Neurological symptoms in hospitalised patients with COVID-19 and their association with in-hospital mortality.

OBJECTIVES: To evaluate the spectrum of neurological symptoms in patients with COVID-19 during the first 14 days of hospitalisation and its association with in-hospital mortality. MATERIAL AND METHODS: We included 200 patients with RT-PCR-confirmed COVID-19 admitted to University Hospital in Krakow, Poland. In 164 patients, a detailed questionnaire concerning neurological symptoms and signs was performed prospectively within 14 days of hospitalisation. In the remaining 36 patients, such questionnaires were completed retrospectively based on daily observations in the Department of Neurology. RESULTS: During hospitalisation, 169 patients (84.5%) experienced neurological symptoms; the most common were: fatigue (62.5%), decreased mood (45.5%), myalgia (43.5%), and muscle weakness (42.5%). Patients who died during hospitalisation compared to the remainder were older (79 [70.5-88.5] vs. 63.5 [51-77] years, p = 0.001), and more often had decreased level of consciousness (50.0% vs. 9.3%, p < 0.001), delirium (33.3% vs. 4.4%, p < 0.001), arterial hypotension (50.0% vs. 19.6%, p = 0.005) or stroke during (18.8% vs. 3.3%, p = 0.026) or before hospitalisation (50.0% vs. 7.1, p < 0.001), whereas those who survived more often suffered from headache (42.1% vs. 0%, p = 0.012) or decreased mood (51.7% vs. 0%, p = 0.003). CONCLUSIONS: Most hospitalised patients with COVID-19 experience neurological symptoms. Decreased level of consciousness, delirium, arterial hypotension, and stroke during or before hospitalisation increase the risk of in-hospital mortality.

Changes in the clinical characteristics of women with gestational diabetes mellitus - a retrospective decade-long single center analysis.

AIMS: Gestational diabetes mellitus (GDM) is an emerging worldwide problem. Changes in clinical characteristics of women affected by GDM in a long-term perspective are still not properly investigated. We aimed to examine such changes over a decade in a retrospective single-center analysis. METHODS: The medical documentation from Department of Metabolic Diseases, Krakow, Poland was analyzed. We included 633 women consecutively diagnosed with GDM in one of three time intervals: 2007-2008 (N = 157), 2012-2013 (N = 272), 2016-2017 (N = 234). Statistical analyses were performed. RESULTS: Comparison of the three groups identified differences in the mean age of women at the GDM diagnosis (30.7 ± 5.0 years vs. 31.2 ± 4.7 vs. 32.5 ± 4.7, respectively, starting from the earliest 2007-2008 group), pregnancy week at GDM diagnosis (28.0 ± 5.3 wks. vs. 25.9 ± 4.9 vs. 23.4 ± 6.8), the proportion of women diagnosed before the 24th week of pregnancy (12.8% vs. 16.5% vs. 31.3%), and gestational weight gain (12.4 ± 5.0 kg vs. 10.4 ± 5.2 vs. 10.0 ± 5.7); (p = 0.001 or less for all comparisons). We also found differences for glucose values on fasting and at 2 hours with the highest (0 min) and lowest level (120 min) in the 2016-2017, respectively. Finally, a borderline difference for the weight, but not for BMI, was found (64.1 ± 14.1 kg vs. 66.2 ± 13.1 vs. 67.8 ± 15.6; p = 0.04). Differences were also identified in the post hoc analysis between cohorts. CONCLUSION: This retrospective analysis illustrates changes in characteristics of women with GDM occurring over the period of decade in Poland. They likely result from both epidemiological trends and modifications of the WHO criteria for the GDM diagnosis.

