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1.
Neurol Res ; 42(6): 471-476, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32241245

RESUMO

Aim of the Study: Cardioembolic stroke accounts for approximately 15-25% of ischemic strokes and is characterized by a poor prognosis. Atrial fibrillation (AF) is more commonly diagnosed in the elderly.The aim of the study was the assessment of the manifestations of AF in patients hospitalized due to cerebral stroke, with particular attention paid to newly diagnosed AF.Methods: A retrospective analysis was performed on 998 cerebral stroke patients. The data were analyzed for sex, age, cerebral stroke risk factors, drugs, NIHSS, RANKIN scores and ECG recordings on admission and at discharge.Results: The mean age of disease onset was 73 ± 16 years. Women accounted for 50.8% of patients. AF prior to hospital admission was diagnosed in 20.1% of patients, while de novo AF in 26.3% of patients during hospitalization. Hypercholesterolemia, hypertriglyceridemia and smoking were more commonly reported in ischemic stroke patients without AF compared to patients with ischemic stroke and AF. Ischemic heart disease, more frequent deaths, and a worse prognosis were more frequently observed in patients with ischemic stroke and AF compared to patients without AF. The first manifestation of AF in 25% of stroke patients was related to the period of the first 10 days of hospitalization.Discussion: The above data should prompt neurologists, cardiologists and family doctors to try to detect AF as a risk factor for ischemic stroke which worsens patient prognosis, prolongs hospital stay and contributes to increase in mortality, especially when more effective drug treatment is currently possible.

2.
Neurol Neurochir Pol ; 54(2): 161-168, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32219813

RESUMO

AIM OF STUDY: The aim of this study was to collect and analyse data on relapsing-remitting multiple sclerosis (RRMS) patients receiving disease-modifying therapies (DMTs) in Poland. MATERIAL AND METHODS: This observational, multicentre study with prospective data collection included RRMS patients receiving DMTs reimbursed by the National Health Fund (NFZ) in Poland, monitored by the Therapeutic Programme Monitoring System (SMPT). Demographic profiles, disability status, and treatment modalities were analysed. RESULTS: Data from 11,632 RRMS patients was collected (from 15,368 new prescriptions), including 10,649 patients in the first-line and 983 in the second-line therapeutic programme of DMTs. The proportion of females to males was 2.39 in the first-line and 1.91 in the second-line. The mean age at DMTs start was 36.6 years in the first-line and 35.1 in the second-line. The median time from the first symptoms to MS diagnosis was 7.4 months, and from MS diagnosis to treatment it was 18.48 months. A total of 43.4% of MS patients started DMT during the 12 months following diagnosis. There was a positive correlation between the duration from MS diagnosis to the start of DMT and a higher initial EDSS value [correlation 0.296 (p < 0.001)]. About 10% of patients stopped DMTs. In Poland, about one third of all MS patients are treated in both lines, and the choice of first-line treatment depends on the region of the country. CONCLUSIONS: In Poland there is a need to increase MS patient access to DMTs by improving the organisation of drug programmes.

3.
Neurol Res ; 42(5): 430-438, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32156200

RESUMO

Objective: To determine the time of dementia diagnosis, symptom intensity and to assess the comorbidities.Methods: 110 patients with dementia or mild cognitive impairment were enrolled in this retrospective study. The study group was divided into subgroups: patients with a maximum of three (S ≤ 3 n = 62) and four or more symptoms (S ≥ 4 n = 48). Baseline characteristics, disease duration and the number of comorbidities were analyzed.Results: The median time from the first symptoms to diagnosis [months] (FS-D) was 12.0, while from diagnosis to enrollment (D-E) was 42.66. The median time from D-E was significantly longer in S ≥ 4 and significant correlation was observed between the median time from D-E and number of symptoms [n] (R = 0.3240, p < 0.05). Significantly more patients were newly diagnosed with AF [%] [14.58 vs. 3.23, p = 0.032], Parkinson's disease [29.17 vs. 8.06, p = 0.004] and depression [31.25 vs. 6.45, p = 0.001] in S ≥ 4 compared to S ≤ 3, respectively. Conclusions: A considerable delay in the diagnosis of dementia was confirmed. Clinical features were associated with the disease duration and the severity of symptoms. Appropriate diagnosis of AF in patients with dementia is of great importance.

