Health behaviors and problems in Polish homeless men

Introduction

Homelessness is considered to be a global problem, independent of the material situation of a given country and occurring in most societies around the world.

Aim of the study

Assessment of the preferred health behaviors of homeless people.

Materials and methods

The study covered 153 men who are homeless and 312 men who are not homeless. The original questionnaire of homeless, and validated the Satisfaction with Life Scale (SWLS), the Health Behavior Inventory (HBI), the General Self-Efficacy Scale (GSES) and the Multidimensional Health Locus of Control (MHLC) Scale were used. The research covered fully completed questionnaires from 153 homeless men staying in Białystok and Gdańsk homelss centers.

Results

On average, the homeless men assessed their health at 6.0 ± 2.7 points, and the non-homeless at 7.8 ± 2.2 points (p < 0.001). Significant differences were found between people experiencing a homelessness crisis and the control group in selected aspects concerning the everyday life hygiene of the respondents, health self-assessment, declarations of visits to a specialist and carrying out check-ups, level of satisfaction with life, coping with difficult situations, preferred pro-health behaviors and dimensions of health control. In the used scales, SWLS, HBI, GES, and MHCL, the majority of homeless men obtained average scores. They were rather dissatisfied with their lives, with a low level of effectiveness in coping with difficult situations and obstacles, a low level of health behaviors, and in the scope of health, control increasing the impact of chance.

Conclusion

The level of the presented health behaviors showed statistically significant diversification with all dimensions of the health locus of control, and its internal dimension with age, homelessness phase, the respondents' criminal history, being under constant medical care, and self-assessment of health.

Anxiety and Health Concerns among Healthcare Personnel Working with COVID-19 Patients: A Self-Assessment Study

BACKGROUND Anxiety disorders are currently among the most common psychiatric diagnoses. This study aimed to analyze self-assessment of anxiety disorders, depression, and quality of life among healthcare personnel working during the COVID-19 pandemic, with a focus on sociodemographic sources and psychological indicators. MATERIAL AND METHODS The study covered a group of 318 healthcare professionals from Poland. The study used a self-created questionnaire, Beck Depression Inventory, WHOQOL-BREF, Generalised Anxiety Disorder Questionnaire (GAD-7), and Leibowitz Social Anxiety Scale. RESULTS In the study group, 71.1% of the respondents had coronavirus infection, and only 3.5% were not vaccinated. Almost half (45.6%) of the respondents in this group made independent decisions about performing work (45.6%), and 93.4% were satisfied with their work. Less than half of respondents (46.5%) felt work-related anxiety during the pandemic, 54.7% of respondents reported symptoms of depression, and 57% had a good quality of life. Nearly half (47.2%) of the respondents rated their health as good, but 53.1% feared deterioration after performing the aforementioned work, while 87.1% constantly or periodically felt anxious about their work. CONCLUSIONS Although the respondents usually made their own decisions about working with coronavirus-infected patients, most of them experienced anxiety related to their work during the pandemic and were afraid of damaging their health and contracting COVID-19. In self-assessment using standardized questionnaires, most respondents did not show an increase in generalized or social anxiety, but to a greater or lesser extent were diagnosed with a depressive episode. The majority of respondents had a good quality of life: the highest aspect regarded physical functioning and the lowest regarded social functioning.

The Functioning of Hospice in the Perception of Family Members of Cancer Surgery and Hospice Patients

BACKGROUND

Palliative care in Poland is for all dying people and their families to have timely access to quality care services. The study aimed to assess the perception of the role of hospice care by families of patients treated in oncological surgery departments and hospices.

METHODS

The study included 211 family members of cancer patients, comprising 108 family members of cancer surgery patients (Group I) and 103 hospice patients (Group II). The study used a diagnostic survey method with a proprietary questionnaire.

RESULTS

74.9% of people in Group I and 84.6% in Group II experienced positive associations with hospice care. 86% of respondents from Group I believed that hospice is a place where patients can die with dignity, while 68.3% of those from Group II believed it is where patients receive professional care. 56.7% from Group I and 65.4% from Group II did not feel anxious about hospice care. According to 68.6% of people in Group I, informing the patient that he or she is in hospice as well as about his or her disease should depend on the patient's condition. In the opinion of 75% of Group II, the patient should always be informed. In Group I (68.3%) and Group II (91.5%), the dominant opinion was that the family should take part in the care and treatment of the patient. 78.4% of respondents in Group I and 96.4% in Group II recommend hospice to other families.

CONCLUSIONS

Most families of cancer patients from both the oncological surgery departments (Group I) and hospice (Group II) had positive first associations with hospice care. However, families from Group II had more critical remarks on hospice functioning.

Assessment of anxiety disorders in students starting work with coronavirus patients during a pandemic in Podlaskie Province, Poland

Background

Anxiety disorders are considered the sixth most important factor resulting in non-fatal health loss in the world. Moreover, they are among the first ten causes of years lived with disability (YLD) across the globe. Important clinical disorders include e.g., panic disorder, social anxiety disorder, generalized anxiety disorder and specific phobia.

Objectives

The study aimed to analyse the occurrence of level anxiety in students who start work at the time of the COVID-19 pandemic, with relation to the socio-demographic factors and health status, vaccination, conovirus infection, assistance of a psychologist or psychiatrist in the past, and using tranquilizers.

Methods

The study involved 255 students from Poland starting work with coronavirus patients during the pandemic. It was conducted using our own questionnaire, the Liebowitz Social Anxiety Scale (LSAS) and the State-Trait Anxiety Inventory (STAI).

Results

Fifty-one percent of subjects demonstrated symptoms of mild to severe social phobia. Level of trait anxiety among students correlated significantly with age and gender (females). The level of social anxiety in the evaluated students was significantly correlated with marital status, the self-assessment of the experienced fear, self-perceived health status, having had a coronavirus infection, fear of deterioration of one's health after starting work with coronavirus patients, and fear of contracting the disease while working with coronavirus patients, and using tranquilizers. Level of state anxiety significantly correlated with state anxiety, the self-assessment of professional preparedness for work with coronavirus patients, self-perceived health status, vaccination against coronavirus, and the assistance of a psychiatrist in the past.

Conclusions

The proportion of students showing social anxiety is alarming. Anxiety among the evaluated students during the COVID-19 pandemic was correlated with many factors.

Impact of the Pandemic on Selected Aspects of Health-Promoting Attitudes in 2020–2021: A Cross-Sectional Study

Introduction

In the face of the COVID-19 pandemic, people began to change both their health-promoting and anti-health behaviors.

Aim of the Paper

To assess the impact of the pandemic on selected health-promoting attitudes.

Methods

The cross-sectional study was conducted from March 2020 to September 2021. We have used the author's survey questionnaire and the standardized Wellness Behaviors Inventory (WBI). The questionnaires were given to respondents in paper versions to fill it.

Results

The study group included 600 urban residents aged 32–73. Based on the opinions of the respondents, during the pandemic, the following activities increased the most: hand washing (93.3%), eating sweets and snacks (80%), and surfing the Internet (60%). An increase in drug/legal use was reported by 13.3%, with no indication of a decrease or no change in consumption of the above. The overall WBI index for all subjects before the pandemic was 81.3 ± 20.2 points, and the increase significantly (p < 0.001) during the pandemic was 87.7 ± 16.7 points. In addition, an increase in preferred eating habits was found (from 19.5 ± 6.4 to 21.1 ± 6.9 points; p < 0.001), preferred prophylactic behaviors (from 21.1 ± 6.0 to 22.7 ± 5.2 points; p < 0.001) and level of presented health practices during the pandemic (from 20.3 ± 5.1 to 24.7 ± 2.7 points; p < 0.001), and a decrease significantly (p < 0.001) in the degree of positive mental attitude (from 20.3 ± 5.4 points to 19.3 ± 4.9 points).

