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3. The Swiss Multiple Sclerosis Cohort-Study (SMSC): A Prospective Swiss Wide Investigation of Key Phases in Disease Evolution and New Treatment Options

Author

Ludwig Kappos, Till Sprenger, Jens Kuhle, Johannes Lorscheider, Krassen Nedeltchev, Simon Ramseier, Oliver Findling, Ernst-Wilhelm Radue, Jean-François Louvion, Myriam Schluep, Giulio Disanto, Lutz Achtnichts, Renaud Du Pasquier, Claudio Gobbi, Christoph Stippich, Heinrich Mattle, Jochen Vehoff, Patrice H. Lalive, Pascal Benkert, Chiara Zecca, Christoph Lotter, Özgür Yaldizli, Smsc Scientific Board, Tobias Derfuss, Caroline Pot, Christian P. Kamm, Stefanie Karin Mueller, SMSC Scientific, Board, Ramseier, S., Achtnichts, L., Findling, O., Saxer, J., Nedeltchev, K., Remonda, L., Boxheimer, L., Kuhle, J., Kappos, L., Yaldizli£££Özguer£££ Ö., Derfuss, T., Sprenger, T., Limberg, M., Scheerer, I., Orleth, A., Treppke, F., Beregi, E., Stippich, C., Reinhardt, J., Fellner, I., Würfel, J., Radue, EW., Thoeni, A., Palatini, A., Pauli-Magnus, C., Fabbro, T., Benkert, P., Roesler, A., Mechati, S., Louvion, JF., Kamm, C., Chan, A., Mattle, H., Salmen, A., Kaeser, M., Wagner, F., Verma, R., Lalive, P., Di Marco, M., Haller, S., Lovblad, KO., Du Pasquier, R., Schluep, M., Pot, C., Granziera, C., Hagmann, P., Maeder, P., Gobbi, C., Zecca, C., Disanto, G., Tschuor, S., Cianfoni, A., Müller, S., Vehoff, J., Weber, J., and Lotter, C.

Subjects
Male, 0301 basic medicine, Physiology, Adult, Biomarkers/blood, Biomarkers/cerebrospinal fluid, Brain/radiography, Cohort Studies, Demography, Female, Fingolimod Hydrochloride/therapeutic use, Follow-Up Studies, Humans, Immunosuppressive Agents/therapeutic use, Magnetic Resonance Imaging, Middle Aged, Multiple Sclerosis/diagnosis, Multiple Sclerosis/drug therapy, Natalizumab/therapeutic use, Prognosis, Prospective Studies, Recurrence, Switzerland, lcsh:Medicine, ddc:616.07, Nervous System, Diagnostic Radiology, Geographical Locations, 0302 clinical medicine, Natalizumab, Medicine and Health Sciences, Medicine, 10. No inequality, Prospective cohort study, lcsh:Science, Cerebrospinal Fluid, Multidisciplinary, Clinically isolated syndrome, Radiology and Imaging, Brain, Neurodegenerative Diseases, Fingolimod, Body Fluids, 3. Good health, Europe, Neurology, Research Design, Cohort, Observational Studies, Anatomy, Immunosuppressive Agents, Research Article, medicine.drug, Cohort study, medicine.medical_specialty, Multiple Sclerosis, Imaging Techniques, Immunology, Research and Analysis Methods, Autoimmune Diseases, 03 medical and health sciences, Diagnostic Medicine, Internal medicine, Expanded Disability Status Scale, Fingolimod Hydrochloride, business.industry, Multiple sclerosis, lcsh:R, Biology and Life Sciences, medicine.disease, Demyelinating Disorders, Long-Term Care, Surgery, Health Care, Radiography, 030104 developmental biology, People and Places, Clinical Immunology, lcsh:Q, Clinical Medicine, business, Biomarkers, 030217 neurology & neurosurgery
Abstract

