[show abstract][hide abstract] ABSTRACT: BACKGROUND: In Poland, the prevalence of cardiovascular diseases is increasing. This might be associated with the constantly growing proportion of elderly people and inappropriate cardiovascular prevention. This study aimed to evaluate the frequency of use of oral antiplatelet (OAP) and oral anticoagulant (OAC) drugs among older people in Poland and to assess their association with cardiovascular risk factors. METHODS: The study was based on data collected during the implementation of a multicentre, publicly funded research project called PolSenior. RESULTS: The study group consisted of 4,979 people with the average age of 79.35 +/- 8.69 years. Among them, 1,787 people (35.9%) used at least one drug in the prevention of cardiovascular diseases. OAPs were used regularly by 1,648 (33.1%) elderly people and OACs were used by 165 elderly people (3.3%). Acetylsalicylic acid was used by 32.2% of elderly people. Use of drugs significantly depended on age (p < 0.01), sex (p < 0.01), place of residence (p < 0.001), level of education (p < 0.0001) and personal income (p < 0.0001). Among all the respondents treated with OAPs, therapy was applied as secondary cardiovascular prevention in 717 respondents (43.5%), and as primary prevention in 705 respondents (42.8%). Among the respondents treated with OACs, 117 (71%) elderly people had a history of atrial fibrillation. Secondary cardiovascular prevention should be considered in a further 482 respondents (15.1% of untreated elderly people), and primary cardiovascular prevention in 1,447 respondents (45.3%). CONCLUSIONS: Our study is the first to determine the frequency of use of OAP and OAC drugs among elderly people in Poland in relation to cardiovascular risk factors. The most commonly used drug for cardiovascular prevention is acetylsalicylic acid, but it appears that it is used too rarely in high-risk patients. Educational programs should be developed among general practitioners concerning current recommendations for pharmacological cardiovascular prevention.
[show abstract][hide abstract] ABSTRACT: Background and purpose: The aetiopathogenesis of fatigue in multiple sclerosis (MS) is not clear. It could be associated with structural changes of the central nervous system, but also with mood and sleep disorders. The purpose of the study was to evaluate frequency of fatigue and its association with sleep and mood disorders in MS patients. Material and methods: The examined group consisted of 122 MS patients (mean age 37.7 ± 10.8 years). The following questionnaires were used: Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS), Montgomery-Asberg Depression Rating Scale (MADRS), and Hospital Anxiety and Depression Scale (HADS). Results: Fatigue was present in 75 MS patients (61.5%). Excessive daytime sleepiness was observed in 25 (20.5%), insomnia in 73 patients (59.8%). According to MADRS, depressive symptoms were present in 33 (27%), according to HADS in 15 people (12.3%). Anxiety was present in 32 patients (26.2%). We observed an association between fatigue (FSS) and sleep disorders (ESS, AIS) and also between fatigue and either depression (MADRS, HADS-D) or anxiety (HADS-A). The FSS score was not associated with age, sex, disease course and duration, Expanded Disability Status Stage (EDSS), treatment or level of education in MS patients. In inactive professionally people we noted significantly higher FSS scores (44.8 ± 13.8) in comparison with active individuals (37.2 ± 14.9; p = 0.0053). Conclusions: Fatigue is a very common symptom in MS, sometimes associated with sleep disorders, depressive symptoms or anxiety. The treatable causes of fatigue in MS such as sleep and mood disturbances should be identified and treated.
Neurologia i neurochirurgia polska 01/2012; 46(4):309-317. · 0.49 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of the study was to perform an analysis of the recorded tremor using accelerometry and select those parameters that are the most useful in differentiation of tremor types.
We examined 45 patients with parkinsonian tremor (PT), 39 patients with essential tremor (ET) and 35 patients with cerebellar tremor (CT). The control group consisted of 52 healthy persons. The analysis included tremor intensity, frequency of spectral peaks, centre frequency, standard deviation of the centre frequency, and harmonic index. Parameters of tremor were compared between particular groups of patients with pathological tremor and with the control group. The side-to-side symmetry of these parameters was also analysed.
Tremor intensity was significantly higher in patients than in controls. There was a significant side-to-side asymmetry of intensity in all patient groups. Significantly lower peak frequency, centre frequency and standard deviation of centre frequency were found in patients compared to the control group. The frequency was symmetric in ET and in controls, but asymmetric in other subjects. The differences between hands regarding the standard deviation of centre frequency were significantly greater in all patient groups than in controls, who revealed no difference of this parameter between sides. Harmonic index was significantly greater and asymmetric in all groups of patients when compared to the control group.
