Internet Usage by Polish Patients With Multiple Sclerosis: A Multicenter Questionnaire Study.

BACKGROUND: The internet is a source of knowledge and medium widely used in services that facilitate access to information and networking. Multiple sclerosis (MS) patients find the possibility of acquiring information relating to their condition particularly rewarding. OBJECTIVE: We aimed to identify Polish MS patients' preferences by analyzing a percentage of internet users and determining the most common search subjects and patients' approach to information on the internet. Disability connected with the condition, its duration, and other factors that influence patients' internet use were examined along with instances of relations established through the internet and their durability. METHODS: The study examined 1045 patients (731 women, 314 men) treated in 10 Polish MS centers, of whom 932 (89.19%) declared to be internet users. Their average age was 40.65 (SD 11.06) and average MS duration was 9.08 (SD 6.97) years. The study used a proprietary survey on information seeking, the range of searched subjects, and internet usage frequency. RESULTS: The majority of the patients (494/932, 53.0%) used the internet 6-7 times per week and 4.3% (40/932) declared they spent minimum 2 hours per day. The most commonly searched subjects were world news (604/932, 72.9% of patients using the internet); 60.8% (504/932) searched for information on their condition, particularly for new treatment methods (562/932, 67.8%) and the course of illness (520/932, 62.7%). One's sex had no impact on internet usage (female vs male, odds ratio [OR] 1.13, 95% CI 0.72-1.77), although a patient's age might, at varying degrees. We found several significant associations using a .05 significance level: a patient with higher education used the internet 9 times more often than one with primary education (OR 8.64, 95% CI 3.31-22.57); lasting relationships increased chances of internet usage by 10-fold compared to widowers (OR 0.12, 95% CI 0.05-0.31); living in a city with a population over 100,000 increased chances by nearly 6 times compared with the countryside (OR 5.59, 95% CI 2.72-11.48); the relapsing-remitting MS type saw a 2-fold increase compared with the primary progressive MS type (OR 0.47, 95% CI 0.29-0.75); and those needing assistance were 2 times less likely to use the internet than patients who could move independently (OR 0.53, 95% CI 0.31-0.89). More than half of the patients (489/932, 52.5%) did not discuss the information found on the internet with their neurologists; 15.9% (148/932) believed that relationships established through the internet can be stable. CONCLUSIONS: The majority of Polish patients use the internet as a crucial information source on their condition and innovative treatment methods. The internet can be helpful in establishing new relationships, which are usually short-lived. Polish patients do not frequently discuss the information gathered on the internet with their doctors.

Secondary progressive multiple sclerosis - clinical course and potential predictive factors.

BACKGROUND AND PURPOSE: To characterize the course of secondary progressive multiple sclerosis (SPMS), with an attempt to assess the predictive value of early clinical variables. MATERIAL AND METHODS: Medical records of 100 patients with SPMS (40 men, 60 women, aged 34-73) were analyzed retrospectively. Age at onset of MS, first symptoms, annual exacerbation rate (AER), time to progressive phase (TTP), degree of disability at its beginning (Expanded Disability Status Scale; EDSS SP), and annual progression in disability in relapsing-remitting and progressive phases (APD RR and APD SP) were compared for the gender subgroups, and the relationships between them were analyzed. RESULTS: Time to progressive phase range was 2-29 years (mean 11.51) and EDSS SP 2-7.5 (mean 5.55). Time to progressive phase in women was longer and EDSS SP was lower than in men. Age at onset of MS, AER and ADP RR correlated positively with TTP. Optic neuritis was the most common first symptom (49%; motor deficit and cerebellar/brainstem involvement 26% and 21%, respectively). Time to progressive phase in the former subgroup was shorter than in the latter, but no differences in ADP SP were found. Annual progression in disability in relapsing-remitting was higher than APD SP. Degree of disability at its beginning (EDSS SP) correlated negatively with ADP SP. CONCLUSIONS: Older age at onset, male gender, frequent relapses and fast increase in disability in the relapsing-remitting phase are risk factors for conversion to SPMS. Increase in disability during the progressive phase is slower than in the relapsing-remitting phase and depends mainly on initial EDSS. Individual variability of the course of MS has to be considered.

[Diagnostic problems in case of primary central nervous system lymphoma]. / Trudnosci diagnostyczne w przypadku pierwotnego chloniaka mózgu.

The authors described a case of young patient with primary central nervous system lymphoma (PCNSL). Unspecific initial symptoms and clinical course, as well as neuroimaging findings caused many diagnostic difficulties. The diagnosis of PCNSL was finally established on the basis of stereotactic brain biopsy, after 18 months of follow-up.

[Clinical assessment of the course of relapsing-remitting multiple sclerosis in patients treated with interferon beta]. / Ocena klinicznego przebiegu zwalniajacej postaci stwardnienia rozsianego u chorych leczonych preparatami interferonu beta.

AIM OF THE STUDY: To analyse retrospectively course of the disease in the patients with relapsing-remitting multiple sclerosis (R-R MS), treated with interferon beta (IFN-beta), to compare clinical data within the periods before, during and after IFN-beta treatment and to refer these parameters to clinical state of patients at the beginning of treatment. MATERIAL AND METHOD: The study comprised 40 patients (18 men, 22 women, aged 22-55 years) with R-R MS, treated with IFN-beta for at least 12 months, with documented follow-up before the treatment and for at least 12 months after it was discontinued. Annual exacerbation rate (AER) and annual rate of disability progression measured by means of expanded standard disability status scale (ap-EDSS) within the periods before, during and after the IFN-alpha treatment were compared for all the patients and referred to duration of the disease and EDSS score at the beginning of treatment. AER and ap-EDSS were also analyzed for subgroups of patients who were relapse-free or whose EDSS score improved during the treatment. RESULTS: Mean values of AER and ap-EDSS were significantly lower during the IFN-beta treatment than before and after the treatment. AER during and after the treatment correlated positively with EDSS score at the beginning of the treatment. ap-EDSS during the treatment was significantly lower for the patients with EDSS <3 at the beginning of the treatment than for those with EDSS > or = 3. The patients who were relapse--free during the treatment had significantly lower EDSS score at the beginning of treatment and lower AER after the treatment in comparison with those who had relapses. The patients whose EDSS score improved during the treatment had significantly lower EDSS score at the beginning of treatment and lower AER after the treatment in comparison with those whose EDSS score worsened or remained unchanged. AER and ap-EDSS did not depend upon duration of IFN-beta treatment. CONCLUSIONS: In patients with R-R MS IFN-beta has significant influence upon course of the disease: it causes decrease in exacerbation rate and slower progression of disability. However, improvement of these parameters persists only during the treatment. Clinical effect of treatment depends on initial stage of disability but does not depend on dynamics of the disease before the treatment. For optimal results of IFN-beta treatment, it should be introduced possibly early in the course of MS.