Erectile Dysfunction as an Obesity-Related Condition in Elderly Men with Coronary Artery Disease.

Background: This cross-sectional study aimed to investigate the prevalence of erectile dysfunction (ED) in elderly men with overweight or obesity and coronary artery disease. Methods: Patients recruited in cardiac rehabilitation centers post-myocardial infarction provided demographic and anthropomorphic data. ED was assessed using the abbreviated International Index of Erectile Function 5 (IIEF-5) Questionnaire. Results: The study included 661 men with a mean age of 67.3 ± 5.57 years, a mean BMI of 27.9 ± 3.6 m/kg2, and a mean waist circumference of 98.9 ± 10.23 cm. Over 90% of men experienced ED, with similar proportions across BMI categories. The development of ED in men with a waist circumference of ≥100 cm had 3.74 times higher odds (OR 3.74; 95% CI: 1.0-13.7; p = 0.04) than in men with a waist circumference of <100 cm. Men with obesity and moderate-to-severe and severe ED were older compared to those without these disorders (67.1 ± 5.29 vs. 65.3 ± 4.35; p = 0.23). Conclusions: The prevalence of ED in men with coronary artery disease surpasses 90%. An increased body weight raises the risk of ED, with waist circumference proving to be a more reliable predictor of this risk compared to BMI. Physicians are encouraged to screen elderly patients with cardiovascular disease for ED and address obesity to enhance overall health.

Cardiovascular screening of elderly athletes.

The permanently growing interest in amateur and professional sports activities among young, middle-aged and elderly athletes raises serious concerns about athletes' health, the safety of physical training, and the sports-related risk of sudden cardiac death and other cardiovascular complications during exercise. In recent years there has been an increasing number of cases of sudden cardiac death during physical effort. At present, life expectancy in the most developed countries grows rapidly and the number of people >65 years dramatically increases. Moreover, biological age of the population is lower. Subsequently, relevant increase in the number of elderly athletes involved in various types of sports activities has been reported in many countries. It was also demonstrated that physical activity has strong beneficial effect on cognitive functions, psychomotor performance and thus exercise capacity, which is very important for the elderly people in their everyday routine activities. Nonetheless, it should be remembered that participation in amateur and professional sports activities may be associated with risk of serious cardiovascular events in the elderly athletes often suffering from various civilization diseases. It is also reported that the number of elderly people after interventional cardiology procedures, open heart surgery and cancer treatment (chemotherapy, radiotherapy), who wish to participate in various sports activities, systematically grows. The authors of the paper conduct a literature review on cardiovascular risk assessment in the elderly athletes including the contemporary cardiology diagnostic methods and diagnostic schemes to prevent sudden cardiac death and other cardiovascular events during exercise. The controversies over efficacy of particular diagnostic tools to detect cardiovascular diseases in the elderly athletes and worldwide epidemiologic data concerning risk of sudden cardiac death during physical exercise have been also presented. Here, the authors have derived suggestions for establishment of comprehensive diagnostic schemes to prevent sudden cardiac death during sports activities.

[The influence of sleep deprivation on the cognitive processes in medical students during exam session]. / Wplyw deprywacji snu na procesy poznawcze studentów medycyny w czasie sesji egzaminacyjnej.

