[Lipid profile evolution during the first year of treatment with beta interferon in multiple sclerosis]. / Perfil lipídico durante el primer año de tratamiento con interferón beta en pacientes con esclerosis múltiple.

BACKGROUND AND OBJECTIVE: Treatment with beta interferon (IFNbeta) might alter the lipid profile. Plasmatic levels of total cholesterol and low density lipoprotein-cholesterol have been associated with the number of plaques in magnetic resonance of patients with demyelinating syndromes. PATIENTS AND METHOD: Retrospective analysis of total cholesterol and triglyceride levels during the first year of treatment with IFNbeta in multiple sclerosis patients and association between lipid levels and disease activity, compared to patients using glatiramer acetate (GA). RESULTS: 84 patients under IFNbeta and 23 GA patients were studied. Mean total cholesterol plasmatic levels lowered during the first year, whereas triglyceride levels rose since the first 6 months. These changes were more intense in the IFNbeta(1a) intramuscular group. No changes were observed in the GA group. Lipid changes were not associated with disease activity. CONCLUSIONS: In multiple sclerosis patients, triglyceride levels rise whereas total cholesterol levels decrease during the first year of treatment with IFNbeta. These changes do not seem to be related with disease activity.

Acute stroke unit care and early neurological deterioration in ischemic stroke.

OBJECTIVE: To evaluate the impact that monitored acute stroke unit care may have on the risk of early neurological deterioration (END), and 90-day mortality and mortality-disability. METHODS: Non-randomized prospective study with consecutive patients with acute ischemic stroke (AIS) admitted to a conventional care stroke unit (CCSU), from May 2003 to April 2005, or to a monitored acute stroke unit (ASU) from May 2005 to April 2006. END was defined as an increase in the NIHSS score >or= 4 points in the first 72 hours after admission. RESULTS: END was detected in 19.6% of patients (11.2% of patients admitted to the ASU and 23.8% to the CCSU; p<0.0001). Patients admitted to the ASU received more treatment with intravenous rtPa (13.5% versus 4.2%; p<0.0001), had a shorter length of stay (9.1 [11.0] d versus 13.1 [10.4] d; p<0.0001), lower 90-day mortality (10.2% versus 17.3%; p=0.02), and lower mortality-disability at 90-days (28.4% versus 40.2%; p=0.004) than those admitted to the CCSU. Multivariable analysis showed that ASU admission was a protector for END (OR: 0.37; 95% CI: 0.23-0.62). On admission, higher NIHSS (OR: 1.06; 95% CI: 1.03-1.10), higher glycaemia (OR: 1.003; 95% CI: 1.001-1.006), and higher systolic pressure (OR: 1.01; 95% CI: 1.002-1.017) were independent predictors of END. CONCLUSIONS: END prevention by ASU care might be a key factor contributing to better outcome and decrease of length of stay in patients admitted to monitored stroke units.