Complementary examsThrombocytosis, basic biochemistry, and normal serologies. Cerebrospinal fluid tests showed increased protein content. Electroneuromyography revealed sensorimotor polyneuropathy with a demyelinating pattern and less axonal loss. Computed tomography revealed lymphadenopathy in several chains, and many sclerotic bone lesions. A bone marrow biopsy contained 10% of plasma cells. Protein electrophoresis of the urine showed a lambda monoclonal peak. The vascular endothelial growth factor (VEGF) was 300 times higher than the reference value. Discussion and final commentsThe association of demyelinating polyneuropathy with a monoclonal peak in the electrophoresis results and findings of sclerotic bone lesions, the elevation of VEGF, lymph node organomegaly, and endocrinopathy, confirm the diagnosis of POEMS Syndrome.In this syndrome, neurological damage usually develops with a demyelinating pattern, greater axonal loss, and autonomic preservation. However, we report an atypical case, of neurological impairment with less axonal loss; and relevant dysautonomia.

Water management measures in the 1970s in the Netherlands have produced a large number of "resident" populations of three-spined sticklebacks that are no longer able to migrate to the sea. This may be viewed as a replicated field experiment, allowing us to study how the resident populations are coping with human-induced barriers to migration. We have previously shown that residents are smaller, bolder, more exploratory, more active, more aggressive, exhibited lower shoaling and lower migratory tendencies compared to their ancestral "migrant" counterparts. However, it is not clear if these differences in wild-caught residents and migrants reflect genetic differentiation, rather than different developmental conditions. To investigate this, we raised offspring of four crosses (migrant ♂ x migrant ♀, resident ♂ x resident ♀, migrant ♂ x resident ♀, resident ♂ x migrant ♀) under similar controlled conditions and tested for differences in morphology and behavior as adults. We found that lab-raised resident sticklebacks exhibited lower shoaling and migratory tendencies as compared to lab-raised migrants, retaining the differences in their wild-caught parents. This indicates genetic differentiation of these traits. For all other traits, the lab-raised sticklebacks of the various crosses did not differ significantly, suggesting that the earlier-found contrast between wild-caught fish reflect differences in their environment. Our study shows that barriers to migration can lead to rapid differentiation in behavioral tendencies over contemporary timescales (~50 generations), and that part of these differences reflects genetic differentiation.

Water management measures in the 1970s in the Netherlands have produced a large number of “resident” populations of three-spined sticklebacks that are no longer able to migrate to the sea. This may be viewed as a replicated field experiment, allowing us to study how the resident populations are coping with human-induced barriers to migration. We have previously shown that residents are smaller, bolder, more exploratory, more active, and more aggressive and exhibited lower shoaling and lower migratory tendencies compared to their ancestral “migrant” counterparts. However, it is not clear if these differences in wild-caught residents and migrants reflect genetic differentiation, rather than different developmental conditions. To investigate this, we raised offspring of four crosses (migrant ♂ × migrant ♀, resident ♂ × resident ♀, migrant ♂ × resident ♀, resident ♂ × migrant ♀) under similar controlled conditions and tested for differences in morphology and behavior as adults. We found that lab-raised resident sticklebacks exhibited lower shoaling and migratory tendencies as compared to lab-raised migrants, retaining the differences in their wild-caught parents. This indicates genetic differentiation of these traits. For all other traits, the lab-raised sticklebacks of the various crosses did not differ significantly, suggesting that the earlier-found contrast between wild-caught fish reflects differences in their environment. Our study shows that barriers to migration can lead to rapid differentiation in behavioral tendencies over contemporary timescales (~ 50 generations) and that part of these differences reflects genetic differentiation. Significance statement Many organisms face changes to their habitats due to human activities. Much research is therefore dedicated to the question whether and how organisms are able to adapt to novel conditions. We address this question in three-spined sticklebacks, where water management measures cut off some populations, prohibiting their seasonal migration to the North Sea. In a previous study, we showed that wild-caught “resident” fish exhibited markedly different behavior than migrants. To disentangle whether these differences reflect genetic differentiation or differences in the conditions under which the wild-caught fish grew up, we conducted crosses, raising the F1 offspring under identical conditions. As their wild-caught parents, the F1 of resident × resident crosses exhibited lower migratory and shoaling tendencies than the F1 of migrant × migrant crosses, while the F1 of hybrid crosses were intermediate. This suggests that ~ 50 years of isolation are sufficient to induce behaviorally relevant genetic differentiation.

