scholarly journals Prevalence and burden of multiple sclerosis-related fatigue: a systematic literature review

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abril Oliva Ramirez ◽  
Alexander Keenan ◽  
Olivia Kalau ◽  
Evelyn Worthington ◽  
Lucas Cohen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Literature Review ◽  
Systematic Literature Review ◽  
English Language ◽  
Demyelinating Disease ◽  
Direct Costs ◽  
Economic Outcomes ◽  
Continuous Measure ◽  
Eligibility Criteria ◽  
The Central Nervous System

Abstract Background Multiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system that results in progressive and irreversible disability. Fatigue is one of the most common MS-related symptoms and is characterized by a persistent lack of energy that impairs daily functioning. The burden of MS-related fatigue is complex and multidimensional, and to our knowledge, no systematic literature review has been conducted on this subject. The purpose of this study was to conduct a systematic literature review on the epidemiology and burden of fatigue in people with multiple sclerosis (pwMS). Methods Systematic searches were conducted in MEDLINE, Embase, and Evidence-Based Medicine Reviews to identify relevant studies of fatigue in pwMS. English-language records published from 2010 to January 2020 that met predefined eligibility criteria were included. We initially selected studies that reported quality of life (QoL) and economic outcomes according to categories of fatigue (e.g., fatigued vs non-fatigued). Studies assessing associations between economic outcomes and fatigue as a continuous measure were later included to supplement the available data. Results The search identified 8147 unique records, 54 of which met the inclusion criteria. Of these, 39 reported epidemiological outcomes, 11 reported QoL, and 9 reported economic outcomes. The supplementary screen for economic studies with fatigue as a continuous measure included an additional 20 records. Fatigue prevalence in pwMS ranged from 36.5 to 78.0%. MS-related fatigue was consistently associated with significantly lower QoL. Results on the economic impact of fatigue were heterogeneous, but most studies reported a significant association between presence or severity of fatigue and employment status, capacity to work, and sick leave. There was a gap in evidence regarding the direct costs of MS-related fatigue and the burden experienced by caregivers of pwMS. Conclusion Fatigue is a prevalent symptom in pwMS and is associated with considerable QoL and economic burden. There are gaps in the evidence related to the direct costs of MS-related fatigue and the burden of fatigue on caregivers. Addressing fatigue over the clinical course of the disease may improve health and economic outcomes for patients with MS.

scholarly journals The Role of Fampridine in the Symptomatic Treatment of Gait Impairment in Patients with Multiple Sclerosis

2019 ◽  
Vol 61 (3) ◽  
pp. 199-207
Author(s):  
Michał Piwoński ◽  
Klaudia Żak ◽  
Patrycja Gierszon ◽  
Izabela Morawska ◽  
Dominika Psiuk ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
English Language ◽  
Demyelinating Disease ◽  
Symptomatic Treatment ◽  
Gait Pattern ◽  
Modern Medicine ◽  
Gait Impairment ◽  
Slowing Down ◽  
The Central Nervous System ◽  
Short Time

Introduction: Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system, the treatment of which remains a great challenge for modern medicine. An important part of it, apart from the treatment slowing down the process of demyelination, is the symptomatic treatment of sphincteral disorders, spasticity, muscle weakness, visual disturbances, mood, depression and gait impairment, which have been carried out with the use of fampridine for a short time. Materials and Methods: The study uses the method of literature analysis in the form of full English-language articles available in the PubMed and Google Scholar database describing the assessment of the effectiveness of fampridine in the symptomatic treatment of gait impairment in MS patients. Results: In each of the studies cited, the ability to walk is indicated in patients taking fampridine compared to placebo. An improvement in walking speed, distance and physical activity is observed. The gait pattern changes. In addition, there is a lack of efficacy of 5 mg dalfampridine ER, with a significant effect on the dose rate of 10 mg. After 2 weeks of discontinuation, the improvement is reversed. Conclusion: A significant effect of fampridine in a dose of 10 mg on improvement of walking in patients with MS is observed. However, it seems necessary for the therapy to be carried out without interruption.

scholarly journals AB0747 MATERNAL AND FETAL OUTCOMES IN PREGNANT WOMEN WITH JUVENILE IDIOPATHIC ARTHRITIS: A SYSTEMATIC LITERATURE REVIEW

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1402.1-1402
Author(s):  
R. Pinheiro Torres ◽  
M. H. Fernandes Lourenco ◽  
A. Neto ◽  
F. Pimentel Dos Santos ◽  
I. Silva ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Literature Review ◽  
Pregnant Women ◽  
Systematic Literature Review ◽  
English Language ◽  
Placenta Previa ◽  
Bibliographic Databases ◽  
Fetal Outcomes ◽  
Term Birth ◽  
Increased Risk

