-There are no published studies on the characteristics of multiple sclerosis (MS) patients from the south of Brazil. Objective: To identify the clinical features of a series of MS patients and to compare to other Brazilian series. Method: Retrospective study with 67 patients followed in The MS Reference Center -RS, Brazil during the year of 2008. We analyzed demographic and clinical data. Results: Most were women (74.6%), the general average age was 43.5 years old, and the general average EDSS score was 4.1. Of those patients, 81.8% had relapsing-remitting MS. Sexual dysfunction prevalence was 31.1% in men and 68.9% in women (p<0.01). We found a positive correlation (Spearman=0.444, p<0.05) between EDSS and depressive symptoms. Conclusion: This study showed a very similar sample compared to other states of Brazil. Moreover, there was found a high prevalence of sexual dysfunction and a straight relation between EDSS and depressive symptoms.KEy WORDS: multiple sclerosis, epidemiology, depressive symptoms, sexual dysfunctions.Características clínicas da esclerose múltipla no sul do Brasil: uma análise parcial resumo -Não há dados publicados sobre as características clínicas da esclerose múltipla (EM) no estado do Rio Grande do Sul (RS). Objetivo: Identificar e comparar as características clínicas de uma série de pacientes com EM no RS com as de outras séries nacionais. Método: Foram coletados e avaliados dados demográficos e clínicos de 67 pacientes atendidos em nosso centro. Resultados: Houve predomínio de mulheres (74,6%), idade média geral foi de 43,5 anos e EDSS médio de 4,1. O tipo surto-remissão correpondeu a 81,8%. A prevalência de disfunção sexual foi de 31,1% nos homens e 68,9% nas mulheres (p<0,01). Encontrou-se correlação de 0,444 (p<0,05) entre depressão e EDSS. Conclusão: Este estudo demonstrou uma amostra semelhante às demais amostras brasileiras, apresentando, adicionalmente, elevada prevalência de sintomas sexuais e a estreita associação entre depressão e o grau de incapacidade. PALAVRAS-CHAVE: esclerose múltipla, epidemiologia, sintomas depressivos, disfunção sexual.
IntroductionThe aim of this study was to investigate how infection with SARS-CoV-2 affected headache in individuals with migraine, and to identify characteristics associated with a worsening of the migraine post COVID-19.MethodsObservational study composed of 157 individuals with migraine and who had been infected with the SARS-CoV-2 virus. They were recruited from the database of the headache research group at the Pontifical Catholic University of Paraná. The participants responded online to questions about their anthropometric data, history of infection with SARS-CoV-2, presence and characteristics of the headache in the acute phase, perception of a worsening of the migraine after infection, use of analgesics and prophylactic migraine medication. Validated digital questionnaires were used: Migraine Disability Assessment (MIDAS), Beck Depression Inventory (BDI) and Allodynia Symptom Checklist (ASC-12). The results of these questionnaires were compared to values previously recorded in the database, this information having been obtained prior to the infection with COVID-19.ConclusionIndividuals who notice a worsening in migraine post-COVID-19 have a more severe migraine condition prior to infection, have more prominent headache during the acute phase and, subsequently, present with greater disability.
IntroduçãoA Migrânea é um tipo de cefaleia primária que afeta muito a qualidade de vida dos pacientes. Com uma fisiopatologia complexae forte influência genética, possui tratamento agudo e profilático com diversas opções disponíveis – e um futuro promissor de novasdrogas, bem como forte influência de hábitos de vida, que incluem atividades físicas e qualidade de sono. A educação dos pacientestem sido cada dia mais valorizada e é muito importante porque proporciona maiores conhecimentos sobre a condição e estimula oacompanhamento médico adequado, já que se trata de uma doença de alta prevalência e notório impacto pessoal, econômico e social.ObjetivosDesenvolver ferramenta que promova a compreensão da enxaqueca e a auto- gestão do tratamento pelo paciente através da educação acerca de sua doença.Material e MétodosFoi desenvolvido um e-book voltado para pacientes com Migrânea, disponibilizado gratuitamente no site www.naoedrama.com.br.As informações obtidas para a elaboração do mesmo foram trabalhadas para serem abordadas de forma simplificada, para acompreensão por leigos. Após a leitura, os indivíduos foram convidados a responder avaliação sobre o conteúdo, por meio daferramenta Google Forms, com ciência e aceite do TCLE.ResultadosDentre mais de 1000 indivíduos que fizeram o download do arquivo, 66 responderam ao questionário, dos quais 55 afirmaramapresentar cefaleia frequentemente. Desse total, 89,1% pretendem mudar algumas atitudes ou tratamentos após a leitura do conteúdo, principalmente hábitos de vida, que são muito ligados à prevenção da doença. A média de idade foi de 33 anos, com níveis de escolaridade altos: 95,5% dos participantes têm ensino médio completo. Os conteúdos foram considerados de fácil compreensão por 100% dos participantes e com informações novas por 89,4% deles.ConclusõesA utilização de novas ferramentas tecnológicas, como o e-book, se provou como uma opção extremamente viável para a educaçãodo paciente, já que houve considerável número de downloads do arquivo, ampla aprovação dos participantes da pesquisa e altosníveis de compreensão das informações. A principal vantagem desse método foi a capacidade de influenciar os pacientes a buscarem melhorias em seu estilo de vida. De acordo com os resultados obtidos, o e-book gerou um impacto muito positivo para o auto-manejo da Migrânea: cerca de 9 em cada 10 pacientes com cefaleia afirmaram que pretendem mudar algumas atitudes após a leitura do mesmo.
