Espectro de neuromielitis óptica: ¿seropositivo para la anticuaporina es una entidad diferente de los pacientes que son seronegativos? Una perspectiva de Colombia / Neuromyelitis optica spectrum disorder: Do patients positive and negative for anti–aquaporin-4 antibodies present distinct entities? A Colombian perspective

Introducción: La neuromielitis óptica es una enfermedad inflamatoria del sistema nervioso central, caracterizada por ataques de neuritis óptica y mielitis transversa longitudinalmente extensa. El descubrimiento del biomarcador diagnóstico anticuerpo anti-acuaporina-4 y los hallazgos imagenológicos en resonancia magnética cerebral han permitido el reconocimiento de un fenotipo clínico más amplio y detallado denominado espectro neuromielitis óptica. Objetivo: Determinar las características demográficas y clínicas de los pacientes diagnosticados con NMO/NMOSD, de acuerdo con la seropositividad del anticuerpo, en dos instituciones de cuarto nivel de complejidad en Bogotá. Métodos: Se realizó un estudio tipo serie de casos. Fueron incluidos aquellos pacientes > 18 años con diagnóstico de NMO/NMOSD, valorados en el Servicio de Neurología de dos hospitales de alta complejidad entre los años 2013 y 2017, con disponibilidad de estudios imagenológicos y resultados de serología. Se evaluaron variables demográficas, clínicas e imagenológicas, y se realizó un análisis de estas variables, según seropositividad del Ac-AQP4. Resultados: Se incluyeron 35 pacientes con NMO/NMOSD, la mediana de edad de inicio fue de 46,5 años (P25-P75 = 34,2-54,0), la mayoría de los pacientes tuvo manifestaciones clínicas a nivel sensitivo (n = 25) y motor (n = 26), en seis (n = 6) pacientes se identificó una enfermedad autoinmune concomitante. Se encontró seropositividad en 20 pacientes. Encontramos algunas diferencias en las características clínicas e imagenológicas, pero solo la edad y el compromiso de nervio óptico mostraron diferencia estadísticamente significativa (p = 0,03). Conclusiones: No se encontraron grandes diferencias clínicas, imagenológicas y de laboratorio, según la seropositividad del Ac-AQP4, excepto en la edad de inicio y el compromiso de nervio óptico (uni o bilateral), pero deben ser estudiadas de manera más detallada en poblaciones más amplias.(AU)

Introduction: Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system characterised by attacks of optic neuritis and longitudinally extensive transverse myelitis. The discovery of anti–aquaporin-4 (anti-AQP4) antibodies and specific brain MRI findings as diagnostic biomarkers have enabled the recognition of a broader and more detailed clinical phenotype, known as neuromyelitis optica spectrum disorder (NMOSD). Objective: This study aimed to determine the demographic and clinical characteristics of patients with NMO/NMOSD with and without seropositivity for anti-AQP4 antibodies, in 2 quaternary-level hospitals in Bogotá. Methods: Our study included patients > 18 years of age and diagnosed with NMO/NMOSD and for whom imaging and serology results were available, assessed between 2013 and 2017 at the neurology departments of hospitals providing highly complex care. Demographic, clinical, and imaging data were gathered and compared in patients with and without seropositivity for anti-AQP4 antibodies. Results: The sample included 35 patients with NMO/NMOSD; the median age of onset was 46.5 years (P25-P75, 34.2-54.0); most patients had sensory (n = 25) and motor manifestations (n = 26), and a concomitant autoimmune disease was identified in 6. Twenty patients were seropositive for anti-AQP4 antibodies. Only age and presence of optic nerve involvement showed statistically significant differences between groups (p = .03). Conclusions: Clinical, imaging, and laboratory variables showed no major differences between patients with and without anti-AQP4 antibodies, with the exception of age of onset and presence of optic nerve involvement (uni- or bilateral); these factors should be studied in greater detail in larger populations.(AU)

Herramientas para la evaluación integral de la función sexual en pacientes con esclerosis múltiple / Tools for comprehensive evaluation of sexual function in patients with multiple sclerosis

