Relapse occurrence in women with multiple sclerosis during pregnancy in the new treatment era

Neurology ◽  
2018 ◽  
Vol 90 (10) ◽  
pp. e840-e846 ◽  
Author(s):  
Raed Alroughani ◽  
Maryam S. Alowayesh ◽  
Samar F. Ahmed ◽  
Raed Behbehani ◽  
Jasem Al-Hashel
Keyword(s):  
Multiple Sclerosis ◽  
Age At Onset ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
Pregnancy And Postpartum ◽  
Prior Use ◽  
The Mean ◽  
New Treatment ◽  
The Relationship

ObjectiveTo determine the rate of relapse occurrence during pregnancy and postpartum.MethodsIn a cross-sectional study using the national multiple sclerosis (MS) registry, pregnant women with relapsing MS were identified. Data on demographics, clinical characteristics, and disease-modifying therapies (DMTs), including washout periods, were collected. Timings and durations of relapses were extracted. A multivariate logistic regression was used to assess the relationship between relapses and prior use of different DMTs.ResultsCompleted data were available for 99 pregnancies (87 patients). Mean age and mean age at onset were 31.8 ± 5 and 24.4 ± 5.6 years, respectively, while the mean disease duration was 7.4 ± 4.6 years. Most pregnancies (89.9%) occurred in patients who were on DMTs in the year preceding pregnancy with a mean treatment duration of 63.4 ± 29 months. The rates of occurrence of relapses during pregnancy and postpartum were 17.2% and 13.7%, respectively. Most of the relapses occurred during the first (n = 6) and third (n = 7) trimesters. Rate of relapse was highest among patients receiving natalizumab and fingolimod before pregnancy. A longer washout period was significantly associated with relapse occurrence.ConclusionThe relapse occurrence during pregnancy is higher than the previously published rates. The use of high-efficacy therapies with long washout periods before conception was associated with an increased risk of relapses during pregnancy. Postpartum relapse occurrence was similar to that in previous reports.

Fatigue in multiple sclerosis is closely related to sleep disorders: a polysomnographic cross-sectional study

2011 ◽  
Vol 17 (5) ◽  
pp. 613-622 ◽  
Author(s):  
C Veauthier ◽  
H Radbruch ◽  
G Gaede ◽  
CF Pfueller ◽  
J Dörr ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Cross Sectional Study ◽  
Sleep Related Breathing Disorders ◽  
Cross Sectional ◽  
Entire Cohort ◽  
Impact Scale ◽  
Increased Risk ◽  
The Relationship

Background: Sleep disorders can cause tiredness. The relationship between sleep disorders and fatigue in patients with multiple sclerosis (MS) has not yet been investigated systematically.Objective: To investigate the relationship between fatigue and sleep disorders in patients with MS.Methods: Some 66 MS patients 20 to 66 years old were studied by overnight polysomnography. Using a cut-off point of 45 in the Modified Fatigue Impact Scale (MFIS), the entire cohort was stratified into a fatigued MS subgroup ( n = 26) and a non-fatigued MS subgroup ( n = 40).Results: Of the fatigued MS patients, 96% ( n = 25) were suffering from a relevant sleep disorder, along with 60% of the non-fatigued MS patients ( n = 24) ( p = 0.001). Sleep-related breathing disorders were more frequent in the fatigued MS patients (27%) than in the non-fatigued MS patients (2.5%). Significantly higher MFIS values were detected in all (fatigued and non-fatigued) patients with relevant sleep disorders (mean MFIS 42.8; SD 18.3) than in patients without relevant sleep disorders (mean MFIS 20.5; SD 17.0) ( p < 0.001). Suffering from a sleep disorder was associated with an increased risk of fatigue in MS (odds ratio: 18.5; 95% CI 1.6–208; p = 0.018).Conclusion: Our results demonstrate a clear and significant relationship between fatigue and sleep disorders.

scholarly journals Effects of parity on the age at menopause and menopausal syndrome: a cross-sectional study in Northwest China

