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Randomized feasibility trial of the Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program.

BACKGROUND: The Scleroderma Patient-centered Intervention Network (SPIN) developed an online self-management program (SPIN-SELF) designed to improve disease-management self-efficacy in people with systemic sclerosis (SSc, or scleroderma). The aim of this study was to evaluate feasibility aspects for conducting a full-scale randomized controlled trial (RCT) of the SPIN-SELF Program. METHODS: This feasibility trial was embedded in the SPIN Cohort and utilized the cohort multiple RCT design. In this design, at the time of cohort enrollment, cohort participants consent to be assessed for trial el

[Wake disorders. I. Primary wake disorders].

Primary wake disorders encompass various conditions of excessive daytime sleepiness and/or increased nighttime sleep, of unknown origin beginning most often in adolescence and of chronic or recurrent natural history. The best known of these conditions is narcolepsy associating two major clinical features, irresistible episodes of sleep, sleep onset REM periods and an almost constant association with HLA DR2-DQ1. The prevalence of the condition is close to the one of multiple sclerosis but positive diagnosis requires most often over 10 years to be made. The treatment of excessive daytime sleepi…

Понимание отказа от долгосрочных условий с помощью электронных медицинских записей: обзор скопирования.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Множественные долгосрочные условия (ДТЦ) требуют сложных и продолжительных режимов лечения. Ремиссия в долгосрочных условиях (ДКН) имеет важное значение для понимания динамики заболеваний и оценки эффективности лечения. Электронные медицинские записи (ЭПЧ) все чаще используются для мониторинга клинических результатов, однако вопрос о том, каким образом определяется ремиссия в рамках ЭПЧ, остается неясным. ЦЕЛЬ: Цель настоящего исследования заключалась в обобщении и обобщении предыдущей литературы о том, каким образом ремиссия ЛТК определяется в ЭПЧ.МЕТОДЫ: Систематически

Совпадение в аннотации оригинала
BACKGROUND: Multiple long-term conditions (MLTCs) require complex and prolonged treatment regimens. Remission in long-term conditions (LTCs) … es (n=15, 16.5%), depression (n=15, 16.5%), alcohol or drug misuse (n=8, 8.8%), asthma (n=3, 3.3%), multiple sclerosis (n=3, 3.3%), epilepsy (n=1, 1.1%), anemia (n=1, 1.1%), chronic kidney disease (n=1, 1.1%), autoimmune pancreatitis (n=1, 1.1%), hypertension (n=1, 1.1%), heart failure (n=1, 1.1%), and MLTC (n=1, 1.1%). Remission was typically defined using a combin …

Geriatric syndromes in intestinal failure: An accelerated aging phenomenon in middle adulthood patients?

Aging is a progressive deterioration of organ systems, involving molecular and cellular changes known as hallmarks of aging. These alterations affect all body systems and may contribute to the development of geriatric syndromes-multifactorial conditions resulting from the interaction of biological, psychological, and social factors that tend to accumulate over time, thereby increasing morbidity and mortality in older adults. Several studies have documented the presence of these hallmarks in diseases considered as models of accelerated aging. Furthermore, some of these mechanisms have been repo

Siponimod for multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, with an unpredictable course. Current MS therapies such as disease-modifying therapies focus on treating exacerbations, preventing new exacerbations and avoiding the progression of disability. Siponimod (BAF312) is an oral treatment, a selective sphingosine-1-phosphate (S1P) receptor modulator, for the treatment of adults with relapsing forms of MS including active, secondary progressive MS with relapses. OBJECTIVES: To assess the benefits and adverse effects of siponimod as monotherapy or …

Antiviral and immunomodulatory interferon-beta in high-risk COVID-19 patients: a structured summary of a study protocol for a randomised controlled trial.

OBJECTIVES: The primary objective of the study is to demonstrate the efficacy of low-dose IFN-β in reducing the risk of SARS-CoV-2 recently … requiring mechanical ventilation and/or supplemental oxygen; Patients currently using IFN-β (e.g., multiple sclerosis patients); Patients undergoing chemotherapy or other immunosuppressive treatments; Patients with chronic kidney diseases; Known allergy or hypersensitivity to IFN (including asthma); Any autoimmune disease (resulting from patient anamnesis); Patient …

[Establishment of age- and sex-specific reference intervals for cerebrospinal fluid total protein based on dry chemistry method].

