Search results

1

Severe atopic dermatitis in children: therapeutic dilemmas

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Lis-Święty A., Milewska-Wróbel D.

Pediatria i Medycyna Rodzinna

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2018

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vol. 14

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issue 4

376-380

EN

Atopic dermatitis is the most common skin disorder diagnosed in early childhood. Some children do not experience a relief of symptoms as they get older, and severe atopic dermatitis may develop, with manifestations including widespread skin lesions and unremitting itching. The disease is both physically and emotionally disabling, and significantly compromises the patient’s quality of life. Indications to intensify therapy include resistance to topical treatment and multidrug resistance. However, in many cases non-adherence to the treatment regimen, including inadequate skin care techniques, contribute to the development of severe or refractory atopic dermatitis. Persistent eczematous lesions may be a result of exacerbating environmental factors, secondary infection, and hypersensitivity reactions to topical treatments or other allergens. Wet-wrap treatment with topical corticosteroids, narrow-band UVB phototherapy and systemic immunosuppressive drugs, such as cyclosporine A, methotrexate, mycophenolate mofetil and azathioprine, are recommended for the treatment of severe atopic dermatitis in children. However, there are no evidence-based guidelines for using these agents. Systemic corticosteroids should be avoided, but they can be used for a short period of time for the immediate relief of acute flares before introducing other therapies. Patients need a holistic approach including education and modern biopsychosocial techniques. Paediatric studies are currently under way to test the safety and tolerability of dupilumab which was approved by the US Food and Drug Administration in 2017 for the treatment of adults with moderate-to-severe atopic dermatitis.

PL

Atopowe zapalenie skóry jest najczęstszym schorzeniem skóry rozpoznawanym we wczesnym dzieciństwie. U części dzieci objawy nie łagodnieją w miarę dorastania, lecz rozwija się atopowe zapalenie skóry o ciężkim przebiegu z uogólnionymi zmianami skórnymi, uporczywym świądem; choroba przyczynia się do cierpienia fizycznego i psychicznego, znacząco pogarszając jakość życia. Sygnałem do intensyfikacji terapii powinna być oporność na leczenie zewnętrzne i wielolekowość. Jednak w wielu przypadkach przyczyną ciężkiego i opornego na terapię atopowego zapalenia skóry jest niedostosowanie się do zaleceń terapeutycznych (non-adherence), w tym nieprawidłowa pielęgnacja skóry. Uporczywość zmian wypryskowych może być także skutkiem narażenia na środowiskowe czynniki drażniące, wtórnej infekcji, reakcji nadwrażliwości na leki zewnętrzne czy inne alergeny. W ciężkim atopowym zapaleniu skóry u dzieci zaleca się stosowanie mokrych opatrunków z kortykosteroidami miejscowymi, fototerapii światłem wąskopasmowym UVB, ogólnoustrojowych leków immunosupresyjnych, takich jak cyklosporyna A, metotreksat, mykofenolan mofetylu i azatiopryna. Brak jest wytycznych opartych na dowodach naukowych dotyczących leczenia tymi lekami. Należy unikać kortykosteroidów ogólnych, ale można zastosować krótkotrwałą terapię w celu szybkiego opanowania dużych zaostrzeń przed wdrożeniem innych form leczenia. Pacjenci wymagają podejścia holistycznego, obejmującego edukację i stosowanie nowoczesnych technik biopsychospołecznych. W populacji pediatrycznej obecnie prowadzone są badania kliniczne oceniające bezpieczeństwo i tolerancję dupilumabu, leku biologicznego zaaprobowanego w 2017 roku przez amerykańską Agencję ds. Żywności i Leków w leczeniu umiarkowanego i ciężkiego atopowego zapalenia skóry u dorosłych.

2

Dynamical Asymmetry of Upper-Limb Movements During Swimming

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Jaszczak M., Zatoń K.

Human Movement

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2011

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vol. 12

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issue 4

337-341

EN

Purpose. This study aimed at introducing a method towards determining the dynamical asymmetry of the upper extremities during swimming and to find its relationship with lower-limb movements in children when swimming the breaststroke. Methods. Twenty boys participated in the research, where seven boys were found to perform incorrect lower-limb movements when swimming. Therefore, the subjects were divided into two groups, those who maintained correct lower-limb movements when swimming and those who did not. The subjects swam for short distances using either only their upper limbs or both upper and lower limbs. The water pressure that was exerted on the right and left hand of the subject was recorded for both tests. On the basis of the compiled data, the upper-limb movements' asymmetry index was calculated. Results. Incorrect lower extremity movements when performing the breaststroke resulted in increased upper-limb dynamical asymmetry. Conclusion. The method applied in this study enables one to diagnosis the dynamical asymmetry of upper-limb movements when swimming. Altogether, it was found in the examined group that incorrect lower-limb movements in the breaststroke did not decrease swimming efficiency. However, an increase of the upper extremities' dynamical asymmetry might have decreased the efficiency of the shoulder-girdle muscles' symmetrization. In the case of individuals performing incorrect lower-limb movements in the breaststroke, it is recommended to improve their performance or to swim with the upper limbs only.

