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Opara J.,Katedra Fizjoterapii Ukladu Nerwowego i Narzadu Ruchu | Jaracz K.,University Medyczny Im rcinkowskiego | Brola W.,Oddzial Neurologiczny
Neurologia i Neurochirurgia Polska | Year: 2012

Multiple sclerosis (MS) is the second most common cause of disability among nervous system diseases. This disease causes reduced quality of life of patients and those caring for them. Quality of life (QoL) measures consist of at least three broad domains: physical, mental and social. In the field of medicine, researchers have often used the concept of health-related quality of life, which specifically focuses on the impact of an illness and/or treatment on patients' perception of their status of health and on subjective well-being or satisfaction with life. Subjective factors of QoL in MS patients include perception of symptoms, level of fitness, self-image, satisfaction with family life, work, the economic situation, interaction with other people, social support and life in general. Objective factors include the clinical picture of disease, social status, social and living conditions and the number and intensity of social contacts. While many generic and specific questionnaires have been developed to assess QoL in patients with MS, including general fatigue, there is a lack of specific questionnaires assessing QoL of caregivers. In this paper, a review of selected studies on QoL and caregiver burden in MS and a summary of the most popular questionnaires measuring burden and QoL are presented. Special attention is paid to the first questionnaire specific for QoL of carers of persons with MS, CAREQOL-MS by Benito-León et al. Source

Examination of visual evoked potentials (VEP) enables objective, non-invasive diagnostics of vision damage in children and adolescents. It is important to choose proper stimulus for individual patient. The aim of this research was analysis of VEP variability and disclosure of possible differences recorded in healthy children and adolescents while binocular recording, using four various types of stimulus. VEPs with pattern reversal (PR 15 and 40 min arc), flashing screen and light emitting diodes (LEDs) in goggles were measured in 100 children and adolescents 1-18 year according to International Federation of Clinical Neurophysiology recommendations. Normative data for VEP's parameters and hemispheric differences under these kinds of simulations were reported. Influence of used stimulation on value of only VEP component latency was confirmed. Application of PR brings longer latencies than with use of flash methods. Changes of VEP parameters connected with maturation of visual pathway in children up to age of 8 were demonstrated. The constant value of responses registered from above left and right cerebral hemispheres was observed which indicates symmetry of recording obtained. Variability of VEP recording character depends on application of various stimulus parameters and various methods of their presentations. Consequently, every laboratory performing potential examinations should establish parameter pattern of VEP with strictly defined standardized conditions of stimulation and recording. Source

Kalinowska-Lyszczarz A.,University Medyczny Im rcinkowskiego
Neuropsychiatria i Neuropsychologia | Year: 2012

Neurotrophins regulate neuronal survival and differentiation, and facilitate synaptic plasticity in the central nervous system (CNS). Although neurons are the major source of neurotrophic factors, they are also expressed within the peripheral blood mononuclear cell (PBMC) fraction of the immunological system. Multiple sclerosis (MS) is a chronic inflammatory demyelinating and neurodegenerative disease of the central nervous system (CNS), causing cognitive impairment in approximately half of the patients. In MS additional neurotrophic support from PBMCs might compensate the relative neurotrophin deficiency in the damaged CNS tissue that needs to be repaired. Neurotrophins, namely nerve growth factor (NGF), brainderived neurotrophic factor (BDNF), neurotrophin-3 (NT-3) and neurotrophin-4/5 (NT-4/5), may exert a potentially neuroprotective role in MS-damaged CNS, in fluencing the structural brain atrophy rate and functional connectivity, with both these aspects contributing to cognitive performance in MS patients. So far a lot of evidence has been gathered based on animal model studies, and evidence from studying human disease is gradually emerging. The association between neurotrophins and the CNS cholinergic system has been underlined; however, the exact mechanism of neurotrophin-mediated neuroprotection is not yet fully understood. Neurotrophins have been considered as potential novel therapies for neurodegenerative diseases, especially those with cognitive involvement. The aim of this review is to present the role of neurotrophins in the context of MS-related cognitive impairment. Source

The aim of the study was to asses the influence of tobacco smoking on plasma oxidative stress parameters in normal glucose tolerance persons and pre-diabetic individuals, separately. Caucasian females and males aged 35-64, with no acute or severe chronic disorder, taking no medication, special diet nor supplementation were enrolled to the study. After receiving oral glucose tolerance test results, newly diagnosed type 2 diabetic subjects were excluded, and normal glucose tolerance (NGT) and pre-diabetic (PreDM) persons underwent further investigation. Both groups were divided due to their positive (P) or negative (N) history of smoking. The studied subjects were determined in plasma: lipid parameters (T-C, HDL-C, TG, LDL-C), total antioxidant status, TAS (Randox, Statfax 1904 Plus) and thiobarbituric acid-reactive substances, TBARS (Sigma, UV-160A Shimadzu) as lipid peroxidation products. They were also measured serum insulin concentration (ELISA-BioSource, Sunrise Tecan) and insulin resistance indices IR = Ins/G0'[mg/ dl] and HOMA-IR = {G0'[mmol/l]*Ins}/ 22.5 were calculated. Statistical analysis was performed using Statistica 6.0 program for following groups: NGT-N (n = 25: 15 F, 10 M), NGT-P (n = 21: 10 F, 11 M), PreDM-N (n = 23: 13 F, 10 M) and PreDM-P (n = 21: 7 F, 14 M). 1. NGT-P group comparing with NGT-N group presented higher concentration of fasting glucose, T-C, LDL-C, and TBARS (8.43 +/- 5.24 vs 4.81 +/- 2.58 nmol/ l). PreDM-P individuals, as compared with PreDM-N, were found decreased TAS (1.20 +/- 0.16 vs 1.42 +/- 0.19 mmol/l) and increased TBARS (10.87 +/- 6.79 vs 6.67 +/- 4.90 nmol/l), negatively correlated TAS & TBARS (R = -0.87; p = 0.0000). 2. The comparison among groups NGT-N, NGT-P, PreDM-N, PreDM-P (using Kruskal-Wallis ANOVA test) revealed marked increase of TAS in PreDM-N subjects and higher TBARS concentration in smokers (both NGT-P and PreDM-P). Systematical regress in plasma HDL-C and progress in TG concentrations were observed from NGT-N through NGT-P and PreDM-N to PreDM-P. In case of increased risk for type 2 diabetes, we suggest an effective mobilization of plasma antioxidant status preventing high concentration of lipid peroxidation products, in nonsmokers only. Source

The aim of the study was to compare obstetric results in two groups of pregnant women (patients that had and had not planned their pregnancy) suffering from pregestational diabetes mellitus (PGDM). 400 women with PGDM were divided into two subgroups: planned pregnancy (P) (N = 200) and unplanned pregnancy (NP) (N = 200). The study was based on retrospective analysis of data collected at the Department of Obstetrics and Women Diseases, University of Medical Sciences, Poznan, from patients who delivered between 1995-2006. In both groups obstetrical complications and selected neonatal parameters were analyzed. Statistically important differences in obstetric results between the two analyzed subgroups of patients were observed P-group was metabolically better controlled, both upon admission to our department and in the third trimester The mean daily insulin requirement among P-group patients was smaller than among pregnant NP-women upon admission to our department. P-patients suffered from miscarriages and stillbirths less frequently Neonates born to P-mothers had higher gestational age at delivery and their Apgar score and cord blood results were significantly better Our results confirmed that patients with PGDM who plan their pregnancies achieve significantly better obstetric results compared with unplanned pregnancy group. Pregnancy planning should become a standard of obstetric and diabetic care in this group of patients. Source

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