Multiple sclerosis and thyroid gland diseases

Multiple sclerosis (MS) often presents with accompanying diseases. Thyroid gland pathology is not a rare finding in MS patients. Among a hospital cohort of 305 MS patients, 16 females with five thyroid gland diseases were diagnosed during a 14-year period. There were six cases of diffuse goiter, four of postoperative hypothyroidism, three of thyroid adenoma, two of autoimmune thyroiditis, and one of hyperthyroidism. Age characteristics of the patients varied for the specific diseases. We emphasize the need for regular monitoring of the thyroid function in MS patients

Individual training for self-injection of disease-modifying medications in multiple sclerosis patients - a guarantee for successful treatment

Въведение: МС е хронично инвалидизиращо заболяване, което е сред най-често срещаните причини за сериозно физическо увреждане при възрастни в трудоспособна възраст. Индивидуално обучение за самоинжектиране на медикаменти, модифициращи хода на заболяването, е гаранция за успешно лечение при пациенти с множествена склероза (МС). Цел: Да се проучи мнението на пациенти с МС, преминали индивидуално обучение за самоинжектиране на медикаменти, модифициращи хода на заболяването (ММХЗ), относно ефективността му. Материал и методи: Проведено е проучване сред пациенти с МС (n=50) през месец октомври 2016 г., преминали индивидуално обучение за самоинжектиране с медикаменти, модифициращи хода на заболяването чрез пряка индивидуална анкета. Използваните методи са документален, социологически (анкета), статистически и графичен анализ. Резултати и обсъждане: Анкетирани са 50 пациенти с диагноза МС, посещаващи специализирана комисия към УМБАЛ „Света Марина` ЕАД - Варна. Всички анкетирани пациенти са преминали обучение при медицинска сестра - спе циалист по МС. Повече от половината пациенти (58%) са се нуждаели от над три визити за обучение. Почти 80% от участниците в анкетното проучване посочват, че при проблем се обръщат към медицинската сестра, специалист по МС. Изводи: Всички анкетирани, без изключение, считат, че не биха се справили със самоинжектирането без обучение. Източникът на информация за наличие на медицинска сестра - специалист по МС, която може да проведе обучението по самоинжектиране, отразява актуалната ситуация. Заключение: Индивидуалното обучение за самоинжектиране с медикаменти, модифициращи хода на заболяването, е една нова различна потребност от здравни грижи и психологическа подкрепа, която би била удовлетворена от медицинска сестра -специалист по МС. Пациентите в ситуация на хронично заболяване като МС и тяхното продължително лечение зависят и от собственото им умение да се справят. Затова още по-голяма значимост може да се отдаде на постигнатото чувство за сигурност след проведено индивидуално обучение за самоинжектиране на ММХЗ.Introduction: Individual training for self-injection of disease-modifying medications is a guarantee for successful treatment in patients with Multiple Sclerosis (MS). MS is a chronic disabling disease, which is among the most common causes of serious physical disability in working-age adults. Aim: The aim of this paper is to investigate the opinion of patients with MS, who have undergone inductive self-injection training to modify the course of the disease. Materials and Methods: A study through a direct individual survey was conducted among patients (n=50) in October 2016 who had undergone individual self-injection training for medications modifying the course of the disease (MMCD). The used methods were documentary, sociological (questionnaire), statistical and graphical analysis. Results and Discussion: Fifty patients with an MS diagnosis visiting a specialized commission at St. Marina University Hospital, Varna were interviewed. All of the surveyed patients have received training with a nurse, an MS specialist. More than half of the patients (58%) needed more than three study visits. Nearly 80% of the survey respondents indicated that they contacted an MS specialist nurse, if there was a problem.Conclusion: All respondents, without exception, consider that they would not cope with self-injection without training. The information about the presence of a nurse specialist on MS who can carry out self-injection training reflects the current situation. Individual training for self-injection of disease-modifying medications is a new and different need for health care and psychological support that would be met by a nurse specialist on MS. Patients with a chronic disease such as MS and their long-term treatment depend on their own ability to cope with it. Therefore, even greater significance can be attributed to the attainment of a certain sense of security after individual self-injection of MMCD

Continuing education of nurses from outpatient care - prerequisite for improving quality of life in patients with chronic diseases