Conclusions

Respondents generally rated their own and their family's health as worse during the pandemic period, and this trend continued when broken down by gender, cohabitant, place of residence, and education. According to the largest group of respondents, the frequency of handwashing, eating sweets and snacks, surfing the Internet, and using drugs/legal highs increased the most during the pandemic. The overall WBI index for all respondents before and during the pandemic was slightly higher during the pandemic period. Monitoring health behavior during a pandemic is essential for prevention and health care institutions. Further studies are needed to assess the long-term impact of the pandemic on pro-and anti-health behavior of people.

Well-Being at Home During Forced Quarantine Amid the COVID-19 Pandemic

INTRODUCTION

People recently or currently in forced quarantine or isolation at home have shown high levels of depression and symptoms of generalized anxiety.

AIM OF THE STUDY

To assess the impact of the COVID-19 pandemic on certain aspects of people's day-to-day functioning.

MATERIALS AND METHODS

The study involved using an online diagnostic survey including a proprietary questionnaire, the DASS 21, and the Liebowitz Social Anxiety Scale.

RESULTS

Information about the pandemic in Poland and around the world was systematically obtained by 48.8 and 27.4% of respondents, respectively (N = 1,312). Whereas, 75.6% of respondents declared having knowledge about the number of infected people in Poland, only 28.7% declared having such knowledge about infections worldwide. Most often, respondents had obtained information online (65.9%). According to 45.7% of respondents, infection with COVID-19 is a major threat, and not enough has been done to reduce its spread in Poland (66.7%) or worldwide (56.1%). Respondents considered social distancing (68.3%), quarantining people arriving from abroad (63.4%), and wearing protective masks and/or gloves (60.4%) to be the most effective actions for combatting the pandemic. Most often, in compulsory quarantines, respondents surfed the Internet (48.8%) and experienced a lack of energy or fatigue (40.2%) and anxiety (54.9%). The severity of anxiety (mean = 4.6 points), stress (7.5 points), and depression (7.3 points) were within normal ranges, and the respondents could generally be included in the group showing mildly severe social phobia (57.9 points).

CONCLUSIONS

Most respondents considered infection with COVID-19 to be a major threat and feared another quarantine. During quarantine, respondents most often experienced fatigue, a lack of energy, nervousness, anxiety, anger, and sadness. Despite demonstrating anxiety, stress, and depression with severity in the normal range, respondents showed no statistically significant correlation between severity and age, gender, place of residence, or level of education. Although they also showed mildly severe social phobia, only gender, not age, place of residence, or level of education, showed a statistically significant correlation with its severity.

Trust in Nurse Scale Developed on the Basis of the Standardized Trust in Physician Scale by Anderson and Dedrick

Introduction:

Nursing care is one of the most important areas of health services, taking place in direct contact with the patient, constituting a subsystem deciding about the general level of services.

Aim:

The aim of the study was to construct the Trust in Nurse Scale on the basis of the standardized Trust in Physician Scale by Anderson and Dedrick.

Methods:

The study included a group of 1,200 people selected at random, 600 each from surgical and medical treatment wards. Patients did not report any problems with understanding the statements on the scale.

Results:

The internal accuracy scores were excellent, all Cronbach’s a values were well above 0.70. The Spearman’s rank correlation coefficient values were highly statistically significant (p <0.001), and correlation strength was very high (for most items r_s > 0.90).

Conclusion:

We suggest that The Trust in Nurse Scale, developed on the basis of the standardized Trust in Physician Scale by Anderson and Dedrick, can be used in studies on patient satisfaction with nursing care.

Mandatory and recommended vaccinations in Poland in the views of parents

Background: Vaccinations are currently the key element in the prevention of the spread of infectious diseases. We studied parents' opinions about mandatory and recommended preventive vaccinations in Poland. Methods: A diagnostic survey using an original questionnaire was done in a group of 300 parents. Results: A total of 3.7% of parents did not vaccinate their children. 90% were aware of the threat potentially posed by infectious diseases, and 73.7% knew that breastfeeding alone does not ensure sufficient protection against them. 28% believed that it is necessary to vaccinate a child against all diseases, 51.7% that the number of vaccinations is insufficient, and 62.7% that vaccine use is safe. 40.7% thought that unvaccinated children should not be able to attend nurseries and kindergartens, as they pose a threat to other children. Postvaccinal adverse events occurred in 21.3% of children, mainly (71.9%) an increase in body temperature above 38°C. 88.3% were informed about possible vaccine-induced complications, most often by nurses (79.7%). 88% of the respondents were aware of the possibility to switch to an alternative immunization program, 92% were informed on the possible administration of recommended vaccines, and 53% took advantage of combined vaccines. Conclusions: Views on vaccinations were mostly varied, depending on the age, sex, education, and financial situation of the respondents. Most of the parents who did not vaccinate their children believed that immunity can be acquired by infection. They were in favor of a limited number of vaccinations, were more critical of the vaccination program in Poland, considered the vaccines used in Poland to be unsafe, and blamed vaccines for multiple developmental defects and autism in children. Parents whose children experienced vaccine-induced adverse reactions were more likely to have doubts before the next vaccination.

Seasonal Variations in Cerebral Palsy Births

INTRODUCTION

Previous studies of cerebral palsy (CP) suggest that it seasonal variations in the incidence of CP. The purpose of this paper was to compare seasonal variations in the incidence of cerebral palsy (CP) in Podlaskie Province, Poland, between 1990-1999 (study 2005) and 2000-2014 (study 2017) in a retrospective case-controlled study.

MATERIALS AND METHODS

Data were obtained from the hospital database. We compared CP births between January 1, 1990, and December 31, 1999, n = 212 (116 boys, 96 girls) and January 1, 2000, and December 31, 2014, n = 205 (114 boys, 91 girls). We used Cosinor analysis to examine the seasonality of CP births.

RESULTS

The highest number of CP births occurred in spring and the lowest in winter, with intermediate values in summer and autumn. This seasonal pattern was significant for spring vs. winter. The peaks in the numbers of CP births occurred in May and August; the lowest numbers of CP births occurred in February, December, and November. In the 2017 study, we observed a slight increase in spastic tetraplegia and a decrease in mixed CP. No significant corrections between mean temperature and Apgar score, low birth weight, and asphyxia were found.

CONCLUSIONS

Our study confirmed the existence of seasonal patterns for CP births.

Efficacy and the Safety of Granulocyte Colony-Stimulating Factor Treatment in Patients with Muscular Dystrophy: A Non-Randomized Clinical Trial

Introduction

The current standard treatment for patients with Duchenne muscular dystrophy (DMD) involves corticosteroids. Granulocyte colony-stimulating factor (G-CSF) induces the proliferation of satellite cells and myoblasts and, in turn, muscle regeneration. Beneficial effects of G-CSF were also described for skeletal muscle disorders.

Aim

We assessed the safety and effects of using G-CSF to promote muscle strength in patients with DMD.

Materials and methods

Inclusion criteria were as follows: patients aged 5–15 years with diagnosed with DMD confirmed by genetic test or biopsy. Fourteen patients were treated with steroids, and their use was not changed in this study. Diagnoses were confirmed by genetic tests: deletions were detected in 11 patients and duplications in 5 patients. Nineteen 5- to 15-year-old patients diagnosed with DMD—9 were in wheelchairs, whereas 10 were mobile and independent—completed an open study. Participants received a clinical examination and performed physiotherapeutic and laboratory tests to gage their manual muscle strength, their isometric force using a hand dynamometer, and aerobic capacity [i.e., 6-min walk test (6MWT)] before and after therapy. Each participant received G-CSF (5 µg/kg/body/day) subcutaneously for five consecutive days during the 1st, 2nd, 3rd, 6th, and 12th month. Laboratory investigations that included full blood count and biochemistry were performed. Side effects of G-CSF treatment were assessed during each visit. During each cycle of G-CSF administration in the hospital, rehabilitation was also applied. All patients received regular ambulatory rehabilitation.

