Neuromyelitis optica spectrum disorder in a tertiary hospital in the Philippines: a case series

Espiritu, Adrian I.; Mesina, Bryan Vincent Q.; Puerto, Athena Angellie Dl.; Reyes, Nikolai Gil D.; Damian, Ludwig F.; Pascual, Jose Leonard R.

doi:10.1016/j.msard.2019.04.006

Cited by 8 publications

(4 citation statements)

References 17 publications

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“…Regardless of AQP4‐serostatus, acute myelitis was the predominant manifestation along the disease course, in 80% followed by optic neuritis in 74.4%. This was correlated with other studies reporting that the most common clinical core presentation along the disease course were acute myelitis ranging from 60% to 100% in populations with different racial backgrounds 43,45,48–50 …”

Section: Discussionsupporting

confidence: 88%

“…This was correlated with other studies reporting that the most common clinical core presentation along the disease course were acute myelitis ranging from 60% to 100% in populations with different racial backgrounds. 43,45,[48][49][50] Although patients' EDSS scores at the last follow up visit showed a wide variation ranging from 0 to 10 with a high mean score of 5.2 ± 2.6, no statistically significant differences could be found between the two groups. Similar scores were reported in studies from Africa, Latin America and Middle East.…”

Section: Discussionmentioning

confidence: 85%

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Radiological characteristics of neuromyelitis optica spectrum disorder in Egypt

Nasreldein

Farweez

El-Fetoh

et al. 2022

Clinical & Exp Neuroim

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Background Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune demyelinating disease of the central nervous system, which mainly affects the optic nerves and the spinal cord. Magnetic resonance imaging (MRI) plays an important role in the diagnosis of NMOSD based on the 2015 consensus criteria. Methods The objective of this study was to describe the MRI characteristics of NMOSD patients in Egypt. This were a prospective, observational study on patients fulfilling the 2015 diagnostic criteria of NMOSD. Patients were recruited consecutively from the Neurology, Psychiatry and Neurosurgery hospital, Assiut University Hospitals, Egypt from March 2019 until August 2020. Data on demographics, clinical and laboratory features were collected. MRI scan results were reviewed for each patient and compared according to Aquaporin4‐seropositivity. Results Ninety patients fulfilled NMOSD diagnostic criteria. The mean age at onset was 30.7±11.8 with a female predominance of 3:1. AQP4 antibodies were positive in 77/90 patients (85.6%). Seventy‐two patients (80%) had acute myelitis, 44 cases (61.1%) had longitudinally extensive transverse myelitis (LETM) and 61 cases (87.1%) had a central position in the cord. Bright spotty lesions (BSL) were found in 44 cases (61.1%). The most common site of cord involvement was the cervical region. Abnormal MRI brain scans were found in 81.1% of patients. No statistically significant differences could be found between the two groups. Conclusion There was a high frequency of abnormal spine and brain MRI findings in the Egyptian population. Even though no specific patterns were typical for AQP4‐specific serostatus, certain findings may suggest NMOSD diagnosis and warrant AQP4‐IgGs testing.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 85%

Radiological characteristics of neuromyelitis optica spectrum disorder in Egypt

Nasreldein

Farweez

El-Fetoh

et al. 2022

Clinical & Exp Neuroim

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“…: some studies are referred to as cohort studies when they are actually case series because the inquiring the population was carried out based on the outcome and, in consequence, it is discordant with the population assembly (the assembly is always made in the baseline state) and only a portion of the original cohort is available, which makes up a population of survivors that corresponds to a survivor case series. 21,22 If the candidate population is searched in the registry of patients attending for medical care at the moment of the research, all patients who died or who stopped attending for medical care for any reason within the previous period between what their baseline state was and the moment at which the investigation is carried out will have been left out. 23 Overestimation of the prognosis and therapeutic benefits are common problems deriving from this type of designs.…”

Section: Research Design Characteristics (Table 1)mentioning

confidence: 99%

Back to the clinic. Methods I. Research designs. Higher quality of information, more certainty to the answer