4.
Neurol Neurochir Pol ; 54(2): 125-137, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32083716

RESUMO

INTRODUCTION: Multiple sclerosis (MS) is the most common non-traumatic neurological cause of disability in young adults, affecting women 1-3 times more often than men. Several specific challenges arise from the fact that young women diagnosed with MS often have to make decisions related to treatment and family planning at the same time. These issues are connected with fertility, the impact of pregnancy on disease course, the choice of pregnancy timing, and the optimal mode of disease-modifying therapy in the context of a planned pregnancy, contraception, urological complaints, and sexual dysfunction. STATE OF THE ART: While MS does not in itself adversely affect fertility, pregnancy or childbirth, pregnancy needs to be carefully planned. This requires the interdisciplinary co-operation of a neurologist, gynaecologist and psychologist. Data on the impact of disease-modifying drugs on foetal development are very limited, and none of these drugs is 100% safe during pregnancy. In the second and third trimesters, MS relapse rate decreases. Unfortunately, it increases within the first 3-6 months after delivery. Adequate disease control should be achieved before pregnancy, as relapse rate in the period of two years preceding pregnancy is one of the strongest predictive factors for post-partum relapses. CLINICAL IMPLICATIONS: The following is a statement by a working group of experts in neurology, gynaecology, obstetrics and urology, convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society, addressing the issues that are specific to the female MS population. The aim of this statement is to provide guidance in pregnancy planning and disease management, both during pregnancy and post-partum. FUTURE DIRECTIONS: This statement reflects expert opinion and is not intended to be read as guidelines. It rather provides up-to-date information on how to optimise care of female MS patients of childbearing age.

5.
Neurol Res ; 42(1): 1-7, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31679480

RESUMO

According to recent reports, malnutrition may be associated with a worse prognosis in stroke patients. The aim of this study was to determine the nutritional status of stroke patients and its impact on neurological and functional status of patients in the early post-stroke period. Our prospective study included a total of 128 patients admitted to the Stroke Unit. The assessment was made in the patients within the first week after the onset of stroke symptoms. Groups of patients with abnormal body mass index (BMI <20kg/m2 or >25kg/m2) were compared to the group of normal BMI, serum albumin, total cholesterol, HDL and LDL levels were determined in each patient within 24h following admission. The analysis showed that the patients with lower levels of serum albumin and triglycerides had higher scores in the National Institutes of Health Stroke Scale (NIHSS) on admission. Patients with a higher risk of malnutrition, confirmed by the Subjective Global Assessment scale, had higher NIHSS scores. The study showed a positive relationship between the nutritional status and worse neurological status of patients in the early post-stroke period.Abbreviation: NIHSS; Rankin scale.

6.
PLoS One ; 14(10): e0223863, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31647829

RESUMO

OBJECTIVE: The aim of the study was to assess the effectiveness of disease-modifying therapies (DMTs) in relapsing-remitting multiple sclerosis (RRMS) patients treated in MS centres in Poland. METHODS: Demographic and clinical data of all Polish RRMS patients receiving DMTs were prospectively collected from 2014 to 2018 in electronic files using the Therapeutic Program Monitoring System (SMPT). RESULTS: The study included 10,764 RRMS patients treated with DMTs in first-line and 1,042 in second-line programmes. IFNß more effectively lengthened the times to the first relapse, disability progression, and brain MRI activity than GA. After 2 and 4 years of follow-up, more patients on IFNß showed no evidence of disease activity (NEDA-3) in comparison to GA (66.3% and 44.3% vs 55.2% and 33.2%, respectively; p<0.001). NAT more effectively reduced brain MRI activity than FTY (p = 0.001). More patients under NAT had NEDA-3 after 2 and 4 years of follow-up compared to FTY (66.2% and 42.1% vs 52.1% and 29.5%, respectively; p = 0.03). In adjusted analysis, a higher baseline Expanded Disability Status Score (EDSS) was a predictor of relapse (p<0.001) and NEDA-3 failure (p = 0.003). CONCLUSION: IFNß compared to GA and NAT compared to FTY more effectively reduced disease activity in a Polish population of RRMS patients.


