1
|
Campbell JA, Simpson-Yap S, Taylor BV, van der Mei I, Laslett L, Henson G, Zhao T, Palmer AJ. Significantly increasing multiple sclerosis prevalence in Australia from 2010 to 2021. Mult Scler 2024; 30:1113-1127. [PMID: 39104180 DOI: 10.1177/13524585241265890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) prevalence is increasing globally. OBJECTIVES To determine whether increased prevalence is continuing within Australia using our validated prescription-based ascertainment method. METHODS We used methods employed in our 2010 and 2017 prevalence estimates. Disease-modifying therapy (DMT) prescriptions were extracted from Australia's Pharmaceutical Benefits Scheme data for January-December 2021. DMT penetrance was calculated using data from the Australian MS Longitudinal Study. We divided the total number of monthly prescriptions by 12 or 2 (except alemtuzumab), adjusted for DMT penetrance and Australian population estimates. Prevalences in Australian states/territories were age-standardised. 2021 prevalence estimates were compared with 2010 and 2017 prevalence estimates using Poisson regression. RESULTS Number of people with MS in Australia in 2021 was 33,335; an increase of 7728 from 2017 (30.2%) and 12,092 from 2010 (56.6%) and increasing at a faster rate than population change (+10.1%, +14.1%). Age-standardised prevalence was 136.1/100,000 (increased from 103.7/100,000 in 2017). The previously demonstrated positive latitudinal gradient in 2010 and 2017 persisted in 2021, with Tasmania (southernmost state) having the highest prevalence (age-standardised: 203.5/100,000) while northernmost states had the lowest. CONCLUSIONS In line with global trends, MS prevalence is escalating in Australia, particularly in higher-latitude states. MS prevention is crucial to halt this disturbing trend.
Collapse
Affiliation(s)
- Julie A Campbell
- MS Research Flagship, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Steve Simpson-Yap
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
- CORe, School of Medicine, The University of Melbourne, Parkville, VIC, Australia
- Neuroepidemiology Unit, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Bruce V Taylor
- MS Research Flagship, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Ingrid van der Mei
- MS Research Flagship, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Laura Laslett
- MS Research Flagship, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Glen Henson
- MS Research Flagship, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Ting Zhao
- MS Research Flagship, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Andrew J Palmer
- MS Research Flagship, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| |
Collapse
|
2
|
Pierret C, Mainguy M, Leray E. Prevalence of multiple sclerosis in France in 2021: Data from the French health insurance database. Rev Neurol (Paris) 2024; 180:429-437. [PMID: 38423846 DOI: 10.1016/j.neurol.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND France is among the countries with high prevalence of multiple sclerosis (MS). The most recent estimates are from 2012 and need to be updated because MS prevalence has increased worldwide. OBJECTIVE To estimate MS prevalence in France on December 31, 2021 and to describe the characteristics of the French MS population using data from the French national health insurance database (SNDS). MATERIAL AND METHODS Persons with MS (PwMS) were identified in the SNDS database (99% of national coverage) using an algorithm with three criteria: long-term disease status, hospitalizations, and MS-specific drug reimbursements. Crude and sex- and age-stratified prevalence rates were calculated with their 95% confidence intervals as well as the standardized prevalence stratified on the region of residence. RESULTS In total, 134,062 PwMS were identified (71.8% of women, median age 53.0±14.8years) yielding a prevalence of 197.6 per 100,000 (95% CI [196.5-198.7]). Prevalence rates in women and men were respectively 274.9 (95% CI [273.2-276.6]) and 115.2 (95% CI [114.0-116.4]). In metropolitan France, the highest prevalence rates were observed in the northeastern regions (e.g.>230 PwMS per 100,000 in Grand Est and Hauts-de-France), and the lowest rates in the southwestern regions (∼180 PwMS per 100,000 in Nouvelle-Aquitaine and Occitanie). Overall, 32.1% of PwMS had another long-term disease and 51.8% received at least one MS-specific drug in 2021. CONCLUSION MS prevalence in France has increased by ∼30% in the last 10years. This increase is probably linked to population ageing, longer survival of PwMS, and the long observation period. The part attributable to a possible increase in MS risk remains to be determined with incidence studies.
