Synthetic clinical texts can improve transparency and reduce bias and costs when training and evaluating specialized language models in the medical domain. Synthetic texts are freely shareable, as they contain no real patient information, and can be customized for a specific task. The objective of this study is to develop a methodology for generating, validating, and correcting synthetic discharge summaries using LLMs without requiring any real patient data. The proposed approach uses an LLM to generate synthetic discharge summaries for specific diseases and standard medical references from Merck Manuals to ground the generation in internationally accepted medical practices. We validate the generated summaries using LLMs as well as by human expert validation. In addition, we propose a method for automatic correction of the generated discharge summaries using Knowledge Graphs to ensure medical factual correctness. The conducted human expert evaluation shows that the generated synthetic discharge summaries are credible and factually accurate when provided with the medical reference context. The generated summaries achieve a System Usability Score of 94.35% based on a comprehensive rubric evaluated by medical professionals and a score of 93.65% on the Faithfulness metric evaluated by an LLM. The proposed methodology can be utilized to generate high-quality synthetic discharge summaries for various diseases. The generated synthetic corpus consists of 900 discharge summaries in English representing nine socially significant diseases and is publicly available under an open license. The community can take advantage of the corpus and proposed methodology to train complex machine learning models, helping medical professionals in their daily work without using real patient data.

Background: Sleep disturbances in the multiple sclerosis (MS) population are increasingly recognized, but the factors driving this association remain understudied. This study aimed to determine the prevalence and associations of poor sleep quality in the relapsing–remitting MS (RRMS) population receiving disease-modifying therapy (DMT). Methods: We conducted a cross-sectional study that enrolled 399 individuals diagnosed with RRMS on DMT. Data on patient demographics, clinical presentation, and treatment were systematically evaluated. Sleep-related outcomes were assessed using validated questionnaires—the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), STOP-Bang questionnaire, and Hamilton Anxiety Rating Scale (HAM-A). Independent associations of poor sleep were examined using log-binomial regression to estimate risk ratios (RR). Results: Poor sleep was reported in 42% of the participants in our cohort. In multivariable analysis, only insomnia severity (RR = 1.07; 95% CI 1.05–1.09, p < 0.001) and anxiety (RR = 1.02; 95% CI 1.01–1.04, p = 0.001) remained independently associated with poor sleep. Conclusions: Sleep disturbances are common among patients with RRMS. Insomnia severity and anxiety, rather than demographic or disease-related characteristics, showed independent associations with impaired sleep. Routine screening and targeted interventions addressing insomnia and anxiety may improve sleep quality and, consequently, overall quality of life in this population.

Миастения гравис (МГ) е автоимунно заболяване, което се дължи на наличието на антитела срещу ацетилхолиновите рецептори (AChR), мускулно-специфичната тирозин киназа (MuSK) и други свързани протеини в постсинаптичната мембрана. Основни изяви на заболяването са патологичната мускулна уморяемост на напречно-набраздената мускулатура и мускулната слабост поради нарушено предаване на нервния импулс. Много от пациентите с МГ страдат от различни нарушения на съня. При невромускулните заболявания, включително и МГ, най-често срещани са дихателните нарушения като сънна апнея, безсънието и двигателните нарушения по време на сън. Те могат да утежнят основното заболяване и да влошат количеството и качеството на съня, което ги прави и социално значими. Важно е те да бъдат навременно диагностицирани и лекувани.

Синдромът на неспокойните крака е сензомоторно неврологично заболяване, което се характеризира с неприятни усещания и непреодолимо желание за движения на крайниците, с поява основно в покой и вечер и с подобрение при движение. Разпространението на заболяването е между 7 и 10% в европейската популация. В патогенезата на заболяването са включени няколко механизма като дефицит на желязо в мозъка, допаминергична дисфункция, участието на глутамат и на аденозин. Лечението на болестта бива нефармакологично и фармакологично. След първоначалната оценка на железния статус и правилното коригиране на дефицита на желязо е възможно приложението на допаминови агонисти и α2δ лигандите – двата основни класа медикаменти, които се използват за лечение на синдрома. Рискът от развитие на феномен на засилване на симптомите и нарушения, свързани с контрола на импулсите налага индивидуален подход към всеки отделен пациент, страдащ от синдрома на неспокойните крака.

Background: Sleep disturbance is common in multiple sclerosis (MS), but its relationship with relapse status remains insufficiently defined. This study examined whether poorer subjective sleep quality was associated with relapse status in patients with relapsing-remitting multiple sclerosis. Methods: This propensity score–matched nested case–control analysis included 132 patients with relapsing-remitting MS selected from 473 consecutively evaluated patients at a tertiary multiple sclerosis centre. Patients in relapse were matched 1:1 to patients in remission by age, sex, disease duration, Expanded Disability Status Scale score, disease-modifying therapy duration and efficacy class, and relapse in the previous year. Sleep quality and related symptoms were assessed using validated questionnaires. Results: Patients in relapse were more frequently classified as poor sleepers than those in remission (59.1% vs. 36.4%; p = 0.009). In the double-adjusted logistic regression model, higher Pittsburgh Sleep Quality Index scores were independently associated with relapse status (OR = 1.16; 95% CI 1.02–1.32; p = 0.023), whereas the remaining variables were not independently associated with relapse status. Conclusions: Poorer subjective sleep quality was independently associated with relapse status in relapsing-remitting MS, supporting sleep disturbance as a relapse-associated clinical feature rather than a proven causal risk factor.