Clinical Features and Course in Pediatric Onset Multiple Sclerosis

WOS: 000312600000015Objective: Multiple Sclerosis is uncommon in children and adolescents. Two to 5 % of all patients with MS have onset before age 16. Although the clinical profile of MS appears similar to adults some features may differ. The disease may lead to significant disability at a younger age. Our aim is to determine the clinical features and, disease course in pediatric onset multiple sclerosis. Methods: In this study, we evaluated 21 patients with pediatric onset (before age 18). The records of patients were reviewed retrospectively. The following variables were evaluated; sex, age at onset, presenting symptoms, disease course, relapse rate, immunomodulatory treatment. Results: Twenty one patients were included to study. The mean age at onset was 15.2 (ranged 8-17). The female/male ratio was 1.3. The median follow up period was 5 years. The major presenting symptoms were pyramidal (9 patients), brainstem (8 patients) and optic neuritis (4 patients). The initial disease course was relapsing remitting in 19 patients but in 3 patients, secondary progression was observed before age 30. Two patients were with clinically isolated syndrome. Nineteen patients were treated with immunomodulatory drugs. In 4 patients Mitoxantrone was used because of progressive course and relapses. Conclusion: The clinical presentation of multiple sclerosis with pediatric onset is usually benign but in the long term, patients with pediatric onset can become disabled at a younger age

Juvenile myasthenia gravis: Comparison of pre and postpubertal cases

12th International Congress of Neuroimmunology (ISNI) -- NOV 09-13, 2014 -- Mainz, GERMANYWOS: 00034519210010

Assessment of Olfaction and Gustation in Multiple Sclerosis: Correlation with Cognition

68th Annual Meeting of the American-Academy-of-Neurology (AAN) -- APR 15-21, 2016 -- Vancouver, CANADAWOS: 000411279005237Amer Acad Neuro

Assessment of Early Cognitive Impairment in Patients with Clinically Isolated Syndromes and Multiple Sclerosis

WOS: 000335016500001PubMed ID: 25944978Objective. The aim of our study was to investigate the frequency and pattern of cognitive impairment in patients with clinically isolated syndromes and definite diagnosis of multiple sclerosis within the last 2 years. Methods. We assessed the cognitive status of 46 patients aged 18-49 years with clinically isolated syndromes or definite diagnosis of multiple sclerosis who have onset of their symptoms within the last 2 years. Patients were matched with 40 healthy participants for age, sex, and educational level. Neuropsychological assessment was performed by stroop test, paced auditory serial addition test (PASAT), controlled oral word association test (COWAT), clock drawing test, trail making test (TMT), faces symbol test (FST). Hamilton Depression Scale and Modified Fatigue Impact Scale were used to quantify the severity of any depression and fatigue the subjects might suffer. Results. 19.6% of early MS/CIS group failed at 4 and more tests and had significant cognitive impairment focused on attention, executive functions, memory, and learning. No significant relationship was found between cognitive impairment and disability and fatigue scores. Discussion. Cognitive impairment can be present from the earliest stage of multiple sclerosis. It should be considered among the main manifestations of MS even in the earliest stages of the disease

Propuesta de reducción del retraso de productos terminados en el área de producción de una empresa metalmecánica mediante la Teoría de las Restricciones y herramientas Lean

La siguiente tesis está conformada por cuatro capítulos, donde el primero presenta el marco teórico investigado en fuentes académicas respaldadas por autores especializados en metodologías de administración de producción y manufactura. En el segundo capítulo se muestra el análisis y diagnóstico realizado a una empresa metalmecánica nacional donde explica su entorno, sus procesos y el problema que enfrenta. En el capítulo 3 se muestra la propuesta de solución en función al diagnóstico realizado y el marco teórico investigado, se aterrizará al entorno de la empresa las diferentes metodologías explicadas en el capítulo 1, además se presentará una análisis económico justificando la rentabilidad de la implementación de la solución. Para finalizar en el capítulo 4 brinda las principales conclusiones a partir de la propuesta de solución y recomendaciones futuras para la empresa en estudio.Tesi

Combined Central And Peripheral Nervous System Demyelination: A Case Report

WOS: 000422853200007Combined central and peripheral nervous system demyelination (CCPD) is a fairly new concept and our knowledge is restricted to several case series and case reports. We aimed to contribute to the literature with our experiences in the management of a patient representing both chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multiple sclerosis (MS) features. A 32-year-male patient presented with neuropathic compaints for one year and recent onset of optic neuritis with central demyelinating lesions. Clinical, electrophysiological and radiological response was achieved with corticosteroid treatment and relapsed after cessation. His second simultaneous CCPD exacerbation did not respond on intravenous immunoglobulins (IVIG) but responded well on intravenous high dose corticosteroid. Previous studies reported inadequate responses to high-dose corticosteroids and IVIG in the majority of patients with CCPD. It's estimated to be a unique disease beyond MS and CIDP with heterogenous features. We suggest that awareness of this steroid-dependent condition may improve our knowledge in the pathophysiology and management strategies