BACKGROUND: Along with socio-economic pression increase in developed countries, the progressive shortening of night sleep has been observed. Sleep plays a vital role in human organism regeneration, and its deprivation leads to a series of adverse psychosomatic effects, including intellectual performance limitation or reducing body immunity, which increases susceptibility to diseases. Chronic sleep deprivation, quite often affecting medical students, significantly contributes to hypersomnia and leads to chronic fatigue. MATERIAL AND METHODS: The results of 60 students were analysed; students were divided into 2 subgroups, depending on the average sleep duration during previous 2-3 nights: IA (2.3±0.8 h on average) and IB (4.9±0.5 h on average). The control group consisted of 50 students, whose night sleep duration in that period was 7.5±0.62 h. In all subjects under analysis visual and auditory evoked potentials were registered, which is a non-invasive method of cognitive performance tests. RESULTS: The obtained results showed that people with average night sleep duration 2.3±0.8 h (subgroup IA) had worse rate and precision of stimulus response, and thereby significantly worse (p < 0.001) sensorimotor performance, then those from subgroup IB. The study of evoked potentials showed significant (from p < 0.04 to p < 0.001) elongation of all latency p-waves connected with the stimulus perception (N75) and attention span (P100, N135). Moreover, significant elongation of visual latency wave P100 and auditory wave V was related to psychophysical fatigue occurring in sleep deprivation. CONCLUSIONS: The analysis of this study results, obtained in medical students showed that sleep deprivation occurring during exam session is closely related to cognitive abilities, which in turn adversely affects the academic achievement. These results indicate that night sleep duration is a differentiating factor for cognitive abilities quality. Also, psychosomatic fatigue adversely affects cognitive processes. Med Pr. 2023;74(1):27-40.

Use of natural cysteine protease inhibitors in limiting SARS-Co-2 fusion into human respiratory cells.

Specific antibodies that humans acquire as a result of disease or after vaccination are needed to effectively suppress infection with a specific variant of SARS CoV-2 virus. The S protein of the D614G variant of coronavirus is used as an antigen in known vaccines to date. It is known that COVID-19 disease resulting from infection with this coronavirus can often be very dangerous to the health and lives of patients. In contrast, vaccines produce antibodies against an older version of the protein S-D614G (January 2020) and therefore have difficulty recognizing new variants of the virus. In our project we propose to obtain specific and precise antibodies by means of so-called controlled infection against specific infectious variants of the SARS-CoV-2 virus "here and now". Currently, several variants of this pathogen have already emerged that threaten the health and lives of patients. We propose to reduce this threat by partially, but not completely, blocking the fusion mechanism of the SARS-CoV-2 virus into human respiratory cells. According to our plan, this can be achieved by inhibiting cathepsin L activity in respiratory cells, after introducing natural and non-toxic cysteine protease inhibitors into this area. We obtain these inhibitors by our own method from natural, "human body friendly" natural resources. We hypothesize that blocking cathepsin L will reduce the number of infecting viruses in cells to such an extent that COVID-19 developing in infected individuals will not threaten their health and life. At the same time, the number of viruses will be sufficient for the body's own immune system to produce precise antibodies against a specific version of this pathogen.

The circadian rhythm of blood pressure in patients with panic disorder and generalized anxiety disorder.

BACKGROUND: Anxiety disorders affect blood pressure both during the day and at night. Little is known about the effect of individual anxiety disorders on the circadian rhythm of blood pressure. OBJECTIVES: The purpose of this study is to compare the nocturnal drop in blood pressure in patients with panic disorder (PD), generalized anxiety disorder (GAD), and healthy individuals. METHODS: The study was conducted on fifty consecutive outpatients with anxiety disorders and personality disorders who participated in intensive group psychotherapy. Diagnoses were made according to DSM-IV-TR criteria using the PSE-10 questionnaire. Out of 50 patients under study, 17 were diagnosed with PD and 21 with GAD. The control group consisted of 40 healthy people recruited in the course of other studies. The resulting three groups were compared in terms of circadian blood pressure using the ABPM method. RESULTS: Mean nocturnal falls in systolic and diastolic blood pressure were the following: 2% and 3% (PD), 11% and 12% (GAD), 27% and 23% (control). Four people out of PD group had higher systolic and diastolic blood pressure at night than during the day. The ratios between non-dippers/dippers were: 0/15 (PD), 8/21 (38% - GAD) and 40/40 (100% - control). CONCLUSIONS: The patients with PD were characterized by an almost flat course of circadian blood pressure. The patients with GAD had a lower mean nocturnal fall in blood pressure than the control group, but significantly higher than the patients with PD. The differences in the circadian course of blood pressure between PD and GAD are so large that the impact of these disorders should be investigated separately.

