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Kraków, Poland

Czepko R.,St. Raphaels Hospital | Cieslicki K.,Warsaw University of Technology
Acta Neurochirurgica | Year: 2016

Background: Only a few reports have been published on the natural history of non-shunted patients suspected of having NPH. The aim of this study is to follow up a group of such cases. Methods: It was possible to follow up 27 patients who had not been qualified for shunting after the primary diagnosis. An assessment of Hakim’s triad was performed, together with an analysis of radiological parameters and the results of lumbar infusion tests (LITs), both on admission and at the later date (on average, after 5.6 months). All parameters were analyzed with respect to periventricular lucency (PVL), atrophy, type of NPH, and the age of the patients. Results: There were no deteriorations and six patients improved. Those who were over 50 and who had no PVL or secondary NPH tended to improve more frequently. Significant improvement of dementia was noted (p = 0.042) in all cases, and in the group of patients without PVL (p = 0.04). The size of the ventricles did not change significantly. The values of the resistance to outflow (R), elastance (E), and ICP remained stable. Conclusions: Analysis of our series revealed that the patients suspected of having NPH who had not been qualified for shunting did not deteriorate, while some of them even improved significantly as far as the level of dementia was concerned. As the CT and LIT parameters remained stable, there were no indications for repeating these examinations, at least within the period of nearly 6 months, which followed the primary diagnosis. © 2016, Springer-Verlag Wien. Source

Miekisiak G.,Specialist Medical Center | Banach M.,St. Raphaels Hospital | Kiwic G.,Regional Specialist Hospital | Kubaszewski L.,Poznan University of Medical Sciences | And 8 more authors.
European Spine Journal | Year: 2014

Purpose: Patient reported outcome measures play an increasingly important role in the outcomes research. The Core Outcome Measures Index (COMI) is a short, multidimensional instrument initially developed for the use by patients with low back pain. This study is an evaluation of a Polish version of COMI adapted for neck pain. Methods: One hundred twenty-three patients complaining of neck pain were enrolled. All of them completed a questionnaire booklet containing COMI-neck, Neck Disability Index and Likert-type questions regarding the frequency of use of pain medications and pain frequency. Ninety-eight patients returned the retest questionnaire. Data quality was also assessed. Assessment of psychometric properties included examination of data quality, construct validity, test-retest reliability and factor analysis. Results: The quality of data was good with no missing answers and a little floor effect. Exploratory factor analysis revealed a single-factor structure. Reliability expressed as intraclass correlation coefficient was 0.88 (95 % CI 0.84-0.92) for the overall COMI score and was generally good for most of individual core items. The minimum detectable change (MDC95%) was 1.97. Conclusion: This version of the COMI-neck is a valid and reliable instrument, with good psychometric properties. It can be recommended for Polish-speaking patients. © 2013 The Author(s). Source

Jurczyszyn A.,Jagiellonian University | Czepko R.,St. Raphaels Hospital | Banach M.,St. Raphaels Hospital | Godlewski B.,St. Raphaels Hospital | And 3 more authors.
Advances in Clinical and Experimental Medicine | Year: 2015

Background. In patients with multiple myeloma (MM) there is a high risk of compression fractures of the spine. In the majority of cases, the method of treatment is percutaneous vertebroplasty (PV) or kyphoplasty (PK). The number of studies verifying their efficacy in MM is still relatively small. Objectives. The aim of this study has been to assess medium- and long-term pain relief as well as improvement in the quality of life (QL) after PV in MM cases. Material and Methods. There was a prospective group of 34 MM cases in which a total of 131 vertebral bodies were augmented by means of PV. It was possible to follow up 22 patients who agreed to take part in the assessment. Their level of daily activity and the level of pain were assessed using the Oswestry Back Pain scale and a visual analogue scale (VAS) before PV and at a later date (medium-term follow up was a mean of 10 months after the last operation). Five out of eight cases in which 4.5-5 years had elapsed since the first PV were tested again (long-term follow-up). Results. Relief of pain and improvement of QL, assessed a mean of 10 months after PV, proved to be statistically significant. On the average, pain decreased by 4.7 points as measured on the VAS scale and the average improvement in the QL measured on the Oswestry scale was 27.7%. There were no neurological or general complications. After 4.5-5 years, there has not been any significant change in the level of pain relief or the improvement in the QL in the 5 cases in which long-term assessment was possible. Conclusions. In MM cases, PV is a simple, effective and safe method for the treatment of vertebral infiltration and compression fractures, giving permanent long-term pain relief and concomitant improvement in the QL. © Copyright by Wroclaw Medical University. Source

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