Including a subject-paced trial may make the PASAT more acceptable for MS patients.

UNLABELLED: The Paced Auditory Serial Addition Test (PASAT) is regularly used in the evaluation of cognition in multiple sclerosis (MS). However, the test may impose frustration, distress, and anxiety in patients, which may result in refusal to participate by many patients. OBJECTIVES: In this study, a subject- and experimenter-paced PASAT was compared and analyzed, with regard to independent measures of cognitive functions, as well as disability, fatigue, depression, and anxiety. METHODS: A population-based sample of patients with MS (n = 34; mean age 47.2 ± 8.6) was examined with the PASAT, including a subject-paced condition, in addition to the standard experimenter-paced conditions using three levels of interstimuli intervals (ISI: 3.0, 2.5, and 2.0 s). A comprehensive set of neuropsychological tests, measures of disease severity, fatigue, anxiety, and depression were studied as potentially associated factors. RESULTS: Subject- and experimenter-paced PASAT performance correlated significantly and the subject-paced administration correlated even higher with measures of information processing speed, executive function, attention, and working memory than standard experimenter-paced administration of PASAT. DISCUSSION: The associations between PASAT performance and measures of fatigue, anxiety, and depression were not significant. CONCLUSION: The results indicate that the altered PASAT procedure measures the same cognitive functions in MS as the standard procedure. At the same time, the altered procedure may make the PASAT more user-friendly for patients with MS.

Waterborne campylobacteriosis in northern Norway.

A suspected waterborne outbreak of presumed campylobacteriosis involving approximately 680 of the 1000 inhabitants in a community is described. Twenty-two strains of Campylobacter jejuni were isolated from patients. Ten randomly chosen isolates were identified as biotype 1 LAU 0:1 (n = 9) and biotype 2 PEN 0:6, 7 (n = 1) and one from tap water as biotype 1 PEN 0:19, 22. The majority of cases occurred within a period of 1 week. Examination of human sera obtained during the first 2 weeks of the epidemic (n = 38) revealed two patients producing antibodies directed only against the water isolate. The majority (89%) of sera collected 4 weeks later (n = 18) had antibodies directed against the most common human isolate. We suggest that all three serotypes of C. jejuni were involved in this outbreak, stressing the need for continuous surveillance and treatment of public drinking water sources.

Clinical and serological manifestations in patients during a waterborne epidemic due to Campylobacter jejuni.

A clinical and serological investigation of an epidemic due to Campylobacter jejuni in a community with a population of 1026 is presented. Altogether, 22 faecal samples from 27 patients were positive, with serotypes O 2 (n = 21) and O 6, 7 (n = 1) being identified. Serotype O 19, 21 was isolated from drinking water which had been consumed by 89.5% households answering a questionnaire, thereby indicating an attack rate of 66.5% (i.e. 680 persons). Mean duration of illness was 6.5 +/- 4.6 days. Diarrhoea (82.3%), abdominal pains (62.8%) and fever (41.8%) were the most common symptoms. Acute stage samples of serum from Campylobacter-positive patients had lower concentrations of IgG antibodies against the most common serotype (O 2) than against serotype O 6, 7 (P = 0.05), which had previously been implicated in epidemics in the region. More than 80% samples drawn after 1-2 weeks of illness were positive for either IgA, IgM or IgG antibodies to serotype O 2 with a dominance of IgA. In the convalescent group (n = 24), serum from only one patient who developed a long-lasting reactive arthritis had antibodies to all serotypes.

Multiple sclerosis in Nord-Trøndelag County, Norway: a prevalence and incidence study.

OBJECTIVE: To calculate the prevalence and incidence of multiple sclerosis (MS) in Nord-Trøndelag County, Norway. MATERIAL AND METHODS: The study comprised everyone diagnosed with MS according to the Poser criteria. On 1 January 2000 a total of 208 were identified: 130 women (62.5%) and 78 men (37.5%). We calculated the crude and age-adjusted annual incidence rates from 1974 to 1999. RESULTS: The prevalence on 1 January 2000 was 163.6 of 100,000, 204.8 of 100,000 for women and 122.6 of 100,000 for men. The age-adjusted annual incidence increased from 3.9 to 5.6 per 100,000 from 1974 to 1999; women from 4.6 to 6.3 and men from 2.2 to 4.4. After 1984, the incidence among women increased most, peaking at 10.2 per 100,000 in 1984-88. CONCLUSIONS: MS incidence is increasing in Nord-Trøndelag County. The prevalence is among the highest ever in Norway.

[Encephalitis after acute Epstein-Barr virus infection]. / Encefalitt etter akutt Epstein-Barr-virusinfeksjon.

BACKGROUND: Epstein-Barr virus (EBV) infection is known to cause severe neurological complications such as encephalitis. MATERIAL AND METHODS: We present the history of two men, aged 17 and 22, who developed encephalitis after acute primary EBV infection. One of them survived with cerebral complications, the other died. RESULTS: One of them had the classic presentation of infectious mononucleosis and EBV-specific findings in the cerebrospinal fluid. The other had neither signs of infectious mononucleosis nor specific findings in the cerebrospinal fluid such as EBV-PCR. Nevertheless, the clinical features of encephalitis were very similar. They were characterized by memory problems, personality changes, reduced consciousness, brainstem disorders and epileptic seizures. CT and MRI findings indicated involvement of basal ganglia and limbic structures. None of them responded to acyclovir. INTERPRETATION: We conclude that EBV infection can lead to severe cerebral complications without general symptoms of infectious mononucleosis and specific serologic findings in the cerebrospinal fluid.