Disturbances in the intraventricular conduction system in teenagers with type 1 diabetes. A pilot study.

Body Surface Potential Mapping (BSPM) is a multi-electrode synchronous method for examining electrocardiographic records on the patients' body surface that allows the assessment of changes in the heart conduction system. The aim of the study was to visualize and evaluate changes in the intraventricular system in adolescents with T1D. PATIENTS AND METHODS: Inclusion criteria: age > 12 years, T1D duration >3 years, HbA1c >8%. EXCLUSION CRITERIA: diagnosis of autonomic neuropathy, heart structural defects, heart failure. BSPM data were processed into map plotting to illustrate differences in ventricular activation time (VAT, isochron lines). RESULTS: 33 teenagers (20 boys), mean age 15.0 ± 2.1 years, T1D from 6.8 ± 4.1 years were included. Mean HbA1c was 9.6 ± 2.0%. In the standard ECG recording abnormalities were not present. The distribution of isolines on the group-mean map plotted for T1D patients only initially resembles the course of isolines on the group-map for normal subjects (N = 30), in whom the electrical impulse stimulating the heart ventricles passes through the atrio-ventricular node, then symmetrically excites the branches of His bundle and finally the Purkinje fibers. In T1D patients, after proper onset of intraventricular stimulation, the isolines reflecting the both ventricles reach higher time values, which indicates problems in the propagation of the ventricular depolarization.

The effects of chicken egg white cystatin and proteinase inhibitor on cysteine peptidase-like activity in the sera of patients with breast cancer.

BACKGROUND: The activity of autogenic proteolytic enzymes is regulated in vivo by autogenic inhibitors. They play important roles in maintaining a balance in many processes in the human body. In pathological conditions, enzymes are overexpressed and the balance is disturbed. Such uncontrolled changes may lead to the development of local or systemic cancer. OBJECTIVES: To evaluate the effects of specific inhibitors, i.e., chicken egg white cystatin (CEWC) and proteinase inhibitor (E-64) on autogenic cysteine peptidases (CPs) in the sera of patients reporting for subsequent stages of treatment after being diagnosed with breast cancer. Cysteine peptidases play a vital role in the basic processes that are associated with cancer progression. MATERIAL AND METHODS: We selected serum samples from 108 patients with a diagnosis of breast cancer (stages IIA-IIIA) who had received no previous treatment. The blood samples were centrifuged, and the resulting serum was placed in liquid nitrogen and stored at -80°C. The biochemical tests were performed at the laboratory of the Department of Physical Chemistry and Microbiology. RESULTS: For CEWC, we found an inhibitory effect in 37 out of 108 samples; for E-64, 14 out of 22 samples displayed an inhibitory effect. In the remaining blood samples, these inhibitors caused an increase in fluorescence. In a parallel test, we added pure cathepsin B to 9 serum samples, and then used CEWC to inhibit the activity of autogenic CPs. Chicken egg white cystatin completely inhibited the cathepsin B that was added to the serum without changing its effect on the autogenic CPs. CONCLUSIONS: The results suggest that there may be a potential difference between the commercially available cathepsin B and its autogenic analogues found in the serum of cancer patients. The increase in fluorescence induced in the reaction between the inhibitors and autogenic CPs is still unexplained. There was no relationship between the observed inhibition/activation of CPs and any of the available indicators of the health of the patients examined.

Sexual health in Polish elderly men with coronary artery disease: importance, expectations, and reality.

