[Genetically determined abnormal electrical activity of the brain and the heart].

Mutations leading to disorders within ion (mainly potassium and sodium) channels, have different degrees of expression in the brain and in the heart, which can cause simultaneous occurrence of disorders in both organs. This is manifested by the occurrence of epileptic seizures and cardiac electrical disturbances, further exacerbated by stimulation of autonomic structures within the central nervous system. In all patients with unclear paroxysmal disorders, and in those with unexplained sudden cardiac death, consideration should be given to the possibility of occurrence of genetically determined disorders in the ion channels. This article concerns the most common genetically determined epilepsy syndromes and genetically determined cardiac diseases.

Pharmacological stroke prevention in the elderly with atrial fibrillation in Poland - Results of PolSenior study.

INTRODUCTION: Atrial fibrillation (AF) is the most frequent clinically significant arrhythmia, especially common in the elderly. As it is known, AF is associated with increased risk of stroke. Little is known about pharmacological cardiovascular prevention in the elderly with AF in Poland. OBJECTIVES: The purpose of the study was to evaluate the frequency of pharmacological stroke prevention among the elderly with AF in Poland and its association with clinical characteristics and concomitant cardiovascular risk factors. PATIENTS AND METHODS: The analysis included elderly (≥65 years) participants of the PolSenior study performed in years 2008-2012. RESULTS: The study group consisted of 4979 people (mean age: 79.3±8.7 years). Among them, there were 875 patients (18.7%) with documented history of AF. Pharmacological prevention with the use of vitamin K antagonists (VKA) was applied by 117 (13.4%) of the elderly with AF, including 15 (1.7%) on dual therapy. Additionally, 386 (45.3%) subjects with AF were using oral antiplatelet therapy (OAPs), mostly aspirin. Acenocoumarol was much more often used than warfarin. New oral anticoagulant drugs (NOACs) were not used at all. Only personal income was associated with the use of VKA. No significant correlation was found for the age, sex, place of residence and level of education. CONCLUSIONS: The study was unique to determine the frequency of pharmacological stroke prevention among elderly people with AF in Poland. It occurred that oral anticoagulant drugs were applied too rarely in this group of patients. Educational programs should be developed among general practitioners concerning current recommendations for patients with AF.

Multimodal evoked potentials in patients with multiple sclerosis in assessment of the course of the disease.

INTRODUCTION: Multiple sclerosis (MS) is a chronic inflammatory, demyelinating disease of the central nervous system with a multifocal damage. THE AIM: The assessment of the MS course by multimodal evoked potentials (EP). MATERIAL AND METHODS: We evaluated 95 patients (63 female, 32 male) with relapsing-remitting MS in the average age of 36.4±10.4. The average disease duration was 4.6±7.4 year. Among them, 48 patients (50.5%) were treated with immunomodulatory drugs. All patients underwent neurological examination and EP testing: VEP (visual evoked potentials), SEP (somatosensory evoked potentials), endogenous potential P300. The latencies of following waves were evaluated: P100 (VEP), N4 , N9 , N13, N20, P22 (SEP) and P300, with the reference values of the Neurophysiological Research Laboratory of the Department of Neurology in Zabrze. RESULTS: Abnormal VEP(I) was found in 80 patients (84.2%), SEP(I) in 9 patients (9.5%), P300(I) in 15 patients (15.8%). Abnormal result of the control research VEP (II) was found in 23 patients (82.1%), SEP(II) in 1 patient (3.6%), P300(II) in 4 patients (14.3%). The average values of the waves latencies in the control study were higher, however the statistical significance was not found. The correlation was observed between EDSS, and N20 and P22. No relationship was found between EP and age, disease duration, number of relapses and treatment. CONCLUSIONS: In the era of neuroimaging, usage of EP in the diagnosis and assessment of MS is limited. Electrophysiological studies may be used in addition to the clinical examination to confirm the multifocal damage.

Interictal heart rate in patients with epilepsy.

