<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2631-2581</journal-id>
<journal-title><![CDATA[Revista Ecuatoriana de Neurología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Ecuat Neurol]]></abbrev-journal-title>
<issn>2631-2581</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Médica Ecuatoriana de Neurología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2631-25812019000200059</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[El Perfil Epidemiológico Y Clínico De La Esclerosis Múltiple En El Ecuador]]></article-title>
<article-title xml:lang="en"><![CDATA[The Clinical And Epidemiological Profile Of Multiple Sclerosis In Ecuador]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Correa-Díaz]]></surname>
<given-names><![CDATA[Edgar Patricio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jácome-Sánchez]]></surname>
<given-names><![CDATA[Elisa Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres Herrán]]></surname>
<given-names><![CDATA[Germaine Eleanor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Buestán Zumba]]></surname>
<given-names><![CDATA[María Eugenia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Altamirano-Brito]]></surname>
<given-names><![CDATA[María José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caiza-Zambrano]]></surname>
<given-names><![CDATA[Francisco José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortega Heredia]]></surname>
<given-names><![CDATA[Andrés Damián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez Cedillo]]></surname>
<given-names><![CDATA[Verónica Tatiana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Castillo]]></surname>
<given-names><![CDATA[María Ariana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez-Díaz]]></surname>
<given-names><![CDATA[Roberto J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jiménez Zambrano]]></surname>
<given-names><![CDATA[Joyce Antonella]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Carlos Andrade Marín  ]]></institution>
<addr-line><![CDATA[Quito ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Teodoro Maldonado Carbo  ]]></institution>
<addr-line><![CDATA[Guayaquil ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Católica de Santiago de Guayaquil  ]]></institution>
<addr-line><![CDATA[Guayaquil ]]></addr-line>
<country>Ecuador</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<volume>28</volume>
<numero>2</numero>
<fpage>59</fpage>
<lpage>70</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_arttext&amp;pid=S2631-25812019000200059&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_abstract&amp;pid=S2631-25812019000200059&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_pdf&amp;pid=S2631-25812019000200059&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen En el Ecuador ha habido un importante incremento en el número de publicaciones sobre Esclerosis Múltiple (EM) en los últimos años. Este interés por conocer el comportamiento clínico y epidemiológico de la enfermedad nos ha permitido establecer semejanzas y diferencias con otras cohortes de pacientes con EM que provienen de regiones en donde la prevalencia de la enfermedad es alta. El Ecuador sigue siendo un país de baja prevalencia, los estudios han demostrado que la misma fluctúa entre 3 a 5 casos por 100.000 habitantes. El comportamiento epidemiológico es muy similar a la de cohortes europeas por ejemplo el sexo femenino es el principalmente afectado. Sin embargo, el comportamiento clínico difiere en lo que respecta a deterioro cognitivo, fatiga siendo éstos menos frecuentes. Aún se desconoce el impacto de la vitamina D en nuestros pacientes debido a que, solo un estudio ha sido llevado a cabo. Al parecer, existe una alta prevalencia de deficiencia e insuficiencia de vitamina D en los pacientes ecuatorianos pero no se traduce en un incremento de prevalencia o discapacidad como ocurre en poblaciones europeas. A pesar de que tenemos una mejor comprensión de la enfermedad en el país, más estudios son necesarios y es imperativo incluir a todos los pacientes ecuatorianos con esclerosis múltiple con el fin de mejorar nuestro conocimiento sobre el comportamiento de esta patología en nuestra región.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract In recent years, the number of publications on Multiple Sclerosis (MS) from Ecuador has seen a significant increase. As a result, the research on the clinical and epidemiological behaviour of the disease has allowed us to make comparisons with other cohorts of patients with MS that come from regions where the prevalence of the disease is high. Nevertheless, Ecuador is still a country in which the prevalence of MS is low with a prevalence that fluctuates between 3 to 5 cases per 100,000 inhabitants. The epidemiological behaviour of MS is very similar to that of european cohorts, for example female patients are the most affected. However, the clinical behaviour of multiple sclerosis differs in terms of cognitive impairment and fatigue being less frequent. The impact of vitamin D on patients with MS is still unknown as only one study has been carried out. This study show that there is a high prevalence of vitamin D deficiency and insufficiency in ecuadorian patients, but this does not translate into an increase in prevalence or disability as it does in european populations. Although we have a better understanding of the disease in the country, more studies are necessary, and it is imperative that all ecuadorian patients with MS be included in future studies in order to improve our knowledge about the behaviour of this disease in our region.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Ecuador]]></kwd>