Results

The subcutaneous administration of G-CSF improved muscle strength in participants. We recorded a significant increase in the distance covered in the 6MWT, either on foot or in a wheelchair, increased muscle force in isometric force, and a statistically significant decrease in the activity of the muscle enzyme creatine kinase after nearly every cycle of treatment. We observed no side effects of treatment with G-CSF.

Conclusion

Our findings suggest that G-CSF increases muscle strength in patients with DMD, who demonstrated that G-CSF therapy is safe and easily tolerable.

Comparison of the Results of Studies of Air Pollution Fungi Using the SAS Super 100, MAS 100, and Air IDEAL

Although several air sampling devices for identifying and enumerating airborne microorganisms are commercially available, each poses some limitations. The aim of this study was to evaluate air pollution fungi using three such samplers: SAS Super 100, Microbiological Air Sampler (MAS) 100, and Air IDEAL. Mycological air was taken from the cellars of a 17th-century church in Siemiatycze, Poland, and the nearby outdoor environment. With samplers placed 1.5 m above the floor, microbial flora in air samples collected inside and outside the cellar were detected. The number of colony-forming units (CFU) of fungi obtained with the three samplers from the cellars and outdoor environment differed; the most CFU were obtained with the Air IDEAL and the least with the SAS Super 100. Significant differences emerged in CFUs collected from air samples with the MAS 100 and SAS Super 100, on the one hand, and the SAS Super 100 and Air IDEAL, on the other. Otherwise, results among the samplers were different. More Cladosporium species were collected with the MAS 100 sampler, whereas more Fusarium and Aspergillus species were collected with the Air IDEAL sampler. Significant differences among CFU/m³ values among the tested sites depended on the sampler used.

Identification of demographic factors and health problems that affect the acceptance of disease and health behaviors of patients with osteoarthritis

Introduction

Osteoarthritis (OA) is one of the most common causes of musculoskeletal system’s ailments. In the prevention of the disease and in its comprehensive treatment, proper health-related behavior becomes an extremely important factor for maintaining an optimal health condition. The aim of the study is to assess the relationship between the reported pain and the disability level, and the health-related behaviors undertaken by OA patients as well as their acceptance of the disease.

Materials/Methods

The study group consisted of 198 patients with diagnosed OA, according to ACR criteria (1988). The method used in the study employed a Pain VAS (0-10), Health Assessment Questionnaire Disability Index (HAQ DI 0-3), Acceptance of Illness Scale (AIS 8-40) and Health and Behavior Inventory (IZZ 24-120).

Results

The average age among respondents with OA has been 59.16 years of age (±15.87), duration of disease 5.5 years (±4.32). Pain experienced both during movement (r_s = 0.319, p < 0.001) and at rest (r_s = 0.382, p < 0.001) correlated positively with physical disability (HAQ DI). Studies indicated a positive linear correlation between the age and physical disability (r_s = 0.200, p = 0.005). Acceptance of the disease (AIS) depends mostly on age (r_s =  − 0.325, p < 0.001), on pain in motion (r_p =  − 0.209, p < 0.001) and at rest (r_p =  − 0.218, p < 0.001) and on the disability levels (r_p =  − 0.353, p < 0.001). Analysis of the health-related behaviors (IZZ) indicates that the average severity of declared behavior is statistically significant with physical disability (HAQ DI) (p = 0.029).

Conclusions

The acceptance of illness is significantly reduced with age and progressive levels of disability as well as with the severity of pain. The progressive levels of disability and the younger age of the respondents motivate them to engage in health beneficial behavior.

Retrospective observation of drug susceptibility of Candida strains in the years 1999, 2004, and 2015

Introduction

There is much literature devoted to the problem of drug resistance and decreased susceptibility of fungi to commonly used antifungals.

Aim

To analyze drug susceptibility of Candida albicans and non-Candida albicans strains isolated from the hands of people without any symptoms of disease over a 16-year period.

Materials and Methods

The study included a total of 1,274 Candida-type strains isolated from the hands of people without any symptoms of disease, including: in 1999, 432 strains; in 2004, 368; and in 2015, 454 strains. Biological monitoring of hand surface contamination was performed using the Count-Tact^TM applicator with Count-Tact plates (bioMerieux). Drug susceptibility was evaluated using FUNGITEST^®.

Results

In 1999, the most strains showed resistance to fluconazole (53.2%), in 2004 to itraconazole (52.9%), and in 2015 to fluconazole (85.8%). Resistance to more than one drug was 35.8% in 1999, 64.7% in 2004, and 92% in 2015. Mean resistance to azole antifungals significantly increased from 98 ± 39.7 strains in 1999 to 118.3 ± 29.6 in 2015 (p < 0.001). In 1999, the most strains showed resistance to fluconazole (50.6%), in 2004 to itraconazole (52.9%), and in 2015 to fluconazole (44.9%). Resistance to more than one drug was 52.9% in 1999, 64.3% in 2004, and 88.1% in 2015. Mean resistance to azole antifungals significantly increased from a mean of 76 ± 9.7 strains in 1999, to 95.3 ± 24.2 in 2004, and to 97.3 ± 16.6 in 2015 (p < 0.001).

Conclusions

We showed increased C. albicans and non-Candida albicans strain resistance to commonly used antifungal chemotherapeutics, mainly imidazole. We found a clear rise in susceptibility of C. albicans and non-Candida albicans strains to several studied antifungals.

Medical students’ perceptions of people with disabilities

Introduction: Little is known about associations of attitudes of medical students towards people with disabilities and their life satisfaction and empathy. Purpose: To assess the social perception of people with disabilities by medical students. Materials and methods: The present study interviewed 451 medical students of the Medical University of Białystok regarding their perceptions of people with disabilities, especially in light of their own satisfaction with life and empathy. We used the following questionnaires: the original questionnaire about attitudes towards people with disabilities, The Satisfaction with Life Scale (SWLS), and Empathy Understanding Questionnaire (KRE). Results: Attitudes towards people with disabilities people were generally positive. Almost 40% of respondents expressed a willingness to help for people with disabilities. In general, disabled people do not have full access to all fields of social (63.4%) and professional (63.2%) life. At the same time, disabled people tend to marry (84.9%), have children (82.1%), work (88.2%), and drive cars (76.1%). Respondents were convinced that contact with a disabled person teaches ways to help others (42.1%), and in fact 58.6% of respondents reported having decided to participate with helping the disabled. The average life satisfaction of the students was 22.7 ± 5.3 which indicates that the respondents are satisfied with their lives. The empathy level of respondents was 66.97 points ± 2.98, which indicates average level of empathy. Conclusions: This study shows that students’ perception of people with disabilities depends upon how the students viewed disabled people’s, life satisfaction and empathy.

Evaluation of quality of life in chronic, progressing rheumatic diseases based on the example of osteoarthritis and rheumatoid arthritis

Background

Rheumatic diseases, irrespective of etiology and clinical course, influence different areas of a patient’s life. Adapting to disability and limitations caused by an illness is very difficult for many patients. The main goal of a therapeutic procedure should be improvement of health-related quality of life (QoL).

Objective

Evaluation of the factors that influence the QoL that are conditioned by the state of health of patients with osteoarthritis (OA) and rheumatoid arthritis (RA).

Methods

The study group consisted of 198 patients diagnosed with OA, according to the American College of Rheumatology criteria (1988), and 100 patients diagnosed with RA, according to the American College of Rheumatology criteria (2010). A diagnostic survey using visual analog scale of pain, health assessment questionnaire disability index, and 36-item short form health survey were used in this study.