2020 ◽  
Author(s):  
Xiaoyan Sun ◽  
Weiguo Li ◽  
Rui Zhang ◽  
Lirong Wang ◽  
Xiping Shen ◽  
...  
Keyword(s):  
Cox Regression ◽  
Chinese Women ◽  
Cross Sectional Study ◽  
Menopausal Syndrome ◽  
Cross Sectional ◽  
Age At Menopause ◽  
Increased Risk ◽  
The Mean ◽  
The Relationship ◽  
Urogenital Symptoms

AbstractObjectiveThis study evaluated the relationship between the number of births and the age at menopause and menopausal syndrome among Chinese women in Gansu.MethodsA cross-sectional study was conducted by a local university from March to November in 2016. A total of 7236 women aged 40–55 years met study eligibility criteria. The modified KMI was used to assess the menopausal syndrome. Cox regression was applied to estimate HR and 95% CI of the relationship between parity and age at menopause. Logistic regression was performed to calculate OR and CI of the effects of birth times on the menopausal syndrome.Outcome measureThe relationship between the parity and the age at menopause and menopausal syndrome in mid-life northwest Chinese women was analyzed.ResultsThe mean age at menopause was 47.91 ± 3.31 years. The relationships between parity and age at menopause were not significant by applying Cox regression (P = 0.488). Women with nulliparity and more births (3 and ≥4) seemed to have higher risks of moderate and severe menopausal syndrome. In addition, the potential beneficial effects of 1 or 2 births on menopausal syndrome were still observed by applying the multivariable logistic regression analysis, particularly in urogenital symptoms.ConclusionsNo obvious relationship was found between parity and age at menopause among Chinese women in Gansu. Women with nulliparity and more births appeared to be at the increased risk of menopause syndrome compared with women with 1 and 2 births. The underlying mechanisms were not assessed and deserved further investigation.Highlight. The mean age at menopause was lower among Chinese women in Gansu than developed countries and regions.. There is no obvious relationship between parity and age at menopause.. Women with nulliparity and more births (3 and ≥4) appeared to be at the increased risk of menopause syndrome, particularly in urogenital symptoms.

Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Diagnosis ◽  
Optic Neuropathy ◽  
Cross Sectional Study ◽  
P Value ◽  
Pattern Reversal ◽  
Cross Sectional ◽  
The Mean ◽  
Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

scholarly journals Konsep Diri dan Ketidakberdayaan Berhubungan dengan Risiko Bunuh Diri pada Remaja yang Mengalami Bullying

2020 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Udi Wahyudi ◽  
Bram Burnamajaya
Keyword(s):  
Emotional Disorders ◽  
Self Esteem ◽  
Cross Sectional Study ◽  
Correlation Study ◽  
Self Concept ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Relationship