The mechanisms leading to disability and the long-term efficacy and safety of disease modifying drugs (DMDs) in multiple sclerosis (MS) are unclear. We aimed at building a prospective cohort of MS patients with standardized collection of demographic, clinical, MRI data and body fluids that can be used to develop prognostic indicators and biomarkers of disease evolution and therapeutic response. The Swiss MS Cohort (SMSC) is a prospective observational study performed across seven Swiss MS centers including patients with MS, clinically isolated syndrome (CIS), radiologically isolated syndrome or neuromyelitis optica. Neurological and radiological assessments and biological samples are collected every 6-12 months. We recruited 872 patients (clinically isolated syndrome [CIS] 5.5%, relapsing-remitting MS [RRMS] 85.8%, primary progressive MS [PPMS] 3.5%, secondary progressive MS [SPMS] 5.2%) between June 2012 and July 2015. We performed 2,286 visits (median follow-up 398 days) and collected 2,274 serum, plasma and blood samples, 152 cerebrospinal fluid samples and 1,276 brain MRI scans. 158 relapses occurred and expanded disability status scale (EDSS) scores increased in PPMS, SPMS and RRMS patients experiencing relapses. Most RRMS patients were treated with fingolimod (33.4%), natalizumab (24.5%) or injectable DMDs (13.6%). The SMSC will provide relevant information regarding DMDs efficacy and safety and will serve as a comprehensive infrastructure available for nested research projects.

Published
2016

4. Diffusion-weighted imaging in acute demyelinating myelopathy.

Author

Zecca C, Cereda C, Wetzel S, Tschuor S, Staedler C, Santini F, Nadarajah N, Bassetti CL, and Gobbi C

Subjects
Acute Disease, Adult, Female, Humans, Male, Middle Aged, Reproducibility of Results, Sensitivity and Specificity, Demyelinating Diseases pathology, Diffusion Magnetic Resonance Imaging methods, Spinal Cord pathology, Spinal Cord Diseases pathology
Abstract

Introduction: Diffusion-weighted imaging (DWI) has become a reference MRI technique for the evaluation of neurological disorders. Few publications have investigated the application of DWI for inflammatory demyelinating lesions. The purpose of the study was to describe diffusion-weighted imaging characteristics of acute, spinal demyelinating lesions., Methods: Six consecutive patients (two males, four females; aged 28-64 years) with acute spinal cord demyelinating lesions were studied in a prospective case series design from June 2009 to October 2010. We performed magnetic resonance imaging studies from 2 to 14 days from symptom onset on the patients with relapsing remitting multiple sclerosis (n = 3) or clinically isolated syndrome (n = 3). Main outcome measures were diffusion-weighted imaging and apparent diffusion coefficient pattern (ADC) of acute spinal cord demyelinating lesions., Results: All spinal lesions showed a restricted diffusion pattern (DWI+/ADC-) with a 24% median ADC signal decrease. A good correlation between clinical presentation and lesion site was observed., Conclusion: Acute demyelinating spinal cord lesions show a uniform restricted diffusion pattern. Clinicians and neuro-radiologists should be aware that this pattern is not necessarily confirmatory for an ischaemic aetiology.

Published
2012
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5. Pneumocephalus with intense headache and unilateral pupillary dilatation after accidental dural puncture during epidural anesthesia for cesarean section.

Author

Laviola S, Kirvelä M, Spoto MR, Tschuor S, and Alon E

Subjects
Adult, Anesthesia, Epidural methods, Anesthesia, Obstetrical methods, Cesarean Section, Female, Humans, Pregnancy, Anesthesia, Epidural adverse effects, Anesthesia, Obstetrical adverse effects, Headache etiology, Mydriasis etiology, Pneumocephalus etiology, Spinal Puncture adverse effects
Published
1999
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6. Sonographic appearance of urethral diverticulum in the male.

Author

Kauzlaric D, Barmeir E, Peyer P, and Tschuor S

Subjects
Adult, Diverticulum etiology, Diverticulum physiopathology, Epididymitis diagnosis, Epididymitis pathology, Fistula physiopathology, Humans, Male, Scrotum pathology, Testicular Hydrocele diagnosis, Testicular Hydrocele physiopathology, Urethral Diseases etiology, Urethral Diseases physiopathology, Urinary Bladder, Neurogenic complications, Urography, Diverticulum diagnosis, Fistula diagnosis, Scrotum physiopathology, Ultrasonography, Urethral Diseases diagnosis
Published
1988
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