10 results on '"Roberto Rey"'
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2. Utilidad de la identificación de anticuerpos en neuropatías periféricas, neuronopatías y ganglionopatías: revisión
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Gabriel Rodriguez, Eugenia Conti, Valeria Alvarez, Maria Alejandra Figueredo, Ricardo Reisin, Gisella Gargiulo, Mariela Bettini, Cecilia Quarracino, Paola Pivetta, Roberto Rey, María del Carmen Martínez Perea, Mariano M. Borrelli, Mariana di Egidio, Laura Pirra, Agustín Jáuregui, Paz Zuberhbuler, Mariana Bendersky, José M. Crespo, María Lucía Rattagan, Florencia Aguirre, Luciana Leon Cejas, Elisa M. Cisneros, Fabio Barroso, Marcelo Rugiero, Valeria Lujan Salutto, Belen Tillard, Alejandro Rodríguez, Marcelo Chaves, Paula Landriscina, and Andrés Berardo
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03 medical and health sciences ,0302 clinical medicine ,Neurology ,030212 general & internal medicine ,Neurology (clinical) ,030217 neurology & neurosurgery - Abstract
Resumen Introduccion En los ultimos anos la identificacion de anticuerpos y gammapatias monoclonales ha permitido comprender la fisiopatologia y favorecer el diagnostico y tratamiento de una multiplicidad de neuropatias inmunomediadas. Objetivo Describir los anticuerpos de mayor relevancia clinica en las neuropatias, ganglionopatias y neuronopatias inmunomediadas caracterizando en cada caso su valor fisiopatologico o diagnostico, asi como la sensibilidad y especificidad de los metodos utilizados para su determinacion. Desarrollo Se analizaran los anticuerpos identificados en 1) sindrome de Guillain-Barre; 2) polineuropatia inflamatoria desmielinizante cronica (PDIC), 3) neuropatia motora con bloqueo multifocal (NMM); 4) CANOMAD (neuropatia ataxica cronica, oftalmoplejia, proteina IgM monoclonal, aglutininas frias y anticuerpos disialosil); 5) ganglionopatias y neuronopatias y la utilidad de identificar las gammapatias monoclonales. Conclusiones Los anticuerpos y las gammapatias monoclonales son herramientas que han permitido mejorar el diagnostico y la comprension fisiopatologica de las neuropatias inmunomediadas y algunas criptogenicas, asi como orientar el tratamiento mas adecuado.
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- 2020
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3. WITHDRAWN: Efectividad, Persistencia del Tratamiento y Seguridad a Largo Plazo de Fingolimod en Pacientes con Esclerosis Múltiple en la Práctica Habitual. Resultados del registro de 24 meses de pacientes Argentinos tratados con fingoLimod (REAL)
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Vladimiro Sinay, Marcela Parada Marcilla, Marcos Burgos, Andres Villa, Fernando Caceres, Maria Laura Saladino, Miguel Jacobo, Roberto Rey, and Gustavo Seifer
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Neurology ,business.industry ,Medicine ,Neurology (clinical) ,business - Published
- 2021
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4. Siponimod versus placebo in secondary progressive multiple sclerosis (EXPAND): a double-blind, randomised, phase 3 study