Bullying merupakan perilaku negatif yang dilakukan secara berulang-ulang oleh seseorang atau sekelompok orang yang bersifat menyerang karena adanya ketidakseimbangan kekuatan antara pihak yang terlibat.Tindakan bullying dapat berdampak buruk bagi korban maupun pelakunya di masa depannya. Dampak tersebut meliputi kesepian, pencapaian akademik yang buruk, kesulitan penyesuaian (adaptasi), meningkatnya risiko penggunaan zat, keterlibatan dalam tindakan kriminal dan kerentanan gangguan mental emosional seperti cemas, insomnia, penyalahgunaan zat, depresi, mempunyai self-esteem rendah, kesulitan interpersonal, gangguan konsep diri, dan depresi (ketidakberdayaan). Tujuan penelitian ini adalah untuk mengetahui hubungan antara konsep diri dan ketidakberdayaan dengan risiko bunuh diri pada remaja yang mengalami bullying di SMA Negeri 7 Kota Bogor. Penelitian ini merupakan penelitian kuantitatif dengan menggunakan metode cross-sectional study dengan bentuk pendekatan rancangan correlation study. Sampel dalam penelitian ini berjumlah 183 orang didapat dari teknik randomsampling. Hasil penelitian menunjukkan bahwa berdasarkan hasil uji hubungan dengan menggunakan Chi-Square antara konsep diri dengan ketidakberdayaan didapatkan nilai ρ (0,000) lebih kecil daripada nilai α (0,05), sedangkan uji hubungan antara konsep diri dengan risiko bunuh diri didapatkan nilai ρ (0,013) lebih kecil daripada nilai α (0,05). Dengan demikian bahwa ada hubungan antara konsep diri dan ketidakberdayaan dengan risiko bunuh diri pada remaja yang mengalami bullying di SMA Negeri 7 Kota Bogor. Kata kunci: bullying, konsep diri, ketidakberdayaan, risisko bunuh diri SELF-CONCEPT AND INEQUALITY CONNECTED WITH RISK OF SELF-SUFFICIENT IN ADOLESCENTS WHO HAVE BULLYING ABSTRACTBullying is a negative behavior that is carried out repeatedly by a person or group of people who are attacking because of an imbalance of power between the parties involved. Bullying actions can have a negative impact on victims and perpetrators in the future. These impacts include loneliness, poor academic achievement, adaptation difficulties, increased risk of substance use, involvement in criminal acts and susceptibility to mental emotional disorders such as anxiety, insomnia, substance abuse, depression, low self-esteem, interpersonal difficulties, disturbances self concept, and depression (helplessness). The purpose of this study was to determine the relationship between self-concept and powerlessness with the risk of suicide in adolescents who experienced bullying in SMA Negeri 7 Kota Bogor. This research is a quantitative study using a cross-sectional study method with a correlation study design approach. The sample in this study amounted to 183 people obtained from random sampling techniques. The results showed that based on the results of the relationship test using Chi-Square between self-concept and powerlessness, the value of ρ (0,000) was smaller than the value of α (0.05), while the test of the relationship between self-concept and risk of suicide obtained a value of ρ (0.013 ) is smaller than the value of α (0.05). Thus that there is a relationship between self-concept and powerlessness with the risk of suicide in adolescents who experience bullying in SMA Negeri 7 Kota Bogor. Keywords: bullying, self-concept, helplessness, suicide risk

The Correlation Between Arterial Lactate and Venous Lactate in Patients With Sepsis and Septic Shock

2016 ◽  
Vol 33 (2) ◽  
pp. 116-120 ◽  
Author(s):  
Pongdhep Theerawit ◽  
Chalermpon Na Petvicharn ◽  
Viratch Tangsujaritvijit ◽  
Yuda Sutherasan
Keyword(s):  
Characteristic Curve ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Strongly Correlated ◽  
Cross Sectional ◽  
Arterial Lactate ◽  
Paired Samples ◽  
The Mean ◽  
Sepsis And Septic Shock ◽  
The Relationship

Background: Applying peripheral venous lactate instead of arterial lactate in clinical practice is questionable because of deviation between both values. We aimed to find the relationship between the arterial lactate and the peripheral venous lactate before reasoned that the venous lactate could be used in substitution to the arterial lactate in sepsis. Methods: We conducted a prospective, cross-sectional study at a university hospital. The patients with sepsis in ICU who required lactate level monitoring were enrolled in this research. The correlation and agreement between arterial lactate (A-LACT) and peripheral venous lactate (V-LACT) were the primary outcomes. Results: A total of 63 paired samples were collected. The A-LACT and V-LACT were strongly correlated ( r = .934, P < .0001, r2 = .873). The regression equation was A-LACT = (0.934 × V-LACT) − 0.236. The mean difference between V-LACT and A-LACT was 0.66 ± 1.53 mmol/L. The 95% limits of agreement were between −3.66 and 2.33 mmol/L. The V-LACT ≥ 4 mmol/L can predict A-LACT level ≥ 4 mmol/L with 87.5% sensitivity and 91.5% specificity, and the area under receiver operating characteristic curve was 0.948. Conclusion: The present study demonstrated a strong correlation between A-LACT and V-LACT, but an agreement between both parameters was poor. We suggest not to use the V-LACT in substitution to the A-LACT in sepsis regarding the absolute value and clearance rate, but the V-LACT ≥ 4.5 mmol/L may be used for predicting the A-LACT ≥ 4 mmol/L.

