High Prevalence and Fast Rising Incidence of Multiple Sclerosis in Caltanissetta, Sicily, Southern Italy

2006 ◽  
Vol 28 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Luigi M.E. Grimaldi ◽  
Barbara Palmeri ◽  
Giuseppe Salemi ◽  
Giuseppe Giglia ◽  
Marco D’Amelio ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Southern Italy ◽  
High Prevalence ◽  
Rising Incidence

scholarly journals Hepatitis C virus infection and risk of liver-related and non-liver-related deaths: a population-based cohort study in Naples, southern Italy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pierluca Piselli ◽  
Diego Serraino ◽  
Mario Fusco ◽  
Enrico Girardi ◽  
Angelo Pirozzi ◽  
...  
Keyword(s):  
Southern Italy ◽  
Population Based ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Risk Of Death ◽  
High Prevalence ◽  
Specific Mortality ◽  
Chronic Hcv Infection ◽  
Chronic Hcv ◽  
Related Mortality

Abstract Background Hepatitis C virus (HCV) infection represents a global health issue with severe implications on morbidity and mortality. This study aimed to evaluate the impact of HCV infection on all-cause, liver-related, and non-liver-related mortality in a population living in an area with a high prevalence of HCV infection before the advent of Direct-Acting Antiviral (DAA) therapies, and to identify factors associated with cause-specific mortality among HCV-infected individuals. Methods We conducted a cohort study on 4492 individuals enrolled between 2003 and 2006 in a population-based seroprevalence survey on viral hepatitis infections in the province of Naples, southern Italy. Study participants provided serum for antibodies to HCV (anti-HCV) and HCV RNA testing. Information on vital status to December 2017 and cause of death were retrieved through record-linkage with the mortality database. Hazard ratios (HRs) for cause-specific mortality and 95% confidence intervals (CIs) were estimated using Fine-Grey regression models. Results Out of 626 deceased people, 20 (3.2%) died from non-natural causes, 56 (8.9%) from liver-related conditions, 550 (87.9%) from non-liver-related causes. Anti-HCV positive people were at higher risk of death from all causes (HR = 1.38, 95% CI: 1.12–1.70) and liver-related causes (HR = 5.90, 95% CI: 3.00–11.59) than anti-HCV negative ones. Individuals with chronic HCV infection reported an elevated risk of death due to liver-related conditions (HR = 6.61, 95% CI: 3.29–13.27) and to any cause (HR = 1.51, 95% CI: 1.18–1.94). The death risk of anti-HCV seropositive people with negative HCV RNA was similar to that of anti-HCV seronegative ones. Among anti-HCV positive people, liver-related mortality was associated with a high FIB-4 index score (HR = 39.96, 95% CI: 4.73–337.54). Conclusions These findings show the detrimental impact of HCV infection on all-cause mortality and, particularly, liver-related mortality. This effect emerged among individuals with chronic infection while those with cleared infection had the same risk of uninfected ones. These results underline the need to identify through screening all people with chronic HCV infection notably in areas with a high prevalence of HCV infection, and promptly provide them with DAAs treatment to achieve progressive HCV elimination and reduce HCV-related mortality.

scholarly journals The Role of the Primary-Care Physician in Treating Relapses in Multiple Sclerosis Patients

2009 ◽  
Vol 11 (3) ◽  
pp. 122-126 ◽  
Author(s):  
Sarah A. Morrow ◽  
Marcelo Kremenchutzky
Keyword(s):  
Multiple Sclerosis ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Tertiary Care ◽  
Care Physician ◽  
Diagnosis And Treatment ◽  
High Prevalence ◽  
Tertiary Care Centers ◽  
Multiple Sclerosis Patients

Multiple sclerosis (MS) is a common disabling neurologic disease with an overall prevalence in Canada of 240 in 100,000. Multiple sclerosis clinics are located at tertiary-care centers that may be difficult for a patient to access during an acute relapse. Many relapses are evaluated by primary-care physicians in private clinics or emergency departments, but these physicians' familiarity with MS is not known. Therefore, a survey was undertaken to determine the knowledge and experience of primary-care physicians regarding the diagnosis and treatment of MS relapses. A total of 1282 licensed primary-care physicians in the catchment area of the London (Ontario, Canada) Multiple Sclerosis Clinic were identified and mailed a two-page anonymous survey. A total of 237 (18.5%) responses were obtained, but only 216 (16.8%) of these respondents were still in active practice. Of these 216 physicians, only 9% reported having no MS patients in their practice, while 70% had one to five patients, 16.7% had six to ten, and 1.9% had more than ten (3.7% did not respond to this question). Corticosteroids were recognized as an MS treatment by 49.5% of the respondents, but only 43.1% identified them as a treatment for acute relapses. In addition, 31% did not know how to diagnose a relapse, and only 37% identified new signs or symptoms of neurologic dysfunction as indicating a potential relapse. Despite the high prevalence of MS in Canada, primary-care physicians require more education and support from specialists in MS care regarding the diagnosis and treatment of MS relapses.

