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In recent decades, there has been a significant rise in the utilization of medical cannabis. Understanding the various facets surrounding its usage and regulation is paramount for patients, health professionals, and policymakers. This cross-sectional study conducted at the CANNAVITAL clinic in Lima, Peru aimed to assess the basic knowledge, attitudes towards use, and beliefs regarding regulation and safety of Cannabis sativa L. Among 86 patients (mean age: 41 ± 7.8 years; 53.4% women) actively receiving medical cannabis treatment for at least one year, we utilized the 22-item KUC-22 questionnaire to evaluate their understanding of cannabis, risk factors, legislation, medical and recreational use. The average duration of medical cannabis use was 3 ± 1.2 years. Results showed that 60.2% of patients were familiar with different forms of cannabis consumption, while 77.3% recognized the importance of product quality. Chronic pain, nausea and vomiting (each 23.9%) were the primary conditions treated with cannabis, followed by cancer and epilepsy (both 21.6%). A significant correlation was found between knowledge and cannabis use (p < 0.001). Furthermore, 92% of patients believed that a medical prescription was necessary, while 84.1% engaged in self-medication practices. Concerning perceptions, 69.3% of participants perceived psychological dependence from long-term cannabis use, and 65.9% believed it could cause health damage. Significant correlations were observed between the perception of risk factors, knowledge of legislation, and cannabis use (p < 0.001). In conclusion, Peruvian patients exhibited a high level of knowledge regarding the risks, uses, and regulatory framework surrounding Cannabis sativa L. These findings provide valuable insights into patients' perspectives on medical cannabis, offering important information for medical providers and researchers aiming to enhance cannabinoid-based therapies.

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We study the problem of a target search by a Brownian particle subject to stochastic resetting to a pair of sites. The mean search time is minimized by an optimal resetting rate which does not vary smoothly, in contrast with the well-known single site case, but exhibits a discontinuous transition as the position of one resetting site is varied while keeping the initial position of the particle fixed, or vice versa. The discontinuity vanishes at a "liquid-gas" critical point in position space. This critical point exists provided that the relative weight m of the further site is comprised in the interval [2.9028...,8.5603...]. When the initial position is a random variable that follows the resetting point distribution, a discontinuous transition also exists for the optimal rate as the distance between the resetting points is varied, provided that m exceeds the critical value m_{c}=6.6008.... This setup can be mapped onto an intermittent search problem with switching diffusion coefficients and represents a minimal model for the study of distributed resetting.

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Cannabis is a plant that is cultivated worldwide, and its use is internationally regulated, but some countries have been regulating its medicinal, social, and industrial uses. This plant must have arrived in Peru during the Spanish conquest and remains widely cultivated illicitly or informally to this day. However, new regulations are currently being proposed to allow its legal commercialization for medicinal purposes. Cannabis contains specific metabolites known as cannabinoids, some of which have clinically demonstrated therapeutic effects. It is now possible to quantitatively measure the presence of these cannabinoids in dried inflorescences, thus allowing for description of the chemical profile or "chemotype" of cannabinoids in each sample. This study analyzed the chemotypes of eight samples of dried inflorescences from cannabis cultivars in four different regions of Peru, and based on the significant variation in the cannabinoid profiles, we suggest their therapeutic potential. The most important medical areas in which they could be used include the following: they can help manage chronic pain, they have antiemetic, anti-inflammatory, and antipruritic properties, are beneficial in treating duodenal ulcers, can be used in bronchodilators, in muscle relaxants, and in treating refractory epilepsy, have anxiolytic properties, reduce sebum, are effective on Methicillin-resistant Staphylococcus aureus, are proapoptotic in breast cancer, can be used to treat addiction and psychosis, and are effective on MRSA, in controlling psoriasis, and in treating glioblastoma, according to the properties of their concentrations of cannabidiol, cannabigerol, and Δ9-tetrahydrocannabinol, as reviewed in the literature. On the other hand, having obtained concentrations of THC, we were able to suggest the psychotropic capacity of said samples, one of which even fits within the legal category of "non-psychoactive cannabis" according to Peruvian regulations.