INTRODUCTION: Electrocardiographic abnormalities in patients with epilepsy are related to the presence of discharges in central autonomic structures and the effect of antiepileptic drugs. These patients are at risk for sudden unexpected death, and cardiac arrhythmias are one of the most probable causes related to it. THE AIM: The heart rate (HR) assessment recorded on electrocardiography (ECG) in the interictal period in patients with newly diagnosed and previously treated epilepsy, depending on the type of changes in electroencephalography (EEG) and the treatment option. MATERIAL AND METHODS: Fifty patients with epilepsy were enrolled in the study: 22 comprised a non-treated patient (NTP) group with newly diagnosed epilepsy and 28 comprised a treated patient (TP) group that had been treated for more than 2 years. Resting ECG and EEG were performed in all patients. RESULTS: A significantly higher HR was recorded in the TP group compared to the NTP group (80±13 vs 67±15 bpm, p=0.00006). The tendency to higher HR was observed in polytherapy patients, carbamazepine patients and in patients with a focus in the right hemisphere. CONCLUSIONS: There is a relationship between the presence of the disorders related to bioelectric activities of the brain and the heart, therefore the ECG should be periodically monitored in epileptic patients.

Interictal heart rate in patients with epilepsy.

INTRODUCTION: Electrocardiographic abnormalities in patients with epilepsy are related to the presence of discharges in central autonomic structures and the effect of antiepileptic drugs. These patients are at risk for sudden unexpected death, and cardiac arrhythmias are one of the most probable causes related to it. THE AIM: The heart rate (HR) assessment recorded on electrocardiography (ECG) in the interictal period in patients with newly diagnosed and previously treated epilepsy, depending on the type of changes in electroencephalography (EEG) and the treatment option. MATERIAL AND METHODS: Fifty patients with epilepsy were enrolled in the study: 22 comprised a non-treated patient (NTP) group with newly diagnosed epilepsy and 28 comprised a treated patient (TP) group that had been treated for more than 2 years. Resting ECG and EEG were performed in all patients. RESULTS: A significantly higher HR was recorded in the TP group compared to the NTP group (80±13 vs 67±15 bpm, p=0.00006). The tendency to higher HR was observed in polytherapy patients, carbamazepine patients and in patients with a focus in the right hemisphere. CONCLUSIONS: There is a relationship between the presence of the disorders related to bioelectric activities of the brain and the heart, therefore the ECG should be periodically monitored in epileptic patients.

[Psychometric and neurophysiological assessment of cognitive functions in patients with epilepsy].

BACKGROUND: The aim of the study was to assess cognitive functions in patients with epilepsy using the neurophysiological method and psychological tests, and analysis the relationship between clinical features of the disease and test results. MATERIAL AND METHODS: The study included 31 patients with epilepsy aged 37.3±18.4 years. The control group consisted of 40 healthy volunteers aged 33.5±12.2 years. Cognitive functions were assessed using endogenous evoked potential P300 and psychological tests - Mini-Mental State Examination (MMSE), three subtests of Wechsler Adult Intelligence Scale-Revised (WAIS-R), Trail Making Test (TMT), Benton Visual Retention Test (BVRT) and State-Trait Anxiety Inventory (STAI). RESULTS: Epileptic patients achieved significantly lower scores in all, except STAI-1, psychological tests in relation to the controls. A correlation between age and TMT-A (p<0.050) and BVRT (p<0.050) was observed. The disease duration affected results of MMSE (p<0.050), TMT-B (p<0.050) and BVRT (p<0.050). Type of seizures was related to results of MMSE (p=0.005), type of therapy - to results of STAI-1 (p=0.014) and TMT-B (p=0.008). The average latency of P300 was significantly prolonged (p=0.00003) in epileptic patients (348±38ms) in relation to the controls (324±26ms). The relationship between P300 and the duration of seizures (p=0.017) was observed. There was no correlation between P300 and age, sex, frequency and type of seizures and therapy. A correlation between P300 and TMT-B (p<0.050), BVRT-LPO(p<0.050) and STAI-1 (p<0.050) was noticed. CONCLUSION: In epileptic patients cognitive impairment is often found. It is advisable to perform regular neuropsychological testing; P300 can be used only as a preliminary assessment.

Secondary prevention of stroke in elderly people in Poland--results of PolSenior study.

BACKGROUND AND PURPOSE: The purpose of the study was to evaluate the frequency of use of oral antiplatelet (OAP) and anticoagulant (OAC) drugs as secondary stroke prevention among older people in Poland and its association with sociodemographic factors, place of residence, and concomitant cardiovascular risk factors. MATERIAL AND METHODS: The study group consisted of 426 subjects with a history of a previous stroke (mean age of 81.5±8.2 years), participants of multicentre, population-based PolSenior study. RESULTS: Among the study group, 261 people (61.3%) used at least one drug as a secondary prevention. OAPs were regularly used by 237 people (55.6%), and OACs-by 25 people (5.9%). The most often used drug was acetylsalicylic acid. Ticlopidine was more frequently used than clopidogrel, and acenocoumarol was used more often than warfarin. Among all of the concomitant cardiovascular risk factors, congestive heart failure was mostly associated with OAP treatment, and a history of atrial fibrillation-with OAC treatment. Use of drugs did not depend on age, sex, place of residence (rural or urban), level of education and personal income, but it was associated with the region where the respondents lived. CONCLUSIONS: Secondary cardiovascular preventive therapy in Poland is used too rarely in older people after stroke, and it especially concerns anticoagulant therapy in those with a history of atrial fibrillation. Structured educational programmes should be developed in Poland to improve usage of secondary preventive therapy in the elderly.

