Gravidez e esclerose múltipla : resultados preliminares de base de dados Brasileira

Propósito: O manejo da gravidez cria um desafio extra aos médicos e aos pacientes com esclerose múltipla (EeM). Eexistem poucos trabalhos relatando bases de dados neste tema. Método: Base de dados brasileira de nove centros clínicos e de pesquisa na EeM, com dados completos de 47 mulheres grávidas (49 gestações). Resultados: Apesar da exposição a drogas para EeM ter sido relativamente alta, não foram registradas malformações. Baixo peso e prematuridade foram semelhantes àqueles de países em desenvolvimento. Três complicações podem ter sido associadas a drogas, enquanto outras três foram consideradas como sendo de natureza puramente obstétrica. Conclusão: Nossos resultados confirmam os achados de menor taxa de surtos na gestação e adicionam dados relacionados a exposição a drogas, na literatura atual.Purpose: Pregnancy management poses an extra challenge to physicians and their multiple sclerosis (MS) patients. There are few papers reporting databases on the subject. Method: Brazilian database from nine MS clinical and research units, with complete data on 47 pregnant women (49 pregnancies). Results: Despite relatively high exposure to MS medications, no birth defects were reported. Low birth weight and prematurity were similar to those for developing countries. Three complications may have been associated with these medications, while three others were considered to be of purely obstetric nature. Conclusion: Our results confirm previous findings on lower relapse rate during pregnancy and add to the present literature informing on data related to drug exposure

Gravidez e esclerose múltipla : resultados preliminares de base de dados Brasileira

Propósito: O manejo da gravidez cria um desafio extra aos médicos e aos pacientes com esclerose múltipla (EeM). Eexistem poucos trabalhos relatando bases de dados neste tema. Método: Base de dados brasileira de nove centros clínicos e de pesquisa na EeM, com dados completos de 47 mulheres grávidas (49 gestações). Resultados: Apesar da exposição a drogas para EeM ter sido relativamente alta, não foram registradas malformações. Baixo peso e prematuridade foram semelhantes àqueles de países em desenvolvimento. Três complicações podem ter sido associadas a drogas, enquanto outras três foram consideradas como sendo de natureza puramente obstétrica. Conclusão: Nossos resultados confirmam os achados de menor taxa de surtos na gestação e adicionam dados relacionados a exposição a drogas, na literatura atual.Purpose: Pregnancy management poses an extra challenge to physicians and their multiple sclerosis (MS) patients. There are few papers reporting databases on the subject. Method: Brazilian database from nine MS clinical and research units, with complete data on 47 pregnant women (49 pregnancies). Results: Despite relatively high exposure to MS medications, no birth defects were reported. Low birth weight and prematurity were similar to those for developing countries. Three complications may have been associated with these medications, while three others were considered to be of purely obstetric nature. Conclusion: Our results confirm previous findings on lower relapse rate during pregnancy and add to the present literature informing on data related to drug exposure

Pregnancy and multiple sclerosis: the initial results from a Brazilian database Gravidez e esclerose múltipla: resultados preliminares de base de dados Brasileira

PURPOSE: Pregnancy management poses an extra challenge to physicians and their multiple sclerosis (MS) patients. There are few papers reporting databases on the subject. METHOD: Brazilian database from nine MS clinical and research units, with complete data on 47 pregnant women (49 pregnancies). RESULTS: Despite relatively high exposure to MS medications, no birth defects were reported. Low birth weight and prematurity were similar to those for developing countries. Three complications may have been associated with these medications, while three others were considered to be of purely obstetric nature. CONCLUSION: Our results confirm previous findings on lower relapse rate during pregnancy and add to the present literature informing on data related to drug exposure.<br>PROPÓSITO: O manejo da gravidez cria um desafio extra aos médicos e aos pacientes com esclerose múltipla (EM). Existem poucos trabalhos relatando bases de dados neste tema. MÉTODO: Base de dados brasileira de nove centros clínicos e de pesquisa na EM, com dados completos de 47 mulheres grávidas (49 gestações). RESULTADOS: Apesar da exposição a drogas para EM ter sido relativamente alta, não foram registradas malformações. Baixo peso e prematuridade foram semelhantes àqueles de países em desenvolvimento. Três complicações podem ter sido associadas a drogas, enquanto outras três foram consideradas como sendo de natureza puramente obstétrica. CONCLUSÃO: Nossos resultados confirmam os achados de menor taxa de surtos na gestação e adicionam dados relacionados a exposição a drogas, na literatura atual

Alternatives For Reducing Relapse Rate When Switching From Natalizumab To Fingolimod In Multiple Sclerosis.

