El insomnio es el trastorno de sueño más frecuente y, a menudo, se encuentra asociado a otros trastornos mentales. El diagnóstico se realiza cuando la queja principal es un sueño no reparador o una dificultad para iniciar o mantener el sueño y dura, al menos, tres meses. El objetivo del presente artículo es describir los diferentes modelos del insomnio primario, así como las aproximaciones terapéuticas no farmacológicas derivadas de estos esquemas. Las modalidades más comunes de tratamiento incluyen enfoques de tipo comportamental, control de estímulos, restricción de sueño, higiene de sueño y relajación muscular progresiva. Al ser el insomnio una condición crónica, se recomiendan tratamientos a largo plazo con un alto perfil de seguridad.
This article describes the rationale for the development of the MSProDiscuss™ clinical decision support (CDS) tool, its development, and insights into how it can help neurologists improve care for patients with multiple sclerosis (MS). MS is a progressive disease characterized by heterogeneous symptoms and variable disease course. There is growing consensus that MS exists on a continuum, with overlap between relapsing–remitting and secondary progressive phenotypes. Evidence demonstrates that neuroaxonal loss occurs from the outset, that progression can occur independent of relapse activity, and that continuous underlying pathological processes may not be reflected by inflammatory activity indicative of the patient’s immune response. Early intervention can benefit patients, and there is a need for a tool that assists physicians in rapidly identifying subtle signs of MS progression. MSProDiscuss, developed with physicians and patients, facilitates a structured approach to patient consultations. It analyzes multidimensional data via an algorithm to estimate the likelihood of progression (the MSProDiscuss score), the contribution of various symptoms, and the impact of symptoms on daily living, enabling a more personalized approach to treatment and disease management. Data from CDS tools such as MSProDiscuss offer new insights into disease course and facilitate informed decision-making and a holistic approach to MS patient care.
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