Objective: To establish age- and sex-specific reference intervals (RIs) for cerebrospinal fluid total protein (CSF-TP) in a single-center Ha … ervous system lymphoma 1 079 (902, 1 710) mg/L (U=2 242) (all P<0.001). In the demyelinating group, multiple sclerosis patients exhibited significantly lower levels 693.5 (612.0, 726.5) mg/L compared to chronic inflammatory demyelinating polyneuropathy 1 080 (939, 1 494) mg/L (U=23), myelitis 1 064 (842, 1 580) mg/L (U=155), and Guillain-Barré syndrome 1 355 (975, 2 …

Unraveling a new player in multiple sclerosis pathogenesis: The RNA-binding protein HuR.

BACKGROUND: ELAV-like proteins are a small family of RNA-binding proteins that are fundamental players in post-transcriptional mechanisms and are involved in the pathogenesis of neurologic and psychiatric disorders. HuR, the ubiquitously expressed member of the family, is also implicated in sustaining inflammation and inflammatory diseases, supporting the production of pro-inflammatory cytokines. Inflammation plays a central role in Multiple Sclerosis (MS), which represents the most common cause of permanent physical disability in young adults. MS is a chronic autoimmune disease affecting the …

Association of Physician-Patient Communication and Treatment Satisfaction with Adherence to Disease-Modifying Therapies Among Patients with Relapsing-Remitting Multiple Sclerosis: A Cross-Sectional Study.

BACKGROUND: Adherence to disease modifying therapies (DMTs) is essential for treatment outcomes in relapsing-remitting multiple sclerosis (RRMS). Non-adherence has been associated with an increased risk of relapses, disease progression and higher healthcare costs; therefore, it is essential to identify factors associated with adherence. PURPOSE: The aim of the study was to evaluate self-reported adherence to therapeutic recommendation among patients with RRMS and to examine its associations with treatment satisfaction and physician-patient communication. MATERIAL AND METHODS: This cross-sect…

Uncommon Non-MS Demyelinating Disorders of the Central Nervous System.

PURPOSE OF REVIEW: Definitive diagnosis of multiple sclerosis (MS) requires exclusion of other central nervous system (CNS) disorders sharing similar clinical, pathological and radiological features. In this review we discuss some relatively uncommon disorders with special emphasis on their differentiation from MS clinically and radiologically. While most conditions have a demyelinating pathology, a few very important mimics may have a non-demyelinating pathology to merit some discussion. RECENT FINDINGS: Two major areas of diagnostic advances have been made in recent times, the recognition o…

Neuronal injury in chronic CNS inflammation.

INTRODUCTION: Multiple sclerosis (MS) is the most common chronic inflammatory disease of the central nervous system which is characterized by inflammatory demyelination and neurodegeneration. Neurological symptoms include sensory disturbances, optic neuritis, limb weakness, ataxia, bladder dysfunction, cognitive deficits and fatigue. PATHOPHYSIOLOGY: The inflammation process with MS is promoted by several inflammatory cytokines produced by the immune cells themselves and local resident cells like activated microglia. Consecutive damaging pathways involve the transmigration of activated B lymp…

Frequency and prognostic outcomes of emergency diagnosis in 13 non-neoplastic conditions in England: A population-based cohort study using linked electronic health records of 1.7 million patients.

BACKGROUND: In patients with cancer, diagnosis through or soon after the use of emergency hospital care ('emergency diagnosis') is associate … ease, chronic obstructive pulmonary disease (COPD), inflammatory bowel disease (IBD), Lyme disease, multiple sclerosis (MS), Parkinson's disease, polycystic ovary syndrome, rheumatoid arthritis, schizophrenia, subacute bacterial endocarditis, and tuberculosis) in England between 1999 and 2019. We examined the percentage of patients diagnosed as an emergency and comp …

Prognostic models for predicting clinical disease progression, worsening and activity in people with multiple sclerosis.

BackgroundMultiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that affects millions of people worldwide. The disease course varies greatly across individuals and many disease-modifying treatments with different safety and efficacy profiles have been developed recently. Prognostic models evaluated and shown to be valid in different settings have the potential to support people with MS and their physicians during the decision-making process for treatment or disease/life management, allow stratified and more precise interpretation of interventional trials, and …

Single-centre, prospective cohort to predict optimal individualised treatment response in multiple sclerosis (POINT-MS): a cohort profile.