Background:Juvenile idiopathic arthritis (JIA), one of the most common chronic diseases in children, can be classified in seven different categories according to its onset presentation. Concerns about pregnancy outcomes play a secondary role in disease approach. However, recent data showed an increased risk of pre-term birth in women with JIA instead the small patient samples analysed.Objectives:In this review, our aim is to describe the current available knowledge on JIA adverse, maternal and fetal, outcomes.Methods:A systematic literature review was conducted since January of 2000 until December 2020, by searching the PubMed and Embase bibliographic databases. The search was limited to articles in English language, presenting a comparator group (healthy individuals or patients without known auto-immune rheumatic diseases) and at least one clinical outcome of interest. Two independent reviewers screened the titles and abstracts followed by a full-text review to assess papers regarding their eligibility.Results:Ten observational studies out of 1560 references, fulfilled the inclusion criteria, of which, 9 were retrospective and 1 prospective. A total of 6.214 women with JIA (with 6.811 pregnancies) and 18.659.513 healthy controls (with 21.339.194 pregnancies) were included in this review.Concerning maternal outcomes, delivery by caesarian section (CS) was more frequent among JIA women (in 4 out of 6 studies). Pre-eclampsia was referred in 3 out of 6 studies and a higher risk of vaginal bleeding and placenta previa in one additional study. No study found an increased risk for gestational diabetes or hypertension in pregnant women with JIA.Regarding fetal outcomes, 8 studies revealed significantly increased of pre-term birth (only in first births in one study) but one study didn’t show any increased risk. Two studies showed a higher risk of small gestational age (SGA) and in another 2, increased risk for low birth weight (LBW). No evidence of increased risk of major congenital malformations.Conclusion:This systematic review suggests an increased risk for pre-eclampsia, preterm birth, delivery by CS, SGA and LBW, among pregnant women with JIA. Conclusions should be carefully interpreted, giving the heterogeneity of studied populations regarding demography, disease type, disease activity, and prescribed medication.Disclosure of Interests:None declared

scholarly journals Asian American Older Adults and Social Isolation: A Systematic Literature Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 328-328
Author(s):  
Simona Kwon ◽  
Deborah Min ◽  
Stella Chong
Keyword(s):  
United States ◽  
Older Adults ◽  
Literature Review ◽  
Social Isolation ◽  
Asian Americans ◽  
Systematic Literature Review ◽  
Asian American ◽  
Minority Group ◽  
The United States ◽  
Eligibility Criteria

Abstract Asian Americans are the fastest growing racial and ethnic minority group in the United States, whose population is aging considerably. Previous studies indicate that social isolation and loneliness disproportionately affects older adults and predicts greater physical, mental, and cognitive decline. A systematic literature review using PRISMA guidelines was conducted to address this emerging need to understand the scope of research focused on social isolation and loneliness among the disparity population of older Asian Americans. Four interdisciplinary databases were searched: PubMed, CINAHL, PsycINFO, and AgeLine; search terms included variations on social isolation, loneliness, Asian Americans, and older adults. Articles were reviewed based on six eligibility criteria: (1) research topic relevance, (2) study participants aged >60 years, (3) Asian immigrants as main participants, (4) conducted in the United States, (5) published between 1995-2019, and (6) printed in the English language. The search yielded 799 articles across the four databases and 61 duplicate articles were removed. Abstracts were screened for the 738 remaining studies, 107 of which underwent full-text review. A total of 56 articles met the eligibility criteria. Synthesis of our review indicates that existing research focuses heavily on Chinese and Korean American immigrant communities, despite the heterogeneity of the diverse Asian American population. Studies were largely observational and employed community-based sampling. Critical literature gaps exist surrounding social isolation and loneliness in Asian American older adults, including the lack of studies on South Asian populations. Future studies should prioritize health promotion intervention research and focus on diverse understudied Asian subgroups.

scholarly journals HIV infection and multiple sclerosis: a case with unexpected “no evidence of disease activity” status

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199957
Author(s):  
Fernando Labella ◽  
Fernando Acebrón ◽  
María del Carmen Blanco-Valero ◽  
Alba Rodrígez-Martín ◽  
Ángela Monterde Ortega ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Hiv Infection ◽  
Disease Activity ◽  
Demyelinating Disease ◽  
Clinical Course ◽  
Disease Modifying Drugs ◽  
Immunodeficiency Virus ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Disease Modifying

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system whose etiology remains unclear. It has been suggested that MS can be triggered by certain viruses; however, human immunodeficiency virus (HIV) infection is associated with reduced incidence of MS. We present the case of a young patient diagnosed with active relapsing-remitting MS whose clinical course substantially improved following HIV infection and treatment. The patient achieved no evidence of disease activity status without any disease-modifying drugs. Both HIV-induced immunosuppression and antiretroviral therapy may have attenuated the clinical course in this patient.