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Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann-Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.

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Health professionals are able to improve the care quality of chronic wounds by monitoring and reporting the wound status. Resorting to visual representations of wound status enhances comprehension by facilitating knowledge transfer to all stakeholders. However, selecting appropriate healthcare data visualisations is a critical challenge and healthcare platforms must be designed to meet their users' needs and constraints. This article describes the methods used to identify the design requirements and inform the development of a wound monitoring platform through a user-centred approach.

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BACKGROUND: Lower urinary tract symptoms (LUTS) are common in women with multiple sclerosis. OBJECTIVE: To investigate the impact of LUTS on pelvic floor muscle contraction, sexual function, and quality of life in women with multiple sclerosis. METHODS: Thirty-nine women with relapsing-remitting multiple sclerosis were enrolled in this study. Participants were divided into the presence or not of LUTS. Assessments involved the Expanded Disability Status Scale score, the NEW PERFECT scheme, the Female Sexual Function Index, and the Qualiveen Questionnaire. Statistical procedures involved Student t-tests, chi-squared, and regression analyses (R2). RESULTS: Nineteen women (48.7%) presented LUTS. Women with LUTS were in a more advanced stage of multiple sclerosis (p = .029), presented weaker pelvic muscle contraction (p = .009), less sexual function satisfaction (p = .018), and more limitations in the quality of life (p = .001) than women without LUTS. Regression analyses pointed out that the quality of life and sexual function of women with multiple sclerosis are affected by intercourse pain (R2 = 12.9) and perineal contraction force (R2 = 19.2). CONCLUSION: LUTS affects pelvic floor muscle contraction, sexual function, and quality of life in women with multiple sclerosis. A multi-professional rehabilitation team should assist women with multiple sclerosis, taking special care of LUTS.

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Objective: To evaluate the volar cortical angle (VCA), the variation in lateral and intermediate columns, the shape and pattern of the watershed line (WL) of the distal radius and its correlation with locking volar plates available. Methods: 27 human cadaveric radial bones of the Department of Morphology and nine locking volar plates of six different companies were analyzed. VCA were measured from lateral and intermediate columns and their corresponding values on plates, as well as comparing the relief of radius and plates. In the WL analysis, we compared the standard format found on the radius and its equivalent on plates and divided into four types: biconvex, convex, ulnar convex and plan. Results: VCA varied between columns of the distal radius extremity. The mean in the lateral column was 153.40 degrees and 146.06 degrees in the intermediate. Four of nine plates showed no variation in volar angulation. From 27 distal radius, 13 showed convex pattern and 12 had biconvex, whereas most plates (seven of the nine analyzed) were biconvex drawing. Conclusion: Radial bone anatomy was variable. The intermediate column was, on average, steeper than lateral column. Synthes®-2 plate presented the closest design to the anatomy of the distal end of the radial bone, followed by Newclip®-2 plate. Level of Evidence II, Anatomic and Descriptive Study.

Objetivos: Avaliar o ângulo palmar cortical (APC) da extremidade distal do rádio, sua variação nas colunas lateral e intermédia, o formato e o padrão da watershed line (WL) e sua correlação com as placas volares bloqueadas disponíveis no mercado. Métodos: Foram analisados 27 ossos rádios do Departamento de Morfologia e nove placas de seis fabricantes diferentes. Medimos os APCs das colunas lateral e intermédia dos rádios e seus correspondentes nas placas, além de compararmos o relevo do terço distal do rádio e das placas. Quanto a WL, comparamos o formato nas peças e seu equivalente nas placas, sendo classificados em quatro tipos: biconvexo, convexo, convexo ulnar e plano. Resultados: O APC variou entre as colunas do rádio, sendo a média da coluna lateral 153,40° e, da intermédia 146,06°. Quatro das nove placas não apresentaram variação na angulação volar. Dos 27 rádios, 13 apresentaram padrão convexo e 12 biconvexo, enquanto a maioria das placas (sete das nove analisadas) tinham desenho biconvexo. Conclusão: A anatomia dos rádios foi variável entre as peças, sendo a coluna intermédia mais inclinada que a coluna lateral. A placa Synthes ® -2 foi a que apresentou relevo mais próximo dos achados anatômicos da extremidade distal do rádio, seguida pela Newclip ® -2. Nível de Evidência II, Estudo Anatômico Descritivo.

