The social and occupational consequences of the COVID-19 pandemic among patients with multiple sclerosis in three distinct populations: A web-based cross-sectional survey.

Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the disease COVID-19, has caused a pandemic that has rapidly affected the whole world and caused a significant threat to public health. The aim of this study was to investigate and analyze the social and occupational effects of the COVID-19 pandemic on patients with multiple sclerosis (MS) in three different countries: China, Spain, and Cuba. Methods: A cross-sectional survey was designed to assess the social and occupational effects of the COVID-19 pandemic in MS patients in these three countries, using a 25-item anonymous online questionnaire, structured into three sections. Quantitative data are expressed as mean (standard deviation), and quantitative data as absolute frequency and percentage. Results: A total of 361 participants responded to the questionnaire: 194 from China, 104 from Spain, and 63 from Cuba. We found no cases of COVID-19 among Chinese patients with MS, and few cases in Spain and Cuba. Respondents reported different levels of impact on relationships with friends, family, and colleagues, and patients in all three countries described increased use of digital or social media platforms. Spanish patients reported a significantly less negative impact than those in Cuba and China. Mental and cognitive effects were similar in all three countries, although China seemed to have a better situation. We also found that the time spent exercising decreased at specific points during the pandemic, but with few changes in dietary habits. Patients reported little or no change in their means of transport in all three countries. Most patients in all three countries reported little or no physical deterioration, especially in Chinese patients (82.47%), compared to the Spanish (70.20%) and Cuban respondents (73.02%). In general, patients from all three countries demonstrated confidence in overcoming the COVID-19 pandemic, although to a lesser extent among Spanish respondents. Conclusions: During the pandemic, family support was more effective in China than in Cuba and Spain. Neither COVID-19 infections nor the number of MS relapses increased significantly during lockdown in any of the three countries. Regarding their economic situation, Spanish MS patients reported a significantly less severe negative impact than those in Cuba and China. Patients from all three countries used digital or social media platforms more frequently, probably to maintain personal relationships. Chinese and Cuban respondents were more confident of the control of the pandemic than the Spanish, who were more pessimistic.

Introducción: El nuevo coronavirus de tipo 2, causante del síndrome respiratorio agudo severo o COVID-19, se ha expandido rápidamente a nivel mundial, convirtiéndose en una grave amenaza para la salud pública en forma de pandemia. El objetivo de este estudio es analizar los efectos sociolaborales de la pandemia de COVID-19 en pacientes con esclerosis múltiple (EM) en 3 países diferentes (China, España y Cuba). Métodos: Diseñamos un estudio transversal para valorar los efectos sociolaborales de la pandemia de COVID-19 en pacientes con EM procedentes de China, España y Cuba mediante un cuestionario digital de 25 preguntas divididas en 3 apartados. Los datos cuantitativos se expresan como medias y desviaciones estándar, mientras que los datos cualitativos se expresan mediante valores y porcentajes. Resultados: Un total de 361 pacientes respondieron al cuestionario (194 de China, 104 de España y 63 de Cuba). No encontramos ningún paciente chino con EM que hubiera padecido COVID-19, y los casos diagnosticados en España y Cuba fueron muy infrecuentes. A raíz de la pandemia, se observaron cambios en las relaciones con amigos, familiares y compañeros; además, los pacientes con EM usaron plataformas digitales y redes sociales con más frecuencia en los 3 países. El impacto negativo fue significativamente menor en España que en Cuba o China. Los efectos mentales y cognitivos de la pandemia fueron similares en los 3 países, aunque parece que la situación previa era mejor en China. Igualmente, observamos que el tiempo dedicado al ejercicio se redujo en momentos específicos durante la pandemia. Por el contrario, no se detectaron grandes cambios en los hábitos alimentarios. Los pacientes de los 3 países consideraron que no se produjeron cambios en su medio de transporte, o que estos fueron escasos. La mayoría de los pacientes ha experimentado poco o ningún deterioro físico, particularmente los pacientes chinos (82,47%) en comparación con los españoles (70,20%) y cubanos (73,02%). En líneas generales, todos los pacientes se mostraron esperanzados en superar la pandemia, aunque los pacientes españoles en menor grado. Conclusiones: Durante la pandemia, el apoyo familiar fue más importante en China que en Cuba o España. En ninguno de los 3 países se observó un aumento significativo en el número de casos de COVID-19 ni de brotes o recaídas durante el periodo de confinamiento. En términos económicos, los pacientes con EM españoles sufrieron un impacto negativo significativamente menor que los cubanos y chinos. Todos los pacientes usaron plataformas digitales o redes sociales con más frecuencia, probablemente con el fin de mantener relaciones personales. Los pacientes chinos y cubanos mostraron mayor confianza en el control de la pandemia que los españoles, que resultaron ser más pesimistas.