Assessment of selected food intake frequency in patients with type 1 diabetes treated with personal insulin pumps

Background: It has been established that in Type 1 Diabetes Mellitus (T1DM), regardless of the insulin therapy model used, diet and proper eating habits are still important in the treatment of the disease. The dietary intervention in these patients is aimed at maintaining proper body weight, obtaining target fasting and post meal blood glucose levels, optimizing lipid profiles. Objective: The aim of the study was to assess dietary habits in a homogeneous group of adults with T1DM treated with personal insulin pumps. Material and methods: The study included 141 adult patients (57% women) with type 1 diabetes treated with personal insulin pumps. The surveyed population was characterized by an average age of 25.8 ± 6.2 years, an average duration of diabetes 13.9 ± 6.9 years, and treatment with a personal pump for 8.2 ± 4.1 years and mean BMI 23.0 ± 2.8 g/m2. All were dwellers of south-eastern Poland. The validated KomPAN questionnaire was used to assess the frequency of consumption of individual food products. Results: The mean percentage of HbA1c in the study group was 7.3% [56 mmol/mol]. The mean total cholesterol level was 4.4 mmol/l, HDL - 1.7 mmol/l, LDL - 2.3 mmol/l and triglycerides - 0.8 mmol/l. In the multivariate regression model, no correlation was found between dietary quality parameters and metabolic compensation measured with HbA1c or lipidogram and the place of residence (village, small town, big city). However, there were differences in the quality of the diet depending on the sex. Women were characterized by higher index of a healthy diet (pHDI-10) (26.3 vs 21.4, p=0.005) and lower index of unhealthy diet (nHDI-14) (13.3 vs 18.6, p <0.001) than men. Conclusions: The results of this study clearly suggest, that despite good metabolic control, patients require more education on the choice of healthy product groups.

Tight versus less tight 1-hour postprandial glycemic target in women with gestational diabetes mellitus - a single-center cohort study.

OBJECTIVES: We aimed to assess the impact of the change of 1-hour postprandial glycemic target from < 6.7 mmol/L (120 mg/dL) to < 7.8 mmol/L (140 mg/dL) on gestational diabetes mellitus (GDM) treatment and pregnancy outcomes. MATERIAL AND METHODS: In a retrospective analysis of 1021 GDM patients from the Department of Metabolic Diseases, University Hospital in Cracow, Poland, we compared insulin therapy regimens and pregnancy outcomes between women admitted in 2014-2016 (before the change) and in 2018-2019 (after it). RESULTS: A total of 377 patients were admitted between 2014 and 2016 (TIGHT group) and 644 between 2018 and 2019 (LESS TIGHT group). Women from the LESS TIGHT group were older (32 vs 30 years, p < 0.001) and gained less weight during pregnancy (7.0 vs 9.0 kg, p < 0.001). There was no change in the frequency of any insulin therapy (51.6% vs 56.1%, p = 0.168). In the LESS TIGHT group, the basal insulin-only model was used more frequently (32.5% vs 10.2%, p < 0.001), while the prandial insulin and basal-bolus model less frequently (23.6% vs 42.6% and 21.4% vs 36.7%, p < 0.001, respectively) than in the TIGHT group. There were no differences in the frequency of cesarean sections, preterm births, Hbd of delivery, mean birth weight or prevalence of perinatal complications. CONCLUSIONS: Less tight glycemic targets in women with GDM, compared to tighter targets, were associated with less frequent use of prandial insulin, with insulin therapy often limited to basal administration. The change in glycemic targets did not affect the prevalence of adverse pregnancy outcomes, providing evidence supporting new recommendations.

Education of adult type 1 diabetes patients in a diabetes ward setting: a best practice implementation project.

INTRODUCTION AND OBJECTIVES: Type 1 diabetes is an autoimmune disease that destroys insulin-producing cells in the pancreas. Education is the cornerstone of effective diabetes care. In this implementation project, we aimed to improve compliance with best practices regarding type 1 diabetes educational interventions for adult hospitalized patients. METHODS: This project was guided by the JBI Evidence Implementation Framework. A baseline audit was conducted involving 20 nurses and 20 type 1 diabetes patients who received regular educational measures. Areas of non-compliance were identified and an improvement strategy was implemented. A follow-up audit was then conducted to evaluate the effectiveness of the improvement strategy. The project was conducted in Poland in 2021 in a tertiary referral unit that specializes in the diagnosis and treatment of diabetes. RESULTS: Substantial improvements were noted for all audit criteria after the implementation of strategies to address areas of non-compliance. Use of the education program improved from 0% to 100%. Compliance regarding patients receiving handouts and personalization of the program increased to 100%. We observed a significant improvement from 0% to 80% in the structuring of the program content. CONCLUSIONS: This project successfully improved the quality of education provided for type 1 diabetes patients in all relevant areas. We devised an education program, covering important aspects of diabetes education, with the patients reporting increased satisfaction with the personalized educational measures during their hospital stay. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A215.

