Background: Current guidance on the selection of appropriate contraception for people with multiple sclerosis (PwMS) is lacking.
Objective: To address this gap, an expert-led consensus program developed recommendations to support clinicians in discussing family planning and contraception with women and men with multiple sclerosis (MS).
Methods: A multidisciplinary steering committee (SC) of 13 international clinical experts led the program, supported by an extended faculty of 32 experts representing 18 countries. A modified Delphi methodology was used for decision-making and consensus-building. The SC drafted 15 clinical questions focused on patient-centered care, selection of contraception, and timing of stopping/starting contraception and disease-modifying therapies (DMTs). Statements addressing each question were drafted based on evaluation of published evidence and the experts' clinical experience. Consensus was reached if ⩾75% of respondents agreed (scoring 7-9 on a 9-point scale) with each recommendation.
Results: Consensus was reached on 24 of 25 proposed recommendations, including how and when to discuss contraception, types and safety of contraceptives, and how to evaluate the most appropriate contraceptive options for specific patient groups, including those with significant disability or being treated with DMTs.
Conclusion: These expert recommendations provide the first practical, relevant, and comprehensive guidance for clinicians on the selection of contraception in PwMS.
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http://dx.doi.org/10.1177/13524585241228103 | DOI Listing |
Nutrients
December 2024
Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.
Aim: This article aims to explore the role of the human gut microbiota (GM) in the pathogenesis of neurological, psychiatric, and neurodevelopmental disorders, highlighting its influence on health and disease, and investigating potential therapeutic strategies targeting GM modulation.
Materials And Methods: A comprehensive analysis of the gut microbiota's composition and its interaction with the human body, particularly, its role in neurological and psychiatric conditions, is provided. The review discusses factors influencing GM composition, including birth mode, breastfeeding, diet, medications, and geography.
Nutrients
December 2024
Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA.
Neuropathic pain is a complex and debilitating condition resulting from nerve damage, characterized by sensations such as burning, tingling, and shooting pain. It is often associated with conditions such as multiple sclerosis (MS), Guillain-Barré syndrome (GBS), and diabetic polyneuropathy. Conventional pain therapies frequently provide limited relief and are accompanied by significant side effects, emphasizing the need to explore alternative treatment options.
View Article and Find Full Text PDFNutrients
December 2024
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Background: Dietary intake of polyunsaturated fatty acids (PUFA) plays a significant role in the onset and progression of neurodegenerative diseases. Since the neuroprotective effects of n-3 PUFA have been widely validated, the role of n-6 PUFA remains debated, with their underlying mechanisms still not fully understood.
Methods: In this study, 169,295 participants from the UK Biobank were included to analyze the associations between dietary n-6 PUFA intake and neurodegenerative diseases using Cox regression models with full adjustments for potential confounders.
Pharmaceuticals (Basel)
December 2024
Department of Neurology, Oregon Health & Science University (OHSU), Portland, OR 97239, USA.
(L.) Urban (family Apiaceae) () is a traditional botanical medicine used in aging and dementia. Water extracts of (CAW) have been used to treat neuropsychiatric symptoms in related animal models and are associated with increases in antioxidant response element (ARE) genes and improvements in mitochondrial respiratory function and neuronal health.
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Department of Biology, University of Toronto Mississauga, Mississauga, ON L5L 1C6, Canada.
The predominant neurodegenerative diseases, Alzheimer's disease, Parkinson's disease, dementia with Lewy Bodies, Huntington's disease, amyotrophic lateral sclerosis, and frontotemporal dementia, are rarely pure diseases but, instead, show a diversity of mixed pathologies. At some level, all of them share a combination of one or more different toxic biomarker proteins: amyloid beta (Aβ), phosphorylated Tau (pTau), alpha-synuclein (αSyn), mutant huntingtin (mHtt), fused in sarcoma, superoxide dismutase 1, and TAR DNA-binding protein 43. These toxic proteins share some common attributes, making them potentially universal and simultaneous targets for therapeutic intervention.
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