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ABSTRACT Objective: To evaluate the volar cortical angle (VCA), the variation in lateral and intermediate columns, the shape and pattern of the watershed line (WL) of the distal radius and its correlation with locking volar plates available. Methods: 27 human cadaveric radial bones of the Department of Morphology and nine locking volar plates of six different companies were analyzed. VCA were measured from lateral and intermediate columns and their corresponding values on plates, as well as comparing the relief of radius and plates. In the WL analysis, we compared the standard format found on the radius and its equivalent on plates and divided into four types: biconvex, convex, ulnar convex and plan. Results: VCA varied between columns of the distal radius extremity. The mean in the lateral column was 153.40 degrees and 146.06 degrees in the intermediate. Four of nine plates showed no variation in volar angulation. From 27 distal radius, 13 showed convex pattern and 12 had biconvex, whereas most plates (seven of the nine analyzed) were biconvex drawing. Conclusion: Radial bone anatomy was variable. The intermediate column was, on average, steeper than lateral column. Synthes®-2 plate presented the closest design to the anatomy of the distal end of the radial bone, followed by Newclip®-2 plate. Level of Evidence II, Anatomic and Descriptive Study.

RESUMO Objetivos: Avaliar o ângulo palmar cortical (APC) da extremidade distal do rádio, sua variação nas colunas lateral e intermédia, o formato e o padrão da watershed line (WL) e sua correlação com as placas volares bloqueadas disponíveis no mercado. Métodos: Foram analisados 27 ossos rádios do Departamento de Morfologia e nove placas de seis fabricantes diferentes. Medimos os APCs das colunas lateral e intermédia dos rádios e seus correspondentes nas placas, além de compararmos o relevo do terço distal do rádio e das placas. Quanto a WL, comparamos o formato nas peças e seu equivalente nas placas, sendo classificados em quatro tipos: biconvexo, convexo, convexo ulnar e plano. Resultados: O APC variou entre as colunas do rádio, sendo a média da coluna lateral 153,40° e, da intermédia 146,06°. Quatro das nove placas não apresentaram variação na angulação volar. Dos 27 rádios, 13 apresentaram padrão convexo e 12 biconvexo, enquanto a maioria das placas (sete das nove analisadas) tinham desenho biconvexo. Conclusão: A anatomia dos rádios foi variável entre as peças, sendo a coluna intermédia mais inclinada que a coluna lateral. A placa Synthes ® -2 foi a que apresentou relevo mais próximo dos achados anatômicos da extremidade distal do rádio, seguida pela Newclip ® -2. Nível de Evidência II, Estudo Anatômico Descritivo.