Introducción: La esclerosis múltiple (EM) es una enfermedad desmielinizante del sistema nervioso central (SNC) que afecta a adultos jóvenes, ocasionando una variedad de síntomas (motores, visuales, control de esfínteres, alteraciones de la marcha) que impactan la funcionalidad del paciente; sin embargo, otros síntomas, como la disfunción sexual (DS), también pueden tener un efecto sobre la calidad de vida.DesarrolloLa DS puede presentarse en cualquier momento del curso de la enfermedad, su prevalencia varía entre 50 y 90%, puede ser secundaria a lesiones desmielinizantes en médula espinal y/o cerebro, ocasionada por síntomas que no incluyen directamente el sistema nervioso —fatiga, aspectos psicológicos, sociales y culturales—. Si bien se ha logrado establecer su prevalencia y su impacto sobre la calidad de vida, la DS todavía es una condición frecuentemente subestimada, razón por la cual en este artículo se revisan las diferentes escalas que ayudan a evaluar la presencia o la severidad de esta para dar un manejo multidisciplinario temprano, según corresponda.ConclusiónCinco cuestionarios han sido evaluados y/o diseñados para pacientes con EM, los cuales podrían identificar la presencia de DS, su etiología y, con esto, determinar posibilidades de tratamiento. La EM debe ser comprendida como una enfermedad compleja que abarca y compromete diferentes aspectos de la salud de los pacientes, y va más allá de solo medir escalas de discapacidad. (AU)

Introduction: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) that affects young adults, causing a variety of symptoms (motor alterations, visual alterations, loss of sphincter control, gait alterations) that impair the patient's functional status. However, other symptoms, such as sexual dysfunction, can also have an effect on quality of life.DevelopmentSexual dysfunction can occur at any time during the course of the disease; its prevalence varies between 50% and 90%, and it can be secondary to demyelinating lesions in the spinal cord and/or brain or caused by symptoms that do not directly involve the nervous system (fatigue; psychological, social, and cultural factors; etc.). Although its prevalence and impact on quality of life are well known, sexual dysfunction is still frequently underestimated. Therefore, in this article we review the different scales for assessing presence or severity of sexual dysfunction, in order to offer early multidisciplinary management.ConclusionWe evaluated 5 questionnaires that could identify the presence of sexual dysfunction in patients with MS and determine its aetiology, assisting in treatment decision making. MS must be understood as a complex disease that encompasses and compromises different aspects of patients’ health, and goes beyond simply measuring disability. (AU)

SARS-CoV-2 seroprevalence in workers from a Colombian University Hospital.

BACKGROUND: Antibody (Ab) tests for SARS-CoV-2 virus allows for the estimation of incidence, level of exposure and duration of immunity acquired by a previous infection. In health workers, the hospital setting might convey a greater risk of infection. AIMS: To describe the frequency of immunoglobulin G (IgG) Abs (IgG-Abs) to the SARS-CoV-2 virus among workers at a third-level university hospital in Colombia. METHODS: In this cross-sectional study, we included medical and non-medical personnel with at least one real-time polymerase chain reaction (RT-PCR)/antigen test between March 2020 and March 2021. In April 2021, an IgG-Ab test against SARS-CoV-2 was conducted for all participants and replicated 2 weeks later in a random sample (10%). The frequency of IgG-Abs is presented based on status (positive/negative) and time elapsed since RT-PCR/antigen test (<3 months, 3-6 months, >6 months). RESULTS: We included 1021 workers (80% women, median age 34 years (interquartile range 28-42), 73% medical personnel, 23% with previous positive RT-PCR/antigen). The overall seroprevalence was 35% (95% CI 31.6-37.4, 35% in medical and 33% in non-medical personnel). For those with a previous positive RT-PCR/antigen test, the seroprevalence was 90% (<3 months), 82% (3-6 months) and 48% (>6 months). In participants with a previous negative RT-PCR/antigen test, the seroprevalence was 17% (<3 months), 21% (3-6 months) and 29% (>6 months). CONCLUSIONS: High IgG-Ab positivity was found in hospital personnel, regardless of work activities. The prevalence of detectable Abs differed by previous RT-PCR/antigen status and time elapsed since the diagnostic test.

Tools for comprehensive evaluation of sexual function in patients with multiple sclerosis.

INTRODUCTION: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) that affects young adults, causing a variety of symptoms (motor alterations, visual alterations, loss of sphincter control, gait alterations) that impair the patient's functional status. However, other symptoms, such as sexual dysfunction, can also have an effect on quality of life. DEVELOPMENT: Sexual dysfunction can occur at any time during the course of the disease; its prevalence varies between 50% and 90%, and it can be secondary to demyelinating lesions in the spinal cord and/or brain or caused by symptoms that do not directly involve the nervous system (fatigue; psychological, social, and cultural factors; etc.). Although its prevalence and impact on quality of life are well known, sexual dysfunction is still frequently underestimated. Therefore, in this article we review the different scales for assessing presence or severity of sexual dysfunction, in order to offer early multidisciplinary management. CONCLUSION: We evaluated 5 questionnaires that could identify the presence of sexual dysfunction in patients with MS and determine its aetiology, assisting in treatment decision making. MS must be understood as a complex disease that encompasses and compromises different aspects of patients' health, and goes beyond simply measuring disability.

