Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 7 de 7
Filtrar
3.
J Clin Neurosci ; 45: 257-260, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28844615

RESUMEN

Multiple Sclerosis (MS) treatment with natalizumab is associated with Progressive Multifocal Leukoencephalopathy (PML). The risk of PML being related to the anti-JCV antibody index is well established, but there is less known about seroconversion rates in natalizumab-treated patients and longitudinal variation in the anti-JCV antibody index. Our objective was to assess anti-JCV antibody prevalence in an MS population and to evaluate the evolution of the anti-JCV antibody index in natalizumab-treated patients. To assess anti-JCV antibody prevalence, we included all patients who had the anti-JCV antibody test in our consultation, regardless of the treatment. To evaluate the evolution of the anti-JCV antibody index and seroconversion, only natalizumab-treated patients with at least two samples were selected. Demographic characteristics were evaluated. From a total of 371 patients included, 68.19% (n=253) were seropositive for anti-JCV antibodies (JCV+). There was a significant difference in anti-JCV antibody seropositivity concerning gender (male 76.27% vs. female 64.43%, p=0.023), but not age. To evaluate seroconversion, 85 patients who were initially seronegative (JCV-) were selected. The annual rate of seroconversion in the first two years was stable, but after that there was a significant increase with treatment duration (ρ=0.90, p=0.037): in the first year it was 5.88% (n=5/85); in the second, 5.71% (n=4/70); in the third, 6.82% (n=3/44); in the fourth, 10.34% (n=3/29); and in the fifth, 15.0% (n=3/20). The mean index variability was higher in patients who experienced seroconversion (1.16±0.97), followed by JCV+ patients (0.44±0.48), compared to JCV- patients (0.08±0.05). In conclusion, anti-JCV antibody prevalence in our population is comparable to other reported cohorts. The seroconversion rate increased with treatment duration. We found a high fluctuation in the antibody index in JCV+ patients.


Asunto(s)
Anticuerpos Antivirales/sangre , Factores Inmunológicos/efectos adversos , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Natalizumab/efectos adversos , Seroconversión , Adulto , Femenino , Humanos , Virus JC/inmunología , Leucoencefalopatía Multifocal Progresiva/inducido químicamente , Masculino , Persona de Mediana Edad , Esclerosis Múltiple Recurrente-Remitente/inmunología , Prevalencia , Estudios Retrospectivos , Caracteres Sexuales
4.
Int Immunopharmacol ; 46: 105-111, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28282574

RESUMEN

OBJECTIVES: Natalizumab long-term effectiveness data in real-world relapsing-remitting multiple sclerosis (RRMS) is needed. Our objective is to report the long-term effectiveness and safety of natalizumab in a cohort of RRMS patients. METHODS: This is a retrospective study of natalizumab treatment for two years or longer in RRMS. Annualized relapse rate, Expanded Disability Status Scale (EDSS), brain magnetic resonance imaging T2 lesion volume, JC virus antibody status, previous treatments and adverse events were analysed. RESULTS: Seventy-one patients were included with a mean treatment duration of 44.86±17.39months. Over the treatment duration there was a significant decrease in annualized relapse rate (88.37%) and EDSS (28.57%); no evidence of clinical disease activity in 73.24% and 61.97% after one and two-years respectively; and brain magnetic resonance imaging T2 lesion volume remained stable. Forty patients suspended natalizumab, in 85% due to high risk of developing progressive multifocal leukoencephalopathy (PML). The major complication was PML (n=3). CONCLUSIONS: Natalizumab showed effectiveness in the long-term follow up period of our cohort, with reduction of ARR, EDSS, and MRI lesion load stabilization. PML was the major complication.