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RATIONALE: Teriflunomide is an inhibitor of pyrimidine synthesis available as a first-line treatment for relapsing-remitting multiple sclerosis. Drug-induced liver damage is a relevant problem in clinical practice, representing a frequent cause of treatment discontinuation. This case report describes the occurrence of liver injury, with a 33.7-fold increase in the upper limit of normality of the liver enzyme alanine aminotransferase during treatment with teriflunomide 14 mg. PATIENT CONCERN: A 44-year-old woman receiving teriflunomide 14 mg for the treatment of multiple sclerosis presented symptoms suggestive of liver dysfunction 54 days after starting treatment. The patient had no history of using disease-modifying therapy, neither previous liver disease nor other comorbidities. DIAGNOSTICS: The suggested diagnosis was drug-induced liver injury, classified as hepatocellular. Other possible hepatic and autoimmune etiologies were ruled out. INTERVENTIONS: Replacement of teriflunomide treatment with glatiramer acetate and follow-up of the disease. OUTCOMES: Signs and symptoms regressed after treatment with teriflunomide 14 mg was discontinued, with normalization of liver enzyme activity in ∼5 months. The causality assessment of the adverse drug reaction was determined by the Naranjo scaling system, resulting in probable, with a final score of 7. CONCLUSIONS: Teriflunomide-induced liver injury in patients with multiple sclerosis is a serious adverse reaction. The report of this case contributes to updating knowledge about the safety aspects of treatment with teriflunomide and planning of monitoring strategies and patient risk management.

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Introdução: A esclerose múltipla (EM) é a mais comum das doenças desmielinizantes, caracterizada pela localização de múltiplas placas de desmielinização na substância branca encefálica e medular. A mielopatia associada ao HTLV-I (HAM/TSP) é uma doença neurodegenerativa progressiva cuja resposta imune é exacerbada. Objetivo: Avaliar o efeito da eletroterapia na musculatura do assoalho pélvico (MAP) sobre os sintomas hiperatividade detrusora em mulheres com EM e HTLV-1. Métodos: Ensaio clínico randomizado e controlado com 4 meses de acompanhamento, no qual 20 mulheres em estágio moderado de EM ou HTLV1 submetidas a um programa de treinamento da MAP associado ou não à eletroterapia. As variáveis analisadas foram: sintomas de bexiga hiperativa (BH) pelo questionário validado OAB v8, contração perineal pelo esquema PERFECT e índice de qualidade de vida por meio do questionário Qualiveen. Divididas em dois grupos, grupo controle (G2) e grupo tratamento (G1) que foi submetido a um protocolo de treinamento da MAP, realizado duas vezes por semana por 20 sessões e após este período de tempo todas as mulheres foram reavaliadas. Resultados: Sob-homogeneidade inicial observada nas variáveis pessoais e clínicas, o protocolo a que o grupo tratamento (G1) foi submetido resultou na melhora da contração voluntária (p ≤ 0,001), teste de esforço (p ≤ 0,001), reflexo cutâneo-anal (p ≤ 0,001), força de contração (p ≤ 0,001), sustentação (p ≤ 0,001), contrações rápidas (p ≤ 0,001), contrações lentas (p ≤ 0,001) e nos sintomas de bexiga hiperativa (p ≤ 0,001), em relação à comparação inicial. Os resultados comprovam a eficácia de exercícios de fortalecimento da MAP acompanhados por um fisioterapeuta e o uso de correntes eletroterápicas de média frequência para o tratamento da BH na Esclerose Múltipla e na mielopatia associada ao HTLV-1. Conclusão: O protocolo de eletroestimulação mostrou-se benéfico em pacientes com EM e HTLV-1, promovendo melhora da BH e grau de contração perineal. (AU)

Introduction: Multiple sclerosis (MS) is the most common of demyelinating diseases, characterized by multiple demyelination plaques in white brain and spinal cord. Myelopathy associated with HTLV-I (HAM/TSP) is a progressive neurodegenerative disease whose immune response is exacerbated. Objective: To evaluate the effect of electrotherapy in the pelvic floor muscles (MAP) on the symptoms of overactive bladder in women with MS and HTLV-1. Methods: Randomized, controlled clinical trial with 4 months of follow-up, in which 20 women in the moderate stage of MS or HTLV-1 performed a MAP training program associated or not with electrotherapy. The variables analyzed were: overactive bladder, validated OAB v8 questionnaire, perineal contraction by PERFECT scheme, and quality of life index using the Qualiveen questionnaire. Divided into two groups, control group (G2) and treatment group (G1) who underwent a MAP training protocol, performed twice a week for 20 sessions and after this time period all the women were re-evaluated. Results: Under initial homogeneity observed in the personal and clinical variables, the protocol to which the treatment group (G1) was submitted resulted in the improvement of the voluntary contraction (p = 0.001), stress test (p ≤ 0.001), pudendo-anal reflex (p ≤ 0.001), contraction force (p ≤ 0.001), sustentation (p ≤ 0.001), rapid contractions (p ≤ 0.001), slow contractions (p ≤ 0.001) and symptoms of overactive bladder (p ≤ 0.001) compared to the initial controle. The results demonstrate the effectiveness of MAP strengthening exercises followed by a physiotherapist and the use of medium frequency electrotherapy currents for the treatment of BH in multiple sclerosis and HTLV-1 associated myelopathy. Conclusion: The protocol of electrostimulation was beneficial in patients with MS and HTLV-1, promoting improvement of overactive bladder and degree of perineal contraction. (AU)