Zinc Evaporation from Brass Scraps in the Atmosphere of Inert Gas.

A description of the process of metal evaporation from liquid alloys at an atmospheric pressure has a practical value for both the smelting and remelting of their scraps. The quantities of volatile components that are eliminated in these processes depend on many factors of which the type of melting device, the method and conditions of the process performance, the alloy composition and the kind of applied atmosphere are of the greatest importance. In this paper, the results of the research on zinc evaporation from brass scraps containing 10.53 wt% Zn are presented. The experiments were conducted using the thermogravimetric method at 1080 ÷ 1240 °C in a helium atmosphere. In the research, the levels of zinc removal from copper ranged between 82% and 99%. The values of the overall mass transfer coefficient for zinc kZn, determined based on the experimental data, ranged from 4.74 to 8.46 × 10-5 ms-1. The kinetic analysis showed that the rate of the analysed process was determined by mass transfer in the gas phase.

Comparison of the clinical characteristics, glycemic control, and pregnancy outcomes between women with gestational diabetes mellitus in waves I and III of the COVID-19 pandemic: a reference center report.

OBJECTIVES: The medical care of patients with gestational diabetes mellitus (GDM) during the COVID-19 pandemic was influenced by changing epidemiological conditions and government regulations. Aim - To compare the clinical pregnancy data of GDM women between waves I and III of the pandemic. MATERIAL AND METHODS: We performed a retrospective analysis of medical records from the GDM clinic and compared the periods of March-May 2020 (wave I) and March-May 2021 (wave III). RESULTS: Women with GDM during wave I (n = 119) compared to wave III (n = 116) were older (33.0 ± 4.7 vs 32.1 ± 4.8 years; p = 0.07), booked later (21.8 ± 8.4 vs 20.3 ± 8.5 weeks; p = 0.17), and had their last appointment earlier (35.5 ± 2.0 vs 35.7 ± 3.2 weeks; p < 0.01). Telemedicine consultations were used more frequently during wave I (46.8% vs 24.1%; p < 0.01), while insulin therapy was used less often (64.7% vs 80.2%; p < 0.01). Mean fasting self-measured glucose did not differ (4.8 ± 0.3 vs 4.8 ± 0.3 mmol/L; p = 0.49), but higher postprandial glucose was reported during wave I (6.6 ± 0.9 vs 6.3 ± 0.6 mmol/l; p < 0.01). Pregnancy outcome data were available for 77 wave I pregnancies and 75 wave III pregnancies. The groups were similar in terms of gestational week of delivery (38.3 ± 1.4 vs 38.1 ± 1.6 weeks), cesarean sections (58.4% vs 61.3%), APGAR scores (9.7 ± 1.0 vs 9.7 ± 1.0 pts), and birth weights (3306.6 ± 457.6 g vs 3243.9 ± 496.8 g) (p = NS for all). The mean wave I neonate length was slightly higher (54.3 ± 2.6 cm vs 53.3 ± 2.6 cm; p = 0.04). CONCLUSIONS: We identified differences between wave I and wave III pregnancies for several clinical characteristics. However, nearly all pregnancy outcomes were found to be similar.

Characteristics, Mortality, and Clinical Outcomes of Hospitalized Patients with COVID-19 and Diabetes: A Reference Single-Center Cohort Study from Poland.