Assuntos
Cloridrato de Fingolimode/uso terapêutico , Acetato de Glatiramer/uso terapêutico , Interferon beta/uso terapêutico , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Natalizumab/uso terapêutico , Adulto , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Fatores Imunológicos/uso terapêutico , Imunossupressores/uso terapêutico , Masculino , Esclerose Múltipla Recidivante-Remitente/epidemiologia , Esclerose Múltipla Recidivante-Remitente/patologia , Polônia/epidemiologia , Prognóstico , Estudos Prospectivos , Taxa de Sobrevida
7.
Pol J Radiol ; 84: e80-e85, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31019599

RESUMO

Purpose: Leukoaraiosis (LA), according to the latest classification, is white matter hyperintensity - morphological findings of small blood vessel disease of the brain. This radiological detection of small vessels disease is important because there are no technical possibilities to assess small vessels of the brain using computed tomography (CT) or magnetic resonance imaging (MRI) angiography. Our aim was to analysis the relationship between the extension of leukoaraiosis and severity of ischaemic stroke and brain atrophy. Material and methods: We retrospectively analysed 77 head CT scans of patients admitted from the emergency room (ER) to the Radiology Department due to suspected stroke. We assessed the severity of leukoaraiosis using the van Swieten scale and brain atrophy by numerous linear measurements. Results: Statistical analysis failed to demonstrate differences between LA1 and LA2 groups with regard to stroke severity in National Institutes of Health Stroke Scale (NIHSS) (p = 0.2159). There were no differences with regard to clinical severity of stroke between the study groups divided depending on the extent of brain atrophy. There were statistically significant differences with regard to the anterior horn width of the right and left lateral ventricle, posterior horn width of the right and left lateral ventricle, distance between occipital horn of the left lateral ventricle and internal surface of the cranium and third ventricle width depending on the severity of leukoaraiosis. Conclusions: The results of our studies present an association between the degree leukoaraiosis extension and brain atrophy, but no association between central nervous system tissue atrophy of extent of leukoaraiosis and ischaemic stroke severity.

8.
Neurol Neurochir Pol ; 53(2): 131-137, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30855704

RESUMO

BACKGROUND: Prospective database studies can provide useful information regarding 'real-world' outcomes and drug efficacy. OBJECTIVE: To determine the early predictors of suboptimal treatment responses at two and three years under injectable Disease Modifying Therapy (DMT). METHODS: This was a multi-centre prospective database study. Adult patients who started injectable DMTs between January 2008 and June 2013 were included. The follow-up continued until July 2014. Suboptimal treatment responses were defined as: the presence of clinical relapse and/or Expanded Disability Status Score (EDSS) progression and/or newly emerging T2 lesions or/and gadolinium enhancing lesions on magnetic resonance imaging (MRI). The parameters were assessed up to 24 months prior to, and every 12 months during, the treatment. RESULTS: Analysis included 297 MS (multiple sclerosis) patients followed for a mean time of 2.3 ± 1.3 years (range 1-5). Within the three years of observation, the persistence and efficacy with injectable DMTs was high. With increased disability, defined by EDSS ≥ 3, the risk of treatment failure increased up to seven times, OR 7.33 in the second year radiological analysis (CI 95% : 1.69-29.2) p < 0.01, similar to over two times in the second year clinical analysis, with the baseline symptomatic hemiparesis OR 2.75 (CI 95% : 1.06-7.06) p 0.034. A high relapse rate one year prior to treatment adversely influenced the treatment success at three years, OR 3.04 (CI 95% : 1.49-8.43) p < 0.01. CONCLUSIONS: Injectable DMTs should not be chosen for treatment initiation in motoric disabled patients (EDSS ≥ 3) with a high grade of clinical activity. These drugs are effective in less active relapsing-remitting (RR) MS patients.


