[Certification of the inability to an independent existence in Social Insurance Institution]. / Orzecznictwo o niezdolnosci do samodzielnej egzystencji w Zakladzie Ubezpieczen Spolecznych.

On October 1, 2019 the Act of July 31, 2019 on supplementary benefit for persons who are unable to exist independently, commonly referred to as the "500 plus act on the disabled people", entered into force. In accordance with the will of the Legislator, pensions institutions including the Social Insurance Institution (ZUS) are the competent authority to examine applications for supplementary benefit. One of the conditions to get that benefit is having a certificate of the inability to an independent existence which is issued in ZUS by evaluating doctors and medical boards. Therefore in this article we would like to look closely at the aspects of certification of the inability to an independent existence in ZUS. From October 1, 2019 not only insured persons may apply for a certificate of the inability to an independent existence. According to the new Act supplementary benefit may be applied for by anyone who is at least 18 years old and the sum of this person's cash benefits financed from public funds other than one-offs does not exceed PLN 1,600. The answer to the question of who is incapable of independent existence can be found in the Act of 17 December 1998 on pension benefits from the Social Insurance Fund. This is the basis to issue medical opinions in ZUS.

Patient with glossopharyngeal schwannoma of cerebellopontine angle.

We present a case of a man diagnosed with a rare tumour of cerebellopontine angle-glossopharyngeal schwannoma. First symptoms started at the beginning of January 2014, patient complained of tinnitus in his right ear. He had a magnetic resonance imaging (MRI) and it revealed a tumour of cerebellopontine angle. The patient underwent a surgery in September 2014. In this case tinnitus was the only symptoms of glossopharyngeal schwannoma. After surgery patient suffered from hoarseness and mild difficulty in swallowing. After analyzing the available literature it turned out that the symptoms of this tumor are not characteristic.

Inability to live independently in the course of breast cancer: main risk factors.

INTRODUCTION: A number of articles focus on functioning in breast cancer. However, there are no papers on factors which result in the inability to live independently in the course of the disease. OBJECTIVES: This study assesses risk factors regarding the inability to live independently among individuals with breast cancer. PATIENTS AND METHODS: This study included 130 patients who displayed interest in obtaining a certificate of inability to live independently. RESULTS: Over the study period, 52% of patients did not obtain the certificate of inability to live independently (group A) and 48% did so (group B). There was only a single man in the whole cohort. Metastases were revealed in 13.4% of patients from group A and in 74.2% from group B. Patients from group A had a significantly higher score in the Barthel Index for Activities of Daily Living compared with those from group B (P <⁠0.001). In group A, only 10.6% of patients had no surgery, while in group B, 41.7%. In group B, only 16.7% of patients had breast-conserving surgery, while in group A, 51.5%. CONCLUSIONS: Information on the presence of metastases and on the type of surgery is useful in assessing the risk of being unable to live independently in patients with breast cancer. The Barthel Index for Activities of Daily Living is helpful in assessing the inability to live independently.

[Significance of biomechanical criteria in proper treatment planning in knee osteoarthritis].

Introduction: Following the established and unequivocal criteria when choosing the treatment of knee osteoarthritis, despite possibility of precise imaging, is still very problematic. This is partly because doctors of different disciplines: general practitioners, orthopaedic surgeons, rheumatologists, physiotherapists, are involved in the treatment of this disease. For most of them the basic criteria to implement the treatment are: pain and assessment of X -ray in the supine position. As a result of that, despite slight and doubtful improvement, treatment is improperly targeted and extended. The aim of the study was to prove that the correct diagnosis, including biomechanical characteristics of the affected limb, choice of correct treatment, and observance of indications, can shorten treatment, make it more efficient and less expensive. Material and methods: We analyzed of 103 patients qualified for total knee arthroplasty between 2006 and 2011. The indication was primary and advanced knee osteoarthritis in phases III and IV according to Ahlbäcka scale medial displacement of mechanical axis deviation in the lower limb with club- -foot (I to IV degrees) and with centre of rotation of angulation (CORA) in the proximal part of the tibia. Only subjects with body mass index under 25 were included in the study. Surveys were used to assess the pre -operative duration of illness, non-surgical methods of treatment and their effects. Final evaluation was made using the Visual Analogue Scale (10 -degrees) of pain (during the effort and rest) and gait efficiency 30 days after completed treatment. Results: The 66.5% of patients showed no significant improvement in all assessed parameters, which would justify to continuation of the therapy as described above.