PURPOSE: Multiple sclerosis (MS) is a chronic neurological condition that affects approximately 150 000 people in the UK and presents a significant healthcare burden, including the high costs of disease-modifying treatments (DMTs). DMTs have substantially reduced the risk of relapse and moderately reduced disability progression. Patients exhibit a wide range of responses to available DMTs. The Predicting Optimal INdividualised Treatment response in MS (POINT-MS) cohort was established to predict the individual treatment response by integrating comprehensive clinical phenotyping with imaging, s…

[Application of chromatography-mass spectrometry in the clinical analysis of multiple sclerosis].

Multiple sclerosis （MuS） is a chronic， inflammatory， demyelinating disease of the central nervous system， with a globally increasing prevalence. Its pathogenesis involves complex interactions among immune dysregulation， genetic predisposition， and environmental factors. These contribute to a wide spectrum of clinical manifestations， posing significant challenges for both diagnosis and treatment. Metabolomics， the comprehensive analysis of small-molecule metabolites， has emerged as a powerful approach to elucidate MuS pathophysiology and identify potential biomarkers. In particular， alterations…

Pediatric Multiple Sclerosis: Diagnostics and Treatment (Review)

Рассеянный склероз (РС) – хроническое воспалительное аутоиммунное демиелинизирующее нейродегенеративное заболевание центральной нервной системы, клинически проявляющееся гетерогенной неврологической симптоматикой. У 3–5% пациентов с РС заболевание начинается в детском возрасте. РС у детей имеет свои клинические особенности: рецидивно-ремиттирующее течение в 95–98%, более высокая частота рецидивов в течение первых 2–5 лет, большая распространенность демиелинизирующего процесса, в 15% случаев первый эпизод демиелинизации может иметь клинику острого рассеянного энцефаломиелита. В то же время у де…

Safety and efficacy of laquinimod for Huntington's disease (LEGATO-HD): a multicentre, randomised, double-blind, placebo-controlled, phase 2 study.

BACKGROUND: Laquinimod modulates CNS inflammatory pathways thought to be involved in the pathology of Huntington's disease. Studies with laq … group was discontinued before recruitment was finished because of cardiovascular safety concerns in multiple sclerosis studies. The primary endpoint was change from baseline in the UHDRS-TMS and the secondary endpoint was percent change in caudate volume, both comparing the 1·0 mg group with the placebo group at week 52. Primary and secondary endpoints were assessed …

Cladribine for people with multiple sclerosis.

RATIONALE: Multiple sclerosis (MS) is a chronic, degenerative, autoimmune-mediated disease of the central nervous system (CNS). Although its pathogenesis is not fully understood, inflammation involving both T and B cells is considered an essential factor. Cladribine induces targeted lymphocyte depletion in the peripheral and central nervous system, potentially lowering inflammation and slowing disease progression. OBJECTIVES: To assess the short- and long-term benefits and harms of cladribine compared to no intervention, placebo, or any other disease-modifying drugs (DMDs) in people with any …

Cannabis and cannabinoids for symptomatic treatment for people with multiple sclerosis.

BackgroundSpasticity and chronic neuropathic pain are common and serious symptoms in people with multiple sclerosis (MS). These symptoms increase with disease progression and lead to worsening disability, impaired activities of daily living and quality of life. Anti-spasticity medications and analgesics are of limited benefit or poorly tolerated. Cannabinoids may reduce spasticity and pain in people with MS. Demand for symptomatic treatment with cannabinoids is high. A thorough understanding of the current body of evidence regarding benefits and harms of these drugs is required.ObjectivesTo as…

Seropositive Neuromyelitis Optica in a Case of Undiagnosed Ankylosing Spondylitis: A Neuro-Rheumatological Conundrum.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune astrocytopathy against foot processes of aquaporin-4 (AQP4) water channels. … to have other coexisting autoimmune/connective tissue diseases.7 For example, cases with NMOSD and multiple sclerosis, which are other autoimmune primary demyelinating disorders of the CNS, have been reported.8,9 However, concurrent existence of AS and NMOSD in the same patient even over years of disease course is rare.10,11 In addition, studies describing neurolog …