Background: Diabetes is a risk factor for a severe course of COVID-19. We evaluated the characteristics and risk factors associated with undesirable outcomes in diabetic patients (DPs) hospitalized due to COVID-19. Materials and Methods: The data analysis of patients admitted between March 6, 2020, and May 31, 2021, to the University Hospital in Krakow (Poland), a reference center for COVID-19, was performed. The data were gathered from their medical records. Results: A total number of 5191 patients were included, of which 2348 (45.2%) were women. The patients were at the median age of 64 (IQR: 51-74) years, and 1364 (26.3%) were DPs. DPs, compared to nondiabetics, were older (median age: 70 years, IQR: 62-77 vs. 62, IQR: 47-72, and p < 0.001) and had a similar gender distribution. The DP group had a higher mortality rate (26.2% vs. 15.7%, p < 0.001) and longer hospital stays (median: 15 days, IQR: 10-24 vs. 13, IQR: 9-20, and p < 0.001). DPs were admitted to the ICU more frequently (15.7% vs. 11.0%, p < 0.001) and required mechanical ventilation more often (15.5% vs. 11.3%, p < 0.001). In a multivariate logistic regression, factors associated with a higher risk of death were age >65 years, glycaemia >10 mmol/L, CRP and D-dimer level, prehospital insulin and loop diuretic use, presence of heart failure, and chronic kidney disease. Factors contributing to lower mortality were in-hospital use of statin, thiazide diuretic, and calcium channel blocker. Conclusion: In this large COVID-19 cohort, DPs constituted more than a quarter of hospitalized patients. The risk of death and other outcomes compared to nondiabetics was higher in this group. We identified a number of clinical, laboratory, and therapeutic variables associated with the risk of hospital death in DPs.

Type 1 diabetes outpatient care and treatment effectiveness during COVID-19: A single-center cohort study.

PURPOSE: COVID-19 has brought many challenges for providing quality healthcare for type 1 diabetes (T1DM). We evaluated the impact of the COVID-19 pandemic on the medical care, glycemic control, and selected outcomes in T1DM patients. METHODS: We retrospectively analyzed medical records from 357 T1DM adults enrolled in the Program of Comprehensive Outpatient Specialist Care at the University Hospital in Krakow, and assessed differences in patient data from before the COVID-19 period (March 2019-February 2020) and after it started COVID-19 (March 2020-February 2021). RESULTS: The median HbA1c levels and the percentage of patients within the HbA1c target of <7 % (53 mmol/mol) were similar in both periods: before and after the beginning of the pandemic (6.86 % [51.5 mmol/mol], IQR 6.23-7.58 % [44.6-59.3 mmol/mol] vs. 6.9 % [51.9 mmol/mol], IQR 6.2-7.61 % [44.3-59.7 mmol/mol]; p = 0.50 and 56.3 % vs. 57.1 %, p = 0.42, respectively). However, we observed a rise in BMI and body weight (median 24.25, IQR 21.97-27.05 vs. 24.82, IQR 22.17-27.87 and median weight 71.0 IQR 61-82 vs. 72.55, IQR 55-85; p < 0.001 for both comparisons). There was no reduction in the numbers of total diabetes-related visits (median 4, IQR 4-5 vs. 5, IQR 4-5; p = 0.065), but the frequency of other specialist consultations decreased (2, IQR 0-2 vs. 1, IQR 0-2). During the pandemic, telehealth visits constituted of 1191 out of 1609 (71.6 %) total visits. CONCLUSIONS: In this single-center observation, the COVID-19 pandemic did not have a negative impact on glycemic control in T1DM patients, but the patients' weight did increase. Telemedicine proved to be a valuable tool for T1DM care.

The supramolecular architecture of tris(naphthalene-1,5-diaminium) bis(5-aminonaphthalen-1-aminium) octakis[hydrogen (5-carboxypyridin-3-yl)phosphonate].

The asymmetric unit of the title compound, 3C(10)H(12)N(2)(2+)·2C(10)H(11)N(2)(+)·8C(6)H(5)NO(5)P(-), contains one and a half naphthalene-1,5-diaminium cations, in which the half-molecule has inversion symmetry, one 5-aminonaphthalen-1-aminium cation and four hydrogen (5-carboxypyridin-3-yl)phosphonate anions. The crystal structure is layered and consists of hydrogen-bonded anionic monolayers between which the cations are arranged. The acid monoanions are organized into one-dimensional chains along the [101] direction via hydrogen bonds established between the phosphonate sites. (C)O-H···N(py) hydrogen bonds (py is pyridine) crosslink the chains to form an undulating (010) monolayer. The cations serve both to balance the charge of the anionic network and to connect neighbouring layers via multiple hydrogen bonds to form a three-dimensional supramolecular architecture.

