Two decades of soldiers’ medical records implicate common virus in multiple sclerosis

2022 ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Medical Records

scholarly journals Multiple sclerosis relapse risk in the postoperative period: Effects of invasive surgery and anesthesia

2019 ◽  
Vol 26 (11) ◽  
pp. 1437-1440
Author(s):  
Lindsey B De Lott ◽  
Samantha Zerafa ◽  
Kerby Shedden ◽  
Galit Levi Dunietz ◽  
Michelle Earley ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Logistic Regression ◽  
Medical Records ◽  
Odds Ratio ◽  
Conditional Logistic Regression ◽  
Unadjusted Odds Ratio ◽  
Relapse Risk ◽  
Multiple Sclerosis Relapse ◽  
Period Effects ◽  
Tertiary Center

Background: Postoperative multiple sclerosis (MS) relapses are a concern among patients and providers. Objective: To determine whether MS relapse risk is higher postoperatively. Methods: Data were extracted from medical records of MS patients undergoing surgery at a tertiary center (2000–2016). Conditional logistic regression estimated within-patient unadjusted and age-adjusted odds of postoperative versus preoperative relapse. Results: Among 281 patients and 609 surgeries, 12 postoperative relapses were identified. The odds of postoperative versus preoperative relapse in unadjusted (odds ratio (OR) = 0.56, 95% confidence interval (CI) = 0.18–1.79; p = 0.33) or age-adjusted models (OR = 0.66, 95% CI = 0.20–2.16; p = 0.49) were not increased. Conclusions: Surgery/anesthesia exposure did not increase postoperative relapse risk. These findings require confirmation in larger studies.

scholarly journals Assessment of treatment patterns associated with injectable disease-modifying therapy among relapsing–remitting multiple sclerosis patients

2017 ◽  
Vol 3 (1) ◽  
pp. 205521731769611 ◽  
Author(s):  
J Nicholas ◽  
JJ Ko ◽  
Y Park ◽  
P Navaratnam ◽  
HS Friedman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Medical Records ◽  
Treatment Patterns ◽  
Oral Disease ◽  
Disease Modifying Therapy ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
Remitting Multiple Sclerosis ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis

Background Availability of oral disease-modifying therapy (DMT) for relapsing–remitting multiple sclerosis (RRMS) may affect injectable DMT (iDMT) treatment patterns. Objective The objective of this paper is to evaluate iDMT persistency, reasons for persistency lapses, and outcomes among newly diagnosed RRMS patients. Methods Medical records of 300 RRMS patients initiated on iDMT between 2008 and 2013 were abstracted from 18 US-based neurology clinics. Eligible patients had ≥3 visits: pre-iDMT initiation, iDMT initiation (index), and ≥1 visit within 24 months post-index. MS-related symptoms, relapses, iDMT treatment patterns (i.e. persistency, discontinuation, switching, and restart), and reasons for non-persistency were tracked for 24 months. Results At 24 months, iDMT persistency was 61.0%; 28.0% of patients switched to another DMT, 8.0% discontinued, and 3.0% stopped and restarted the same iDMT. The most commonly identified reasons for non-persistency were perceived lack of efficacy (22.2%), adverse events (18.8%), and fear of needles/self-injecting (9.4%). At 24 months, 38.0% of patients had experienced a relapse and 11.0% had changes in MRI lesion counts. Patients without MS-related symptoms at index reported increases in the incidence of these symptoms at 24 months. Conclusions Non-persistency with iDMT remains an issue in the oral DMT age. Many patients still experienced relapses and disease progression, and should consider switching to more effective therapies.

scholarly journals Optic Nerve and Spinal Cord Are the Major Lesions in Each Relapse of Japanese Multiple Sclerosis

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Yoko Warabi
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Optic Nerve ◽  
Medical Records ◽  
Age At Onset ◽  
Demyelinating Diseases ◽  
Brainstem Lesion ◽  
Spinal Lesions ◽  
Initial Symptoms ◽  
Relapsing Remitting

For the purpose of predicting multiple sclerosis (MS) and neuromyelitis optica (NMO) relapses in Japanese population, we evaluated the localization and age of each demyelinating attack. We retrospectively analyzed the 78 medical records of Japanese MS and NMO patients. Then we identified 49 cases of relapsing-remitting-type patients and defined each of 116 demyelinating attacks. NMO had an older age at onset than MS, although the initial symptoms cannot predict the clinical phenotypes. Only 21.3% of demyelinating attacks were localized in the cerebrum and 78.7% were optic-spinal lesions, although MS comprised 70% and NMO comprised 30% of these 78 cases. Brainstem lesion had a relative male predominancy and a young age at attack. Our findings showed that optic nerve and spinal cord lesions are the major and critical lesions in each attack of Japanese CNS demyelinating diseases. There might be distinctive Japanese pathogenic features even in Western type MS.

scholarly journals Perspectives on illness-related stigma and electronically sharing psychiatric health information by people with Multiple Sclerosis.

