The purpose — to explore prevalence and clinical particularities of the pediatric multiple sclerosis in Bashkortostan Republic. Material and methods. The data of 21 children with multiple sclerosis were analyzed. The data were provided by the Republican Centre of the multiple sclerosis (Ufa) and outpatient records of the Kuvatov’s Republican Clinical Hospital (Ufa). All children were examined out patiently at the Neurology Department at the Republican Children’s Clinical Hospital (Ufa) and the polyclinics of the Republican Clinical Hospital (Ufa). Diagnosis «multiple sclerosis» (MS) was issued by McDonald criteria (2017). Results. MS affects female children more often. City residents are hit much more frequently. The onset occurs among senior schoolchildren in most cases. Most of the patients have remitting course of MS. Conclusion. The main epidemiological indicators of childhood onset MS in the Republic of Bashkortostan are comparable to those in neighboring regions of Russia, and the observed changes reflect the global trends. The study confirmed the findings of other authors on the main characteristics of childhood MS. Pediatric patients require a specialized approach to the diagnosis and careful monitoring of neurological symptoms in order to timely identify multiple sclerosis.
The study objective was to analyze the results of 20 years of clinical follow-up and genetic study of 247 patients with multiple sclerosis (MS) registered at the Republican MS Centre. Material and methods. The study comprised unrelated patients with a verified diagnosis of MS included in the register of the Republican MS Center, and age-, gender-, and ethnicity-matched controls. DNA was isolated from whole venous blood by phenol-chloroform extraction. Genotyping was performed by PCR and PCR-RFLP methods. Quantitative variables were assessed using the non-parametric Mann — Whitney test (U-test); the exact two-sided Fisher’s test was applied to compare the distribution of genotypes and alleles frequencies in the groups of patients and controls. Differences were considered statistically significant at p < 0,05. Results. The group of 247 patients enrolled in the clinical genetic study in 2000 included 123 (49,8%) Russians, 98 (39,7%) Tatars, and 26 (10,5%) Bashkirs. The ratio of women to men was 2:1 (166:81). A polysymptomatic debut with a predominance of motor disorders was more often observed in the Bashkir group compared with others. At the time of inclusion in the study, the rate of progression in the Bashkir group was statistically significantly higher than in the Russian group, and non-significantly higher than in the Tatars group. Over a 20-year follow-up period, the rate of progression slowed in all groups. With the advent of magnetic resonance imaging in the region, the time to establish a verified diagnosis of MS has significantly decreased (p = 0,001). An increase in disability was not recorded during the observation period in 46 patients, 43 of them were taking disease modifying drugs. In a clinical genetic study, ethnospecific associations between MS and the polymorphismsin TNF and IL1B genes was revealed. Conclusion. The findings of the study emphasize the need for the continued follow-up and more in-depth investigation of the regional characteristics of MS, course variants and risk factors for the development of the disease.
An expansion of the age range of multiple sclerosis (MS) manifestation has been reported recently. Considering the multifactorial etiology, high heterogeneity of the clinical symptoms, and the difficulties of early MS diagnosis in young people, the onset and course of this disease in students can be considered as one of the significant medical and social problems.Objective: to analyze the clinical and epidemiological characteristics of MS in university and secondary specialized educational institutions students in the Republic of Bashkortostan (RB).Patients and methods. This case-control study included 32 patients aged 15 to 24 years studying in universities and secondary schools of the RB. The clinical and epidemiological indicators analysis was carried out based on data from the register of MS patients in the RB. 32 sex-, age-, place of birth and residence-matching patients with MS, who were not students, were included in the control group.Results and discussion. The median age of disease manifestation in students was 18 [16.5; 20] years, in the control group – 16 [14; 19] years (p=0.010). We found a lower «disease onset – diagnosis» in the students group of revealed a lower interval «disease onset – diagnosis» (0.5 [0; 1] years, p=0.006), and a shorter duration of MS compared to the control group ((2.8 [2; 4] years and 4 [2; 7] years, respectively, p=0.020). Students with MS predominantly had movement disorders: central paresis and cerebellar ataxia. Students also had a faster MS progression (0.4 [0.2; 0.6] EDSS scores per year, p=0.001), despite of the disease-modifying therapies.Conclusion. MS manifestation and course in students receiving disease-modifying therapies indicate the need for close follow-up, adherence control, and psychological support in the educational process.
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