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1.
BMC Neurol ; 21(1): 53, 2021 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-33535985

RESUMEN

BACKGROUND: In Egypt, the characterization of Neuromyelitis Optica Spectrum Disorder (NMOSD) is lacking. OBJECTIVES: To determine the demographics, clinical features, aquaporin4 antibodies (AQP4-IgG) status, and neuroimaging of Egyptian NMOSD patients. METHODS: Retrospective analysis of 70 NMOSD patients' records from the MS clinic, Kasr Alainy hospital, between January 2013 and June 2018. RESULTS: Patients' mean age was 34.9 ± 9.2 years, and the mean at disease onset was 28.9 ± 10.5 years. Fifty-nine patients had an initial monosymptomatic presentation. AQP4-IgG was measured using either enzyme-linked immunosorbent assay (ELISA) (22 patients) or cell-based assay (CBA) (34 patients). Six and 29 patients had positive results, respectively (p < 0.001). 84% had typical NMOSD brain lesions. Longitudinally extensive myelitis was detected in 49 patients, and 9 had either short segments or normal cords. Treatment failure was higher in seropositive patients. Rituximab significantly reduced the annualized relapse rate (ARR) compared to Azathioprine with a percentage reduction of (76.47 ± 13.28) and (10.21 ± 96.07), respectively (p = 0.04). Age at disease onset was the only independent predictor for disability (p < 0.01). CONCLUSION: Treatment failure was higher in seropositive patients. However, there was no difference in clinical or radiological parameters between seropositive and seronegative patients. Patients, who are polysymptomatic or with older age of onset, are predicted to have higher future disability regardless of the AQP4-IgG status.

2.
Sensors (Basel) ; 21(3)2021 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-33498231

RESUMEN

The purpose of this study was to examine the changes in co-activation around the knee joint during different walking speeds in healthy females using the co-activation index. Ten healthy females (age: 21.20 ± 7.21 years, height: 164.00 ± 4.00 cm, mass: 60.60 ± 4.99 kg) participated in this study and performed three walking speeds (slow, normal, and fast). A Qualisys 11-camera motion analysis system sampling at a frequency of 200 Hz was synchronized with a Trigno EMG Wireless system operating at a 2000 Hz sampling frequency. A significant decrease in the co-activation index of thigh muscles was observed between the slow and fast, and between the normal and fast, walking speeds during all walking phases. A non-significant difference was observed between the slow and normal walking speeds during most walking phases, except the second double support phase, during which the difference was significant. A negative relationship was found between walking speed and the co-activation index of thigh muscles in all speeds during walking phases: first double support (r = -0.3386, p < 0.001), single support (r = -0.2144, p < 0.01), second double support (r = -0.4949, p < 0.001), and Swing (r = -0.1639, p < 0.05). In conclusion, the results indicated high variability of thigh muscle co-activation in healthy females during the different walking speeds, and a decrease in the co-activation of the thigh muscles with the increase of speed.

3.
Acta Cardiol ; : 1-8, 2020 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-33308047

RESUMEN

BACKGROUND: The prevalence of heart failure among patients with Parkinson's disease (PD) was found to be twice that of the general population. The aim of this work is to evaluate the global left ventricular systolic function in patients with PD in comparison with healthy controls using speckle tracking echocardiography and to correlate the global left ventricular systolic function with both motor and cognitive functions in PD patients. METHODS: A case-control study was conducted on 40 patients diagnosed with PD and 40 healthy controls. Evaluation and staging of PD were performed using the Modified Hoehn and Yahr staging scale (H&Y staging) and Unified Parkinson's Disease Rating Scale (UPDRS). Cognitive assessment for PD patients was done using Parkinson's Disease - Cognitive Rating Scale (PD-CRS). Conventional and two-dimensional (2D) speckle-tracking strain echocardiography was done for both groups to assess the global left ventricular systolic function. RESULTS: There was a statistically significant difference between PD patients and controls regarding global longitudinal strain (p = 0.025), left ventricular end-diastolic dimension (p = 0.032), left ventricular end-systolic dimension (p = 0.003) and ejection fraction (p = 0.015). There were statistically significant negative correlations between both H&Y staging and UPDRS and both GLS (p ˂ 0.001, p ˂ 0.001) and EF (p = 0.017, p = 0.05). There were statistically significant positive correlations between PD-CRS and both GLS (p = 0.025) and EF (p = 0.012). CONCLUSION: PD patients were found to have significant subclinical left ventricular systolic dysfunction in comparison with healthy controls. Such dysfunction was correlated with the severity of the motor disability and cognitive impairment.