<kwd lng="es"><![CDATA[Esclerosis Múltiple]]></kwd>
<kwd lng="es"><![CDATA[prevalencia]]></kwd>
<kwd lng="es"><![CDATA[deterioro cognitivo]]></kwd>
<kwd lng="es"><![CDATA[fatiga]]></kwd>
<kwd lng="es"><![CDATA[vitamina D.]]></kwd>
<kwd lng="en"><![CDATA[Ecuador]]></kwd>
<kwd lng="en"><![CDATA[Multiple Sclerosis]]></kwd>
<kwd lng="en"><![CDATA[prevalence]]></kwd>
<kwd lng="en"><![CDATA[cognitive impairment]]></kwd>
<kwd lng="en"><![CDATA[fatigue]]></kwd>
<kwd lng="en"><![CDATA[vitamin D.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nylander]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hafler]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
</person-group>
<source><![CDATA[J Clin Invest]]></source>
<year>2012</year>
<volume>122</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>1180-8</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Multiple sclerosis: Prospects and promise]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hauser]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Chan]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Oksenberg]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
</person-group>
<source><![CDATA[Ann Neurol]]></source>
<year>2013</year>
<volume>74</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>317-27</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prevalence of multiple sclerosis in Latin America and its relationship with European migration]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Correa]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Paredes]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Marti&#769;nez]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<source><![CDATA[Mult Scler J Exp Transl Clin]]></source>
<year>2016</year>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Murray]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<source><![CDATA[Multiple Sclerosis. The History Of A Disease]]></source>
<year>2004</year>
<edition>1st edition</edition>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[Demos Medical Publishing]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thompson]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Banwell]]></surname>
<given-names><![CDATA[BL]]></given-names>
</name>
<name>
<surname><![CDATA[Barkhof]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<source><![CDATA[Lancet Neurol]]></source>
<year>2018</year>
<volume>17</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>162-73</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Epidemiological evidence of multiple sclerosis in Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Abad]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Alarcón]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Castro]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Santibañez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Multiple Sclerosis Journal]]></source>
<year>2008</year>
<volume>14</volume>
<page-range>s29-s923</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prevalence of multiple sclerosis in Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Abad]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Pe&#769;rez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Castro]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Neurologia]]></source>
<year>2010</year>
<volume>25</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>309-13</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Multiple sclerosis in a hospital of the Ecuadorian coast.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alarco&#769;n]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Aguirre]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Di&#769;az]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Revista Ecuatoriana de neurología]]></source>
<year>2011</year>
<volume>20</volume>
<numero>1­3</numero>
<issue>1­3</issue>
<page-range>27-33</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prevalence of multiple sclerosis in Quito, Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Correa]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Buesta&#769;n]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Multiple Sclerosis Journal]]></source>
<year>2017</year>
<volume>23</volume>
<numero>S3</numero>
<issue>S3</issue>
<page-range>680-975</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prevalence of multiple sclerosis in Cuenca, Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Correa]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Guillen]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<source><![CDATA[Multiple Sclerosis Journal]]></source>
<year>2018</year>
<volume>24</volume>
<numero>S2</numero>
<issue>S2</issue>
<page-range>738-980</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Epidemiology of Multiple Sclerosis in the Andean Region of Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Correa]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[Multiple Sclerosis Journal]]></source>
<year>2018</year>
<volume>24</volume>
<numero>S1</numero>
<issue>S1</issue>
<page-range>11-117</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thompson]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Baranzini]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Geurts]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Lancet]]></source>
<year>2018</year>