Standard deviation of centre frequency and harmonic index are the most valuable variables in differentiation of tremor. The assessment of symmetry of tremor parameters is useful in discrimination of various types of pathological tremor.
Neurologia i neurochirurgia polska 01/2012; 46(2):145-56. · 0.49 Impact Factor
[show abstract][hide abstract] ABSTRACT: Epilepsy is one of the most frequent neurological diseases. Social acceptance is very important for people with epilepsy and their relatives. The aim of the study was to assess public knowledge and attitudes towards epilepsy in Silesia.
We examined 419 people, inhabitants of Silesia, at the mean age of 34 ± 15 years. The study was performed using a questionnaire containing 15 questions evaluating knowledge about epilepsy and attitudes towards people with epilepsy.
43.2% of the respondents knew an epileptic person themselves. 44.7% had witnessed an epileptic seizure; 68.8% would help a person during an epileptic seizure, but most of them (73.4%) would do it incorrectly (by putting an object into the mouth to prevent biting the tongue). 94.5% of respondents had nothing against friendship with an epileptic person, but 12.1% suggested that children with epilepsy should attend special schools. 85.9% of all those examined said that people with epilepsy should inform others about their disease, 81.9% would mention the existence of an epileptic person in their family. 40.5% of respondents believe that people with epilepsy can do the same jobs as healthy people, 75.3% would employ an epileptic person themselves.
The knowledge about epilepsy and first aid during epileptic seizure is still insufficient among inhabitants of Silesia. Most of the responders, especially better educated ones, declare acceptance and tolerance of people with epilepsy. More effort should be made to improve public knowledge of epilepsy by preparing wide-spread educational programmes.
Neurologia i neurochirurgia polska 01/2011; 45(2):107-14. · 0.49 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of the study was an analysis of causes, clinical symptoms, complications and predictors of an unfavorable course of status epilepticus (SE).
Retrospective evaluation of medical files of 28 patients (17 M, 11 F, aged 52 +/- 15 yrs) was made. Patients were treated for status epilepticus in a Neurology Clinic in Zabrze between January 1997 and March 2008.
Chronic epilepsy existed in 64% pts, for 10 yrs on an average, in 10% pts SE was a subsequent one. Chronic alcoholism was defined as a most frequent cause of SE, followed by cerebrovascular disorders and brain tumor (32, 14 and 14%, resp.); in 25% pts the cause was not specified. Generalized seizures predominated (82%), in 90% they lasted longer than 60 minutes. In 43% pts biochemical inflammatory indicators on admission were found, more than 20% had fever, in 10% pneumonia was diagnosed. 1/3 of individuals suffered from respirocirculatory insufficiency and in more than 21% new neurological deficits appeared. In treatment, following benzodiazepines, intravenous phenytoin (50%) was used. 35% pts was subjected to pharmacological coma, predominantly by means of thiopental and propofol (25 and 7%, resp.). Mechanical ventilation was necessary in 40% pts. Mortality rate was 32%, with 33% of deaths on the 1st day and 78% before the 7th day.
Chronic alcoholism and older age predominate among causes of death in patient with SE.
[show abstract][hide abstract] ABSTRACT: Central pontine myelinolysis (CPM) is a neurologic disorder that the most often is related to rapid correction of hyponatremia. It is concentrated, frequently symmetric, noninflammatory demyelination within the base of the pons with a relative sparing of the axons and the nerve cells. Focal demyelination can occur outside the pons (extrapontine myelinolysis--EPM). Clinical symptoms have various manifestations and the prognosis can be different. In the diagnosis of CPM the most useful is magnetic resonance imaging (MRI), that is more sensitive than computed tomography (CT). The authors present two cases of CPM with different aetiology, clinical features and course of the disease.
[show abstract][hide abstract] ABSTRACT: Accelerometric registration of tremor with the subsequent estimation of its parameters allows objective collection of information. The aim of the study was an analysis and visualization of the signal of the recorded tremor, including assessment of spectral components at the dominant frequency and selection of those parameters that are most useful in differentiation of tremor types.
