Results Of the 76 patients, there was a significant increasing trend (p=0.01) between CAS scores and neurological symptom status. The presence of DLS also demonstrated a significant increasing trend (p&amp;lt0.001) versus CAS with rates 0% (0/7), 7% (2/27), 35% (7/20) and 59% (13/22). ROC analysis of CAS also showed it was a good classifier of symptom status (AUC = 0.67, p=0.01) and DLS (AUC = 0.80, p&amp;lt0.001) Conclusion In this study, we conclude that the CAS computed from clinically collected MRI data can stratify the severity of carotid atherosclerotic disease as indicated by neurological symptom status and DLS, both of which are important in monitoring patients and evaluating treatment options. Further study is needed to assess how a fully automated CAS analysis affects the quality of the score and how well the score can stratify the risk of future outcomes.

Imunological and clinical characteristics in children with polyarteritis nodosa: a retrospective study over the last 20 years

Results PAN was diagnosed in 12 patients (6 girls and 6 boys). The share of PAN amongst all vasculitides was 4%. The mean age at disease onset was (±SD) 11.33±3,08 years. Systemic PAN was diagnosed in 7 children (58%), microscopic polyangiitis in 3 (25%), cutaneus PAN in 2 (17%) and classic PAN in 0 (0%). The most consistent symptoms were skin involvement (90%) and arthritis/ arthralgia (60%). The CNS was affected in 40% of patients. ESR and CRP were elevated in all patients. Antineutrophil cytoplasmic antibodies were elevated in 3 patients (25%). Antistreptolysin O was elevated in 4 patients (25%). The relation between the severity of skin involvement and involvement of other organs was not found. Therapy mode for all patients was corticosteroids. Immunosuppressive drugs and Rituximab (antiCD20) were used as additional therapy for patients with severe symptoms. Two patients with microscopic polyangiitis died due to chronic renal and pulmonary failure during the follow-up. Conclusion In comparison to available studies, we found a difference in distribution of childhood polyarteritis nodosa as well as some clinical characteristics (e.g. higher prevalence of neurological symptoms), while other researched features, laboratory and treatment, were similar.