4.
Indian J Ophthalmol ; 68(12): 2691-2698, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33229644

RESUMEN

Photorefractive keratectomy (PRK) eye surgery is widely used for patients at risk for corneal ectasia to maintain an aspheric corneal shape. Wavefront-guided (WFG) ablation profile was designed to reduce pre-existing higher-order aberrations (HOA). We aimed to compare the corneal aberrations and visual outcomes between WFG and Wavefront Optimized (WFO) PRK in patients with myopia. Eight randomized clinical trials were included. We searched PubMed, Scopus, Web of Science and CENTRAL at March 2020, and updated the search in September 2020 using relevant keywords, The data were extracted and pooled as Mean Difference (MD) with a 95% Confidence Interval (CI), using Review Manager software (version 5.4). Pooled results showed no significance between Uncorrected Distance Visual Acuity (UDVA) and Corrected Distance Visual Acuity (CDVA) between both groups underwent WFG and WFO PPR after three months follow up (MD = -0.03; 95% CI: [-0.06, 0.00]; P = 0.07), (MD = -0.02; 95% CI: [-0.04, 0.01]; P = 0.22) respectively. Although, no significant difference between mean manifest cylinder after three and 12 months follow up, but the total MD for mean manifest cylinder difference was significantly lower with the WFG treatment method (MD = -0.12, (95% CI: [0.23:-0.01], P = 0.03). This shows a slight advantage of the WFG over the WFO method. The visual performance showed similarity and excellent refractive outcomes in both WFO and WFG PRK. No significant statistical differences between the two approaches. On further comparison, there was a slight advantage of the WFG over the WFO method.

5.
Int J Pharm ; 591: 120027, 2020 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-33130220

RESUMEN

Spray drying can be utilized to produce highly dispersible powder aerosol formulations. However, these formulations are known to be hygroscopic, leading to potential solid-state stability and aerosol performance issues. This study aims to investigate if control of the spray drying particle formation conditions could be employed to improve the solid-state stability and alter the aerosol performance of tobramycin EEG formulations. Eight formulations were prepared, each had the same drug:excipient ratio of 60%w/w tobramycin, 20% w/w l-leucine, 18% w/w mannitol, and 2% w/w poloxamer 188. An experimental design matrix was performed with drying air water content of 1 or 10 g/m3 and spray drying solution l-leucine concentrations of 4.6, 7.6, 15.2 or 23.0 mmol/L. The particle size, morphology and crystallinity of spray dried formulations were characterized together with their dynamic moisture vapor sorption and aerosol performance. Higher crystallization and glass transition %RH were observed for the formulations spray dried using drying air with higher water content indicating more stable characteristics. Initial screening using a handheld dry powder inhaler of the realistic aerosol performance revealed that neither changing l-leucine concentration nor the drying gas water content affect the in-vitro expected lung dose. However, using a novel positive pressure inhaler, formulations produced using spray drying solutions with lower l-leucine concentrations showed better aerosol performance with MMAD around 2 µm and FPF < 5 µm around 80%.

6.
Ther Clin Risk Manag ; 16: 759-767, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32884277

RESUMEN

The ongoing coronavirus (COVID-19) pandemic is a global health emergency of international concern and has affected management plans of many autoimmune disorders. Immunosuppressive and immunomodulatory therapies are pivotal in the management of neuromyelitis optica spectrum disorder (NMOSD), potentially placing patients at an increased risk of contracting infections such as COVID-19. The optimal management strategy of NMOSD during the COVID-19 era remains unclear. Here, however, we examined the evidence of NMOSD disease-modifying therapies (DMTs) use during the present period and highlighted different scenarios including treatment of relapses as well as initiation and maintenance of DMTs in order to optimize care of NMOSD patients in the COVID-19 era.

