Conus involvement and leptomeningeal enhancement in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder: A case report.

There are a variety of clinical phenotypes and radiological features that continue to make a diagnosis of neuromyelitis optica spectrum disorder (NMOSD) challenging. We present an atypical case of an adult woman who presented with flaccid paralysis of all extremities with unusual neuroimaging features, including extensive enhancing lesions in the upper cervical cord and conus medullaris with associated leptomeningeal enhancement. She was ultimately found to have AQP4 antibody-positive NMOSD. We discuss the factors that complicated a timely diagnosis, including her atypical radiographic features and an initially negative cell-based assay for myelin oligodendrocyte glycoprotein (MOG) and aquaporin-4 (AQP4) antibodies. Despite the rarity of conus medullaris involvement or leptomeningeal enhancement in AQP4 antibody-positive NMOSD, it is important to maintain a high level of clinical suspicion to avoid diagnostic and therapeutic delays. Though cell-based assays have high sensitivities, testing should be repeated on negative values in these scenarios.

Comparing levels of fitness of police Officers between two United States law enforcement agencies.

BACKGROUND: The general physical task demands of law enforcement may suggest that police Officers are of similar fitness levels across cities, states and countries. OBJECTIVE: To investigate whether fitness levels of police Officers from two different United States (U.S.) Law Enforcement Agencies (LEA) are similar. METHODS: Retrospective data were analysed from two LEAs (LEA1 n = 79 and LEA2 n = 319). The data for Officers included: age, mass, 1-minute push-up repetitions, 1-minute sit-up repetitions, vertical jump height, 2.4 km run time (LEA 1) and 20-meter Multi-Stage Fitness Test results (LEA 2). Independent samples t-tests were used to compare anthropometric and fitness data between LEA with significance set at 0.05. RESULTS: Officers from LEA1 weighed significantly less and performed significantly better than Officers from LEA2 on all fitness measures. When comparing male Officers alone, there was no statistical difference in age and mass; nonetheless, Officers from LEA1 significantly outperformed Officers from LEA2 on all fitness measures. CONCLUSION: While similarities / differences in job tasks performed between these two LEA are not known, the results from this study suggest differences in fitness between these two different U.S. LEA. Fitness standards and training protocols need to be developed and contextualized to each LEA's specific population and needs.