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Yıl:2023; Cilt: 60; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2023;60(2):104-109
Türkiye’deki Göçmen ve Yerel Multipl Skleroz Hastalarının Klinik ve Demografik Özellikleri
B.P Balcı, E.B.Duman, C Tunç, B.P Tüzün, Ö Çokar
Hacettepe Üniversitesi, Ankara
Amaç: Savaşlar nedeniyle artan göç, multipl skleroz (MS) etiyolojisinde çevresel faktörlerden biridir. Bu çalışma, göçmen ve yerel MS hastalarının demografik ve klinik özelliklerinin yanı sıra kadın hastalarda gebelik ve doğum sonrası nüksleri karşılaştırmayı amaçlamaktadır. Yöntem: Ocak 2019 – Eylül 2020 tarihleri arasında MS tanılı göçmen (Grup 1) ve yerli (Grup 2) hastalar retrospektif olarak değerlendirildi. Demografik veriler, beyin omurilik sıvısı (BOS) bulguları, manyetik rezonans görüntüleme (MRG) bulguları, MS tipleri, genişletilmiş özürlülük durumu skorları (EDSS), ilk iki atak arası süre, komorbid hastalıklar, kullanılan tedaviler, göç etme yaşı ve geldiği yer, gebelik, gebelikte atak, doğum sayısı, emzirme, doğum sonrası atak bilgileri kaydedildi ve iki grup karşılaştırıldı. Bulgular: Her grup için 34 MS hastası (toplam n=68) dâhil edildi. Cinsiyet dağılımı, ortalama yaş, MS alt tipleri, ilk iki atak arası geçen süre, hastalık süresi, EDSS, BOS bulguları ve komorbiditeler gruplar arasında benzerdi. Başlangıç belirtisi her iki grupta da ağırlıklı olarak duyusaldı. Yerli hastalarda servikal lezyon sayısı ve total lezyon yükü daha fazlaydı (p=0,003, p=0,006). Göçmen MS hastalarının %20,6’sı tedavi görmedi, tüm yerel hastalar tedavi görüyordu. Enjeksiyon ve infüzyon tedavi oranları benzerdi, ikinci grupta oral tedavi oranı daha yüksekti. Kadın hastaların klinik özellikleri ve doğurganlık durumları benzerdi. Sonuç: Çalışmamız, MRI lezyon yükü ve tedavi parametreleri dışında göçmen ve yerel MS hastaları arasında fark göstermedi. Dil engeli ve düzensiz takipler tedavi yönetimindeki en büyük problemlerdi.
Clinical and Demographic Characteristics of Immigrant and Local Multiple Sclerosis Patients in Turkey
Introduction: Increasing migration, due to wars, is one of the environmental factors in the etiology of multiple sclerosis. This study aims to compare demographic and clinical features of immigrant and local MS patients, as well as relapses during pregnancy and postpartum in female patients. Method: Immigrant (Group 1) and local (Group 2) MS patients were evaluated between January 2019 – September 2020 retrospectively. Below-mentioned data of two groups were recorded and compared: i) demographic data, ii) cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) findings, iii) MS subtypes, iv) expanded disability status scores (EDSS), v) the time between first two relapses, vi) comorbidities, vii) treatment, viii) age of migration and country of origin, ix) pregnancy, x) relapse during pregnancy, xi) birth number, xii) breastfeeding, xiii) postpartum relapses. Results: Both of the groups were composed of 34 MS patients (in total n=68). Gender distribution, mean age, MS subtypes, the time between first two relapses, disease duration, EDSS, CSF findings and comorbidities were similar between groups. Symptom of onset was predominantly sensory in both groups. Local patients had more cervical lesions and higher lesion load (p=0.003, p=0.006). 20.6% of migrant MS patients were untreated, all local patients were on treatment. Rates of injection and infusion therapies were similar, the rate of receiving oral therapy was higher in the second group. Clinical features and fertility status of female patients were similar. Conclusion: According to the study no differences were preseentpresent between immigrant and local MS patients except for MRI lesion load and treatment parameters. The language barrier and irregular follow-ups were the major problems in treatment management

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