scholarly journals The relationship between body mass index before pregnancy and the amount of weight that should be gained during pregnancy: A cross-sectional study

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Resmiye Özdilek ◽  
Yılda Arzu Aba ◽  
Sena Dilek Aksoy ◽  
Bulat Aytek Şık ◽  
Yaşam Kemal Akpak
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Pregnant Women ◽  
Body Mass ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
The Relationship

Objective: To investigate the adaptation of pregnant women to the recommended weight gain range according to body mass index (BMI) and to determine the factors affecting them. Methods: This cross-sectional study was performed in a university hospital’s obstetrics and gynecology unit (tertiary center) in Turkey. This study was conducted between March 2018 and August 2018 (6 months) in pregnant women. Pregnant women with chronic disease and receiving treatment during antenatal follow-up, with twin pregnancy, with a fetus with a congenital abnormality, and nutritional disturbance were excluded from the study. Eight hundred twelve pregnant women with normal antenatal follow-up and who volunteered to participate were included in the study. Results: The mean age of the participants was 27.66±5.05 years. The mean weight and BMI before pregnancy were near standard in all participants. The group with the highest rate of recommended weight gain according to BMI before pregnancy was the group with low weight pregnant women. The ideal weight gain rate in all groups was 32%. Conclusions: The groups with overweight and obese pregnant women according to BMI before pregnancy had the highest rates of weight gain, above the recommended limits. BMI before pregnancy directly affects weight gain during pregnancy and the importance of pre-pregnancy counseling and weight loss is emphasized once again. doi: https://doi.org/10.12669/pjms.35.5.133 How to cite this:Ozdilek R, Aba YA, Aksoy SD, Sik BA, Akpak YK. The relationship between body mass index before pregnancy and the amount of weight that should be gained during pregnancy: A cross-sectional study. Pak J Med Sci. 2019;35(5):---------.  doi: https://doi.org/10.12669/pjms.35.5.133 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Evaluation of Demographic, Clinical and Beyond Clinical Characteristics in Patients with Multiple Sclerosis in Rafsanjan City, Iran

2017 ◽  
Vol 2 (2) ◽  
pp. 63
Author(s):  
Amir Moghaddamahmadi ◽  
Pouria Yazdian-Anari ◽  
Siamak Kazemisufi ◽  
Alireza Vakilian ◽  
Aliasghar Ranjbartotoei ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Characteristics ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Mcdonald Criteria ◽  
Male Female Ratio ◽  
The Central Nervous System ◽  
The Mean

Background and objectives: Multiple sclerosis is a chronic and progressive autoimmune disease of the central nervous system that causes motor and sensory impairment and physical disability in patients. This study was conducted to determine the demographic, clinical, and beyond clinical characteristics in patients with multiple sclerosis to help identify common disabilities and better understand of the specific needs of these ones.Materials and methods: This descriptive cross-sectional study was carried out on 50 MS patients in Rafsanjan, Iran. A definitive diagnosis has been done according to neurologist and McDonald criteria. The neurologist conducted examinations. The demographic data were recorded using questionnaire. MRI images were analyzed with the help of radiologist and all data were analyzed using SPSS software.Results: The mean age was 33.81±8.38 years and male/female ratio was 7/42. According to data, 66.7% of the patients were suffering from relapsing-remitting type (RR) disease, and most lesions on MRI in these patients were observed in pyramidal and JuxtaCortical areas. The mean EDSS scores of patients was 1.46. The duration of disease and the number of attacks had a significant correlation with educational level (P<0.05); age was significantly associated with pyramidal, mental and sphincter symptoms (P<0.05).Conclusion: These results suggest that the prevalence of MS in women is higher than in men, especially among housekeeper women. Relapsing and remitting disease showed higher frequency.

scholarly journals TL 18165 - Relationship between lower limb dysmetria and plantar fasciitis

