Mobile apps for multiple sclerosis: a focus on self-management (Preprint)

BACKGROUND The explosion of mobile phone users along with the importance of user’s role in managing their health provides a unique opportunity for mHealth applications in the management of chronic illnesses such as multiple sclerosis. OBJECTIVE To identify available MS applications and to characterize the content of MS self-management apps. METHODS Two popular online application stores (iTunes, Google play) were searched for multiple sclerosis-related apps using the following keywords: multiple sclerosis, disseminated multiple sclerosis, disseminated sclerosis, and MS. Apps were considered eligible if they had been customized only on multiple sclerosis. First, data were extracted from the description page for any eligible app. To achieve the study goal, the secondary analysis was performed only for self-management apps. RESULTS The search of two popular markets was identified 1042 applications (747 apps from google play, 295 apps from iTunes). Of these, 104 unique apps met the inclusion criteria. Almost a quarter of eligible applications (26%) had been designed for multiple sclerosis self-management. Other purposes of the identified apps were diagnosis & treatments (7.7%), doing tests (7.7%), connecting & communication for MS patients (4.8%), raise awareness of multiple sclerosis (15.4%), access to journals & news (6.7%), conferences & meetings (17.3%), supporting & donating to MS community (14. 4%). CONCLUSIONS It appears the mobile apps provide a multidimensional tool for the patient with Multiple Sclerosis to improve self-management. These apps can contribute to the empowerment of the patients, and help their adherence to the therapeutic and management regimen of their conditions. Moreover, they can facilitate information gathering of the MS progress pattern on a personal level for each individual patient. This information may provide health care professionals with evidence for helping their patients to enhance self-management of their disease.

Efectos del estado nutricional en la enfermedad de la esclerosis múltiple: revisión sistemática

Objetivo: Revisar la literatura científica existente sobre los efectos del estado nutricional en la esclerosis múltiple.Método: Revisión sistemática de la literatura científica recogida en las bases de datos MEDLINE (PubMed), Scopus, Cochrane Library y Web of Science, hasta noviembre de 2016. Ecuación de búsqueda: (“Multiple Sclerosis”[Mesh] OR “Multiple Sclerosis”[Title/Abstract] OR “Disseminated Sclerosis”[Title/Abstract] OR “Multiple Sclerosis Acute Fulminating”[Title/Abstract]) AND (“Nutritional Status”[Mesh] OR “Nutritional Status”[Title/Abstract] OR “Nutrition Status”[Title/Abstract]. La calidad de los artículos se evaluó mediante el cuestionario STROBE. Se completó la búsqueda con la consulta a expertos y la revisión de la bibliografía de los artículos seleccionados.Resultado: De las 160 referencias recuperadas, tras aplicar los criterios de inclusión y exclusión, se seleccionaron para la revisión 29 artículos. La gran mayoría de los estudios determinaron los niveles de vitamina D. Otros centraron su búsqueda en averiguar qué déficits de nutrientes podrían estar relacionados con el desarrollo de la Esclerosis Múltiple.Conclusiones: La vitamina D puede influir en la mejora de la Esclerosis Múltiple. La luz solar y la actividad física serían factores importantes, junto al estado nutricional, en el curso de dicha enfermedad. Sería necesaria la generación de nuevos trabajos específicos que profundizaran en el tema para averiguar más acerca de la relación existente entre el estado nutricional y la Esclerosis Múltiple.

Wavelet-analysis of central hemodynamics rhythms inpatients with disseminated sclerosis and disturbed cognitive status

The wavelet analysis of rhythm parameters of central hemodynamics in patients with multiple sclerosis (MS) and compromised cognitive status is of great interest for better understanding formation of neurogenic disorders of regulation of blood pressure (BP) associated with organic lesions of brain and higher nervous system at large. Aim. To study circadian hemodynamic parameters in patients with MS depending on cognitive status. Materials and methods. 55 patients with verified diagnosis of disseminated sclerosis (DS) underwent standard neurological examination. A BPLab portable system (Russia) was employed during 24 hours for analysis of diurnal hemodynamic parameters using the BPLab v.2.1 software in combination with the original wavelet analysis for determining the rhythmic structure of individual characteristics and evaluating synchronization and coherence of the described parameters. Results. The observed disturbances of temporal organization of the rhythms of central hemodynamic parameters due to climatic and geographical features of the Northern region in patients with DS manifested themselves as ultradian desynchronosis. In the group of DS patients with cognitive impairment, disintegration of the time structure was characterized by bursts of rhythmic activity in the form of intercalated rhythms with periods of 12, 8 and 6 hours and non-uniform distribution during the diurnal cycle. No increase of the average BP values in the presence of a large number of risk factors for the development of hypertension in the form of non-modifiable and modifiable complications of pathogenetic therapy was documented. Conclusion. The established rigidity of the mechanisms regulating BP in patients with DS may be due to an organic lesion of the autonomic nervous system at the cerebral, spinal or peripheral levels, and even more so to the disturbed higher nervous activity concomitant with impaired cognitive functions. This clinical study may suggest the inverse model of comorbidity (dystrophy) with the abnormal relationship between pressor and depressor mechanisms of BP regulation and leveling the influence of risk factors on the development of arterial hypertension.