<volume>391</volume>
<numero>10130</numero>
<issue>10130</issue>
<page-range>1622-36</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[New Multiple Sclerosis Phenotypic Classification]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lublin]]></surname>
<given-names><![CDATA[FD]]></given-names>
</name>
</person-group>
<source><![CDATA[Eur Neurol]]></source>
<year>2014</year>
<volume>72</volume>
<numero>s1</numero>
<issue>s1</issue>
<page-range>1-5</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Defining the clinical course of multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lublin]]></surname>
<given-names><![CDATA[FD]]></given-names>
</name>
<name>
<surname><![CDATA[Reingold]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<source><![CDATA[Neurology]]></source>
<year>2014</year>
<volume>83</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>278-86</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Multiple sclerosis: A practical overview for clinicians]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rejdak]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Jackson]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Giovannoni]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[Br Med Bull]]></source>
<year>2010</year>
<volume>95</volume>
<page-range>79-104</page-range></nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Factors associated with benign multiple sclerosis in the New York State MS Consortium (NYSMSC)]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zivadinov]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Cookfair]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Krupp]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[BMC Neurol]]></source>
<year>2016</year>
<volume>16</volume>
<numero>102</numero>
<issue>102</issue>
<page-range>1-10</page-range></nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Disability progression in aggressive multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Menon]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Zhu]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Shirani]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Mult Scler]]></source>
<year>2017</year>
<volume>23</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>456-63</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Can we predict benign multiple sclerosis? Results of a 20-year long-term follow-up study]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sartori]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Abdoli]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Freedman]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
</person-group>
<source><![CDATA[J Neurol]]></source>
<year>2017</year>
<volume>264</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1068-75</page-range></nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Severe, Highly Active, or Aggressive Multiple Sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Freedman]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Rush]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
</person-group>
<source><![CDATA[Continuum. (Minneap Minn)]]></source>
<year>2016</year>
<volume>22</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>761-84</page-range></nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The Clinical and Epidemiological Spectrum of Multiple Sclerosis in Quito, Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Correa Díaz]]></surname>
<given-names><![CDATA[EP]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz Yepez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Herran]]></surname>
<given-names><![CDATA[GT]]></given-names>
</name>
</person-group>
<source><![CDATA[J Neurol Disord]]></source>
<year>2016</year>
<volume>04</volume>
<numero>07</numero>
<issue>07</issue>
</nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Correa]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<source><![CDATA[Esclerosis Multiple en el Ecuador, características clínicas y tratamiento. Ponencia presentada en el IV Simposio Internacional de Neurología y Cuidados Neurocríticos]]></source>
<year>2017</year>
</nlm-citation>
</ref>
<ref id="B22">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gelfand]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Ed]]></surname>
<given-names><![CDATA[Goodin]]></given-names>
</name>
</person-group>
<source><![CDATA[Handbook of Clinical Neurology. Multiple sclerosis: Diagnosis, differential diagnosis, and clinical presentation. Vol 122]]></source>
<year>2014</year>
<edition>1st ed</edition>
<publisher-loc><![CDATA[San Francisco, California ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B23">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Primary progressive multiple sclerosis: Progress and challenges]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rice]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Cottrell]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Wilkins]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[J Neurol Neurosurg Psychiatry]]></source>
<year>2013</year>
<volume>84</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1100-6</page-range></nlm-citation>
</ref>
<ref id="B24">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prevalence of fatigue in patients with multiple sclerosis of Quito city and its effect on the quality of life]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sánchez-Cedillo]]></surname>
<given-names><![CDATA[Verónica Tatiana]]></given-names>