Results

The average age of patients with OA was 59.16 (±15.87) years and patients with RA was 55.22 (±14.87) years. The average duration of illness examined for OA was 5.5 (±4.32) years, whereas for RA, it was slightly more at 6.8 (±5.21) years. Overall the QoL in both study groups was of medium level. Among patients with OA and RA, lower evaluation of QoL was mainly affected by age (OA – physical sphere [PCS] r_s=−0.177, P<0.012; MCS r_s=−0.185, P=0.008; RA – PCS r_s=−0.234, P=0.019; MCS r_s=−0.208, P=0.038), the level of physical disability (OA – PCS r_p=−0.532, P<0.001; MCS r_s=−0.467, P<0.001; RA – PCS r_p=−0.326, P<0.001; MCS r_s=−0.229, P<0.001), and pain (OA – PCS r_p=−0.425, P<0.001; mental sphere/mental functioning (MCS) r_s=−0.359, P<0.001; RA – PCS r_p=−0.313, P<0.001; MCS r_p=−0.128, P<0.001).

Conclusion

Patients with OA, despite their average older age, had a higher evaluated QoL than patients with RA. Overall QoL in terms of mental functioning in both rheumatic diseases was assessed at a higher level than in the area of physical functioning.

Stem cells therapy in cerebral palsy: A systematic review

The aim of this study was to systematically present the best available stem cell therapies for children with cerebral palsy (CP). The databases Medline, PubMed, EMBASE, and the Cochrane Controlled Trials Register for RCTs were searched for studies published from 1967 to August 2015. Systematic reviews, randomised controlled trials (RCTs), controlled trials, uncontrolled trials, cohort studies, open-label studies, and a meta-analysis were analysed. Of 360 articles, seven fulfilled the inclusion criteria: one RCT and six were open-label trials. In these studies, one application of stem cells for children with CP was typical, and the total number of cells administered to patients ranged from 10(6) to 10(8)/kg. Different routes of cell delivery were used, though in most studies motor development was applied as an indicator of primary outcomes. In three articles, neuroimaging studies were also implemented to confirm the efficacy of the therapies. Observation periods varied from 3months to 5years, and patients' tolerance of the therapy was generally good. Stem cell therapy may improve some symptoms in patients with CP, though larger studies are needed to examine the impact of stem cell therapy upon CP.

Isolation frequency of Candida present on the surfaces of mobile phones and handsx

BACKGROUND

It is known that mobile phones may play a role in microorganism transmission. The aim of this study was to analyze the relationship between the number of Candida genera/species isolated from samples collected from the surfaces of mobile phones and the hands of the staff as well as the preferred health-related behavior.

METHODS

The mycological evaluation included 175 mobile telephones and the hands of staff members at the University Hospital in Białystok, Poland. We used the Count-Tact(TM) applicator, with CandiSelect (Bio-Rad). Self-administered questionnaire was used to gather data on mobile phones disinfection practices. Assessment of the preferred health-related behavior was based on The Multidemensional Health Locus of Control Scale (MHLC).

RESULTS

Out of 175 mobile phones, 131 (74.9 %) were colonized. Candida glabrata, C. albicans and C.krusei were isolated more frequently from the hand as well as phone surface. The mean number of Candida colonies was higher in samples collected from hand surfaces than mobile phone surfaces. No significant correlation was found between the preferred health-related behavior and the frequency of washing hands, the way of using a mobile phone, the number of colonies or the isolation frequency for the fungi collected from the surface of the phones and hands of their owners. Only 19.4 % of the participants cleaned the surface of their phones.

CONCLUSION

The prevalence of mobile phone contamination by Candida is high in the University Hospital in Białystok, Poland. Candida albicans, C. glabrata, and C. krusei were the dominant species in the samples collected from mobile phones and hands. These results pose the need to develop guidelines for mobile phone disinfection.

Acceptance of illness and satisfaction with life among malaria patients in rivers state, Nigeria

BACKGROUND

Health condition is one of the basic factors affecting satisfaction with life, and the level of illness acceptance. The purpose of the study was to analyse the level of illness acceptance, the level of satisfaction with life among malaria patients, and the level of trust placed in the physician and the nurse.

METHODS

The study employs the method of diagnostic survey based on standardised AIS and SWLS scales, as well as Anderson and Dedrick's PPTS and PNTS scales.

RESULTS

The average AIS level was 12 points, while the average level of SwL at the SWLS scale was 16.5 points. The average level of trust in the physician and the nurse amounted to 50.6 points and 51.4 points, respectively. The correlation between the level of illness acceptance and self-evaluated satisfaction with life was statistically significant, with R = 0.56. The marital status influenced the level of illness acceptance with p < 0.05 and the level of satisfaction with life with p < 0.05. The employment status affected the level of satisfaction with life with p < 0.05 and the level of illness acceptance with p < 0.05.

CONCLUSIONS

The majority of malaria patients did not accept their illness, while the level of satisfaction with life was low. The majority of respondents trusted their physician and nurse. There is a statistically significant correlation between the level of illness acceptance and the self-evaluated satisfaction with life. The marital status had a statistically significant effect on the acceptance of illness and the satisfaction with life. The individuals who had a job demonstrated higher levels of quality of life and illness acceptance.

[Refractive errors in patients with cerebral palsy]

Ocular changes are common in patients with cerebral palsy (CP) and they exist in about 50% of cases. The most common are refractive errors and strabismus disease. The aim of the paper was to estimate the relativeness between refractive errors and neurological pathologies in patients with selected types of CP. MATERIAL AND METHODS. The subject of the analysis was showing refractive errors in patients within two groups of CP: diplegia spastica and tetraparesis, with nervous system pathologies taken into account. Results. This study was proven some correlations between refractive errors and type of CP and severity of the CP classified in GMFCS scale.

CONCLUSIONS

Refractive errors were more common in patients with tetraparesis than with diplegia spastica. In the group with diplegia spastica more common were myopia and astigmatism, however in tetraparesis - hyperopia.

Serum 25-hydroxyvitamin D, osteocalcin, and parathormone status in children with meningomyelocele

Sufficient vitamin D levels are required for normal skeletal development and mineralization. This is particularly important in children with meningomyelocele who are at an increased risk of osteoporosis. The purpose of this study was to assess serum 25-hydroxyvitamin D [25(OH)D] and the biochemical markers of bone metabolism (parathormone, osteocalcin, alkaline phosphatase, and electrolytes) in children with meningomyelocele. The patient group comprised 33 children with meningomyelocele. The mean 25(OH)D was 11.51 ± 7.87 ng/mL. A total of 97% of the subjects had a 25(OH)D level in the insufficient range (< 30 ng/mL) and 48.5% had a 25(OH)D level less than 10 ng/mL. Almost all patients had serum osteocalcin and phosphorus concentrations above the normal limits. The level of 25(OH)D negatively correlated with age and body weight. There were no correlations between the biochemical markers of bone metabolism and the ambulatory status. A significant correlation between serum 25(OH)D and osteoporosis was found.

[Analysis of quality of life in patiens with low back pain after receiving transcutaneous electrical nerve stimulation (TENS)]

INTRODUCTION

Low back pain (LBP) is one of the most common disorders affecting office employees working with a computer, which inevitably leads to lower quality of life. The aim of this study was to analyze the quality of life of patients with LBP after application of TENS (Transcutaneous Electrical Nervous Stimulation).

MATERIAL AND METHODS

The study group included 30 computer workers (26 females and 4 males) aged 30-60 years (45 +/- 12). The quality of life was assessed using the World Health Organization Quality of Life instrument-Abbreviated version (WHOQOL-Bref) before and after 10 applications of TENS. Outcomes were evaluated with a visual analog score (VAS) for pain and Schober's test to measure the ability of a patient to flex his or her lower back.