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Ludwig Kappos, Amit Bar-Or, Bruce A C Cree, Robert J Fox, Gavin Giovannoni, Ralf Gold, Patrick Vermersch, Douglas L Arnold, Sophie Arnould, Tatiana Scherz, Christian Wolf, Erik Wallström, Frank Dahlke, Anat Achiron, Lutz Achtnichts, Kadriye Agan, Gulsen Akman-Demir, Alison B Allen, Jack P Antel, Alfredo Rodriguez Antiguedad, Michelle Apperson, Angela M Applebee, Guillermo Izquierdo Ayuso, Masayuki Baba, Ovidiu Bajenaru, Rodica Balasa, Belgin Petek Balci, Michael Barnett, Ann Bass, Veit U Becker, Mihaela Bejinariu, Florian Then Bergh, Arnfin Bergmann, Evanthia Bernitsas, Achim Berthele, Virender Bhan, Felix Bischof, Randall John Bjork, Gregg Blevins, Matthias Boehringer, Thomas Boerner, Robert Bonek, James D Bowen, Allen Bowling, Alexey N Boyko, Cavit Boz, Vera Bracknies, Stefan Braune, Vincenzo Brescia Morra, Bruno Brochet, Waldemar Brola, Paul Kenneth Brownstone, Miroslav Brozman, Donald Brunet, Ioan Buraga, Margaret Burnett, Mathias Buttmann, Helmut Butzkueven, Jonathan Cahill, Jonathan C Calkwood, William Camu, Mark Cascione, Giovani Castelnovo, Diego Centonze, Joao Cerqueira, Andrew Chan, Andrea Cimprichova, Stanley Cohan, Giancarlo Comi, Jill Conway, Joanna A Cooper, John Corboy, Jorge Correale, Brian Costell, David A Cottrell, Patricia K Coyle, Matthew Craner, Liying Cui, Luis Cunha, Anna Czlonkowska, Ana Martins da Silva, Joao de Sa, Jérôme de Seze, Marc Debouverie, Jan Debruyne, Danny Decoo, Gilles Defer, Tobias Derfuss, Norma H Deri, Bhupesh Dihenia, Peter Dioszeghy, Vladimir Donath, Benedicte Dubois, Martin Duddy, Pierre Duquette, Gilles Edan, Husnu Efendi, Stanton Elias, Peter J Emrich, Bonaventura Casanova Estruch, Evgeniy P Evdoshenko, Juergen Faiss, Alexander S Fedyanin, Wolfgang Feneberg, Jiske Fermont, Oscar Fernandez Fernandez, Francisco Coret Ferrer, Katharina Fink, Helen Ford, Corey Ford, Ada Francia, Mark Freedman, Benjamin Frishberg, Simonetta Galgani, George P Garmany, Klaus Gehring, Jeffrey Gitt, Claudio Gobbi, Lawrence P Goldstick, Rafael Arroyo Gonzalez, Francois Grandmaison, Nikolaos Grigoriadis, Olga Grigorova, Luigi Maria Edoardo Grimaldi, Jeffrey Gross, Katrin Gross-Paju, Mark Gudesblatt, Daniel Guillaume, Judith Haas, Viera Hancinova, Anca Hancu, Orla Hardiman, Arndt Harmjanz, Fedor R Heidenreich, G J D Hengstman, Joseph Herbert, Mark Herring, Suzanne Hodgkinson, Olaf M Hoffmann, Werner E Hofmann, William D Honeycutt, Le Hanh Hua, Dehui Huang, Yining Huang, DeRen Huang, Raymond Hupperts, Piroska Imre, Alan Keith Jacobs, Gabor Jakab, Elzbieta Jasinska, Kenichi Kaida, Jolanta Kalnina, Ara Kaprelyan, Guntis Karelis, Dimitrios Karussis, Amos Katz, Farit A Khabirov, Bhupendra Khatri, Takashi Kimura, Ilya Kister, Rasa Kizlaitiene, Eleonora Klimova, Juergen Koehler, Aparna Komatineni, Anselm Kornhuber, Krisztina Kovacs, Agnes Koves, Wojciech Kozubski, Georgi Krastev, Lauren B Krupp, Egon Kurca, Christoph Lassek, Guy Laureys, Liesly Lee, Eckart Lensch, Fritz Leutmezer, Hongzeng Li, Ralf A Linker, Michael Linnebank, Petra Liskova, Cristina Llanera, Jiahong Lu, Andreas Lutterotti, Jan Lycke, Richard Macdonell, Maciej Maciejowski, Mathias Maeurer, Rim V Magzhanov, Eva-Maria Maida, Lina Malciene, Yang Mao-Draayer, Girolama Alessandra Marfia, Clyde Markowitz, Vasileios Mastorodimos, Klotild Matyas, Jose Meca-Lallana, Juan Antonio Garcia Merino, Ioan Gheorghe Mihetiu, Ivan Milanov, Aaron E Miller, Andrejs Millers, Massimiliano Mirabella, Masanori Mizuno, Xavier Montalban, Lilina Montoya, Masahiro Mori, Stefanie Mueller, Jin Nakahara, Yuji Nakatsuji, Scott Newsome, Richard Nicholas, A Scott Nielsen, Esmaeil Nikfekr, Ugo Nocentini, Chiyoko Nohara, Kyoichi Nomura, Miroslav M Odinak, Tomas Olsson, B W van Oosten, Celia Oreja-Guevara, Patrick Oschmann, James Overell, Andrew Pachner, Gyula Panczel, Massimo Pandolfo, Caroline Papeix, Liliana Patrucco, Jean Pelletier, Raul Piedrabuena, Misha Pless, Udo Polzer, Krisztian Pozsegovits, Daiva Rastenyte, Sebastian