Effect of pregnancy and exclusive breastfeeding on the rate of relapses and degree of disability in two years after pregnancy in patients with multiple sclerosis

2018 ◽  
Author(s):  
Mehran Ghaffari
Keyword(s):  
Multiple Sclerosis ◽  
Exclusive Breastfeeding ◽  
Degree Of Disability

scholarly journals Patient’s point of view on the use of telemedicine in multiple sclerosis: a web-based survey

2021 ◽  
Author(s):  
Doriana Landi ◽  
Marta Ponzano ◽  
Carolina Gabri Nicoletti ◽  
Gaia Cola ◽  
Gianluca Cecchi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Point Of View ◽  
Physical Parameters ◽  
Chronic Medical Conditions ◽  
Socioeconomic Conditions ◽  
Web Based ◽  
Healthcare Facilities ◽  
Advantages And Disadvantages ◽  
Disease Characteristics ◽  
Degree Of Disability

AbstractRestrictions in the access to healthcare facilities during COVID-19 pandemic have raised the need for remote monitoring of chronic medical conditions, including multiple sclerosis (MS). In order to enable the continuity of care in these circumstances, many telemedicine applications are currently tested. While physicians’ preferences are commonly investigated, data regarding the patients’ point of view are still lacking. We built a 37 items web-based survey exploring patients’ propensity, awareness, and opinions on telemedicine with the aim to evaluate the sustainability of this approach in MS. Analysing 613 questionnaires out of 1093 that were sent to persons with MS followed at the Multiple Sclerosis Center of Tor Vergata University, Rome, we found that more than half of respondents (54%) were open to having a televisit. Propensity toward telemedicine significantly depended on having a higher income (p = 0.037), living farther from the center (p = 0.038), using computer and tablet (p = 0.010) and using the Internet for other remote activities (p < 0.001), conversely it was not influenced by any specific disease characteristics (i.e. degree of disability). The main advantages and disadvantages of televisit reported by participants were respectively saving time (70%) and impossibility to measure physical parameters (71%). Although the majority of respondents are in favour of televisit, so far this approach is restricted to those displaying better socioeconomic conditions and higher familiarity with technology. Implications of the study are that telemedicine platforms should be better tailored to patients’ demands in order to spread the use of telemedicine, to enhance usability and to increase patients’ adherence.

scholarly journals Correlation between fatigue and self-esteem in patients with multiple sclerosis

2009 ◽  
Vol 67 (3b) ◽  
pp. 818-821 ◽  
Author(s):  
Yára Dadalti Fragoso ◽  
Érika Oliveira da Silva ◽  
Alessandro Finkelsztejn
Keyword(s):  
Multiple Sclerosis ◽  
Severe Depression ◽  
Self Esteem ◽  
Socioeconomic Level ◽  
Mild Depression ◽  
Degree Of Disability ◽  
Severe Anxiety ◽  
The Way

OBJECTIVE: To assess the possible association of fatigue with self-esteem in multiple sclerosis (MS) patients. METHOD: Thirty patients were prospectively assessed. None of them presented moderate or severe depression or anxiety and their degree of disability was low (EDSS<3.5). They had been clinically stable for at least three months and had been receiving the same medication for at least six months. Socioeconomic level was assessed. Severity of fatigue and self-esteem were evaluated using specific, validated scales. Patients with moderate to severe anxiety and/or depression were excluded. RESULTS: Low self-esteem correlated with fatigue (p=0.01), but not with any other variables, such as age, gender, EDSS, MS duration, number of relapses, mild depression and/or anxiety. CONCLUSION: Greater severity of fatigue in MS correlates with low self-esteem, thus suggesting that this chronic complaint that affects so many patients can interfere with the way in which they see and value themselves.