RESULTS

The mean VAS value decreased significantly from 3.83 +/- 1.31 cm at baseline to 3.36 +/- 1.21 cm after treatment. Patients reported pain relief. The highest quality of life scores in terms of social relationships were found in the social category evaluating personal relationships, social support and sexual activity (15.91 +/- 2.07) and mental health (14.32 +/- 1.59). After treatment a significant increase in the flexion of lower back was observed in the majority of patients. No significant correlations between the quality of life and the intensity of pain and the flexion of lower back before and after treatment were found.

CONCLUSIONS

TENS therapy is an effective technique for pain relief in patients with LBP. TENS can also be used with other methods of LBP treatment and may improve the patients' quality of life.

Assessment of physician-patient trust in the obstetrics and gynecology departments in Poland and Greece

AIM

To evaluate patient trust in their physicians of the obstetrics and gynecology departments.

MATERIAL AND METHODS

We used the Trust in Physician Scale comprising 11-items. Data were collected from 150 women hospitalized in the obstetrics and gynecology departments in Poland and 109 in Greece.

RESULTS

Of the surveyed, 25.3% from Poland and 47.4% from Greece did not doubt their doctors' proper care. Almost 90% of the respondents from Poland and 58.8% from Greece agreed with the statement "I trust my doctor very much, that is why I always comply with his/her advice". More than 68% of the patients from Poland and 56.9% from Greece were convinced that "if my physician tells me something, this has to be the truth": Almost 77% of patients from Poland and 43.1% from Greece declared trust in their physicians therapy. Eighty-four percent of women from Poland and 49.55% from Greece were convinced that their doctor is a true expert in the treatment of their diseases. Nearly 97% of the patients from Poland and 35.8% from Greece did not declare fear of their physician not keeping the professional secret.

CONCLUSIONS

The Trust in Physician Scale is an appropriate tool for assessing levels of patient trust in their gynecologist. Patients reported a relatively high degree of trust in their gynecologists. Women from Greece more often than from Poland did not trust their physicians, and declared that doctors did not do all for their care.

Quality of life in children and adolescents with cerebral palsy and myelomeningocele

The aim of this study was to compare health-related quality of life in children with cerebral palsy and with myelomeningocele. Fifty-seven children with spastic cerebral palsy and 34 patients with myelomeningocele aged 5-16 years were included in the study. Their mothers completed standardized measures on the Revidierter Kinder Lebensqualitätsfragebogen (KINDL-R) parent questionnaire. The 2 groups were demographically comparable. The children with cerebral palsy were classified more frequently into levels II (n = 24) and III (n = 18) of the Gross Motor Function Classification System. Other patients were classified into levels IV (n = 5) and V (n = 10). Three patients with myelomeningocele were community walkers, 10 could walk with assistive devices, and 21 used a wheelchair. Lesion level was thoracic in 13 patients, lumbar in 17, and sacral in 4. Twenty-nine patients (85.3%) with myelomeningocele had hydrocephalus, and 27 had a shunt. Parents in the both studied groups reported similar overall quality of life of their children in the dimensions of physical and emotional well-being, self-esteem, family, friends, and school. No significant correlations between the quality-of-life scores and age, walking ability, and mental development of the studied groups were found.

Amino acid metabolic processes in the temporal lobes assessed by proton magnetic resonance spectroscopy (1H MRS) in children with Down syndrome

Down syndrome (DS), or trisomy 21, is one of the most common autosomal mutations. The overexpression of the β-amyloid precursor protein gene, located on chromosome 21, causes an increased production of the specific amyloid. The current study is a continuation of our earlier investigations relating to the profile of metabolic changes in the frontal lobes of DS patients as assessed by proton magnetic resonance spectroscopy ((1)H MRS). The aims of the study were the morphological assessment of the brain using magnetic resonance imaging (MRI) and the evaluation of metabolic disorders of the temporal lobes using (1)H MRS in DS children. The study group included 20 children with DS aged 3-15 years and treated in the Department of Pediatric Neurology and Rehabilitation, Medical University of Białystok. The control group included healthy children (n = 20). MRI scans of the heads of DS children were performed using a 1.5 T MR scanner under standard conditions. (1)H MRS investigations were also carried out to assess metabolic changes in the temporal lobes. Metabolites, such as N-acetylaspartate (NAA), glutamate-glutamine complex (Glx), choline (Cho), myoinositol (mI) and γ-aminobutyric acid (GABA), were determined in both temporal lobes with reference to the internal marker creatine (Cr). Results were compared with the control group.We found a statistically significant decrease in NAA/Cr, Cho/Cr, mI/Cr and GABA/Cr ratios. The Glx/Cr ratio in both temporal lobes of DS patients did not differ from the control group. Our results indicate metabolic neurotransmitter disorders in the central nervous system in children with DS.

Anti-inflammatory plasma cytokines in children and adolescents with migraine headaches

Studies have shown fluctuations of cytokine levels in patients with migraine headaches; however, further studies are needed to verify these results. Our previous studies suggest increased levels of pro-inflammatory cytokines, such as IL-1alpha, sTNF-RI and TNF-alpha, in children with migraine headaches. In this study, we analyzed anti-inflammatory cytokines interleukin-4 (IL-4), interleukin-10 (IL-10) and interleukin-13 (IL-13) in plasma from children and adolescents with migraine and tension-type headaches during the interictal period. The study group consisted of 35 children and adolescents between 8-18 years old, suffering from migraine headaches with or without aura. The control group consisted of 33 patients suffering from episodic tension-type headaches. IL-4 was detected in 17.1% of patients with migraine headaches and in 28.6% of patients with tension-type headaches. IL-13 was detected in 17.1% of patients with migraine headaches and in 15.2% of patients with tension-type headaches. IL-10 was only detected in 3 of 68 (4.4%) patients. Any significant correlations between measurable cytokine levels and age, gender, aura, duration of disease, frequency and severity of headaches were determined. Any significant fluctuations of selected anti-inflammatory cytokines during the headache-free period in children with migraine and tension-type headaches have been found, immune dysfunction in migraineurs could not be excluded.

Somatosensory and visual evoked potentials in children with cerebral palsy: Correlations and discrepancies with MRI findings and clinical picture

PURPOSE

To determine if there is any association between the findings of visual evoked potentials (VEPs), somatosensory evoked potentials (SEPs), and magnetic resonance imaging (MRI) findings with the neurodevelopment and severity in children with cerebral palsy (CP).

METHODS

The present study included 15 children with spastic diplegic CP and five children with spastic hemiplegic CP and 42 healthy children as controls. The number of the controls was two-times greater than the study group to increase statistical power of this study. VEPs and SEPs were recorded in the CP children and compared with healthy controls. All MR scans were obtained using a 1.5 T MR scanner.

RESULTS

A significant difference was found in the latencies P100 (VEP) between the CP and controls. No correlations between increased P100 latencies and asphyxia, prematurity, the CP severity, MRI findings and mental retardation were noted. A significant difference in N13-N20 conductions (SEPs) between the subjects with CP and the control group was found. SEPs were positively correlated with mental retardation in CP children. The brain lesions in MRI showed a significant correlation with the CP severity scores and mental retardation.

CONCLUSION

The differences in VEPs and SEPs were determined between CP children and healthy children. The MRI findings were positively correlated with the CP severity and mental retardation.

