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Rzepka M, Chmiela T, Kaczmarczyk A, Krzystanek E. Insomnia, Fatigue, Bladder Disorders and Mood Disorders among Polish Patients with Multiple Sclerosis: Cross-Sectional Study. J Clin Med 2024; 13:1043. [PMID: 38398356 PMCID: PMC10888699 DOI: 10.3390/jcm13041043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND To investigate the prevalence of sleep disorders in patients with multiple sclerosis (PwMS) in comparison to healthy controls (HCs), we aim to explore the correlation between sleep disorders and fatigue, bladder dysfunction, mood disorders in PwMS. METHODS This study involved 175 PwMS and 115 HCs. We conducted a self-administered survey using questionnaires (the authors' questionnaire, the Athens Insomnia Scale (AIS), the Epworth Sleepiness Scale (ESS), the Modified Fatigue Impact Scale (MFIS), the Fatigue Severity Scale (FSS), the Hospital Anxiety and Depression Scale (HADS), and the Numerical Rating Scale (NRS). The neurological disability was determined using Expanded Disability Status Scale. Logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS According to AIS, insomnia was found in 20.6% of PwMS compared to 9.6% of HCs (p < 0.001). Comparing female and male PwMS, we observed that insomnia was more prevalent among female PwMS (25.95% vs. 4.55%, respectively, p < 0.05). Excessive daytime sleepiness was more prevalent in female PwMS (p < 0.05). Female PwMS were more fatigue based on the FSS and the MFIS (p < 0.05). Bladder disorders were observed in 39.43% of PwMS and were significantly linked to MS (p < 0.001). Sleep disturbances were associated with anxiety disorders (OR = 0.22, 95% CI 0.12-0.32 p < 0.001), bladder dysfunction (OR = 0.52 95% CI 0.16-0.87 p < 0.05), and female gender (OR = 0.49, 95% CI 0.037-0.94 p < 0.05). CONCLUSIONS Insomnia is prevalent among PwMS. Our study revealed independent predictors of sleep disturbances among PwMS: female gender, bladder disorders, and anxiety.
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Affiliation(s)
- Michalina Rzepka
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (T.C.); (A.K.)
| | - Tomasz Chmiela
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (T.C.); (A.K.)
| | - Aleksandra Kaczmarczyk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (T.C.); (A.K.)
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-635 Katowice, Poland;
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Podlecka-Piętowska A, Sierdziński J, Nojszewska M, Stawicki J, Bartosik-Psujek H, Lech B, Popiel M, Perenc A, Kułakowska A, Czarnowska A, Kulikowska J, Kapica-Topczewska K, Jamróz-Wiśniewska A, Rejdak K, Zaborski J, Kubicka-Bączyk K, Niedziela N, Wierzbicki K, Adamczyk-Sowa M, Zwiernik J, Zwiernik B, Milewska-Jędrzejczak M, Głąbiński A, Jasińska E, Puz P, Krzystanek E, Stęposz A, Karuga A, Lasek-Bal A, Siuda J, Kściuk B, Walawska-Hrycek A, Patalong-Ogiewa M, Kaczmarczyk A, Siutka K, Brola W, Zakrzewska-Pniewska B. Analysis of seroconversion following COVID-19 vaccination among multiple sclerosis patients treated with disease-modifying therapies in Poland. Neurol Neurochir Pol 2024; 58:112-119. [PMID: 38251955 DOI: 10.5603/pjnns.96425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/09/2023] [Accepted: 11/30/2023] [Indexed: 01/23/2024]
Abstract
CLINICAL RATIONALE FOR THE STUDY The rapid spread of SARS-CoV-2 throughout the world has highlighted the importance of vaccinations to control the pandemic and to protect people at risk for severe disease courses. Disease-modifying therapies (DMT) in multiple sclerosis (MS), whether immunomodulatory or immunosuppressive, may affect the immune response. Therefore, the question arose as to whether these vaccinations would be effective. AIM OF THE STUDY We planned a study to assess the immune response to SARS-CoV-2 vaccines by type of therapy. MATERIAL AND METHODS Participants were recruited from 14 Polish MS centres. The data was obtained by neurologists using a questionnaire. We collected data on 353 MS patients (269 females, 84 males) who received complete primary SARS-CoV-2 vaccination. All persons with MS (PwMS) were treated with disease-modifying therapies. RESULTS 305 out of 353 PwMS (86.4%) were positive for IgG Abs against SARS-CoV-2 S domain S1 Ag after vaccination. A strong immune response was noted in 129 PwMS (36.5%). The rate of seroconversion after SARS-CoV-2 vaccination in PwMS who received immunomodulatory DMTs (interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate, natalizumab) was 91.5%, in PwMS receiving immune reconstruction therapy (alemtuzumab, cladribine) was 92%, and in immunosuppressive DMTs (fingolimod, ocrelizumab), the seroconversion rate was 59%. CONCLUSIONS AND CLINICAL IMPLICATIONS Our study shows that, in PwMS receiving immunomodulatory therapy, the immune response to vaccination is generally excellent. Even in immunosuppressive patients, seroconversion is satisfactory.
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Affiliation(s)
| | - Janusz Sierdziński
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Monika Nojszewska
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Jakub Stawicki
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów
| | - Beata Lech
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska
| | - Małgorzata Popiel
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska
| | - Adam Perenc
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Kulikowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | | | | | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Jacek Zaborski
- Department of Neurology and Neurorehabilitation, Miedzyleski Specialist Hospital, Warsaw, Poland
| | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Natalia Niedziela
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Krzysztof Wierzbicki
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Jacek Zwiernik
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland
| | - Beata Zwiernik
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | | | - Andrzej Głąbiński
- Department of Neurology and Stroke, Medical University of Lodz, Lodz, Poland
| | | | - Przemysław Puz
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Ewa Krzystanek
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Arkadiusz Stęposz
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Aleksandra Karuga
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
| | - Joanna Siuda
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Barbara Kściuk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Anna Walawska-Hrycek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Maja Patalong-Ogiewa
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Aleksandra Kaczmarczyk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Katarzyna Siutka
- Department of Neurology, Specialist Hospital in Konskie, Collegium Medicum, Jan Kochanowski University Kielce, Konskie, Poland
| | - Waldemar Brola
- Department of Neurology, Specialist Hospital in Konskie, Collegium Medicum, Jan Kochanowski University Kielce, Konskie, Poland
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Lasek-Bal A, Dewerenda-Sikora M, Binek Ł, Student S, Łabuz-Roszak B, Krzystanek E, Kaczmarczyk A, Krzan A, Żak A, Cieślik A, Bosak M. Epileptiform activity in the acute phase of stroke predicts the outcomes in patients without seizures. Front Neurol 2023; 14:1096876. [PMID: 36994378 PMCID: PMC10040780 DOI: 10.3389/fneur.2023.1096876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/13/2023] [Indexed: 03/14/2023] Open
Abstract
Background and purposeThe abnormalities in EEG of stroke-patients increase the risk of epilepsy but their significancy for poststroke outcome is unclear. This presented study was aimed at determining the prevalence and nature of changes in EEG recordings from the stroke hemisphere and from the contralateral hemisphere. Another objective was to determine the significance of abnormalities in EEG in the first days of stroke for the post-stroke functional status on the acute and chronic phase of disease.MethodsIn all qualified stroke-patients, EEG was performed during the first 3 days of hospitalization and at discharge. The correlation between EEG abnormalities both in the stroke hemisphere and in the collateral hemisphere with the neurological and functional state in various time points was performed.ResultsOne hundred thirty-one patients were enrolled to this study. Fifty-eight patients (44.27%) had abnormal EEG. The sporadic discharges and generalized rhythmic delta activity were the most common abnormalities in the EEG. The neurological status on the first day and the absence of changes in the EEG in the hemisphere without stroke were the independent factors for good neurological state (0–2 mRS) at discharge. The age-based analysis model (OR 0.981 CI 95% 0.959–1.001, p = 0.047), neurological status on day 1 (OR 0.884 CI 95% 0.82–0.942, p < 0.0001) and EEG recording above the healthy hemisphere (OR 0.607 CI 95% 0.37–0.917, p = 0.028) had the highest prognostic value in terms of achieving good status 90 days after stroke.ConclusionsAbnormalities in EEG without clinical manifestation are present in 40% of patients with acute stroke. Changes in EEG in acute stroke are associated with a poor neurological status in the first days and poor functional status in the chronic period of stroke.