Sleep disorders in patients with multiple sclerosis in Spain.

OBJECTIVE: This study assesses the presence of sleep disturbances and their relationship with clinical and demographic variables in patients with MS, with a view to establishing correlations between the different variables and the frequency of sleep disturbances. METHODS: The Pittsburgh Sleep Quality Index (PSQI) was used to detect sleep disorders. We contacted patients treated at the MS unit and distributed a questionnaire (PSQI) to 221 patients, receiving 142 usable questionnaires between 8 and 30 September 2019. RESULTS: The prevalence of patients with sleep disturbances in our study was 74.7% (73.7% in women and 76.8% in men). Therefore, sleep disorders are pervasive in patients with MS, with 3 out of 4 patients experiencing them, a higher rate than that observed in the population without the disease. The frequency of sleep disorders gradually increased in line with age. In the 2 age groups analyzed, 44-54 years and 55-68 years, the proportion of moderate and severe sleep disorders was 42.8% and 53.9%, respectively. Moderate and severe sleep disturbances were observed in 27.5%, 44.7%, and 58.3% of patients with Expanded Disability Status Scale scores of 0-3, 3-6, and >6, respectively. CONCLUSION: Our results indicate that sleep disorders are more common in patients with MS than in other populations. Patients with secondary progressive forms of MS more frequently present sleep disturbances, while patients with primary progressive forms report them less frequently. Age and degree of disability were positively correlated with the prevalence and severity of sleep disorders in MS patients.

Consecuencias sociolaborales del confinamiento por la COVID-19 en pacientes con esclerosis múltiple en dos poblaciones muy diferentes / Socio-labor consequences of confinement by COVID-19 in patients with multiple sclerosis in two very different populations

El confinamiento debido a la pandemia de la COVID-19, realizado a nivel mundial, ha tenido consecuencias casi siempre negativas en los pacientes con esclerosis múltiple (EM). OBJETIVO: Hemos comparado el efecto sociolaboral que el confinamiento ha podido tener en pacientes con EM de dos poblaciones tan diferentes como son España y China. MÉTODO: Se elaboraron unos cuestionarios a lo que respondieron un grupo de pacientes de EM que son revisados en la unidad de EM del hospital Vithas (Fundación DINAC) en Sevilla, y pacientes con EM atendidos en varias provincias de China durante el mes de abril de 2020, con el objetivo de analizar las diferencias y similitudes del efecto sociolaboral entre ambas poblaciones. Para llevar a cabo este análisis se creó una base de datos que se analizó posteriormente. RESULTADOS: La población china tiene una mayor proporción de pacientes más jóvenes y no hay diferencia respecto al género. La mayoría de las variables estudiadas se comportaron de igual forma en los pacientes con EM tanto españoles como chinos. Los pacientes españoles presentaron menos impacto (30,7%) en su situación socioeconómica que los chinos (44%), p < 0,05. No hubo diferencias importantes en el resto de las variables entre las dos poblaciones. Las redes sociales fueron muy utilizadas en la mayoría de los enfermos de ambas poblaciones. CONCLUSIONES: Los pacientes con EM padecen de forma muy similar las consecuencias de la pandemia en su situación sociolaboral y utilizan de forma parecida las redes sociales y el apoyo de la familia. Los pacientes españoles disfrutan de más estabilidad económica, probablemente gracias al apoyo social que reciben

The confinement due to the global COVID-19 pandemic has almost had negative consequences in patients with multiple sclerosis (MS). OBJECTIVE: We wanted to compare the socio-labor effect of confinement in two populations as different as Spain and China, in patients with MS. METHOD: Questionnaires were applied to a group of MS patients who have been reviewed in the MS unit of the Vithas hospital (DINAC Foundation) in Seville, and MS patients attended in various provinces of China during the month of April 2020, with the aim of analyzing the differences and similarities of the socio-labor effect between both populations. To carry out this analysis, a database was created and subsequently analyzed. RESULTS: The Chinese population has a higher proportion of younger patients and there is no difference regarding gender. Most of the variables studied behaved the same way in both Spanish and Chinese MS patients. Spanish patients had less impact (30.7%) on their socio-economic situation than Chinese (44%), P < .05. There were no important differences in the rest of the variables between the two populations. Social networks were widely used in the majority of patients in both populations. CONCLUSIONS: MS patients suffer in a very similar way from the consequences of the pandemic on their socio-labor situation and similarly use social networks and family support. Spanish patients seem to have more economic stability, which may be due to social economic support

Associations of OSAHS complicated by cerebral infarction with intestinal flora, inflammatory factors, homocysteine and adiponectin expression.

