Publications (14)6.79 Total impact
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Article: An Investigation of the Neurological and Neuropsychiatric Disturbances in Adults with Undiagnosed and/or Untreated Phenylketonuria in Poland
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ABSTRACT: Background The aim of the study was to determine neurological and neuropsychiatric manifestations in a group of patients with previously undiagnosed or untreated phenylketonuria (PKU) in the south-eastern part of Poland.Methods The study was conducted among 400 adults with severe intellectual disability who were born prior to neonatal screening and who resided in Social Welfare Homes in south-eastern Poland. Participants were aged between 27 and 89 years (mean 51 years). The screening for PKU was performed by blood test using tandem mass spectrometry method (MS/MS) and analysis of organic acids in urine. Among all new identified untreated individuals, neurological symptoms were recorded and neuropsychiatric disturbances were assessed with The Neuropsychiatric Inventory-Nursing Home Version (NPI-NH).Results We found 10 previously undiagnosed and one previously diagnosed but untreated individuals with PKU (four women and seven men). The most commonly exhibited neurological manifestations included the following: profound speech disturbances, balance disturbances, muscular hypertonicity, muscular tremors and seizures. The most frequent behaviours included the following: aberrant/troublesome motor behaviour, agitation/aggression and euphoria/elation.Conclusion Data from the present study indicate that future treatment of these individuals should combine a dietary intervention with individual behavioural therapy and neurorehabilitation to improve general health and quality of life.Journal of Applied Research in Intellectual Disabilities 04/2011; 24(5):482 - 488. · 1.38 Impact Factor -
Article: Evaluation of somatic development in adult patients with previously undiagnosed and/or untreated phenylketonuria.
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ABSTRACT: To evaluate physical growth, development and nutritional status in adults with previously undiagnosed/ untreated phenylketonuria (PKU). Four hundred adults (201 females and 199 males) with severe intellectual disability who were born prior to compulsory neonatal screening (before 1976) and who resided in social welfare homes in southeastern Poland were screened for PKU. The screening was performed by blood test using a tandem mass spectrometry method (MS/MS) and was confirmed by analysis of organic acids in urine. Eleven were identified as previously undiagnosed and/or untreated PKU cases. They underwent an assessment of their somatic development/status. Among the 11 PKU patients (4 females and 7 males) the following characteristics were observed: poor physical growth after somatic development (n = 8, 2 females aged 23 and 56 years and 6 males aged 28-59 years); decreased head circumference - microcephaly (n = 5, 1 female aged 56 years and 4 males aged 28-59 years); poor body height (n = 2, 1 female aged 23 years and 1 male aged 59 years); poor thoracic circumference (n = 9, 3 females aged 23-56 years and 6 males aged 28-59 years). Overall, body weight imbalance was noted in 9 (81.8%) patients and irregularity of body proportions in 6 (54.5%) patients. Our data showedthe importance of nutritional surveillance and impact of metabolic imbalance on physical growth and body stature in untreated PKU patients. We therefore recommend an adequate and individually planned introduction of dietary intervention among that group of patients in order to ameliorate its nutritional status, general fitness and health.Medical Principles and Practice 01/2010; 19(1):46-50. · 0.89 Impact Factor -
Article: Measurement of functional independence level and falls-risk in individuals with undiagnosed phenylketonuria.
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ABSTRACT: The aim of the study was to determine the level of functional independence in adult patients with previously undiagnosed or untreated phenylketonuria (PKU). The study was conducted among 400 intellectually impaired adult residents of Social Welfare Homes in South-Eastern Poland born prior to the introduction of neonatal PKU screening programs. PKU was screened by filter paper test using tandem mass spectrometry methods, and confirmed by gas chromatography-mass spectrometric analysis of PKU organic acids in urine. Degree of functional independence included the assessment of activities of daily living (Barthel Index) and measures of balance and gait (Tinetti scale). Eleven individuals with previously untreated PKU were identified whereby eight presented with moderate disability and three with mild disability. Six had a high risk of falls and five had a moderate risk of falls. This study indicates that there is considerable number of undiagnosed PKU patients within the Polish population who require assessment and management in order to reduce the impact of the neurological and neuropsychiatric problems associated with the condition. Appropriate therapy for those with undiagnosed PKU should, in particular, address the risk of falls.Acta biochimica Polonica 12/2009; 56(4):613-8. · 1.49 Impact Factor -
Article: The butterfies' vertebra-diagnostic difficulties - case report.