IntroductionFew studies have been conducted into neurogenic inflammation and neuroinflammation in respect of migraine. However, evidence suggests that the immune system may exert an influence over trigeminal activation and cortical spreading depression in individuals suffering from migraine. The interleukin (IL)-18 is a pro-inflammatory cytokine and increased plasma levels have been confirmed in individuals with migraine. However, as yet, the genetic variants of IL-18 have not been investigated in the context of migraine. ObjectiveTo investigate the association between genetic variants IL18 -105G>A (rs360717) and IL18 -137G>C (rs187238) and susceptibility to migraine and its clinical characteristics. Subjects and MethodsCase control study comprising 307 participants, of whom 152 had a diagnosis of migraine and 155 were healthy controls, paired by sex, age, ethnicity and BMI. The clinical and demographic data were evaluated. The patients with migraine were interviewed using a structured form containing information about the type of migraine (with or without aura, episodic or chronic), age at onset of the disease, frequency of attacks, accompanying symptoms that triggered headaches. The patients also answered validated questionnaires to evaluate incapacity (Migraine Disability Assessment - MIDAS) and impact (Headache Impact Test - HIT-6) for migraine, the presence of allodynia (ASC-12), as well as symptoms of anxiety (State Anxiety Inventory - STAI 1 and 2), depression (Beck Depression Inventory) and a hyperacusis scale.The genetic variants IL18 -105G>A (rs360717) and IL18 -137G>C (rs187238) were identified using polymerase chain reaction (PCR) and the fluorescence levels of PCR products were evaluated using a Step One thermocycler (Applied Biosystems). The analyses were conducted using the dominant, codominant, recessive and overdominant genetic models. (To see the complete abstract, please, check out the PDF).
IntroductionMigraine is a complex brain disorder that is influenced by different pathophysiological aspects such as inflammation, structural changes, and dysfunctions in multisensory processing. Recent studies have showed that possible mutations in genes that interfere with the excitability of ion channels linked to nociception are one of the key mechanisms for the development of a migraine. In this sense, it is known that familial hemiplegic migraine type 3 (FHM3) undergoes specific missense mutational influences on the SCN1A gene that encodes the α1 subunit of NAV1.1, a voltage-gated sodium channel present in the brain that demonstrates that the deregulation of the excitatory- inhibitory balance of these channels in specific circuits may come to characterize the pathogenic mechanism of FHM3. ObjectivesInvestigate the relation of single nucleotide variants (SNVs) on the SCN1A gene encoder of the a1 subunit of the NAV1.1 channel with the development of FHM3. MethodsNarrative review performed by active search in the digital databases Virtual Health Library (BVS), PubMed, SciElo and Google Scholar. DevelopmentMigraine pathophysiology involves the distribution of ions between intracellular and extracellular compartments, which shows the role of the ion channels in the disease. In this regard, there is an activation of the trigeminal vascular meningeal system by the NaV1.1 channels, which are expressed in Aδ fibers. Therefore, it is believed that mutations on genes that encodes the ion channels act in the development of migraine, mainly by the meninges, as they are densely innervated by trigeminal nerve endings. (To see the complete abstract, please, check out the PDF).
BackgroundMigraine is among the 3 most burdensome neurological disorders in the US in terms of absolute number of disability-adjusted life years (DALYs) from 1990 to 2017, behind just stroke and Alzheimer disease and other dementias. Migraine is characterized as a type of unilateral primary headache marked by a series of neurological and vascular alterations, which can occur episodically or chronically and course with intermittent attacks of intense or moderate headache. Moreover, cognitive dysfunctions are interim and disabling components of this disorder and may be related to the brain processes underlying the pathophysiology. ObjectiveExamine the effects of migraine in the cognitive functions, such as language function, visuospatial function, attention, executive function and memory, of adults between 19 and 45 years old. MethodThis study consists in a narrative review of articles published in the last 5 years on MEDLINE database searched through PubMed. The articles were found using the following MESHs: Migraine and Cognition. ResultsWe utilized 3 studies that approached cognitive impairment in migraine attacks and interictally. In a clinical trial, 144 pacients with chronic migraine (CM) and 44 age-matched patients with episodic migraine (EM) (a maximum of 4 headache days per month) were compared by cognitive assesments. In the Montreal Cognitive Assessment (MoCA), CM patients demonstrated the most striking impairment in memory/delayed recall (65.3%), attention (46.5%), abstraction (30.6%), and language (27.1%). (To see the complete abstract, please, check out the PDF).
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