Asunto(s)
Encéfalo/efectos de los fármacos , Leucoencefalopatía Multifocal Progresiva/prevención & control , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Natalizumab/uso terapéutico , Adolescente , Adulto , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Leucoencefalopatía Multifocal Progresiva/diagnóstico , Leucoencefalopatía Multifocal Progresiva/etiología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Esclerosis Múltiple Recurrente-Remitente/complicaciones , Esclerosis Múltiple Recurrente-Remitente/diagnóstico , Portugal , Estudios Retrospectivos , Riesgo , Privación de Tratamiento , Adulto Joven
5.
Mult Scler Relat Disord ; 6: 41-48, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27063621

RESUMEN

INTRODUCTION: Fingolimod is an oral treatment for Relapsing-Remitting Multiple Sclerosis (RRMS) with established efficacy in clinical trials. Post-marketing studies are important to assess its effectiveness in real-world populations. OBJECTIVES: To report the effectiveness and safety of fingolimod in a real-world population. METHODS: A retrospective study of patients with RRMS treated with fingolimod for at least six months. The demographic characteristics, Annualized Relapse Rate (ARR), Expanded Disability Status Score (EDSS), previous treatments and Adverse Events (AE) were analysed. RESULTS: 104 patients were included, with a mean treatment duration of 21.06 months. First-line disease modifying therapy failure patients (n=56) had an ARR decrease of 68.53% (1.43 vs. 0.45, p<0.001), 66.07% of them were relapse-free, EDSS significantly decreased (2.5 vs. 2.0, p<0.001) and 91.07% showed no disability progression. In patients previously treated with natalizumab as a second-line drug mainly switched due to safety concerns (n=41), although the differences were not statistically significant, both the ARR and EDSS increased in 41.46% and 19.51% of patients, respectively. In treatment-naive patients (n=7) the ARR decreased 94.90% (1.57 vs. 0.08, p=0.027) and there was no disability progression. 56.7% of all patients experienced AE not considered serious in any of the cases. CONCLUSION: In this population, fingolimod was an effective treatment after first-line treatment failure, decreasing both the ARR and EDSS, and may be an effective option after natalizumab.


Asunto(s)
Clorhidrato de Fingolimod/uso terapéutico , Inmunosupresores/uso terapéutico , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Adolescente , Adulto , Anciano , Evaluación de la Discapacidad , Progresión de la Enfermedad , Femenino , Clorhidrato de Fingolimod/efectos adversos , Humanos , Inmunosupresores/efectos adversos , Masculino , Persona de Mediana Edad , Natalizumab/uso terapéutico , Portugal , Retratamiento , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
6.
Nephron ; 75(1): 94-7, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9031277

RESUMEN

Sneddon's syndrome is a systemic disease characterized by livedo reticularis and cerebrovascular disease. Other organs may be involved as well. Typical vascular lesions in the skin biopsy and/or digital arteries biopsy can be found. Arterial hypertension, cardiac pathology (ischemic disease, myocardial infarction, valvulopathy), venous thrombosis and even fetal death are also found sometimes. We present a case of Sneddon's syndrome in which typical vascular lesions in the kidney were demonstrated for the first time unequivocally confirming the systemic nature of this syndrome.


Asunto(s)
Enfermedades Renales/complicaciones , Síndrome de Sneddon/complicaciones , Adulto , Biopsia , Femenino , Humanos , Enfermedades Renales/patología , Enfermedades Renales/orina , Proteinuria/complicaciones , Proteinuria/patología , Proteinuria/orina , Síndrome de Sneddon/patología
7.
Acta Med Port ; 8(11): 629-34, 1995 Nov.
Artículo en Portugués | MEDLINE | ID: mdl-8713508

RESUMEN

A case of presenile dementia with dominant frontal disfunction, progressive aphasia and Motor Neuron Disease with prominent bulbar signs is reported. Considering the clinical examination, the measurements of the regional cerebral flow (SPECT) and the histological appearances, we suggest the diagnosis of Dementia of Frontal Lobe Type and Motor Neuron Disease. We reviewed other disorders labelled Primary Frontal or Fronto-temporal Dementias and we discuss this new dementia and the difficulty in its classification.


Asunto(s)
Demencia/diagnóstico , Lóbulo Frontal , Enfermedad de la Neurona Motora/diagnóstico , Biopsia , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Demencia/patología , Diagnóstico Diferencial , Femenino , Lóbulo Frontal/patología , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Enfermedad de la Neurona Motora/patología , Pruebas Neuropsicológicas , Tomografía Computarizada de Emisión de Fotón Único , Tomografía Computarizada por Rayos X
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...