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ABSTRACT: The hemivertebras constitute about 33% of all congenital defects of spine and can be detected accidentally during diagnostics of pain syndrome of spine or other neurological disturbances. In the paper is introduced the case of patient with pain syndrome of spine (man, physical worker, 47years old), who was directed to the rehabilitation ward with recognition of pathologic fracture of vertebra Th10. In consideration on lack of correlation between radiological pictures and patient's neurological state the diagnostics was extended for 3D CT. CT revealed the presence of development defect of spine. Conducted diagnostics and rehabilitation permitted for improvement of patient's state as well as settlement of principles for further procedures. The necessary verification of diagnosis and diagnostics of patients during inpatient and ambulatory rehabilitation shouldn't be sensation but should constitute standard in contracts with National Health Fund.Ortopedia, traumatologia, rehabilitacja 01/2007; 8(6):704-7. -
Article: [Stroke in young woman in the first day after delivery].
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ABSTRACT: Strokes among young people are not only the most threatening complications of the cerebrovascular diseases, but they also lead to considerable disability and society' dependency. Among patients under 40 years old heart diseases constitute about 18% causes of ischaemic strokes. Other causes of strokes are: artery wall dissection, blood clotting disturbances, birth control pills, stimulants (alcohol abuse, cigarettes, narcotics), vascular immunological diseases. Among these causes there are modifiable factors, which can be eliminated through patients' education, change of the lifestyle and proper treatment of diseases. In paper there is presented the case of 22-year-old woman, who had in the first hours after delivery the paresis of left limbs with paresis of left facial nerve, proceded by loss of consciousness and convulsions. In computer tomography (CT) and magnetic resonance imaging (MRI) there was extensive angiogenic lesion in the area of right internal cervical artery revealed in duplex ultrasonography. In transesophageal echocardiography (TEE) there was revealed haemodynamically significant patent foramen ovale (PFO). In the patient in ten months after stroke there was performed diagnostic cathetarization and then transvascular occlusion of PFO using Starflex 28 mm implant. The patient was rehabilitated from the early time after stroke. Based on carried out examination results that the most likely hypothesis seems to be embolic-thrombotic stroke in the course of hemodynamically significant heart defect (paradoxical embolism in patent foramen ovale) revealed in drastic way during delivery. The earlier lasted process of dissection of cervical internal right artery cannot be also excluded as a cause of stroke.Wiadomości lekarskie (Warsaw, Poland: 1960) 02/2006; 59(3-4):280-4. -
Article: [Rehabilitation of patients with Parkinson disease].
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ABSTRACT: The treatment of patients with Parkinson disease should consist of early, complex and continuous rehabilitation connected with reasonable drug therapy. Rehabilitation carried out in hospital, rehabilitation center, sanatorium and outpatient rehabilitation clinic enables better education of patients and their families. Patients' self-consciousness of necessity of continuous daily physical activity at home has a great influence on the length and quality of their life. Physical activity is the best way of prevention of disability and secondary complications caused by immobilization in movement and other systems. It improves also patients' protective forces. Rehabilitation, on the contrary to drug therapy, is cheep, has no adverse effects and can be carried out at home. I this paper are presented the following principles of complex rehabilitation: patients' self-education of Parkinson disease, the proper way of life and work as well as the most effective ways of physiotherapy, occupational therapy and art therapy.Neurologia i neurochirurgia polska 02/2003; 37 Suppl 5:211-20. · 0.43 Impact Factor -
Article: Analysis of reasons for falls of hemiparetic inpatient rehabilited patients.
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ABSTRACT: Background. Patients undergoing rehabilitation in rehablitation wards particulary those focused on geriatry or neurology are expose to falls.It is connected with advanced age and also their illness essence. This kind of falls appears to be very important problem because some of them could lead to severe physical contusion or loss of trust in own ability and fear against the activities. The aim of this study was to analyse incidence of falls in all groups of patients rehabilited in the ward, the causes of falls and consequences of them and estabilshing the preventional rules for hemiparetic patients after stroke or operated brain's tumors. Material and methods. The prospective study was conducted during 2000 year. We used erlier prepared record of falls included data conected with age, diagnosis, day of hospitalisation, causes, circumstances and consequences of falls. Results. Among 724 observed inpatient rehabilited patients falled 46 persons what is 6,3%. The most often falls concerned hemiparetic patients (8,7% rehabilited patients). In group with patients after cranio-cerebral trauma falls were registered in 18,1% rehabilited. Walking without support was the most frequent circumstance of falls (27%). In 9 % of falled patients suffered from consequences as local petechie, swellings, tenderness of soft tissue whereas 1 patient needed to be transfered and observated in traumatic ward after fall. Conclusions. From this analysis come that restriction of ussing sleeping and psychotropic pills, creation of save enviroment, isolation of group of patients predisponated to falls are very important factors in prevention of falls.Ortopedia, traumatologia, rehabilitacja 11/2002; 4(5):606-12. -
Article: [Factors determining the quality of life of residents in homes for the aged--preliminary report].