Collapse
Affiliation(s)
- C Pierret
- Rennes University, EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, Rennes, France.
| | - M Mainguy
- Rennes University, EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, Rennes, France
| | - E Leray
- Rennes University, EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, Rennes, France
| |
Collapse
|
3
|
Rzepka M, Chmiela T, Kaczmarczyk A, Krzystanek E. Insomnia, Fatigue, Bladder Disorders and Mood Disorders among Polish Patients with Multiple Sclerosis: Cross-Sectional Study. J Clin Med 2024; 13:1043. [PMID: 38398356 PMCID: PMC10888699 DOI: 10.3390/jcm13041043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND To investigate the prevalence of sleep disorders in patients with multiple sclerosis (PwMS) in comparison to healthy controls (HCs), we aim to explore the correlation between sleep disorders and fatigue, bladder dysfunction, mood disorders in PwMS. METHODS This study involved 175 PwMS and 115 HCs. We conducted a self-administered survey using questionnaires (the authors' questionnaire, the Athens Insomnia Scale (AIS), the Epworth Sleepiness Scale (ESS), the Modified Fatigue Impact Scale (MFIS), the Fatigue Severity Scale (FSS), the Hospital Anxiety and Depression Scale (HADS), and the Numerical Rating Scale (NRS). The neurological disability was determined using Expanded Disability Status Scale. Logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS According to AIS, insomnia was found in 20.6% of PwMS compared to 9.6% of HCs (p < 0.001). Comparing female and male PwMS, we observed that insomnia was more prevalent among female PwMS (25.95% vs. 4.55%, respectively, p < 0.05). Excessive daytime sleepiness was more prevalent in female PwMS (p < 0.05). Female PwMS were more fatigue based on the FSS and the MFIS (p < 0.05). Bladder disorders were observed in 39.43% of PwMS and were significantly linked to MS (p < 0.001). Sleep disturbances were associated with anxiety disorders (OR = 0.22, 95% CI 0.12-0.32 p < 0.001), bladder dysfunction (OR = 0.52 95% CI 0.16-0.87 p < 0.05), and female gender (OR = 0.49, 95% CI 0.037-0.94 p < 0.05). CONCLUSIONS Insomnia is prevalent among PwMS. Our study revealed independent predictors of sleep disturbances among PwMS: female gender, bladder disorders, and anxiety.
Collapse
Affiliation(s)
- Michalina Rzepka
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (T.C.); (A.K.)
| | - Tomasz Chmiela
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (T.C.); (A.K.)
| | - Aleksandra Kaczmarczyk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (T.C.); (A.K.)
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-635 Katowice, Poland;
| |
Collapse
|
4
|
Ducatel P, Debouverie M, Soudant M, Guillemin F, Mathey G, Epstein J. Performance of administrative databases for identifying individuals with multiple sclerosis. Sci Rep 2023; 13:18310. [PMID: 37880330 PMCID: PMC10600163 DOI: 10.1038/s41598-023-45384-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/19/2023] [Indexed: 10/27/2023] Open
Abstract
Administrative databases are an alternative to disease registries as a research tool to study multiple sclerosis. However, they are not initially designed to fulfill research purposes. Therefore, an evaluation of their performance is necessary. Our objective was to assess the performance of the French administrative database comprising hospital discharge records and national health insurance databases in identifying individuals with multiple sclerosis, in comparison with a registry that exhaustively compiles resident multiple sclerosis cases in Lorraine, northeastern France, as reference. We recorded all individuals residing in the Lorraine region who were identified by the administrative database or the registry as having multiple sclerosis from 2011 to 2016. We calculated the Matthews correlation coefficient and other concordance indicators. For identifying individuals with multiple sclerosis, the Matthews correlation coefficient by the administrative database was 0.79 (95% CI 0.78-0.80), reflecting moderate performance. The mean time to identification was 5.5 years earlier with the registry than the administrative database. Administrative databases, although useful to study multiple sclerosis, should be used with caution because results of studies based on them may be biased. Our study highlights the value of regional registries that allow for a more exhaustive and rapid identification of cases.