Assuntos
Esclerose Múltipla , Avaliação da Deficiência , Progressão da Doença , Humanos , Polônia , Estudos Prospectivos
9.
Wiad Lek ; 72(10): 1995-2004, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31982612

RESUMO

Sporadic Creutzfeldt-Jakob disease (sCJD) is the most common spongiform encephalopathy caused by protein infectious agents called prions. Despite the lack of known treatment which would cure or at least slow down the progression of the disease, its proper diagnosis is extremely important, because of the large group of diseases that may imitate its course and for which a causal / symptomatic treatment has already been developed. The main problem that prevents the differential diagnosis is the lack of a commonly available and non-invasive procedure for antemortem finding the pathological PrPSc protein in a patient's nervous system. In addition, the current WHO criteria are outdated and need to be updated due to the emergence of new diagnostic methods since their publication. The aim of this study is to collect the latest trends in the diagnosis of sporadic Creutzfeldt-Jakob disease, to draw attention to the need for careful differential diagnosis in patients with suspected sporadic Creutzfeldt-Jakob disease, and to verify the current criteria for its diagnosis and update.


Assuntos
Síndrome de Creutzfeldt-Jakob , Encéfalo , Diagnóstico Diferencial , Humanos
10.
Free Radic Res ; 52(10): 1083-1093, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30326767

RESUMO

So far little has been known about antioxidant properties of immunomodulatory drugs. The aim of the study was to evaluate the antioxidant status in serum of relapsing-remitting multiple sclerosis (RRMS) patients treated with II-line immunomodulatory therapy compared to de novo diagnosed patients, subjects treated with interferon (IFN) beta and healthy controls. We analyzed the relationships depending on the gender, age, disease duration, the Expanded Disability Status Scale, the annualised relapse rate, and MRI lesions in patients treated with II-line. One hundred and twenty one RRMS patients were enrolled in the prospective study. Patients were divided into the following groups: de novo, IFN, fingolimod (FG), natalizumab (NT), and the control. The total antioxidant capacity, sulfhydryl groups (SH groups, PSH groups), ceruloplasmin, and superoxide dismutase (SOD) activity were determined in serum. NT and FG groups presented with lower SOD activity compared to controls. The levels of antioxidants in NT- and FG-treated patients were not different from the IFN group. Antioxidant parameters increased with disease duration in the FG group. FG and NT could have an effect on the antioxidant system in multiple sclerosis (MS) patients. The results of this study propose a novel aspect of antioxidative properties of II-line immunomodulatory therapy in MS.


Assuntos
Antioxidantes/uso terapêutico , Imunomodulação/imunologia , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Esclerose Múltipla Recidivante-Remitente/imunologia , Adulto , Antioxidantes/farmacologia , Feminino , Humanos , Masculino , Esclerose Múltipla Recidivante-Remitente/patologia
11.
Ther Clin Risk Manag ; 14: 1515-1525, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30214215

RESUMO

Objective: Myasthenia gravis (MG) is a disease with autoimmune etiology. The main pathomechanism is related to the production of antibodies against nicotinic acetylcholine receptor. The present study is aimed to compare the serum level of adipokines in patients with MG with that in controls, as well as to study the relation of these levels with disease severity. Patients and methods: Fifty patients with MG and 30 healthy individuals were enrolled in our study. Serum concentrations of select adipokines, namely adiponectin, leptin, omentin, visfatin, and resistin were measured. Results: The results showed a significant increase in serum concentrations of adiponectin and resistin in the patients with MG compared with the controls. Conclusion: Further studies are warranted to assess changes in adipokine concentration levels in patients with MG.

12.
Biomed Res Int ; 2018: 9329123, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30211230

RESUMO

Background: In addition to the widely known effect of vitamin D3 (vitD3) on the skeleton, its role in the regulation of the immune response was also confirmed. Aim: The assessment of biochemical and densitometric markers of calcium-phosphate metabolism in the groups of patients with relapsing-remitting multiple sclerosis (RRMS) selected due to the serum level of vitamin D3. Methods: The concentrations of biochemical markers and indices of lumbar spine bone densitometry (DXA) were determined in 82 patients divided into vitamin D3 deficiency (VitDd), insufficiency (VitDi), and normal vitamin D3 level (VitDn) subgroups. Results: The highest level of the parathyroid hormone (PTH) and the highest prevalence of hypophosphatemia and osteopenia were demonstrated in VitDd group compared to VitDi and VitDn. However, in VitDd, VitDi, and VitDn subgroups no significant differences were observed in the levels of alkaline phosphatase (ALP) and ionized calcium (Ca2+) and in DXA indices. A negative correlation was observed between the level of vitamin D3 and the Expanded Disability Status Scale (EDSS) in the whole MS group. The subgroups were significantly different with respect to the EDSS scores and the frequency of complaints related to walking according to the EQ-5D. Conclusions: It is necessary to assess calcium-phosphate metabolism and supplementation of vitamin D3 in RRMS patients. The higher the clinical stage of the disease assessed with the EDSS, the lower the level of vitamin D3 in blood serum. Subjectively reported complaints related to difficulties with walking were reflected in the EDSS in VitDd patients.