Natalizumab is a therapeutic option for treating multiple sclerosis (MS) and is particularly efficacious for patients with highly active disease. A long washout period has been recommended between withdrawal of natalizumab and start of fingolimod (another option for treating MS). This long washout period has been associated with a significant increase in MS activity. In the present study, a group of 96 patients who were switched from natalizumab to fingolimod had short washout periods between drugs, or monthly corticosteroid pulse therapy if longer washout periods were recommended. This therapeutic approach led to the lowest reported relapse rate so far, among patients with MS switching from natalizumab to fingolimod (8.3%). No complications from short withdrawal were observed in this group of patients.

Flow Separation in Falling Liquid Films

BACKGROUND: Neuromyelitis optica (NMO) is considered relatively more common in non-Whites, whereas multiple sclerosis (MS) presents a high prevalence rate, particularly in Whites from Western countries populations. However, no study has used ancestry informative markers (AIMs) to estimate the genetic ancestry contribution to NMO patients. METHODS: Twelve AIMs were selected based on the large allele frequency differences among European, African, and Amerindian populations, in order to investigate the genetic contribution of each ancestral group in 236 patients with MS and NMO, diagnosed using the McDonald and Wingerchuck criteria, respectively. All 128 MS patients were recruited at the Faculty of Medicine of Ribeirão Preto (MS-RP), Southeastern Brazil, as well as 108 healthy bone marrow donors considered as healthy controls. A total of 108 NMO patients were recruited from five Neurology centers from different Brazilian regions, including Ribeirão Preto (NMO-RP). PRINCIPAL FINDINGS: European ancestry contribution was higher in MS-RP than in NMO-RP (78.5% vs. 68.7%) patients. In contrast, African ancestry estimates were higher in NMO-RP than in MS-RP (20.5% vs. 12.5%) patients. Moreover, principal component analyses showed that groups of NMO patients from different Brazilian regions were clustered close to the European ancestral population. CONCLUSIONS: Our findings demonstrate that European genetic contribution predominates in NMO and MS patients from Brazil

Information of ancestry informative markers (AIMs) set for ancestral populations, multiple sclerosis (MS) and neuromyelitis optica (NMO) patients.

<p>(A) The panel of 12 ancestry informative markers (AIMs) for Africans (green), Europeans (red) and Amerindians (blue) were sufficient for an adequate discrimination among ancestral populations. (B) Principal components analysis (PCA) for NMO [Southeastern: Ribeirão Preto (NMO-RP), São Paulo (NMO-SP) and Belo Horizonte (NMO-BH); Central:-Goiânia (NMO-GO), and Northeastern: (Recife-Pernambuco (NMO-PE)] and MS patients from Ribeirão Preto (MS-RP) and control individuals from Ribeirão Preto (CTRL-RP) together with ancestral populations [Africans (green), Europeans (red) and Amerindians (blue)], showing that they clustered closer to Europeans than to Africans and Amerindians.</p

African ancestry indexes (AAI) distribution for ancestral populations, multiple sclerosis (MS) and neuromyelitis optica (NMO) patients.

<p>Distribution of African ancestry Index (AAI) for Africans (AFR-green), Amerindians (AMZ-blue) and Europeans (EUR-red) in NMO patients from several Brazilian regions [Southeastern: Ribeirão Preto (NMO-RP), São Paulo (NMO-SP) and Belo Horizonte (NMO-BH); Central:-Goiânia (NMO-GO), and Northeastern: (Recife-Pernambuco (NMO-PE)]; in MS patients from Ribeirão Preto (MS-RP); and in healthy controls from Ribeirão Preto (CTRL-RP).</p

Demographic, clinical and laboratory findings of neuromyelitis optica (NMO) and multiple sclerosis (MS) Brazilian patients.

<p>Demographic, clinical and laboratory findings of neuromyelitis optica (NMO) and multiple sclerosis (MS) Brazilian patients.</p

AIMs frequencies observed in MS and NMO patients and healthy controls from Ribeirao Preto (RP), and in Africans (AFR), Europeans (EUR) and Amerindians (AMZ).

<p>Significant differences (δ > 0.30) between ancestral populations are underlined in the last columns. European, African and Amerindian ancestry contributions and respective R² values are shown at the bottom of the Table.</p>a<p>Ancestry informative marker *1 alleles with their reference sequence number from database of National Center for Biotechnological Information (dbSNP/NCBI).</p>b<p>Single nucleotide polymorphism (SNP), insertion/deletion (Indel), and <i>Alu</i> insertion (Alu) polymorphism / allele that characterizes the *1 allele.</p>c<p>Chromosomal location of each AIM.</p