</name>
<name>
<surname><![CDATA[Correa-Díaz]]></surname>
<given-names><![CDATA[Edgar Patricio]]></given-names>
</name>
<name>
<surname><![CDATA[Ortíz-Yépez]]></surname>
<given-names><![CDATA[María Angélica]]></given-names>
</name>
</person-group>
<source><![CDATA[Multiple Sclerosis Journal]]></source>
<year>2018</year>
<page-range>1-44</page-range></nlm-citation>
</ref>
<ref id="B25">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prevalence of cognitive impairment in patients with multiple sclerosis from the Andean region of Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Villacrés Guerrero]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez Porras]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Mateo Calderón]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Mult Scler J]]></source>
<year>2018</year>
<volume>65</volume>
<page-range>23</page-range></nlm-citation>
</ref>
<ref id="B26">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Urinary, faecal and sexual dysfunction in patients with multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hennessey]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Robertson]]></surname>
<given-names><![CDATA[NP]]></given-names>
</name>
<name>
<surname><![CDATA[Swingler]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[J Neurol]]></source>
<year>1999</year>
<volume>246</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1027-32</page-range></nlm-citation>
</ref>
<ref id="B27">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neuropsychological correlates of multiple sclerosis across the lifespan]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nunan-Saah]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Paulraj]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Waubant]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Mult Scler]]></source>
<year>2015</year>
<volume>21</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1355-64</page-range></nlm-citation>
</ref>
<ref id="B28">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Cognitive impairment in multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chiaravalloti]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[DeLuca]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Lancet Neurol]]></source>
<year>2008</year>
<volume>7</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1139-51</page-range></nlm-citation>
</ref>
<ref id="B29">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Risk factors for and management of cognitive dysfunction in multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Benedict]]></surname>
<given-names><![CDATA[RH]]></given-names>
</name>
<name>
<surname><![CDATA[Zivadinov]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Nat Rev Neurol]]></source>
<year>2011</year>
<volume>7</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>332-42</page-range></nlm-citation>
</ref>
<ref id="B30">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neuropsychological Features of Multiple Sclerosis: Impact and Rehabilitation]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Messinis]]></surname>
<given-names><![CDATA[Lambros]]></given-names>
</name>
<name>
<surname><![CDATA[Papathanasopoulos]]></surname>
<given-names><![CDATA[Panagiotis]]></given-names>
</name>
<name>
<surname><![CDATA[Kosmidis]]></surname>
<given-names><![CDATA[Mary]]></given-names>
</name>
</person-group>
<source><![CDATA[Behav Neurol]]></source>
<year>2018</year>
<volume>2018</volume>
</nlm-citation>
</ref>
<ref id="B31">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Do Anxiety and Depression Levels Interfere with Cognitive Performance in Ecuadorian Multiple Sclerosis Patients? - a Case-Control Study]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barzola-Castro]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Cepeda-Escalante]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Jimenez-Zambrano]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Neurology]]></source>
<year>2019</year>
<volume>92</volume>
<numero>s15</numero>
<issue>s15</issue>
<page-range>1-12</page-range></nlm-citation>
</ref>
<ref id="B32">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neuropsychiatric syndromes of multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Murphy]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[O&#8217;Donoghue]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Counihan]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<source><![CDATA[J Neurol Neurosurg Psychiatry]]></source>
<year>2017</year>
<volume>88</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>697-708</page-range></nlm-citation>
</ref>
<ref id="B33">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The neuropsychiatry of multiple sclerosis: Focus on disorders of mood, affect and behaviour]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Paparrigopoulos]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Ferentinos]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Kouzoupis]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Int Rev Psychiatry]]></source>
<year>2010</year>
<volume>22</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>14-21</page-range></nlm-citation>
</ref>
<ref id="B34">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The neuropsychiatry of multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ron]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[BJ Psych Advances]]></source>
<year>2018</year>
<volume>24</volume>
<numero>03</numero>