7.
Ther Clin Risk Manag ; 16: 651-662, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32801722

RESUMEN

The emergence of the novel coronavirus disease 2019 (COVID-19) pandemic has become a major public health challenge of global concern since December 2019, when the virus was recognized in Wuhan, the capital city of Hubei province in China and epicenter of the COVID-19 epidemic. Given the novelty of COVID-19 and the lack of specific anti-virus therapies, the current management is essentially supportive. There is an absence of consensus on guidelines or treatment strategies for complex disorders such as multiple sclerosis (MS), in which the risk of infections is higher than in the general population. This is due to the overall impairment of the immune system typical of autoimmune diseases, in addition to accumulation of disabilities, and the iatrogenic effect generated by corticosteroids and the recommended disease-modifying therapies (DMTs). DMTs have different modes of action, but all modulate and interfere with the patient's immune response, thereby raising concerns about adverse effects, such as an increased susceptibility to infections. In this review, we analyze the evidence for use of DMTs during the current critical period and ratify an algorithmic approach for management to optimize care between keeping DMTs, with their infection hazards, or coming off them, with the risk of disease activation. We also provide an algorithmic approach to the management of breakthrough activity during the COVID-19 pandemic.

8.
Nanomedicine ; 29: 102262, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32623017

RESUMEN

Tenacious sputum poses a critical diffusion barrier for aerosol antibiotics used to treat cystic fibrosis (CF) lung infection. We conducted a proof-of-concept study using dense poly(ethylene glycol) coated polystyrene nanoparticles (PS-PEG NPs) as model muco-inert particles (MIPs) formulated as a powder using an excipient enhanced growth (EEG) strategy, aiming to minimize extrathoracic airway loss, maximize deposition in the airway and further overcome the sputum barrier in the CF lungs. The EEG aerosol formulation containing PS-PEG MIPs was prepared by spray drying and produced discrete spherical particles with geometric diameter of approximately 2 µm; and >80% of the powder dose was delivered from a new small-animal dry powder inhaler (DPI). The MIPs released from the EEG aerosol had human airway mucus and CF sputum diffusion properties comparable to the suspension formulation. These properties make this formulation a promising pulmonary drug delivery system for CF lung infections.

9.
Molecules ; 25(12)2020 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-32545457

RESUMEN

Copper ferrite nano-particles (CuFe2O4) were synthesized, characterized, modified with polyaniline to form CuFe2O4/PANI nano-composite. They were used as new adsorbents for the removal of the hazardous mercuric ions from aqueous solutions. High resolution transmission electron microscope (HR-TEM), X-ray diffraction (XRD), Fourier-transform infrared (FT-IR) and Brunauer-Emmett-Teller (BET) were used for the characterization of the synthesized CuFe2O4 nano-particles (NPs) in presence and absence of PANI nano-composite. The synthesized CuFe2O4NPs were of spherical shape with an average size of 10.8 nm. XRD analysis displayed crystal peaks for CuFe2O4NPs and amorphous peaks CuFe2O4/PANI nano-composite due to the existence of polyaniline layer. Contact time, adsorbent dose, solution pH, adsorption kinetics, adsorption isotherm and recyclability were studied. The method at the optimum conditions exhibited high performance with high mercury removal percentage of up to 99% with a maximum adsorption capacity 12.5 and 157.1 mg/g for CuFe2O4 and CuFe2O4/PANI, respectively. The adsorption processes were fitted to Langmuir isotherms. The adsorption behavior of CuFe2O4@PANI composite towards Hg2+ ions is attributed to the soft acid-soft base strong interaction between PANI and Hg(II) ions. High stability and enhanced re-usability are offered using CuFe2O4@PANI composite due to its enhanced removal efficiency. No significant removal decrease was noticed after five adsorption-desorption cycles. In addition, it possesses an easy removal from aqueous solutions by external magnetic field after adsorption experiments. These indicated the enhancement of polyaniline to the surface of CuFe2O4 toward the adsorption of mercury from aqueous solutions.