Recent advances on immunosuppressive drugs and remyelination enhancers for the treatment of multiple sclerosis

2021 ◽  
Vol 27 ◽  
Author(s):  
Jennifer Cadenas-Fernández ◽  
Pablo Ahumada-Pascual ◽  
Luis Sanz Andreu ◽  
Ana Velasco
Keyword(s):  
Multiple Sclerosis ◽  
Intracellular Signaling ◽  
Demyelinating Disease ◽  
Lipid Synthesis ◽  
Immunosuppressive Drugs ◽  
Nerve Fibers ◽  
Myelin Sheaths ◽  
Demyelinating Lesions ◽  
The Central Nervous System ◽  
Lipid Structures

: Mammalian nervous systems depend crucially on myelin sheaths covering the axons. In the central nervous system, myelin sheaths consist of lipid structures which are generated from the membrane of oligodendrocytes (OL). These sheaths allow fast nerve transmission, protect axons and provide them metabolic support. In response to specific traumas or pathologies, these lipid structures can be destabilized and generate demyelinating lesions. Multiple sclerosis (MS) is an example of a demyelinating disease in which the myelin sheaths surrounding the nerve fibers of the brain and spinal cord are damaged. MS is the leading cause of neurological disability in young adults in many countries, and its incidence has been increasing in recent decades. Related to its etiology, it is known that MS is an autoimmune and inflammatory CNS disease. However, there are no effective treatments for this disease and the immunomodulatory therapies that currently exist have proven limited success since they only delay the progress of the disease. Nowadays, one of the main goals in the MS research is to find treatments which allows the recovery of neurological disabilities due to demyelination. To this end, different approaches, such as modulating intracellular signaling or regulating the lipid metabolism of OLs, are being considered. Here, in addition to immunosuppressive or immunomodulatory drugs that reduce the immune response against myelin sheaths, we review a diverse group of drugs that promotes endogenous remyelination in MS patients and whose use may be interesting as potential therapeutic agents in MS disease. To this end, we compile specific treatments against MS that are currently in the market with remyelination strategies which have entered into human clinical trials for future reparative MS therapies. The method used in this study is a systematic literature review on PubMed, Web of Science and Science Direct databases up to May 31, 2020. To narrow down the search results in databases, more specific keywords, such as, “myelin sheath”, “remyelination”, “demyelination”, “oligodendrocyte” and “lipid synthesis” were used to focus the search. We favoured papers published after January, 2015, but did not exclude earlier seminal papers.

Еarly diagnosis of multiple sclerosis: experience with the use of class G oligoclonal immunoglobulin

2021 ◽  
Vol 26 (3) ◽  
pp. 34-39
Author(s):  
Z. A. Goncharova ◽  
Y. Y. Pogrebnova ◽  
N. M. Yarosh ◽  
S. M.M. Sehweil
Keyword(s):  
Multiple Sclerosis ◽  
Early Diagnosis ◽  
Literature Review ◽  
Demyelinating Disease ◽  
Mcdonald Criteria ◽  
Mri Features ◽  
Oligoclonal Igg ◽  
Relationship Of ◽  
The Relationship

The article presents the literature review and our experience in early diagnosis of multiple sclerosis based on the updated McDonald criteria of 2017. The study included 256 patients with clinic symptoms of probable idiopathic infl ammatory demyelinating disease, including rare and atypical forms of demyelination. As a result of the study the sensitivity and specifi city of the determination of oligoclonal immunoglobulin G in the population of Rostov-on-Don was described for the fi rst time, including dependence of the duration of the disease. The relationship of clinical and MRI features of the fi rst attack of the disease with the probability of determining oligoclonal IgG in the cerebrospinal fl uid is refl ected

scholarly journals Homicides and socio-environmental determinants of health in Brazil: a systematic literature review

2018 ◽  
Vol 34 (12) ◽  
Author(s):  
Clovis Wanzinack ◽  
Marcos Claudio Signorelli ◽  
Clóvis Reis
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Protective Factor ◽  
Social Inequalities ◽  
Determinants Of Health ◽  
Environmental Determinants ◽  
Development Education ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Environmental Determinants Of Health

Abstract: Brazil currently has the highest absolute number of homicides in the world, which results from a complex range of factors. This study aimed at understanding the associations between socio-environmental determinants of health (SDH) and homicides in Brazil through a systematic literature review. The review followed PRISMA guidelines, selecting quantitative and qualitative studies published in Portuguese, English, and Spanish carried out between 2002 and 2017, available in the PubMed, MEDLINE, LILACS, SciELO and BVS-BIREME databases. Two trilingual reviewers tracked studies independently by basing on the eligibility criteria. We critically assessed the selected studies with the Critical Appraisal Skills Programme (CASP) or the Checklist for Analytical Cross-Sectional Studies, depending on the study design. We considered 60 studies and grouped their SDH into categories to develop a narrative synthesis about each SDH. These categories were: territory; race/ethnicity; gender; age; social inequalities and economic factors; development; education; work and employment; drugs and trafficking; other SDH. We found some SDH were more associated with homicides, such as being young, black, male, of low education level, and also people who lived in places of high social inequality, such as urban suburbs and agricultural frontiers. Unemployment and drug trafficking, as well as intersections between various SDH were also prominent. Education seems to be a protective factor for homicide. Despite the limited capacity of interpretation due to the high range of methodological approaches, this review shows the importance of considering SDH and their intersections when developing homicide prevention policies.

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