<issue>03</issue>
<page-range>178-87</page-range></nlm-citation>
</ref>
<ref id="B35">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Nivel de depresión en pacientes con Esclerosis Múltiple del Hospital Carlos Andrade Marín]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cajo Villalva]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Tesis doctoral. Universidad Central del Ecuador]]></source>
<year>2018</year>
</nlm-citation>
</ref>
<ref id="B36">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Social Anxiety Among Patients with Multiple Sclerosis: A Population-Based Controlled Study in Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jiménez-Zambrano]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez-Díaz]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Acuña-Chong]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Mult Scler J]]></source>
<year>2019</year>
<volume>25</volume>
<numero>S1</numero>
<issue>S1</issue>
<page-range>20-156</page-range></nlm-citation>
</ref>
<ref id="B37">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Anxiety and depression in multiple sclerosis. A comparative population-based study in Nord-Trøndelag County, Norway]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dahl]]></surname>
<given-names><![CDATA[OP]]></given-names>
</name>
<name>
<surname><![CDATA[Stordal]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Lydersen]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Mult Scler]]></source>
<year>2009</year>
<volume>15</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1495-501</page-range></nlm-citation>
</ref>
<ref id="B38">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The multiple sclerosis functional composite a clinically meaningful measure of disability]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Polman]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Rudick]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
</person-group>
<source><![CDATA[Neurology]]></source>
<year>2010</year>
<volume>74</volume>
<page-range>S3:S8-15</page-range></nlm-citation>
</ref>
<ref id="B39">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Clinical significance of the multiple sclerosis functional composite: relationship to patient-reported quality of life]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Miller]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Rudick]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Cutter]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[Arch Neurol]]></source>
<year>2000</year>
<volume>57</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1319-24</page-range></nlm-citation>
</ref>
<ref id="B40">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Multiple sclerosis functional composite in a cohort of patients with multiple sclerosis in Quito, Ecuador, and its relationship to the expanded scale of Disability]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Correa-Díaz]]></surname>
<given-names><![CDATA[Edgar Patricio]]></given-names>
</name>
<name>
<surname><![CDATA[Jácome]]></surname>
<given-names><![CDATA[Elisa]]></given-names>
</name>
<name>
<surname><![CDATA[Santos-Saltos]]></surname>
<given-names><![CDATA[Denny Maritza]]></given-names>
</name>
<name>
<surname><![CDATA[Llerena-Pallango]]></surname>
<given-names><![CDATA[Andrea Fernanda]]></given-names>
</name>
</person-group>
<source><![CDATA[Multiple Sclerosis Journal]]></source>
<year>2018</year>
<page-range>1-44</page-range></nlm-citation>
</ref>
<ref id="B41">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neuromyelitis Optica Spectrum Disorder in Quito, Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Correa-Díaz]]></surname>
<given-names><![CDATA[Edgar]]></given-names>
</name>
<name>
<surname><![CDATA[Vasconez]]></surname>
<given-names><![CDATA[Vanessa]]></given-names>
</name>
<name>
<surname><![CDATA[Paredes]]></surname>
<given-names><![CDATA[Victor]]></given-names>
</name>
</person-group>
<source><![CDATA[Multiple Sclerosis Journal]]></source>
<year>2017</year>
<volume>23</volume>
<numero>S1</numero>
<issue>S1</issue>
<page-range>2-89</page-range></nlm-citation>
</ref>
<ref id="B42">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neuromyelitis Optica Spectrum Disorders in third level hospitals of Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[EP]]></surname>
<given-names><![CDATA[Correa-Díaz]]></given-names>
</name>
<name>
<surname><![CDATA[GE]]></surname>
<given-names><![CDATA[Torres-Herrán]]></given-names>
</name>
<name>
<surname><![CDATA[F]]></surname>
<given-names><![CDATA[Guillén-López]]></given-names>
</name>
</person-group>
<source><![CDATA[Multiple Sclerosis Journal]]></source>
<year>2018</year>
<volume>24</volume>
<numero>S2</numero>
<issue>S2</issue>
</nlm-citation>
</ref>
<ref id="B43">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Coexistence of systemic lupus erythematosus and multiple sclerosis. A case report and literature review]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jácome-Sánchez]]></surname>
<given-names><![CDATA[EC]]></given-names>
</name>
<name>
<surname><![CDATA[García-Castillo]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[VP]]></given-names>
</name>
</person-group>
<source><![CDATA[Mult Scler J Exp Transl Clin]]></source>
<year>2018</year>
<volume>4</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B44">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Esclerosis múltiple asociada a disfunción tiroidea en pacientes de la Provincia de Pichincha.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zambrano]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Mosquera]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<source><![CDATA[Revista Cambios]]></source>