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Affiliation(s)
- Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
- Department of Neurology, Upper-Silesian Medical Centre of the Silesian Medical University, Katowice, Poland
- *Correspondence: Anetta Lasek-Bal
| | - Milena Dewerenda-Sikora
- Department of Neurology, Upper-Silesian Medical Centre of the Silesian Medical University, Katowice, Poland
| | - Łukasz Binek
- Department of Neurology, Upper-Silesian Medical Centre of the Silesian Medical University, Katowice, Poland
| | - Sebastian Student
- Faculty of Automatic Control Electronics and Computer Science, Silesian University of Technology, Gliwice, Poland
- Biotechnology Center, Silesian University of Technology, Gliwice, Poland
| | - Beata Łabuz-Roszak
- Department of Neurology, Institute of Medical Sciences University of Opole, Opole, Poland
| | - Ewa Krzystanek
- Department of Neurology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
- Department of Neurology, Upper-Silesian Medical Centre of the Silesian Medical University, Katowice, Poland
| | - Aleksandra Kaczmarczyk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Aleksandra Krzan
- Department of Neurology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
- Department of Neurology, Upper-Silesian Medical Centre of the Silesian Medical University, Katowice, Poland
| | - Amadeusz Żak
- Department of Neurology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
- Department of Neurology, Upper-Silesian Medical Centre of the Silesian Medical University, Katowice, Poland
| | - Aleksandra Cieślik
- Department of Neurology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
- Department of Neurology, Upper-Silesian Medical Centre of the Silesian Medical University, Katowice, Poland
| | - Magdalena Bosak
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
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Bożek M, Kurkowska-Jastrzebska I, Krzystanek E, Bienkowski P, Konopko M, Sienkiewicz-Jarosz H. Attitudes towards the switching of anti-epileptic medications in pharmacies: the patients' perspective. Postep Psychiatr Neurol 2023; 32:12-17. [PMID: 37287735 PMCID: PMC10243292 DOI: 10.5114/ppn.2023.126329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/07/2023] [Indexed: 06/09/2023]
Abstract
Purpose A survey of epilepsy patients' experiences of and attitudes towards the pharmacy switching of anti-epileptic medications. Methods A structured questionnaire was administered to a group of epilepsy patients treated at the Institute of Psychiatry and Neurology and the Medical University of Silesia, Poland. Two hundred and eleven patients (mean [± SD] age: 41.0 ± 15.6 years) were recruited; 60.6% were women. 68.2% had been treated for over 10 years. Results Most individuals (63%) claimed that they had never bought a generic substitute medication. Among the patients who declared that a switch had been proposed to them at a pharmacy (~40%), only 68.7% received any explanation at all from a pharmacist. Some reported positive emotions mostly related to a lower price of the new drug but also to the explanations received. Most respondents who accepted the pharmacy switch (67.4%) did not notice any significant changes in the efficacy or tolerability of treatment, while the remaining subjects reported an increase in seizure frequency (23.2%) and deterioration in treatment tolerance (9%). Conclusions Around 40% of Polish epilepsy patients have been confronted with a proposal to switch their anti-epileptic medications at a pharmacy. More of them report negative attitudes towards the pharmacist's proposal than do not. It is possible that one of the major reasons for this is the insufficient information provided by pharmacists. It remains to be established whether the reported decrease in seizure control could be accounted for by a low concentration of the anti-epileptic drug in the blood after the switch.
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Affiliation(s)
- Milena Bożek
- 1 Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Ewa Krzystanek
- Department of Neurology, Silesian Medical University in Katowice, Katowice, Poland
| | | | - Magdalena Konopko
- 1 Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
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Gorzelak-Magiera A, Bobola A, Robek A, Krzystanek E, Gisterek I. Selected neurological complications of oncological treatment — literature overview. Oncol Clin Pract 2022. [DOI: 10.5603/ocp.2022.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Czarnowska A, Tarasiuk J, Zajkowska O, Wnuk M, Marona M, Nowak K, Słowik A, Jamroz-Wiśniewska A, Rejdak K, Lech B, Popiel M, Rościszewska-Żukowska I, Perenc A, Bartosik-Psujek H, Świderek-Matysiak M, Siger M, Ciach A, Walczak A, Jurewicz A, Stasiołek M, Kania K, Dyczkowska K, Kalinowska-Łyszczarz A, Galus W, Walawska-Hrycek A, Krzystanek E, Chojdak-Łukasiewicz J, Ubysz J, Pokryszko-Dragan A, Kapica-Topczewska K, Chorąży M, Bazylewicz M, Mirończuk A, Kulikowska J, Kochanowicz J, Białek M, Stolarz M, Kubicka-Bączyk K, Niedziela N, Warmus P, Adamczyk-Sowa M, Podlecka-Piçtowska A, Nojszewska M, Zakrzewska-Pniewska B, Jasińska E, Zaborski J, Milewska-Jȩdrzejczak M, Zwiernik J, Zwiernik B, Potemkowski A, Brola W, Kułakowska A. Analysis of Side Effects Following Vaccination Against COVID-19 Among Individuals With Multiple Sclerosis Treated With DMTs in Poland. Front Neurol 2022; 13:913283. [PMID: 35775049 PMCID: PMC9237390 DOI: 10.3389/fneur.2022.913283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives Since vaccination against COVID-19 is available for over a year and the population of immunized individuals with autoimmune disorders is higher than several months before, an evaluation of safety and registered adverse events can be made. We conducted a large study of side effects following the COVID-19 vaccine among patients with multiple (MS) sclerosis treated with disease-modifying therapies (DMTs) and analyzed factors predisposing for particular adverse events. Methods We gathered data of individuals with MS treated with DMTs from 19 Polish MS Centers, who reported at least one adverse event following COVID-19 vaccination. The information was obtained by neurologists using a questionnaire. The same questionnaire was used at all MS Centers. To assess the relevance of reported adverse events, we used Fisher's exact test, t-test, and U-Menn-Whutney test. Results A total of 1,668 patients with MS and reports of adverse events after COVID-19 vaccination were finally included in the study. Besides one case marked as “red flag”, all adverse events were classified as mild. Pain at the injection site was the most common adverse event, with a greater frequency after the first dose. Pain at the injection site was significantly more frequent after the first dose among individuals with a lower disability (EDSS ≤2). The reported adverse events following immunization did not differ over sex. According to age, pain at the injection site was more common among individuals between 30 and 40 years old, only after the first vaccination dose. None of the DMTs predisposed for particular side effects. Conclusions According to our findings, vaccination against COVID-19 among patients with MS treated with DMTs is safe. Our study can contribute to reducing hesitancy toward vaccination among patients with MS.
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Affiliation(s)
- Agata Czarnowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
- *Correspondence: Agata Czarnowska
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Olga Zajkowska
- Faculty of Economic Sciences, University of Warsaw, Warsaw, Poland
| | - Marcin Wnuk
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Monika Marona
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Klaudia Nowak
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Beata Lech
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska, Poland
| | - Małgorzata Popiel
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska, Poland
| | - Iwona Rościszewska-Żukowska
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | - Adam Perenc
- Neurology Clinic With Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Lwowska, Poland
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | | | - Małgorzata Siger
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | - Agnieszka Ciach
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | - Agata Walczak
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | - Anna Jurewicz
- Department of Neurology, Medical University of Lodz, Łódz, Poland
| | | | - Karolina Kania
- Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
| | - Klara Dyczkowska
- Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Weronika Galus
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Anna Walawska-Hrycek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Jakub Ubysz
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Monika Chorąży
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Marcin Bazylewicz
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Anna Mirończuk
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Joanna Kulikowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, Białystok, Poland
| | - Marta Białek
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Bytom, Poland
| | - Małgorzata Stolarz
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Bytom, Poland
| | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Natalia Niedziela
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Paweł Warmus
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | | | - Monika Nojszewska
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | | | - Elżbieta Jasińska
- Jan Kochanowski University, Collegium Medicum, Kielce, Poland
- Clinical Center, Resmedica, Kielce, Poland
| | - Jacek Zaborski
- Department of Neurology and Neurorehabilitation, Miedzyleski Szpital Specjalistyczny, Warsaw, Poland
| | | | - Jacek Zwiernik
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | - Beata Zwiernik
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
- Clinic of Neurology, University of Warmia and Mazury, Olsztyn, Poland
| | - Andrzej Potemkowski
- Department of Clinical Psychology and Psychoprophylaxis, University of Szczecin, Szczecin, Poland
| | - Waldemar Brola
- Department of Neurology, Specialist Hospital in Końskie, Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
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Krzystanek E, Jurczak A, Kocur K, Jurkiewicz J, Kaczmarczyk A. Awareness of COVID-19 Symptoms, Risk Factors, and Vaccinations in Patients with Multiple Sclerosis. IJERPH 2022; 19:ijerph19063366. [PMID: 35329050 PMCID: PMC8951455 DOI: 10.3390/ijerph19063366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 12/04/2022]
Abstract
Multiple Sclerosis (MS) is the most common chronic autoimmune disease of the central nervous system, affecting around 2.8 million people worldwide. Patients’ knowledge about COVID-19 infection, and their proper protective actions, may reduce the risk of infection. The aim of this study was to assess the knowledge of patients with MS about SARS-CoV-2, COVID-19 illness, the relationship between MS and COVID-19, willingness to be vaccinated, and the impact of the pandemic on MS care. An original, anonymous, 35-items, self-reported questionnaire was used in both web-based and on-site survey formats. Two-hundred and forty-eight questionnaires were analyzed (mean age 40.8 ± 10.6 years, 77.8% women). Participants reported the use of multiple sources of information, and the most common were websites (77.8%) and television (59.3%). The majority of participants knew the correct symptoms of COVID-19 or transmission routes (94.4%), and accepted the pandemic’s restrictions (96.8%). A total of 93.2% considered SARS-CoV-2 as highly infectious, and 69% thought they were at higher risk of being infected with SARS-CoV-2, mainly because of immunodeficiency (82.7%). Although most of them were afraid of COVID-19 (69.0%), only two-thirds wanted to be vaccinated. Patients who were afraid of COVID-19 had a 3.5-times higher chance to declare willingness for vaccination. A total of 29.8% patients claimed that the COVID-19 pandemic limited access to the healthcare system. This study shows that Polish patients with MS represent a good level of knowledge about COVID-19 disease, and acceptance for public rules, but their willingness for vaccinations is not sufficient. Country-wide educational campaigns should be conducted, particularly on the internet and TV. Restrictions in healthcare facilities should be balanced to secure access for patients with MS.