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OBJECTIVE: The aim of the study was to investigate the effects of two pelvic floor exercise programs on lower urinary tract symptoms and quality of life in participants with multiple sclerosis. DESIGN: This is a prospective, single-blind, clinical trial. SETTINGS: The study used a community rehabilitation program within a large metropolitan health service. PARTICIPANTS: Thirty women in moderate stage of multiple sclerosis were referred for outpatient rehabilitation. INTERVENTIONS: In a period of 6 mos, participants underwent a pelvic floor exercise program, associated or not with vaginal electrotherapy. MAIN OUTCOMES: The main outcomes are overactive bladder, perineal contraction, and quality of life. RESULTS: The findings showed benefits of both programs on overactive bladder and quality of life. Participants undergoing exercise plus electrotherapy presented greater improvement on contraction of the perineal musculature and quality of life. CONCLUSIONS: Six months of exercise provided benefits on lower urinary tract symptoms and quality of life in women with multiple sclerosis. Electrical stimulation potentiated the improvement on perineal musculature and quality of life. This trial was registered prospectively with the Clinical Trials Register, ID: BR-287q65 (http://www.ensaiosclinicos.gov.br/rg/RBR-287q65/).

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OBJECTIVE: The aim of the study was to investigate the effects of a 6-mo exercise program on cognition and mobility in participants with multiple sclerosis. DESIGN: This is a prospective, single-blind, controlled clinical trial. SETTING: A community rehabilitation program within a large metropolitan health service. PARTICIPANTS: Twenty-eight patients with multiple sclerosis were referred for outpatient rehabilitation. INTERVENTIONS: Participants were allocated to one of two groups and undertook a cognitive-motor exercise program or monitoring (control group). MAIN OUTCOME MEASURES: Cognition and mobility were the main outcome measures. Cognition was evaluated using the Mini-Mental State Examination and the Frontal Assessment Battery. Mobility was assessed with the Timed Get Up and Go test, applied with and without dual task distractors. RESULTS: The findings showed benefits provided by exercise on cognition and mobility. Differently, participants of the control group did not have significant changes in cognition scores after 6 mos of follow-up and had a worse performance in mobility tests. CONCLUSION: Six months of exercise provided benefits to cognition and mobility in adults with multiple sclerosis. This trial was registered prospectively with the Brazilian Clinical Trials Register, ID: RBR-9gh4km (http://www.ensaiosclinicos.gov.br/rg/?q=RBR-9gh4km). TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Recognize the physical and cognitive decline in multiple sclerosis; (2) Identify the importance of exercise on cognition and mobility in patients with multiple sclerosis; and (3) Appreciate the potential benefit of dual tasking in the rehabilitation of individuals with multiple sclerosis.Level: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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In this paper we propose and demonstrate two alternative methods for the high-precision calibration of fiber Bragg grating (FBG) interrogators. The first method is based on the direct comparison between the wavelength measurements of the interrogator under test and a calibrated wavemeter, while analyzing a simulated symmetric Bragg grating constructed by a tunable filter and a fiber mirror. This first method is applicable to most commercial systems but presents an uncertainty limited by the spectral width and the wavelength stability of the tunable filter. The second method consists in measuring multiple reference absorption lines of calibrated absorption gas cells. This second method presents lower uncertainties, limited only by the optical resolution of the interrogator and the wavelength uncertainty of the reference cell absorption lines. However, it imposes more restrictive requirements on the interrogator software. Both methods were experimentally demonstrated by calibrating multiple commercial systems, reaching uncertainties down to 0.63 pm at a central wavelength of 1550 nm.