Въведение: Комплексните грижи за пациенти с хронични заболявания като множествена склероза са предпоставка за повишаване качеството на живот както на пациентите, така и на техните семейства. Тези грижи се планират от медицински сестри, които работят в извънболничната помощ. Цел: Да се проучи мнението на медицински сестри от извънболничната помощ относно ефек-тивността на сестринските грижи за пациенти с хронични заболявания. Материал и методи: Проведено е проучване сред медицински сестри от извънболничната медицинска помощ (ИБМП) (n=50) в периода декември 2015 - април 2016 г. Използваните методи са документален, социологически (анкета), статистически и графичен анализ. Резултати и обсъждане: Анкетирани са 50 медицински сестри, работещи при невролог (64%) от ИБМП и при ОПЛ (36%). Превалира процентът на анкетирани (88%), които считат, че е необходимо периодично опресняване и обогатяване на професионалните компетентности. Висок дял от респондентите (96%) подкрепят идеята за продължаващо обучение, a 92% изразяват готовност за инвестиране на време за продължа ващо обучение, като предпочитаната форма е кратък специализиран курс (58%). Изводи: Продължаващото обучение на медицински сестри в ИБМП е ключов елемент от повишаването на качеството на живот на пациенти с хронични заболявания. Идеята за продължаващо обучение на медицинските сестри намира подкрепа от почти всички. Представеният избор на формата на обучение вероятно отразява не само собственото мнение, но и личните възможности. Силният стремеж за продължаващо обучение се доказва от изразената готовност от мнозинството за инвестиране на време и финансови средства. Заключение: Опитът в редица европейски държави показва, че медицинските сестри са заели своето място в мултидисциплинарни практики. Този процес в България е в начален етап. Медицинските сестри от ИБМП трябва да придобиват нови знания и умения, за да могат да организират комплексни мероприятия за обучение на пациентите и техните близки.Introduction: Complex care for patients with chronic diseases such as multiple sclerosis is a prerequisite for improving the quality of life of both patients and their families. These cares are planned by nurses, working in outpatient care. Aim: The aim of this paper is to investigate the opinion of outpatient care nurses about the effectiveness of nursing care for patients with chronic diseases. Materials and Methods: A survey was conducted among outpatient nurses (n=50) between December 2015 and April 2016. The used methods were documentary, sociological (questionnaire), statistical and graphic analysis. Results and Discussion: Fifty nurses were interviewed and 64% of them work with a neurologist in outpatient care and 36% work for general practitioners. Most of the respondents (88%) considered that periodic refreshing and enrichment of professional competencies is necessary. Almost all of the respondents (96%) support the idea of continuing education and 92% express their willingness to invest time in continuing education. The preferred form is a short specialized course (58%). Conclusion: Continuing education for nurses in outpatient care is a key element in improving the quality of life of patients with chronic diseases. The idea of continuing education for nurses finds support from almost everyone. The presented choice of form of education probably reflects not only their opinion but also their personal abilities. The strong pursuit of continuing training is evidenced by the willingness of the majority to invest time and money. Experience in many European countries has shown that nurses have taken their place in multidisciplinary practices. This process in Bulgaria is at an early stage. Outpatient care nurses need to acquire new knowledge and skills to be able to organize comprehensive training events for patients and their relatives

FEELING OF HAPPINESS IN PATIENTS WITH MULTIPLE SCLEROSIS AND COMORBIDITY

Purpose: As the feeling of happiness in multiple sclerosis (MS) is not investigated in Bulgaria yet, we decided to reveal some essential features of this non-motor symptom in multiple sclerosis patients with and without comorbidity. Material/Methods: We examined 80 MS patients, 56 females and 24 males, at a mean age of 49 years. Forty of them presented with multiple sclerosis alone, and 40 did with multiple sclerosis and accompanying diseases. Health-related quality of life was assessed by means of Short Form-36 questionnaire and Multiple Sclerosis Quality of Life Questionnaire with 54 items. Results: We established a lower frequency of feeling of happiness reported in MS patients with comorbidity. There were statistically significant positive correlations between the health status self-assessment and MS influence upon the feeling of happiness (R=0.428; p<0.01) as well as between MS influence upon social activities and the feeling of happiness (R=0.539; p<0.01). There were statistically reliable negative correlations between depression and feeling of happiness (R=-0.591; p<0.01) as well as between health-related quality of life scores and feeling of happiness in MS patients (R=-0,565; p<0,01). There was a statistically significant difference concerning the feeling of happiness (p<0.001) between the patients with MS only and those with MS and comorbidity. Conclusion: Multiple sclerosis alone and with comorbidity exerts an unfavourable influence on individual patient’s feeling of happiness. The presence of this common non-motor symptom in MS patients needs more comprehensive research