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Affiliation(s)
- Ewa Krzystanek
- Department of Neurology, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-635 Katowice, Poland
- Correspondence:
| | - Agata Jurczak
- Students’ Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (A.J.); (K.K.); (J.J.)
| | - Kinga Kocur
- Students’ Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (A.J.); (K.K.); (J.J.)
| | - Jakub Jurkiewicz
- Students’ Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (A.J.); (K.K.); (J.J.)
| | - Aleksandra Kaczmarczyk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
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8
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Chmiela T, Piekarz P, Łabuz-Roszak B, Warchala A, Krzystanek E, Gorzkowska A. Analysis of psychiatric consultations in the department of neurology and stroke unit: diagnosis and therapy. Psychiatr Pol 2021; 55:989-1000. [PMID: 34997738 DOI: 10.12740/pp/onlinefirst/116320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The aim of this study was to analyze psychiatric consultations of patients hospitalized in the Department of Neurology and Stroke Unit (DN/SU) of University Clinical Center in Katowice from 2017 to 2018. METHODS A retrospective analysis of psychiatric consultations, psychiatric diagnoses (according to the ICD-10) and treatment recommendations was done. RESULTS 719 psychiatric consultations were performed in all hospital departments in the analyzed period. 488 (67.87%) consultations were conducted in the Department of Neurology and Stroke Unit. Most patients who required psychiatric consultations were diagnosed with Huntington's disease (n = 25; 37.31%), Parkinson's disease (n = 60; 23.9%) and epilepsy (n=40; 22.73%). The most commonpsychiatric diagnoses included organic mental disorders (n=229; 55.85%), particularly organic mood disorders (n =73; 14.96%) and organic anxiety disorders (n =32;6.56%) whereas in thecase of vascular diseases themost common diagnoses included disturbances of consciousness associated with delirium (n =30; 40.54%). The majority of consultations (n = 388; 79.51%) resulted in the onset or modification of pharmacological treatment. The most frequently prescribed drugs were: neuroleptics (n =174; 35.66%), mostly atypical (n = 152; 87,36%), and antidepressants (n = 230; 47.13%), mostly SSRIs (n = 216; 93.91%). In patients > 60 years of age organic disorders were more prevalent (n =179; 66.30% vs. n = 49; 35.0%) and neuroleptics were more frequently prescribed (n = 131; 42.12% vs. n= 44; 24.86%) compared to patients < 60 years. CONCLUSIONS Patients in the department of neurology and stroke unit underwent a psychiatric consultation most frequently. Optimizing the care of aneurological patient is related to close cooperation of a neurologist and a psychiatrist, as well as developing and updating common positions for the management of selected disease entities.
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Affiliation(s)
- Tomasz Chmiela
- Śląski Uniwersytet Medyczny, Wydział Nauk Medycznych w Katowicach, Katedra i Klinika Neurologii
| | - Paweł Piekarz
- Uniwersyteckie Centrum Kliniczne w Katowicach, Oddział Neurologii i Oddział Udarowy
| | - Beata Łabuz-Roszak
- Śląski Uniwersytet Medyczny w Katowicach, Wydział Zdrowia Publicznego w Bytomiu, Katedra i Zakład Podstawowych Nauk Medycznych; Wojewódzki Szpital Specjalistyczny im. Św. Jadwigi w Opolu, Oddział Neurologii
| | - Anna Warchala
- Śląski Uniwersytet Medyczny w Katowicach, Wydział Nauk Medycznych, Klinika Psychiatrii i Psychoterapii
| | - Ewa Krzystanek
- Śląski Uniwersytet Medyczny, Wydział Nauk Medycznych w Katowicach, Katedra i Klinika Neurologii
| | - Agnieszka Gorzkowska
- Śląski Uniwersytet Medyczny, Wydział Nauk Medycznych w Katowicach, Katedra i Klinika Neurologii
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9
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Wasiuk-Zowada D, Knapik A, Szefler-Derela J, Brzęk A, Krzystanek E. Kinesiophobia in Stroke Patients, Multiple Sclerosis and Parkinson's Disesase. Diagnostics (Basel) 2021; 11:diagnostics11050796. [PMID: 33924856 PMCID: PMC8145970 DOI: 10.3390/diagnostics11050796] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 04/25/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Stroke (S), multiple sclerosis (MS), Parkinson's disease (PD) are chronic neurological diseases that are a challange for public health and represent a real social problem. Physical activity (PA) improves functional performance, reduces various symptoms in PD and MS, in stroke- reduced neurological impairment of patients and provides a chance for independence. One of the main obstacles in successful rehabilitation is patients' movement passivity. The reason might be the psychological aspects, in particular fear of movement-kinesiophobia. Aim: To determine how many patients with S, MS, and PD suffer from kinsiophobia and what factors influence this process. METHODS Fifty patients after stroke, eighty one MS patients and sixty one PD patients were consecutively recruited from hospital and outpatients clinics. The sociodemographic data, self- assesment of fitness, Visual Analogue Scale (VAS) for pain, Tampa Scale of Kinesiophobia (TSK) and The Modified Baecke Questionnarie for Older Adults for physical activity were collected. A score >37 was considered to indicate a high level of kinesiophobia according to the TSK. RESULTS High level of kinesiophobia was shown in 66.67% of the subjects. TSK medians in particular illnesses were above the cut-off score and amounted: S-42.50 points; MS-38 points; PD-42.00 points. Regression showed 15% of fluctuation of variance (R2 = 0.1498; p < 0.0001), where regression factor showed: for mobility self-assessment: b = -0.2137 and for the age b = 0.0065. CONCLUSIONS Kinesiophobia among the patients suffering from S, MS and PD concerns most of the subjects. Predictors of kinesiophobia are: limitations connected with functioning and age. The meaning of kinesiophobia in neurological disorders requires further research.
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Affiliation(s)
- Dagmara Wasiuk-Zowada
- Department of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia, 40-754 Katowice, Poland; (D.W.-Z.); (J.S.-D.)
| | - Andrzej Knapik
- Department of Adapted Physical Activity and Sport, School of Health Sciences in Katowice, Medical University of Silesia, 40-754 Katowice, Poland;
| | - Justyna Szefler-Derela
- Department of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia, 40-754 Katowice, Poland; (D.W.-Z.); (J.S.-D.)
| | - Anna Brzęk
- Department of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia, 40-754 Katowice, Poland; (D.W.-Z.); (J.S.-D.)
- Correspondence: ; Tel.: +48-32-208-8721
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-754 Katowice, Poland;
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10
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Jamroz-Wiśniewska A, Zajdel R, Słowik A, Marona M, Wnuk M, Adamczyk-Sowa M, Adamczyk B, Lasek-Bal A, Puz P, Stęposz A, Krzystanek E, Patalong-Ogiewa M, Pokryszko-Dragan A, Budrewicz S, Koziarska D, Karbicka A, Wawrzyniak S, Fryze W, Furtak-Niczyporuk M, Rejdak K. Modified Rio Score with Platform Therapy Predicts Treatment Success with Fingolimod and Natalizumab in Relapsing-Remitting Multiple Sclerosis Patients. J Clin Med 2021; 10:jcm10091830. [PMID: 33922368 PMCID: PMC8122749 DOI: 10.3390/jcm10091830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 01/16/2023] Open
Abstract
Background: Reliable markers of disease outcomes in multiple sclerosis (MS) would help to predict the response to treatment in patients treated with high efficacy drugs. No evidence of disease activity (NEDA) has become a treatment goal whereas the modified Rio score (MRS) predicts future suboptimal responders to treatment. The aim of our study was to identify factors that would predict poor response to treatment with natalizumab and fingolimod. Methods: In the multicenter prospective trial, 336 subjects were enrolled, initiating therapy with natalizumab (n = 135) or fingolimod (n = 201). Data on relapse rate, the expanded disability status scale, and MRI results were collected, and MRS was estimated. Results: NEDA-3 after the first year of therapy was 73.9% for natalizumab and 54.8% for fingolimod (p < 0.0001). Patients with MRS = 0 in the last year on platform therapy had the best NEDA-3 (71%) and patients with MRS = 3 had the worst NEDA-3 (41%) in the first year of treatment with the second-line therapy. Conclusion: We conclude that switching to the second-line therapy should occur earlier to enable better results for patients treated with natalizumab or fingolimod. The outcome on both drugs is better with better neurological conditions and lower MRS of the patient on the platform therapy.
