Thursday, August 23, 2018

No Evidence of Disease Activity after Five Years of Autologous Hematopoietic Stem Cell Therapy for Multiple Sclerosis: Detailed Report of Five Patients

Background:: Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system. Its treatment has focused on inflammation control as early as possible to avoid disability. Autologous hematopoietic stem cell transplantation (AHSCT) has been used for treating MS since 1996 without decisive results regarding benefits or long-term efficacy. We report the follow-up of five patients who were evaluated for up to five years after the stem cell transplantation treatment and who did not present any disease activity.
Methods: Five patients followed up at an MS center in Belo Horizonte, Brazil, who had relapsing-remitting MS with high disease activity, underwent AHSCT from 2009 to 2011. They were evaluated clinically, with magnetic resonance imaging, and by the Expanded Disability Status Scale, every six months and up to five years after transplantation.
Results: The patients in our study comprised four women and one man, with age ranging from 25 to 50 years, and time since disease onset ranging from 4 to 17 years at the time of the procedure. Four patients improved, one patient was stabilized, and all patients continued to be free of disease activity after 5 years.
Discussion:: Through improving patient selection and decreasing the time since disease onset, AHSCT could stop epitope spreading and disease progression. Despite multiple other therapeutic choices, AHSCT is a treatment to consider for aggressive MS disease.
Keywords: Stem cell; Autologous Transplant; Multiple Sclerosis Treatment; NEDA

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Friday, September 2, 2016

Journal of Nutrition and Obesity

Dr. Katsunori Nonogaki is a specialist of Diabetes care and Internal medicine. He received PhD in Endocrinology, Metabolism, and Diabetes from Nagoya University Graduate School of Medicine, Japan. His research has mainly focused on “the role of the central nervous system in the regulation of hepatic glucose production”.

Journal of Gastroenterology and Metabolism

Dr. Pia Munkholm currently working as a professor in the Department of Gastroenterology at the University Of Copenhagen, Denmark. She is a member of many gastroenterology associations i.e., American Gastroenterology Association as Fellow, Member of EC-IBD, European Collaborative study group of Inflammatory Bowel Disease. She has received several honors. She is serving as a referee for different international gastroenterology journals. She has many scientific publications and abstracts presented at international scientific meetings.

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Journal of Pediatric Disorders and Neonatal Care

Dr. Mirko Bertozzi is currently working as an Associate professor in the Department of Pediatric Surgery at S. Maria Della Misericordia Hospital in the University of Perugia, Italy. He received his Ph.D in Pediatric Surgery from the University of Bologna, Italy. He is an Executive board member for the Italian Society of Pediatric Video surgery –SIVI and he also serves as an associate member for Italian, European pediatric societies and Italian Group of Endoscopic Mini invasive Pediatric surgery.

Friday, June 3, 2016

A Case Report of Psychosis in a Patient of Myxedema: Myxedema Madness

Hypothyroidism is one of the most important causes of organic psychosis and sometimes can be missed. There are some cases showing extreme degree of hypothyroidism leading to psychiatric illnesses like mania, depression and psychosis. In present case, a 21year old well-functioning female developed hypothyroidism initially with symptoms of Myxedema which was undiagnosed for 2 years. She had psychotic features after 2 years in form of hallucinatory behavior, poor self-care, persecutory and referential delusions, episodes of violent behavior and suicidal attempts. Thyroid supplementation was given in therapeutic dose but there was no improvement in her clinical profile. It was decided by experts to add antidepressant and antipsychotic medicines. Patient had marked improvement. She started talking with family, her aggression subsided. Only persecutory delusion and memory impairment persisted so doses of antipsychotic medicine was gradually built up. 

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Administration of Vasoconstrictor, But Not Volume Expander Prevents Maternal Hypotension During Spinal-Epidural Anesthesia For Elective Cesarean Section

Administration of vasoconstrictor preventing maternal hypotension after combined spinal-epidural , anesthesia(CSEA) in elective cesarean section patients.A total of 240 full-term, single pregnancy women, undergoing elective cesarean section in CSEA were included. Multiple linear regression analysis was used to identify major contributing factors for maternal hypotension from 18 independent variables. The model was set as ╬▒entry= 0.05, ╬▒remove = 0.15, and condition index <15. The incidence of hypotension from different combinations of vasoconstrictors for hypotension prevention were calculated and compared, then correlated with pH and base excess in neonatal umbilical venous blood, as well as 1 and 5 min Apgar score, using one-way ANOVA. p<0.05 was considered to be significant difference. Continuous dosage of phenylephrine decrease incidence of maternal hypotension after CSEA for elected cesarean section.

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