Deterioration in overall health, hormonal disturbances, and erectile dysfunction (ED) contributes to limitations in sexual activity in the elderly, which is further limited by incorrect beliefs about the hazards of sexual activity in cardiac patients. We aimed to analyze the occurrence of ED in elderly men, their perception of the relevance of good sexual function, and their expectations of physicians. A cross-sectional study encompassed 731 patients with coronary artery disease (CAD) subjected to cardiac rehabilitation. Demographic data and data on modifiable risk factors and patient expectations were collected. ED was assessed using the IIEF-5 questionnaire. Relationships among the risk factors for ED, occurrence of ED, and patient expectations, as well as the changes in the indicators between 2012 and 2016, were analyzed. The mean age of men was 70.7 ± 5.1 years. The prevalence of ED was 93.0%. The IIEF-5 score was significantly associated with age, tobacco smoking, exercise tolerance, time to diagnosis of CAD, and treatment with calcium channel blockers and diuretics. Patients declared that sexual activity was overall important (47.9%) or very important (25.6%). Three hundred and sixty (49.3%) patients expected their physician to show interest in their sexual health, but the topic was addressed in only 12.5%. Over the past few years, we have observed an increase in the awareness and importance of sexual health as well as a significant increase in patients' expectations of physicians to show interest in their sexual health. Patients' expectations of discussing and receiving treatment for ED remain an unmet medical need.

Differences in cysteine peptidases-like activity in sera of patients with breast cancer.

BACKGROUND: The key role in carcinogenesis with destruction of the extracellular matrix is played by proteases released by invasive cancer cells. Cysteine peptidases, such as cathepsin B and L, take an important role in cancer progression and metastasis. OBJECTIVES: Cysteine peptidase-like activity (CPA) in sera of patients with breast cancer at different stages of disease and the influence of genetic predisposition associated with BRCA-1 gene mutations were analysed. METHODS: CPA in serum was determined with the spectrofluorometric technique using Z-Phe-Arg-AMC as a substrate. Determination was carried out in 111 breast cancer patients in comparison to a control group of 50 healthy subjects. RESULTS: The highest CPA was found in breast cancer patients with a hereditary predisposition bearing BRCA1 gene mutations, and the lowest activity was found in patients who had a tumour surgically removed and before adjuvant therapy. The differences in the activities between control group and cancer groups were statistically significant (p< 0.05), except from group of cancer patients in complete remission (p< 0.52). CONCLUSIONS: Serum CPA in patients with breast cancer differs depending on the cancer stage and treatment methods. Our study demonstrate the correlation between BRCA-1 gene mutations and the increased level of CPA.

Assessment of body surface potential mapping in diabetic patients with recognized depression.

OBJECTIVES: Parameters of body surface potential mapping (BSPM) in DM II patients are significantly different comparing with healthy non-diabetic subjects. Hypothesis that these changes are more pronounced in DM II patients with depression was tested in the present study. For this purpose, analysis of the relationship between the Int-QRST (isointegral) maps distribution and the depressive symptoms intensification, as well interrelation between depressive and diabetic symptoms were performed. MATERIAL AND METHODS: BSPM registrations were obtained from the three study groups (aged 37-52 years), namely 40 diabetic patients with clinically documented depression, 30 depressive patient without DM and 90 normal subjects. BSPM recordings were displayed in a form of the Int-QRST maps. Examination with BDI and HbA1c test were also performed in all investigated subjects. RESULTS: Isointegral QRST maps turned out to display abnormal, i.e. non-dipolar distribution. Moreover, extent of Int-QRST maps multipolarity increased in the examined diabetic patients along with DM II duration, BDI scores and HbA1c level. CONCLUSIONS: Non-dipolar distribution of Int-QRST maps, more pronounced in diabetic patients with depression, can be a specific indicator of the increased risk of severe ventricular arrhythmias occurring prior to abnormalities detectable on the standard 12-lead ECG recordings, which is of great importance especially in prevention of life-threatening arrhythmias.

Antipapain activity in the serum of patients with breast cancer.

BACKGROUND: Complement information about the share the role of antipapain activity in serum people with breast cancer. OBJECTIVE: We measured the activity of cysteine peptidase inhibitors in the sera of 150 patients with breast cancer. Patients were divided into four groups depending on the cancer type and treatment method. We also analysed the control group. The activity of cysteine peptidase inhibitors was defined as a 'defensiveness' marker. METHODS: The activity of cysteine peptidase inhibitors was measured against papain using the colorimetric method and the BANA substrate. RESULTS: The highest activity of enzymes was found in the group of patients with BC and hereditary predisposition to it, and the lowest activity was found in patients after surgical treatment. CONCLUSION: The activity of cysteine peptidase inhibitors in serum was measured against papain. We found that the activity levels were correlated with the cancer stage and treatment method. The lowest activity was found in patients after surgical treatment; the highest in women with active cancer and a hereditary predisposition to it.