Rauer, Gerd Reifschneider, Roberto Rey, Syed A Rizvi, Derrick Robertson, Jose Martinez Rodriguez, David Rog, Homayoun Roshanisefat, Vernon Rowe, Csilla Rozsa, Susan Rubin, Stanislaw Rusek, Francesco Saccà, Takahiko Saida, Antonio Vasco Salgado, Victoria Eugenia Fernandez Sanchez, Kalina Sanders, Maria Satori, Denis V Sazonov, Elio Angelo Scarpini, Eugen Schlegel, Myriam Schluep, Stephan Schmidt, Erich Scholz, H M Schrijver, Matthias Schwab, Raymond Schwartz, James Scott, Krzysztof Selmaj, Stuart Shafer, Basil Sharrack, Ivan A Shchukin, Yuko Shimizu, Penko Shotekov, Arno Siever, Karl-Otto Sigel, Scott Silliman, Magdolna Simo, Mihaela Simu, Vladimiro Sinay, Antonio Escartin Siquier, Aksel Siva, Ondrej Skoda, Andrew Solomon, Martin Stangel, Dusan Stefoski, Brian Steingo, Igor D Stolyarov, Pavel Stourac, Katrin Strassburger-Krogias, Erik Strauss, Olaf Stuve, Ivaylo Tarnev, Antonios Tavernarakis, Cristina Ramo Tello, Murat Terzi, Veronika Ticha, Marina Ticmeanu, Klaus Tiel-Wilck, Toomas Toomsoo, Niall Tubridy, Mark J Tullman, Hayrettin Tumani, Peter Turcani, Ben Turner, Antonio Uccelli, Francisco Javier Olascoaga Urtaza, Marta Vachova, Attila Valikovics, Silke Walter, Bart Van Wijmeersch, Ludo Vanopdenbosch, Joerg R Weber, Sara Weiss, Robert Weissert, Timothy West, Heinz Wiendl, Sandrine Wiertlewski, Brigitte Wildemann, Barbara Willekens, L H Visser, Galina Vorobeychik, Xianhao Xu, Takashi Yamamura, Yi N Yang, Sergio Martinez Yelamos, Michael Yeung, Alan Zacharias, Marvin Zelkowitz, Uwe Zettl, Meini Zhang, Hongyu Zhou, Ulf Zieman, Tjalf Ziemssen, Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital, University of Basel, Basel, Center for Neuroinflammation and Neurotherapeutics, and Multiple Sclerosis Division, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, Neuroimmunology Unit, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA, Mellen Centre for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, Department of Neurology St. Josef-Hospital, Ruhr University Bochum, Germany, Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Montreal Neurological Institute, McGill University, Montreal, QC, Canada, NeuroRx Research, Montreal, QC, Novartis Pharma AG, Lycalis, Brussels, AP-HM, CHU Timone, Pole de Neurosciences Cliniques, Department of Neurology, Marseille, France., Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM] (CEMEREM), Hôpital de la Timone [CHU - APHM] (TIMONE)-Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Kappos, Ludwig, Bar-Or, Amit, Cree, Bruce A C, Fox, Robert J, Giovannoni, Gavin, Gold, Ralf, Vermersch, Patrick, Arnold, Douglas L, Arnould, Sophie, Scherz, Tatiana, Wolf, Christian, Wallström, Erik, Dahlke, Frank, Achiron, Anat, Achtnichts, Lutz, Agan, Kadriye, Akman-Demir, Gulsen, Allen, Alison B, Antel, Jack P, Antiguedad, Alfredo Rodriguez, Apperson, Michelle, Applebee, Angela M, Ayuso, Guillermo Izquierdo, Baba, Masayuki, Bajenaru, Ovidiu, Balasa, Rodica, Balci, Belgin Petek, Barnett, Michael, Bass, Ann, Becker, Veit U, Bejinariu, Mihaela, Bergh, Florian Then, Bergmann, Arnfin, Bernitsas, Evanthia, Berthele, Achim, Bhan, Virender, Bischof, Felix, Bjork, Randall John, Blevins, Gregg, Boehringer, Matthia, Boerner, Thoma, Bonek, Robert, Bowen, James D, Bowling, Allen, Boyko, Alexey N, Boz, Cavit, Bracknies, Vera, Braune, Stefan, Brescia Morra, Vincenzo, Brochet, Bruno, Brola, Waldemar, Brownstone, Paul Kenneth, Brozman, Miroslav, Brunet, Donald, Buraga, Ioan, Burnett, Margaret, Buttmann, Mathia, Butzkueven, Helmut, Cahill, Jonathan, Calkwood, Jonathan