Collapse
Affiliation(s)
- Pauline Ducatel
- Department of Neurology, Nancy University Hospital, 29 Avenue du Maréchal de Lattre de Tassigny, Nancy, France.
- CIC-EC 1433, CHRU, Inserm, Université de Lorraine, 9 Av. de La Forêt de Haye, Vandoeuvre-Lès-Nancy, France.
| | - Marc Debouverie
- Department of Neurology, Nancy University Hospital, 29 Avenue du Maréchal de Lattre de Tassigny, Nancy, France
- Université de Lorraine, EA 4360 Apemac, 9 Av. de La Forêt de Haye, Vandoeuvre-Lès-Nancy, France
| | - Marc Soudant
- CIC-EC 1433, CHRU, Inserm, Université de Lorraine, 9 Av. de La Forêt de Haye, Vandoeuvre-Lès-Nancy, France
| | - Francis Guillemin
- CIC-EC 1433, CHRU, Inserm, Université de Lorraine, 9 Av. de La Forêt de Haye, Vandoeuvre-Lès-Nancy, France
- Université de Lorraine, EA 4360 Apemac, 9 Av. de La Forêt de Haye, Vandoeuvre-Lès-Nancy, France
| | - Guillaume Mathey
- Department of Neurology, Nancy University Hospital, 29 Avenue du Maréchal de Lattre de Tassigny, Nancy, France
- Université de Lorraine, EA 4360 Apemac, 9 Av. de La Forêt de Haye, Vandoeuvre-Lès-Nancy, France
| | - Jonathan Epstein
- CIC-EC 1433, CHRU, Inserm, Université de Lorraine, 9 Av. de La Forêt de Haye, Vandoeuvre-Lès-Nancy, France
- Université de Lorraine, EA 4360 Apemac, 9 Av. de La Forêt de Haye, Vandoeuvre-Lès-Nancy, France
| |
Collapse
|
5
|
Warmbier WA, Popiel M, Guzik A, Drużbicki M, Bartosik-Psujek H. Objective assessment of dysarthric disorders in patients with multiple sclerosis depending on sex, age, and type of text read. Front Neurol 2023; 14:1225754. [PMID: 37621859 PMCID: PMC10445038 DOI: 10.3389/fneur.2023.1225754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/07/2023] [Indexed: 08/26/2023] Open
Abstract
Purpose To assess dysarthric disorders in multiple sclerosis (MS) patients in comparison with healthy individuals and MS patients without dysarthria depending on the patient's sex, age, and the type of text read using an objective tool. Methods The study was carried out in a group of 72 persons, including 24 with MS presenting dysarthria (study group) and 24 healthy individuals (healthy control group), and 24 with MS without dysarthria (MS control group). Performance (reading) time was evaluated by means of an objective tool created for the purpose of the analysis. Results The study showed significant statistical differences in the analyzed performance time of: poetry reading, prose reading, and completing a diction exercise, among persons with MS from the study group presenting dysarthria and both control groups (p < 0.05). It took more time to read the poem, and prose and to perform a diction exercise in the study group with dysarthria than in both control groups (with no significant differences between the two) Similarly, the comparison between the groups in terms of sex and age showed disturbances in the above-mentioned parameter in the study group. What was not demonstrated were significant differences in the evaluated speech parameters depending on both sex and age separately in the group of MS patients with dysarthria, and both control groups (p < 0.05). Conclusion The objective tool created for the purpose of speech analysis is useful in detecting discrepancies in performance (reading) time among MS patients with dysarthria, and healthy individuals, as well as patients with MS without dysarthria and can be used in clinical practice for diagnostic purposes, however, further research is essential to complete its validation.