Energy cost of exercise in multiple sclerosis patients with low degree of disability

1996 ◽  
Vol 2 (3) ◽  
pp. 161-167 ◽  
Author(s):  
C Tantucci ◽  
M Massucci ◽  
R Piperno ◽  
V Grassi ◽  
CA Sorbini
Keyword(s):  
Multiple Sclerosis ◽  
Minute Ventilation ◽  
Respiratory Muscles ◽  
Metabolic Cost ◽  
Mild Degree ◽  
Cardiorespiratory Response ◽  
Low Degree ◽  
Mild Disability ◽  
Degree Of Disability ◽  
Multiple Sclerosis Patients

In 10 patients (five females) suffering from multiple sclerosis with mild degree of disability, (EDSS ranging from 0 to 2) and in 10 age and sex matched control subjects we investigated lung function, respiratory muscles strength and cardiorespiratory response to incremental exercise in order to assess the metabolic cost of exercise. In the absence of any impairment of lung volumes and flows and in-and expiratory maximal mouth pressures, at peak of exercise oxygen consumption (VO2max=1886 ± 145 ml/min) and workload (Wmax = 137 ± 9.8 watts) were slightly diminished in patients, as compared with controls (VO2max = 2246 ± 196 ml/min and Wmax = 164 ± 14.7 watts). These findings were associated with an increased heart rate (HR) and reduced oxygen pulse (VO2/HR) at the same workloads. During the whole exercise, however, the slope of the linear relationship between VO2 and work exhibited by the patients, amounting to 9.9 ± 0.6 ml/min/watt, was similar to that of the controls (10.9 ± 0.42 ml/min/watt). Incidentally, both at rest and during exercise, the patients showed a significantly greater minute ventilation (due to a faster respiratory rate, associated with an augmented dead space (P<0.05). We conclude that an increase of metabolic cost of exercise does not occur in multiple sclerosis patients with mild disability, suggesting a lack or a low degree of spasticity and/or ataxia elicited by the effort Thus, their exertional capacity appears to be limited mainly by a poor training. The tachypnea observed in these patients at rest and during exercise was unexpected and the reason for adopting such a pattern of breathing is unclear.

scholarly journals The Significance of HLA DRB1*1501 and Oligoclonal Bands in Multiple Sclerosis: Clinical Features and Disability

Medicina ◽  
2011 ◽  
Vol 47 (7) ◽  
pp. 368 ◽  
Author(s):  
Renata Balnytė ◽  
Daiva Rastenytė ◽  
Ingrida Ulozienė ◽  
Dalia Mickevičienė ◽  
Erika Skrodenienė ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Features ◽  
Clinical Symptoms ◽  
Oligoclonal Bands ◽  
Disability Score ◽  
Mcdonald Criteria ◽  
Disability Status ◽  
Igg Index ◽  
Degree Of Disability ◽  
A Prospective Study

The aim of the present study was to determine the value of immunogenetic risk factors and to estimate their relationship with the clinical features and disability status of patients with multiple sclerosis in a Lithuanian population. Materials and Methods. This was a prospective study of 80 patients with multiple sclerosis. The diagnosis of multiple sclerosis was based on the revised McDonald criteria. Oligoclonal bands (OCBs) of immunoglobulin G (IgG) were tested using isoelectric focusing and IgG specific immunofixation. HLA DRB1 alleles were genotyped using polymerase chain reaction. Results. Of all patients, 55% were positive for OCBs and 56% for HLA DRB1*1501. OCBpositive patients with multiple sclerosis had higher EDSS scores than their OCB-negative counterparts at onset of the disease (3.93±1.21 and 3.36±0.96 points, respectively; P=0.02) and during the last visit (4.31±2.06 and 3.09±1.98 points, respectively; P=0.009). The mean relapse rate was higher in the OCB-positive group compared with OCB-negative group (1.45±0.69 and 0.58±0.64, respectively; P=0.001). OCB-positive patients had higher IgG index compared with OCB-negative patients (P=0.0001). No relationship was found between HLA DRB1*1501 antigen status and the clinical features or EDSS score, and presence or absence of OCB in the present subset of patients with multiple sclerosis. Conclusions. The presence of oligoclonal bands in the cerebrospinal fluid of the patients with multiple sclerosis was associated with the greater number of exacerbations, higher degree of disability, and higher IgG index. There were no significant associations between the presence of HLA DRB1*1501 allele and the clinical symptoms, course of disease, or disability score.