C, Camu, William, Cascione, Mark, Castelnovo, Giovani, Centonze, Diego, Cerqueira, Joao, Chan, Andrew, Cimprichova, Andrea, Cohan, Stanley, Comi, Giancarlo, Conway, Jill, Cooper, Joanna A, Corboy, John, Correale, Jorge, Costell, Brian, Cottrell, David A, Coyle, Patricia K, Craner, Matthew, Cui, Liying, Cunha, Lui, Czlonkowska, Anna, da Silva, Ana Martin, de Sa, Joao, de Seze, Jérôme, Debouverie, Marc, Debruyne, Jan, Decoo, Danny, Defer, Gille, Derfuss, Tobia, Deri, Norma H, Dihenia, Bhupesh, Dioszeghy, Peter, Donath, Vladimir, Dubois, Benedicte, Duddy, Martin, Duquette, Pierre, Edan, Gille, Efendi, Husnu, Elias, Stanton, Emrich, Peter J, Estruch, Bonaventura Casanova, Evdoshenko, Evgeniy P, Faiss, Juergen, Fedyanin, Alexander S, Feneberg, Wolfgang, Fermont, Jiske, Fernandez, Oscar Fernandez, Ferrer, Francisco Coret, Fink, Katharina, Ford, Helen, Ford, Corey, Francia, Ada, Freedman, Mark, Frishberg, Benjamin, Galgani, Simonetta, Garmany, George P, Gehring, Klau, Gitt, Jeffrey, Gobbi, Claudio, Goldstick, Lawrence P, Gonzalez, Rafael Arroyo, Grandmaison, Francoi, Grigoriadis, Nikolao, Grigorova, Olga, Grimaldi, Luigi Maria Edoardo, Gross, Jeffrey, Gross-Paju, Katrin, Gudesblatt, Mark, Guillaume, Daniel, Haas, Judith, Hancinova, Viera, Hancu, Anca, Hardiman, Orla, Harmjanz, Arndt, Heidenreich, Fedor R, Hengstman, G J D, Herbert, Joseph, Herring, Mark, Hodgkinson, Suzanne, Hoffmann, Olaf M, Hofmann, Werner E, Honeycutt, William D, Hua, Le Hanh, Huang, Dehui, Huang, Yining, Huang, Deren, Hupperts, Raymond, Imre, Piroska, Jacobs, Alan Keith, Jakab, Gabor, Jasinska, Elzbieta, Kaida, Kenichi, Kalnina, Jolanta, Kaprelyan, Ara, Karelis, Gunti, Karussis, Dimitrio, Katz, Amo, Khabirov, Farit A, Khatri, Bhupendra, Kimura, Takashi, Kister, Ilya, Kizlaitiene, Rasa, Klimova, Eleonora, Koehler, Juergen, Komatineni, Aparna, Kornhuber, Anselm, Kovacs, Krisztina, Koves, Agne, Kozubski, Wojciech, Krastev, Georgi, Krupp, Lauren B, Kurca, Egon, Lassek, Christoph, Laureys, Guy, Lee, Liesly, Lensch, Eckart, Leutmezer, Fritz, Li, Hongzeng, Linker, Ralf A, Linnebank, Michael, Liskova, Petra, Llanera, Cristina, Lu, Jiahong, Lutterotti, Andrea, Lycke, Jan, Macdonell, Richard, Maciejowski, Maciej, Maeurer, Mathia, Magzhanov, Rim V, Maida, Eva-Maria, Malciene, Lina, Mao-Draayer, Yang, Marfia, Girolama Alessandra, Markowitz, Clyde, Mastorodimos, Vasileio, Matyas, Klotild, Meca-Lallana, Jose, Merino, Juan Antonio Garcia, Mihetiu, Ioan Gheorghe, Milanov, Ivan, Miller, Aaron E, Millers, Andrej, Mirabella, Massimiliano, Mizuno, Masanori, Montalban, Xavier, Montoya, Lilina, Mori, Masahiro, Mueller, Stefanie, Nakahara, Jin, Nakatsuji, Yuji, Newsome, Scott, Nicholas, Richard, Nielsen, A Scott, Nikfekr, Esmaeil, Nocentini, Ugo, Nohara, Chiyoko, Nomura, Kyoichi, Odinak, Miroslav M, Olsson, Toma, van Oosten, B W, Oreja-Guevara, Celia, Oschmann, Patrick, Overell, Jame, Pachner, Andrew, Panczel, Gyula, Pandolfo, Massimo, Papeix, Caroline, Patrucco, Liliana, Pelletier, Jean, Piedrabuena, Raul, Pless, Misha, Polzer, Udo, Pozsegovits, Krisztian, Rastenyte, Daiva, Rauer, Sebastian, Reifschneider, Gerd, Rey, Roberto, Rizvi, Syed A, Robertson, Derrick, Rodriguez, Jose Martinez, Rog, David, Roshanisefat, Homayoun, Rowe, Vernon, Rozsa, Csilla, Rubin, Susan, Rusek, Stanislaw, Saccà, Francesco, Saida, Takahiko, Salgado, Antonio Vasco, Sanchez, Victoria Eugenia Fernandez, Sanders, Kalina, Satori, Maria, Sazonov, Denis V, Scarpini, Elio Angelo, Schlegel, Eugen, Schluep, Myriam, Schmidt, Stephan, Scholz, Erich, Schrijver, H