[The quality of life of patients with atherosclerosis of lower extremities - 15-year observation]. / Jakosc zycia chorych z miazdzyca zarostowa tetnic konczyn dolnych ­ obserwacja 15-letnia.

An improving quality of life of a patient seems to be the primary goal of contemporary medicine facing the controversies arising over the duration of persistent therapy, on the one hand, and mounting costs of health care, on the other. AIM: The aim of the study was to assess the applicability of the SF-36 (Short Form Health Survey) quality-of-life scale to the evaluation of patients with lower-extremity atherosclerosis and to find a link with the new composite endpoint of the study which the quality of life predisposes to. MATERIALS AND METHODS: The patients operated on for lower-extremity atherosclerosis (y-graft) in one centre in the years 1999-2004 were invited to take part in the study. 64 out of 172 patients joined the study. The study participants were assessed for the quality of life, distance intermittent claudication and lower-extremity pulse presence. Information was also collected on their past medical history and life style. The works of the study group undertaken in 2021 thanks to cooperation with the Ministry of Digitalization allowed to determine deaths among the study participants and link them to the information collected earlier, including the quality of life. RESULTS: It was confirmed that the SF-36 scale, a tool from the group of general tools, i.e. a tool not dedicated to any particular disease, allows to perfectly assess the quality of life in the studied group of patients. The assessments obtained in the SF-36 subscales were higher for patients with an at least 10-year post-surgery survival. Yet, it is the differences observed in the analysis of the three variables, namely, social functioning (t=3.825, p<0.001), limitations due to emotional problems (t=3.496, p=0.001) and emotional well-being (t+2.179, p=0.033) that are statistically significant. CONCLUSIONS: The results of the study indicate that the main factors differentiating patients who die within 10 years from the surgery and those with an over-10 survival are primarily emotional well-being related issues.

Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion: Study Protocol for a Prospective, Open Label, Single-Center Study With 12 Months of Follow-Up.

This study is designed to determine the efficacy of Cerebrolysin treatment as an add-on therapy to mechanical thrombectomy (MT) in reducing global disability in subjects with acute ischemic stroke (AIS). We have planned a single center, prospective, open-label, single-arm study with a 12-month follow-up of 50 patients with moderate to severe AIS, with a small established infarct core and with good collateral circulation who achieve significant reperfusion following MT and who receive additional Cerebrolysin within 8 h of stroke onset compared to 50 historical controls treated with MT alone, matched for age, clinical severity, occlusion location, baseline perfusion lesion volume, onset to reperfusion time, and use of iv thrombolytic therapy. The primary outcome measure will be the overall proportion of subjects receiving Cerebrolysin compared to the control group experiencing a favorable functional outcome (by modified Rankin Scale 0-2) at 90 days, following stroke onset. The secondary objectives are to determine the efficacy of Cerebrolysin as compared to the control group in reducing the risk of symptomatic secondary hemorrhagic transformation, improving neurological outcomes (NIHSS 0-2 at day 7, day 30, and 90), reducing mortality rates (over the 90-day and 12 months study period), and improving: activities of daily living (by Barthel Index), health-related quality of life (EQ-5D-5L) assessed at day 30, 90, and at 12 months. The other measures of efficacy in the Cerebrolysin group will include: assessment of final stroke volume and penumbral salvage (measured by CT/CTP at 30 days) and its change compared to baseline volume, changes over time in language function (by the 15-item Boston Naming Test), hemispatial neglect (by line bisection test), global cognitive function (by The Montreal Cognitive Assessment), and depression (by Hamilton Depression Rating Scale) between day 30 and day 90 assessments). The patients will receive 30 ml of Cerebrolysin within 8 h of AIS stroke onset and continue treatment once daily until day 21 (first cycle) and they will receive a second cycle of treatment (30 ml/d for 21 days given in the Outpatient Department or Neurorehabilitation Clinic) from day 69 to 90.

Change in the Results of Motor Coordination and Handgrip Strength Depending on Age and Body Position-An Observational Study of Stroke Patients and Healthy Volunteers.