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Affiliation(s)
- Anna Jamroz-Wiśniewska
- Department of Neurology, Medical University of Lublin, Jaczewskiego 8, 20-054 Lublin, Poland;
- Correspondence: ; Tel.: +48-81-72-44-720
| | - Radosław Zajdel
- Chair of Informatics in Business, University of Lodz, Rewolucji 1905 Roku 37/39, 91-001 Lodz, Poland;
| | - Agnieszka Słowik
- Department of Neurology, Collegium Medicum, Jagiellonian University, Jakubowskiego 2, 30-688 Krakow, Poland; (A.S.); (M.M.); (M.W.)
| | - Monika Marona
- Department of Neurology, Collegium Medicum, Jagiellonian University, Jakubowskiego 2, 30-688 Krakow, Poland; (A.S.); (M.M.); (M.W.)
| | - Marcin Wnuk
- Department of Neurology, Collegium Medicum, Jagiellonian University, Jakubowskiego 2, 30-688 Krakow, Poland; (A.S.); (M.M.); (M.W.)
| | - Monika Adamczyk-Sowa
- Department of Neurology, School of Health Sciences in Zabrze, Medical University of Silesia in Katowice, 3-go Maja 13-15, 41-800 Zabrze, Poland; (M.A.-S.); (B.A.)
| | - Bożena Adamczyk
- Department of Neurology, School of Health Sciences in Zabrze, Medical University of Silesia in Katowice, 3-go Maja 13-15, 41-800 Zabrze, Poland; (M.A.-S.); (B.A.)
| | - Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Ziolowa 45-47, 40-635 Katowice, Poland; (A.L.-B.); (P.P.); (A.S.)
| | - Przemysław Puz
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Ziolowa 45-47, 40-635 Katowice, Poland; (A.L.-B.); (P.P.); (A.S.)
| | - Arkadiusz Stęposz
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Ziolowa 45-47, 40-635 Katowice, Poland; (A.L.-B.); (P.P.); (A.S.)
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland;
| | - Maja Patalong-Ogiewa
- Department of Neurorehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland;
| | - Anna Pokryszko-Dragan
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-566 Wroclaw, Poland; (A.P.-D.); (S.B.)
| | - Sławomir Budrewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-566 Wroclaw, Poland; (A.P.-D.); (S.B.)
| | - Dorota Koziarska
- Department of Neurology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland;
| | - Anna Karbicka
- Department of Neurology, Regional Hospital, Arkonska 4, 71-455 Szczecin, Poland;
| | - Sławomir Wawrzyniak
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Powstancow Warszawy 5, 85-681 Bydgoszcz, Poland;
| | - Waldemar Fryze
- Department of Neurology, Copernicus Pl, M. Kopernik Hospital, Nowe Ogrody 1-6, 80-803 Gdansk, Poland;
| | | | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Jaczewskiego 8, 20-054 Lublin, Poland;
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11
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Czempik PF, Gawryluk J, Wiórek A, Krzystanek E, Krzych ŁJ. Efficacy and safety of therapeutic plasma exchange in stiff person syndrome. Open Med (Wars) 2021; 16:526-531. [PMID: 33821220 PMCID: PMC8010154 DOI: 10.1515/med-2021-0220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 11/20/2020] [Accepted: 01/08/2021] [Indexed: 12/29/2022] Open
Abstract
The stiff person syndrome (SPS) is an extremely rare neurological disorder with primarily immune-mediated etiology. The cardinal symptoms are progressive, fluctuating axial/proximal limb muscle stiffness and spasms. The diagnosis is based on the clinical picture, electromyography examination and detection of antibodies to glutamic acid decarboxylase (anti-GAD). Adverse effects of medications might preclude its use or increase in dosing, therefore symptomatic and/or immunomodulatory medical therapy might be ineffective in acute exacerbation of the disease. We present a case of a 49-year-old female with exacerbation of SPS, in whom some standard pharmacotherapy could not be introduced (clonazepam, baclofen used in the past) and doses of existing standard medications could not be increased (diazepam, gabapentin, and levetiracetam) due to adverse effects. Moreover, a newly introduced medication (methylprednisolone) also led to a serious adverse effect (severe hyperglycemia). The patient underwent therapeutic plasma exchange (TPE) with good effect and no complications. We review the literature regarding the efficacy and safety profile of TPE in exacerbation of SPS unresponsive to medical therapy. The procedure seems to have a good safety profile as an adjunct therapy for exacerbation of SPS not responding to standard medical therapy in this patient population.
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Affiliation(s)
- Piotr F Czempik
- Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 14, Katowice, 40-752, Poland
| | - Justyna Gawryluk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 14, Katowice, 40-752, Poland
| | - Agnieszka Wiórek
- Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 14, Katowice, 40-752, Poland
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 14, Katowice, 40-752, Poland
| | - Łukasz J Krzych
- Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 14, Katowice, 40-752, Poland
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12
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Krzystanek E, Gawryluk J, Arkuszewski M. Fatal intracranial haemorrhage in a hypertensive patient with atrial fibrillation and coronavirus disease 2019. Neuroradiol J 2021; 34:147-150. [PMID: 33307996 PMCID: PMC8041405 DOI: 10.1177/1971400920978438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
We present a case of a fatal cerebral haemorrhage in an 82-year-old male patient with coronavirus disease 2019 (COVID-19), who was taking prophylactic oral anticoagulation because of atrial fibrillation (rivaroxaban 20 mg q.d. for two years). On admission, the patient was deeply comatose, mechanically ventilated, with tachycardia up to 150 bpm, high blood pressure >210/120 mmHg and a body temperature >39°C. A computed tomography scan of the head showed a large intracerebral haemorrhage located in the deep structures of the right hemisphere, with a mass effect and bleeding to the ventricles. Rivaroxaban was discontinued at admission. The patient tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but he did not have typical symptoms of pneumonia. In the following days, the patient's neurological condition did not improve, and a fever of up to 40°C and abnormal coagulation parameters remained resistant to pharmacotherapy. The patient developed multi-system organ failure and died on day 8. Here, we review the recent literature and discuss the possible association of SARS-CoV-2-mediated endothelial injury and cardiovascular disorders with cerebrovascular complications. We postulate that anti-inflammatory treatment in COVID-19 and the stabilisation of endothelium functions can be particularly important in patients with pre-existing cardiovascular conditions.
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Affiliation(s)
- Ewa Krzystanek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Justyna Gawryluk
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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13
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Rzepka M, Toś M, Boroń M, Gibas K, Krzystanek E. Relationship between Fatigue and Physical Activity in a Polish Cohort of Multiple Sclerosis Patients. ACTA ACUST UNITED AC 2020; 56:medicina56120726. [PMID: 33371510 PMCID: PMC7767485 DOI: 10.3390/medicina56120726] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 12/19/2022]
Abstract
Background and objectives: Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). It can be defined as a subjective lack of physical and mental energy. The aim of this study was to evaluate the frequency and severity of fatigue in patients with MS and its relationship with overall physical activity and disease-related disability. Materials and Methods: The study included 100 patients with a clinical relapsing-remitting form of MS. Patients with severe depression were excluded. Neurological impairment was rated using the Expanded Disability Status Scale (EDSS). Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS) and the Fatigue Severity Scale (FSS), with FSS scores greater than 36 indicating patients with fatigue. Physical activity was evaluated with the International Physical Activity Questionnaire (IPAQ) and categorized on three levels: low, moderate, and high, using standard metabolic equivalents (MET). Results: The average FSS and MFIS scores were (mean ± SD) 31.3 ± 15.2 and 30.1 ± 17.0, respectively. The mean EDSS score was 2.5 ± 1.5. 42%. Patients were classified as fatigued based on FSS. Fatigued patients had higher mean EDSS scores than non-fatigued (3.0 ± 1.6 vs. 2.2 ± 1.4, respectively, p = 0.002). Low, moderate, and high levels of physical activity were reported in 35%, 20%, and 45% of patients, respectively. Higher scores of fatigue in FSS and MFIS were inversely correlated with the intensity of physical activity (r = -0.38, p < 0.001 and r = -0.33, p < 0.001, respectively). Conclusions: In patients with MS, fatigue is a common symptom. Patients with lower physical activity and greater MS-related disability have a higher severity of fatigue, which negatively affects cognitive, psychosocial, and physical functioning.
