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Healthcare providers caring for people with multiple sclerosis (MS) have had significant concerns about the intersection of MS and COVID-19. As a result, there has been an urgency to understand and share information about how to best provide MS clinical care during COVID-19. The Project ECHO model is well-suited for this challenge, as it provides a uniquely efficient and effective approach to sharing information in real-time using real cases. We report on the translation of the Project ECHO model for the rapid sharing of knowledge among MS clinical providers during COVID-19.

The ECHO MS COVID-19 Response Clinic was a videoconference-based education and case consultation program offered to providers in the U.S. who care for individuals with MS. The Response Clinic was offered as four sessions, each delivered by three regional hubs. Data were collected on participation and the self-reported impact of the program.

A total of 132 unique providers participated in the Response Clinic, which consisted of 11 didactic modules and 43 case consultations. Participant providers overwhelmingly indicated that the program improved their knowledge, attitude, and skills for providing healthcare for people with MS during the COVID-19 pandemic.

The Project ECHO model was successfully adapted to serve the needs of the MS community during COVID-19, suggesting the program could be continued or could be expanded to other disease areas for a similar purpose. More research is needed to objectively measure the impact of the program on patient outcomes.

The Project ECHO model was successfully adapted to serve the needs of the MS community during COVID-19, suggesting the program could be continued or could be expanded to other disease areas for a similar purpose. More research is needed to objectively measure the impact of the program on patient outcomes.Myelin oligodendrocyte glycoprotein (MOG) antibody-related diseases are inflammatory demyelinating conditions of the central nervous system (CNS) that induce a broad spectrum of symptoms. Since MOG is expressed exclusively in the CNS, the lesions are thought to be confined to the CNS. However, few cases of MOG antibody-related disease involve the peripheral nervous system (PNS); the mechanisms underlying such PNS involvement remain unclear. We herein present the case of a patient with MOG antibody-related disease with recurrent optic neuritis and sensory polyradiculoneuropathy unaccompanied by CNS lesions. Our report presents a novel phenotype of PNS involvement in MOG antibody-related disease.

Fatigue is a common impairment in a wide range of disorders. Numerous fatigue scales have been designed in an attempt to quantify this impairment without any clear distinction between them. The International Classification of Functioning, Disability and Health (ICF) is a useful tool for content comparison of measurement scales.

To explore the content of generic fatigue scales using the ICF.

Twenty generic fatigue scales were identified and linked to the ICF by two health care professionals according to the established linking rules. The contents of the 20 scales were compared and the inter-rater agreement was estimated using kappa coefficients.

The content of generic fatigue scales varies and was found to focus mostly on body functions, activities and participation components of the ICF with a moderate to high degree of inter-observer agreement.

The content comparison of fatigue questionnaires would assist clinicians and researchers in selecting the most appropriate measurement for use and precisely analyze the results of these measurements.

The content comparison of fatigue questionnaires would assist clinicians and researchers in selecting the most appropriate measurement for use and precisely analyze the results of these measurements.

Comorbid conditions are known to affect the clinical course of multiple sclerosis (MS). Our objective was to determine the impact of comorbidities on the processing speed test (PST).

We conducted a retrospective, longitudinal analysis of all patients who completed PST testing from June 2015 - August 2019 at our center. Our electronic medical record was queried to determine the presence of the following comorbidities diabetes mellitus (DM), hypertension (HTN), hyperlipidemia (HLD), coronary artery disease, and depression. To help address baseline PST performance and practice effect, patients were also divided into four quartiles by baseline PST scores. Brain MRIs obtained within a 90-day window from the initial clinical assessment were quantitatively analyzed via fully-automated methods to calculate whole brain fraction (WBF), T2 lesion volume (T2LV), gray matter fraction (GMF), and thalamic volume (TV). selleck chemicals llc Univariable and multivariable linear regression models were used to determine the relationship between d conditions in MS patients.

Comorbidities are common within a MS cohort and adversely impact processing speed. Depression adversely impacted PST scores with worse MRI outcomes. HLD was associated with lower longitudinal PST measures but favorable quantitative MRI metrics. MS patients with faster baseline processing speeds were most sensitive to comorbid conditions. Our findings suggest a complex interplay between cognition and comorbid conditions in MS patients.Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) represents a demyelinating disorder for which tocilizumab, an anti-IL6 receptor, has been tested to prevent disabling relapses. In a subgroup of patients affected with novel Coronavirus disease (COVID-19), tocilizumab has also increased the survival rate. We present the case of a 31-years-old Caucasian patient who experienced an almost asymptomatic Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection during treatment with tocilizumab, which was continued due to the very high risk of relapses of the patient. According to this case, tocilizumab might be not discontinued during COVID-19.

It is essential to distinguish acute disseminated encephalomyelitis (ADEM) from MS early. Our aim was to determine MRI features at baseline and follow-up to distinguish pediatric ADEM from MS stratified according to age at onset.

Using hospital ICD-10 codes for acquired demyelinating syndromes from a nationwide register and subsequent chart review, we identified 52 children (<18 years) with ADEM and 66 children with MS. We undertook a retrospective analysis of MRI scans at onset and at follow-up. The MRI rater was a senior neuroradiologist blinded to clinical characteristics.

At baseline, children with ADEM had more diffuse poorly demarcated lesions, particularly in the basal ganglia/thalamus (p=0.001) and cerebellar peduncles (p<0.0001). Further, longitudinal extensive transverse myelitis was strongly associated with ADEM (p<0.0001). Children with ADEM had fewer contrast-enhancing lesions (p=0.0004), occipital lesions (p=0.01), optic nerve lesions (p=0.01), periventricular lesions, well-defined lesions only (p<0.