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 96S
Author(s):  
Henrique Mansur ◽  
Guilherme Gonçalves Feijó Carvalho ◽  
Isnar Moreira de Castro Júnior
Keyword(s):  
Lower Limb ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Lower Limbs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Calcaneal Spur ◽  
The Mean ◽  
The Relationship

Introduction: Plantar fasciitis is an inflammatory process of multifactorial etiology that affects the origin of the plantar fascia and surrounding structures. A difference in length between lower limbs is relatively common within the population and can sometimes cause changes in biomechanics and symptoms. The objective of this study is to evaluate the relationship between lower limb dysmetria and plantar fasciitis. Methods: A cross-sectional study was performed to measure the length of the lower limbs by scanometry in patients diagnosed with plantar fasciitis. Other risk factors, such as body mass index, foot shape and the presence of plantar calcaneal spur, were also assessed in foot radiographs. Results: Of the 54 patients included in the study, 44.4% were men, and the mean age was 50.38 (23-73 years); 81.5% had pain in one foot, and 53.7% had feet that were considered plantigrade. We observed dysmetria in 88.9% of the sample, with a mean of 0.749 cm (SD ±0.63). In addition, 46.3% feet with pain showed calcaneal spurs on the radiographs. Conclusion: Approximately 90% of patients showed lower-limb dysmetria and, in most cases, the side with the shorter limb was affected by plantar fasciitis

scholarly journals The Relationship Between Defense Mechanisms and Nurses’ Occupational Burnout: A Cross-Sectional Study

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Forouzan Elyasi ◽  
Seyed Mohammad Hosseininejad ◽  
Parisa Islami Parkoohi ◽  
Mahsa Kamali ◽  
Marzieh Azizi ◽  
...  
Keyword(s):  
Significant Relationship ◽  
Defense Mechanisms ◽  
Maslach Burnout Inventory ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Occupational Burnout ◽  
Cross Sectional ◽  
Low Level ◽  
The Mean ◽  
The Relationship

Background: Occupational burnout is a psychological syndrome that occurs in response to chronic stress in the workplace. Nowadays, it is known as one of the most important consequences of occupational stress. Defense mechanisms may also affect occupational burnout. Objectives: Since burnout is an important factor influencing the productivity of nurses, this study was conducted to investigate the relationship between the defense mechanisms and occupational burnout among nurses in the educational hospitals of an urban area in Iran. Methods: This descriptive cross-sectional study was conducted on 318 nurses who had at least one-year of work experience in four educational hospitals in Sari city, Iran, in 2018. Sampling was performed using the proportional stratified sampling method. The data were collected by the Maslach Burnout Inventory (MBI) scale, psychological Defense Styles questionnaire (DSQ-40), and a demographic questionnaire. Data were analyzed using descriptive and inferential statistics via the SPSS software V.20. Results: A total of 318 nurses were studied, 13 (4.1%) of the nurses had a burnout. The mean score of the dimension of emotional exhaustion (EE) was 17.49, in the dimension of depersonalization (DP) it was 5.42, and in the dimension of personal achievement (PA) it was 31.58. They indicated a low level of occupational burnout, and the mean scores of FE, DP, and PA subscales indicated a low level of occupational burnout. The use of more mature defense mechanisms had a significant negative correlation with the increase of the EE score (rho = -0.210, P < 0.001), but no significant relationship was reported with other aspects of burnout. Increased use of immature defense mechanisms had a direct correlation with the increase in the score of DP (rho = 0.255 and P < 0.001), but had a significant inverse relationship with the PA score (rho = -0.238 and P < 0.001) and no significant relationship with EE (P = 0.627). No significant relationship was found between the use of neurotic defense mechanisms and burnout dimensions (PEE = 0.119, PDP = 0.174, and PPA = 0.127). Conclusions: Since there is a significant relationship between defense mechanisms and occupational burnout, using the components of defense mechanisms in job interviews can lead to choosing appropriate nurses to perform different tasks in different settings, in accordance with individual and psychological characteristics. Also, teaching problem-solving skills, stress management, and useful information can improve defense mechanisms, nurses’ job performance, and patient satisfaction.

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