M, Schwab, Matthia, Schwartz, Raymond, Scott, Jame, Selmaj, Krzysztof, Shafer, Stuart, Sharrack, Basil, Shchukin, Ivan A, Shimizu, Yuko, Shotekov, Penko, Siever, Arno, Sigel, Karl-Otto, Silliman, Scott, Simo, Magdolna, Simu, Mihaela, Sinay, Vladimiro, Siquier, Antonio Escartin, Siva, Aksel, Skoda, Ondrej, Solomon, Andrew, Stangel, Martin, Stefoski, Dusan, Steingo, Brian, Stolyarov, Igor D, Stourac, Pavel, Strassburger-Krogias, Katrin, Strauss, Erik, Stuve, Olaf, Tarnev, Ivaylo, Tavernarakis, Antonio, Tello, Cristina Ramo, Terzi, Murat, Ticha, Veronika, Ticmeanu, Marina, Tiel-Wilck, Klau, Toomsoo, Tooma, Tubridy, Niall, Tullman, Mark J, Tumani, Hayrettin, Turcani, Peter, Turner, Ben, Uccelli, Antonio, Urtaza, Francisco Javier Olascoaga, Vachova, Marta, Valikovics, Attila, Walter, Silke, Van Wijmeersch, Bart, Vanopdenbosch, Ludo, Weber, Joerg R, Weiss, Sara, Weissert, Robert, West, Timothy, Wiendl, Heinz, Wiertlewski, Sandrine, Wildemann, Brigitte, Willekens, Barbara, Visser, L H, Vorobeychik, Galina, Xu, Xianhao, Yamamura, Takashi, Yang, Yi N, Yelamos, Sergio Martinez, Yeung, Michael, Zacharias, Alan, Zelkowitz, Marvin, Zettl, Uwe, Zhang, Meini, Zhou, Hongyu, Zieman, Ulf, Ziemssen, Tjalf, and EXPAND Clinical Investigators
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Adult ,Male ,0301 basic medicine ,Relative risk reduction ,medicine.medical_specialty ,Adolescent ,Placebo ,law.invention ,Cohort Studies ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,Multiple Sclerosis, Chronic Progressive / drug therapy ,0302 clinical medicine ,Double-Blind Method ,Randomized controlled trial ,law ,Internal medicine ,Benzyl Compounds ,Clinical endpoint ,Humans ,Medicine ,ComputingMilieux_MISCELLANEOUS ,Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA ,Expanded Disability Status Scale ,Dose-Response Relationship, Drug ,business.industry ,Hazard ratio ,General Medicine ,Middle Aged ,Multiple Sclerosis, Chronic Progressive ,Fingolimod ,Treatment Outcome ,Settore M-EDF/01 - METODI E DIDATTICHE DELLE ATTIVITÀ MOTORIE ,030104 developmental biology ,Siponimod ,chemistry ,Disease Progression ,Azetidines ,Female ,Settore MED/26 - Neurologia ,Human medicine ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Summary Background No treatment has consistently shown efficacy in slowing disability progression in patients with secondary progressive multiple sclerosis (SPMS). We assessed the effect of siponimod, a selective sphingosine 1-phosphate (S1P) receptor 1,5 modulator, on disability progression in patients with SPMS. Methods This event-driven and exposure-driven, double-blind, phase 3 trial was done at 292 hospital clinics and specialised multiple sclerosis centres in 31 countries. Using interactive response technology to assign numbers linked to treatment arms, patients (age 18–60 years) with SPMS and an Expanded Disability Status Scale score of 3·0–6·5 were randomly assigned (2:1) to once daily oral siponimod 2 mg or placebo for up to 3 years or until the occurrence of a prespecified number of confirmed disability progression (CDP) events. The primary endpoint was time to 3-month CDP. Efficacy was assessed for the full analysis set (ie, all randomly assigned and treated patients); safety was assessed for the safety set. This trial is registered with ClinicalTrials.gov, number NCT01665144. Findings 1651 patients were randomly assigned between Feb 5, 2013, and June 2, 2015 (1105 to the siponimod group, and 546 to the placebo group). One patient did not sign the consent form, and five patients did not receive study drug, all of whom were in the siponimod group. 