10.
Sensors (Basel) ; 20(11)2020 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-32517063

RESUMEN

Predicting the results of soccer competitions and the contributions of match attributes, in particular, has gained popularity in recent years. Big data processing obtained from different sensors, cameras and analysis systems needs modern tools that can provide a deep understanding of the relationship between this huge amount of data produced by sensors and cameras, both linear and non-linear data. Using data mining tools does not appear sufficient to provide a deep understanding of the relationship between the match attributes and results and how to predict or optimize the results based upon performance variables. This study aimed to suggest a different approach to predict wins, losses and attributes' sensitivities which enables the prediction of match results based on the most sensitive attributes that affect it as a second step. A radial basis function neural network model has successfully weighted the effectiveness of all match attributes and classified the team results into the target groups as a win or loss. The neural network model's output demonstrated a correct percentage of win and loss of 83.3% and 72.7% respectively, with a low Root Mean Square training error of 2.9% and testing error of 0.37%. Out of 75 match attributes, 19 were identified as powerful predictors of success. The most powerful respectively were: the Total Team Medium Pass Attempted (MBA) 100%; the Distance Covered Team Average in zone 3 (15-20 km/h; Zone3_TA) 99%; the Team Average ball delivery into the attacking third of the field (TA_DAT) 80.9%; the Total Team Covered Distance without Ball Possession (Not in_Poss_TT) 76.8%; and the Average Distance Covered by Team (Game TA) 75.1%. Therefore, the novel radial based function neural network model can be employed by sports scientists to adapt training, tactics and opposition analysis to improve performance.

11.
Rev. senol. patol. mamar. (Ed. impr.) ; 33(2): 45-49, abr.-jun. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-197283

RESUMEN

INTRODUCTION: Breast cancer is a common worldwide healthcare problem. Identifying metastatic lesions is crucial for adequate staging. However, there is no standardized metastatic work-up in early-stage breast cancer patients. MATERIALS AND METHODS: We retrospectively analyzed data from patients treated in a tertiary hospital for clinical early-stage breast cancer, to assess the value of alkaline phosphatase (ALP) as a predictor of metastasis and as a prognostic factor. RESULTS: We detected a significant correlation between ALP and metastasis at diagnosis, and found that ALP is both a sensitive and specific marker in screening for metastasis in early-stage breast cancer. CONCLUSION: ALP is a useful marker of metastasis at diagnosis. Further prospective studies are needed to delineate the incidence and impact of missed metastatic patients if metastatic work-up is omitted


INTRODUCCIÓN: El cáncer de mama es un problema de salud común en todo el mundo. La identificación de lesiones metastásicas es crucial para una estadificación adecuada. Sin embargo, no hay un estudio metastásico estandarizado en pacientes de cáncer de mama precoz. MATERIALES Y MÉTODOS: Se analizaron retrospectivamente datos de pacientes tratados en un hospital terciario por cáncer de mama en estadio clínico temprano, para evaluar el valor de la fosfatasa alcalina (ALP) como predictor de metástasis y como factor pronóstico. RESULTADOS: Los autores detectaron correlación significativa entre ALP y metástasis en el momento del diagnóstico, y demostraron que ALP es un marcador sensible y específico en la detección de metástasis en cáncer de mama precoz. CONCLUSIÓN: La ALP es útil en el diagnóstico de metástasis en el momento de la valoración. Se necesitan más estudios prospectivos para delinear la incidencia y el impacto de los pacientes metastásicos perdidos, si se omite el análisis metastásico


Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Neoplasias de la Mama/patología , Fosfatasa Alcalina/análisis , Metástasis de la Neoplasia/patología , Recurrencia Local de Neoplasia/patología , Estudios Retrospectivos , Biomarcadores de Tumor/análisis , Estadificación de Neoplasias/métodos , Atención Terciaria de Salud/tendencias
12.
Pharm Res ; 37(6): 101, 2020 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-32440940