Increasing incidence of multiple sclerosis in women in Northern Finland

2010 ◽  
Vol 17 (2) ◽  
pp. 133-138 ◽  
Author(s):  
O Krökki ◽  
R Bloigu ◽  
M Reunanen ◽  
AM Remes
Keyword(s):  
Multiple Sclerosis ◽  
Geographical Location ◽  
Epidemiological Studies ◽  
The Arctic ◽  
Time Intervals ◽  
The Past ◽  
Mcdonald Criteria ◽  
Epidemiological Features ◽  
High Prevalence ◽  
The Mean

Background: The geographical distribution of multiple sclerosis (MS) means that prevalence rates increase with latitude north or south of the equator. Temporally, a tendency for increased incidences of MS has been observed over the past two decades. Objectives: Since epidemiological studies of MS in areas close to the Arctic Circle are rare, we evaluated the incidence and prevalence of MS in Northern Ostrobothnia by means of a retrospective cohort study covering the period 1992–2007. Methods: Patients with a definite clinical diagnosis of MS based on the Poser criteria and the early McDonald criteria of 2001 were identified in the region of Northern Ostrobothnia (population 386,972) and the incidence was calculated at 1-year time intervals, both overall and by gender. Results: The overall prevalence was 103/100,000 (95% CI, 93–113), with a female/male ratio of 2.17. The mean overall incidence was 6.3/100,000 (95% CI, 5.2–7.2). The incidence shows a tendency to increase over the 16-year period due to a pronounced rise in the female incidence. Conclusions: Our results show a high prevalence of MS in Northern Ostrobothnia and a disproportional increase in the female MS incidence. These recent epidemiological features may be associated with environmental risk factors such as a vitamin D deficit, low life-long UV radiation and the high-latitude geographical location.

Neurogenic lower urinary tract dysfunction in the early disease phase of paediatric multiple sclerosis

2016 ◽  
Vol 22 (11) ◽  
pp. 1490-1494 ◽  
Author(s):  
Jeroen R Scheepe ◽  
Yu Yi M Wong ◽  
E Daniëlle van Pelt ◽  
Immy A Ketelslegers ◽  
Coriene E Catsman-Berrevoets ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Upper Urinary Tract ◽  
Lower Urinary Tract Dysfunction ◽  
Early Disease ◽  
High Prevalence ◽  
Potential Damage ◽  
Urinary Problems ◽  
Lower Urinary

Neurogenic lower urinary tract dysfunction (LUTD) in multiple sclerosis (MS) is highly prevalent in adults, but has not previously been described in paediatric MS. A total of 24 consecutive children with newly diagnosed MS were prospectively assessed for bladder and bowel problems early after diagnosis. Five of 24 children (21%) showed LUTD during assessment. One of these patients did not report voiding complaints. This high prevalence of LUTD indicates that all recently diagnosed patients with paediatric MS should be evaluated early in their disease and treated for urinary problems in order to prevent potential damage to the upper urinary tract.

scholarly journals Adding to the Burden: Gastrointestinal Symptoms and Syndromes in Multiple Sclerosis

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
David J. Levinthal ◽  
Ambreen Rahman ◽  
Salman Nusrat ◽  
Margie O’Leary ◽  
Rock Heyman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Fecal Incontinence ◽  
Functional Dyspepsia ◽  
Gastrointestinal Symptoms ◽  
Functional Constipation ◽  
Full Extent ◽  
Gi Symptoms ◽  
High Prevalence ◽  
Dyspeptic Symptoms ◽  
Routine Assessment

Background. Multiple sclerosis (MS) patients often suffer from gastrointestinal (GI) symptoms. However, the full extent and prevalence of such symptoms are not clearly established. Thus, we sought to define the prevalence of GI symptoms and syndromes in those with MS.Methods. 218 MS patients completed self-reported demographic and clinical data questionnaires as well as several standardized surveys probing MS severity and GI health.Results. Nearly two thirds (65.6%) of patients endorsed at least one persistent GI symptom. Constipation (36.6%), dysphagia (21.1%), and fecal incontinence (15.1%) were common. Surprisingly, nearly 30% (28.4%) of the patients reported dyspeptic symptoms. Using validated diagnostic algorithms, patients met criteria for functional dysphagia (14.7%), functional dyspepsia (16.5%), functional constipation (31.7%), and IBS (19.3%), among others. Functional dysphagia, functional dyspepsia, and IBS were significantly more common in those with self-identified mood disorders.Conclusions. Constipation, fecal incontinence, and dysphagia are indeed frequent symptoms seen in MS patients. We also noted a ~30% prevalence of dyspepsia in this population. The mechanisms driving this association are not clear and require further study. However, due to this high prevalence, dyspeptic symptoms should be incorporated into the routine assessment of MS patients and, if found, may warrant collaborative referral with a GI specialist.

