Progressive multifocal leukoencephalopathy with a benign prognosis in an immunocompetent patient - A case report.

John Cunningham virus (JCV) is most commonly acquired in childhood and is often asymptomatic throughout life. However, in the case of primary or secondary immunosuppression, it is known to cause progressive multifocal leukoencephalopathy (PML) in the central nervous system. Hereby, we describe a rare case of PML in a patient without known factors of immunosuppression or use of immunomodulation. A 53-year-old female patient was presented with progressive left-side weakness and tremors in the left hand over a period of two months. The patient was diagnosed with PML based on history, examination, cerebrospinal fluid markers, histopathology, and brain magnetic resonance imaging at presentation. Despite detailed examination, nothing was found in the patient to cause an immunosuppressed state. Therapy was started with mirtazapine with significant neurological improvement.To our knowledge, PML in immunocompetent patient with bening prognosis is a very rare condition. There is also no effective treatment. Our case is a complicated example of this condition.

Plasma disposition and faecal excretion of eprinomectin following subcutaneous administration in Saanen and Alpine goats.

Eprinomectin is extensively used in veterinary medicine, particularly in the treatment of internal and external parasites in livestock, including goats. The pharmacokinetic behavior of eprinomectin in plasma and faeces was studied after a single subcutaneous administration in two different goat breeds at a dose of 0.2 mg/kg body weight. The study was conducted on one-year-old female Saanen (n = 8) and Alpine (n = 8) goats in a parallel design. There were no significant differences between Saanen and Alpine goats on the peak plasma concentration (Cmax, 28.59 ± 7.46 ng/mL vs. 37.69 ± 14.89 ng/mL), area under the curve (AUC0-∞, 93.08 ± 11.66 ng.d/mL vs. 116.98 ± 48.36 ng.d/mL), area under the first moment curve (AUMC0-∞, 311.05 ± 67.23 ng.d2/mL vs. 348.25 ± 202.64 ng.d2/mL) and mean residence time (MRT, 3.24 ± 0.77 d vs. 2.74 ± 0.64 d) values. The plasma terminal half-life and the time to reach peak plasma concentration were significantly higher in Saanen goats (T1/2λz, 2.18 ± 0.43 d; Tmax, 1.21 ± 0.25 d) than in Alpine goats (T1/2λz, 1.66 ± 0.41 d; Tmax, 0.79 ± 0.25 d). The results revealed that the plasma concentration of eprinomectin did not differ depending on the breed in Saanen and Alpine goats. However, it was determined that the eprinomectin clearance from the body may vary depending on the breed in goats. The faecal eprinomectin concentration of Saanen and Alpine goats was 90 and 80 times higher than the plasma eprinomectin concentration, respectively. Although high faecal excretion of eprinomectin confers a high efficacy advantage against parasites in the gastrointestinal tract, it may pose an ecotoxicological risk to manure fauna and aquatic organisms with high susceptibility to this compound.

The minnesota manual dexterity test as a bimanual performance measure in people with multiple sclerosis.

BACKGROUND: Increasing knowledge about unilateral or bilateral upper limb (UL) involvement in multiple sclerosis (MS) has revealed the need for an objective assessment tool. OBJECTIVE: The aims of our study were to evaluate manual dexterity using Minnesota Manual Dexterity Test (MMDT) in people with MS (pwMS), to investigate the validity and feasibility of MMDT, and to examine its relationship with other variables. METHODS: Eighty pwMS and forty healthy controls were enrolled. Demographic and clinical characteristics of pwMS were recorded, and manual dexterity, activity performance of the UL, hand grip and pinch strength, and fatigue levels were evaluated. Validity was performed using the Nine Hole Peg Test (NHPT). Feasibility was evaluated with questions directed to pwMS. The relationship between MMDT and strength, ABILHAND, fatigue, Expanded Disability Status Scale (EDSS) and disease duration was examined and multiple regression analysis was established. RESULTS: For the MMDT of pwMS were mean placing-dominant 82.73 s, mean placing-nondominant 88.6 s, and mean two-hand turning and placing 61.75 s. All results were statistically significantly different compared to healthy controls. There was moderate to high correlation between the subtests of the MMDT and the NHPT. 85-90% positive feedback was received for the feasibility of MMDT. A significant interaction was found between all subtests of MMDT and EDSS, ABILHAND and disease duration in predicting manual dexterity scores. CONCLUSIONS: MMDT is a valid and feasible tool for assessing manual dexterity and it can be used as an appropriate outcome measure in researches aiming to evaluate bilateral UL function in pwMS.