scholarly journals Assessment of cognitive functions in patients with multiple sclerosis

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Tara A. Al-Falaki ◽  
Farqad B. Hamdan ◽  
Nawfal M. Sheaheed
Keyword(s):  
Multiple Sclerosis ◽  
Functional Disability ◽  
Disease Duration ◽  
Education Level ◽  
Cognitive Changes ◽  
Duration Of Illness ◽  
Disability Status ◽  
Visuospatial Learning ◽  
Degree Of Disability ◽  
Moca Score

Abstract Background About 40–70% of patients with multiple sclerosis (MS) develop cognitive impairment (CI) throughout their life. We aim to study the influence of MS on cognitive changes. This is a case–control study of fifty patients with MS who met the revised 2017 Mc Donald Criteria and fifty age- and sex-matched healthy subjects. The Expanded Disability Status Scale (EDSS) was used to assess the degree of disability, and the Montreal Cognitive Assessment (MoCA) scoring system was used to assess cognitive function. Results MS patients show low total MoCA score than the controls. Total MoCA scores were lower in patients with CI versus those with intact cognition. CI was higher in those with a longer duration of illness and a high EDSS. MoCA was positively correlated with education level but negatively with EDSS and disease duration. Conclusion MoCA scale has optimal psychometric properties for routine clinical use in patients with MS, even in those with mild functional disability. The longer the disease duration and the higher the EDSS, the lower the MoCA score and the higher the education level, the higher the MoCA score. As for the profile of cognitive dysfunction in patients with MS, the domains most frequently failed by the patients were memory, attention, visuospatial learning, and language.

scholarly journals Outcomes of pregnancy in Egyptian women with multiple sclerosis in the new treatment era: a multi-center retrospective observational study

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Ali Mahmoud Ahmed ◽  
Mohamed Al-Bahay M. G. Reda ◽  
Ahmed Hassan Elsheshiny
Keyword(s):  
Multiple Sclerosis ◽  
Observational Study ◽  
Exclusive Breastfeeding ◽  
Retrospective Observational Study ◽  
Third Trimester ◽  
Early Postpartum ◽  
Egyptian Women ◽  
History Of ◽  
New Treatment ◽  
The Relationship

Abstract Background Pregnancy is a recent growing issue in multiple sclerosis (MS) and the update in the diagnostic criteria of MS and introduction of many disease-modifying therapies (DMTs) may cause changes in the relationship between MS, pregnancy, and breastfeeding. This study aimed to investigate the effect of pregnancy and breastfeeding on MS and vice versa. A retrospective observational study was conducted to include MS women with a history of at least one pregnancy during the last 7 years. Data were collected from the archived files in addition to a self-administrating questionnaire. The annualized relapsing rate (ARR) was calculated before, during, and after pregnancy. Results We included 116 successful pregnancies from 93 MS women with mean age 32.74 ± 5.12 years. Interferon-beta was the commonly used DMT during and after pregnancy. Despite the ARR during the two years preceding the conception was 0.36 (95% CI 0.32–0.41), this rate was significantly decreased during first, second, and third trimester (0.07; 95% CI 0.04–0.15, 0.10; 95% CI 0.03–0.17, and 0.15; 95% CI 0.08–0.24, respectively; P-value < 0.001 in all). Furthermore, this ARR was significantly decreased during the first and last three months after delivery (0.27; 95% CI 0.16–0.39; P-value = 0.037, and 0.24; 95% CI 0.17–0.38; P-value = 0.023). Exclusive breastfeeding was associated with deceased risk of postpartum relapse, with HR 0.31 (95% CI 0.12–0.67; P = 0.002). Conclusions Pregnancy is protective from MS relapse, with a significant decrease of ARR from the pre-pregnancy period. Postpartum reactivation of the disease occurs from the third month after labor, rather than the early postpartum period. Exclusive breastfeeding for at least 2 months decreased the risk of postpartum relapse.