Poly[aqua[µ3-(pyridin-1-ium-3,5-diyl)diphosphonato-κ3O:O':O''][µ2-(pyridin-1-ium-3,5-diyl)diphosphonato-κ2O:O']calcium(II)].

The rigid organic ligand (pyridine-3,5-diyl)diphosphonic acid has been used to create the title novel three-dimensional coordination polymer, [Ca(C(5)H(6)NO(6)P(2))(2)(H(2)O)](n). The six-coordinate calcium ion is in a distorted octahedral environment, formed by five phosphonate O atoms from five different (pyridin-1-ium-3,5-diyl)diphosphonate ligands, two of which are unique, and one water O atom. Two crystallographically independent acid monoanions, L1 and L2, serve to link metal centres using two different coordination modes, viz. η(2)µ(2) and η(3)µ(3), respectively. The latter ligand, L2, forms a strongly undulated two-dimensional framework parallel to the crystallographic bc plane, whereas the former ligand, L1, is utilized in the formation of one-dimensional helical chains in the [010] direction. The two sublattices of L1 and L2 interweave at the Ca(2+) ions to form a three-dimensional framework. In addition, multiple O-H···O and N-H···O hydrogen bonds stabilize the three-dimensional coordination network. Topologically, the three-dimensional framework can be simplified as a very unusual (2,3,5)-connected three-nodal net represented by the Schläfli symbol (4·8(2))(4·8(8)·10)(8).

[The awareness of addictive effect of nicotine --a questionnaire survey of students and employees of CM UMK]. / Swiadomosc uzalezniajacego dzialania nikotyny--badania ankietowe studentów i pracowników CM UMK.

Tobacco is one of the main factors responsible for the development of human tumors, cardiovascular diseases and non-malignant respiratory diseases. Tobacco products are harmful to health and they contain nicotine, which is highly addictive. Many studies in humans and in animal models have shown that nicotine is addictive psychoactive drug, which triggers a cascade of neurobiological events in the brain reward centers leading to the intensity of behavior what aims to enhanced use of tobacco. In Poland the number of smokers is estimated at about 9.5 million people. Among active smokers is a significant number of medical students. 480 people have joined the study (253 women and 227 men): 416 student of Collegium Medicum in Bydgoszcz of Nicolaus Copernicus University in Torun (CM UMK), 59 students of biomedical engineering at the University of Technology and Life Sciences in Bydgoszcz and 5 employees of CM UMK. 13% of all respondents admitted to smoking cigarettes. Respondents students and university staff mainly responded affirmatively to the question about psychoactive addiction by smoking-Performed questionnaire also revealed a high awareness about the use of nicotine during smoking cessation. Most people had their first contact with tobacco smoke in the early years of life, meeting with tobacco smoke in the home and in school. A much smaller percentage of the students met for the first time to tobacco smoke in the later stages of education: high school and college. Even fewer respondents had their first encounter with tobacco smoke in the workplace. In summary, we can conclude that students and workers CM UMK show considerable awareness of the dangers of smoking and the addictive properties of tobacco smoke.

[The awareness of carcinogenic effect of tobacco smoke--a questionnaire survey of students and employees of Collegium Medicum of Nicolaus Copernicus University]. / Swiadomosc rakotwórczego dzialania dymu tytoniowego--badania ankietowe studentów i pracowników CM UMK.

