Introduction: Multiple sclerosis (MS) is a demyelinating and autoimmune disease that affects the central nervous system (CNS). It is the most common CNS disabling disease in young adults, predominantly in the 20-40 age group. Patients with MS have a compromised quality of life. The Short Form Health Survey 36 (SF-36) is the most widely used questionnaire to assess quality of life in patients with MS. Objectives: To analyze the quality of life of patients diagnosed with relapsingremitting multiple sclerosis (RRMS), in a Reference Center for Multiple Sclerosis in Paraíba. Methods: This is a cross-sectional field work of quantitative approach, of descriptive and exploratory nature. The SF-36 questionnaire was applied in April 2021, at the Reference Center for Multiple Sclerosis. At the study site, 390 patients with Multiple Sclerosis were registered. For the research to present a confidence level of 90% and an expected error of 10%, a sample of 58 patients was determined. The statistical data were made by IBM SPSS statistics. The study was approved by the Research Ethics Committee of Joao Pessoa University Center. Results: The data found in the sample are compatible with what is described in literature, reaffirming the predominance of MS for the female gender of 77%. As for the analysis of the patients’ quality of life, the domains with the most impairment were limitation by emotional aspects, followed by vitality and limitation by physical aspects. The use of Betainterferone 1a was associated with a better quality of life in six of the eight domains studied. Conclusion: Patients with RRMS have a decreased perception of Quality of Life. Other factors that affect the quality of life of these patients are gender and the use of betainterferone 1a.
Introduction: Multiple sclerosis (MS) is an inflammatory, immune-mediated disease of the central nervous system, characterized by multifocal areas of demyelination. There is a knowledge gap in understanding the disease, particularly the progressive forms in different regions of the country, such as the Northeast. Objectives: To report the profile of progressive MS at a reference center in Ceará. Methods: This observational and cross-sectional study was conducted through a review of medical records and interviews at a Reference Center for Demyelinating Diseases in the city of Fortaleza, Ceará. Results: From 283 patients with MS diagnosis according to the 2017 McDonald criteria, 36 (12.7%) had progressive phenotype, 20 (56%) secondary progressive and 16 (44%) primary progressive. From those 36 patients currently followed up, 25 (69.4%) were women, 19 (52.8%) were caucasian and 18 (50%) were high educated. The median follow-up time was five years and the peak prevalence was between the 4th and 5th decades. Regarding disability, 27.8% already used support in the first assessment (EDSS 6.0), and in the last assessment, considering the last EDSS recorded, the percentage of patients in need of support almost doubled: 52.8%. Regarding the first disease-modifying drugs (DMD), there was a prevalence of interferons, considering that it was the most used class in the 1990s. Considering the current DMD, there is a prevalence of monoclonal antibodies (47%), with Natalizumab (25%) and Ocrelizumab (22%). In a comparative analysis, there is a drop in the use of interferons (8%). Conclusion: Understanding the clinical-epidemiological profile of MS patients with a progressive phenotype is essential to guide the propaedeutic reasoning, guise the conduct and restructure the dynamics of health services.
A craniotomia se faz uma técnica terapêutica eficaz para doenças e lesões cerebrais, sendo a dor pós-operatória uma importante preocupação clínica nesse contexto, a qual atinge em torno de 86% dos pacientes submetidos à craniotomia. O presente estudo de revisão buscou avaliar novas evidências para o alívio da dor em pacientes submetidos à craniotomia, documentadas por meio de estudos clínicos e randomizados. Trata-se de uma pesquisa de revisão integrativa realizada por meio da base de dados PubMed, que levou em consideração os seguintes critérios de inclusão: ensaios clínicos e testes controlados e aleatórios; artigos publicados no último ano; que possuíam texto completo disponível e que abordassem acerca da analgesia em pacientes submetidos à craniotomia. Ficou constatado que a infiltração pós-operatória do couro cabeludo com bupivacaína pura reduz a intensidade da dor e a utilização de analgésicos opioides, sendo considerada uma técnica eficaz de controle da dor após uma craniotomia eletiva. Ademais, a combinação de ropivacaína com costicosteroides como o diprospan pode se tornar uma das estratégias utilizadas para controle da dor incisional em pacientes submetidos a craniotomia, conferindo à esta técnica a capacidade de promover alívio satisfatório da dor pós-operatória nesses pacientes. Por fim, foi verificado que, em comparação com a analgesia sistêmica, a analgesia regional pode auxiliar na redução da incidência e da gravidade da dor após uma craniotomia e a quantidade de analgesia de resgate usada em tais pacientes.
Introduction: Multiple sclerosis (MS) is an autoimmune, demyelinating, and inflammatory disease affecting the central nervous system. This condition has an unknown etiology and variable prevalence, being more common in young adult females. The prevalence of MS in childhood is low, ranging from 2% to 4% of all cases. Objectives: This study aims to describe the clinical development and symptoms of MS in children, contrasting them with the development of MS in adults. Dessign: This is an integrative literature review. Methods: Ten articles were selected from the PubMed and SciELO in English and Portuguese between 2010 and 2020. The keywords used were Multiple Sclerosis and Pediatric. Results: The prevalence of MS in children presenting with clinical symptoms is estimated to be between 2% and 5% of all MS cases. Despite variations in prevalence, the relapsing-remitting subtype and female predominance are similar to MS in adults. The female-to-male ratio ranges from 1.13:1 to 3.88:1. The relapsing-remitting subtype accounted for 85.7% to 100% of cases. While there is no typical presentation of clinical symptoms, optic neuritis, motor alterations, sensory changes, and cerebellum and brain stem dysfunctions are frequently reported. Unlike what is observed in adults, MS in children typically presents in a more diverse range of ways and progresses more rapidly and severely, with multifocal presentations. Also, children experience slower illness progression due to higher neuroplasticity but reach the impairment milestone before adults. Conclusion: The clinical presentation of multiple sclerosis in childhood is diverse, presenting different characteristics of adults. There is no consensus on the most prevalent symptoms. However, there are similarities in gender and subtype between children and adults with the disease.
Introduction: Multiple sclerosis (MS) is a chronic and demyelinating disease of the central nervous system. Among the symptoms that patients with MS may develop, depression stands out, which is associated with an important decline in quality of life. The presence of this symptom is associated with a worse prognosis. There is much support in the literature of the positive role that non-pharmacological measures play in controlling depression in patients with MS, with a range of options for the patient to choose from. Objectives: To analyze studies that deal with non-pharmacological therapeutic strategies against depression in patients with MS. Methods: This scientific article was written in the form of an integrative literature review, which used the databases of the Scielo and the PubMed as a source of extraction of publications. The keywords used were: “Multiple sclerosis”, “Depression” and “Complementary Therapies”’. Among the inclusion criteria, articles were included between the years 2015 and 2020, published in English or Portuguese, available in full and in the form of meta-analyzes, systematic reviews and randomized clinical trials. Results: The bibliographic survey carried out led to 15 scientific articles, all of which were randomized clinical trials and published in English. The articles reported that non-pharmacological interventions, such as Cognitive Behavioral Therapy, physical activity, yoga, Guided Imagery, mindfulness and diet, had positive effects on depressive symptoms in MS. Conclusion: The survey of data for the construction of the scientific article led to the conclusion that non-pharmacological measures play an important role in the control of depressive episodes in patients with MS. The combination of drug therapy and non-pharmacological practice leads to better responses.
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