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Efficacy and safety of disease-modifying therapies in pediatric-onset multiple sclerosis: A systematic review of clinical trials and observational studies.
Mult Scler Relat Disord
January 2025
Department of Nutrition and Drug Research, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Skawińska Street 8, 31-066 Krakow, Poland. Electronic address:
Objective: This study aimed to review the efficacy and safety profile of disease-modifying therapies (DMTs) in patients with relapsing pediatric-onset multiple sclerosis (POMS).
Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Published randomized controlled trials (RCTs), nonrandomized studies with a control group, large single-arm studies, and ongoing (unpublished) studies investigating the use of approved and unapproved DMTs in POMS were included.
Optimizing Drug Selection in Children with Multiple Sclerosis: What Do We Know and What Remains Unanswered?
Paediatr Drugs
December 2024
Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Pediatric-onset multiple sclerosis (POMS) refers to multiple sclerosis with onset before 18 years of age. It is characterized by a more inflammatory course, more frequent clinical relapses, and a greater number of magnetic resonance imaging (MRI) lesions compared with adult-onset MS (AOMS), leading to significant impacts on both disability progression and cognitive outcomes in affected individuals. Managing POMS presents distinct challenges due to the unique needs of pediatric patients and the limited number of disease-modifying therapies (DMTs) approved for pediatric use.
View Article and Find Full Text PDFThe Treatment of Indirect Carotid Cavernous Fistula in a Pediatric Patient With Deep Recurrent Ophthalmic Artery and Hemophilia.
Cureus
November 2024
Neurological Surgery, Hospital Jose Eleuterio Gonzalez, Universidad de Nuevo Leon, Monterrey, MEX.
The treatment of indirect carotid-cavernous fistula (CCF) poses a unique challenge. Currently, endovascular interventions remain the principal treatment option with high cure rates and acceptable safety profiles. The anatomical characteristics of individual cases determine the optimal vascular access routes (transvenous vs.
View Article and Find Full Text PDFParadoxical Deterioration During Treatment of Tuberculous Meningitis Responded to Infliximab But Not to Steroids.
Eur J Case Rep Intern Med
November 2024
Department of Internal Medicine, University Center of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland.
Unlabelled: Paradoxical deterioration in patients with tuberculous meningitis is a significant diagnostic and treatment challenge. We present the case of a 55-year-old previously healthy male, human immunodeficiency virus (HIV)-negative, presenting with headache, fever, agitation and slurred speech, who was ultimately diagnosed with tuberculous meningoencephalitis confirmed by cerebrospinal fluid polymerase chain reaction positive for complex. After initiation of a standard antitubercular therapy combined with glucocorticoids, the patient experienced an initial neurological improvement.
View Article and Find Full Text PDFModulation of cerebellar-cortical connectivity induced by modafinil and its relationship with receptor and transporter expression.
Biol Psychiatry Cogn Neurosci Neuroimaging
November 2024
Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Italy; Institute for Advanced Biomedical Technologies (ITAB), "G. d'Annunzio" University, Chieti-Pescara, Italy; Molecular Neurology Unit, Center for Advanced Studies and Technology (CAST), University "G. d'Annunzio" of Chieti-Pescara, Italy. Electronic address:
Article Synopsis
- - Modafinil is used to treat narcolepsy and as a cognitive enhancer, impacting the connectivity of brain networks related to attention and executive function, with less known about its effects on subcortical areas.
- - In a study with 50 participants, researchers measured resting-state fMRI connectivity before and after a single dose of modafinil or a placebo, focusing on cerebellar-neocortical relationships and neurotransmitter receptor expression.
- - Results showed that modafinil enhanced connectivity in specific cerebellar regions (Crus I and Vermis IX) with prefrontal areas and other brain regions, linking these changes to the presence of dopaminergic and histaminergic receptors.
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