Some Aspects Of The Feeling Of Happiness In Patients With Multiple Sclerosis

Happiness is an emotional state that reflects the positive feelings and satisfaction of life. We examined the subjective feeling of happiness with a questionnaire (MSQOL-54) including a self-assessment of happiness in 80 MS patients with and without accompanying diseases at an average age of 42.95 ± 10.39 years between 2002 and 2015. The results were processed statistically by correlation analysis. There were statistically significant positive correlations between both the self-assessments of the health status and the sense of happiness of MS patients, as well as between the impact on public activities and the sense of happiness of these patients. There were also statistically significant negative correlations between depression and the sense of hap-piness in MS patients as well as between health-related quality of life assessments and the feeling of happi-ness of these patients

Sexual Disturbances in Patients with Multiple sclerosis

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that is accompanied by different concomitant diseases. We have investigated the frequency of sexual disorders as an element of individual quality of life with a questionnaire (MSQOL-54) in 80 MS patients at an average age of 42.95 ± 10.39 for the period between 2002 and 2015. Forty of them had between one and seven accompanying diseases. There were problems in both group of patients concerning specific indicators of sexual function expressed to varying degrees. Sexual disturbances further aggravate the vitality not only of MS patients, but also of those with MS and concomitant diseases and require timely diagnosis and treatment

Diagnostic challenges in a patient with cognitive and motor disturbances: is it Huntington's disease?

Huntington’s disease (HD) is a fatal genetic disorder that causes the progressive breakdown of nerve cells in the brain. It deteriorates a person’s physical and mental abilities usually during their prime working years and there is no cure. HD is known as the quintessential family disease because every child of a parent with HD has a 50% chance of inheriting the faulty gene. Symptoms usually appear between the ages of 30 to 50, and worsen over a 10- to 25-year period. Ultimately, the weakened individual succumbs to pneumonia, heart failure or other complications. Everyone has the gene that causes HD, but only those that inherit the expansion of the gene will develop HD and perhaps pass it on to each of their children. Every person who inherits the expanded HD gene will eventually develop the disease. Over time, HD affects the individual’s ability to reason, walk and speak. Hereby, we describe the case of a 35-year-old patient with HD presenting with cognitive and motor disturbances to underline the diagnostic challenges and differential diagnostic options.

AMYOTROPHIC LATERAL SCLEROSIS AND EFFECTS OF VIBRATIONS

Amyotrophic lateral sclerosis (ALS) is a severe and fatal neurodegenerative disorder affecting both the upper and lower motor neurons. We present the clinical cases of four patients with ALS and vibration syndrome. All patients had over 20 years of exposure to general and local vibrations and common subjective complaints: pain, paresthesia, twitching and weakness of limb muscles. Evidence of ALS syndrome was demonstrated by the abnormal neurological examination (pseudobulbar syndrome and pyramidal signs) as well as by neurophysiological studies (peripheral motor neuron degeneration). We discuss the possible relationship between the exposure to general and local vibrations and the ALS syndrome in our patients, and the role of vibrations as a possible risk factor for the disease. Occupational contact with chemicals and pesticides is also discussed as a risk factor

Comorbidity of Structural Epilepsy and Multiple Sclerosis: MRI, 18FFDG PET/CT and EEG Investigations

There is accumulating evidence of a mutual relationship between multiple sclerosis and structural epilepsy. Comorbidity of these severe neurological disorders is reported in numerous recent publications in the available foreign literature. Modern diagnostic tools include comprehensive neurological examinations as well as computed tomography, electroencephalography and 18FFDG positron emission tomography. In this paper we report the case of a female patient with multiple sclerosis and structural epilepsy