Collapse
Affiliation(s)
- Wojciech A. Warmbier
- BD Center Ltd., Rzeszow, Poland
- Clinical Hospital No 2 in Rzeszow, Rzeszow, Poland
- Subcarpathian Center for Neurorehabilitation, Rzeszow, Poland
| | - Małgorzata Popiel
- BD Center Ltd., Rzeszow, Poland
- Clinical Hospital No 2 in Rzeszow, Rzeszow, Poland
| | - Agnieszka Guzik
- Department of Physiotherapy, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszow, Poland
| | - Mariusz Drużbicki
- Department of Physiotherapy, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszow, Poland
| | - Halina Bartosik-Psujek
- Clinical Hospital No 2 in Rzeszow, Rzeszow, Poland
- Department of Neurology, Institute of Medical Sciences, College of Medical Sciences, University of Rzeszów, Rzeszow, Poland
| |
Collapse
|
6
|
Brola W, Steinborn B, Żak M, Mazurkiewicz-Bełdzińska M, Jóźwiak S, Sobolewski P, Wilski M, Bilska M, Siedlarska M, Puzio-Bochen I, Wencel-Warot A, Lemka M, Kroczka S, Czyżyk E, Bocheńska M, Emich-Widera E, Pietruszewski J, Boćkowski L, Kapica-Topczewska K, Czarnowska A, Kułakowska A, Ujma-Czapska B, Gruna-Ożarowska A, Przysło Ł, Połatyńska K, Dudzińska M, Mitosek-Szewczyk K, Melnyk A, Adamczyk-Sowa M, Kotulska K. The Clinical and Epidemiological Profile of Paediatric-Onset Multiple Sclerosis in Poland. J Clin Med 2022; 11:jcm11247494. [PMID: 36556109 PMCID: PMC9785459 DOI: 10.3390/jcm11247494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/11/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Background. Paediatric-onset MS (POMS) has a unique clinical profile compared to the more prevalent adult-onset MS. For this study, we aimed to determine the demographic and clinical characteristics of POMS in Poland as well as addressing some of its epidemiological aspects. Methods. A retrospective study was conducted based on the Polish Multiple Sclerosis Registry, considering a population of children and adolescents with MS (age ≤ 18 years). Data were collected by all 13 centres across Poland specializing in diagnosing and treating POMS. The actual course of the disease and its clinical properties were compared between child (≤12 years) and juvenile (>12 years) patients. MS onset and its prevalence were assessed at the end of 2019, stratified by age range. Results. A total of 329 paediatric or juvenile patients (228 girls, 101 boys) with a clinically definite diagnosis of MS, in conformity with the 2017 McDonald Criteria, were enrolled. For 71 children (21.6%), the first symptoms appeared before the age of 12. The female: male ratio increased with age, amounting to 1:1 in the ≤12 years group and to 2.9:1 in the >12 years group. In most cases, the disease had multi-symptomatic onset (31.3%), and its course was mostly of a relapsing−remitting character (95.7%). The initial Expanded Disability Status Score for both groups was 1.63 ± 1.1, whereas the annual relapse rate was 0.84 during the first 2 years. The time between the onset of symptoms and diagnosis was longer in the younger patients (8.2 ± 4.2 vs. 4.6 ± 3.6 months; p < 0.005). On 31 December 2019, the age-adjusted prevalence standardized to the European standard population was 5.19/100,000 (95% CI, 4.64−5.78). Significantly higher prevalence was noted in the 13−18 years group (7.12; 95% CI, 6.64−7.86) than in the 9−12 years group (3.41; 95% CI, 2.98−3.86) and the <9 years group (0.56; 95% CI, 0.46−0.64; p < 0.001). Conclusion. POMS commencing at the age of ≤12 years is rare, differing significantly from the juvenile-onset and adult MS in terms of clinical characteristics, course, and incidence, as stratified by gender.
