Postpartum Treatment With Immunoglobulin Does Not Prevent Relapses of Multiple Sclerosis in the Mother.

Multiple sclerosis (MS) is a chronic, neurological, immune-mediated disease that can worsen in the postpartum period. There is no consensus on the use of immunoglobulin for prevention of disease relapses after delivery. We have shown that the controversial beneficial effect of immunoglobulin given immediately after birth could not be observed in patients with MS.

Parents' perception of health-related quality of life in children and adolescents with excess weight.

OBJECTIVE: To evaluate the perception of parents or caregivers on the health-related quality of life (HRQOL) of children/adolescents with overweight/obesity and possible factors associated with this perception. METHODS: This was a cross-sectional study involving 297 caregivers of children and adolescents with normal weight (n=170) and with overweight/obesity (n=127), from public and private schools in the study municipality. HRQOL scores obtained through the Child Health Questionnaire - Parent Form 50 (CHQ-PF50) were compared according to the nutritional status and gender of the children/adolescents. Multiple regression analysis was used to determine the predictive value of studied variables for the variation in HRQOL scores. RESULTS: Parents of children/adolescents with overweight/obesity attributed lower HRQOL scores to their children in the following domains: physical functioning (p<0.01; d=0.49), self-esteem (p<0.01; d=0.38), parental impact-emotional (p<0.05; d=0.29), family cohesion (p<0.05; d=0.26), physical summary score (p<0.05; d=0.29), and psychosocial summary score (p<0.05; d=0.25). In the multiple regression models, the variables with the highest contribution to the variation in HRQOL scores were: in the physical functioning domain, parental impact-time (ß=0.23; p<0.05); self-esteem, nutritional status (ß=-0.18; p≤0.01); emotional impact on parents, impact on parents' time (ß=0.31; p<0.05); and in family cohesion, global behavior (ß=0.30; p<0.05). CONCLUSIONS: A negative impact on HRQOL of children/adolescents with overweight/obesity was observed in the physical and psychosocial aspects. The nutritional status was the variable with the greatest contribution for the assessment the self-esteem of children and adolescents in this study.

The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis.

BACKGROUND AND OBJECTIVE: Women with multiple sclerosis (MS) who intend to get pregnant are often advised to discontinue disease modifying therapy (DMT) prior to conception. This recommendation is not based on medical evidence and may interfere with disease control by immunomodulatory drugs. The present study was designed to help discuss the effect of DMT for MS on pregnancy and on disease course. PATIENTS AND METHODS: Retrospective data from 152 pregnancies of 132 women with MS were collected by the physician in charge of the case. All data were entered into a specific file for qualitative and quantitative statistical analysis. RESULTS: From the total group of patients, 89 pregnancies occurred without any exposure to MS drugs, while 61 pregnancies occurred with at least eight weeks of exposure to MS immunomodulatory drugs. The rate of obstetric and neonatal complications was similar in both groups, except for the newborn weight and height which was smaller for mothers receiving medications. Mothers' post-delivery relapse rate and EDSS scores in the follow-up period were significantly higher in the absence of treatment. CONCLUSION: It is possible that, with further such supportive data, international guidelines on MS treatment in young women who intend to get pregnant may need to be revised.

Parents' perception of health-related quality of life in children and adolescents with excess weight / Percepção dos pais acerca da qualidade de vida relacionada à saúde de crianças e adolescentes com excesso de peso

ABSTRACT OBJECTIVE: To evaluate the perception of parents or caregivers on the health-related quality of life (HRQOL) of children/adolescents with overweight/obesity and possible factors associated with this perception. METHODS: This was a cross-sectional study involving 297 caregivers of children and adolescents with normal weight (n = 170) and with overweight/obesity (n = 127), from public and private schools in the study municipality. HRQOL scores obtained through the Child Health Questionnaire - Parent Form 50 (CHQ-PF50) were compared according to the nutritional status and gender of the children/adolescents. Multiple regression analysis was used to determine the predictive value of studied variables for the variation in HRQOL scores. RESULTS: Parents of children/adolescents with overweight/obesity attributed lower HRQOL scores to their children in the following domains: physical functioning (p < 0.01; d = 0.49), self-esteem (p < 0.01; d = 0.38), parental impact-emotional (p < 0.05; d= 0.29), family cohesion (p < 0.05; d = 0.26), physical summary score (p < 0.05;d = 0.29), and psychosocial summary score (p < 0.05; d = 0.25). In the multiple regression models, the variables with the highest contribution to the variation in HRQOL scores were: in the physical functioning domain, parental impact-time (ß = 0.23; p < 0.05); self-esteem, nutritional status (ß = -0.18;p ≤ 0.01); emotional impact on parents, impact on parents' time (ß = 0.31; p < 0.05); and in family cohesion, global behavior (ß = 0.30;p < 0.05). CONCLUSIONS: A negative impact on HRQOL of children/adolescents with overweight/obesity was observed in the physical and psychosocial aspects. The nutritional status was the variable with the greatest contribution for the assessment the self-esteem of children and adolescents in this study.

RESUMO OBJETIVO: Avaliar a percepção dos pais ou cuidadores a respeito da qualidade de vida relacionada à saúde (QVRS) de crianças/adolescentes com sobrepeso/obesidade e os possíveis fatores associados a essa percepção. MÉTODOS: Estudo transversal com a participação de 297 cuidadores de crianças e adolescentes eutróficos (n = 170) e com sobrepeso/obesidade (n = 127), provenientes de escolas públicas e privadas do município do estudo. Escores de QVRS obtidos por meio do Child Health Questionnaire - Parent Form 50 (CHQ-PF50) foram comparados de acordo com o estado nutricional e sexo das crianças/adolescentes. Análises de regressão múltipla foram usadas para determinar o valor preditivo das variáveis estudadas para a variação dos escores de QVRS. RESULTADOS: Pais de crianças/adolescentes com sobrepeso/obesidade atribuíram menores escores de QVRS para seus filhos nos domínios: função física (p < 0,01; d = 0,49), autoestima (p < 0,01; d = 0,38), impacto emocional dos pais (p < 0,05; d = 0,29), coesão familiar (p < 0,05; d = 0,26), sumário do escore físico (p < 0,05; d = 0,29) e sumário do escore psicossocial (p < 0,05; d = 0,25). Nos modelos de regressão múltipla, as variáveis com maior contribuição para a variação dos escores de QVRS foram: no domínio função física, impacto no tempo dos pais (ß = 0,23; p < 0,05); autoestima, estado nutricional (ß = -0,18; p ≤ 0,01); impacto emocional nos pais, impacto no tempo dos pais (ß = 0,31; p < 0,05); coesão familiar, comportamento global (ß = 0,30; p < 0,05). CONCLUSÕES: Há impacto negativo na QVRS de crianças/adolescentes com sobrepeso/obesidade em aspectos físicos e psicossociais. O estado nutricional foi a variável de maior contribuição para a avaliação da autoestima das crianças e adolescentes do presente estudo.