<year>2018</year>
<volume>17</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>52-6</page-range></nlm-citation>
</ref>
<ref id="B45">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Association of MS with thyroid disorders]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Karni]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Abramasky]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<source><![CDATA[Neurology]]></source>
<year>1999</year>
<volume>53</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>883-5</page-range></nlm-citation>
</ref>
<ref id="B46">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Fatiga en esclerosis múltiple]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Páramo-Camino]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Izquierdo-Ayuso]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[Revista Española de Esclerosis múltiple]]></source>
<year>2007</year>
<page-range>19-25</page-range></nlm-citation>
</ref>
<ref id="B47">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The Impact of Fatigue on Patients with Multiple Sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fisk]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Pontefract]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ritvo]]></surname>
<given-names><![CDATA[PG]]></given-names>
</name>
<name>
<surname><![CDATA[Archibald]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Murray]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
</person-group>
<source><![CDATA[Can J Neurol Sci]]></source>
<year>1994</year>
<volume>21</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>9-14</page-range></nlm-citation>
</ref>
<ref id="B48">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Control del nivel de fatiga en pacientes con esclerosis múltiple: adaptación de un enfoque mixto]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mazón-García]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Tesis doctoral. Universitat de Lleida]]></source>
<year>2017</year>
</nlm-citation>
</ref>
<ref id="B49">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Fatigue in Multiple Sclerosis : Mechanisms , Evaluation, and Treatment]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Braley]]></surname>
<given-names><![CDATA[Tiffany]]></given-names>
</name>
<name>
<surname><![CDATA[Chervin]]></surname>
<given-names><![CDATA[Ronald]]></given-names>
</name>
</person-group>
<source><![CDATA[Sleep]]></source>
<year>2010</year>
<volume>33</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1061-7</page-range></nlm-citation>
</ref>
<ref id="B50">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The effect of functional limitations and fatigue on the quality of life in people with multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nogueira]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
<name>
<surname><![CDATA[Nóbrega]]></surname>
<given-names><![CDATA[FR]]></given-names>
</name>
<name>
<surname><![CDATA[Lopes]]></surname>
<given-names><![CDATA[KN]]></given-names>
</name>
</person-group>
<source><![CDATA[Arq Neuropsiaquiatr]]></source>
<year>2009</year>
<volume>67</volume>
<numero>3B</numero>
<issue>3B</issue>
<page-range>812-7</page-range></nlm-citation>
</ref>
<ref id="B51">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Quality of life in multiple sclerosis (MS) and role of fatigue, depression, anxiety, and stress: A bicenter study from north of Iran]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Salehpoor]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Rezaei]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hosseininezhad]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Iran J Nurs Midwifery Res]]></source>
<year>2014</year>
<volume>19</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>593-9</page-range></nlm-citation>
</ref>
<ref id="B52">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Vitamin D and multiple sclerosis: Correlation, causality, and controversy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Smolders]]></surname>
<given-names><![CDATA[Joost]]></given-names>
</name>
</person-group>
<source><![CDATA[Autoimmune Dis]]></source>
<year>2011</year>
<volume>2011</volume>
<page-range>629538</page-range></nlm-citation>
</ref>
<ref id="B53">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Estimates of optimal vitamin D status]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dawson-Hughes]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Heaney]]></surname>
<given-names><![CDATA[RP]]></given-names>
</name>
<name>
<surname><![CDATA[Holick]]></surname>
<given-names><![CDATA[MF]]></given-names>
</name>
</person-group>
<source><![CDATA[Osteoporos Int]]></source>
<year>2005</year>
<volume>16</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>713-6</page-range></nlm-citation>
</ref>
<ref id="B54">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Vitamin D Status: Measurement, Interpretation, and Clinical Application]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Holick]]></surname>
<given-names><![CDATA[MF]]></given-names>
</name>
</person-group>
<source><![CDATA[Ann Epidemiol]]></source>
<year>2009</year>
<volume>19</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>73-8</page-range></nlm-citation>
</ref>