Smoking is currently the most significant risk factor for health according to WHO statements. It has been proven that smoking is the cause of many diseases, for example cardiovascular and respiratory tract diseases as well as impaired fertility and decreased immunity. The adverse effects of cigarette smoking on pregnancy and health of children were also proved. However, special attention is laid on impact of smoking on the development of cancer. In tobacco smoke there are over 4,000 different chemical substances and compounds, of which more than 50 are carcinogens. The present study was aimed to assess the knowledge of students and employees of Collegium Medicum of Nicolaus Copernicus University in Torun (CM UMK), first on number and types of carcinogens contained in tobacco smoke and secondly on types of diseases caused by smoking. There were 480 responders included to the study(253 women and 227 men). Among them there were 416 students of CM UMK, 59 students of biomedical engineering at the University of Technology and Life Sciences in Bydgoszcz and 5 employees of CM UMK. Among the respondents there was considerable ignorance about the number of carcinogens contained in tobacco smoke with over 50% of them indicating the incorrect answer. Among the carcinogens there were mentioned mostly tar and nicotine, and among the diseases caused by tobacco smoke most often pointed response there were lung and larynx cancer and heart and blood vessels diseases and to reduce the weight of newborns. In summary, we can conclude that the awareness of students and employees of CM UMK about the carcinogenic properties of tobacco smoke was not sufficient. Respondents were aware of the dangers of smoking, they knew the basic carcinogenic substances and pointed a few diseases caused by smoking cigarettes. Unfortunately their knowledge does not refer to a number of diseases which in common believe are not connected to cigarette smoking, but in fact tobacco smoke is very important for their development.

Hexaaquacobalt(II) bis[hydrogen bis(4-carboxyphenylphosphonate)] dihydrate.

The Co(II) ion in the title complex salt, [Co(H(2)O)(6)](C(14)H(13)O(10)P(2))(2)·2H(2)O or [Co(H(2)O)(6)][H(C(7)H(6)O(5)P)(2)]·2H(2)O, resides on an inversion centre and exhibits an octahedral environment formed by six aqua ligands. Two unique acid residues share an H atom between their phosphonate groups, forming a complex monoanion with a very short (P)O···H···O(P) hydrogen bond of 2.435 (2) Å. The crystal structure is layered and consists of thick organic bilayers with hydrated metal [Co(H(2)O)(6)](2+) ions arranged between them. The interior of the bilayer is occupied by the aromatic portions of the complex monoanions and the carboxyl groups, which form hydrogen-bonded R(2)(2)(8) ring motifs. The phosphonate groups are arranged outwards in order to form the hydrogen-bonded surfaces of the bilayer. Electrostatic and multiple hydrogen-bond interactions, established between the coordination and solvent water molecules and the phosphonate O atoms, hold neighbouring bilayers together.

Diabetes Management Delivery and Pregnancy Outcomes in Women with Gestational Diabetes Mellitus during the First Wave of the 2020 COVID-19 Pandemic: A Single-Reference Center Report.

OBJECTIVES: The COVID-19 pandemic has forced a rapid adaptation of healthcare services to secure care for many patient groups. This includes women with gestational diabetes mellitus (GDM). We evaluated the impacts of the first COVID-19 wave on parameters such as the GDM treatment, glycemic control, and pregnancy outcomes. METHODS: In this retrospective study from a reference diabetes center (Krakow, Poland), we compared patient data from two different time periods: the first wave of the COVID-19 pandemic (March 2020-June 2020) and the preceding five months (October 2019-February 2020). Data was collected from the medical records and telephone surveys. RESULTS: We included 155 consecutive women (group N1 = 73 and group N2 = 82 from the COVID-19 pandemic period and non-COVID-19 period, respectively). During the COVID-19 pandemic, almost half of all GDM women (N1 = 36, 49.3%) used telemedicine as a method of contacting their diabetic specialists while this tool was not utilized in the earlier period. Moreover, these patients reported difficulties in performing blood glucose self-control more often (N1 = 20, 27.4%, vs N2 = 7, 8.5%; p ≤ 0.01) and spent less time on diabetes education than the control group on average (N1 = 39, 53.4%, vs N2 = 9, 9.8% below 2 hours of training; p ≤ 0.01). Most analyzed glycemic parameters and pregnancy outcomes were similar. Differences were found with respect to the incidence of prolonged labor (N1 = 12, 16.4%, vs N2 = 3, 3.7%; p ≤ 0.01) and preeclampsia (N1 = 0 vs N2 = 7, 8.5%; p = 0.01). CONCLUSION: In this single-center observational study, the first wave of the COVID-19 pandemic did not seem to have a negative impact on pregnancy outcomes in GDM women, despite the difficulties in diabetes management delivery.