Reoperations of patients with low-grade gliomas in eloquent or near eloquent brain areas.

BACKGROUND AND PURPOSE: Reoperations of patients with recurrent low-grade gliomas (LGG) are not always recommended due to a higher risk of neurological deficits when compared to initial surgery. The purpose of the present study was to evaluate surgical outcomes of patients operated on for recurrent LGG. MATERIAL AND METHODS: Sixteen patients who had surgery for recurrent LGG out of 68 LGG patients who underwent surgery at the Department of Neurosurgery in Sosnowiec, Poland between 2005 and 2011 were enrolled in the study. RESULTS: A large tumour volume prior to the initial surgery was the most significant parameter influencing LGG progression (96.6 cm³ vs. 47.9 cm3, p = 0.01). Increased incidence of epileptic seizures and decreased mental ability according to Karnofsky score were the most common symptoms associated with tumour recurrence. In the group of patients with malignant transformation, the relative cerebral blood volume (rCBV) was considerably increased (1.21 vs. 2.41, p < 0.01). No statistically significant difference was found in terms of the extent of resection between initial surgery and reoperation. Similarly, no significant difference was found in the number of patients with a permanent neurological deficit after initial surgery and reoperation. CONCLUSIONS: Reoperations of the patients with recurrent LGG are not burdened with a higher risk of neurological sequelae when compared to initial surgery. The extent of resection during the surgery for LGG recurrence is comparable to initial surgery. The increase of rCBV seems to be a significant biomarker that indicates malignant transformation.

[Quality of life in multiple sclerosis--association with clinical features, fatigue and depressive syndrome]. / Jakosc zycia chorych na stwardnienie rozsiane--zwiazek z cechami klinicznymi choroby, zespolem zmeczenia i objawami depresyjnymi.

INTRODUCTION: 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. METHODS: 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). RESULTS: 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. CONCLUSION: 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.

Oral anticoagulant and antiplatelet drugs used in prevention of cardiovascular events in elderly people in Poland.

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.

Fatigue and its association with sleep disorders, depressive symptoms and anxiety in patients with multiple sclerosis.

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.

The usefulness of accelerometric registration with assessment of tremor parameters and their symmetry in differential diagnosis of parkinsonian, essential and cerebellar tremor.

BACKGROUND AND PURPOSE: 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. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Essential tremor - assessment of tremor accelerometric parameters' symmetry and the relationship between hand dominance and severity of tremor.

BACKGROUND AND PURPOSE: 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. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Knowledge and attitudes towards epilepsy among inhabitants of Silesia. A questionnaire study.

BACKGROUND AND PURPOSE: 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. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

[Etiology and clinical signs as short-term risk factors of status epilepticus]. / Etiologia i objawy kliniczne jako krótkoterminowe czynniki rokownicze stanu padaczkowego.

INTRODUCTION: The aim of the study was an analysis of causes, clinical symptoms, complications and predictors of an unfavorable course of status epilepticus (SE). MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: Chronic alcoholism and older age predominate among causes of death in patient with SE.

[Central pontine myelinolysis--etiological, clinical and prognostic variety]. / Mielinoliza srodkowa mostu--róznorodnosc etiologiczna, kliniczna i rokownicza.

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.

Sexual Satisfaction in Fully Ambulatory People with Multiple Sclerosis: Does Disability Matter?

