Biomedical subjects

A Carrá

Publications and source records attributed to A Carrá.

3 recordsLinked to original sources

PubMed2003

A retrospective, observational study comparing the four available immunomodulatory treatments for relapsing-remitting multiple sclerosis.

We performed an observational, retrospective analysis of outcome in a sequential cohort of patients with relapsing-remitting multiple sclerosis (RRMS) in Argentina. Patients treated for 16 months with interferon beta-1a (Avonex; 30 micrograms intramuscularly, once a week), interferon beta-1a (Rebif); 44 micrograms subcutaneously, thrice weekly), interferon beta-1b (Betaferon; 250 micrograms subcutaneously, every other day) or glatiramer acetate (Copaxone; 20 mg subcutaneously daily) were compared with a non-treated group of patients. The different treatment groups were similar in baseline demographic and clinical variables. A significant fall in the annual relapse rate was observed for all four treatments, with the largest effect observed with glatiramer acetate (81% reduction in relapse rate, compared with pre-treatment values). The proportion of patients remaining relapse-free for the entire 16-month treatment period varied from 37% in untreated patients to 83% in the glatiramer acetate treated group. No statistically significant changes in disability scores were observed over the treatment period. This first such comparative study in Latin America shows that treatment of multiple sclerosis patients with immunomodulatory therapies in the context of current standards of care in Argentina provides clinically important benefit, and suggest that some of these therapies may be better than others.

Adjuvants, Immunologic↗

PubMed2002

[Language abnormalities in patients with multiple sclerosis].

BACKGROUND: Patients suffering from multiple sclerosis (MS) have a high frequency of cognitive deficits. Research has demonstrated impairments in memory, attention, information-processing speed, and executive functions. Although it has been traditionally held that language function is commonly preserved in MS, some studies have demonstrated language impairment in these patients, particularly in tasks of naming and word-generation. OBJECTIVES: The aim of the study was to examine language functioning in MS, with particular interest in naming ability and verbal fluency. MATERIAL AND METHODS: Thirty patients with MS, and 30 neurologically intact normal controls, matched for age and educational level were evaluated. As part of a wider neuropsychological evaluation, all subjects were administered the Boston Naming Tests. To compare performances, a comprehensive classification of error types was devised. RESULTS: MS patients showed significantly lower performance on both linguistic measures than the control subjects. On the Boston Naming Test, MS patients obtained significant lower scores than controls, with a high rate of semantic errors. Additionally, they tended to show an also high number of visuoperceptual errors. Low scores on naming task correlated with low performance on verbal fluency. CONCLUSIONS: This study reveals that language function can be impaired in MS, and that naming difficulties are a frequent finding. This naming deficit seems to have a double origin, stemming from disruption at the levels of the perceptual and/or the semantic systems.

Adult↗

PubMedDate not supplied

[The treatment of multiple sclerosis in Latin America: current practice and optimal standards. The findings of a survey among neurologists at an interactive workshop].

INTRODUCTION: Considerable progress has been made in the treatment of patients with relapsing-remitting multiple sclerosis (MS) over the last decade. Exactly how these changes are reflected in daily practice, however, is still not very well known. AIM: To hold interactive workshops so as to be able to evaluate the opinions of Latin-American neurologists about the therapeutic decisions taken with regard to MS. MATERIALS AND METHODS: By means of an interactive voting system, professionals attending each workshop replied to ten pre-established questions about when to start treatment, the use of magnetic resonance imaging (MRI) to supervise treatment, the definition of therapeutic failure and the role of treatment using immunosuppressants. The results were compared with those obtained in similar workshops attended by European and North American neurologists held six months earlier. RESULTS: The use of immunomodulators was considered to be useful in isolated demyelinating syndromes, as 40-50% endorsed their use in clinically stable patients. MRI was seen to be the most sensitive method of monitoring the effectiveness of the therapy -70.6% of them proposed the application of annual scans, which suggests a more frequent use in Latin America than in Europe or the USA. On defining therapeutic failure, the clinical criteria were more important than the MRI scan, and a switch from beta interferons to glatiramer acetate or vice versa was recommended. Treatment with immunosuppressants was considered to be useful in reducing the accumulated disability, but there was no agreement on how to use them. In Latin America, decisions about when to begin treatment seem to lie somewhere between the more favourable posture adopted in USA and the more conservative stance in Europe. CONCLUSIONS: This survey reflects the controversies that affect the therapeutic decisions concerning MS in Latin America and highlights the areas in which more data are needed to optimise the standards of treatment.

Consensus Statements as Topic↗