Iulia Georgiana Stamate, Daniel Alexa, Bogdan Ignat and Cristian Dinu Popescu

ABSTRACT

Ankylosing Spondylitis (AS) and Multiple Sclerosis (MS) are two different chronic autoimmune and inflammatory diseases, one rheumatic and the other one neurological, apparently without any connection between them. Yet a few case reports proved that AS may be associated with MS and this situation should be considered in some epidemiological environment.

Although the geographic map of incidence is approximately superposed for both entities there are only a few cases of association. Recent studies revealed that most loci associated with MS are located very close to or even within genes encoding molecules involved in immune system function, confirming the hypothesis that MS is a disease with immunologic mechanism. In addition, some of these loci are also associated at least with another autoimmune disease, thus reinforcing the idea that autoimmune diseases may have a common origin.

If MS is more common in patients with AS than in the general population, we can speculate the existence of common factors involved in these diseases. Because of the limited number of cases that associated these two diseases, the correct diagnosis of both entities considered separately or together becomes mandatory especially reflecting on the anti-TNFα agents used to treat AS which may exacerbate or induce a latent MS or demyelination processes in the central nervous system. In terms of pathogenic mechanisms, they are poorly known in both diseases, but each is characterized by an initial immune and inflammatory attack, in MS the target is the myelin sheath and in AS the enthesis tissue. A case with association between the two diseases raises important issues in choosing an appropriate treatment.

Keywords: ankylosing spondylitis, multiple sclerosis, autoimmune disease, TNFα

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Cristian Dinu Popescu, Dan Trofin, Daniela Trofin, Daniel Alexa, Romeo Dobrin, Bogdan Ignat, Ioan Buraga and Daniela Matei

ABSTRACT

Alzheimer’s Disease (AD) is the most common form of dementia in the old population, carrying a major negative influence upon society and caregivers, as its socio-economic implications are enormous. The devastating impact of AD is also due to the fact that the diagnosis is difficult to be established in an early stage, and in spite of the advances made in medicine, the new symptomatic and disease modifying therapies have still only a mild though promising positive effect. Caregivers are exposed to increased risk of disease themselves, due to the high burden which predisposes them to stress related psychological, behavioral or cognitive disorders. Greater caregiver resilience can predict lower levels of depression. Also a strong external support system was associated with increased resilience. Establishing a pattern for the behavioral and psychological manifestations in dementia can have as direct effect developing better coping strategies in order to reduce stress and the burden of the caregivers.

Some data regarding the economic and social impact of AD, as well as facts and numbers from our local centers will be described in the following pages.

Keywords: dementia, Alzheimer’s Disease, social, economics, caregiver, burden

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