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ABSTRACT: In 1997 people over 60 constituted 16.2% of Poland's population and their percentage will rise to 22.4 by 2020 according to the General Statistics Office (GUS). The increasing number of the elderly entails the need for new demographic, social, economical and health solutions. Thus, the need to create various centres, such as old people's homes. This is where the elderly live for years, often until their death, therefore it is so important to ensure them appropriate living conditions. Over the last years, it has been stressed that improvement in symptoms and lifespan lengthening are not the only important issues for patients but it is also, and even most of all, the improvement of their life's quality. The aim of the paper was to evaluate the factors determining the Quality of life (QoL) of the inhabitants of old people's homes. The study encompassed 80 inhabitants of an old people's home in Podkarpacie region. The Nottingham Health Profile and the Self Evaluation Scale of professor J. Tylka were used to assess the QoL. Both questionnaires were complemented by questions about chronic diseases and rehabilitation procedure applied. Results of the analysis are preliminary. So far the research has shown a significant dependence of the QoL on physical efficiency, pain and depression. It has been also demonstrated that, in spite of a suitable rehabilitation base, too little importance is still attached too a comprehensive rehabilitation in the old people's homes.Wiadomości lekarskie (Warsaw, Poland: 1960) 02/2002; 55 Suppl 1:108-13. -
Article: [Gait characteristics in hemiparetic patients after stroke].
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ABSTRACT: The first and major criterion of success in broadly understood management of patients with stroke is to regain motor ability, at least minimally. It starts as early as possible with mobilisation of patients in bed, in a room or ward since the first days after stroke onset. Standing up and gait learning are subsequent, rapidly coming stages of rehabilitation that are of key importance in reaching the outcome of treatment, prevention of likely complications and change in the quality of life. However, reports on gait impairment have been mostly very brief and limited, and pathological gait of patients with hemiparesis has been thought to be merely "helicopod one". Physiological mechanisms of gait programming, following a focal brain lesion, impairment of gait steering and its clinical manifestation, and some practical suggestions of assessment and prognosis of gait impairment are presented in this article.Neurologia i neurochirurgia polska 36(2):337-47. · 0.43 Impact Factor -
Article: Results of rehabilitation in patients after subarachnoid haemorrhage from ruptured intracranial aneurysm and after surgical treatment.
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ABSTRACT: Non-traumatic, or spontaneous subarachnoid haemorrhage (SAH) is responsible for 5-7% of strokes. In Podkarpackie voivodeship, 217 patients were hospitalized in 2003 with spontaneous SAH. The aim of this study was to assess the relationship between the results of rehabilitation carried out in patients after surgical treatment of SAH estimated on the Brunnström, Barthel, and Rankin scales and patients' initial condition measured by means of the Hunt-Hess Scale. The examined group consisted of 55 patients after surgically treated SAH (clipping). Severity of bleeding was graded with the Hunt-Hess Scale on admission to the neurosurgery ward. Patients' clinical status was assessed with the Barthel Index and Rankin and Brunnström scales on admission to a rehabilitation ward, and rehabilitation effects were assessed after 4 weeks of the rehabilitation period and after at least 6 months from the end of rehabilitation on the ward. The study did not reveal any significant correlation between severity of bleeding and the results of rehabilitation. No explicit advantage was observed in the process of treatment of patients with grade I or II grade according to the Hunt-Hess Scale in the later period. In each group of patients (grades I to IV) there were patients whose final condition improved evidently. No significant correlation was observed between the clinical status at the onset of the disease and clinical or functional status in early and late periods of rehabilitation.Neurologia i neurochirurgia polska 42(2):116-22. · 0.43 Impact Factor -
Article: [Evaluation of needs in early post-stroke rehabilitation in Poland].