Heart ventricular activation in VAT difference maps from children with chronic kidney disease.

Children with chronic kidney disease (CKD) are affected by cardiovascular complications, including disturbances in the intraventricular conduction system. Body surface potential mapping (BSPM) is a non-invasive method of assessing the cardioelectrical field. Our aim was to investigate conduction disturbances in young CKD patients using ventricular activation time (VAT) maps. Our study comprised 22 CKD children (mean age: 13.1 ± 2.5 years) treated conservatively and 29 control patients. For each child 12-lead electrocardiogram (ECG) readings were taken, and blood pressure and serum concentrations of iPTH, Pi, t-Ca, creatinine, Fe(+3), ferritin, and Hb, as well as eGFR were measured. All children underwent registration in the 87-lead BSPM system, and group-mean VAT maps and a difference map, which presents statistically significant differences between the groups, were created. The VAT map distribution in CKD patients revealed abnormalities specific to left anterior fascicle block. The difference map displays the areas of intergroup VAT changes, which are of discriminative value in detecting intraventricular conduction disturbances. Intraventricular conduction impairments in the left bundle branch may occur in children with CKD. BSPM enables conduction disturbances in CKD children to be detected earlier than using 12-lead ECG. The difference map derived from the group-mean isochrone maps precisely localizes the sites of disturbed conduction in the heart intraventricular conduction system.

Cognitive disorders in type 2 diabetic patients with recognized depression.

OBJECTIVES: The most important factors in the pathogenesis of cognitive disorders in diabetes mellitus (DM) are metabolic changes directly caused by hyperglycemia. Impairment of cognitive function is accompanied by a decrease in cerebral insulin. Insulin improves cognitive processes, including somatosensoric cognitive functions. Cognitive disorders are especially pronounced if diabetic patients suffer also from depression. MATERIAL AND METHODS: The evaluation of cognitive functions, especially sensomotoric skills were obtained from three study groups (aged 37-52 years): 30 healthy subjects, 40 diabetic patients with clinically documented depression and 30 depressive patients without DM. The sensomotoric skills were carried out using a SPS-2001E apparatus - a computer working stress simulator. The examination with Beck Depression Inventory (BDI) were also performed in all the investigated persons. RESULTS: Sensomotoric skills investigation revealed slight cognitive disorders in the early stages DM (subgroup IA) and its intensification according to increasing BDI scores and HbA1c blood concentration (from subgroup IA to IC). Intensification of sensomotoric cognitive disorders was significantly higher (p<0.001) in the depressive patients with DM (group I), than in these without DM (group III). CONCLUSIONS: The obtained results suggest that coincidence of aggravating factors, such as depression and metabolic disorders in DM, may cause mutual interactions leading to premature and more intense cognitive impairment. The method proposed by the authors may serve as a screening examination in early diagnosis of CNS disorders reflected by somatosensoric cognitive disorders. The presented work indicates importance of sensomotoric skills investigation for the early diagnosis of the nervous system damage related to DM.

[Evaluation of telemetric method in the assessment of heat stress of copper miners]. / Ocena przydatnosci systemu telemetrii bezprzewodowej do pomiaru obciazenia cieplnego górników w kopalniach miedzi.

BACKGROUND: The aim of this study was to assess the applicability of telemetric method in assessing heat stress of copper miners in a hot environment. MATERIAL AND METHODS: The studies were conducted in 15 mining machine operators (working without air condition). The evaluated parameters were skin temperature, core temperature, heart rate and respiration rate. RESULTS: In every examined miner we have obtained about 340 results (registrations of evaluated parameters during work shift) and this allowed us to evaluate physiological work cost and to determinate thermal homeostasis disturbances. CONCLUSIONS: The telemetric method (VitalSense System) proved to be very useful in monitoring physiological parameters of miners working in a hot environment.

