New oral disease-modifying therapies for multiple sclerosis

Several promising, oral disease-modifying therapies for multiple sclerosis are currently being evaluated in clinical trials. The arrival of effective oral agents for multiple sclerosis will be a major advance in the global effort to alter the natural history of this chronic disease

Pengaruh Jus Buah Nanas (Ananas Comosus (L.) Merr.) Terhadap Profil Farmakokinetik Parasetamol Pada Tikus Putih Jantan (Rattus Norvegicus) Galur Wistar

Obat yang digunakan bersamaan dengan makanan atau minuman dapatmempengaruhi efek terapi obat tersebut. Penelitian ini dilakukan untuk mengetahuipengaruh jus buah nanas (Ananas comosus (L.) Merr.) terhadap profil farmakokinetikparasetamol pada tikus putih jantan galur Wistar. Hewan uji dikelompokkan secara acakdibagi menjadi 3 kelompok. Kelompok I (parasetamol) diberikan parasetamol tunggaldosis 9 mg/200gBB peroral. Kelompok II (parasetamol dan jus nanas dosis 1) diberikanparasetamol dosis 9 mg/200gBB bersamaan dengan jus buah nanas dosis 2,7 g/200gBB.Kelompok III (parasetamol dan jus nanas dosis 2) diberikan parasetamol dosis 9mg/200gBB bersamaan dengan jus buah nanas dosis 5,4 g/200gBB. Cuplikan darahhewan uji diambil selama 9 jam pada vena lateralis ekor tikus. Penetapan kadarparasetamol pada plasma dilakukan dengan spektrofotometer UV. Parameterfarmakokinetik dihitung menggunakan metode regresi linear dan metode residualselanjutnya diuji secara statistik menggunakan One Way ANOVA dengan tingkatkepercayaan 95%. Berdasarkan hasil penelitian memperlihatkan bahwa kelompok II dankelompok III meningkatkan secara signifikan parameter Cpmaks, t, tab, tel, AUCdan menurunkan secara signifikan parameter ka, ke, dan CL. Kelompok III memberikanpengaruh yang paling kuat terhadap profil farmakokinetik parasetamol yaitu denganmenurunkan parameter absorbsi dan eliminasi serta meningkatkan parametermetabolisme parasetamol pada tikus

Gadolinium deposition in neurology clinical practice

Background: Magnetic resonance imaging (MRI) enhanced with gadolinium-based contrast agents (GBCAs) is an essential tool in the diagnosis and management of many neurologic diseases, including multiple sclerosis, brain tumors, and infections. The clinical utility of GBCAs is evidenced by their widespread use. GBCAs are produced in macrocyclic and linear forms. Since 2014, evidence has suggested that repeated administration of GBCAs can lead to gadolinium deposition in the brain.Methods: We review the literature on gadolinium deposition, including both animal and human studies, as well as the literature on GBCA-associated health outcomes. Additionally, we summarize and discuss the updated medical society recommendations and perspectives on GBCA use in clinical practice.Results: The first publication reporting gadolinium deposition in the human brain was published in 2014. Since that seminal report, multiple studies have demonstrated that exposure to linear GBCAs is associated with gadolinium deposition in the dentate nucleus and globus pallidus as seen on brain MRI. Macrocyclic GBCA exposure has not convincingly been associated with gadolinium deposition evident on brain MRI.Conclusion: Clear evidence demonstrates that GBCAs lead to gadolinium deposition in the brain in a dose-dependent manner; however, only linear GBCAs have been associated with gadolinium deposition visualized on MRI. To date, no evidence links gadolinium deposition with any adverse health outcome. Updated medical society guidelines emphasize the importance of an individualized risk-benefit analysis with each administration of GBCAs

Cognition and fatigue in multiple sclerosis : Potential effects of medications with central nervous system activity

To evaluate the potential effects of medications with central nervous system (CNS) activity on cognitive function and fatigue in multiple sclerosis (MS), we performed a retrospective analysis of medication use among 70 subjects with MS who were participating in a clinical trial for evaluation of the effects of yoga and exercise programs on cognition and fatigue. Among these MS subjects, 74% were taking at least one potentially CNS-active medication. These 70 subjects were divided into two groups: those taking at least one CNS-active medication (n = 52) and those not on any medications with potential CNS activity (n = 18). We compared assessments of cognitive function and fatigue using an analysis of covariance. MS subjects on CNS-active medication had greater impairment on measures of processing speed, sustained attention, and fatigue than those not on these medications. While these findings do not establish a causal relationship between medication use and cognitive impairment and fatigue, the data indicate that researchers need to control for use of CNS-active medications when conducting studies of cognitive impairment and fatigue in MS subjects

Correlations of Perceived Deficits Questionnaire of multiple sclerosis quality of life inventory with Beck Depression Inventory and neuropsychological tests

The Perceived Deficits Questionnaire (PDQ) is a part of the Multiple Sclerosis (MS) Quality of Life Inventory that assesses self-perceived cognitive difficulties. We used baseline data from 49 MS subjects participating in a clinical trial to evaluate the correlation of the PDQ with two measures of cognitive impairment, the Paced Auditory Serial Addition Test (PASAT) and the California Verbal Learning Test, 2nd edition (CVLT-II), total score, and one measure of depression, the Beck Depression Inventory-Amended (BDI-IA). The PDQ correlated significantly (r = 0.42; 95% confidence interval [CI], 0.15 to 0.62; p = 0.003) with the BDI-IA scores but not with either the PASAT (r = - 0.22; 95% CI, - 0.48 to 0.06; p = 0.2) or the CVLT-II total (r = - 0.17; 95% CI, -0.43 to 0.12; p = 0.25). A subset of 38 of these subjects who scored worse than 0.5 standard deviation below the mean on the PASAT or CVLT-II received a more extensive neuropsychological battery of tests. No significant correlations were found between any of these tests and the PDQ. These results suggest that self-perceived cognitive dysfunction relates more to depression than to objective cognitive dysfunction