We examined 44 patients with parkinsonian tremor (PT), 39 patients with essential tremor (ET), and 13 patients with cerebellar tremor (CT), diagnosed clinically using the criteria of the Movement Disorders Society and the Tremor Investigation Group. The control group consisted of 26 healthy persons. A biaxial accelerometer mounted at the dorsal surface of the hand was used. Spectral analysis was performed. The analysis focused on determination of spectrum shape, frequency of spectral peaks, centre frequency, standard deviation of the centre frequency, harmonic index, as well as changes in frequency over time.
In patients with pathological tremor (PT, ET, and CT), a single spectral peak was observed that persisted for the whole registration period. In the control group, tremor was characterized by a wide range of spectral frequencies with marked variability in time. Statistical analysis revealed significantly lower frequencies of the highest peak and of the central frequency, a significantly smaller standard deviation of the central frequency and a significantly higher harmonic index in cases of pathological tremors as compared to the control group.
The presented method enables distinction between pathological and physiological tremor and helps in differentiation of various types of pathological tremor.
Neurologia i neurochirurgia polska 01/2007; 41(3):241-50. · 0.49 Impact Factor
[show abstract][hide abstract] ABSTRACT: Epilepsy is one of the most common chronic neurological conditions. The prevalence of epilepsy is estimated at 0.5-5% of population. The etiology of seizures is in a great extent age-related. It is multifactorial in any given individual and is a result of a combination of acquired and genetic factors. The epidemiological studies indicate an increasing number of patients who suffer from active epilepsy with the first epileptic fit in the elderly. In that age range epilepsy, after stroke and dementia, is the third most frequent disease of nervous system. The most frequent causes of the late-onset epilepsy, especially in the elderly, seem to be: cerebrovascular disease, head trauma and alcoholism. On the basis of literature the authors present the epidemiology, clinical and electroencephalographical features and treatment of different kinds of epilepsy: vascular, posttraumatic and related to alcohol abuse.
[show abstract][hide abstract] ABSTRACT: The aim of the study was to assess the health related quality of life in patients suffering from multiple sclerosis (MS) in association with clinical features, fatigue and depressive symptoms.
The examined group consisted of 61 patients (45 women and 16 men) in the mean age of 38.6 +/- 11.4. The mean duration of disease was 7.1 +/- 6.1 years. The control group consisted of 30 healthy volunteers. The following questionnaires were used: EuroQol (EQ5D) with visual scale EuroQol-VAS, Modified Impact Fatigue Scale (MIFS) and Beck Depression Inventory (BDI).
The quality of life in the examined group of MS patients was significantly lower in comparison to the control group. Results of EQ-5D and EQ-VAS were influenced by age, disease course, level of disability and carried treatment. Statistically significant association was also found between results of the questionnaires assessing quality of life and either fatigue or depressive symptoms.
The used questionnaires confirmed that quality of life in patients with MS is significantly worse, especially in the older people with secondary progressive course of the disease, more disable and not treated. Presence of fatigue and depressive symptoms influenced the self-assessment of quality of life. Complex care of MS patient should consider diagnosis and treatment of fatigue and depression which could improve their quality of life.
Psychiatria polska 47(3):433-42. · 1.48 Impact Factor
[show abstract][hide abstract] ABSTRACT: Essential tremor (ET) is likely the most common movement disorder. The aim of the study was to carry out spectral analysis of the essential tremor recorded by an accelerometer and assess the symmetry of tremor parameters between the two hands.
We examined 39 patients with ET diagnosed clinically using the criteria of the Movement Disorder Society. The control group consisted of 52 healthy persons. A biaxial accelerometer mounted at the dorsal side of the hand was used. Spectral analysis was performed. Tremor intensity, frequency of spectral peaks, centre frequency, standard deviation of the centre frequency, and harmonic index were measured. The side-to-side symmetry of these parameters was analysed. The relationship of hand dominance and severity of tremor was also analysed.
There was significant side-to-side asymmetry of intensity in ET. The intensity in the more affected hand was over two times higher than that in the less affected one. The tremor was more severe in the nondominant hand in 62% of patients. In spite of significant difference in tremor intensity between the two sides, tremor frequency was similar in both hands. The standard deviation of centre frequency was significantly lower and the harmonic index was significantly higher in the more trembling hand.
Accelerometric registration revealed that asymmetry of intensity and symmetry of frequency are characteristic features of ET. The remaining two coefficients reflecting the rhythmicity and regularity of tremor also differed considerably between the hands.
Neurologia i neurochirurgia polska 45(2):121-7. · 0.49 Impact Factor