Assuntos
Cálcio/metabolismo , Colecalciferol/sangue , Esclerose Múltipla/metabolismo , Fosfatos/metabolismo , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo , Polônia , Vitamina D , Deficiência de Vitamina D
13.
Neurol Sci ; 39(10): 1677-1682, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30062646

RESUMO

The Klotho protein is a recently discovered protein and its overexpression is associated with life extension. Klotho deficiency or silencing of the Klotho gene in mice leads to an accelerated aging and short life, whereas overexpression of Klotho in mice extends lifespan. Klotho participates in many metabolic pathways and is highly expressed in the kidneys, the choroid plexus and neurons. It plays a key role in the calcium-phosphate metabolism, remyelination, and cognitive processes. The present paper is a short review of the literature on the role of Klotho in neurodegenerative disorders, with special attention paid to multiple sclerosis. The neuroprotective function of Klotho is also reported. It is also important to consider potential clinical applications of Klotho that might be useful in the treatment of many diseases.


Assuntos
Glucuronidase , Doenças Neurodegenerativas , Animais , Glucuronidase/genética , Glucuronidase/metabolismo , Glucuronidase/uso terapêutico , Humanos , Doenças Neurodegenerativas/tratamento farmacológico , Doenças Neurodegenerativas/genética , Doenças Neurodegenerativas/metabolismo
14.
Exp Biol Med (Maywood) ; 243(9): 762-769, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29763370

RESUMO

An increasing number of patients with parotid gland tumors have been observed in recent years. The relationship between the immune system and tumor formation is thoroughly investigated. However, newly discovered molecules offer a new insight into the pathophysiology of malignancies. It would be ideal to find an easily determinable biomarker of tumor existence, its malignant potential or a biomarker suggesting the probability of disease recurrence. Our study is the first to examine serum concentrations of IL-33 and its sST2 receptor in patients with various types of parotid gland tumors. Serum IL33, sST2, IL-4 and IL-10 concentrations were determined in patients with benign and malignant parotid gland tumors (pleomorphic adenoma, Warthin's tumor, myoepithelioma and acinic cell carcinoma). We observed for the first time that serum IL-33 level was significantly elevated in patients with various types of parotid gland tumors and sST2 levels were significantly higher in pleomorphic adenoma and acinic cell carcinoma patients compared to the controls. Our results demonstrate for the first time that serum IL-33 and its sST2 receptor may be important factors in the pathology of parotid gland tumors. Although our results are promising, further investigations are required to detect if serum concentrations of those molecules may be a biomarker in parotid gland tumors. Impact statement Parotid gland tumors seem to be an increasingly important medical challenge, mostly due to a noticeable increase in the incidence. It would be crucial to find an easily determinable biomarker of tumor existence, its recurrence or malignant potential. We observed for the first time that serum IL-33 level was significantly elevated in patients with various types of parotid gland tumors and its sST2 receptor levels were significantly higher in pleomorphic adenoma and acinic cell carcinoma patients compared to the controls. We believe that our study helps to understand the biology of the tumors and a potential role of a relatively newly identified cytokine IL-33 in the pathophysiology of the parotid gland tumors.


