Multiple sclerosis and related disorders
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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.
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Mult Scler Relat Disord · May 2019
Polyneuropathies and chronic inflammatory demyelinating polyradiculoneuropathy in multiple sclerosis.
Polyneuropathies co-occurring with multiple sclerosis (MS) may be underdiagnosed while causing additional disability burden. ⋯ (1) Polyneuropathies occurring in MS contribute to neurological disability. (2) Diagnosing polyneuropathies in people with MS is challenging and, likely, under-diagnosed. Recognition is important as some polyneuropathies (e.g., CIDP) are treatable. (3) The probable over-representation of inflammatory neuropathy (especially CIDP) in MS suggests a shared dysimmune pathogenesis, supported by autoantibodies to neurofascin-155.
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Mult Scler Relat Disord · May 2019
Increased cerebrospinal fluid neurofilament light chain in central nervous system inflammatory demyelinating disease.
Central nervous system (CNS) inflammatory demyelinating disease (IDD) is an immune-mediated disease that is pathologically characterized by demyelination and inflammatory infiltration in the CNS and includes clinically isolated syndrome (CIS), multiple sclerosis (MS), and neuromyelitis optica spectrum disorders (NMOSD). IDD is usually characterized by variable symptoms, multivariate imaging, uncertain reactions to treatment, and a variable prognosis, which makes it difficult to diagnose early. In recent years, the role of the neurofilament light chain (NFL), an axonal injury biomarker, in IDD has become increasingly important. We will detect and analyse cerebrospinal fluid (CSF) NFL levels in IDD and normal control patients to determine the significance of NFL in the diagnosis and prognostic prediction of IDD. ⋯ The NFL level of CSF is conducive to assessing the severity and probable progress of IDD but is not helpful in distinguishing IDD among Chinese.