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MS Prevalence and Patients' Characteristics in the District of Braga, Portugal
Get PDFMultiple Sclerosis (MS) is a chronic autoimmune disease of the Central Nervous System causing inflammation and neurodegeneration. There are only 3 epidemiological studies in Portugal, 2 in the Centre and 1 in the North, and there is the need to further study MS epidemiology in this country. The objective of this work is to contribute to the MS epidemiological knowledge in Portugal, describing the patients' epidemiological, demographic, and clinical characteristics in the Braga district of Portugal. This is a cross-sectional study of 345 patients followed in two hospitals of Braga district. These hospitals cover a resident population of 866,012 inhabitants. The data was collected from the clinical records, and 31/12/2009 was established as the prevalence day. For all MS patients, demographic characteristics and clinical outcomes are reported. We have found an incidence of 2.74/100,000 and a prevalence of 39.82/100,000 inhabitants. Most patients have an EDSS of 3 or lower and a mean age of 42 years. The diagnosis was done at mean age of 35, with RRMS being the disease type in more than 80% of patients. In this cohort, we found a female : male ratio of 1.79. More than 50% of patients are treated with Interferon β-1b IM or IFNβ-1a SC 22 μg
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Luís Lopes, MD, PhD
Mário Dinis-Ribeiro, MD, PhD
Carla Rolanda, MD, PhD
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doi:10.1016/j.gie.2015.01.001
Refers To:
Panagiotis Katsinelos, Georgia Lazaraki, Grigoris Chatzimavroudis, Christos Zavos, Jannis Kountouras
The endoscopic morphology of major papillae influences the selected precut technique for biliary access
Gastrointestinal Endoscopy, Volume 81, Issue 4, April 2015, Page 105
Low serum albumin – another prognostic marker?
Get PDFIntroduction: Population-based studies have suggested an association between low serum albumin levels and coronary atherosclerosis and heart failure. The role of albumin in the context of acute coronary syndromes (ACS) remains unclear, however, seems to associate with an adverse prognosis.
Aim: The aim of the present study was to determine whether low serum albumin levels are associated with development of heart failure in ACS.
Methods: Study of patients consecutively admitted for ACS in a Coronary Unit over 6 months. Patients with infectious complications were excluded.
Results: One hundred sixty-eight patients were eligible for analysis. Males were predominant (81.5%) and the mean age was 61.7±13.4 years old. Low serum albumin levels (serum albumin <3.5g/dl) were present in 44.6%. No significant differences were observed regarding demographic characteristics, except higher mean age (p <0.001) and a higher prevalence of hypertension (p = 0.04) in the hypoalbuminemia group. This group had lower values of hemoglobin (p<0.001) and higher levels of pro-BNP (p=0.018) and C Reactive Protein (p<0.001). In univariate analysis, hypoalbuminemia was associated with a higher prevalence of heart failure (p=0.015, OR 2.45 CI95% 1.17-5.10) and the use of intra-aortic balloon (p = 0.005) during hospitalization. There were no statistically significant differences in the use of ionotropic drugs and invasive ventilation as well as in-hospital mortality. At follow-up at 6 months showed a positive association between hypoalbuminemia and mortality (p <0.05).
Conclusions: The hypoalbuminemia was associated with an increased risk of heart failure during hospitalization and death at 6 months. Although the etiology of hypoalbuminemia remain unclear, albumin assay may be useful in risk stratification of acute coronary syndromes
Leg ulcer as a manifestation of eosinophilic vasculitis in a patient with hepatitis C virus infection, medicated with pegylated interferon/ribavirin.
Get PDFCryoglobulinaemic vasculitis is a complication of hepatitis C virus (HCV) infection, responding to treatment with pegylated interferon (peg-IFN)/ribavirin (RIB), but vasculitis may first appear after treatment with peg-IFN/RIB. A 35-year-old man with HCV infection presented to our department with a 2-month history of a 3.3×3 cm ulcer localised on the right shin, with a regular border, on a violaceous base. Histopathological examination revealed a leucocytoclastic vasculitis, rich in eosinophils. The patient had been treated with peg-IFN/RIB 10 months prior and treatment was discontinued after 2 months because of the appearance of arthralgias and neuropathy. Laboratory investigations revealed positive cryoglobulins, elevation of rheumatoid factor and reduction of C4 after treatment with peg-IFN/RIB. Dressings with a hydrocellular foam were placed and after 2 months the ulcer resolved. We presented this case because of the rarity of development of a cryoglobulinaemic vasculitis in a patient with HCV infection, previously treated with peg-IFN/RIB