1645 patients were included in the analyses (1099 in the siponimod group and 546 in the placebo). At baseline, the mean time since first multiple sclerosis symptoms was 16·8 years (SD 8·3), and the mean time since conversion to SPMS was 3·8 years (SD 3·5); 1055 (64%) patients had not relapsed in the previous 2 years, and 918 (56%) of 1651 needed walking assistance. 903 (82%) patients receiving siponimod and 424 (78%) patients receiving placebo completed the study. 288 (26%) of 1096 patients receiving siponimod and 173 (32%) of 545 patients receiving placebo had 3-month CDP (hazard ratio 0·79, 95% CI 0·65–0·95; relative risk reduction 21%; p=0·013). Adverse events occurred in 975 (89%) of 1099 patients receiving siponimod versus 445 (82%) of 546 patients receiving placebo; serious adverse events were reported for 197 (18%) patients in the siponimod group versus 83 (15%) patients in the placebo group. Lymphopenia, increased liver transaminase concentration, bradycardia and bradyarrhythmia at treatment initiation, macular oedema, hypertension, varicella zoster reactivation, and convulsions occurred more frequently with siponimod than with placebo. Initial dose titration mitigated cardiac first-dose effects. Frequencies of infections, malignancies, and fatalities did not differ between groups. Interpretation Siponimod reduced the risk of disability progression with a safety profile similar to that of other S1P modulators and is likely to be a useful treatment for SPMS. Funding Novartis Pharma AG.
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- 2018
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5. Pituitary macroadenoma causing symptomatic internal carotid artery compression: Surgical treatment through transsphenoidal tumor resection
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Roberto Rey-Dios, Troy D. Payner, and Aaron A. Cohen-Gadol
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Adenoma ,Male ,medicine.medical_specialty ,Decompression ,Infarction ,Brain ischemia ,Pituitary adenoma ,Physiology (medical) ,medicine.artery ,Occlusion ,Humans ,Medicine ,Carotid Stenosis ,Pituitary Neoplasms ,business.industry ,Pituitary tumors ,Brain ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Cerebral Angiography ,Surgery ,Stroke ,Treatment Outcome ,Neurology ,Ischemic Attack, Transient ,Cavernous sinus ,cardiovascular system ,Neurology (clinical) ,Radiology ,Internal carotid artery ,Tomography, X-Ray Computed ,business ,Carotid Artery, Internal - Abstract
Pituitary macroadenomas can invade the cavernous sinus and rarely cause occlusion of the internal carotid artery (ICA). Most patients with symptomatic obstruction of the ICA by a pituitary tumor have been reported as a result of apoplexy. The authors review the literature about this condition and report a 48-year-old man who presented with transient ischemic attacks leading to a stroke. Imaging studies demonstrated complete occlusion of the left ICA and critical narrowing of the right ICA at the level of the clinoid processes, most likely due to macroadenoma mass effect. There was no radiologic evidence of apoplexy. Surgical resection of the tumor and ICA decompression via the transsphenoidal route resulted in prevention of further symptoms. Histopathologic analysis confirmed a nonfunctioning pituitary adenoma without evidence of hemorrhage or intratumoral infarction. This patient, to the authors' knowledge, is the first documented patient with symptomatic carotid compression by a pituitary adenoma without evidence of apoplexy.
