Background
In White populations more than 60% of clinically isolated syndrome (CIS)
convert to multiple sclerosis (MS) on a long-term follow-up; several
predictors for conversion have been identified.
Objective
This study aimed to determine the conversion rate and the predictors of
conversion from CIS to MS (McDonald 2010) among Indians. The other objective
was to evaluate the diagnostic accuracy of the new McDonald 2017 criteria in
prediction of a second clinical attack.
Methods
Clinical and demographic data of CIS cohorts were collected. Baseline
investigations included cerebrospinal magnetic resonance imaging (MRI) with
contrast and cerebrospinal fluid (CSF) testing for oligoclonal band (OCB).
Follow-up clinical and MRI examinations were performed annually for at least
24 months.
Results
Of the 82 subjects (age range 15–58 years), 36 (43.9%) converted to MS; 31/82
(37.8%) converted in 24 months. The predictors for conversion were earlier
age of onset, CSF-OCB, cerebral MRI T2 lesion count, and periventricular and
juxtacortical location of lesions. Twenty-two (26.83%) CIS fulfilled the
McDonald MS 2017 criteria at baseline.
Conclusion
In this first prospective study of CIS in India, the risk factors for
conversion are similar but the conversion rate to MS is lower than that in
the western nations.
Phosphonacetyl-L-aspartate (PALA), in inhibitor of aspartate transcarbamylase that depletes uridine nucleotide pools, selectively potentiates the antitumor activity of 5-fluorouracil (5-FU) in preclinical models. Due to the promising results we obtained using PALA/5-FU in colorectal cancer, we performed a phase II trial in patients presenting with advanced pancreatic cancer. PALA was given intravenously at 250 mg/m2 on day 1, followed 24 h later by 2,600 mg/m2 5-FU given by 24-h infusion. Treatments were repeated weekly. A total of 41 patients who had not previously undergone chemotherapy were entered in the trial; of these, 35 were evaluable for response. Toxicity was generally mild to moderate; neurotoxicity (13/35) and diarrhea (8/35) predominated. Among the 35 patients, 1 achieved a complete response and 4, a partial remission, for an overall response rate of 14%. The median survival was 5.1 months. Pretreatment with PALA alone was not sufficient to enhance the activity of 5-FU in pancreatic cancer.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.