3

Preliminary Clinical Study On Ms Treatment With Hyperbaric Oxygenation

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Ulewicz K., Masłowski J., Michniewski P., Kierznikowicz B., Olszański R.

Polish Hyperbaric Research

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2015

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vol. 51

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issue 2

47-51

EN

The authors conducted the preliminary clinical investigation on 16 multiple sclerosis (Sclerosis multiplex) patients of median disease duration 9.33 years and symptoms evaluated on Kurtzke’s scale. The patients underwent between 25 and 30 hyperbaric oxygen exposures at a pressure of 2 ata in intervals spread over a few days. The patients were qualified and classified to the treatment symptomatologically according to Fisher but the obtained results were evaluated according to the standardised Disability Status Scale by Kurtzke. During the investigations the authors carried out additional quantitative immunoglobulin and complement activity determination, lymphocyte T and B determinations as well as the usually applied clinical and laboratory investigations. Evident clinical improvement was observed in 14 patients, but in the case of one patient a deterioration was observed after 15 hyperbaric expositions (resulting in the hyperbaric oxygen treatment being stopped), whilst in another case no curative effect could be observed. By utilising the 50% haemolysis method, within the examined immunological parameters the authors observed an increase of complement fractions and its activity, white lymphocytes T and B examined qualitatively did not maintain the characteristic shift. The authors are still discussing the obtained results.

4

The effect of probiotic supplementation as alternative therapy for NAFLD: a literature review

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Adnan M. L.

European Journal of Translational and Clinical Medicine

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2021

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vol. 4

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issue 2

75-85

EN

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases, influenced by various risk factors associated with metabolic disorders. Currently there is no specific effective treatment for NAFLD. Probiotics have been extensively researched for their health benefit Probiotic Supplementation for NAFLD. Methods: A simple literature review was performed based on searches via PubMed, ScienceDirect and Google Scholar, using the keywords "probiotic," "microbiota," "non-alcoholic fatty liver disease," "metabolic disorder," and "therapy." Results: Research on the use of probiotics for NAFLD demonstrated improvement in liver function and histology. However, the literature is inconsistent regarding the probiotics’ influence on the NAFLD risk factors. Probiotics can be an alternative therapy for NAFLD through the ability to modulate the microbiota of the gastrointestinal tract. Conclusion: Probiotics can be an alternative therapy in NAFLD patients, however more extensive studies are needed to ensure the safety of this approach.

5

Duchenne muscular dystrophy: overview and future challenges

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Machfoed M. H., Besin V., Basuki M., Lasmono S. F.

Aktualności Neurologiczne

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2017

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vol. 17

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issue 3

144-149

EN

Duchenne muscular dystrophy is a muscle disease caused by mutation in the gene that encodes the cytoskeletal protein dystrophin. It is inherited in an X-linked recessive fashion. A number of therapies are continuously being developed to slow down the progression of the disease and increase patients’ life expectancy. Steroid use in Duchenne muscular dystrophy is associated with a lower mortality rate (hazard ratio = 0.24; 95% CI = 0.07–0.91; p = 0.0351). Although recent studies have concluded that prolonged steroid use is associated with short stature and overweight, a meta-analysis of 12 studies has shown that steroids can increase strength, muscle function, and quality of life. Restoration of dystrophin gene expression is the basis of genetically engineered therapies. Potential therapies of this type include exon skipping, the use of recombinant adenoassociated virus which delivers mini-dystrophin, and surrogate gene transfer. In their development, the common challenges are associated with the size of gene product and the origin of dystrophin gene expression. Stem cells are promising for future therapy. Regardless of the challenges and controversies associated with stem cells, several clinical trials show an increase of muscle strength in patients who have received such therapies.