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Objetivo: Avaliar a presença de disfagia e seu impacto na qualidade de vida de pacientes portadores de doença de Parkinson (DP), correlacionando o estadiamento da doença, a severidade da disfagia e a auto avaliação do risco de disfagia.  Métodos: Estudo observacional e transversal, avaliando 24 pacientes portadores de DP através da escala para sintomas motores de Hoenh e Yahr, da avaliação endoscópica da deglutição (VED), de questionário sobre a qualidade de vida (The 39 item Parkinson´s Disease Question - PDQ-39) e de um instrumento de auto avaliação do risco de disfagia e aspiração (Eating Assessment Tool - EAT-10). Resultados: Na VED, 87,5% dos pacientes apresentaram disfagia, com gravidade independente da severidade motora da doença. Não houve significância entre a gravidade da disfagia e a auto avaliação de disfagia e aspiração. No PDQ-39 houve pior percepção sobre a qualidade de vida com o avançar da doença (p=0,003), com significância no domínio da cognição nos disfágicos graves. Conclusão: a disfagia é um sintoma comum e independente da severidade motora da DP, devendo ser investigada e reabilitada por equipe multiprofissional precocemente a fim de reduzir o impacto na qualidade de vida destes pacientes.

Objetivos: Analisar os níveis da carga proviral (CPV) em portadores de HTLV-1 com diferentes condições de comprometimento neurológico. Metodologia: Estudo transversal, realizado de março a outubro de 2017, com 43 pacientes com HTLV-1, divididos em três grupos por ordem decrescente de envolvimento neurológico, segundo proposta atualizada dos critérios de diagnóstico clínico para HAM/TSP: Definidos para HAM/TSP (Grupo 1, n=7); Prováveis/Possíveis para HAM/TSP (Grupo 2, n=9); Sem HAM/TSP (Grupo 3, n=27).  O teste ANOVA (um critério) foi utilizado para verificar a diferença entre as médias de CPV dos grupos (p-valor≤0,05).  Resultados: Os grupos apresentaram os seguintes valores médios de CPV: G1=9.00±11.18; G2=1.88±3.92; G3=2.81±4.03 cópias/106 PBMC. Na comparação intergrupo, da diferença entre as médias de CPV, foi observada diferença significativa entre os grupos 1 e 2 e entre os grupos 1 e 3 (p<0,05); não foi observada uma média significativamente maior de CPV nos grupos de infectados pelo HTLV-1 com comprometimento neurológico, frente aos infectados sem comprometimento neurológico (p=0,7063). Conclusão: A CPV em portadores de HTLV-1 parece auxiliar a avaliação clínica do comprometimento neurológico na classificação dos casos clássicos de HAM/TSP, mas não se mostra um indicador importante de condições clínicas iniciais da HAM/TSP.

(1) Background: Tropical spastic paraparesis (TSP/HAM) associated with the T cell lymphotropic virus in type I humans (HTLV-1) is a slow, chronic, and progressive disease that causes balance changes. TSP/HAM diagnosis can be classified as probable, possible, and definite. We compared the static balance control of HTLV-1-infected patients with different TSP/HAM diagnosis. (2) Methods: Our sample consisted of 13 participants infected with HTLV-1 and 16 healthy participants. The center of pressure was recorded using a force platform with open and closed eyes. We divided the recordings into three intervals, period T1 (corresponds to the first 10 s); period T2 (from 10 to 45 s); period T3 (from 45 to 55 s). (3) Results: Eight participants infected with HTLV-1 were classified as probable TSP/HAM and five participants infected with HTLV-1 were classified as definite TSP/HAM. There was a significant increase in postural instability in patients with definite PET/MAH considering the structural and global variables of body sway compared to the control and the probable TSP/HAM. (4) Conclusions: We concluded that the severity of balance is directly related to the degree of signs and symptoms of TSP/HAM.