Clinical and EEG features of epilepsy in children and adolescents in Down syndrome

Epilepsy is rarely considered as a major component of Down syndrome. We evaluated the prevalence of epileptic seizures in 252 (97 girls and 155 boys) children and adolescents with Down syndrome evaluated at Department of Pediatric Neurology between 1994 and 2007. Results showed that 15 (6%) patients had epileptic seizures: 8 partial seizures; 1 infantile spasms, 1 Lennox-Gastaut syndrome, and 5 generalized tonic-clonic seizures. Electroencephalography was performed on all patients with Down syndrome. Focal changes, spikes, generalized slowing, and hypsarrhythmia were recorded. The electroencephalography was found to be abnormal in Down syndrome with epilepsy in 100%. Almost 60% of patients with Down syndrome and epilepsy had seizures, but 40% of the patients were seizures-free. Quantitative electroencephalography analysis revealed significant differences between children with Down syndrome and the control groups in the alpha, delta, and beta rhythms. Our findings are in accordance with other reports.

[Aggression as the cause of stress among physicians]

INTRODUCTION

Mental stress is inseparably connected with work. The stress reaction is favored by stagnation in life, lack of prospects for professional growth, uncertainty of stable employment, pressure to work reliably and flexibly, excessive workload, and lack of assigned duties. Interpersonal relations among members of the team represent another significant factor in the appearance and persistence of social pathology.

STUDY OBJECTIVES

Identification of forms and sources of aggression implicated in stress among physicians at the workplace.

MATERIAL AND METHODS

The study was performed in 501 physicians employed by inpatient and outpatient institutions in the province of Podlaskie. We used questionnaires assessing the intensity and type of aggression against physicians and the GHQ28 General Heath Questionnaire.

RESULTS

The patient source of stress for physicians included hostile comportment (53%) and extortion (41%). The source of stress from superiors included vulgar acts in the presence of coworkers (18%) and threats (17%). Stress was also caused by raised voice of other physicians (44%) and nurses (25%).

CONCLUSIONS

The main source of stress for physicians was aggression by patients and fellow physicians.

Serum and intraerythrocyte antioxidant enzymes and lipid peroxides in children with migraine

The oxidant-antioxidant balance disorders underlie a number of acute and chronic diseases of the central nervous system (CNS). It is believed that oxidative stress plays a role in the pathogenesis of migraine. The study objective was to assess the processes of lipid peroxidation with malondialdehyde (MDA) as its major indicator and to determine the activities of antioxidant enzymes: superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and glutathione reductase (GSSG-R) in the serum and erythrocytes of patients at developmental age with migraine with and without aura. The study group consisted of 34 patients at the age of 10-18 years (mean +/- standard deviation: 14.04 +/- 2.29 years), suffering from migraine. The control group included 38 patients, aged 4-17 years (mean age 12.11 +/- 3.46). MDA concentration and activities of SOD, GSH-Px and GSSG-R were determined in serum and erythrocytes of all the patients. In the migraine group, the MDA levels in serum and erythrocytes were statistically significantly lower than in control subjects (p < 0.001). In the migraine group, serum GSH-Px activity was significantly higher (p < 0.05). The GSSG-R activity in the erythrocytes of migraine children was significantly higher compared to controls (p < 0.001). SOD activity was decreased and GSH-Px was increased (non-significantly) in erythrocytes of migraineurs. Our results confirm the disturbances of lipid peroxidation processes in migraine and suggest the activation of antioxidant mechanisms. Its important indicator seems to be the increase in the GSSG-R activity in the erythrocytes and the GSH-Px activity in serum between migraine attacks. Further studies are necessary.

Corpus callosum size in children with spastic cerebral palsy: relationship to clinical outcome

This study examines corpus callosum pathology in children with spastic cerebral palsy aged 7 to 15 years and to investigates the relation between corpus callosum areas and clinical picture. Magnetic resonance images of 46 patients were reviewed prospectively. Twenty-two patients with cerebral palsy were age and gender matched with the control patients. The cerebral palsy group had a significantly smaller mean corpus callosum surface area than did the control group. The cerebral palsy group also had a significantly smaller mean internal skull surface area measurement than did the control group. The corpus callosum/internal skull surface area ratio was also smaller for those with cerebral palsy. Wechsler Intelligence Scale Verbal IQ scores were associated with the surface area of the corpus callosum in cerebral palsy patients. A significant relationship between corpus callosum surface area and IQ scores in children with cerebral palsy was found. A positive correlation between internal skull surface area and IQ scores in children with cerebral palsy was noted. A significant correlation between Apgar score and corpus callosum surface area in the cerebral palsy group was found. A negative correlation between corpus callosum surface area and the Gross Motor Function Classification System in patients with cerebral palsy was noted.

Cortical somatosensory evoked potentials and spasticity assessment after botulinum toxin type A injection in children with cerebral palsy

PURPOSE

The mechanism of Botulinum Toxin Type A (BTX-A) action at the neuromuscular junction is well known. But from the introduction of BTX-A, some authors have suggested a central action of BTX-A and possible side effects far from the site of injection. Some studies demonstrate an improvement of cortical SEPs associated with reduction of spasticity after BTX-A injection. The aim of the present study was to determine the effect of BTX-A treatment on cortical somatosensory potentials (SEP).

MATERIAL AND METHODS

A group of twenty nine children ranging from 2 to 17 years old with cerebral palsy were studied. Each patients spasticity level was evaluated before, 2 weeks and 6 weeks after BTX-A injection by the Modified Ashworth Scale and modified Gait Physician's Rating Scale. The SEPs from lower and upper extremities were performed before and between 2 and 6 weeks (19.34 +/- 8.82 days) after BTX-A administration.

RESULTS

The mean spasitity level was significantly lower 2 and 6 weeks after BTX-A injection. The gait analysis by modified Physician's Rating Scale (PRS) showed significant improvement two weeks and six weeks after BTX-A injection. SEPs results were abnormal before BTX-A injection in 25 children with cerebral palsy. However we didn't find any significant changes of SEPs latencies after BTX-A injection.

CONCLUSIONS

The results of SEP after BTX-A administration in children with cerebral palsy do not confirm the central action of BTX-A on somatosensory pathways. We did not find any significant changes of SEP latencies associated with clinical reduction of spasticity. It seems that SEP results could support the opinion, that BTX-A does not have any direct central effect on sensory pathways. Remote side effects may be explained by an indirect mechanism due to modification of the central loops of reflexes or to hematogenous spread of BTX-A.

Health-related behaviour self-assessment of children living in a children's home; study based on own research realised in the Podlaskie Province

PURPOSE

The purpose of the study was to diagnose the health-related behaviour of children brought up in children's homes, to compare the obtained results with those obtained from a group of peers brought up in their own families.

MATERIAL AND METHODS

The study group included 180 children living in children's homes in the Podlaskie Province and in a control group composed of children brought up in their own families and living in the same places where the children's homes are located. A questionnaire of the Health Behaviour Scale, composed of 40 statements determining health-related issues was used.

RESULTS

Self-assessment of health-related behaviour in the studied youth depended on age, for which a statistical significance was shown for: health self-assessment (p = 0.011), categories of stressful situations (p = 0.047), physical activity (p = 0.028) and social support (p = 0.001); gender, for which a statistical significance was shown for the categories of usage of stimulants (p = 0.000) and place of living, in which the factor "place" was significant (p = 0.000) for all categories; and education, where p = 0.000 for the following categories: stressful situations, using stimulants, physical activity, social support and health self-assessment. Relationships between the categories of health-related behaviour were much stronger in the assessments of the children brought up in children's homes were found.

CONCLUSIONS

The self-assessment of health-related behaviour of the studied youth depended on age, gender, place of living and education. Relationships between the categories of health-related behaviour were much stronger in assessments of the children brought up in children's homes as compared to controls.

Clinical-electroencephalographic analysis of brain bioelectrical activity in children with myelomeningocele and internal hydrocephalus

PURPOSE

The aim of the current study was the clinical and electroencephalographic (EEG) analysis of the brain bioelectrical activity in patients with myelomeningocele and internal hydrocephalus.