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ABSTRACT: According to European Stroke Initiative (EUSI) recommendations every stroke patient should undergo rehabilitation. We aimed to evaluate the needs of comprehensive stroke in-patient rehabilitation in Poland. We designed and distributed a questionnaire evaluating rehabilitation departments in Poland, where stroke patients undergo early rehabilitation. Comprehensive rehabilitation was defined as: kinesitherapy (minimum 60 minutes/day), speech therapy (minimum 30 minutes 5 days a week), rehabilitation of other cognitive impairments and group kinesitherapy. We separated rehabilitation departments where comprehensive post-stroke rehabilitation is conducted, and calculated the number of beds in these departments only for stroke patients. We estimated the number of acute stroke patients in Poland. We evaluated the number of patients requiring in-patient rehabilitation based on results from the 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, where all stroke patients who need in-patient rehabilitation have such a possibility. We estimated the number of beds required in rehabilitation departments for stroke patients in Poland. We obtained responses from 115 out of 172 (66.9%) rehabilitation departments. Comprehensive post-stroke rehabilitation is conducted in 11 departments. 159 beds in these departments are for stroke patients. From 64,896 acute stroke patients 9,927 will need in-patient rehabilitation. We need 604 more beds in rehabilitation departments for stroke patients in Poland. Only 10% of rehabilitation departments could provide comprehensive stroke rehabilitation in Poland. At present, the number of beds in rehabilitation departments for stroke patients covers about 20.8% of actual needs. An increased number of rehabilitation beds for stroke patients could result in a decreased number of disabled post-stroke patients.Neurologia i neurochirurgia polska 40(6):471-7. · 0.43 Impact Factor -
Article: [Incidence of neuromedical complications during rehabilitation after stroke].
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ABSTRACT: The aim of the study was to examine the frequency and types of neuromedical complications in stroke rehabilitation depending on the age, sex and time from the onset of stroke. 498 patients after stroke (225 females, 227 males) during inpatient rehabilitation in the Rehabilitation Department at the Provincial Hospital no. 2 in Rzeszów. At least one complication after stroke was stated in 391 (78.5%) patients. We recorded the following neurological complications: recurrent stroke (2.8%), epileptic seizures (9.8%), depression (14.7%), confusion (10.6%) and medical complications: urinary tract infections (36.9%), pneumonia (9.8%), falls (11.8%), deep vein thrombosis (2%), pulmonary embolism (1.4%) and paretic limb problems (pain -- 23.1%, edema -- 20.9%, shoulder subluxation -- 3.2%). Females were more likely to have urinary tract infections and pulmonary embolism. Patients over 80 years suffered more frequently from multiple complications. Age turned out to be a risk factor for stroke progression, pulmonary embolism, gastrointestinal bleeding and confusion. The frequency of complications was related with duration after stroke. Urinary tract infections, pneumonias, mental disorders and falls were more common up to three months from the onset of stroke, while epileptic seizures occurred more frequently over three months after stroke. At least one medical complication is noted in most patients after stroke during their rehabilitation, careful prevention, early diagnostics and treatment of complications after stroke are necessary in order to make rehabilitation after stroke more effective.Neurologia i neurochirurgia polska 39(4):300-9. · 0.43 Impact Factor -
Article: [Botulinum toxin type A in the management of spasticity in adults: recommendations of an interdisciplinary group of experts].
Neurologia i neurochirurgia polska 38(6):443-5. · 0.43 Impact Factor -
Article: The use of a treadmill with biofeedback function in assessment of relearning walking skills in post-stroke hemiplegic patients--a preliminary report.
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ABSTRACT: One of the most important goals of rehabilitation of post-stroke hemiplegic patients is the recovery of their locomotion function. The aim of the study was to assess walking function recovery by means of in-patient rehabilitation procedures, as well as the effectiveness of treadmill gait training with the use of biological feedback. The research involved groups of chronic post-stroke hemiplegic patients receiving treatment in the rehabilitation ward. Factors under scrutiny included walking speed and capacity, number of steps, weight bearing symmetry for lower extremities while standing, lower limb mobility on the Brunnström scale, and muscle tone on the Ashworth Scale. The study group patients followed a rehabilitation regime that included treadmill training aided with biofeedback function. Each study group participant exercised every day (a total of 15 times), with a single practice time ranging from 5 to 20 minutes. Control patients followed a rehabilitation regime without the additional treadmill exercises. Patients in both groups demonstrated improvement in locomotion abilities. In the group following the physiotherapy regime supplemented with treadmill training with the use of biofeedback, the measures of walking speed, weight bearing symmetry for lower extremities, and number of steps were better than in controls. Treadmill gait training with the use of biofeedback is effective for relearning locomotion functions in post-stroke hemiplegic patients and can constitute a significant type of exercise in a physiotherapy regime.Neurologia i neurochirurgia polska 44(6):567-73. · 0.43 Impact Factor
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2003–2011
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Rzeszów University
Rzeszów, Subcarpathian Voivodeship, Poland
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