Objective: The stroke is considered a common disease of the elderly. Young people also get sick, but the risk of stroke increases with the age of 60. Stroke, regardless of the age of the patients, causes functional deficits; therefore, the aim of the study was to analyze the significance of the body position and examined upper limb on the parameters of motor coordination and handgrip strength in various age groups of people after stroke and healthy people. Material and method: This is an observational study. A total of 117 people participated in the study (60 stroke patients and 57 healthy people without neurological disorders). Both patients and healthy volunteers were prospectively divided into three age groups: 18−45, 46−60, and 61+. The tests were carried out in two starting positions: sitting without back support and lying on the back with the upper limb stabilized against the body. HandTutorTM and a hand dynamometer were used to assess the motor coordination, including the maximum range of motion and frequency of movement, as well as the grip strength. Results: The passive stabilization of the trunk and shoulder improved the maximum wrist ROM (p < 0.001) and frequency of finger movements (Hz F5 p = 0.018; F3 p = 0.010; F2 p = 0.011), especially in the oldest stroke patients. In the group of healthy volunteers, the most statistically significant results were obtained in the age range of 46−60. They occurred in both stable (wrist maxROM p = 0.041 and Hz F5 p = 0.034; Hz F4 p = 0.010; Hz F3 p = 0.028; Hz F1 p = 0.034, maxROM F1 p = 0.041) and unstable positions (maxROM F5 p = 0.034; maxROM F4 p = 0.050; maxROM F3 p = 0.002; maxROM F2 p = 0.002). In the group of the oldest healthy people, only one significant result was obtained in the stable position (Hz F3 p = 0.043). Conclusion: Passive stabilization of the trunk and examined upper limb improves the results of motor coordination of the distal part of the upper limb in both study groups. Passive stabilization of the trunk and upper limb improves motor coordination, especially in the oldest group of patients, after stroke.

[Internal carotid artery dissection in the neurologist's practice - a case study]. / Rozwarstwienie tetnicy szyjnej wewnetrznej w praktyce neurologa ­ opis przypadku.

Dissection of the interior carotid artery is rare in the general population. It can however be a potentially life-threatening condition. In the group of patients below 45 years of age, it constitutes a fairly common cause of cerebral stroke. A CASE REPORT: The study describes the case of a patient with the right interior carotid artery dissection, sustained most probably in the course of work. The patient was admitted to hospital for a severe headache of a few days' duration accompanied by Horner's syndrome on the right side. Promptly undertaken diagnostic procedures allowed for immediate diagnosis and application of the right treatment. The check-up examinations performed showed a healed artery and withdrawal of the neurological syndrome. CONCLUSIONS: The case emphasizes the role of prompt diagnosis and treatment in preventing the development of more serious complications. The article refers also to the standards of treating the dissection of the interior carotid artery which still arouse controversies.

Applications of Smart Textiles in Post-Stroke Rehabilitation.

Stroke is a disease affecting a large part of our society. According to WHO data, it is the second world's biggest killer, accounting for near six million deaths in 2016 and it is about 30% of the total number of strokes per year. Other patients affected by such a disease should be rehabilitated as soon as possible. As a result of this phenomenon, paresis may occur. Among the devices available on the market there are many rehabilitation robots, but the method of electrostimulation can be used. The authors focused their attention on electrostimulation and commercially available therapies. Using this method, application to people with large hand muscle contracture is difficult. The authors of the work present a solution dedicated to exactly such people. A solution of textronic sensors manufactured on a textile substrate using the technology of physical vapor deposition is presented in the article. As a result of the conducted research, an electroconductive structure was obtained with a low surface resistance value of 1 Ω/□ and high flexibility. It can alternatively be used in hand rehabilitation for electrostimulation of fingertips. The solution is dedicated to people with high hands spasticity for whom it is impossible to put on a rehabilitation glove.

State-of-the-art approach towards magnetic resonance imaging of the nervous system structures in patients with cardiac implantable electronic devices.

INTRODUCTION: MRI generated forces are the source of potential complications in patients with cardiac implantable electronic devices (CIED). The technological progress, and growing clinical evidence concerning the operation of the contemporary MR non-conditional CIEDs during MRI, have started to significantly change our every-day clinical practice. Nevertheless, a lot of patients who could have an MRI performed safely, still have been refused the examination. STATE-OF-THE-ART: In many clinical situations, an MRI examination in a patient with a CIED is reasonable, and is linked to a negligible risk of complications if performed under strict precautions. The MagnaSave Registry that evaluated the influence of nonthoracic MRI on the function of MR non-conditional CIEDs, and numerous studies involving thoracic and non-thoracic MRIs in patients with legacy CIEDs, have confirmed the feasibility and safety of such examinations. In this article, practical tips aimed towards improving the safety of MRI in MR conditional and non-conditional CIED patients are largely based on the very recently released (2017) HRS expert consensus statement. CLINICAL IMPLICATIONS: Clinical data emphasize the necessity of making the MRI more accessible to CIED patients, also in the case of MR non-conditional systems or when the thorax MR imaging is clinically reasonable. This goal should be achieved by increasing the number of centers complying with respective recommendations and applying protocols that would guarantee the highest safety level. FUTURE DIRECTIONS: Further studies are warranted to assess safety issues related to the main current contraindication to MRI, i.e., the presence of abandoned leads.