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- 2014
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6. Tratamiento del dolor neuropático. Revisión de las últimas guías y recomendaciones
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Roberto Rey
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Tratamiento farmacologico ,Neurology ,business.industry ,Medicine ,Neurology (clinical) ,business ,Humanities ,Pharmacological treatment - Abstract
Resumen En los ultimos anos la informacion cientifica sobre el tratamiento farmacologico del dolor neuropatico (DN) ha aumentado considerablemente. Estudios aleatorizados, controlados, metaanalisis, guias, recomendaciones y revisiones ofrecen al medico una gran posibilidad de lectura, gran parte de ella en ingles. Consideramos util ofrecer al neurologo no especialista de habla hispana un resumen actualizado en espanol de las guias y recomendaciones sobre el tratamiento farmacologico del DN. En la presente revision consideramos 4 grupos de farmacos clasificados de acuerdo a su sitio y mecanismo de accion:a) receptores perifericos (farmacos de uso topico: lidocaina, capsaicina); b) fibras perifericas (bloqueantes de canales del sodio: carbamazepina, oxcarbacepina);c) moduladores espinales del dolor (bloqueantes de la subunidad alfa 2 delta de los canales de calcio voltaje dependiente: gabapentin, pregabalina); y d) moduladores de la inhibicion central descendente (inhibidores de la recaptacion de aminas) (antidepresivos triciclicos y selectivos «duales»: amitriptilina, duloxetina) y agonistas de receptores opioides (opioides, tramadol). Diferentes autores coinciden en que la primera eleccion en el tratamiento del DN esta compuesta por amitriptilina, gabapentina y pregabalina; como segunda opcion duloxetina; como tercera opioides, tramadol y farmacos de aplicacion topica y finalmente, como cuarta opcion, otros farmacos antiepilepticos y antidepresivos. En circunstancias especiales algunos farmacos pueden considerarse como primera eleccion: polineuropatia diabetica dolorosa pregabalina y duloxetina; neuralgia del trigemino: carbamazepina y oxcarbacepina. DN agudo: opioides, tramadol y DN localizado con alodinia (neuralgia postherpetica): lidocaina topica.
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- 2013
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7. Encuesta sobre educación médica en dolor neuropático en Argentina
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Federico Buonanotte, Gustavo A. Blanco, José Daniel Braver, Fernando Salvat, Roberto H. Wortley, León E. Litvak, Cintia L. Marchesoni, Roberto Rey, Daniel Weissbrod, Eduardo Stonski, Federico Ferrari, and Nicolás Sarria
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Neurology ,business.industry ,Medicine ,Neurology (clinical) ,business ,Humanities - Abstract
Resumen Si bien el dolor neuropatico (DN) es conocido desde la antiguedad y puede presentarse en numerosas entidades, muchos profesionales en nuestro medio consideran que la formacion medica durante la etapa del pregrado en el tema es insuficiente. Para evaluar la opinion que tienen los medicos de su capacitacion en DN en el pregrado y en el posgrado en nuestro pais, los autores realizaron una encuesta a 440 medicos durante el ano 2010. Se consulto a los profesionales si habian recibido educacion de pregrado y de postgrado en DN y si se sentian capacitados para tratarlo. La mayoria de los medicos refirio no haber recibido educacion de pregrado en dolor y DN (53%) y no se sentian capacitados para tratarlo (62%). Gran parte de los medicos adquiria formacion en actividades de posgrado y estaban interesados en continuar su formacion en DN.
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- 2013
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8. Fibromialgia para neurólogos. Controversias sobre una consulta frecuente
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Cintia L. Marchesoni, Federico Buonanotte, and Roberto Rey
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Neurology ,Neurology (clinical) - Abstract
Resumen La fibromialgia (FM) es una entidad que ha sido aceptada por la OMS en 1992. Los criterios diagnosticos han sido postulados inicialmente en 1990 y modificados recientemente. El cuadro clinico se caracteriza por dolor cronico osteoarticular, muscular y del tejido celular subcutaneo, con fluctuaciones a lo largo del tiempo; se asocia a patologias cronicas dolorosas y trastornos del sueno, atencion y del estado de animo. Suele llevar varios anos de evolucion en el momento del diagnostico, provocando disminucion de las capacidades funcionales y conflictos psico-sociales. Afecta entre el 2 y 4,7% de la poblacion entre los 20 y 60 anos y en un 80% al sexo femenino. Los pacientes perciben dolor con estimulos de menor intensidad que la mayoria de los individuos. Si bien no se ha detectado un parametro biologico indicador de FM, estudios con resonancia magnetica funcional detectan imagenes que se correlacionan con una mayor percepcion del dolor y se postulan factores geneticos y fallos en el sistema nervioso central, en los circuitos inhibitorios del dolor. Estos fenomenos son criticados por investigadores que postulan factores psicogenos de mala adaptacion al dolor. El tratamiento debe contemplar farmacos: pregabalina, duloxetina y milnacipram combinados con tratamiento educacional, psicoterapeutico y ejercitacion fisica controlada. En esta revision se plantea una vision critica de la FM dirigida al neurologo que en su practica diaria asiste a pacientes con FM.