[Analysis of the holter records in miners working at the deepest located work stations in copper mines of the Legnica-Glogow copper mining district]. / Wyniki analizy zapisów holterowskich u górników zatrudnionych na najglebiej polozonych stanowiskach pracy kopalni miedzi legnicko-glogowskiego okregu miedziowego.

BACKGROUND: Microclimate at mining stations consists of numerous parameters, such as air temperature, humidity, air flow velocity and rock temperature. These parameters have an impact on thermal work conditions. MATERIALS AND METHODS: The investigation was performed on 71 operators of mining machines from sections G-6 (group I) and G-11 (group II), aged 23-50 years, with mining experience of 7-25 years. One part of operators worked in air-conditioned chambers (subgroups A) and the other in chambers without air-conditioning (subgroups B). The continuous heart rate (HR) recording was taken during the whole shift. RESULTS: Average values of HR in subgroup B were significantly higher than in subgroup A, especially between 8:00 and 9:00, but the increased HR did not exceed the border line of 140 bpm. CONCLUSIONS: The results did not show significant deviation in the range of HR in operators working in unfavorable climatic conditions. They demonstrated benefits from using air-conditioned chambers to reduce effects of hot microclimate.

Brain-stem auditory evoked potentials in children and adolescents with anorexia nervosa.

OBJECTIVE: In the course of anorexia nervosa (AN), the central nervous system (CNS) undergoes both anatomic and functional changes that may cause disturbances of stimulation transmission in the sensory areas of CNS. Method of brain-stem auditory evoked potentials (BAEPs) was used in the children with AN to test the auditory pathway transmission. MATERIALS AND METHODS: The study included 37 children and adolescents, aged 10-18 years, with clinically diagnosed AN. BAEPs were recorded after a click stimulation of 75 dB intensity. Then, wave I latency (response from the auditory nerve) and inter-peak latency I-V (IPL I-V; response from the brain-stem) were analyzed. RESULTS: Abnormalities of the BAEPs recordings were noted total in 32.4% of the study patients. Predominantly (in 24.3%), a decreased transmission within the brain-stem, expressed as the IPL I-V prolongation, was observed. It was also found that the percentage of the abnormal BAEPs results and the degree of IPL I-V prolongation were increasing together with enhancing AN severity. CONCLUSIONS: IPL I-V prolongation observed in the AN children reflects a disturbed neural transmission in the brain-stem section of the auditory pathway and can be ascribed to impairments in the nerves myelin sheath.

Inhibition of cysteine peptidase activity in ascitic fluid in pancreatic cancer patients.

The work's objective is to answer the question whether there is any possibility of activity inhibition of cysteine peptidases inhibitors playing an important role in key processes accompanying cancer formation, including pancreas. There is a justified speculation that specific inhibitors of these enzymes may inhibit development of cancer processes by inhibiting their activity. In vitro studies confirmed that these enzymes in ascitic fluid were inhibited with egg whites inhibitors even to 90% of their original activity.

Interhemispheric cerebral asymmetry detected by VEPS in diabetic patients with recognized depression.

