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Bidzan L.,Medical University of Gdansk | Bidzan M.,University of Gdansk | Pachalska M.,Andrzej Frycz Modrzewski Cracow University | Pachalska M.,Center for Cognition and Communication
Medical Science Monitor | Year: 2012

Background: The symptoms of Alzheimer's disease (AD) are numerous, including worsening of mood, psychotic symptoms, aggressive and impulsive behaviours, and many others. It is generally assumed that there exists a relationship between the severity of dementia and aggressive symptoms. The aim of this study was to assess the relationship between aggressive and impulsive behaviours and cognitive function disorders in AD patients. Material/Methods: Forty-eight AD patients living in a nursing home were included in the research group on the basis of NINCDS/ADRDA criteria. The subjects underwent two years of naturalistic observation. The intensity of agitation and aggressive behaviours was assessed on the basis of the Cohen-Mansfield Agitation Inventory (CMAI). The Alzheimer's Disease Assessment Scale Cog (ADAS-cog) was used to assess cognitive function. Pharmacotherapy administered during the observation period was also taken into account. Results: Thirty-one patients completed the two year long observation. Individuals with more severe cognitive deficiencies demonstrated a greater intensity of aggressive and impulsive behaviours, as assessed using the CMAI scale. Aggression escalated together with the development of dementia disorders. The intensity of dementia disorders was most significantly connected with physical agitation and verbal aggression. The use of neuroleptics and mood stabilisers decreased the progression of aggressive and impulsive behaviours. Conclusions: There is a relationship between cognitive functioning disorders and the intensification of aggressive and impulsive behaviours. More severe forms of dementia are connected with greater intensification of aggressive and impulsive behaviours as the disease progresses. Periodical administration of pharmacotherapy may reduce the development of aggressive behaviours. © Med Sci Monit. Source


Pachalska M.,Andrzej Frycz Modrzewski Cracow University | Pachalska M.,Center for Cognition and Communication | Lukowicz M.,Nicolaus Copernicus University | Kropotov J.D.,Norwegian University of Science and Technology | And 2 more authors.
Medical Science Monitor | Year: 2011

Background: This article examines the effectiveness of differentiated rehabilitation programs for a patient with frontal syndrome after severe TBI and long-term coma. We hypothesized that there would be a small response to relative beta training, and a good response to rTMS, applied to regulate the dynamics of brain function. Case Report: M. L-S, age 26, suffered from anosognosia, executive dysfunction, and behavioral changes, after a skiing accident and prolonged coma, rendering him unable to function independently in many situations of everyday life. Only slight progress was made after traditional rehabilitation. The patient took part in 20 sessions of relative beta training (program A) and later in 20 sessions of rTMS (program B); both programs were combined with behavioral training. We used standardized neuropsychological testing, as well as ERPs before the experiment, after the completion of program A, and again after the completion of program B. As hypothesized, patient M.L-S showed small improvements in executive dysfunction and behavioral disorders after the conclusion of program A, and major improvement after program B. Similarly, in physiological changes the patient showed small improvement after relative beta training and a significant improvement of the P300 NOGO component after the rTMS program. Conclusions: The rTMS program produced larger physiological and behavioral changes than did relative beta training. A combination of different neurotherapeutical approaches (such as neurofeedback, rTMS, tDCS) can be suggested for similar severe cases of TBI. ERPs can be used to assess functional brain changes induced by neurotherapeutical programs. © Med Sci Monit. Source


Debska G.,Andrzej Frycz Modrzewski Cracow University | Mazurek H.,National Tuberculosis and Lung Diseases Research Institute
Patient Preference and Adherence | Year: 2015