2020 ◽  
Author(s):  
Eileen Yu ◽  
Alexis Adams-Clark ◽  
Alison Riehm ◽  
Caroline Franke ◽  
Ryoko Susukida ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Information ◽  
Electronic Medical Records ◽  
Psychiatric Diagnosis ◽  
Medical Records ◽  
Psychiatric Diagnoses ◽  
Sexual Anxiety ◽  
Related Stigma ◽  
Societal Stigma ◽  
Patient Willingness

Abstract Background: Electronic medical records (EMRs) have transformed the way healthcare professionals manage and share patient data while providing integrated and comprehensive care. However, the rate of EMR use among psychiatrists is generally lower compared to physicians in other medical disciplines, in part due to concerns over patients’ experience of stigma surrounding mental health. This paper explores the willingness to share medical records among people with multiple sclerosis (MS), who experience higher rates of psychiatric comorbidities compared to the general population. It also examines the role that stigma plays in patients’ preferences regarding the sharing of their electronic medical records. Methods: MS patients were surveyed regarding their co-occurring psychiatric and non-psychiatric diagnoses, willingness to share their health information electronically among their treating doctors, and levels of self and societal stigma associated with their various co-occurring diagnoses. Results: 96.44% and 87.14% of participants were willing to share their non-psychiatric and psychiatric diagnoses, respectively; 97.70% and 92.78% were willing to share non-psychiatric and psychiatric medications, respectively. MS patients with a psychiatric co-occurring diagnosis, compared to those without, were significantly more likely to share their psychiatric diagnosis (AOR = 2.59) and psychiatric medications (AOR = 3.19). Those with both non-psychiatric and psychiatric co-occurring diagnoses were significantly more likely to share their psychiatric diagnosis (AOR = 3.84) and psychiatric medications (AOR = 7.02) than patients with no co-occurring diagnosis other than MS. Five (substance use, personality, eating, psychotic, and neurodevelopmental disorders) of the top six diagnoses for which societal stigma was greater than self stigma, and three (sexual, anxiety, and mood disorders) of the top five diagnoses for which self stigma was greater than societal stigma were psychiatric diagnoses. High levels of societal stigma correlated with decreased likelihood in sharing non-psychiatric medications, while high levels of self stigma were associated with a greater decrease in patient willingness to share psychiatric medications. Conclusions: Despite the presence of stigma decreasing patient willingness to share medical records, people with MS who had psychiatric disorders, compared to those without, endorsed greater willingness to share their health records electronically.

scholarly journals Survival following the placement of gastrostomy tube in patients with multiple sclerosis

2020 ◽  
Vol 6 (1) ◽  
pp. 205521731990090
Author(s):  
Lisa Grandidge ◽  
Chayaporn Chotiyarnwong ◽  
Sean White ◽  
Jessica Denning ◽  
Krishnan Padmakumari Sivaraman Nair
Keyword(s):  
Multiple Sclerosis ◽  
Medical Records ◽  
Cox Regression ◽  
Gastrostomy Tube ◽  
Specific Information ◽  
Death Certificates ◽  
Younger Patients ◽  
Cox Regression Analysis ◽  
Duration Of Hospital Stay ◽  
Disease Specific

Background Around a third of people with multiple sclerosis (MS) experience dysphagia. There is a need for disease-specific information on survival following placement of gastrostomy tube in people with MS. Objective We aimed to study survival following gastrostomy in patients with MS. Methods We reviewed medical records, home enteral feeding database and death certificates of people with MS who had gastrostomy from 2005 to 2017. Cox regression analysis was performed to identify independent predictors associated with mortality after gastrostomy. Results Median survival of 53 patients with MS after gastrostomy was 21.73 months. Median duration of hospital stay after gastrostomy was 14 days (IQR 5.25, 51.5). Survival at 30 days, 3 months, 1, 2, 5 and 10 years were 100% (53/53), 98.1% (52/53), 81.1% (43/53), 54.7% (29/53), 22.4% (11/49) and 6.8% (3/44), respectively. Of 53 patients, 24 died due to respiratory tract infection. Patients who had gastrostomy tube before 50 years of age survived longer (median 28.48 months) compared with those who had the gastrostomy after age 50 years (median 17.51 months) ( p = 0.040). Conclusion Around 54% of patients with MS survived two or more years following gastrostomy. Younger patients had better survival. The most frequent cause of death was respiratory infection.