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Affiliation(s)
- Michalina Rzepka
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (M.R.); (M.T.); (K.G.)
| | - Mateusz Toś
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (M.R.); (M.T.); (K.G.)
| | - Michał Boroń
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Katarzyna Gibas
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (M.R.); (M.T.); (K.G.)
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (M.R.); (M.T.); (K.G.)
- Correspondence:
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14
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Krzystanek M, Krzystanek E, Skałacka K, Pałasz A. Enhancement in Phospholipase D Activity as a New Proposed Molecular Mechanism of Haloperidol-Induced Neurotoxicity. Int J Mol Sci 2020; 21:ijms21239265. [PMID: 33291692 PMCID: PMC7730321 DOI: 10.3390/ijms21239265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022] Open
Abstract
Membrane phospholipase D (PLD) is associated with numerous neuronal functions, such as axonal growth, synaptogenesis, formation of secretory vesicles, neurodegeneration, and apoptosis. PLD acts mainly on phosphatidylcholine, from which phosphatidic acid (PA) and choline are formed. In turn, PA is a key element of the PLD-dependent secondary messenger system. Changes in PLD activity are associated with the mechanism of action of olanzapine, an atypical antipsychotic. The aim of the present study was to assess the effect of short-term administration of the first-generation antipsychotic drugs haloperidol, chlorpromazine, and fluphenazine on membrane PLD activity in the rat brain. Animals were sacrificed for a time equal to the half-life of the antipsychotic drug in the brain, then the membranes in which PLD activity was determined were isolated from the tissue. The results indicate that only haloperidol in a higher dose increases the activity of phospholipase D. Such a mechanism of action of haloperidol has not been described previously. Induction of PLD activity by haloperidol may be related to its mechanism of cytotoxicity. The finding could justify the use of PLD inhibitors as protective drugs against the cytotoxicity of first-generation antipsychotic drugs like haloperidol.
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Affiliation(s)
- Marek Krzystanek
- Department and Clinic of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences, Medical School of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland
- Correspondence: or
| | - Ewa Krzystanek
- Department of Neurology, Faculty of Medical Sciences, Medical School of Silesia in Katowice, Medyków 14, 40-772 Katowice, Poland;
| | - Katarzyna Skałacka
- Institute of Psychology, University of Opole, Kopernika 11A Street, 45-040 Opole, Poland;
| | - Artur Pałasz
- Department of Histology, Faculty of Medical Sciences, Medical School of Silesia in Katowice, Medyków 18, 40-752 Katowice, Poland;
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15
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Sąsiadek M, Hartel M, Siger M, Katulska K, Majos A, Kluczewska E, Bartosik-Psujek H, Kułakowska A, Słowik A, Steinborn B, Adamczyk-Sowa M, Kalinowska A, Krzystanek E, Bonek R, Serafin Z, Sławek J, Nowacki P, Stępień A, Jóżwiak S, Rejdak K, Selmaj K, Walecki J. Recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology for a protocol concerning routinely used magnetic resonance imaging in patients with multiple sclerosis. Neurol Neurochir Pol 2020; 54:410-415. [PMID: 33085075 DOI: 10.5603/pjnns.a2020.0084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 11/25/2022]
Abstract
Magnetic resonance imaging (MRI) is a widely used method for the diagnosis of multiple sclerosis that is essential for the detection and follow-up of the disease. OBJECTIVE: The Polish Medical Society of Radiology (PLTR) and the Polish Society of Neurology (PTN) present the second version of their recommendations for investigations routinely conducted in magnetic resonance imaging departments in patients with multiple sclerosis. This version includes new data and practical comments for electroradiology technologists and radiologists. The recommended protocol aims to improve the MRI procedure and, most importantly, to standardise the method of conducting scans in all MRI departments. This is crucial for the initial diagnostics necessary for establishing a diagnosis, as well as for MS patient monitoring, which directly translates into significant clinical decisions. INTRODUCTION: Multiple sclerosis (MS) is a chronic immune mediated inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in a CNS destruction process disseminated in time (DIT) and space (DIS). MRI detects focal lesions in the white and grey matter with high sensitivity (although with significantly lower specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume (GMV) and white matter volume (WMV) as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, and hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. Progress in MR techniques, as well as advances in postprocessing the obtained data, has driven the dynamic development of computer programs that allow for a more repeatable assessment of brain atrophy in both cross-sectional and longitudinal studies. MR imaging is unquestionably the best diagnostic tool available to follow up the course of the disease and support clinicians in choosing the most appropriate treatment strategy for their MS patient. However, to diagnose and follow up MS patients on the basis of MRI in accordance with the latest standards, the MRI study must adhere to certain quality criteria. Such criteria are the subject of this paper.
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Affiliation(s)
- Marek Sąsiadek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Poland
| | | | | | - Katarzyna Katulska
- Department of Neuroradiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Poland
| | - Ewa Kluczewska
- Department and Institute of Medical Radiology and Radiodiagnostics in Zabrze, Medical University of Silesia in Katowice, Poland
| | | | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Poland
| | - Agnieszka Słowik
- Jagiellonian University Medical College, Department of Neurology, Krakow, Poland; University Hospital in Krakow, Poland
| | - Barbara Steinborn
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Alicja Kalinowska
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poland
| | - Ewa Krzystanek
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Robert Bonek
- Department of Neurology and Clinical Neuroimmunology, Regional Specialist Hospital, Grudziądz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | | | - Przemysław Nowacki
- Department of Neurology, Pomeranian Medical University, Szczecin, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | - Sergiusz Jóżwiak
- Department of Pediatric Neurology, Warsaw Medical University, Warsaw, Poland
| | - Konrad Rejdak
- Department of Neurology; Medical University of Lublin, Poland
| | - Krzysztof Selmaj
- Department of Neurology, Laboratory of Neuroimmunology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Jerzy Walecki
- Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland
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Sąsiadek M, Hartel M, Siger M, Katulska K, Majos A, Kluczewska E, Bartosik-Psujek H, Kułakowska A, Słowik A, Steinborn B, Adamczyk-Sowa M, Kalinowska A, Krzystanek E, Bonek R, Serafin Z, Sławek J, Nowacki P, Stępień A, Jóżwiak S, Rejdak K, Selmaj K, Walecki J. Recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology for the routinely used magnetic resonance imaging protocol in patients with multiple sclerosis. Pol J Radiol 2020; 85:e272-e276. [PMID: 32612727 PMCID: PMC7315047 DOI: 10.5114/pjr.2020.96010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/13/2020] [Indexed: 11/30/2022] Open
Abstract
Magnetic resonance imaging (MRI) is a widely used method for the diagnosis of multiple sclerosis (MS) that is essential for the detection and follow-up of the disease. The Polish Medical Society of Radiology (PLTR) and the Polish Society of Neurology (PTN) present the second version of the recommendations for examinations routinely conducted in magnetic resonance imaging departments in patients with MS, which include new data and practical comments for electroradiology technicians and radiologists. The recommended protocol aims to improve the MRI procedure and, most importantly, to standardise the method of conducting scans in all MRI departments. This is crucial for the initial diagnostics that are necessary to establish a diagnosis as well as monitor patients with MS, which directly translates into significant clinical decisions. MS is a chronic idiopathic inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in the CNS destruction process disseminated in time and space. MRI detects focal lesions in the white and grey matter with high sensitivity (with significantly less specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume and white matter volume as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. Progress in magnetic resonance techniques, as well as the abilities of postprocessing the obtained data, has become the basis for the dynamic development of computer programs that allow for a more repeatable assessment of brain atrophy in both cross-sectional and longitudinal studies. MRI is unquestionably the best diagnostic tool used to follow up the course of the disease and to treat patients with MS. However, to diagnose and follow up the patients with MS on the basis of MRI in accordance with the latest standards, an MRI study must meet certain quality criteria, which are the subject of this paper.