scholarly journals Evaluation of Retinal Structure and Optic Nerve Function Changes in Multiple Sclerosis: Longitudinal Study with 1-Year Follow-Up

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Riwanti Estiasari ◽  
Adisresti Diwyacitta ◽  
Muhammad Sidik ◽  
Ni Nengah Rida Ariarini ◽  
Freddy Sitorus ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Nerve ◽  
Contrast Sensitivity ◽  
Disease Duration ◽  
Nerve Function ◽  
P100 Latency ◽  
Rnfl Thickness ◽  
Degree Of Disability ◽  
Retinal Structure

Background. Multiple sclerosis (MS) is an autoimmune disease characterized by inflammation and demyelination of the central nervous system which often involves the optic nerve even though only 20% of the patients experience optic neuritis (ON). Objective. This study aims to compare the retinal structure and optic nerve function between patients with MS and healthy controls (HCs), evaluate optic nerve alterations in MS over 1-year follow-up, and analyze its correlations with disease duration, number of relapses, degree of disability, and different subtypes. Methods. This is a prospective cohort study involving 58 eyes of MS patients. Optic nerve function was evaluated with best-corrected visual acuity (BCVA), contrast sensitivity, and P100 latency, while the retinal structure was evaluated from the GCIPL and RNFL thickness measured with optical coherence tomography (OCT) and fundus photography. Results. The MS group had lower BCVA ( p = 0.001 ), contrast sensitivity ( p < 0.001 ), mean GCIPL thickness ( p < 0.001 ), and mean RNFL thickness ( p < 0.001 ) than HC. At 6 and 12 months of observations, GCIPL and RNFL (nasal quadrant) of MS patients decreased significantly ( p = 0.007 and p = 0.004 , respectively). Disease duration and the number of relapses correlated with delayed P100 latency (r = −0.61, p < 0.001 and r = −0.46, p = 0.02 ). GCIPL and RNFL in the SPMS subtype were thinner than in RRMS. Conclusions. The retinal structure and optic nerve function of MS patients are worse than those of normal individuals. GCIPL and RNFL thinning occurs at 6 and 12 months but do not correlate with disease duration, the number of relapses, and degree of disability.

scholarly journals Sleep disorders in patients with multiple sclerosis

2018 ◽  
pp. 31-36
Author(s):  
G.N. Chuprуna
Keyword(s):  
Multiple Sclerosis ◽  
Sleep Disorders ◽  
Total Duration ◽  
Close Correlation ◽  
Control Group ◽  
Comorbid Disease ◽  
Control Groups ◽  
Sf 36 ◽  
Degree Of Disability

Studied sleep disorders (SD) in patients with multiple sclerosis (MS) using a Severity scale of insomnia (ІSІ) and Sleepiness Scale Epworth (ESS) in comparison with the control groups and in the aspect of comorbidity, as well as to determine the correlations between the SD and the degree of disability, the level of severity of fatigue, depression, pain, quality of life (QOL). The study involved 207 MS patients with different forms of cours and 109 people who constituted the control group. Evaluated the clinical and demographic characteristics of the patients with MS due to comorbidity, determines the level of disability (EDSS), severity of pain (VAS), the severity of fatigue (FSS), depression (BDI-II), indicators of QOL (SF-36). Single or multiple co-morbidities found in 102 (49.3%) patients with MS, there was no co-morbidities in 105 (50.7%) patients with MS. It was found that more often among the SD in the study group of patients with MS observed insomnia (54.1%). It led to a decrease in the total duration of a night's sleep, as well as mainly predispose hypersomnia (43.0%). Also found that patients with MS I and II groups SD were significantly more likely than the control groups. It is shown that in patients with MS II group have a more severe manifestations of insomnia and daytime sleepiness (DS), which is associated with the presence of comorbid disease. According to the correlation analysis shows that the degree of the SD in patients with MS is closely correlated with the level of fatigue were also observed close correlation between insomnia and DS.

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