- Published
- 2013
- Full Text
- View/download PDF
9. Cirugía de la epilepsia de la región posterior: pronóstico y estrategias en dos centros de Argentina
- Author
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María del Carmen Garcia, Gabriela Besocke, Carlos Ciraolo, Walter Silva, Marina Aberastury, Ramiro Gil, Esteban Vaucheret, Mercedes Galán, Guillermo Agosta, and Roberto Rey
- Subjects
Neurology ,Neurology (clinical) - Abstract
Resumen Introduccion Las epilepsias de la region posterior (ERP) comprenden las que comprometen los lobulos occipitales, la region parietal por detras del surco poscentral y los limites temporales posteriores, y corresponden a menos del 10% de epilepsias focales. La cirugia de este tipo de epilepsias es poco frecuente, debido principalmente a la alta proporcion de areas elocuentes de esta region. Objetivo Evaluar los resultados y estrategias de la cirugia en ERP en nuestro medio. Material y metodos Se analizaron retrospectivamente pacientes con epilepsia refractaria sometidos a cirugia de la ERP entre los anos 2005 y 2008. La evaluacion prequirurgica fue realizada mediante la semiologia ictal, IRM de alta resolucion, EEG interictal, V-EEG ictal, evaluacion neuropsicologica, EEG invasivo y mapeo funcional por estimulacion electrica. El pronostico de crisis fue evaluado con escala de Engel, con un seguimiento minimo de un ano. Resultados Seis pacientes fueron incluidos, con un seguimiento medio de 2 anos (1 a 3 anos). La edad promedio fue de 23 anos (1 a 33 anos), con una duracion media de la epilepsia de 18 anos (0 a 33 anos). Las etiologias fueron: tumores de bajo grado (2 pacientes), displasias corticales focales (2) y gliosis (2). Durante el seguimiento, 3 pacientes se encontraban libres de crisis, uno continua con auras y 2 presentaron una reduccion mayor del 50% de las crisis. Dos pacientes presentaron exacerbacion de un deficit neurologico previo (hemianopsia). Conclusion La cirugia de la ERP es posible realizarla en nuestro medio, presenta un buen pronostico de crisis y el deficit posquirurgico es aceptable.
- Published
- 2010
- Full Text
- View/download PDF
10. The distal radioulnar ligaments: A biomechanical study
- Author
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Lawrence J. Berglund, William P. Cooney, Ronald L. Linscheid, Frederic Schuind, Roberto Rey, Edmund Y. S. Chao, and Kai Nan An
- Subjects
Wrist Joint ,Movement ,Druj ,Triangular fibrocartilage ,Ulna ,In Vitro Techniques ,Wrist ,Triangular Ligament ,Forearm ,medicine ,Humans ,Orthopedics and Sports Medicine ,business.industry ,Biomechanics ,Anatomy ,musculoskeletal system ,Biomechanical Phenomena ,Radius ,medicine.anatomical_structure ,Photogrammetry ,Ligaments, Articular ,Ligament ,Surgery ,Stress, Mechanical ,business - Abstract
The mechanical roles of the triangular fibrocartilage have been examined in three experiments. Kinematic analysis by a stereophotogrammetric method revealed that the palmar radioulnar ligament was taut in supination and that the dorsal radioulnar ligament was taut in pronation. In full pronation, the palmar radioulnar ligament decreased to an average of 71% of its length in tension. In full supination, the dorsal radioulnar ligament decreased to an average of 90% of its length. Mechanical testing of the triangular fibrocartilage under axial load disclosed a significant laxity (mean: 10.4 mm), which was decreased in pronation. Transverse loading tests demonstrated that the triangular fibrocartilage is less stiff in neutral forearm rotation. Study of the material properties of the palmar and dorsal parts of the triangular fibrocartilage showed these structures to be strong ligaments with material properties similar to those of the radiocarpal ligaments.
- Published
- 1991
- Full Text
- View/download PDF
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