Collapse
Affiliation(s)
- Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
- Correspondence: ; Tel.: +48-601313415
| | - Barbara Steinborn
- Department of Developmental Neurology, Poznan University of Medical Sciences, 61-545 Poznań, Poland
| | - Marek Żak
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | | | - Sergiusz Jóźwiak
- Department of Child Neurology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Piotr Sobolewski
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Maciej Wilski
- Department of Adapted Physical Activity, Poznań University of Physical Education, 61-871 Poznań, Poland
| | - Małgorzata Bilska
- Department of Child Neurology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Magdalena Siedlarska
- Department of Child Neurology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Iwona Puzio-Bochen
- Department of Neurology and Epileptology, The Children’s Memorial Health Institute, 04-783 Warsaw, Poland
| | - Agnieszka Wencel-Warot
- Department of Developmental Neurology, Poznan University of Medical Sciences, 61-545 Poznań, Poland
| | - Małgorzata Lemka
- Department of Developmental Neurology, Medical University of Gdańsk, 80-952 Gdańsk, Poland
| | - Sławomir Kroczka
- Department of Child and Adolescent Neurology, Medical College, Jagiellonian University in Kraków, 30-663 Kraków, Poland
| | - Elżbieta Czyżyk
- Clinical Department of Child Neurology, Clinical Central Hospital No 2 in Rzeszow, 35-301 Rzeszów, Poland
| | - Małgorzata Bocheńska
- Clinical Department of Child Neurology, Clinical Central Hospital No 2 in Rzeszow, 35-301 Rzeszów, Poland
| | - Ewa Emich-Widera
- Department of Pediatric Neurology, School of Medicine in Katowice, Medical University of Silesia Katowice, 41-808 Katowice, Poland
| | - Jerzy Pietruszewski
- Department of Pediatric Neurology, School of Medicine in Katowice, Medical University of Silesia Katowice, 41-808 Katowice, Poland
| | - Leszek Boćkowski
- Department of Pediatric Neurology and Rehabilitation, Medical University of Białystok, 15-274 Białystok, Poland
| | | | - Agata Czarnowska
- Department of Neurology, Medical University of Białystok, 15-276 Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, 15-276 Bialystok, Poland
| | - Barbara Ujma-Czapska
- Department of Social Pediatrics, Faculty of Health Sciences, Wrocław Medical University, 51-618 Wrocław, Poland
| | - Agata Gruna-Ożarowska
- Department of Social Pediatrics, Faculty of Health Sciences, Wrocław Medical University, 51-618 Wrocław, Poland
| | - Łukasz Przysło
- Department of Developmental Neurology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Łódź, Poland
| | - Katarzyna Połatyńska
- Department of Developmental Neurology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Łódź, Poland
| | - Magdalena Dudzińska
- Children’s Neurology Ward, Dr. E. Hanke Centre of Pediatrics and Oncology of Chorzów, 41-500 Chorzów, Poland
| | | | - Aleksandra Melnyk
- Department of Child Neurology, Regional Specialized Children’s Hospital, Olsztyn, Poland, and Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-082 Olsztyn, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
| | - Katarzyna Kotulska
- Department of Neurology and Epileptology, The Children’s Memorial Health Institute, 04-783 Warsaw, Poland
| |
Collapse
|
7
|
Vitamin D Supplementation Practices among Multiple Sclerosis Patients and Professionals. J Clin Med 2022; 11:jcm11247278. [PMID: 36555896 PMCID: PMC9787609 DOI: 10.3390/jcm11247278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Vitamin D serum level increase is associated with a reduction in clinical relapse rate, gadolinium-enhancing lesions, new or enlarging T2 lesions and new active lesions in the MRI in MS patients. However, current RCTs assessing the vitamin D supplementation therapeutic effect in MS provide inconclusive results. Experts recommend vitamin D measurements and implementations among patients with MS. This article discusses an observational study, performed without any intervention to evaluate the vitamin D status and practices among MS patients and professionals in the clinical setting. A total of 139 patients with MS treated by disease-modifying therapy were recruited and fulfilled the standardized questionnaire assessing the vitamin D supplementation practices and vitamin D level influencing factors such as education, insolation, smoking, obesity and current treatment. The collected data were then compared to the patients' vitamin D serum levels available in medical records at the baseline and after 12 months of observation. Professionals' practices and recommendations were also assessed. A total of 74.1% patients confirmed vitamin D supplementation, and all patients were administered cholecalciferol, taken orally. However, only 43.69% of the patients achieved an optimal vitamin D concentration (30-50 ng/mL). The lack of a doctor's recommendation was the most frequent reason for the absence of vitamin D supplementation. The most often recommended vitamin D daily dose was 4000 IU. There was no adverse effect of supplementation observed. Vitamin D status in patients with MS is currently better than in the general population, but still, a significant percentage of patients do not implement vitamin D.
