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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2745_Библиотеки_им_академика_М_И_Перельмана
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Department of Anesthesiology, Harbor - UCLA Medical Center, Torrance,
California
Priyank Trivedi MD Fellow, Weill Cornell Medical College, Fellow, Department
of Pulmonary and Critical Care, New York–Presbyterian Queens, Queens, New
York
Yetsa A. Tuakli-Wosornu MD, MPH Assistant Clinical Professor, Department of
Chronic Disease Epidemiology, Yale School of Public Health, New Haven,
Connecticut
Hunter Vincent DO Resident Physician, Department of Physical Medicine and
Rehabilitation, University of California Davis, Sacramento, California
Karen Yanelli PT, DPT, Cert-MDT Owner/Operator, Karren Yanelli, LLC,
Physical Therapy Private Practice, New York, New York
Sydney Yee MD Anesthesiology Resident, Department of Anesthesia, Harbor –
UCLA Medical Center, Torrance, California
Tiffany Yeh MD Fellow, Division of Endocrinology, Diabetes, and Metabolism,
New York–Presbyterian Hospital – Weill Cornell Medical College, New York, New
York
Michele Yeung MD Fellow, Department of Endocrinology/Department of Diabetes
and Metabolism, New York–Presbyterian Hospital, Weill Cornell Medical College,
New York, New York
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Preface
“My doctor doesn’t understand my MS.” It was statements
such as this heard from my patients that led to the
development of this book. The incidence of MS has increased
but fortunately so has the development of effective diseasemodifying therapies to decrease relapses and slow disability
progression. Patients can discuss many treatment options with
their physicians and are living longer, more active lives.
Research regarding the immunology and epidemiology of the
disease continues to evolve. Therapies used for disease
treatment are often associated with adverse effects and
potential for drug interaction. This book aims to increase
awareness of the problems associated with MS for
nonneurologic specialties such as internal medicine,
emergency medicine, urology, ophthalmology, dermatology,
for example, who often will treat patients with MS. Optimal
comprehensive care for patients involves coordination of care
among many medical fields, not just neurology. Physiatrists,
physical and occupational therapists, podiatrists, residents,
fellows, and nurse practitioners working together can help
improve quality of life for patients and their families. Chapters
in the book are devoted to evaluation of the patient with MS,
public health issues associated with the disease, better
understanding of MRI findings in MS, issues encountered in
surgery and pain management, dental care, and identification
of services for patients and their families.
It is my hope that this book will provide a practical and
comprehensive guide to wide variety of health care
professionals and trainees to increase awareness and
recognition of MS, the problems that MS patients face
particularly as they are encountered in the various medical and
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surgical specialties, better understanding of the importance of
coordination of care with the ultimate goal of improving
patient outcomes. It is meant to be a resource easily accessible
for reference in daily office practice.
I would like to acknowledge and thank all the distinguished
chapter contributors and the team at Wolters Kluwer for their
assistance. I thank my children for their love and support
during the writing of this book.
The editors would also like to thank all our colleagues at
Holy Name Medical Center, Hospital for Special Surgery,
New York–Presbyterian Hospital/Weill Cornell, Yale School
of Public Health, Weill Cornell Medical College, Memorial
Sloan Kettering Cancer Center, and the New York College of
Podiatric Medicine.
In addition the generous support of the Stavros Niarchos
Foundation, Weill Family Foundation, Durst Organization,
James Family Charitable Foundation, Louis and Rachel Rudin
Foundation, Heckscher Foundation, O’Toole Family Fund at
JP Morgan, Jim and Linda Robinson Foundation, Thomas H.
Lee, Mary Lupo, and Ed Ricci.
I want to also thank the Alfiero and Lucia Palestroni
Foundation, George P. Pitkin Foundation, and Larry Inserra for
their invaluable support of the Holy Name MS Center.
Mary Ann Picone, MD
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Foreword
Multiple Sclerosis (MS) is the most prevalent, nontraumatic
neurologic condition among young adults worldwide.
Diagnosis is most common in 20- to 50-year-old individuals
and far more common in females than males.
The disease is remarkably heterogeneous. For some, the
effects of MS are relatively mild and stable. Others experience
wide-ranging, progressive symptoms that can affect a
constellation of physical and mental functions. For the medical
practitioner, optimal management of patients with MS poses
several challenges.
Broad variability in the nature and severity of MS
symptoms may confound the diagnosis of other, unrelated
conditions, challenging physicians across medical specialties,
who must determine whether new symptoms are related to the
underlying MS or represent a distinct medical problem.
Moreover, common symptoms of MS—vision problems,
fatigue and weakness, dizziness, bladder problems, and sexual
dysfunction—can mimic a host of unrelated medical
conditions.
Patients with an established diagnosis of MS also present
challenging management problems to the medical specialist—
internist, gynecologist, surgeon, etc.,—who is not a
neurologist. This comprehensive collection of chapters by
prominent specialists from across the spectrum of medical
disciplines offers practical insights and sage advice about the
differential diagnosis and effective management of patients
with this challenging disease.
