Purpose: To evaluate defecography in assessment of anorectal function in patients with multiple sclerosis (MS) who have intractable constipation.
Materials And Methods: Eleven patients with MS and constipation (10 women, one man) underwent defecography. A total of 130 mL of barium, liquid (20 mL) and paste, was introduced into the rectum. A dab of barium marked the external anal orifice, and, in the women, a tampon soaked with contrast medium marked the vagina. Video radiographic images and supplemental 100-mm static camera images were obtained.
Results: During defecation, six patients had no puborectalis muscle effacement, four patients had partial effacement, and one patient had complete effacement. No rectal emptying occurred in five patients, and emptying was incomplete in the rest. Three patients developed an intussusception, and two developed a posterolateral pouch.
Conclusion: Defecography readily demonstrates rectal outlet obstruction and the failure of the puborectalis and anal sphincter muscles to relax. These are frequent findings in MS patients with intractable constipation.
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http://dx.doi.org/10.1148/radiology.191.2.8153339 | DOI Listing |
Neurology
February 2025
Department of Neurology and Center of Clinical Neuroscience, First Medical Faculty, General University Hospital and Charles University, Prague, Czech Republic.
Background And Objectives: Patients with multiple sclerosis (MS) may demonstrate better disease control when treatment is initiated on high-efficacy disease-modifying therapies (DMTs) from onset. This subgroup analysis assessed the long-term efficacy and safety profile of the high-efficacy DMT ocrelizumab (OCR) as first-line therapy for early-stage relapsing MS (RMS).
Methods: Post hoc exploratory analyses of efficacy and safety were performed in a subgroup of treatment-naive patients with RMS who received ≥1 dose of OCR in the multicenter OPERA I/II (NCT01247324/NCT01412333) studies.
Neurology
February 2025
From the Temple University College of Public Health (I.L.H.); Thomas Jefferson University (G.G.); and Department of Neurology (T.D.H.-P.), Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Background And Objectives: Clinical care for people living with amyotrophic lateral sclerosis (PLWALS) is directed at slowing disease progression and symptom management. The American Academy of Neurology recommends a multidisciplinary approach to providing ALS health care because observational studies show that multidisciplinary clinics (MDCs) extend survival and improve quality of life. However, providing multidisciplinary care is a challenging financial proposition.
View Article and Find Full Text PDFNeurochem Res
January 2025
Department of Basic Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
In recent decades, researchers and clinicians have increasingly focused on glial cell function. One of the primary mechanisms influencing these functions is through extracellular vesicles (EVs), membrane-bound particles released by cells that are essential for intercellular communication. EVs can be broadly categorized into four main types based on their size, origin, and biogenesis: large EVs, small EVs (sEVs), autophagic EVs, and apoptotic bodies.
View Article and Find Full Text PDFCan Assoc Radiol J
January 2025
North York General Hospital, Toronto, ON, Canada.
The Canadian Association of Radiologists (CAR) Central Nervous System Expert Panel is made up of physicians from the disciplines of radiology, emergency medicine, neurosurgery, and neurology, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 24 clinical/diagnostic scenarios, a rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 55 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 51 recommendation statements across the 24 scenarios.
View Article and Find Full Text PDFBMC Neurol
January 2025
School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Introduction: As the most frequent chronic neurological disorder in young adults, Multiple sclerosis (MS) significantly affects neurological function, particularly the autonomic nervous system. While the physical symptoms are visible, MS also causes hidden effects like sexual dysfunction. Research indicates that sexual disorders are more prevalent in MS patients compared to other neurological conditions and are approximately five times more common than in the general population.
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