Urinary Tract Infection in Patients with Multiple Sclerosis: An Overview

2020 ◽  
Author(s):  
Washigton Luiz Gomes de Medeiros Junior ◽  
Caio Cesar Demore ◽  
Larissa Peres Mazaro ◽  
Matheus Fellipe Nascimento de Souza ◽  
Laura Fiuza Parolin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Mortality Rate ◽  
Tract Infection ◽  
Neurological Complications ◽  
Search Terms ◽  
Group Methods ◽  
High Prevalence ◽  
The Central Nervous System

Introduction: Multiple sclerosis (MS) is a demyelinating, chronic, inflammatory and autoimmune disease of the central nervous system (CNS) with axonal degeneration, presenting a progressive and variable course. MS patients usually have complications, such as bladder dysfunction, presence of urinary symptoms and Urinary Tract infection (UTI), which is one of the three most common non-neurological complications in MS patients. Objective: Analyze the most diverse aspects of UTI in MS patients, focusing on risk factors, prevalence, hospitalization and mortality rates of UTIs in this group. Methods: A non-systematic review of articles published on PubMed in the last 10 years with the search terms "Urinary Tract Infection" AND "Multiple Sclerosis". Discussion: MS patients have a high UTI prevalence, mainly due to the occurrence of urinary disorders in these patients. The most common symptoms of UTI in MS patients are urinary urgency, polyuria, nocturia, urinary retention, and incontinence. Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the most found organisms and treatment is based on antibiotic therapy. Moreover, UTIs can precipitate outbreaks, worsen the disease, causing more damage and a severe neurological condition deterioration. Therefore, UTIs in this group are associated with a high hospitalizations rate and a high mortality rate. Conclusion: UTI represents a great risk and concern in MS patients. The high prevalence, hospitalization rate and mortality rate of UTI in MS is worrying, such as the cause-consequence relationship between UTIs and the use of corticosteroids in outbreaks. Therefore, it is important to be aware of a UTI in this group to make early diagnoses, adequate management, and new infections prevention. Thus, further studies are needed to thoroughly analyze each nuance of this important comorbidity for MS patients.

High prevalence of restless legs syndrome in multiple sclerosis

2007 ◽  
Vol 14 (5) ◽  
pp. 534-539 ◽  
Author(s):  
M. Manconi ◽  
M. Fabbrini ◽  
E. Bonanni ◽  
M. Filippi ◽  
M. Rocca ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Restless Legs Syndrome ◽  
Restless Legs ◽  
High Prevalence

scholarly journals High prevalence and indexes of anti-John Cunningham virus antibodies in a cohort of Chinese patients with multiple sclerosis

2018 ◽  
Vol 4 (3) ◽  
pp. 205521731878869 ◽  
Author(s):  
Alexander Lau ◽  
Wei Qiu ◽  
Allan Kermode ◽  
Cheryl Au ◽  
Angel Ng ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cross Sectional Study ◽  
Chinese Patients ◽  
Virus Antibody ◽  
Cross Sectional ◽  
John Cunningham Virus ◽  
High Prevalence ◽  
Scale Scores ◽  
Disease Modifying ◽  
Multiple Sclerosis Patients

We performed a cross-sectional study in 123 Chinese multiple sclerosis patients residing in Hong Kong to evaluate their anti-John Cunningham virus status using STRATIFY JCV DxSelect assays. Anti-John Cunningham virus antibody was present in 98/123 (80%) subjects, among which 75/98 (77%) had an anti-John Cunningham virus index ≥1.5. Anti-John Cunningham virus antibody seropositivity was not correlated with age, disease duration, Expanded Disability Status Scale scores, types of multiple sclerosis (relapsing vs progressive), or disease-modifying treatments used. We found a very high seroprevalence and index of anti-John Cunningham virus antibodies in Chinese multiple sclerosis patients, which may impact the risk assessment and recommendation of disease-modifying treatments in this population.

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