OBJECTIVE: The aim of this study was to investigate the associations between obstructive sleep apnea hypopnea syndrome (OSAHS) complicated by cerebral infarction and intestinal flora, inflammatory factors, homocysteine, and adiponectin expression. PATIENTS AND METHODS: A total of 30 healthy volunteers (control group), 28 patients with simple cerebral infarction (cerebral infarction group) and 28 patients with OSAHS complicated by cerebral infarction (OSAHS + cerebral infarction group) were enrolled as research objects. The fecal bacterial DNA of research objects was extracted and subject to 16S ribosomal ribonucleic acid sequencing. Furthermore, the levels of inflammatory factors, homocysteine and adiponectin in the peripheral blood were detected. RESULTS: Compared with control group, cerebral infarction group exhibited significantly higher levels of interleukin-4 (IL-4), tumor necrosis factor-beta (TNF-ß), IL-1ß and C-reactive protein (CRP) (p<0.05). However, the levels of TNF-ß, IL-1ß and CRP in OSAHS + cerebral infarction group were notably higher than those in cerebral infarction group (p<0.05). The levels of myeloperoxidase (MPO) and malondialdehyde (MDA) were remarkably higher in cerebral infarction group than those in the control group (p<0.05). However, they were significantly higher in OSAHS + cerebral infarction group than cerebral infarction group (p<0.05). Compared with control group, cerebral infarction group exerted a noticeably higher level of homocysteine (p<0.05). However, homocysteine level was markedly higher in OSAHS + cerebral infarction group than that in cerebral infarction group (p<0.05). Adiponectin level was significantly lower in cerebral infarction group than that in the control group (p<0.05). Meanwhile, it was evidently lower in OSAHS + cerebral infarction group than that in the cerebral infarction group (p<0.05). Control group had the highest abundance of Actinobacteria, and cerebral infarction group exhibited the highest abundance of Coriobacteriales, Vagococcus, Sphingobacteriales and Adlercreutzia. However, OSAHS + cerebral infarction group exhibited the highest abundance of Bifidobacterium, Parascardovia, Metascardovia and Anaerostipes caccae. There was a strong positive correlation between Proteobacterium and Ruminococcus (r=0.9, p=0.000) and between Firmicutes and Bacteroidetes (r=0.72, p=0.004). However, there was a significant negative correlation between Firmicutes and Enterobacteriales (r=-0.45, p=0.009). CONCLUSIONS: OSAHS complicated by cerebral infarction is significantly associated with intestinal flora, inflammatory factors, homocysteine and adiponectin expression.

Associations of four common VDR polymorphisms with rheumatoid arthritis and systemic lupus erythematosus: evidence from a meta-analysis.

Associations of polymorphisms in vitamin D receptor (VDR) with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have already been explored by many studies. The aim of this meta-analysis was to better clarify associations between polymorphisms in VDR and RA/SLE by combing the results of all relevant studies. Eligible studies were searched from Pubmed, Embase, WOS and CNKI. We used Review Manager to combine the results of eligible studies. Thirty-seven studies were included in this meta-analysis. VDR rs1544410 (recessive comparison: odds ratio (OR) = 1.36, 95% confidence interval (CI) 1.06-1.76; over-dominant comparison: OR = 0.81, 95% CI 0.71-0.93) and rs731236 (over-dominant comparison: OR = 0.77, 95% CI 0.63-0.94) polymorphisms were found to be significantly associated with RA in overall combined analyses. Besides, VDR rs1544410 (dominant comparison: OR = 0.61, 95% CI 0.46-0.82; over-dominant comparison: OR = 1.45, 95% CI 1.16-1.81; allele comparison: OR = 0.75, 95% CI 0.62-0.92), rs2228570 (dominant comparison: OR = 0.58, 95% CI 0.50-0.67; recessive comparison: OR = 1.57, 95% CI 1.21-2.03; allele comparison: OR = 0.69, 95% CI 0.60-0.80) and rs731236 (dominant comparison: OR = 0.69, 95% CI 0.50-0.96; allele comparison: OR = 0.80, 95% CI 0.70-0.90) polymorphisms were also found to be significantly associated with SLE in overall combined analyses. Subgroup analyses revealed that significant associations for VDR polymorphisms and RA/SLE were mainly driven by Asians. Collectively, this meta-analysis proved that VDR rs7975232, rs1544410, rs2228570 and rs731236 polymorphisms may confer susceptibility to RA and SLE, especially for Asians.