Speech intelligibility in cerebral palsy children attending an art therapy program.

BACKGROUND: Dysarthia is a common sequela of cerebral palsy (CP), directly affecting both the intelligibility of speech and the child's psycho-social adjustment. Speech therapy focused exclusively on the articulatory organs does not always help CP children to speak more intelligibly. The program of art therapy described here has proven to be helpful for these children. MATERIAL/METHODS: From among all the CP children enrolled in our art therapy program from 2005 to 2009, we selected a group of 14 boys and girls (average age 15.3) with severe dysarthria at baseline but no other language or cognitive disturbances. Our retrospective study was based on results from the Auditory Dysarthria Scale and neuropsychological tests for fluency, administered routinely over the 4 months of art therapy. RESULTS: All 14 children in the study group showed some degree of improvement after art therapy in all tested parameters. On the Auditory Dysarthia Scale, highly significant improvements were noted in overall intelligibility (p<0.0001), with significant improvement (p<0.001) in volume, tempo, and control of pauses. The least improvement was noted in the most purely motor parameters. All 14 children also exhibited significant improvement in fluency. CONCLUSIONS: Art therapy improves the intelligibility of speech in children with cerebral palsy, even when language functions are not as such the object of therapeutic intervention.

Rehabilitation of an artist after right-hemisphere stroke.

BACKGROUND: Traditionally, in both medicine and neuropsychology, symptoms are defined as significant deviations in a given parameter from a "physiological" norm largely based on statistical studies of large populations. Thus the goal of rehabilitation is to bring the patient's performance within the bounds of acceptable variation from the norm, and this is what defines a good outcome. Although this model seems reasonable for "average" patients, in the case of "exceptional" patients an "average" outcome may not be acceptable. CASE REPORT: The present study describes the symptoms and successful rehabilitation of a prominent Polish artist, who was referred for rehabilitation after a right hemisphere stroke, and whose chief subjective complaint was the loss of artistic vision. The patient (female, ambidextrous) suffered an RH stroke at the age of 61. In traditional rehabilitation many symptoms resolved and others were well compensated, but the patient continued to complain that she had a "hole" in her brain and could not paint. A special program of rehabilitation was designed for her, based on art therapy, but including many unique elements, using a microgenetic, "bottom-up" approach to energize creativity and bypass obstacles. Ultimately the patient was able to resume her artistic career, thanks to the heuristic, holistic approach to therapy. CONCLUSIONS: The case described here raises a number of theoretical questions about art, imagination, and creativity in the brain, and the goals of rehabilitation in the case of talented and gifted individuals.

Neuropsychological diagnosis and treatment after closed-head injury in a patient with a psychiatric history of schizophrenia.

BACKGROUND: Despite recent interest in the brain/mind problem and possible organic correlates of mental disease, relatively few case studies have examined the problem concretely. The present paper describes a 66-year-old male patient with a long history of schizophrenia, whose psychotic symptoms displayed qualitative and quantitative changes after a closed-head injury. CASE REPORT: After a very disturbed childhood and youth, including several jail terms, the patient was diagnosed with schizophrenia in the early 1960s and frequently thereafter hospitalized. Visual hallucinations were the dominant symptom, and art therapy provided some relief, which led to a successful artistic career. In 1989, while actively hallucinating, he suffered a mild TBI in a pedestrian accident. Despite findings of organic dysfunction, he did not receive full neuropsychological diagnosis and treatment until four years later, when he presented with symptoms of perseveration, hemispatial neglect, and disturbances of working memory. The patient then received an individual program of neuropsychological rehabilitation, while his treating psychiatrist gradually withdrew psychotropic medication. After a year of therapy there was marked improvement of both neuropsychological and psychiatric symptoms. At the same time, he began to paint in a completely different style. CONCLUSIONS: The case described here shows that the pathomechanisms of schizophrenia and neurobehavioral disturbances resulting from organic brain damage are not after all unrelated. Microgenetic theory can provide a basis for explaining the course of symptoms in this and similar cases, as we re-think the brain-mind relationship.

