Multiple sclerosis and related disorders
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Mult Scler Relat Disord · Jun 2019
Meta AnalysisRelationship of High-mobility group box 1 levels and multiple sclerosis: A systematic review and meta-analysis.
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system (CNS) affecting more than 2.5 million people worldwide. However, the exact etiology of MS remains unknown, recent research indicated that High-mobility group box 1(HMGB1) might contribute to MS pathogenesis. By evaluating HMGB1 levels of peripheral blood mononuclear cells (PBMC), serum and cerebrospinal fluid (CSF) in multiple sclerosis (MS) patients and the controls, to reveal the relationship of HMGB1 levels and MS patients. ⋯ MS patients had higher HMGB1 protein levels in PBMC and CSF compared to controls. HMGB1 might be a new treatment target for MS.
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Mult Scler Relat Disord · Jun 2019
Characterization of gray-matter multiple sclerosis lesions using double inversion recovery, diffusion, contrast-enhanced, and volumetric MRI.
To investigate gray-matter (GM) lesions in relapsing-remitting multiple sclerosis (MS) using double-inversion recovery (DIR) MRI, determine GM lesions prevalence, spatial distribution and characterize their contrast-enhancement, diffusion characteristics and compare them to white-matter (WM) lesions. This is the first study, to our knowledge, to investigate GM MS lesions using double-inversion recovery MRI, to determine GM lesion prevalence and location, and characterize contrast-enhancement and diffusion characteristics, compared to WM lesion characteristics in the same patients. We also correlated GM lesion counts, volume and apparent diffusion coefficient (ADC) with total brain, WM, and GM volumes, as well as 25-foot walk test as a clinical disability. ⋯ This study characterized GM MS lesions using double-inversion recovery, contrast-enhanced and diffusion MRI. Understanding GM lesion pathophysiology using MRI in vivo, may prove useful for improving targeted therapy and monitoring disease progression.
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Mult Scler Relat Disord · Jun 2019
Observational StudyThirty-day readmissions in multiple sclerosis: An age and gender-based US national retrospective analysis.
Hospital readmission rate is an important indicator of the quality of care, healthcare economic burden, and post-discharge care. Multiple sclerosis (MS) is a potentially progressive neurological disease predominantly affecting young women. The natural history of the disease involves intermittent relapses and/or accrued baseline disability overtime especially in older patients contributing to frequent hospitalizations. The readmission metrics for patients with MS have not been studied. ⋯ The overall 30-day readmission rate among patients following hospitalization for MS was 10.2%. The readmission rate was higher in older (>40 years) patients. The common causes of readmission were MS exacerbation, respiratory complications, and sepsis. A higher systemic disease burden, longer length of stay, and treatment with IVIG and PLEX were associated with higher risk of readmission. The readmissions were associated with higher cost of care and longer LOS compared to index admissions highlighting the economic impact of readmissions. Future strategies to lower the risk of readmissions in patients with MS should focus on optimal management of medical co-morbidities and infections.
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Mult Scler Relat Disord · Jun 2019
Transorbital ultrasonography in acute optic neuritis: Can it be a supportive diagnostic tool?
Because of limitations of conventional tools for diagnosing optic neuritis (ON), transorbital ultrasonography (TOUS) was introduced as a promising tool to evaluate the optic nerve. However, studies demonstrating its utility are scarce. ⋯ TOUS could be a cost-effective tool for morphologically evaluating acute ON showing a significant thickening of the optic nerve and sheath, although only a limited retrobulbar area could be explored.