RESUMEN

PURPOSE: The purpose of this study was to develop a new computational fluid dynamics (CFD)-based model of the complex transport and droplet drying kinetics within a laboratory-scale spray dryer, and relate CFD-predicted drying parameters to powder aerosolization metrics from a reference dry powder inhaler (DPI). METHODS: A CFD model of the Buchi Nano Spray Dryer B-90 was developed that captured spray dryer conditions from a previous experimental study producing excipient enhanced growth powders with L-leucine as a dispersion enhancer. The CFD model accounted for two-way heat and mass transfer coupling between the phases and turbulent flow created by acoustic streaming from the mesh nebulizer. CFD-based drying parameters were averaged across all droplets in each spray dryer case and included droplet time-averaged drying rate (κavg), maximum instantaneous drying rate (κmax) and precipitation window. RESULTS: CFD results highlighted a chaotic drying environment in which time-averaged droplet drying rates (κavg) for each spray dryer case had high variability with coefficients of variation in the range of 60-70%. Maximum instantaneous droplet drying rates (κmax) were discovered that were two orders of magnitude above time-averaged drying rates. Comparing CFD-predicted drying parameters with experimentally determined mass median aerodynamic diameters (MMAD) and emitted doses (ED) from a reference DPI produced strong linear correlations with coefficients of determination as high as R2 = 0.98. CONCLUSIONS: For the spray dryer system and conditions considered, reducing the CFD-predicted maximum drying rate experienced by droplets improved the aerosolization performance (both MMAD and ED) when the powders were aerosolized with a reference DPI.

13.
Artículo en Inglés | MEDLINE | ID: mdl-32453638

RESUMEN

Background: In neonatal respiratory distress syndrome, breathing support and surfactant therapy are commonly used to enable the alveoli to expand. Surfactants are typically delivered through liquid instillation. However, liquid instillation does not specifically target the small airways. We have developed an excipient enhanced growth (EEG) powder aerosol formulation using Survanta®. Methods: EEG Survanta powder aerosol was delivered using a novel dry powder inhaler via tracheal insufflation to surfactant depleted rats at nominal doses of 3, 5, 10, and 20 mg of powder containing 0.61, 0.97, 1.73, and 3.46 mg of phospholipids (PL), whereas liquid Survanta was delivered via syringe instillation at doses of 2 and 4 mL/kg containing 18.6 and 34 mg of PL. Ventilation mechanics were measured before and after depletion, and after treatment. We hypothesized that EEG Survanta powder aerosol would improve lung mechanics compared with instilled liquid Survanta in surfactant depleted rats. Results and Conclusion: EEG Survanta powder aerosol at a dose of 0.61 mg PL significantly improved lung compliance and elastance compared with the liquid Survanta at a dose of 18.6 mg, which represents improved primary efficacy of the aerosol at a 30-fold lower dose of PL. There was no significant difference in white blood cell count of the lavage from the EEG Survanta group compared with liquid Survanta. These results provide an in vivo proof-of-concept for EEG Survanta powder aerosol as a promising method of surfactant replacement therapy.

14.
Nanomaterials (Basel) ; 10(3)2020 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-32210136

RESUMEN

In this research, CuFe2O4 nanoparticles were synthesized by co-precipitation methods and modified by coating with thiophene for removal of Hg(II) ions from aqueous solution. CuFe2O4 nanoparticles, with and without thiophene, were characterized by x-ray diffraction (XRD), Field emission scanning electron microscopy (FESEM), energy dispersive x-ray (EDX), high-resolution transmission electron microscopy (HRTEM) and Brunauer-Emmett-Teller (BET). Contact time, adsorbent dose, solution pH, adsorption kinetics, adsorption isotherm and recyclability were studied. The maximum adsorption capacity towards Hg2+ ions was 7.53 and 208.77 mg/g for CuFe2O4 and CuFe2O4@Polythiophene composite, respectively. Modification of CuFe2O4 nanoparticles with thiophene revealed an enhanced adsorption towards Hg2+ removal more than CuFe2O4 nanoparticles. The promising adsorption performance of Hg2+ ions by CuFe2O4@Polythiophene composite generates from soft acid-soft base strong interaction between sulfur group of thiophene and Hg(II) ions. Furthermore, CuFe2O4@Polythiophene composite has both high stability and reusability due to its removal efficiency, has no significant decrease after five adsorption-desorption cycles and can be easily removed from aqueous solution by external magnetic field after adsorption experiments took place. Therefore, CuFe2O4@Polythiophene composite is applicable for removal Hg(II) ions from aqueous solution and may be suitable for removal other heavy metals.

