ABSTRACT
Background: Immunomodulatory drugs (IMD), Interferon β1a, β1 b and glatiramer acetate are available in the Chilean public health system since June 2008 for patients with relapsing-remitting multiple sclerosis (RR-MS). Diagnostic confirmation and programmed follow up of these patients is carried out at a public national reference center. Aim: To describe the epidemiological and clinical features of 314 patients evaluated in this center between 2008 and 2012. Patients and Methods: Review of clinical records, to obtain information about demographic background, medical history, expanded disability status scale of Kurtzke (EDSS), multiple sclerosis functional composite (MSfic), intensity fatigue scale of Krupp, Raos Brief Repeatable Battery of Neuropsychological Tests (BNR-R) and anxious-depressive manifestations using Hamilton and Beck questionnaires. Results: The ages of patients ranged from 12 to 63 years and 67% were women. The initial symptoms were sensory disturbances in 20%, motor alterations in 18% and optical neuritis in 16%. In 9% of patients, the disease began with several manifestations. The EDSS was 4 or less in 73% of patients and cognitive impairment was observed in 34%. Treatment failure during the first and second years, occurred in 23 and 26% of patients, respectively. Male gender, age under 40 and brainstem malfunction at the onset of disease, were predictive of treatment failure during the second year. Conclusions: The features of these patients are very similar to those reported abroad.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Cognition Disorders/etiology , Depression/etiology , Multiple Sclerosis, Relapsing-Remitting/complications , Chile , Disease Progression , Immunologic Factors/therapeutic use , Multiple Sclerosis, Relapsing-Remitting/drug therapy , Multiple Sclerosis, Relapsing-Remitting/psychology , Neuropsychological Tests , Retrospective Studies , Severity of Illness IndexABSTRACT
El presente artículo aborda algunas consideraciones generales sobre los derechos humanos -desde que fueron articulados por primera vez en la "Declaración Universal de los Derechos Humanos" en 1948-; sobre el significado y las consecuencias de la descriminación; sobre la práctica de la defensa de los derechos humanos, y sobre la importancia de su defensa como requisito para la prevención del SIDA. A continuación se plantean algunos aspectos éticos generales y dos de las manifestaciones del dilema ético que han surgido con la epidemia del SIDA: la del conflicto entre los derechos individuales y los derechos colectivos, y las reacciones de intolerancia y represión, que claman por instalar medidas coercitivas para controlar la epidemia. Posteriormente se hace una revisión sobre el problema en México y se presentan los datos que al respecto se tienen en el Consejo Nacional de Prevención y Control de SIDA (CONASIDA) a partir del año de 1992, en que se sistematizaron las denuncias a través del Departamento de Orientación Social y Derechos Humanos. Finalmente se plantean algunas conclusiones y perspectivas
AIDS and human rights are closely related issues. This paper describes the relationship between AIDS and human rights, the impact and consequences of discrimination and the importance of the defense of human rights as a cornerstone strategy in AIDS prevention. Some general ethical aspects are addressed and two dilemmas which have been raised by the epidemic are discussed: the apparent conflict between individual and community rights and the reactions of intolerance and repression from those who claim that only through coercitive strategies will the epidemic be brought under control. Specific problems in Mexico are described based on data collected at CONASIDA's Human Rights Department between 1992 and 1994. Finally some conclusions are stated emphasizing that, in the AIDS epidemic, the defense of human rights is the cornerstone of any public health strategy.