Prevalence of isolated RBD in the city of Catania, Italy: a population-based study.

STUDY OBJECTIVES: Few studies have analyzed the prevalence of isolated rapid eye movement sleep behavior disorder (RBD) giving different estimates. Aim of the study was to estimate the prevalence of isolated RBD in the city of Catania. METHODS: A 3-stage design was adopted. Participants attending the offices of general practitioners in the city of Catania were screened with the RBD Single Question Screen questionnaire (Stage I). Positive participants were interviewed by phone and, if suspected of RBD, were invited for clinical examination by a movement disorders specialist and a sleep specialist (Stage II). After the clinical examination, patients diagnosed as probable isolated RBD (pRBD) were invited to undergo a video polysomnography (Stage III) to confirm the diagnosis of definite RBD. RESULTS: A total of 1,524 participants were screened. Of these, 220 (14.4%) screened positive. One hundred forty-three of them were further screened by phone, of whom 75 were suspected RBD. Thirty-six patients were diagnosed as pRBD, giving a prevalence of 2.36% (95% confidence interval, 1.71-3.25). Twelve pRBD agreed to a video polysomnography and, of these, 4 were diagnosed as definite RBD, giving a prevalence of 0.26% (95% confidence interval, 0.07-0.67). Prevalence adjusted by nonparticipants was 3.48% (95% confidence interval, 2.67-4.52) and 1.18% (95% confidence interval, 0.45-1.37) for pRBD and definite RBD, respectively. CONCLUSIONS: Prevalence of both pRBD and definite RBD in Italy is comparable to the estimates reported in literature, confirming that isolated RBD has a low prevalence in the general population. CITATION: Cicero CE, Giuliano L, Sgroi R, et al. Prevalence of isolated RBD in the city of Catania, Italy: a population-based study. J Clin Sleep Med. 2021;17(11):2241-2248.

Toxoplasma gondii and multiple sclerosis: a population-based case-control study.

According to the hygiene hypothesis, parasites could have a protective role in the development of Multiple Sclerosis (MS). Our aim was to assess the association between presence of anti-Toxoplasma gondii antibodies and MS. MS patients were randomly selected from a population-based incident cohort of MS patients in the city of Catania. Age and sex-matched controls were randomly selected from the general population. Clinical and sociodemographic variables were recorded with a structured questionnaire and a blood sample was taken for serological analysis. Specific T. gondii IgG have been detected with a commercial kit. Adjusted Odds Ratios (ORs) were estimated using unconditional logistic regression. 129 MS subjects (66.7% women with a mean age 44.7 ± 11.0 years) and 287 controls (67.3% women with a mean age 48.1 ± 15.6 years) have been enrolled in the study. Anti-T. gondii antibodies were found in 38 cases (29.5%) and 130 controls (45.4%) giving an adjusted OR of 0.56 (95%CI 0.34-0.93). History of mononucleosis and high educational level were significantly associated with MS (adjOR 2.22 and 1.70 respectively) while an inverse association was found between high educational level and T. gondii seropositivity (adjOR 0.42). Our results further support the protective role of parasitic infections in MS.

Seroprevalence of Toxocara Canis in the city of Catania, Italy.

Toxocariasis is one of the most common helminthiases worldwide. However, there is a lack of data regarding Southern Italy. We have evaluated the seroprevalence and associated environmental factors of toxocariasis in a sample of adults living in the city of Catania. Presence of anti-Toxocara canis IgG antibodies was searched using an ELISA test using excretory/secretory antigens. Environmental risk factors have been evaluated with a face-to-face questionnaire. Two hundred eighty-seven subjects (193 [67.3%] women, mean age 48.1±15.6 years) were enrolled, and presence of anti T. canis antibodies was found in 23 participants, of whom 18 (78.3%) were women with a mean age of 51.1±14.0 years, giving a seroprevalence of 8.0% (95%CI 5.4-11.7). At multivariate analysis, a positive association for subjects with more than three siblings (adjOR 3.17; 95%CI 1.09-9.25) was recorded. Our study confirms that exposition to T. canis is frequent also in urban areas of western countries.

Risk factors in multiple sclerosis: a population-based case-control study in Sicily. Background and methods.

Incidence of multiple sclerosis (MS) has steeply increased over time during the last 30 years in the city of Catania. We carried out a population-based case-control study to evaluate the possible role of both environmental and genetic factors. From 1975 to 2004 in Catania, 367 MS patients diagnosed according to the Poser's criteria had the onset of disease. A sample of MS patients was randomly selected from this incident cohort. Three controls matched by age and sex were randomly selected from the rosters of 14 GPs. Controls were proportionally selected according to the distribution by municipality of the target population using a multistage sampling methods. All cases and controls underwent a face-to-face interview to record information concerning environmental factors and a blood sample was taken for serological and genetic analysis. 164 MS patients (64 % women; mean age of 46.4 ± 10.7) and 481 controls (69 % women; mean age of 47.7 ± 14.8) were enrolled in the study. The distribution of the whole population and the selected controls by municipalities was similar. A blood sample was taken from 150 MS cases and from 337 controls. At the end of the enrolment, we obtained a representative sample of the MS cases and population controls avoiding possible selection bias. Participation rate was very high also concerning the collection of biological specimens.

Multiple sclerosis and CCSVI: a population-based case control study.

BACKGROUND: Chronic cerebrospinal venous insufficiency (CCSVI) has been associated to multiple sclerosis (MS). OBJECTIVE: To evaluate the possible association between CCSVI and MS, using a population-based control design. METHODS: A random cohort of 148 incident MS patients were enrolled in the study. We have also studied 20 patients with clinically isolated syndrome (CIS), 40 patients with other neurological diseases (OND), and 172 healthy controls. Transcranial (TCC) and Echo Color Doppler (ECD) were carried out in 380 subjects. A subject was considered CCSVI positive if ≥2 venous hemodynamic criteria were fulfilled. RESULTS: CCSVI was present in 28 (18.9%) of the MS patients, in 2 (10%) of CIS patients, in 11 (6.4%) of the controls, and in 2 (5%) of the OND patients. A significant association between MS and CCSVI was found with an odds ratio of 3.41 (95% confidence interval 1.63-7.13; p = 0.001). CCSVI was significantly more frequent among MS subjects with a disease duration longer than 144 months (26.1% versus 12.6% of patients with duration shorter than 144 months; p = 0.03) and among patients with secondary progressive (SP) and primary progressive (PP) forms (30.2% and 29.4, respectively) than in patients with relapsing remitting (RR) MS (14.3%). A stronger association was found considering SP and PP forms (age adjusted OR = 4.7; 95% CI 1.83-12.0, p = 0.001); the association was weaker with the RR patients (age adjusted OR = 2.58; 95%CI 1.12-5.92; p = 0.02) or not significant in CIS group (age adjusted OR = 2.04; 95%CI 0.40-10.3; p = 0.4). CONCLUSIONS: A higher frequency of CCSVI has been found in MS patients; it was more evident in patients with advanced MS, suggesting that CCSVI could be related to MS disability.