Collapse
|
8
|
Szewczyk AK, Papuć E, Mitosek-Szewczyk K, Woś M, Rejdak K. NMOSD-Diagnostic Dilemmas Leading towards Final Diagnosis. Brain Sci 2022; 12:885. [PMID: 35884693 PMCID: PMC9313254 DOI: 10.3390/brainsci12070885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/31/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: The emergence of white matter lesions in the central nervous system (CNS) can lead to diagnostic dilemmas. They are a common radiological symptom and their patterns may overlap CNS or systemic diseases and provoke underdiagnosis or misdiagnosis. The aim of the study was to assess factors influencing the underdiagnosis of neuromyelitis optica spectrum disorder (NMOSD) as well as to estimate NMOSD epidemiology in Lubelskie voivodeship, Poland. (2) Methods: This retrospective study included 1112 patients, who were made a tentative or an established diagnosis of acute or subacute onset of neurological deficits. The evaluation was based on medical history, neurological examination, laboratory and radiographic results and fulfilment of diagnosis criteria. (3) Results: Up to 1.62 percent of patients diagnosed with white matter lesions and up to 2.2% of the patients previously diagnosed with MS may suffer from NMOSD. The duration of delayed diagnosis is longer for males, despite the earlier age of onset. Seropositive cases for antibodies against aquaporin-4 have worse prognosis for degree of disability. (4) Conclusions: Underdiagnosis or misdiagnosis in NMOSD still remains a problem in clinical practice and has important implications for patients. The incorrect diagnosis is caused by atypical presentation or NMOSD-mimics; however, covariates such as gender, onset and diagnosis age may also have an influence.
Collapse
Affiliation(s)
- Anna K. Szewczyk
- Doctoral School, Medical University of Lublin, ul. Chodźki 7, 20-093 Lublin, Poland
- Department of Neurology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954 Lublin, Poland;
| | - Ewa Papuć
- Department of Neurology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954 Lublin, Poland;
| | - Krystyna Mitosek-Szewczyk
- Department of Child Neurology, Medical University of Lublin, ul. Profesora Antoniego Gebali 6, 20-093 Lublin, Poland;
| | - Michał Woś
- Department of Medical Informatics and Statistics with E-Learning Lab, ul. Jaczewskiego 4, 20-090 Lublin, Poland;
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954 Lublin, Poland;
| |
Collapse
|
9
|
Seasonal Variations in the Concentration of Particulate Matter in the Air of Cracow Affect the Magnitude of CD4+ T Cell Subsets Cytokine Production in Patients with Inflammatory and Autoimmune Disorders. ATMOSPHERE 2022. [DOI: 10.3390/atmos13040529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Recently, the increased prevalence of chronic civilization diseases triggered by environmental pollution has been observed. In this context, the role of air pollution in the pathogenesis of autoimmune and/or inflammatory disorders is poorly elucidated. Here, we asked whether seasonal changes in the air quality of the city of Cracow affect the polarization of T cell subsets in healthy donors (HD) and patients with rheumatoid arthritis (RA), multiple sclerosis (MS), and atherosclerosis (AS). Peripheral blood mononuclear cells (PBMCs) from HD and patients were exposed in vitro to particulate matter isolated from the air of Cracow (PM CRC). Blood samples were collected in two seasons (winter and summer), with differences in air concentration of particulate matter of 10 μm (PM10) (below or above a daily limit of 50 µg/m3). The obtained data showed a significantly elevated frequency of CD4+ lymphocytes specific for IFN-γ and IL-17A after the exposure of PBMCs to PM CRC. This was observed for all patients’ groups and HD. In the case of patients, this effect was dependent on the seasonal concentration of PM in the air, paradoxically being less pronounced in the season with a higher concentration of air pollution. These observations may suggest the role of air pollution on the course of inflammatory and autoimmune disorders.