Assuntos
Adenoma Pleomorfo/sangue , Biomarcadores Tumorais/sangue , Carcinoma de Células Acinares/sangue , Proteína 1 Semelhante a Receptor de Interleucina-1/sangue , Interleucina-33/sangue , Proteínas de Neoplasias/sangue , Neoplasias Parotídeas/sangue , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
15.
Biomed Res Int ; 2018: 4340871, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29651432

RESUMO

Salivary gland tumors account for 3-6% of tumors of the head and neck. About 80% of salivary gland tumors occur in parotid glands. Oxidative stress (OS) is implicated in the origin, development, and whole-body effects of various tumors. There are no data on the occurrence of OS in the parotid gland tumors. The aim of this study was to ascertain if whole-body OS accompanies parotid gland tumors, based first of all on oxidative modifications of blood serum proteins and other markers of OS in the serum of the patients. The group studied included 17 patients with pleomorphic adenoma, 9 patients with Warthin's tumor, 8 patients with acinic cell carcinoma, and 24 age-matched controls. We found increased concentration of interleukin 4 in patients with acinic cell carcinoma, decreased plasma thiols, increased AOPP concentration, and decreased FRAP of blood serum in all groups of the patients while protein oxidative modifications assessed fluorimetrically, protein carbonyls, protein nitration, malondialdehyde concentration, and serum ABTS⁎-scavenging capacity were unchanged. These data indicate the occurrence of OS in patients with parotid gland tumors and point to various sensitivities of OS markers.


Assuntos
Produtos da Oxidação Avançada de Proteínas/sangue , Biomarcadores Tumorais/sangue , Interleucina-4/sangue , Proteínas de Neoplasias/sangue , Estresse Oxidativo , Neoplasias Parotídeas/sangue , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Parotídeas/patologia , Projetos Piloto
16.
Ther Adv Neurol Disord ; 11: 1756286418759189, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29511382

RESUMO

Multiple sclerosis (MS) experts in Europe are facing rapidly rising demands of excellence due to the increasing complexity of MS therapy and management. A central European expert board of MS experts met to identify needs and obstacles with respect to raising quality of MS care in central and Eastern European countries. There are substantial variations across countries regarding delivery of care and its cost structure, as well as access to treatment. To date, Eastern European countries are often less able to afford reimbursement of immunomodulatory agents than Western countries. Overall, approximately 40% of working-age patients are not working due to MS. Costs rise steeply with increasing disability; indirect costs constitute the bulk of the financial burden in patients with severe MS. Magnetic resonance imaging (MRI) assessment is meanwhile obligatory as the diagnostic interface in the management of MS patients. Recommended measures directed at improving quality of care include the collection of patient data in registries, enhanced education of healthcare professionals, implementation of national strategies aiming at reducing regional variation, optimization of approval processes, and removal of administrative barriers. Local partnerships with authorities such as those that represent the interests of employees can contribute to leverage the importance of epidemiological data. The need for education extends to (neuro)radiologists who are responsible for reporting MRI findings in expert quality. Dissemination of the Magnetic Resonance Imaging in MS (MAGNIMS) protocol would be an important step in this context. Also, clinical freedom of choice is rated as essential. Physicians should have access to a range of treatment options due to the complexity of disease. Guidelines such as the upcoming EAN-ECTRIMS clinical practice guideline also aim at providing a basis for argumentation in negotiations with national health authorities.

17.
Cytokine ; 106: 40-44, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29549722

RESUMO

OBJECTIVES: The aim of this study was to evaluate serum levels of adiponectin, leptin, visfatin and IL-6 in patients with pleomorphic adenoma, Warthin's tumor and acinic cell carcinoma of the parotid gland. MATERIALS AND METHODS: Venous blood samples were collected from 30 patients with pleomorphic adenoma, 21 patients with Warthin's tumor and 8 patients with acinic cell carcinoma. Serum adiponectin, leptin, visfatin, IL-6 and CRP concentrations were determined. RESULTS: Our results revealed significantly lower adiponectin serum levels in patients with malignant tumors compared to benign tumor individuals. Moreover, in benign cases the level was significantly higher compared to controls. Furthermore, serum leptin concentrations of benign tumor patients were higher compared to controls. Those differences, however, were observed only in males. The serum visfatin level was elevated in all tumor subjects compared to healthy individuals, whereas the serum IL-6 concentration was similar. CONCLUSIONS: We anticipate that adiponectin may play a potential protective role in salivary gland tumors. Also leptin and visfatin seem to play an important role in salivary gland tumor pathology, although in males and females leptin may act or be regulated in a different manner. The influence of visfatin on salivary gland tumors is probably independent of IL-6 production.


