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Expert consensus from the Arabian Gulf on selecting disease-modifying treatment for people with multiple sclerosis according to disease activity.

阿拉伯海湾根据疾病活动性为多发性硬化症患者选择改善疾病治疗的专家共识。

  • 影响因子:1.99
  • DOI:10.1080/00325481.2020.1734394
  • 作者列表:"Alroughani R","Inshasi J","Al-Asmi A","Alqallaf A","Al Salti A","Shatila A","Boshra A","Canibano B","Deleu D","Al Sharoqi I","Al Khabouri J
  • 发表时间:2020-05-01
Abstract

:Recent research has expanded our understanding of the natural history and clinical course of multiple sclerosis (MS) in the Arabian Gulf region. In addition, the number of available therapies for MS has increased greatly in recent years, which complicates considerably the design of therapeutic regimens. We, an expert group of physicians practising in Arabian Gulf countries, present pragmatic consensus recommendations for the use of disease-modifying therapy, according to the level of MS disease activity, according to objective criteria, and prior treatment (if any) received by a given patient.

摘要

: 最近的研究扩展了我们对阿拉伯海湾地区多发性硬化症 (MS) 自然史和临床病程的理解。此外,近年来用于MS的可用疗法的数量已经大大增加,这使得治疗方案的设计相当复杂。我们是一个由在阿拉伯海湾国家执业的医生组成的专家组,根据MS疾病活动水平、客观标准以及特定患者接受的先前治疗 (如果有的话),提出了使用疾病修正疗法的实用共识建议.

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相关文献
影响因子:1.55
发表时间:2020-01-01
DOI:10.1097/PHM.0000000000001264
作者列表:["Gutiérrez-Cruz C","Rojas Ruiz FJ","De La Cruz Marquez JC","Gutiérrez-Davila M"]

METHODS:PURPOSE:The aim of the study was to assess dual-task cost to spatio-temporal gait parameters in people with multiple sclerosis and a matched control group. METHOD:The multiple sclerosis group was composed of 17 participants with a diagnosis of multiple sclerosis and an Expanded Disability Status Scale score of less than 6. A total of 17 healthy participants were allocated to the control group by stratification. Controls were matched on the basis of age, sex, sociocultural habits, and body structure. Dual-task cost was determined by within-group repeated-measures analysis of variance. Participants were instructed to ambulate under normal conditions and perform a discrimination and decision-making task concurrently. Then, between-group analysis of variance was used to assess differences in mean dual-task cost between groups and determine dual-task cost differential. Testing was performed using three-dimensional photogrammetry and an electronic walkway. RESULTS:Based on dual-task cost differential, gait cycle time increase (-5.8%) and gait speed decrease (6.3%) because of multiple sclerosis-induced impairment. CONCLUSIONS:During single- and dual-task conditions, gait speed was lower in multiple sclerosis participants, because of a shorter step length and increased swing time. Increased gait time might be the result of compensatory mechanisms adopted to maintain stability while walking specially during the double-support phases.

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翻译标题与摘要 下载文献
影响因子:1.55
发表时间:2020-01-01
DOI:10.1097/PHM.0000000000001272
作者列表:["Cattaneo D","Gervasoni E","Pupillo E","Bianchi E","Aprile I","Imbimbo I","Russo R","Cruciani A","Jonsdottir J","Agostini M","Beghi E","NEUROFALL Group."]

METHODS:OBJECTIVE:The aims of the study were to compare mobility in multiple sclerosis, Parkinson disease, and stroke, and to quantify the relationship between mobility and participation restrictions. DESIGN:This is a multicenter cross-sectional study. Included were compliant subjects with Parkinson disease, multiple sclerosis, and stroke seen for rehabilitation, with no comorbidities interfering with mobility. Functional scales were applied to each subject to investigate gait speed (10-meter walking test), balance while maintaining body position (Berg Balance Scale), dynamic balance and mobility (Timed Up and Go and Dynamic Gait Index), and participation (Community Integration Questionnaire). RESULTS:Two hundred ninety-nine patients (111 multiple sclerosis, 94 Parkinson disease, and 94 stroke) were enrolled. Stroke had the slowest gait speed (mean gait speed = 0.9 m/sec) compared with Parkinson disease (1.1 m/sec), and multiple sclerosis (1.2 m/sec) (P < 0.001). Multiple sclerosis was more limited than Parkinson disease and stroke in dynamic balance both in the Timed Up and Go Test (multiple sclerosis = 16.7 secs, Parkinson disease = 11.4 secs, stroke = 14.0 secs; P < 0.001) and Dynamic Gait Index (multiple sclerosis = 11.6 points, Parkinson disease = 12.9 points, stroke = 13.6 points; P = 0.03); ability to maintain balance and body position (Berg Balance Scale) was more affected in stroke and Parkinson disease than multiple sclerosis (multiple sclerosis = 42.6 points, Parkinson disease = 39.4 points, stroke = 39.7 points; P = 0.03). Balance disorders were associated with participation restrictions but not gait speed. CONCLUSIONS:Neurological conditions have differing impacts on gait and balance, leading to different levels of participation restriction.

关键词: 暂无
翻译标题与摘要 下载文献
影响因子:2.61
发表时间:2020-01-01
DOI:10.1111/ane.13152
作者列表:["Ferraro D","Guicciardi C","De Biasi S","Pinti M","Bedin R","Camera V","Vitetta F","Nasi M","Meletti S","Sola P"]

METHODS:OBJECTIVES:Cerebrospinal fluid (CSF) and blood neurofilaments (NFLs) are markers of axonal damage and are being investigated, mostly in relapsing-remitting (RR) MS, as a marker of disease activity and of response to treatment, while there are less data in progressive MS patients. Primary aim was to measure NFL in plasma samples of untreated patients with primary (PP) and secondary (SP) progressive MS and to correlate them with disability, disease severity, and prior/subsequent disability progression. MATERIALS AND METHODS:Neurofilament concentrations were measured using SIMOA (Single Molecule Array, Simoa HD-1 Analyzer; Quanterix). RESULTS:Neurofilament concentrations were measured on plasma samples of 70 progressive (27 PP and 43 SP), 21 RRMS patients, and 10 HCs. Longitudinal plasma NFL (pNFL) concentrations (median interval between sampling: 25 months) were available for nine PP/SP patients. PNFL concentrations were significantly higher in PP/SP compared to RRMS patients. They correlated with EDSS and MS Severity Score values. There was no difference in pNFL levels between PP/SP patients with EDSS progression in the preceding year (14% of patients) or during a median follow-up of 27 months (41%). In the longitudinal sub-study, pNFL levels increased in all patients between sampling by a mean value of 23% while EDSS mostly remained stable (77% of cases). CONCLUSION:In PP/SP progressive MS patients, pNFL levels correlate with disability and increase over time, but are not associated with prior/subsequent disability progression, as measured by EDSS, which may not be a sufficiently sensitive tool in this context.

脱髓鞘疾病方向

急性发作或亚急性损害神经中枢的疾病,发病高峰为二到三周,若治疗延误受损神经继发缺血变性则发生多发性硬化,发病严重时可侵犯脊髓前角细胞和脑干神经核以及大脑运动皮质锥体细胞危及生命,多为基因免疫异常或病毒感染所致。

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