Background: The aim of this study was to determine the effects of clinical factors, physical activity, and sociodemographic variables on 1-year changes in health-related quality of life (HRQoL) in Polish adolescents and adults with cystic fibrosis (CF). Method: The study included 67 subjects with CF (mean age 21.1±5.1 years; range 14–37 years; 34 males and 33 females). The Cystic Fibrosis Quality of Life Questionnaire was used at baseline and after 1 year. Lung function data, body weight, and body height were extracted from medical records. Clinical assessment was performed with the Shwachman–Kulczycki scale. Results: The highest scores in both HRQoL examinations came from the domains of physical and social functioning, and the lowest from future concerns, body image, and career concerns. No significant changes of Cystic Fibrosis Quality of Life Questionnaire scores were documented over a period of 1 year. Patients with better baseline spirometry results more frequently reported an improvement in the treatment issues (subjects with FEV1 > 50% of predicted, P=0.020) and in the career concerns (patients with FVC > 50% of predicted, P=0.039). The improvement in the career concerns also depended upon daily physical activity (P=0.024), which was shown to modulate future concerns (P=0.032), along with place of residence and living conditions (P=0.003). Moreover, the time elapsed from the last pulmonary exacerbation was related to the change in social functioning (P=0.026). Conclusion: When planning treatment, attention should be paid to interventions which may improve HRQoL. Systematic chronic therapy improves lung function, related to treatment issues and career concerns. Maintaining good physical condition and activity may positively influence future and career concerns. Special attention must be devoted to patients living in rural areas and enduring difficult living conditions, as they are especially vulnerable to deterioration in future concerns. © 2015 Dębska and Mazurek. Source


Wilk-Franczuk M.,Andrzej Frycz Modrzewski Cracow University
Medical Science Monitor | Year: 2011

Background: The goal of this study was to evaluate the effect of physiotherapy on the strength of muscles responsible for tibial internal rotation (IR) in male patients after anterior cruciate ligament reconstruction (ACLR) using autografts of the semitendinosus and gracilis muscles (STGR). Material/Methods: Fifty-nine males were examined. The first group consisted of 19 patients subjected to 4-stage physiotherapy following ACLR. The second group consisted of 20 males without knee injuries. The third group consisted of 20 males who had not undergone systematic physiotherapy within the last 12 months following lower limb injuries. Moments of maximal strength (MMS), isometric torque (IT), and peak torque (PT) were measured under static and isokinetic conditions using the Humac Norm System. In the first group, IT measurements were performed during the 13th and 21st week of physiotherapy, while PT measurements were performed during the 16th and 21st weeks of physiotherapy following ACLR. In the control groups (II and III) the measurements were performed once. Results: In the first group, the IT (13 weeks) and PT (16 weeks) values of internal tibial rotator muscles, obtained from the operated extremities were significantly lower than the values obtained from the uninvolved knees and the control group results. During the 21 st week of physiotherapy, the results obtained for IT and PT in patients after ACLR were similar to the values obtained from the uninvolved knees and the results of the second group subjects. Conclusions: The 21-week physiotherapy in ACLR patients favorably affected the PT values of tibial rotator muscles of the operated knees. In the third group, the IT values did not indicate a complete improvement after 12 months without systematic physiotherapy. © Med Sci Monit. Source


Chrapusta A.,The Malopolska Center for Burns and Plastic Surgery | Pachalska M.,Andrzej Frycz Modrzewski Cracow University
Annals of Agricultural and Environmental Medicine | Year: 2014

Objective. The aim of the research was an assessment of the differences in the self-evaluation of health-related quality of life during the treatment of post-burn scars on the upper limbs of pre-school and school children.Materials and method. Agroup of 120 children were examined – 66 boys and 54 girls, divided into a pre-school group of 60 children (average age 4.3 ± 1.7) and a primary school group of 60 children (average age 10.4 ± 1.2). The structured interview and an adopted Visual Analog Anxiety Scale and Visual Analog Unpleasant Events Tolerance Scale were used to evaluate the level of plaster tolerance, and anxiety caused by the removal of dressings during treatment.Results. In the first test, In both groups, a low tolerance was noted to the pressure plaster, with the pre-school aged children obtaining worse results (x=18.9 ± SD 10.16) than those of school age (x=33.65± SD 13,21), regardless of gender. Preschool children were afraid (x=47.5 ± SD 24.26), while school-aged children were not afraid of having the plaster removed (x=20.5 ± SD 9.46). The differences between the groups were statistically significant. In the fourth and final test on preschool aged children, the tolerance of plasters had improved (x=23.24 ± SD 15.43) obtaining a value somewhat lower than for school-aged children (32.4 ± SD 6.45), as well as a noted fall in the anxiety level (30.83 ± SD 23.38) with an average value insignificantly higher than that recorded for the children of school age (15.83 ± SD 6.19).Conclusions. The tests confirmed the appearance of differences in the self-evaluation of health-related life quality in preschool and school-aged children. © 2014, Institute of Agricultural Medicine. All rights reserved. Source

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