[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.

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

Fundamento y objetivo: el tratamiento con interferón (IFN) beta puede modificar el perfil lipídico. La concentración plasmática de colesterol total y de colesterol unido a lipoproteínas de baja densidad se ha relacionado con la actividad radiológica tras un primer brote desmielinizante. Pacientes y método: se ha realizado un análisis retrospectivo de los valores de colesterol y triglicéridos durante el primer año de tratamiento con IFNβ en pacientes con esclerosis múltiple y su relación con la actividad de la enfermedad, comparados con pacientes tratados con acetato de glatirámero (AG). Resultados: se analizaron 84 pacientes en tratamiento con IFNβ y 23 pacientes con AG. Los valores plasmáticos de colesterol disminuyeron al año de tratamiento con IFNβ, mientras que los de triglicéridos aumentaron a partir de los 6 meses. Estos cambios fueron más acentuados con IFNβ1a intramuscular. No se observaron cambios en los pacientes tratados con AG. No hubo asociación entre perfil lipídico y actividad clínica. Conclusiones: en pacientes de esclerosis múltiple se ha observado un aumento de la concentración sérica de triglicéridos y disminución del colesterol total durante el primer año de tratamiento con IFNβ. Estos cambios no se relacionan con la actividad clínica (AU)

Background and objective: Treatment with beta interferon (IFNβ) 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 IFNβ in multiple sclerosis patients and association between lipid levels and disease activity, compared to patients using glatiramer acetate (GA).Results84 patients under IFNβ 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 IFNβ1a 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 IFNβ. These changes do not seem to be related with disease activity (AU)