OBJECTIVES: The present study was undertaken in order to verify the hypothesis stating that patients with depression exhibit some abnormalities concerning a cerebral symmetry. For this purpose, an analysis of the relationship between the VEPs (Visual Evoked Potentials) results and the depressive symptoms intensification, as well interrelation between depressive and diabetic symptoms were performed. MATERIAL AND METHODS: VEPs recordings were obtained from the two study groups (both aged 20-45 years), 20 healthy subjects and 32 diabetic patients with clinically documented depression. The VEPs examination was carried out using a computer system called STELLA (Stimulated Electroencephalogram on Line Analyzer). RESULTS: VEPs examinations revealed a cerebral symmetry in the all control subjects and in 10 out of 32 diabetic patients with depressive disorders. It is noteworthy that 22 of 32 diabetic patients (68.8%) showed a hemispheric asymmetry in the VEPs recordings. Of 12 patients with a moderate depression, 10 showed the left cerebral laterality, and 2--the right laterality. In turn, all 10 patients with major depressive disorder (MDD) demonstrated in the VEPs recordings a significant cerebral laterality with the right hemisphere dominance. CONCLUSIONS: The obtained results suggest that interhemispheric cerebral asymmetry might be considered a specific feature of depression, and, if this is a case, it could justify a conclusion that right hemisphere dominance could be a neurophysiological marker of MDD. It should be emphasized that intensification of the depressive symptoms has an unfavorable influence on course of diabetes mellitus, its self-control and severity of following complications.

Usefulness of body surface potential mapping for early identification of the intraventricular conduction disorders in young patients with chronic kidney disease.

BACKGROUND: Cardiovascular complications are considered a significant problem in patients with chronic kidney disease (CKD). Body surface potential mapping (BSPM) is a noninvasive method that is useful in detecting early changes involving the heart. The aim of the study was to evaluate possible abnormalities within the cardiac intraventricular conduction system in young patients with CKD using the BSPM method. METHODS: Based on the BSPM registrations, the QRS-T isointegral maps were created in 42 young patients with CKD (on hemodialysis, subgroup Ia; on peritoneal dialysis, subgroup Ib; on conservative treatment, group II) and in 26 healthy subjects. Serum levels of electrolytes, urea, and creatinine were also assessed in the entire study population. RESULTS: In the healthy subjects, the maximums of the group mean QRS-T isointegral map were located in the left lower anterior part of the thorax, whereas in the Ia patients, the maximums were focused at the medial sternum line. The QRS-T maps, both for Ib and II groups, showed the positive integrals covering the left part of the anterior thorax. In all the patients with CKD, standard 12-lead electrocardiogram (ECG) and echocardiography findings were within the reference range. CONCLUSIONS: In the hemodialyzed patients with CKD, the group-mean QRS-T isointegral map distribution suggested a significant delay of excitation propagation in the left bundle branch, although no abnormalities were found with standard ECG. In the patients with CKD treated with peritoneal dialysis or conservatively, the group-mean QRS-T isointegral maps were characteristic for the early phase of conduction disturbances within the left bundle branch, which again was not observed on the standard ECG recordings.

Assessment of brainstem auditory evoked potentials (BAEPs) in patients with acromegaly.

OBJECTIVES: Acromegaly is associated by various systemic complications, involving also the nervous system. Other studies revealed peripheral but not central nervous system impairment with somatosensory evoked potentials examinations in acromegaly. Aim of the present study was to assess whether brainstem transmission in acromegaly is disturbed. MATERIAL AND METHODS: The study was carried out in 37 patients. The control group consisted of 47 healthy persons. In all of the subjects, peripheral transmission, reflected by peak I latency, and brainstem transmission, tested by interpeak latency I-V (IPL I-V), were examined. RESULTS: Peak I latency was delayed in 6 out of 37 patients (1 - bilaterally, 2 - right side, 3 - left side). The group-mean latency of peak I was 1.53 msec and 1.56 msec, for the right and left side, respectively. There were found no statistically significant differences between the right and left side, likewise in comparison with control group. In turn, as compared with the controls, IPL I-V was disturbed in 25 out of 37 patients: in most of the cases IPL I-V prolongation was observed (8 - bilateral prolongation, 11 - right side, 6 - left side). Moreover, the statistically significant difference between the brainstem sides (4.27 vs. 4.11 msec; p<0.05) was observed. CONCLUSION: In the examined patients with acromegaly, there was no peripheral disturbance in transmission, as examined by BAEPs registrations. Conversely, in nearly half of the patients with acromegaly, brainstem transmission was found to be delayed, and significant difference between responses from the both sides of the brainstem were noted.