Clinicopathological and prognostic significance of miR-4317 expression in gastric cancer patients.

OBJECTIVE: Previous studies have revealed that miR-4317 was abnormally expressed and functioned as a tumor suppressor in several tumors, including gastric cancer (GC). However, the clinical significance of miR-4317 in GC remains largely unclear. Our present study aimed at investigating the possibility of miR-4317 as a novel prognostic biomarker for GC patients. PATIENTS AND METHODS: RT-PCR was performed to determine the levels of miR-4317 in GC tissues and matched normal gastric tissues. Association between miR-4317 levels and clinicopathological factors was also analyzed using Chi-square test. Kaplan-Meier survival analysis and univariate and multivariate assays were further conducted to investigate the correlation between miR-4317 expression and GC patients prognosis. RESULTS: We showed that miR-4317 expression levels were significantly lower in GC cell lines compared to matched normal tissues (p< 0.01). Down-regulation of miR-4317 was observed to be associated with lymph node metastasis (p = 0.019), distant metastasis (p = 0.011) and TNM stage (p = 0.007). In addition, Kaplan-Meier analysis showed that patients with low miR-4317 expression had a shorter overall survival compared with the high miR-4317 expression group (p = 0.0009). Furthermore, multivariate analysis revealed that miR-4317 expression was an independent prognostic marker of overall survival of GC patients. CONCLUSIONS: miR-4317 expression may be a novel and valuable prognostic factor in GC.

Expression of Notch-signaling pathway in familial adenomatous polyposis and its clinical significance.

OBJECTIVE: To investigate the relationship between Notch-signaling pathway and familial adenomatous polyposis (FAP) through the expressions of Notch-1, DLL-1, and p-mTOR, and to explore its correlation with tumorigenesis. MATERIALS AND METHODS: The expressions of Notch1, DLL-1, and p-mTOR were detected in 21 cases of FAP polyps, 20 cases of colorectal inflammatory polyp, and 20 cases of poorly differentiated colorectal cancer by Western blotting and reverse transcription polymerase chain reaction (RT-PCR). The protein and mRNA expressions of these genes were then compared among the FAP group, colorectal adenoma group, and colorectal cancer group. RESULTS: The protein and mRNA expressions of Notch-1, DLL-1, and p-mTOR in the FAP group were significantly higher than those in colorectal adenoma group; furthermore, they were significantly higher in the colorectal cancer group (all p < 0.05). CONCLUSIONS: Notch signaling is activated in FAP. The activated Notch-signaling pathway may play an important role in the malignant transformation and tumorigenesis.

Involvement of ligninolytic enzymes in degradation of wheat straw by Trametes trogii.

AIMS: Wheat straw is generated in billions of tons around the world every year and has not been fully used. This study sought to evaluate the delignification capacity and enzyme production of Trametes trogii MT strain and to clarify the changes of structure and chemical composition of wheat straw during the decay process. METHODS AND RESULTS: The results obtained revealed that the T. trogii MT strain has the ability to degrade lignin, cellulose as well as hemicellulose of wheat straw simultaneously. The strain can produce high activities of laccase, manganese peroxidase, xylanase, carboxymethylcellulase and feruloyl esterase but no lignin peroxidases during the decay process of a 60-day incubation period on wheat straw. Scanning electron microscopy observation and infrared spectroscopy analysis showed the lignin and carbohydrate of wheat straw were degraded with no obvious different levels. The low molecular mass fractions collected from the culture of the MT strains grown in wheat straw powder liquid medium showed high Fe(3+) chelating, reducing capacity and hydroxyl radical and hydrogen peroxide generation. CONCLUSIONS: Trametes trogii MT has a complex mechanism to degrade lignocellulose, in addition to the extracellular enzymatic systems, and has great potential as an attractive micro-organism used for the biological degradation of waste straws. SIGNIFICANCE AND IMPACT OF THE STUDY: This study revealed the dynamic changes of the ligninolytic enzymes of T. trogii MT during the degradation of wheat straw, and suggested that the decay patterns of wheat straw by T. trogii MT had some simultaneous type characteristics.