Multiple sclerosis: report on 200 cases from Curitiba, Southern Brazil and comparison with other Brazilian series

A prevalência de esclerose múltipla (EM) varia consideravelmente no mundo. De acordo com Kurtzke, a América do Sul é considerada região de baixa prevalência (menor que 5 casos:100000 habitantes). OBJETIVO: Descrever a epidemiologia da EM em centro de referência, comparando-a aos achados de oito serviços nacionais. MÉTODO: Através de estudo de incidência, descritivo, prospectivo, longitudinal, foram analisados dados de 118 pacientes, atendidos no Centro de Referência para Atenção ao Paciente Portador de Doença Desmielinizante do Hospital da Restauração - Recife - PE - Brasil (CRAPPDD-HR), entre janeiro de 1987 e março de 2002, com diagnóstico de EM, segundo critérios de Poser. RESULTADOS: Os pacientes foram acompanhados por um a 15 anos. Noventa e cinco (80,5%) pacientes estavam em tratamento específico com imunomoduladores. A prevalência foi igual a 1,36:100000 habitantes. Identificaram-se: predomínio da etnia parda (110 casos, 93,2%); 82 (82,2%) casos clinicamente definidos, 15 (12,7%) laboratorialmente definidos e 6 (5,1%) clinicamente prováveis; número máximo de surtos igual a 46; maior número de casos com EDSS leve, assim como um a 10 anos de doença na forma surto/remissão (SR). A razão de gênero dos 83 casos da forma SR se equivaleu à geral (4,1:1), contudo na forma SR com progressão secundária houve predomínio duas vezes maior para o sexo feminino e na forma primariamente progressiva, 5,5 vezes maior para o sexo masculino. CONCLUSÃO: Apesar da presente pesquisa ter se assemelhado aos oito estudos utilizados para comparação, as diferenças constatadas irão requerer novas pesquisas e novas abordagens.

Section: Discussionunclassified

“…A incidência de formas benignas, definidas segundo Noseworthy et al 2 , assemelhou-se à referida por Arruda et al 9 , igual a 7,0%, significando que, mesmo no curso longo de doença, esses pacientes manterão boa qualidade de vida em virtude de baixas perdas devidas à EM 17 .…”

Section: Discussionunclassified

Epidemiologia de 118 casos de esclerose múltipla com seguimento de 15 anos no centro de referência do Hospital da Restauração de Pernambuco

Ferreira

Machado

Vilela

et al. 2004

“…Yet, most investigations have focused on clinical description of hospital-based or MS Centers cohorts in different parts of the country [9][10][11][12][13][14][15][16] . Other studies have concentrated on the association with HLA 17, 18 , the influence of ethnic factors on the phenomenological presentation of the disease 19 ; the neuropsychological aspects of the disease 20,21 and the impact of the disease on patients' quality of life 22 .…”

mentioning

confidence: 99%

The prevalence of multiple sclerosis in Belo Horizonte, Brazil

Lana-Peixoto

Frota

Campos

et al. 2012

Multiple sclerosis (MS) is a demyelinating inflammatory and degenerative disease of the central nervous system (CNS) whose etiology is still unknown. Epidemiological studies have suggested that the interaction between genetic susceptibility and a variety of environmental factors may play a key role accounting for the differences in its prevalence in distinct populations 1 .In the last few decades, a large number of studies have demonstrated the frequency of MS in all continents 2 . Unfortunately, however, many of these epidemiological studies lack consistent methodological features, such as strict diagnostic criteria, well defined study populations or geographical areas, and complete case ascertainment 3 . Such faults have rendered their results unreliable for comparisons with established data from other geographical areas 2,3 . In Latin America, surveys on the epidemiology of MS are still scanty and most of them exhibit these methodological limitations [4][5][6][7][8] .Interest in the study of MS in Brazil has markedly increased in the last few years. Yet, most investigations have focused on clinical description of hospital-based or MS Centers cohorts in different parts of the country [9][10][11][12][13][14][15][16] . Other studies have concentrated on the association with HLA 17,18 , the influence of ethnic factors on the phenomenological presentation of the disease 19 ; the neuropsychological aspects of the disease 20,21 and the impact of the disease on patients' quality of life 22 .Three papers on the prevalence of MS in well-defined geographical areas in Brazil have been so far published. The first study, in São Paulo city, considered 1990 as the prevalence year and showed a prevalence rate of 4.3 per 100,000 inhabitants 23 . A re-evaluation of this prevalence rate by the same senior author 24 took 1997 as the prevalence year and, through the use of aBstract Investigations on the prevalence rates of multiple sclerosis (MS) around the world have yielded important clues on the interplay between genetic susceptibility and environmental factors. As Brazil is a huge country laid on many latitudes and inhabited by population with distinct ethnic backgrounds, it might be assumed that the frequency of MS varies in its different regions. Objective: To determine the prevalence rate of MS in Belo Horizonte, the capital of the State of Minas Gerais, Southeastern Brazil. Methods: We used six sources to draw up a provisional list of identified cases of MS. Only patients with diagnosis of clinically definite MS according to Poser Committee criteria were included. Results: The calculated crude MS prevalence was 18.1/100,000 inhabitants. Conclusions: The MS prevalence in Belo Horizonte is similar to that found in São Paulo and Botucatu, two other cities in southeastern Brazil with similar ethnic background.Key words: multiple sclerosis, prevalence, Belo Horizonte, Southeastern Brazil.resumo Estudos sobre as taxas de prevalência da esclerose múltipla (EM) no mundo têm fornecido importantes evidências do papel da inter-relaçã...

“…Epidemiologic studies in many Brazilian regions have been published [2][3][4][5][6][7][8][9][10][11][12] presenting demographic and clinical characteristics of treated patients at different clinics and hospitals. Nevertheless, there are no published data on MS patients in the state of Rio Grande do Sul.…”

mentioning

confidence: 99%

Clinical features of multiple sclerosis in the south of Brazil: a partial analysis

Finkelsztejn

Cristovam

Moraes

et al. 2009

-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.