Assuntos
Adipocinas/sangue , Glândula Parótida/patologia , Neoplasias das Glândulas Salivares/sangue , Neoplasias das Glândulas Salivares/patologia , Adiponectina/sangue , Feminino , Humanos , Interleucina-6/sangue , Leptina/sangue , Masculino , Pessoa de Meia-Idade , Nicotinamida Fosforribosiltransferase/sangue
18.
Neuroepidemiology ; 50(3-4): 183-194, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29587253

RESUMO

BACKGROUND: Poland, classified as a high-income country, is still considered to have a high cardiovascular risk population. During the last decade, the standards of care in acute stroke (AS) had markedly improved; thus, we aimed to assess whether and how it translated into early and late outcomes. METHODS: Silesian Stroke Registry was created from the administrative database of the public, obligatory, health -insurer in Poland. The AS cases were selected based on primary diagnosis coded in ICD-10 as I60-I64 for years 2006-2015 (n = 120,844). Index hospitalization together with data on re-hospitalizations, procedures, ambulatory visits, rehabilitation and all-cause deaths in a 1-year follow-up were analyzed. RESULTS: The rates of admissions per 100,000 adult population varied between 41-47 for haemorrhagic and 257-275 for ischaemic stroke with substantial decrease in almost all age groups except for the oldest patients. In ischaemic stroke, thrombolytic therapy raised from 0 to 8.8% in 2015, along with significant trends of decreasing 30-day (from 20 to 16%) and 12-month (from 35 to 31%) case fatality. In haemorrhagic stroke, case fatality had not changed. After ischaemic stroke, 12-month readmissions due to AS declined from 11-12% in 2006-2009 to 9% in 2010-2014. The percentage of patients benefiting from rehabilitation increased from 24 to 32%. CONCLUSIONS: In a large population of industrial province, we showed recent, positive trends in AS admissions, treatment and 1-year outcomes. Development of stroke unit networks and increase in thrombolytic treatment were at least in part responsible for survival improvement and reduction of recurrence of AS. However, case-fatality and stroke recurrence remain high compared to those of other developed countries.


Assuntos
Isquemia Encefálica/epidemiologia , Hospitalização , Hemorragias Intracranianas/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/mortalidade , Feminino , Humanos , Hemorragias Intracranianas/mortalidade , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Sistema de Registros , Acidente Vascular Cerebral/mortalidade , Taxa de Sobrevida , Adulto Jovem
20.
Neurol Neurochir Pol ; 52(3): 368-373, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29370887

RESUMO

INTRODUCTION: The Myasthenia Gravis-Activities of Daily Living scale (MG-ADL) is a short, and easy to use disease-specific quality of life during daily routine tool in myasthenia gravis. OBJECTIVES: The purpose of our work was to evaluate neurological condition patients with myasthenia gravis using the form MG-ADL in order to enable the introduction in common use of an instrument which allows for the assessment of patients with myasthenia gravis. PATIENTS AND METHODS: The total number of 50 patients with MG were qualified for the examination. Each patient underwent neurological examination and completed the quality of life evaluation questionnaire MQ-ADL. Additionally, each patient was asked to evaluate the quality of his/her life by means of questionnaire MG-QOL 15 and MG Composite in Polish language version. RESULTS: Our analysis showed a positive correlation with other scales used - MG-QOL 15, MGFA, MG Composite. The intensification of neurological symptoms showed significant relation with obtained higher number of points in MG-ADL questionnaire. The MG-ADL was found to have high internal consistency, test-retest reliability, and concurrent validity. CONCLUSION: We confirmed reliability and dependability of the questionnaire in the the test-retest assessment. The MG-ADL is accepted to be a reliable and valuable tool for measuring disease-specific QOL in Polish patients with MG.


Assuntos
Atividades Cotidianas , Miastenia Gravis , Feminino , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Polônia , Qualidade de Vida , Reprodutibilidade dos Testes , Inquéritos e Questionários
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