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Affiliation(s)
- Marek Sąsiadek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Małgorzata Siger
- Department of Neurology, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Katulska
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Lodz, Poland
| | - Ewa Kluczewska
- Department and Institute of Medical Radiology and Radiodiagnostics in Zabrze, Medical University of Silesia in Katowice, Poland
| | | | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, University Hospital in Krakow, Krakow, Poland
| | - Barbara Steinborn
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Alicja Kalinowska
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Krzystanek
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Robert Bonek
- Department of Neurology and Clinical Neuroimmunology, Regional Specialist Hospital, Grudziądz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Jarosław Sławek
- Department of Neurology, St. Adalbert Hospital, “Copernicus” Ltd., Gdańsk, Poland
| | - Przemysław Nowacki
- Department of Neurology, Pomeranian Medical University, Szczecin, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | - Sergiusz Jóżwiak
- Department of Paediatric Neurology, Warsaw Medical University, Warsaw, Poland
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Selmaj
- Department of Neurology, Laboratory of Neuroimmunology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Jerzy Walecki
- Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland
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Knapik A, Krzystanek E, Szefler–Derela J, Siuda J, Rottermund J, Plinta R, Brzęk A. Affective Disorder and Functional Status as well as Selected Sociodemographic Characteristics in Patients with Multiple Sclerosis, Parkinson's Disease and History of Stroke. ACTA ACUST UNITED AC 2020; 56:medicina56030117. [PMID: 32156038 PMCID: PMC7142413 DOI: 10.3390/medicina56030117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/21/2020] [Accepted: 03/03/2020] [Indexed: 11/16/2022]
Abstract
The main arguments in support of researching anxiety and depression in patients with chronic somatic diseases are the prevalence of affective disorders in the population, somatic conditions as risk factors of affective disorders and the search for effective preventative and therapeutic strategies. The aim of the study was to determine the association between the functional status, selected sociodemographic characteristics and prevalence as well as severity of anxiety and depression in patients with multiple sclerosis (MS), Parkinson's disease (PD) and history of stroke (S). Material and methods: Eighty participants (44 women and 36 men) with MS (n = 22), PD (n = 31) and history of stroke (n = 27) were enrolled. All participants completed a questionnaire consisting of metrics, the Katz Index of Independence in Activities of Daily Living and the Hospital Anxiety and Depression Scale (HADS). Results: Fifty-five per cent of all participants did not present with anxiety or depression, 20% scored above the diagnostic threshold on the anxiety scale and 26% scored above the diagnostic threshold on the depression scale. Subgroup analysis revealed that anxiety and depression sufferers were 13.64% and 13.64% of MS patients, respectively; 22.58% and 35.48% of PD patients, respectively; and 22.22% and 25.93% of stroke survivors, respectively. There was a significant correlation between depression and independence level in the entire group and between depression and marital status in stroke survivors. Conclusions: Although depression and anxiety are highly prevalent in patients with neurological conditions, the disorder has a very individual nature and is not associated with the patient's age, duration of a condition or concomitant diseases. Screening for depression and anxiety as a part of comprehensive approach may increase treatment efficacy in neurological patients.
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Affiliation(s)
- Andrzej Knapik
- Department of Adapted Physical Activity and Sport, Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia, 40–055 Katowice, Poland (R.P.)
| | - Ewa Krzystanek
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, 40–055 Katowice, Poland; (E.K.); (J.S.)
| | - Justyna Szefler–Derela
- Department of Physiotherapy, Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia, 40–055 Katowice, Poland;
| | - Joanna Siuda
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, 40–055 Katowice, Poland; (E.K.); (J.S.)
| | - Jerzy Rottermund
- Department of Physiotherapy, School of Health Sciences, University of Dąbrowa Górnicza, 41–300 Dąbrowa Górnicza, Poland
| | - Ryszard Plinta
- Department of Adapted Physical Activity and Sport, Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia, 40–055 Katowice, Poland (R.P.)
| | - Anna Brzęk
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, 40–055 Katowice, Poland; (E.K.); (J.S.)
- Correspondence: ; Tel.: +48-32-2088712
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18
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Łabuz-Roszak B, Niewiadomska E, Starostka-Tatar A, Kubicka-Bączyk K, Krzystanek E, Arkuszewski M, Tyrpień-Golder K, Rybus-Kalinowska B, Pierzchała B, Pierzchała K. Multiple sclerosis: oral health, behaviours and limitations of daily oral hygiene - a questionnaire study. Neurol Neurochir Pol 2019; 53:271-276. [PMID: 31441495 DOI: 10.5603/pjnns.a2019.0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/06/2019] [Accepted: 05/12/2019] [Indexed: 11/25/2022]
Abstract
CLINICAL RATIONALE FOR THE STUDY Neurological deficits and progressing disability in patients with multiple sclerosis (MS) may hamper daily oral hygiene, but their relations with oral problems have not yet been clearly determined. AIM OF THE STUDY The aim of this study was to identify the most significant dental problems and limitations of daily oral hygiene in Polish patients with MS. MATERIAL AND METHODS 199 patients with diagnosed MS (median age 37 years) treated in the neurological outpatient clinic were interviewed using a paper-based questionnaire. They provided answers on oral health, behaviours and the limitations of their daily oral hygiene. Clinical information regarding symptoms, MS phenotype, relapses, medication and degrees of disability was based on medical records. RESULTS The most frequent symptoms were dry mouth (43.2%) and bleeding from gums (28.1%). Dry mouth was more frequent in patients with secondary-progressive MS (SPMS) than relapsing-remitting MS (65.4% vs 41.3%, p = 0.023). Patients with bleeding from gums had had MS for a longer duration (median 6 vs 4 years, p = 0.002). Difficulties in daily oral hygiene were more frequent in patients with SPMS (24.0% vs 8.1%; p = 0.016). Greater proportions of patients with muscle weakness of limbs, imbalance or pain brushed their teeth irregularly. Frequent (i.e. at least every six months) visits to the dentist's surgery were uncommon in patients with SPMS (12.0% vs 39.7%, p = 0.010). CONCLUSIONS AND CLINICAL IMPLICATIONS Dry mouth and bleeding from gums are more frequent in patients with longer lasting and more advanced types of MS. Daily oral hygiene and oral health self-control is limited in patients with MS, mainly due to motor deficits, balance problems and pain, and this becomes worse with disease duration. To minimise the burden of the disease, patients with MS require better education and improvement in their awareness regarding proper oral health control, such as the use of electric toothbrushes. In addition, patients with chronic and progressive disability from multiple sclerosis may benefit from better organised access to dental care.
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Affiliation(s)
- Beata Łabuz-Roszak
- Medical University of Silesia, Faculty of Public Health, Bytom, Piekarska 18, 41-902 Bytom, Poland.
| | - Ewa Niewiadomska
- Medical University of Silesia, Faculty of Public Health, Bytom, Piekarska 18, 41-902 Bytom, Poland
| | - Anna Starostka-Tatar
- Department of Neurology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Kubicka-Bączyk
- Department of Neurology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | | | | | - Barbara Rybus-Kalinowska
- Medical University of Silesia, Faculty of Public Health, Bytom, Piekarska 18, 41-902 Bytom, Poland
| | | | - Krystyna Pierzchała
- Department of Neurology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
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19
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Brozek P, Brachmanska M, Rabiczko K, Bulska W, Ciulkowicz M, Krzystanek E. Depression, sleep disturbances and anxiety in patients with relapsing-remitting multiple sclerosis: a longitudinal cohort observation. Psychiatr Danub 2017; 29:464-468. [PMID: 28953809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Depression, sleep disturbances and anxiety may affect almost half of the population of patients with multiple sclerosis (MS) and they are major determinants of poor quality of life in young adults. The aim of our study was to assess their incidence in patients with MS in Poland, and whether they change during longitudinal observation in routine clinical practice. SUBJECTS AND METHODS We included 53 consecutive patients with relapsing-remitting form of MS in this prospective study, who were treated in our department. All patients were examined at the entry to the study and after at least three or more years after study start with 4 standardized questionnaires and clinical scales that were validated in Polish patients: Athens Insomnia Scale (AIS), Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS) and Expanded Disability Status Scale (EDSS). The data from the two time-points were compared. RESULTS At the entry to the study daytime sleepiness, nighttime insomnia, depression episodes and anxiety were observed in 11.3%, 13.2%, 11.3% and 28.3% of patients, respectively. At the end of the study higher proportion of patients reported any form of drowsiness, depression, insomnia or anxiety, however, the differences were not statistically significant. Except for anxiety, higher proportion of patients reported definite disorders, with the rise from 3.8% to 13.2% having depression and rise from 9.4% to 15.1% having insomnia. Moderate or pathological drowsiness was not reported initially, but it was reported in 5% and 2.5% patients, respectively, at the study end. CONCLUSIONS The incidence of sleep and mood disturbances in polish patients with MS is quite high, and it is comparable to other studies in patients with MS. Possible mood changes or sleep disturbances in individual patients should be routinely monitored by clinicians.
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Affiliation(s)
- Paulina Brozek
- Department of Neurology, Medical University of Silesia, Medical School in Katowice, XXV-lecia str. 12A/2, 58-260 Bielawa, Poland,
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20
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Kaczmarczyk A, Patalong-Ogiewa M, Krzystanek E. [Hashimoto's encephalopathy - rare encephalopathy with good prognosis]. Wiad Lek 2016; 69:768-772. [PMID: 28214813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Hashimoto's encephalopathy (HE) is a rare neuropsychiatric syndrome associated with increased level of antithyroid antibodies. Two types of clinical manifestation can be described: a vasculitic type with stroke like episodes and diffuse progressive type with deterioration of mental function. Neurologic symptoms are present in euthyreosis as well as in thyroid dysfunction. Because of good response to immunosuppressive therapy, the prompt diagnosis and management of HE are crucial. In this study we present the review of current literature and discuss two representative cases.