Neuromyelitis optica spectrum disorder: do patients positive and negative for anti-aquaporin-4 antibodies present distinct entities? A Colombian perspective.

INTRODUCTION: Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system characterised by attacks of optic neuritis and longitudinally extensive transverse myelitis. The discovery of anti-aquaporin-4 (anti-AQP4) antibodies and specific brain MRI findings as diagnostic biomarkers have enabled the recognition of a broader and more detailed clinical phenotype, known as neuromyelitis optica spectrum disorder (NMOSD). OBJECTIVE: This study aimed to determine the demographic and clinical characteristics of patients with NMO/NMOSD with and without seropositivity for anti-AQP4 antibodies, in 2 quaternary-level hospitals in Bogotá. METHODS: Our study included patients > 18 years of age and diagnosed with NMO/NMOSD and for whom imaging and serology results were available, assessed between 2013 and 2017 at the neurology departments of hospitals providing highly complex care. Demographic, clinical, and imaging data were gathered and compared in patients with and without seropositivity for anti-AQP4 antibodies. RESULTS: The sample included 35 patients with NMO/NMOSD; the median age of onset was 46.5 years (P25-P75, 34.2-54.0); most patients had sensory (n = 25) and motor manifestations (n = 26), and a concomitant autoimmune disease was identified in 6. Twenty patients were seropositive for anti-AQP4 antibodies. Only age and presence of optic nerve involvement showed statistically significant differences between groups (P = .03). CONCLUSIONS: Clinical, imaging, and laboratory variables showed no major differences between patients with and without anti-AQP4 antibodies, with the exception of age of onset and presence of optic nerve involvement (uni- or bilateral); these factors should be studied in greater detail in larger populations.

Neuromyelitis optica spectrum disorder: Do patients positive and negative for anti-aquaporin-4 antibodies present distinct entities? A Colombian perspective. / Espectro de neuromielitis óptica: ¿seropositivo para la anticuaporina es una entidad diferente de los pacientes que son seronegativos? Una perspectiva de Colombia.

INTRODUCTION: Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system characterised by attacks of optic neuritis and longitudinally extensive transverse myelitis. The discovery of anti-aquaporin-4 (anti-AQP4) antibodies and specific brain MRI findings as diagnostic biomarkers have enabled the recognition of a broader and more detailed clinical phenotype, known as neuromyelitis optica spectrum disorder (NMOSD). OBJECTIVE: This study aimed to determine the demographic and clinical characteristics of patients with NMO/NMOSD with and without seropositivity for anti-AQP4 antibodies, in 2 quaternary-level hospitals in Bogotá. METHODS: Our study included patients > 18 years of age and diagnosed with NMO/NMOSD and for whom imaging and serology results were available, assessed between 2013 and 2017 at the neurology departments of hospitals providing highly complex care. Demographic, clinical, and imaging data were gathered and compared in patients with and without seropositivity for anti-AQP4 antibodies. RESULTS: The sample included 35 patients with NMO/NMOSD; the median age of onset was 46.5 years (P25-P75, 34.2-54.0); most patients had sensory (n = 25) and motor manifestations (n = 26), and a concomitant autoimmune disease was identified in 6. Twenty patients were seropositive for anti-AQP4 antibodies. Only age and presence of optic nerve involvement showed statistically significant differences between groups (p = .03). CONCLUSIONS: Clinical, imaging, and laboratory variables showed no major differences between patients with and without anti-AQP4 antibodies, with the exception of age of onset and presence of optic nerve involvement (uni- or bilateral); these factors should be studied in greater detail in larger populations.

Tools for comprehensive evaluation of sexual function in patients with multiple sclerosis. / Herramientas para la evaluación integral de la función sexual en pacientes con esclerosis múltiple.

INTRODUCTION: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) that affects young adults, causing a variety of symptoms (motor alterations, visual alterations, loss of sphincter control, gait alterations) that impair the patient's functional status. However, other symptoms, such as sexual dysfunction, can also have an effect on quality of life. DEVELOPMENT: Sexual dysfunction can occur at any time during the course of the disease; its prevalence varies between 50% and 90%, and it can be secondary to demyelinating lesions in the spinal cord and/or brain or caused by symptoms that do not directly involve the nervous system (fatigue; psychological, social, and cultural factors; etc.). Although its prevalence and impact on quality of life are well known, sexual dysfunction is still frequently underestimated. Therefore, in this article we review the different scales for assessing presence or severity of sexual dysfunction, in order to offer early multidisciplinary management. CONCLUSION: We evaluated 5 questionnaires that could identify the presence of sexual dysfunction in patients with MS and determine its aetiology, assisting in treatment decision making. MS must be understood as a complex disease that encompasses and compromises different aspects of patients' health, and goes beyond simply measuring disability.