Peter T. Scardino, MD
Chairman EmeritusM
Department of Surgery
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Memorial Sloan Kettering Cancer Center
Professor of Surgery
Department of Urology
Weill Medical College of Cornell University
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Contents
title
Copyright
Dedication
Contributors
preface
Foreword
1 Epidemiology
Mary Ann Picone, Qibin Qi
2 Immunology of Multiple Sclerosis
Regina Berkovich
3 Evaluation and Diagnosis of the Multiple Sclerosis Patient
Hunter Vincent, Mary Ann Picone, Constantine J. Pella, Annette F. Okai
4 Magnetic Resonance Imaging in Multiple Sclerosis
Carlos A. Pérez, John A. Lincoln
5 Internal Medicine I
Mary Ann Picone
6 Internal Medicine II: Disease-Modifying Therapies and
Adverse Effects
Mary Ann Picone, Constantine J. Pella
7 Multiple Sclerosis in Emergency Medicine
Richard I. Lappin
8 Visual Dysfunction in Multiple Sclerosis
Doria M. Gold, Janet C. Rucker, Steven Galetta
9 Cutaneous Disorders Associated With Multiple Sclerosis
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Anna-Marie Hosking, Joseph L. Jorizzo
10 Endocrine Disorders in Multiple Sclerosis
Tiffany Yeh, Michele Yeung, Dorothy A. Fink
11 Obesity and Multiple Sclerosis
Katherine H. Saunders, Mohini Aras, Louis J. Aronne
12 Rheumatology
Molly Forlines, Mary Ann Picone, Anthony M. Iuso, Michael A.
Ciaramella
13 Pulmonary Complications in Multiple Sclerosis
Priyank Trivedi, Anthony J. Smith, Joseph T. Cooke
14 Public Health Considerations in Multiple Sclerosis
Nida Naushad, Catherine Stratton, Yetsa A. Tuakli-Wosornu
15 Multiple Sclerosis in the Female Patient
Tracy B. Grossman, Kathy C. Matthews
16 Urologic Issues in the Multiple Sclerosis Patient
Philip J. Aliotta
17 Bowel and Sexual Dysfunction in the Multiple Sclerosis
Patient
Philip J. Aliotta
18 Cognitive Function in Multiple Sclerosis
Jeffrey G. Portnoy, Frederick W. Foley
19 Mood Disorders in Multiple Sclerosis
Jagriti “Jackie” Bhattarai, Jeffrey G. Portnoy, Frederick W. Foley,
Meghan Beier
20 Multiple Sclerosis in Adolescents and Children
Tanuja Chitnis
21 Dental and Oral Health Considerations in Multiple
Sclerosis
Danielle E. Currier, Gwendolyn S. Reeve, Marsha E. Rubin
22 Otolaryngologic Manifestations of Multiple Sclerosis
Alisha N. Dua, Tiffany Peng, George Alexiades
23 Orthopedic Issues in the Multiple Sclerosis Patient
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Brandon J. Erickson, Joshua S. Dines
24 Upper Extremity Evaluation in Patients with Multiple
Sclerosis
Kyle W. Morse, Michelle G. Carlson
25 Foot and Ankle Manifestations of Multiple Sclerosis
Rock CJay Positano, Michael A. Ciaramella, Rock G. Positano, Molly
Forlines
26 Common Foot and Ankle Conditions Associated With
Multiple Sclerosis
Ronald Guberman, Waldemar Majdanski, Rock CJay Positano, Rock G.
Positano
27 Perioperative Care of the Lower Extremity Orthopedic
Patient With Multiple Sclerosis
W. Mark Richardson, Dale J. Lange, Karen Yanelli
28 Pain Management in Multiple Sclerosis
Andrui Nazarian
29 Multiple Sclerosis and General Anesthetic Considerations
Christopher Der, Quy Tran, Sydney Yee
30 Neurosurgery
Mostafa El Khashab, Constantine J. Pella
31 Rehabilitation in Multiple Sclerosis
Francois Bethoux, Randy Karim, Robert W. Motl
32 The Presence, Type, and Burden of Walking, Gait, and
Balance Dysfunction in Multiple Sclerosis
Stephanie L. Silveira, Robert W. Motl, Francois Bethoux
33 Exercise Prescription in Multiple Sclerosis
Herbert I. Karpatkin
34 Comprehensive Care in Multiple Sclerosis: The Nursing
Professional as a Linchpin
June Halper
35 Palliative Medicine in Multiple Sclerosis
Misa Hyakutake, Mary Ann Picone
APPENDIX A: Patient Resources and Support Services
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Andrea Arzt, Lauren Hooper, Dorothy E. Northrop
Index
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C H A P T E R 1
Epidemiology
Mary Ann Picone, Qibin Qi
Introduction
The etiology of multiple sclerosis (MS) is complex and not
fully understood, but there have been various environmental
and genetic factors associated with increased MS risk. 1 The
prevailing thought is that MS is an autoimmune disorder
whereby either viral or environmental agents, or both, trigger a
T cell–mediated inflammatory attack, causing demyelination
in the central nervous system (CNS). This is thought to result
from a complex interplay between genes and the environment.
The environmental factors most thought to be involved are
vitamin D and Epstein-Barr virus (EBV). Obesity, particularly
when present early in life, appears to play a role. Cigarette
smoking also has been linked. 1 The aim of this chapter is to
discuss genetic and environmental risk factors, both infectious
and noninfectious, that are associated with MS development.
Demographics
MS is the most common cause of nontraumatic disability in
young adults.
1,2
The exact etiology remains unknown, but it
is thought to be associated with genetic factors and
environmental exposures with environmental factors
playing a role in altering gene expression. 3 Genes are
needed for the development of MS, but the environment plays
a predominant role in determining risk. These factors must act
at an early age.
The National MS Society Prevalence Initiative, using
administrative databases from a variety of sources including
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