How does fingolimod (gilenya(®)) fit in the treatment algorithm for highly active relapsing-remitting multiple sclerosis?

Multiple sclerosis (MS) is a neurological disorder characterized by inflammatory demyelination and neurodegeneration in the central nervous system. Until recently, disease-modifying treatment was based on agents requiring parenteral delivery, thus limiting long-term compliance. Basic treatments such as beta-interferon provide only moderate efficacy, and although therapies for second-line treatment and highly active MS are more effective, they are associated with potentially severe side effects.

Recommendations for the use of prolonged-release fampridine in patients with multiple sclerosis (MS).

Prolonged-release fampridine (fampridine PR) is a potassium channel blocker that improves conductivity of signal on demyelinated axons in central nervous system. Fampridine PR has been approved to improve speed of walking in patients with multiple sclerosis. This statement provides a brief summary of data on fampridine PR and recommendations on practical use of the medication in clinical practice, prediction, and evaluation of response to treatment and patient management.

Fingolimod in the treatment algorithm of relapsing remitting multiple sclerosis: a statement of the Central and East European (CEE) MS Expert Group.

Fingolimod is the first oral treatment of multiple sclerosis. It is the first-in-class sphingosine 1-phosphate receptor modulator that binds to sphingosine 1-phophate receptors on lymphocytes and via downregulation of the receptor prevents lymphocyte egress from lymphoid tissues into the circulation. This mechanism reduces the infiltration of potentially auto-aggressive lymphocytes into the central nervous system.

Hashimoto encephalopathy: a rare intricate syndrome.

Recently, several patients have been reported with various signs of encephalopathy and high thyroid antibody levels together with good responsiveness to glucocorticoid therapy. Despite the various clinical presentations, these cases have been termed "Hashimoto encephalopathy" (HE). Although all of the pathogenic components have not yet been clearly elucidated, it is believed that brain vasculitis and autoimmunity directed against common brain-thyroid antigens represent the most likely etiologic pathway.

The effect of anti-inflammatory (aspirin and/or statin) therapy on body weight in Type 2 diabetic individuals: EAT, a retrospective study.

Aims: Obesity is associated with inflammation. Anti-inflammatory interventions such as aspirin and statins (anti-IFRx) might be a novel approach to the treatment of obesity and Type 2 diabetes mellitus (T2DM). The present study was designed to determine whether exposure to anti-IFRx is associated with weight loss in T2DM patients.

[Hashimoto's encepahlopthy--a rare and unusual syndrome].

Hashimoto's encephalopathy (HE) is a brain disease associated with autoimmune thyroid disease. Over 100 articles have been published on the topic, especially in connection with hypothyroidism. In addition to an overview of the relevant literature, we also report a case of a female patient with a rare association of HE with thyreotoxicosis.

Mitral annular calcifications and aortic plaques as predictors of increased cardiovascular mortality.

Objectives: Mitral annular calcifications (MAC) and aortic plaques are predictive for higher incidence of recurrent embolic events, the presence and severity of coronary artery disease and total cardiac deaths. However, no data exist comparing the impact of combined presence of both aortic plaques and MAC on embolic events, deaths associated with cerebral embolism or cardiac deaths during the follow-up.

Patients And Methods: In 100 consecutive patients with aortic plaques detected by transesophageal echocardiography (mean age 69.

[Immunopathogenesis of myasthenia gravis and the Lambert-Eaton myasthenic syndrome].

Myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) are autoimmune diseases manifestant a disorder of neuromuscular transmission. In MG, the autoimmune process is directed against the postsynaptic part whereas in LEMS, it is focused at the presynaptic part of this connection. Current immunological studies have confirmed the polyclonal and heterogenous characters of the autoimmune process.

[Reflex response in the masseter muscle after tapping the chin in healthy persons--an electromyographic study].

In a group of healthy subjects the author evoked reflex responses in both masseters by percussion of the chin with a reflex hammer. The reflexes were evoked during relaxation, slight or intense contraction of the masseters with the mouth open or closed. By percussion of the chin from above extension reflexes were evoked and by percussion of the chin from below contracting reflexes.

[Reflex response of the masseter muscle after percussion of the chin and electrical stimulation of the upper lip in patients with central motor disorders].

In 23 patients with central motor disorders (spastic hemiparesis, pseudobulbar syndrome and parkinsonism) reflex responses in both masseters were evoked during their relaxation and contraction by percussion with a reflex hammer on the chin and by electric stimulation of the upper lip. For recording of the reflex responses the electromyographic method was used. On the side of the spastic hemiparesis, as compared with the finding on the non-paretic side, the author found changes in the short-, medium and late-latency excitation and inhibition segments of the reflex response.

[The stretch reflex response in the abductor pollicis brevis muscle in persons with organic and probably functionally conditioned central motor impairment (electromyographic study)].

Stretch reflex responses in the m. abductor pollicis brevis were elicited by percussion with the reflex hammer on the distal digit of the thumb. On the side of spastic hemiparesis the author revealed more marked short-latency and suppression of medium- and late-latency parts of the reflex response.

[The reflex response in the abductor pollicis brevis muscle after tapping the distal segments of the fingers, the ulnar olecranon and scapular acromion. Electromyographic study].

The author made an electromyographic investigation of reflex responses in the abductor pollicis brevis muscle abductor pollicis brevis muscle after percussion with a hammer on the dorsal, lateral, palmar, medial and distal surface of the distal digit of the thumb, on the dorsal and palmar area of the distal digits of the other fingers and also on the olecranon ulnae and acromion scapulae. The investigation was made to detect the influence of the site of percussion on the character of the reflex response. The reflex responses were examined during slight isometric contraction of the muscle.

[Reflex reaction in the abductor pollicis brevis muscle after mechanical and electrical stimulation in patients with central hemiparesis and Parkinsonism. Electromyographic study].

The reflex responses in the abductor pollicis brevis muscle were examined in 22 patients with mild central hemiparesis and in nine patients with Parkinson's disease. In the group of patients with central hemiparesis there were 15 subjects with a spastic and seven subjects with a flaccid type of affection. The reflex responses in the abductor pollicis brevis muscle were evoked during isometric contraction.

[Reflex responses in the trapezius muscle after percussion of various parts of the body].

In a Group of 20 healthy subjects and 16 patients with different central motor disorders a reflexological investigation was made in the upper part of the trapezius muscle. The reflex responses were produced by percussion with a reflex hammer on several sites on the head, trunk and upper extremities and identified as excitatory and inhibitory modulations of recorded EMG activity resulting from the stimulus, after averaging of 50 responses. In the group of healthy subjects after percussion of the chin, upper lip, cheek, mastoid process, back of the skull, the processus spinosus of vertebras C7 and Th12 and both sides of the volar area of the wrist, reflex responses with a short and long latency were recorded.