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Affiliation(s)
- Aleksandra Kaczmarczyk
- Katedra I Klinika Neurologii, Wydział Lekarski, Śląski Uniwersytetu Medyczny, Katowice, Polska
| | - M Patalong-Ogiewa
- Katedra I Klinika Neurologii, Wydział Lekarski, Śląski Uniwersytetu Medyczny, Katowice, Polska
| | - E Krzystanek
- Katedra I Klinika Neurologii, Wydział Lekarski, Śląski Uniwersytetu Medyczny, Katowice, Polska
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21
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Walawska-Hrycek A, Krzystanek E, Rudzińska M. [Systemic lupus erythematosus of the nervous system--selected aspects]. Wiad Lek 2015; 68:39-44. [PMID: 26094332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Neurological symptoms in SLE are still the challenge for the practitioners. It is assumed that that the central nervous system (CNS) is affected in 95% patients with SLE. It is a cause significantly worsening the prognosis, responsible for the mortality increase in this disease. In 1999 American Academy of Rheumatology published the first formal classification of the neurological symptoms in SLE. 19 types of the neuropsychiatric systemic lupus erythematosous (NPSLE) are distinguished. Ischaemic strokes of CNS, transistent ischaemic attaks, epileptic seizures and mobility disturbances are the most common symptoms. It is assumed that antiphospholipid antibodies are the most important factors in the NPSLE pathogenesis. These antibodies reveal prothrombotic and proinflammatory activities with vasculitis as the effect of this action. However it should be stressed that cause-effect relationship between the action of specific antibodies and neurological symptoms are still unclear. Better understanding of neurological and psychiatric symptoms of SLE may allow faster diagnosis, as well as the disease exacerbation and the application of proper therapy.
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22
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Krzystanek M, Krzystanek E, Trzeciak HI, Małecki A, Krupka-Matuszczyk I, Janas-Kozik M, Rybakowski JK. Effects of olanzapine and paroxetine on phospholipase D activity in the rat brain. Pharmacol Rep 2014; 65:724-9. [PMID: 23950596 DOI: 10.1016/s1734-1140(13)71051-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 02/02/2013] [Indexed: 01/28/2023]
Abstract
BACKGROUND Phospholipase D (PLD) plays a key role in a second messenger system producing phosphatidic acid, mediating, among others, serotonin 5-HT2 receptor activity. The aim of the study was to evaluate a possible effect of atypical antipsychotic drug, olanzapine (OLZ), and selective serotonin reuptake inhibitor (SSRI) antidepressant, paroxetine (PX), on oleate-activated PLD activity in plasma membranes isolated from rat brain cortex. METHODS PLD activity was determined using a fluorometric assay. Ritanserin was used to determine the 5-HT receptor mode of action. RESULTS A single dose of 10 mmol/kg OLZ produced no change in rat brain cortex PLD activity, 20 mmol/kg OLZ caused a nonsignificant decrease, and long-term (21 days) administration of OLZ resulted in a 41.9% decrease in PLD activity. Single doses of PX significantly decreased PLD activity: 10 mmol/kg - by 28.6%; 20 mmol/kg - by 31.5%, and long-term (21 days) administration of PX - by 39.5%. CONCLUSION The study indicates that the 5-HT2 receptor-mediated inhibition of oleate-activated PLD may be a common part of the mechanisms of action of OLZ and PX.
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Affiliation(s)
- Marek Krzystanek
- Department and Clinic of Psychiatry and Psychotherapy, Medical University of Silesia, Katowice, Poland.
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23
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Krzystanek M, Pałasz A, Krzystanek E, Krupka-Matuszczyk I, Wiaderkiewicz R, Skowronek R. [S-adenosyl L-methionine in CNS diseases]. Psychiatr Pol 2011; 45:923-931. [PMID: 22335134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
S-adenosyl L-methionine (SAMe) is the natural, universal methyl group donor, participating in transmethylation reactions, known and commonly used as a dietary supplement since 1952. It plays an important role in the synthesis of neuromediators and melatonin and mechanisms of epigenetic regulation. The aim of this article is to review the literature about possibilities of SAMe application in the therapy of CNS diseases: depression, dementia syndromes, schizophrenia and somatic disorders. SAMe is the promising dietary supplement, which may be successfully used as a substance increasing effectiveness of the treatment of depression, with antidepressants in monotherapy in mild depressive states or depressive symptoms. SAMe addition to antipsychotic drug, may lead to the improvement of the quality of life and reduction of aggressiveness of patients. SAMe may be an effective substance in the therapy and prophylaxis of mild cognitive impairments and mild dementia syndrome. SAMe possesses some hepatoprotective action, so it may decrease the risk of the development of neoplasm, alcohol-induced liver disease (ALD) and cirrhosis. SAMe improves the functions of joints and decreases the experience of pain in rheumatoid arthritis (RA).
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Affiliation(s)
- Marek Krzystanek
- Katedra i Klinika Psychiatrii i Psychoterapii, Slaski UM w Katowicach
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Kostecki J, Zaniewski M, Ziaja K, Urbanek T, Kuczmik W, Krzystanek E, Ziaja D, Korzeniowski T, Majewski E, Hartel M, Swiat M, Sioma-Markowska U. An endovascular treatment of Chronic Cerebro-Spinal Venous Insufficiency in multiple sclerosis patients - 6 month follow-up results. Neuro Endocrinol Lett 2011; 32:557-562. [PMID: 21876515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Accepted: 05/04/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE In this study, the mid-term results (6 month follow-up) of the endovascular treatment in patients with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and multiple sclerosis (MS) were prospectively evaluated. METHODS Thirty-six patients with confirmed MS and CCSVI underwent endovascular treatment by the means of the uni- or bilateral jugular vein angioplasty with optional stent placement. All the patients completed 6 month follow-up. Their MS-related disability status and quality of life were evaluated 1, 3 and 6 months postoperatively by means of the following scales: Expanded Disability Status Scale (EDSS), Multiple Sclerosis Impact Scale (MSIS-29), Epworth Sleepiness Scale (ESS), Heat Intolerance scale (HIS) and Fatigue Severity Scale (FSS). For patency and restenosis rate assessment, the control US duplex Doppler examination was used. RESULTS Six months after the procedure, restenosis in post-PTA jugular veins was found in 33% of cases. Among 17 patients who underwent stent implantation into the jugular vein, restenosis or partial in-stent thrombosis was identified in 55% of the cases. At the 6 month follow-up appointment, there was no significant improvement in the EDSS or the ESS. The endovascular treatment of the CCSVI improved the quality of life according to the MSIS-29 scale but only up to 3 months after the procedure (with no differences in the 6 month follow-up assessment). Six months after the jugular vein angioplasty (with or without stent placement), a statistically significant improvement was observed only in the FSS and the HIS. CONCLUSIONS The endovascular treatment in patients with MS and concomitant CCSVI did not have an influence on the patient's neurological condition; however, in the mid-term follow-up, an improvement in some quality-of-life parameters was observed.
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Affiliation(s)
- Jacek Kostecki
- Department of Surgery, Medical University of Silesia, District Specialist Hospital, Tychy, Poland.
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Krzystanek M, Trzeciak HI, Krzystanek E, Małecki A. Fluorometric assay of oleate-activated phospholipase D isoenzyme in membranes of rat nervous tissue and human platelets. Acta Biochim Pol 2010. [DOI: 10.18388/abp.2010_2418] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Phospholipase D plays a key role in the biosynthesis of phosphatidic acid, a second messenger involved in essential cellular processes. Oleate-activated phospholipase D was the first mammalian phospholipase D isoform to be discovered but is the least known. The study was aimed to test a fluorometric method of assessment of oleate-activated phospholipase D activity in different biological materials. The brain cortex of male Wistar rats, cultured rat brain astrocytes, and human platelets were processed to yield plasmatic membranes for experiments. To assess phospholipase D activity the modified fluorometric method was used. Previously, the method was used only to determine H₂O₂. In this enzyme-coupled assay phospholipase D activity is monitored indirectly using 10-acetyl-3,7-dihydroxyphenoxazine. First, phospholipase D cleaves exogenous phosphatidylcholine to yield choline and phosphatidic acid. Second, choline is oxidized by choline oxidase to betaine and H₂O₂. Finally, in the presence of horseradish peroxidase, H₂O₂ reacts with 10-acetyl-3,7-dihydroxyphenoxazine to generate the highly fluorescent product, resorufin. The concentration of resorufin was measured using excitation and emission at 560 nm and 590 nm, respectively. The proposed optimal parameters of the tested assay are 25 µg of rat brain cortex protein, 50 µg of rat brain astrocyte protein, and 50 µg of human platelet protein in a reaction volume of 200 µL, and 2 min enzymatic reaction at 37°C. The fluorometric method may be applied to assay phospholipase D in different biological materials.