Estimating the prevalence and incidence of multiple sclerosis in the Lorraine region, France, by the capture–recapture method

2012 ◽  
Vol 18 (9) ◽  
pp. 1244-1250 ◽  
Author(s):  
Haritina El Adssi ◽  
Marc Debouverie ◽  
Francis Guillemin ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Medical Records ◽  
Linear Models ◽  
Health Insurance System ◽  
Regional Health ◽  
Crude Incidence ◽  
Capture Recapture ◽  
Log Linear ◽  
Incident Cases ◽  
Crude Prevalence

Objective: The objective of this study was to assess the prevalence and incidence of multiple sclerosis (MS) in the Lorraine region, in France. Methods: Data from three sources – Regional Health Insurance System, medical records departments and the Lorraine registry of MS – and a capture–recapture method with log-linear models were used to estimate the prevalence and incidence of MS. Results: We identified 7193 records of reported MS corresponding to 4299 unique suspected cases of MS existing on 31 December 2008, in Lorraine. On the basis of the 4001 validated cases, the observed crude prevalence of MS was 170.9 cases per 100,000 inhabitants (95% confidence interval [CI]: 165.7; 176.3), and the observed annual crude incidence of MS was 4.4 cases per 100,000 inhabitants (95% CI: 3.6; 5.4). With the capture–recapture method, the estimated prevalence of MS was 4405.7 (95% CI: 4261.5; 4629.7), so an estimated 405 cases were not identified by the three sources. The estimated prevalence was 188.2 cases per 100,000 inhabitants (95% CI: 182.7; 193.8), and the estimated annual incidence was 8.5 cases per 100,000 inhabitants (95% CI: 7.3; 9.7). Conclusions: The capture–recapture method allowed us to estimate an additional 10.1% of unobserved prevalent cases and to anticipate 47.5% of unobserved incident cases.

scholarly journals Electronic medical records in multiple sclerosis research

2018 ◽  
Vol 9 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Vincent Damotte ◽  
Pierre-Antoine Gourraud
Keyword(s):  
Multiple Sclerosis ◽  
Electronic Medical Records ◽  
Medical Records

scholarly journals Incidence of Optic Neuritis and the Associated Risk of Multiple Sclerosis for Service Members of U.S. Armed Forces

2021 ◽  
Author(s):  
Weidong Gu ◽  
Nathan T Tagg ◽  
Nileshkumar L Panchal ◽  
Cherrishe A Brown-Bickerstaff ◽  
Julie M Nyman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Medical Records ◽  
Vision Loss ◽  
Armed Forces ◽  
Service Members ◽  
Identification Algorithm ◽  
Case Identification ◽  
Conversion Rates ◽  
The U.S

ABSTRACT Introduction Optic neuritis (ON), an acute inflammation of the optic nerve resulting in eye pain and temporary vision loss, is one of the leading causes of vision-related hospital bed days in the U.S. Military and may be a harbinger of multiple sclerosis (MS). We developed a case identification algorithm to estimate incidence rates of ON and the conversion rate to MS based on a retrospective assessment of medical records of service members (SMs) of the U.S. Armed Force. Materials and Methods Electronic medical records (EMRs) from 2006 to 2018 in the Defense Medical Surveillance System were screened using the case identification algorithms for ON and MS diagnosis. The incidences rates of ON were calculated. The rates of conversion to MS was modeled using the Kaplan–Meier survival analysis. Results The overall incidence rate of ON was 8.1 per 100,000 from 2006 to 2018. Females had a rate (16.9 per 100,000) three times higher than males. Most (68%) of subsequent diagnoses of MS were made within 1 year after diagnosis of ON. The overall 5-year risk of progression to MS was 15% (11%–16% for 95% CI). The risk of conversion to MS in females was significantly higher than in males. Conclusions We developed an efficient tool to explore the EMR database to estimate the burden of ON in the U.S. Military and the MS conversion based on a dynamic cohort. The estimated conversion rates to MS feeds into inform retention and fitness-for-duty policy in these SMs.

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