The sample of caregivers we studied was psychologically burdened to a significant degree, a fact that obviously deteriorates their QOL. Appropriate psychopharmacological interventions are warranted to reduce caregivers' burden.

Most cases of scapular winging (SW) are attributed to either long thoracic or spinal accessory nerve lesions. Dorsal scapular nerve lesions are quite rare and the literature contains very few case reports of SW secondary to rhomboid paralysis. We are reporting the unusual case of a young patient who developed right-side scapular winging due to dorsal scapular neuropathy and rhomboids palsy, and we highlight the role of conservative treatment and rehabilitation for cases of mild/medium injury to the dorsal scapular nerve or to the rhomboid muscles. For those cases, physiotherapy is recommended, and this is mainly aimed at strengthening the trapezius in order to compensate for rhomboids weakness.

The first objective of the current observational study was to assess the degree of religiosity in Greek Christian Orthodox primary caregivers of patients with multiple sclerosis (MS). The second objective was to evaluate the interrelations between religiosity and quality of life (QOL) and to identify the determinants of QOL, an endpoint of considerable importance in clinical research and practice. Twenty-two male and 13 female primary caregivers (mean age 47.3 ± 12.4 years) of an equal number of patients with MS, who consented to participate, completed the Systems of the Greek version of the Belief Inventory (SBI-15R) and the Greek validated version of EuroQOL (EQ-5D). The analysis revealed high scores on religiosity, especially among females. Caregivers scored in the religious beliefs and practices subscale of SBI-15R with a mean score of 22.8 ± 7.8 (range 0-30) and with 7.1 ± 4.8 (range 0-14) in the social support subscale. However, both of the SBI-15R domains were almost unrelated to the degree of overall QOL. There was only a reliable (but with little clinical value) association between the pain/discomfort domain of the EQ-5D with the SBI-15R beliefs and practices subscale (r = -0.38, p = 0.03). Although high levels of religiosity among Greek Christian Orthodox primary caregivers of MS patients were evident, this study did not demonstrate any beneficial effect of religious beliefs and practices on their QOL. Further prospective studies with a population with the same and/or diverse religious and cultural backgrounds are needed to better elucidate the complex association between religiosity and QOL in primary caregivers of MS patients.

We sought to identify significant ulnar nerve conduction abnormalities and also to detect ulnar F-wave variable changes in patients with secondary progressive multiple sclerosis (MS). Conventional conduction study was performed unilaterally to ulnar nerves of eight men and 12 women with secondary progressive MS (mean age, 47.5 +/- 6.6 years), having spastic hemiparesis and hand spasticity. A series of 40 electrical stimuli were also delivered to their ulnar nerves unilaterally so as to obtain F waves. The side of examination was ipsilateral to the side of spastic paresis. The following F-wave variables were estimated: F-wave persistence, latency, amplitude, duration, and F chronodispersion. Ten patients with remitting-relapsing MS without any evidence of hand spasticity and 20 age- and gender-matched healthy volunteers served as controls. Motor and sensory conduction study was normal in all participants. The F-wave persistence, latency, and duration parameters and also the F chronodispersion were comparable between groups. The mean and maximum F-wave amplitude values (P = 0.005) and the F mean/M (P = 0.001) and F maximal/M (P = 0.001) ratios were significantly higher than those of controls. Finally, the F-wave amplitude parameters in patients with secondary progressive MS significantly correlated with the degree of spasticity and the duration of disease. Significant amplitude F-wave abnormalities occurred in patients with secondary progressive MS and hand spasticity, emphasizing the contribution of upper motor neurons damage in the genesis of F waves.

A significant proportion of primary caregivers of MS patients experience poor sleep quality. The degree of their emotional distress appears to significantly influence their quality of sleep. Appropriate psychopharmacological interventions may be required for those individuals.