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OBJECTIVE: The objective of this study was to investigate the effects of two programs for strengthening the pelvic floor on the urinary incontinence of patients with multiple sclerosis (MS). DESIGN: This is a prospective study of the clinical trial type, monitored for 6 mos, in which 24 women in the moderate stage of MS participated in a program of exercises for strengthening the pelvic floor-associated (experimental group) or not (control group) with electrotherapy. The variables analyzed were as follows: quality-of-life, overactivity of the bladder, perineal contraction, and level of anxiety and depression. The statistical procedures involved multivariate analyses of repeated measurements, with a significance of 5%. RESULTS: Initial homogeneity being observed in the anthropometric and clinical variables, both protocols resulted in improvements in quality-of-life (P = 0.001), overactive bladder (P = 0.001), perineal contraction (P = 0.004), and level of anxiety (P = 0.001) and depression (P = 0.001), in relation to the initial comparison. The association of electrotherapy with strengthening exercises increased the improvement of the patients regarding overactive bladder (P = 0.039) and perineal contraction (P = 0.001), in comparison with the control group. CONCLUSIONS: The results reinforce the benefit of exercises for strengthening the musculature of the pelvic floor in women with overactive bladder in MS and demonstrate a potential of the action when associated with electrotherapy. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Identify common dysfunctions of the lower urinary tract in women with multiple sclerosis; (2) Discuss the relationship between quality-of-life, level of anxiety and depression, degree of perineal contraction, and overactive bladder; and (3) Recognize the benefits promoted by physical therapy for strengthening the pelvic floor in patients with multiple sclerosis. LEVEL: Advanced ACCREDITATION: : The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

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Multiple sclerosis (MS) is a chronic, neurological, immune-mediated disease that can worsen in the postpartum period. There is no consensus on the use of immunoglobulin for prevention of disease relapses after delivery. We have shown that the controversial beneficial effect of immunoglobulin given immediately after birth could not be observed in patients with MS.

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OBJECTIVE: Natalizumab is a new and efficient treatment for multiple sclerosis (MS). The risk of developing progressive multifocal leukoencephalopathy (PML) during the use of this drug has created the need for better comprehension of JC virus (JCV) infection. The objective of the present study was to assess the prevalence of JCV-DNA in Brazilian patients using natalizumab. METHOD: Qualitative detection of the JCV in the serum was performed with real-time polymerase chain reaction (PCR). RESULTS: In a group of 168 patients with MS who were undergoing treatment with natalizumab, JCV-DNA was detectable in 86 (51.2%) patients. DISCUSSION: Data on JCV-DNA in Brazil add to the worldwide assessment of the prevalence of the JCV in MS patients requiring treatment with natalizumab.

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Objective Natalizumab is a new and efficient treatment for multiple sclerosis (MS). The risk of developing progressive multifocal leukoencephalopathy (PML) during the use of this drug has created the need for better comprehension of JC virus (JCV) infection. The objective of the present study was to assess the prevalence of JCV-DNA in Brazilian patients using natalizumab. Method Qualitative detection of the JCV in the serum was performed with real-time polymerase chain reaction (PCR). Results In a group of 168 patients with MS who were undergoing treatment with natalizumab, JCV-DNA was detectable in 86 (51.2%) patients. Discussion Data on JCV-DNA in Brazil add to the worldwide assessment of the prevalence of the JCV in MS patients requiring treatment with natalizumab. .