MATERIAL AND METHODS

The present study included 86 children (44 boys and 42 girls) with myelomeningocele. The children were aged 1-17 years (mean 7 +/- 4.4 years). Thoracic myelomeningocele was identified in 24 children (28%), lumbar in 53 (62%) and sacral in 9 cases (10%).

RESULTS

The standard EEG examination performed in the waking state revealed generalized changes in 53 patients (62%), including 19 (79%) with thoracic, 28 (53%) with lumbar and 6 (66%) with sacral myelomeningocele. Approximately 70% of the patients underwent ventriculoperitoneal shunting and epilepsy was found in 27 children (31.4%). The prevalence of changes detected in the left temporal region did not differ between the respective myelomeningocele types. No correlations were noted between the degree of spinal cord injury and the changes observed in the left temporal region in EEG recording. Likewise, changes found in the centroparietal region in EEG did not correlate with the site of myelomeningocele. Focal changes in the frontotemporal (p < 0.0067) and right temporal region (p < 0.0314) showed a positive correlation with the degree of spinal cord injury and were most frequent in patients with thoracic myelomeningocele.

CONCLUSION

The analysis of EEG might facilitate evaluation and prognosis of epileptic seizures in children with myelomeningocele and internal hydrocephalus.

Severity of dysarthric speech in children with infantile cerebral palsy in correlation with the brain CT and MRI

PURPOSE

Dysarthria is a sequel of reduced motor functions and refers to the sound aspect of the language. In children suffering from cerebral palsy, CT (computer tomography) and MRI (magnetic resonance imaging) examinations provide data on the relationship between the range of structural changes detected by neuroimaging investigations and the severity of motor dysfunction. The aim of study was to assess the severity of dysarthria in children with cerebral palsy in correlation with the pattern of morphological changes revealed on CT and MRI.

MATERIAL AND METHODS

The study involved 48 children with the pyramidal form of infantile cerebral palsy aged 3-15 years, treated in the Department of Pediatric Neurology and Rehabilitation in Białystok. All the patients underwent CT examination, 29 of them also had MRI. Severity of speech dysfunction was established based on "Dysarthria profile" by Robertson. The degree of damage severity in the respective brain structures was determined according to the scale Kraegeloh-Mann. Statistical analysis was performed using % calculations, the arithmetic mean, standard deviation, the chi-square test of independence or t-Student test to compare the means of two samples.

RESULTS

Significant differences were shown in dysarthria severity depending on lesions seen on CT and their intensity revealed by MRI, which were found to correlate positively with the severity of articulation disorders.

CONCLUSIONS

The results indicate that CT and MRI are useful for predicting prognosis of severity of speech disturbances in children and for early programming of the therapeutic process.

Seasonal variation in ischaemic stroke frequency in Podlaskie Province by season

PURPOSE

The aim of the present study was to assess seasonal differences in ischaemic stroke among patients hospitalized in Department of Neurology in Białystok during 2002-2005.

MATERIAL AND METHODS

To examine the seasonal incidence of ischaemic stroke, we analyzed data from the Department of Neurology in Białystok in a retrospective study. The year was divided into four seasons: spring (March, April, May), summer (June, July, August), autumn (September, October, November), and winter (December, January, February). Seasonal differences were studied in relation to the following clinical characteristics: age, gender, history of stroke, and time of stroke onset.

RESULTS

Age of patients with ischaemic stroke ranged 19 between 101 years, a mean age was 72.4 +/- 12 years. Incidence of ischaemic stroke increased in the last years. We noted a higher incidence of ischaemic stroke in older patients (mean 74.36 years old) during winter months than in patients (71.40 years) in summer months. Gender had no effect on incidence of ischaemic stroke. Significant seasonal variation of ischaemic stroke in all years (p = 0.0010) and for 2005 year (0.0090) were found. Incidence of ischaemic stroke was depend on month of year. Significant increase of ischaemic stroke was noted in December. The lowest incidence of stroke was observed in August and September.

CONCLUSION

Incidence of ischaemic stroke increased in the last years. The present findings suggest an increase in the incidence of ischaemic stroke in winter in December.

Spastic cerebral palsy: clinical magnetic resonance imaging correlation of 129 children

A prospective study was undertaken of 129 children with spastic cerebral palsy to clarify the relationship between magnetic resonance imaging (MRI) findings and clinical features of cerebral palsy. Low birth weight, asphyxia, prematurity, seizures, mental development, Gross Motor Function Classification System, and MRI findings were analyzed. Significant abnormalities relevant to the cerebral palsy were evident on imaging in 123 (95.3%). A similar percentage of MRI abnormalities were detected in the groups, 45 (100%) in patients with tetraplegic cerebral palsy, 37 (92.5%) in children with diplegic cerebral palsy, and 42 (95.4%) with hemiplegic cerebral palsy. Periventricular leukomalacia was detected more frequently in the children with spastic diplegia than in the patients with tetraplegia or hemiplegia. Cerebral atrophy was found more often in the tetraplegic group compared to the diplegic patients. Porencephalic cysts were detected more frequently in children with spastic hemiplegia. Congenital brain anomalies were found in a higher proportion in tetraplegic children. Significant correlations between the MRI findings and Gross Motor Function Classification System in the diplegic and tetraplegic patients were found. No correlations between the MRI results and risk factors for cerebral palsy in the tetraplegic patients were noted. Early detection of brain abnormalities in children with cerebral palsy may help in the prognosis and in the initiation of appropriate therapy

Quality of life self-assessment of children living in a children's home, based on own research conducted in the Podlaskie Province

PURPOSE

The purpose of the study was to diagnose the quality of life (QoL) of children brought up in children's homes, to compare findings with results for peers living in complete families.

MATERIAL AND METHODS

In the Stage I was to determine the usefulness of tools for QoL evaluation in a group of 120 children from children's homes in the Podlaskie Province and in a group of 120 children belonging to a control group, brought up in their own families, in the same places where the children's homes were located. Selected research tools were used in Stage II, and the study was carried out in a group of 180 children in the same children's homes and a control group. We used the following survey questionnaires: the standardised CHQ-CF87 survey, standardised KINDL survey and Children's Survey based on WHOQOL-BREF.

RESULTS

Significant relationship between the quality of life self-assessment and the place of being brought up for all categories of quality of life was found. A relationship was indicated between the QoL self-assessment and the place of living, age, gender, and physical condition. The charges of a children's home assessed their QoL as significantly lower compared to children living in normal families, mostly in the following categories: health, physical domain and psychological domain, social relations and the ability to function in everyday life. In KINDL survey, strong relationships were found between assessments of QoL categories.

CONCLUSIONS

Significant relation between QoL self-assessment and where children were brought up was found. Positive relationship between QoL self-assessment and the place of living, age, gender, and children's physical condition was found.

Relations occurring between health-related behaviour categories and quality of life made by children brought up in a children's home, in the Podlaskie Province

PURPOSE

The purpose of the study was to determine relations between health-related behaviour categories and quality of life (QoL) categories made by children brought up in a children's home and to compare the results obtained with the results for a group of peers brought up by their own families.

MATERIAL AND METHODS

The study was performed on a group of 180 children living in children's homes located in Białystok, Krasne, Supraśl, Lomza, Nowa Pawłówka; and on a control group of children living with their own families in the same places where children's homes were located. The diagnostic survey method with the Health Behaviour Scale questionnaire, composed of 40 statements defining various behaviours connected with health, and the Children's Questionnaire, based on The World Health Organization Quality of Life (WHOQOL-BREF) was used.