Talavera¹,

Roy-García²,

Palacios‐Cruz³

et al. 2023

GMM

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Research designs refer to the way information is obtained and are limited by ethical, economic and temporal viability. Research designs are standardized strategies to reduce biases, which in the architectural model of research are identified in the baseline state, the maneuver and the outcome; hence, there are no specific designs for each question. The design with the lowest probability of bias is the clinical trial, followed by cohort and case-control studies and, finally, by cross-sectional surveys. Among the main characteristics that give merit to research designs are the following: population inquiry, which refers to the situation of the population in relation to the clinical course/natural history of the disease; the maneuver, or action that is expected to modify the baseline state, which can be observational or experimental; follow-up, or documented monitoring that is given to each subject, which can be longitudinal or cross-sectional; and directionality, which can prolective or retrolective and refers to the timing of data collection for research purposes. It will always be better having a valuable question, even when answered with a design with higher risk of bias, than a question that is irrelevant or has no applicability.

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“…Frecuentemente se cometen errores y diseños que no corresponden se asumen como cohortes retrospectivas o históricas, por ejemplo: algunos estudios se refieren como cohorte cuando en realidad se trata de series de casos porque la pesquisa de la población se realizó partiendo del desenlace, en consecuencia resulta discordante con el ensamble de la población (el ensamble siempre se realiza en el estado basal) y solo se cuenta con una porción de la cohorte original, que conforma una población de sobrevivientes que corresponde a una serie de casos de sobrevivientes. 21,22 Si la población candidata se busca en el registro de pacientes asistentes a atención médica en el momento de la investigación, se habrán dejado fuera todos los pacientes que murieron o que dejaron de asistir a atención médica por cualquier razón en el periodo previo entre lo que fue su estado basal y el momento en el que se lleva a cabo la investigación. 23 La sobreestimación del pronóstico y de los beneficios de las terapias son problemas frecuentes derivados de este tipo de diseños.…”

Section: Características De Los Diseños De Investigación (Tabla 1)unclassified

De vuelta a la clínica. Métodos I. Diseños de investigación. Mayor calidad de información, mayor certeza a la respuesta

Talavera

Roy-García

Palacios‐Cruz

et al. 2019

GMM

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Los diseños de investigación se refieren a la forma como se obtiene la información y están limitados por viabilidad ética, económica y temporal. Son estrategias estandarizadas para disminuir los sesgos que en el modelo arquitectónico de la investigación se identifican en el estado basal, maniobra y desenlace; de ahí que no hay diseños específicos para cada pregunta. El diseño con menor probabilidad de sesgos es el ensayo clínico, seguido de la cohorte, el estudio de casos y controles y, finalmente, la encuesta transversal. Entre las principales características que dan mérito a los diseños están las siguientes: la pesquisa de la población, que se refiere a la ubicación de la población en relación con el curso clínico o historia natural de la enfermedad; la maniobra, o acción que se espera modifique la condición basal, que puede ser observacional o experimental; el seguimiento, o monitoreo documentado que se le da a cada sujeto, que puede ser longitudinal o transversal; y la direccionalidad, prolectiva o retrolectiva, que alude al tiempo de recopilación de la información con fines de investigación. Siempre será mejor tener una pregunta valiosa, incluso cuando se responda con un diseño con mayor riesgo de sesgos, que una pregunta irrelevante o sin aplicabilidad.

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Neuromyelitis optica spectrum disorder in a tertiary hospital in the Philippines: a case series

Cited by 8 publications

References 17 publications

Radiological characteristics of neuromyelitis optica spectrum disorder in Egypt

Radiological characteristics of neuromyelitis optica spectrum disorder in Egypt

Back to the clinic. Methods I. Research designs. Higher quality of information, more certainty to the answer

De vuelta a la clínica. Métodos I. Diseños de investigación. Mayor calidad de información, mayor certeza a la respuesta

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