Objetivo Natalizumabe é um tratamento novo e eficaz para esclerose múltipla (EM). O risco constatado de desenvolver leucoencefalopatia multifocal progressiva (LEMP) durante o uso desta droga criou a necessidade de melhor estudar a infecção pelo vírus JC (JCV). O objetivo do presente estudo foi avaliar a prevalência de DNA-JCV em paciente brasileiros usando natalizumabe. Método Detecção qualitativa de JCV no soro foi realizada através de reação em cadeia por polimerase (PCR) em tempo real. Resultados DNA-JCV foi detectado em 86 pacientes (51,2%) de um grupo de 168 pessoas com EM recebendo tratamento com natalizumabe,). Discussão Dados do DNA-JCV no Brasil complementam as avaliações mundiais sobre a prevalência de JCV em pacientes com EM que necessitam tratamento natalizumabe. .

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OBJECTIVE: To assess the prevalence and the profile of adverse events (AE) of natalizumab in patients with multiple sclerosis (MS). METHODS: Data collection from neurologists attending to patients with MS at specialized units in Brazil. RESULTS: Data from 103 patients attending the infusion centers of 16 MS units in 9 Brazilian states were included in the study. The total number of infusions was 1,042. Seventy-nine patients (76.7%) did not present any AE. Twenty-four patients (23.3%) presented only mild AE. There were three major AE, including two deaths. These three occurrences, although not necessarily being drug-related, must be taken into consideration. CONCLUSION: The profile of AEs for natalizumab shows that 97% of patients have none or only mild AE. However, still due to safety worries, the use of this medication should be restricted to MS units under the care of specialized neurologists.

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Phase-sensitive optical time-domain reflectometry (φOTDR) is a simple and effective tool allowing the distributed monitoring of vibrations along single-mode fibers. We show in this Letter that modulation instability (MI) can induce a position-dependent signal fading in long-range φOTDR over conventional optical fibers. This fading leads to a complete masking of the interference signal recorded at certain positions and therefore to a sensitivity loss at these positions. We illustrate this effect both theoretically and experimentally. While this effect is detrimental in the context of distributed vibration analysis using φOTDR, we also believe that the technique provides a clear and insightful way to evidence the Fermi-Pasta-Ulam recurrence associated with the MI process.

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To assess the prevalence and the profile of adverse events (AE) of natalizumab in patients with multiple sclerosis (MS). Data collection from neurologists attending to patients with MS at specialized units in Brazil. Data from 103 patients attending the infusion centers of 16 MS units in 9 Brazilian states were included in the study. The total number of infusions was 1,042. Seventy-nine patients (76.7%) did not present any AE. Twenty-four patients (23.3%) presented only mild AE. There were three major AE, including two deaths. These three occurrences, although not necessarily being drug-related, must be taken into consideration. The profile of AEs for natalizumab shows that 97% of patients have none or only mild AE. However, still due to safety worries, the use of this medication should be restricted to MS units under the care of specialized neurologists. .

Avaliar a prevalência e o perfil dos eventos adversos (EA) por natalizumabe em pacientes com esclerose múltipla (EM). Coleta de dados fornecidos por neurologistas de unidades especializadas em EM no Brasil. No estudo, foram incluídos dados de 103 pacientes em tratamento em centros de infusão de 16 unidades de EM em 9 estados brasileiros. O número total de infusões foi 1.042. Setenta e nove pacientes (76,7%) não apresentaram nenhum EA. Vinte e quatro pacientes (23,3%) apresentaram apenas EA leves. Foram relatados três importantes EA, incluindo duas mortes. Embora não necessariamente ligadas à droga, estas EA devem ser levadas em consideração. O perfil de EA para natalizumabe mostrou que em 97% dos pacientes não houve EA ou houve apenas EA leves. No entanto, dadas as preocupações com segurança da droga, o uso deste medicamento deve continuar restrito às unidades de EM sob os cuidados de neurologistas especializados. .

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