15.
J Pain Res ; 13: 537-545, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32210609

RESUMEN

Background: Studies have shown that interferon-beta (IFN-ß) treatment is associated with headaches in patients with multiple sclerosis (MS). Headaches can affect quality of life and overall function of patients with MS. We examined the frequency, relationships, patterns, and characteristics of headaches in response to IFN-ß in patients with relapsing-remitting multiple sclerosis (RRMS). Patients and Methods: This study was a prospective, longitudinal analysis with 1-year follow-up. The study comprised 796 patients with RRMS treated with IFN-ß (mean age 30.84±8.98 years) at 5 tertiary referral center outpatient clinics in Egypt between January 2015 and December 2017. Headaches were diagnosed according to the International Classification of Headache Disorders ICHD-3 (beta version), and data were collected through an interviewer-administered Arabic-language-validated questionnaire with an addendum specifically designed to investigate the temporal relationship between commencement of interferon treatment, and headache onset and characteristics. Results: Two hundred seventy-six patients had pre-existing headaches, and 356 experienced de novo headaches. Of 122 patients who experienced headaches before IFN-ß treatment, 55 reported headaches that worsened following onset of IFN-ß treatment. In patients with post-IFN-ß headaches, 329 had headaches that persisted for >3 months, 51 had chronic headaches, and 278 had episodic headaches, and 216 of these patients required preventive therapies. Univariate analysis showed a >6- and an approximately 5-fold increased risk of headache among those treated with intramuscular (IM) INF-ß-1a (OR 6.51; 95% CI: 3.73-10.01; P-value <0.0001) and 44 µg of SC INF-ß-1a (OR 5.44; 95% CI: 3.15-9.37; P-value <0.0001), respectively, compared with that in patients who received 22 µg of SC INF-ß-1a. Conclusion: Interferon-ß therapy aggravated pre-existing headaches and caused primary headaches in patients with MS. Headache risk was greater following treatment with IM INF-ß-1a and 44 µg SC INF-ß-1a.

16.
Nanomaterials (Basel) ; 10(2)2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-32024060

RESUMEN

A new SnO2/CeO2 nano-composite catalyst was synthesized, characterized and used for the removal of alizarin dyes from aqueous solutions. The composite material was prepared using a precipitation method. X-ray powder diffractometry (XRD), high resolution transmission electron microscopy (HR-TEM), Brunauer-Emmett-Teller methodology (BET) and Fourier Transform Infrared Spectrometry (ATR-FTIR) were utilized for the characterization of the prepared composite. The prepared nano-composite revealed high affinity for the adsorption and decomposition of alizarin dyes. The adsorption capacity under different experimental conditions (adsorbate concentration, contact time, adsorbent dose and pH) was examined. Under optimized experimental conditions, the removal of alizarin yellow, alizarin red and alizarin-3-methylimino-diacetic acid dyes from aqueous solutions was about 96.4%,87.8% and 97.3%, respectively. The adsorption isotherms agreed with the models of Langmuir, Freundlich and Temkin isotherms.