Miniaturized Temperature-Controlled Planar Chromatography (Micro-TLC) as a Versatile Technique for Fast Screening of Micropollutants and Biomarkers Derived from Surface Water Ecosystems and During Technological Processes of Wastewater Treatment.

There is increasing interest in the development of simple analytical systems enabling the fast screening of target components in complex samples. A number of newly invented protocols are based on quasi separation techniques involving microfluidic paper-based analytical devices and/or micro total analysis systems. Under such conditions, the quantification of target components can be performed mainly due to selective detection. The main goal of this paper is to demonstrate that miniaturized planar chromatography has the capability to work as an efficient separation and quantification tool for the analysis of multiple targets within complex environmental samples isolated and concentrated using an optimized SPE method. In particular, we analyzed various samples collected from surface water ecosystems (lakes, rivers, and the Baltic Sea of Middle Pomerania in the northern part of Poland) in different seasons, as well as samples collected during key wastewater technological processes (originating from the "Jamno" wastewater treatment plant in Koszalin, Poland). We documented that the multiple detection of chromatographic spots on RP-18W microplates-under visible light, fluorescence, and fluorescence quenching conditions, and using the visualization reagent phosphomolybdic acid-enables fast and robust sample classification. The presented data reveal that the proposed micro-TLC system is useful, inexpensive, and can be considered as a complementary method for the fast control of treated sewage water discharged by a municipal wastewater treatment plant, particularly for the detection of low-molecular mass micropollutants with polarity ranging from estetrol to progesterone, as well as chlorophyll-related dyes. Due to the low consumption of mobile phases composed of water-alcohol binary mixtures (less than 1 mL/run for the simultaneous separation of up to nine samples), this method can be considered an environmentally friendly and green chemistry analytical tool. The described analytical protocol can be complementary to those involving classical column chromatography (HPLC) or various planar microfluidic devices.

Phenotype Heterogeneity in Glucokinase-Maturity-Onset Diabetes of the Young (GCK-MODY) Patients.

OBJECTIVE: The aim of the study was to evaluate the clinical phenotypes of glucokinase-maturity-onset diabetes of the young (GCK-MODY) pediatric patients from Southwest Poland and to search for phenotype-genotype correlations. METHODS: We conducted a retrospective analysis of data on 37 CGK-MODY patients consisting of 21 girls and 16 boys of ages 1.9-20.1 (mean 12.5±5.2) years, treated in our centre in the time period between 2002 and 2013. RESULTS: GCK-MODY carriers were found in a frequency of 3% among 1043 diabetes mellitus (DM) patients and constituted the second most numerous group of DM patients, following type 1 DM, in our centre. The mean age of GCK-MODY diagnosis was 10.4±4.5 years. The findings leading to the diagnosis were impaired fasting glucose (IFG) (15/37), symptoms of hyperglycemia (4/37), and a GCK-MODY family history (18/37). Mean fasting blood glucose level was 6.67±1.64 mmol/L. In the sample, there were patients with normal values (4/37), those with DM (10/37), and IFG (23/37). In OGTT, 120 min glucose level was normal in 8, diabetic in 2, and characteristic for glucose intolerance in 27 of the 37 cases. Twelve of the 37 cases (32%) were identified as GCK-MODY carriers. In the total group, mean C-peptide level was 2.13±0.65 ng/mL and HbA1c was 6.26±0.45% (44.9±-18 mmol/mol). Thirty-two patients had a family history of DM. DM autoantibodies were detected in two patients. The most common mutations were p.Gly318Arg (11/37) and p.Val302Leu (8/37). There was no correlation between type of mutations and plasma glucose levels. CONCLUSION: The phenotype of GCK-MODY patients may vary from those characteristic for other DM types to an asymptomatic state with normal FG with no correlation with genotype.