Primary sexual dysfunctions (SD) are a direct result of neurological changes that affect the sexual response. Secondary SD result from the symptoms that do not directly involve nervous pathways to the genital system, such as bladder and bowel problems, fatigue, spasticity, or muscle weakness. Tertiary SD are the result of disability-related psychosocial and cultural issues that can interfere with sexual feelings and experiences. The aim of this study was to assess the sexual satisfaction (SS) in people with multiple sclerosis (PwMS) without significant mobility impairment and to estimate the influence of SD, the score on the Kurtzke Expanded Disability Status Scale (EDSS), lowered mood, and stress coping strategies on SS. Methods. 76 PwMS with the EDSS score < 5.0 points were enrolled in the study. The subjects completed the Montgomery-Asberg Depression Scale (MADRS), the Coping Inventory for Stressful Situations (CISS), the Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-19), and the Sexual Satisfaction Questionnaire (SSQ). Results. The level of SS in PwMS was not significantly lower compared to that of the general population. It correlated with the primary, secondary, and tertiary SD and lowered mood. However, it did not correlate with disability measured by the EDSS. Conclusions. The level of SS in PwMS with the EDSS score below 5.0 points was not significantly lower. SS depended on SD, lowered mood, and stress coping style, and it was not significantly related to the level of disability in patients with the EDDS score below 5.0.

Analysis of selected parameters of tremor recorded by a biaxial accelerometer in patients with parkinsonian tremor, essential tremor and cerebellar tremor.

BACKGROUND AND PURPOSE: 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. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: The presented method enables distinction between pathological and physiological tremor and helps in differentiation of various types of pathological tremor.

[Consumption of psychoactive substances--awareness of health consequences among the students of university schools in Poznan]. / Konsumpcja substancji psychoaktywnych--swiadomosc zdrowotnych konsekwencji wsród studentów poznanskich uczelni.

The goal of this paper is to estimate the phenomenon of consuming psychoactive substances such as: alcohol, nicotine, caffeine and narcotics among the students of Poznan's universities, and evaluating the level of consciousness of the dangers resulting from using those substances. The authors wanted to check, whether the consumption of psychoactive substances depends on such traits as: sex, place of living, subjective evaluation of one's health, the type of university they attend, and whether the respondents think that the knowledge passed onto them on the universities about the dangers resulting from consuming such substances is sufficient, and whether they know how to help an addicted person. The research, done with the use of a survey, was conducted among 504 students from six universities in Poznan: Medical University (16.7% of the respondents), University School of Economics (15.3%), University School of Agriculture (162%), University School of Physical Education (16.1%), Poznan Technical University School (184%) and Poznan University (17.3%). The research has shown, that the most of the students consume alcohol (81.1% of the respondents), followed by caffeine (75.8%). The third place was taken by narcotics (38%), and the fourth by cigarettes (20%). Most people that smoke are the ones that are renting an apartment by themselves. No statistic difference was found in the usage of cigarettes between women and men, nor was there a relation between the subjectively evaluated state of one's health, or the attended university (the students of the Medical University smoke as much as the others). The average ago of the initiation into tobacco usage of the respondents was 17 years of age, which is a time when one doesn't have a legal right to obtain cigarettes.

Antiplatelet and anticoagulant therapy in elderly people with type 2 diabetes mellitus in Poland (based on the PolSenior Study).

INTRODUCTION: Type 2 diabetes mellitus (T2DM) is an important and common cardiovascular risk factor. The purpose of the study was to evaluate the frequency of use of oral antiplatelet drugs (OAPs) and oral anticoagulant drugs (OACs) among the elderly with T2DM in Poland. MATERIAL AND METHODS: The study was based on the data collected in the Polish national PolSenior study. RESULTS: Among 4979 PolSenior participants aged 65 and over, 883 (17.8%) had previously diagnosed T2DM. Among them, 441 (49.9%) used at least one drug in pharmacological cardiovascular prevention, i.e. OAPs (mostly ASA) in 405 (45.9%) cases and OACs in 38 (4.3%). The use of these drugs significantly depended on the sex (p = 0.02) and personal income (p = 0.05). Age, place of residence and level of education did not affect the prevalence of pharmacological prevention. Previous stroke and myocardial infarction were mostly associated with OAPs, whereas a history of atrial fibrillation (AF) was related to OAC treatment. Among participants treated with OAPs, therapy was applied as secondary cardiovascular prevention in 211 (52.1%) subjects, and as primary prevention in 194 (47.9%) subjects. Among participants treated with OACs, 24 (64.9%) persons had a history of AF. Secondary cardiovascular pharmacological prevention should be considered in 45 untreated participants (12.5%), and primary cardiovascular pharmacological prevention (SCORE ≥ 10 and/or AF) in 154 participants (42.7%). CONCLUSIONS: Cardiovascular pharmacological prevention in the elderly with T2DM in Poland seems to be unsatisfactory. Educational programmes concerning current recommendations for pharmacological cardiovascular prevention should be developed among general practitioners.