RESULTS

Strong correlations between assessments of the Health Behaviour Scale categories and assessments of quality of life categories were found in the group of children living in children's homes, mostly in respect to the relation between health self-assessment and physical activity r = 0.77, mental activity r = 0.74 and environment r = 0.72, and between the physical domain and eating habits r = 0.70, and physical activity and the physical domain r = 0.69. The determination coefficient R2 for the study group had high values for three QoL categories: physical domain 71.5%, mental domain 69.7% and environment 70.1%.

CONCLUSIONS

Correlations between Health Behaviour Scale categories and QoL categories were found in the group of children living in children's homes compared to children living with their own families. The relationships for health self-assessment and the physical and mental domains and the environment, and for the physical domain and eating habits and physical activity were found.

Analysis of the incidence of fungal pathogens in air of the Department of Dermatology, Venereology and Allergology of Medical University in Wrocław

PURPOSE

Analysis of incidence of fungal pathogens in air of Department of Dermatology, Venereology and Allergology of Medical University in Wrocław.

MATERIAL AND METHODS

Materials for the tests were: the air samples in front of the building, corridors, library, lecture hall, and mycological laboratory. The air pollution was determined using SAS SUPER 100. Humidity and temperature were evaluated by a termohigrometr. Classification of the isolated fungi was made with an accordance to the current procedures.

RESULTS

From the air was isolated: in library 69 colonies (mean CFU 138 +/- 41.5), from the bookstands--25 colonies (mean CFU-125 +/- 63.6), lecture hall--119 colonies (mean CFU-380 +/- 98.8), mason room--52 colonies (mean CFU-104 +/- 21.9), mycological laboratory--154 colonies (mean CFU-513 +/- 155.3). Temperature in the tested rooms ranged from 24.5 degrees C (mason room) to 26.1 degrees C (library), humidity ranged from 40.1%-53.1%. Temperature outside of the building was 23.6 degrees C, and humidity 51.6%. Moulds Peniciullium citricum and Aspergillus niger and the yeasts Candida albicans were isolated more frequently.

CONCLUSIONS

The highest number of fungi colonies were isolated from the air sampled at the lecture hall and mycological laboratory. Moulds were the most common airborne fungi. Temperature and huimidity in the tested rooms are good conditions for the development of fungi.

Low back pain in school-age children: risk factors, clinical features and diagnostic managment

PURPOSE

Low back pain (LBP) is common in adult population, and it is becoming a serious health concern in adolescents. On surveys, about every fifth child in the school-age reports LBP. The study objective was to analysis the natural history, risk factors, clinical symptoms, causes and diagnostic management in school-age children hospitalized with LBP.

MATERIAL AND METHODS

The study group consisted of 36 patients at the age between 10 and 18 years, 22 girls and 14 boys suffering from LBP hospitalized in our Department of Pediatric Neurology and Rehabilitation in years 2000-2004.

RESULTS

The mean age of clinical onset of LBP in our group was 14.7 years, earlier in girls, later in boys. We find the family history of LBP in 50% children. Most frequent factors associated with LBP were: spina bifida (16.7%) and incorrect posture (13.9%). Half of patients pointed the factor initialising LBP: rapid, incoordinated move (39%) or heavy load rise (11%). 58% of patients present the symptoms of ischialgia. Diagnostic imaging showed disc protrusion in 11 children (31%) 6 in computed tomography, 4 in magnetic resonance imaging and 1 in X-Ray examination only. Other causes of LBP included: spondylolysis in 2 patients, Scheuermann disease in one case and juvenile reumatoid arthritis in one case.

CONCLUSIONS

Some school-age children suffering on low back pain, particulary with sciatic neuralgia symptoms seek medical care in hospital. Althought the main causes are mechanical, associated with lack of physical activity or strenous exercise, serious diagnostic managment is strongly recommended.

Magnetic resonance imaging of the cerebellum and brain stem in children with cerebral palsy

PURPOSE

The study aimed to examine the volumes of cerebellum and the brain stem in children with cerebral palsy (CP).

MATERIAL AND METHODS

The present study included 21 children with spastic diplegic CP (11 girls and 10 boys). Twenty-one patients with CP were age- and gender-matched with the control patients. All subjects were free from neurological or psychiatric disease, had normal intellectual development, and their brain magnetic resonance imaging (MRI) scans were normal. MRI of forty-two patients were reviewed prospectively.

RESULTS

The CP group had significantly smaller mean of the cerebellar hemispheres and the brain stem than did the control group. The cerebellar volumes were positively correlated with age of children with CP and the control group. No significant correlations between gender and the volumes of cerebellar hemispheres and the brain stem in controls and in the CP group were found. No significant correlations between asphyxia and the volumes of cerebellar hemispheres and the brain stem in the CP group were noted. Positive correlation between the cerebellum volume and IQ scores in children with CP was found. Negative relationship between the cerebellar hemispheres volume and Gross Motor Function Classification System in patients with CP was found. No significant correlation between the brain stem volume and IQ scores in the CP group was detected.

CONCLUSION

Our data demonstrate that children with CP had smaller volumes of the cerebellum and the brain stem as compared to controls.

Proton magnetic resonance spectroscopy in patients with normal pressure hydrocephalus

The objective of this prospective study was the application of proton magnetic resonance spectroscopy (1HMRS) in patients with normal pressure hydrocephalus (NPH) to determine the metabolite profile in the white matter next to left lateral ventricle and to assess the relationship of this profile with Evan's index. The study included 26 patients with NPH. Diagnosis of NPH was confirmed by clinical symptoms such as gait disturbance, dementia or urinary incontinence and CT study with ventricular enlargement. Ratios of NAA/Cr, Cho/Cr, Lac/Cr and mI/Cr from deep white matter were measured and compared with Evan's index and diameter of the IIIrd ventricle. Patients with hydrocephalus showed decreased ratios of N-acetylaspartate (NAA)/Cr (creatine), and increased ratios of Lac(lactate)/Cr in the white matter near the left frontal horn of the lateral ventricle compared with a well-matched control group. There was no correlation between NAA/Cr, Ch/Cr, Lac/Cr, mI (myo-Inositol)/Cr and Evan's index. A significant correlation was found between Lac/Cr and third ventricle diameter. A positive correlation was noted between Cho/Cr and dementia in patients with NPH. Our preliminary results of 1 H MRS support the idea that NPH is associated with white matter ischemia. Proton MRS is a very useful tool for evaluating major changes in metabolic levels in deep white matter in NPH patients.

Neurophysiologic and neuroimaging studies of brain plasticity in children with spastic cerebral palsy

Patients with cerebral palsy (CP) may have some problems other than this motor impairment: mental retardation, epilepsy and sensory disturbance. Healthy children and children with CP have an enhanced capacity for learning and memory compared to adults. There are few tools for brain plasticity investigations. The utility of the neurophysiologic and MRI techniques in the determination of brain reorganization and repair in patients with cerebral palsy is described. The authors discuss their results of quantitative EEG and spectroscopy MRI studies in children with CP. Quantitative EEG and spectroscopy MRI can be useful tools in the determination of these processes in children with CP.

[Facial palsy as the first syndrome of multiple sclerosis in 16 years old girl]

INTRODUCTION

Multiple sclerosis (MS) is demyelinating disease characterized by scattered neurologic deficits the central nervous system. The large number of scattered lessions produce many clinical symptoms. Facial palsy is rarely ascribed to multiple sclerosis as first syndrome.

MATERIAL AND METHODS

16-years old girl with sequence of features: 1. facial palsy, 2. transitional sudden hearing loss 3. transitory vertigo is presented. In audiologic examination pure tone audiogram, impedance audiometry, ABR and ENG were done. Air and bone thresholds were normal, stapedial reflex was absent and ABR suggested retrocochlear involvement in affected ear.

RESULTS

In this case after MRI examination multiple sclerosis was diagnosed.

CONCLUSION

ENT specialists should considered MS like a reason of facial palsy.