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Biomedical subjects

Marcos Aurélio Moreira

Publications and source records attributed to Marcos Aurélio Moreira.

4 recordsLinked to original sources

[Depression in relapsing-remitting multiple sclerosis].

The suggestion of a possible relationship between depression and multiple sclerosis (MS) has existed for many years, and the prevalence studies are believed by potential biases. In our country, the prevalence of clinical depression in patients with MS is unknown. The objective of the present study was to ascertain the rate of depression in a group of MS patients and to analyze the relationship to depression, disability, gender, age and duration of illness. We evaluated 84 relapsing-remitting MS patients using the Beck Scale (BS), the Hospital Anxiety and Depression scale (HAD) and the Expanded Disability Status Scale (EDSS). The depression was presented at 17.9% and the anxiety at 34.5% of the RRMS patients. There is a correlation between depression and functional disability (p=0.0002), but there is no relation between depression and sex, age or duration of the illness. This analysis confirms that depression is common in persons with MS and suggests the association with functional disability.

Adolescent↗

[The BCTRIMS Expanded Consensus on treatment of multiple sclerosis: I. The evidences for the use of immunosuppressive agents, plasma exchange and autologous hematopoietic stem cell transplantation].

Since the sixties immunosuppressive agents have been used in the treatment of multiple sclerosis as there was cumulating evidence of the inflammatory nature of the disease. Cyclophosphamide, azathioprine and methotrexate have been the most frequently employed drugs whereas other agents such as cyclosporine and cladribine have been recently tested for RRMS. Mithoxantrone, on the other hand, was approved by the FDA for treatment of aggressive forms of the disease. Other immunointerventions such as plasma exchange and autologous hematopoietic stem cell transplantation have recently been employed in some special circumstances. This paper analyses the most important published data on the use of the immunosuppressive agents, plasma exchange and autologous hematopoietic stem cell transplantation according to the classes of evidences and types of recommendations of these drugs and immunointerventions. It provides sufficient information to support the guidelines expressed in the BCTRIMS Expanded Consensus on Treatment of MS.

Evidence-Based Medicine↗

[The BCTRIMS expanded consensus on treatment of multiple sclerosis: II. The evidences for the use of glucocorticoids and immunomodulatory treatments].

Multiple sclerosis is an inflammatory disease in which immunological mechanisms play an important role in causing demyelinating lesions in the central nervous system. A number of drugs acting in different stages of these mechanisms have been tested for its treatment. This paper analyses the most important clinical trials with glucocorticoids and immunomodulatory treatments, including human immunoglobulin, using the classes of evidences and types of recommendations as have been defined and widely accepted by the international scientific community. It aims to provide sufficient information to support the BCTRIMS Expanded Consensus on Treatment of MS.

Adjuvants, Immunologic↗

[The BCTRIMS Expanded Consensus on treatment of multiple sclerosis: III. Evidence and recommendation-based guidelines].

There has been unprecedented advances in knowledge of multiple sclerosis (MS) in the last few years. A new set of criteria for its diagnosis and a bunch of recent clinical trials with disease-modifying agents (DMA) have been published. All of that has made it necessary to update and expand the previous consensus for MS treatment as formulated by the Brazilian Committee for Treatment and Research in Multiple Sclerosis (BCTRIMS) two years ago. The BCTRIMS Expanded Consensus emphasizes the need to (1) consider MS treatment on an individual basis; (2) educate patients about the potential benefits and risks of treatment; (3) monitor drugs side effects; (4) have a signed Informed Consent Form; (5) consider the relative cost of the drug. The various clinical possibilities and the indications of the DMA and other immunointerventions are considered according to classes of evidences and types of recommendations. The BCTRIMS Expanded Consensus on Treatment of MS may turn out to be a model to other developing countries.

Evidence-Based Medicine↗