17.
Mult Scler Relat Disord ; 38: 101873, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31816505

RESUMEN

BACKGROUND: Despite multiple diagnostic tests, multiple sclerosis (MS) remains a clinical diagnosis with supportive paraclinical evidence. OBJECTIVE: To measure glutamate and nitric oxide serum levels in MS patients during and in between relapses to assess their potential role as biomarkers of disease activity and relapses. SUBJECTS AND METHODS: This cross sectional study was carried out on 70 MS patients and 40 age and sex matched apparently healthy controls. MS patients were divided into 2 groups; group 1 that included thirty MS patients without history of relapse within the last 3 months prior to recruitment and group 2 that included forty MS patients with history of relapse within the last 30 day prior to recruitment. RESULTS: Serum glutamate was significantly higher in group 2 (24.67 ±â€¯9.58 µg/ml) compared to group 1(12.5 ±â€¯4.9 µg/ml) (P value < 0.0001) and apparently healthy controls (3.5 ±â€¯1.3 µg/ml) (P value < 0.0001). Serum nitric oxide was significantly higher in group 2 (84.87 ±â€¯29.6 nmol/µl) than group 1 (41.99 ±â€¯24.2 nmol/µl) (P value < 0.0001) and apparently healthy controls (12.03 ±â€¯3.59 nmol/µl) (P value < 0.0001). Cutoff values of 17.5 µg/ml for glutamate and 75.2 nmol/µl for nitric oxide were found to predict occurrence of a relapse (sensitivity = 70% and 72.5% and specificity= 90% and 93.3% respectively). CONCLUSION: Serum glutamate and nitric oxide can be potential easily-accessible biomarkers of disease activity and relapses in MS patients.

19.
Neuropsychiatr Dis Treat ; 15: 2571-2578, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31564882

RESUMEN

Background and purpose: The development of new biomarkers for multiple sclerosis (MS) is of paramount importance to improve our ability to predict disease progression and disability. The aim of this study was to evaluate the potential role of the optic nerve diameter (OND) measured by ultrasonography as a biomarker of early disability in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: Forty-nine RRMS patients, 23 with a history of optic neuritis (MS-ON) and 26 without a history of optic neuritis (MS N-ON), and 50 age- and sex-matched healthy control subjects were included in the study. The OND and optic nerve sheath diameter (ONSD) were measured by transorbital sonography (TOS), and the retinal nerve fibre layer (RNFL) and ganglion cell complex (GCC) thicknesses were measured by optical coherence tomography (OCT) using the Optovue RTVue™ system (Optovue, Inc., Fremont, CA, USA). Results: There was no significant difference between the patient (whether ON or N-ON eyes) and control groups in either the OND (p=0.979) or the ONSD (p=0.911). However, patients with an expanded disability status scale (EDSS) score >2 had a significantly lower OND and RNFL thicknesses (p=0.014, p=0.010 respectively) than patients with an EDSS score ≤2. Statistical logistic regression revealed that OND was an independent predictor of EDSS>2 (p=0.044, OR =0.000, 95% CI=0.000-0.589). Conclusion: The OND, as measured by ultrasonography, could be potentially used as a biomarker for the detection of early disability in RRMS patients.

20.
J Nerv Ment Dis ; 207(10): 863-868, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31365433

RESUMEN

The aim is to examine the cognitive domains, behavioral domains, and electroencephalogram (EEG) findings in children of mothers with idiopathic generalized epilepsy who had been exposed to antiepileptic drugs (AEDs) in utero. Forty school-aged children born to 23 mothers with idiopathic generalized epilepsy were compared with 40 healthy children born to 34 healthy mothers. Stanford-Binet Intelligence Scale was applied to all children to assess their cognitive functions. Child Behavior Checklist was used to assess their behavioral characteristics. EEG was done for the epileptic mothers and their children. Children exposed to AEDs showed significantly lower scores in the verbal reasoning, visual reasoning, and global intelligence quotient (IQ). There was a significantly positive correlation between children's global IQ and maternal global IQ. Multiple regression analysis showed that in utero exposure to valproate and maternal IQ were the most independent factors affecting children's IQ. EEG findings of participating children were normal. Exposure to valproic acid during fetal life and maternal IQ represent confounding factors affecting the IQ of children with in utero exposure to AEDs.


Asunto(s)
Anticonvulsivantes/efectos adversos , Evaluación Educacional/métodos , Epilepsia Generalizada/epidemiología , Complicaciones del Embarazo/epidemiología , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Efectos Tardíos de la Exposición Prenatal/epidemiología , Adulto , Estudios de Casos y Controles , Niño , Preescolar , Estudios Transversales , Electroencefalografía/efectos de los fármacos , Electroencefalografía/métodos , Epilepsia Generalizada/complicaciones , Epilepsia Generalizada/tratamiento farmacológico , Femenino , Humanos , Pruebas de Inteligencia , Masculino , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Efectos Tardíos de la Exposición Prenatal/diagnóstico , Estudiantes/psicología
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