550 e-Letters

  • A radiological curiosity of hyperammonaemia!
    Michael Kinney

    We would like to draw attention to one important point in regard to hyperammonaemic encephalopathy which was not mentioned in the recent excellent article by Sutter and Kaplan discussing the imaging features of encephalopathy.

    The cases of hyperammonaemic encephalopathy with neuroimaging features number less than 10 in the reported literature. As the authors stated they can develop cortical signal abnormalitie...

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  • New Insights on AD: Comment on The identification of cognitive subtypes in Alzheimer's disease dementia using latent class analysis
    Ashima Nehra

    We read with interest the recent article published by Scheltens et. al. [1] The article helped us in understanding greater insights about AD dementia. As rightly stated by the authors that one magic bullet will never be found, but different therapeutic agents may benefit different subgroups of patients. The identification and importance of cognitive AD subtypes for making differentiated diagnoses will also help in the fu...

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  • IgG subclass in combined central and peripheral demyelination associated with anti-neurofascin 155 antibodies
    Nobuhiro Yuki

    At paranodes of both central and peripheral nerves, neurofascin-155 (NF155) is expressed by the terminal loops of myelin and associates with the axonal cell adhesion molecules contactin-1 and contactin-associated protein-1. They are important in maintaining the integrity of axo-glial junction and forming barrier against lateral diffusion of nodal channels. Human IgG antibodies consist of four subclasses (IgG1-4) with dif...

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  • Sensory Ataxia and Anti-contactin-1 IgG4-Associated Paranodopathy
    Nobuhiro Yuki

    With interest, we read an excellent paper written by a German group, in which four patients with chronic inflammatory demyelinating polyneuropathy (CIDP) carried IgG autoantibodies against contactin-1 (CNTN1) expressed at the paranodes in the peripheral nerves.[1] Human IgG antibodies consist of four subclasses (IgG1-4) with different structural and functional characteristics. IgG4 are generally believed to be non- infla...

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  • Nodopathy or paranodopathy: that is the question
    Nobuhiro Yuki

    In peripheral nerves, the domain organization of myelinated axons depends on specific axoglial contacts between the axonal membrane and Schwann cells at nodes, paranodes and juxtaparanodes. The term nodo- paranodopathy was originally proposed to characterize neuropathies with anti-ganglioside antibodies by a common pathological continuum starting with dysfunction/disruption at the nodes of Ranvier, a transitory nerve fai...

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  • CNS involvement in V30M transthyretin amyloidosis: clinical, neuropathological and biochemical data from another center.
    Isabel S. Conceicao

    We read with great interest the recent study by Maia et al., which reports retrospectively central nervous system (CNS) involvement in patients with familial amyloid polyneuropathy associated with Val30Met mutation (ATTR Val30Met FAP)1. This complication was observed in 31% of ATTR Val30Met FAP patients with long survival due to liver transplantation (LT). CNS disorders occurred on average 14.6 years after the onset of TT...

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  • Cerebellar ataxia: lessons from research
    Graziella Quattrocchi

    I read with interest the review by Tada et al. [1], which, based on the current knowledge on the cerebellar systems, propose an interesting framework to interpret cerebellar ataxias in clinical settings. The Authors classify cerebellar ataxias into two main categories: those with a loss of Purkinje cells, translating into a malformation of internal models; and those with a disturbance of afferent systems, causing a mis- s...

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  • Azathioprine and cyclosporine for myasthenia gravis in pregnancy
    Alexander F. Lipka

    We read the recently published UK guideline for treating myasthenia gravis (MG) patients in pregnancy with great interest [1]. As stated by the workgroup in their article, few studies are available concerning drug safety in pregnancy in these patients. In our experience, most drugs indeed carry a very small risk in the treatment of MG during pregnancy. However, based on additional literature we would advise some caution...

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  • Re:How accurate is the record linkage?
    Julian Gold

    We thank Dr. Voci for his comments[1] on our article.[2] As described in the paper, our data comprise Hospital Episode Statistics (HES) obtained from the English national Health and Social Care Information Centre (HSCIC) and mortality record abstracts obtained from the Office for National Statistics. All data from both sources were anonymised to the same standard by encryption of personal identifiers before being supplied...

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  • How accurate is the record linkage?
    Claudio Voci

    This is an interesting study. However, I am somewhat concerned whether the record linkage could be appropriately performed. In most healthcare information systems, HIV patients characteristics are protected. Did the authors have enough information on the patients to perform probabilistic matching? It would be of interest if the authors could show that the matching is adequate by showing that there is not a general reduce...

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