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26
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Krzystanek M, Trzeciak HI, Krzystanek E, Małecki A. Fluorometric assay of oleate-activated phospholipase D isoenzyme in membranes of rat nervous tissue and human platelets. Acta Biochim Pol 2010; 57:369-372. [PMID: 20835407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 06/24/2010] [Accepted: 09/07/2010] [Indexed: 05/29/2023]
Abstract
Phospholipase D plays a key role in the biosynthesis of phosphatidic acid, a second messenger involved in essential cellular processes. Oleate-activated phospholipase D was the first mammalian phospholipase D isoform to be discovered but is the least known. The study was aimed to test a fluorometric method of assessment of oleate-activated phospholipase D activity in different biological materials. The brain cortex of male Wistar rats, cultured rat brain astrocytes, and human platelets were processed to yield plasmatic membranes for experiments. To assess phospholipase D activity the modified fluorometric method was used. Previously, the method was used only to determine H₂O₂. In this enzyme-coupled assay phospholipase D activity is monitored indirectly using 10-acetyl-3,7-dihydroxyphenoxazine. First, phospholipase D cleaves exogenous phosphatidylcholine to yield choline and phosphatidic acid. Second, choline is oxidized by choline oxidase to betaine and H₂O₂. Finally, in the presence of horseradish peroxidase, H₂O₂ reacts with 10-acetyl-3,7-dihydroxyphenoxazine to generate the highly fluorescent product, resorufin. The concentration of resorufin was measured using excitation and emission at 560 nm and 590 nm, respectively. The proposed optimal parameters of the tested assay are 25 µg of rat brain cortex protein, 50 µg of rat brain astrocyte protein, and 50 µg of human platelet protein in a reaction volume of 200 µL, and 2 min enzymatic reaction at 37°C. The fluorometric method may be applied to assay phospholipase D in different biological materials.
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Affiliation(s)
- Marek Krzystanek
- Department and Clinic of Psychiatry and Psychotherapy, Medical University of Silesia, Katowice, Poland.
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Siuda J, Gorzkowska A, Patalong-Ogiewa M, Krzystanek E, Czech E, Wiechuła B, Garczorz W, Danch A, Jasińska-Myga B, Opala G. From mild cognitive impairment to Alzheimer's disease - influence of homocysteine, vitamin B12 and folate on cognition over time: results from one-year follow-up. Neurol Neurochir Pol 2009; 43:321-329. [PMID: 19742390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND AND PURPOSE People with mild cognitive impairment (MCI) have higher risk of developing dementia than the general population. Currently known risk factors for dementia include older age, low education level, gait disorders, hippocampal atrophy, and apolipoprotein E allele. Vascular risk factors may modify the neurodegenerative process. The aim of this study was therefore to assess the influence of vascular (genetic and environmental) risk factors on progression to dementia in an MCI group during a one-year period. MATERIAL AND METHODS Fifty-five MCI patients (30 men and 25 women) and 44 controls (25 men and 19 women) matched for age, gender and education were studied. Mild cognitive impairment was diagnosed according to Petersen criteria (Mayo Clinic Group). Neuropsychological evaluation was made. Assessed vascular risk factors included hypertension, cardiovascular disease, diabetes, cigarette smoking, hyperlipidaemia, hyperhomocysteinaemia with vitamin B12 and folate deficiency. Genetic risk factors (APOE polymorphism, C677T and A1298C MTHFR polymorphisms) were also assessed. RESULTS Vascular risk factors were found significantly more often in the MCI group (p = 0.041), including APOE4 allele (p = 0.018), hyperhomocysteinaemia (p = 0.012) and folate deficiency (p = 0.023). Discriminant function analysis showed that only age and hypertension are potential factors which may have an influence on progression to dementia in the MCI group within one year of prospective observation. CONCLUSION Vascular risk factors are associated with cognitive impairment but do not have a significant influence on progression to dementia in the MCI group.
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Affiliation(s)
- Joanna Siuda
- Katedra i Klinika Neurologii, SP Centralny Szpital Kliniczny SUM im. prof. K. Gibińskiego, ul.Medyków 14, 40-752 Katowice.
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Krzystanek E, Krzystanek M, Opala G, Trzeciak HI, Siuda J, Małecki A. Platelet phospholipase A2 activity in patients with Alzheimer’s disease, vascular dementia and ischemic stroke. J Neural Transm (Vienna) 2007; 114:1033-9. [PMID: 17447002 DOI: 10.1007/s00702-007-0669-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2006] [Accepted: 02/18/2007] [Indexed: 11/26/2022]
Abstract
Phospholipase A(2) (E.C. 3.1.1.4, PLA(2)) plays an essential role in metabolism of membrane phospholipids, it is related to inflammatory reactions, secretion of amyloid precursor protein and activation of NMDA receptor after ischemia. In the present study we investigated PLA(2) activity in platelets from 37 Alzheimer's disease (AD) patients, 32 vascular dementia (VaD) patients and 32 individuals with ischemic stroke as compared to 27 healthy elderly controls. PLA(2) activity was determined using radiometric assay. Mean platelet PLA(2) activity was increased in individuals with Alzheimer's disease (p < 0.001). In VaD group the enzyme activity was between the values in AD and controls, these differences being significant from both groups. In the group of patients with ischemic stroke mean PLA(2) activity was higher either 48 h after the stroke or 7 days later (in both cases p < 0.001). The results may be particularly interesting in light of the fact, that inhibitors of PLA(2) activity are known.
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Affiliation(s)
- E Krzystanek
- Department of Late Age Neurology, Silesian Medical University, Katowice, Poland.
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Opala G, Krzystanek E, Siuda J, Pilch-Kowalczyk J. [Melkersson-Rosenthal syndrome as a rare cause of recurrent facial nerve palsy]. Neurol Neurochir Pol 2005; 39:335-8. [PMID: 16096940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Melkersson-Rosenthal syndrome is a rare cause of recurrent facial nerve palsy. The syndrome is classically characterized by a triad of signs consisting of facial edema, recurrent peripheral facial nerve paralysis, and congenital fissured tongue, although it may also present in a mono- or oligosymptomatic form. The paper presents a 24-year-old woman with right-sided peripheral facial nerve palsy and a history of left-sided episodes of facial nerve palsy. Magnetic resonance angiography of the cerebral vessels suggested compression of the right seventh and eighth cranial nerves by a vascular loop. The authors describe the patient with a complete picture of Melkersson-Rosenthal syndrome and discuss the diagnosing process and treatment.
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Affiliation(s)
- Grzegorz Opala
- Department of Neurology, Aging, Degenerative and Cerebrovascular Diseases, Silesian Medical Academy, Central University Hospital, ul. Medyków 14, 40-752 Katowice, Poland.
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Krzystanek E, Opala G. [Teleneurology: a new form of physician--patient communication]. Wiad Lek 2005; 58:21-4. [PMID: 15991548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The Internet is an increasingly popular medical information source. 281 electronic mails to a neurologist concerning medical consultation were analyzed. Demographic features of senders and subject of electronic mails were characterized.
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Affiliation(s)
- Ewa Krzystanek
- Katedry i Kliniki Neurologii Wieku Podeszłego Slaskiej Akademii Medycznej w Katowicach
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Krzystanek E, Klimek B. [The treatment of migraine and tension headache in children]. Wiad Lek 2000; 52:441-7. [PMID: 10628267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The authors present the problem of the migraine and tension-type headache treatment in the children basing on the questionnaires, carried out among the participants of The Third Polish Days of Children Neurology.
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Affiliation(s)
- E Krzystanek
- Studenckiego Koła Naukowego przy Oddziale Neurologii Dzieciecej II Katedry i Kliniki Pediatrii Slaskiej Akademii Medycznej w Katowicach
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Krzystanek E, Krzystanek M, Saczewski F, Debowski T, Trzeciak H. Structure of new imidazoline derivatives and their cardiovascular effect in rats. Ann N Y Acad Sci 1999; 881:106-9. [PMID: 10415904 DOI: 10.1111/j.1749-6632.1999.tb09348.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E Krzystanek
- Department of Pharmacology, Silesian Medical University, Katowice-Ligota, Poland
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Saczewski F, Debowski T, Petrusewicz J, Trzeciak H, Krzystanek E, Krzystanek M, Gdaniec M, Nowakowska E. Synthesis, structure, and biological activities of some N-(4,5-dihydro-1H-imidazol-2-yl)-1,3-dihydrobenzimidazole derivatives. Arch Pharm (Weinheim) 1998; 331:241-8. [PMID: 9747180 DOI: 10.1002/(sici)1521-4184(199807)331:7/8<241::aid-ardp241>3.0.co;2-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A series of novel N-(4,5-dihydroimidazol-2-yl)-1,3-dihydrobenzimidazole derivatives 2a-d, 3a-d and 4a-p were prepared and their structure was determined by IR and NMR spectroscopic data as well as X-ray analysis of carbonitrile 2a. The compounds were studied as potential inhibitors of the human blood platelet aggregation induced by adrenaline or ADP. Compounds of type 3 proved efficacious for the reduction of arterial blood pressure upon intravenous administration to normotensive rats.
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Affiliation(s)
- F Saczewski
- Department of Organic Chemistry, Medical University of Gdańsk, Poland
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