Collapse
|
10
|
Krzystanek E, Jurczak A, Kocur K, Jurkiewicz J, Kaczmarczyk A. Awareness of COVID-19 Symptoms, Risk Factors, and Vaccinations in Patients with Multiple Sclerosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063366. [PMID: 35329050 PMCID: PMC8951455 DOI: 10.3390/ijerph19063366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 12/04/2022]
Abstract
Multiple Sclerosis (MS) is the most common chronic autoimmune disease of the central nervous system, affecting around 2.8 million people worldwide. Patients’ knowledge about COVID-19 infection, and their proper protective actions, may reduce the risk of infection. The aim of this study was to assess the knowledge of patients with MS about SARS-CoV-2, COVID-19 illness, the relationship between MS and COVID-19, willingness to be vaccinated, and the impact of the pandemic on MS care. An original, anonymous, 35-items, self-reported questionnaire was used in both web-based and on-site survey formats. Two-hundred and forty-eight questionnaires were analyzed (mean age 40.8 ± 10.6 years, 77.8% women). Participants reported the use of multiple sources of information, and the most common were websites (77.8%) and television (59.3%). The majority of participants knew the correct symptoms of COVID-19 or transmission routes (94.4%), and accepted the pandemic’s restrictions (96.8%). A total of 93.2% considered SARS-CoV-2 as highly infectious, and 69% thought they were at higher risk of being infected with SARS-CoV-2, mainly because of immunodeficiency (82.7%). Although most of them were afraid of COVID-19 (69.0%), only two-thirds wanted to be vaccinated. Patients who were afraid of COVID-19 had a 3.5-times higher chance to declare willingness for vaccination. A total of 29.8% patients claimed that the COVID-19 pandemic limited access to the healthcare system. This study shows that Polish patients with MS represent a good level of knowledge about COVID-19 disease, and acceptance for public rules, but their willingness for vaccinations is not sufficient. Country-wide educational campaigns should be conducted, particularly on the internet and TV. Restrictions in healthcare facilities should be balanced to secure access for patients with MS.
Collapse
Affiliation(s)
- Ewa Krzystanek
- Department of Neurology, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-635 Katowice, Poland
- Correspondence:
| | - Agata Jurczak
- Students’ Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (A.J.); (K.K.); (J.J.)
| | - Kinga Kocur
- Students’ Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (A.J.); (K.K.); (J.J.)
| | - Jakub Jurkiewicz
- Students’ Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (A.J.); (K.K.); (J.J.)
| | - Aleksandra Kaczmarczyk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
| |
Collapse
|
11
|
Gender-Related Differences in Prodromal Multiple Sclerosis Characteristics: A 7-Year Observation Study. J Clin Med 2021; 10:jcm10173821. [PMID: 34501269 PMCID: PMC8432063 DOI: 10.3390/jcm10173821] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 01/07/2023] Open
Abstract
Increasing evidence supports the observation that multiple sclerosis (MS) has a preclinical period, with various prodromal signs and symptoms more frequently represented in patients with confirmed MS many years later. Considering the apparent gender differences in the incidence and clinical course of MS, it remains unclear whether it could be reflected in prodromal symptom features. This study aimed to compare a broad spectrum of prodromal signs and symptoms between males and females in the 7-year period before the definite diagnosis of MS. Data came from the central register of the national payer of services, financed under the public healthcare system in Poland. They covered a 7-year period of patient health record claims, from 2009 to 2016. The following groups of symptoms were significant with women: musculoskeletal (p < 0.001), ophthalmic (p < 0.001), laryngological (p < 0.001), digestive system (p < 0.001), urinary tract (p < 0.001), mental (p < 0.001), cardiovascular (p < 0.001), complaints and headaches (p < 0.001). There was also a weak correlation with head injuries (p = 0.03) while dermatological and reproductive system complaints did not appear to be significant (p < 0.05). For males, the following groups of symptoms were significant: musculoskeletal (p < 0.001), ophthalmic (p < 0.001), laryngological (p = 0.007), cardiovascular system symptoms (p < 0.001), and headaches (p < 0.001). Interestingly, reproductive system problems were overrepresented in the male population (p = 0.008). There was no significant correlation with MS risk for dermatological, digestive, urinary, and mental complaints. Similarly, head injuries were not significant. Our results shed more light on well-known differences in the epidemiological and clinical characteristics between sexes in multiple sclerosis, and show differences in prodromal complaints before MS onset.
Collapse
|