<ref id="B55">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Serum Concentrations of Vitamin D in Patients with Multiple Sclerosis at the Pichincha Province of Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zambrano]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
</person-group>
<source><![CDATA[Mult Scler J]]></source>
<year>2016</year>
<volume>22</volume>
<numero>S1</numero>
<issue>S1</issue>
</nlm-citation>
</ref>
<ref id="B56">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Vitamin D in multiple sclerosis patients: Not the same risk for everybody]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rito]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Flores]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández-Aguilar]]></surname>
<given-names><![CDATA[Á]]></given-names>
</name>
</person-group>
<source><![CDATA[Mult Scler]]></source>
<year>2016</year>
<volume>22</volume>
<page-range>126-7</page-range></nlm-citation>
</ref>
<ref id="B57">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Predictores de la suficiencia de vitamina D en un grupo de pacientes ecuatorianos con esclerosis múltiple]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zambrano]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
<name>
<surname><![CDATA[Mosquera]]></surname>
<given-names><![CDATA[Felipe]]></given-names>
</name>
</person-group>
<source><![CDATA[Mult Scler J]]></source>
<year>2016</year>
<volume>22</volume>
<numero>S1</numero>
<issue>S1</issue>
</nlm-citation>
</ref>
<ref id="B58">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Vitamin D and Multiple Sclerosis: A Comprehensive Review]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sintzel]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Rametta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Reder]]></surname>
<given-names><![CDATA[AT]]></given-names>
</name>
</person-group>
<source><![CDATA[Neurol Ther]]></source>
<year>2018</year>
<volume>7</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>59-85</page-range></nlm-citation>
</ref>
<ref id="B59">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Vitamin D as a protective factor in multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Salzer]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Hallmans]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Nystrom]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Neurology]]></source>
<year>2012</year>
<volume>79</volume>
<numero>21</numero>
<issue>21</issue>
<page-range>2140-5</page-range></nlm-citation>
</ref>
<ref id="B60">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Munger]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
<name>
<surname><![CDATA[Levin]]></surname>
<given-names><![CDATA[LI]]></given-names>
</name>
<name>
<surname><![CDATA[Hollis]]></surname>
<given-names><![CDATA[BW]]></given-names>
</name>
</person-group>
<source><![CDATA[JAMA]]></source>
<year>2006</year>
<volume>296</volume>
<numero>23</numero>
<issue>23</issue>
<page-range>2832-8</page-range></nlm-citation>
</ref>
<ref id="B61">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Regulatory role of vitamin D in T-cell reactivity against myelin peptides in relapsing-remitting multiple sclerosis patients]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Grau-López]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Granada]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Raich-Regue]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<source><![CDATA[BMC Neurol]]></source>
<year>2012</year>
<volume>12</volume>
<page-range>103</page-range></nlm-citation>
</ref>
<ref id="B62">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Vitamin D Status among Older Adults Residing in the Littoral and Andes Mountains in Ecuador]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Orces]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
</person-group>
<source><![CDATA[ScientificWorldJournal]]></source>
<year>2015</year>
<page-range>545297</page-range></nlm-citation>
</ref>
<ref id="B63">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The association between obesity and vitamin D status among older adults in Ecuador: analysis of the SABE survey]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Orces]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
</person-group>
<source><![CDATA[Nutr Hosp]]></source>
<year>2018</year>
<volume>35</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1066-71</page-range></nlm-citation>
</ref>
<ref id="B64">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Vitamin D is not useful as a biomarker for disease activity in rheumatoid arthritis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[De la Torre-Lossa]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno-Álvarez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[González-Guzmán]]></surname>
<given-names><![CDATA[MDC]]></given-names>
</name>
</person-group>
<source><![CDATA[Reumatol Clin]]></source>
<year>2018</year>
<volume>S1699-258X</volume>
<numero>18</numero>
<issue>18</issue>
<page-range>30077-9</page-range></nlm-citation>
</ref>
<ref id="B65">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Hygiene hypothesis and autoimmune diseases]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rook]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
</person-group>
<source><![CDATA[Clin Rev Allergy Immunol]]></source>
<year>2012</year>
<volume>42</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>5-15</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