PL

Dystrofia mięśniowa Duchenne’a jest chorobą dziedziczoną w sposób recesywny, sprzężoną z chromosomem X, spowodowaną mutacjami w genie DMD kodującym białko dystrofinę. Obecnie opracowywane terapie mają na celu spowolnienie progresji choroby oraz przedłużenie przeżycia pacjentów. Leczenie z użyciem kortykosteroidów wiąże się z mniejszym ryzykiem zgonu (współczynnik ryzyka = 0,24; 95% CI = 0,07–0,91; p = 0,0351). Choć ostatnio prowadzone badania wykazały, że długotrwałe stosowanie kortykosteroidów przyczynia się do niskiego wzrostu i nadwagi, w metaanalizie 12 badań stwierdzono ich wpływ na zwiększenie siły mięśni, poprawę ich funkcji i lepszą jakość życia chorych. Odzyskanie ekspresji genu dystrofiny stanowi podstawę terapii genowych, w tym metody pomijania zmutowanego egzonu (tzw. exon skipping), zastosowania rekombinowanych wirusów związanych z adenowirusami w celu wprowadzenia minidystrofiny oraz wymiany genu (gene transfer). Trudności związane z terapiami genowymi wiążą się z rozmiarem genu oraz pochodzeniem ekspresji dystrofiny. Inną obiecującą terapię stanowią komórki macierzyste. Bez względu na trudności i kontrowersje związane z leczeniem tego typu kilka badań klinicznych wykazało, że poprawia ono siłę mięśniową u osób z chorobą Duchenne’a.

6

Physical Activity During Therapy of Self- Disorder Among Patients with Schizophrenia.A Phenomenological Understanding of the Relationship Between Healing and Physical Activity

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Toft J.

Physical Culture and Sport. Studies and Research

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2015

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vol. 65

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issue 1

51-62

EN

Studies indicate that physical activity has a positive effect both physiologically and socially for psychologically ill and vulnerable people, and that this effect is the same or greater for psychologically well-functioning people. In spite of this, treatment sites often hesitate to include sports and physical activity as part of the treatment offered. This article argues that there is a strong correlation between the body and mind, but from a different point of view than that adopted by the prevalent scientific research in the field. Specifically, I elucidate how the mind-body relationship and self-consciousness are influenced by physical activity for people with schizophrenia, and argue that symptoms are relieved as a result of physical activity. Consciousness has a bodily component that, for people with schizophrenia, is less well-integrated in the consciousness than for psychologically well-functioning people, and sports and physical activity can help facilitate this integration. My argument is based partly on phenomenological concepts and partly on an empirical research project concerning physical activity for people with schizophrenia. The conclusion is that their level of functioning and self-assessed quality of life increased markedly through physical activity. The purpose of the present article is thus partly to qualify the treatment chosen for people with schizophrenia, and partly to qualify the theoretical discussion concerning the role played by the body and physical activity in connection with consciousness and relief.

7

Merkel cell carcinoma

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Markiewicz J., Dziewirski W.

OncoReview

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2014

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vol. 4

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issue 3

A121-125

EN

Merkel cell carcinoma (MCC) is a rare cutaneous malignancy, with aggressive behaviour. The discovery of MCC polyomavirus (MCPyV) provided a major insight into pathogenesis of MCC, as MCPyV is present in most MCC tumours. The primary treatment of locoregional MCC is surgery, and sentinel lymph node biopsy should be performed in all cases at clinical stage I-II. Adjuvant radiotherapy decreases disease recurrences in stage I-III of the disease. Chemotherapy is primarily used for palliation and provides overall response rates of approximately 70%; however, the disease often recurs within a few months. All cases of MCC should be managed in an experienced multidisciplinary setting.

8

Efficacy of craniosacral therapy in tension-type headaches in adult patients

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Domarańczyk K., Truszczyńska-Baszak A.

Advances in Rehabilitation

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2020

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vol. 34

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issue 2

26-31

EN

Introduction Headaches are a common health issue. The second most common type of headache is the tension-type headache (migraine-type headache is the most common type). Tension-type headaches are often referred to as stress-related or psychogenic headaches. Tension-type headaches often correspond with feeling unwell, and with depression or anxiety. Often they are drug resistant. This means that the treatment process may require patients to consider lifestyle changes. Patients seek other treatment types than pharmacotherapy and consider more holistic approaches, for instance natural medicine, breathing exercises or traditional Chinese medicine. The literature presents relationships between craniosacral therapy and headaches of various etiology, yet relatively few studies have been conducted on this matter. This study provides an additional insight into this therapeutic method. The aim of this study was to establish whether craniosacral therapy can reduce pain. Material and methods the study involved 30 adult patients. There were 22 women (73.3%) and 8 male patients (26.7%). Their mean age was 30.13 ± 5.33 years. The treatment used the Upledger’s 10-step protocol and sessions were performed four times within a two-week period. Results Prior to the treatment, the mean HIT-6 scale pain intensity was 62.67 ± 4.65 points. After the treatment, pain intensity reduced to a statistically significant level of 48.43 ± 9.45 points. We found that pain reduction was greater in patients with higher BMI. The gender or age of patients did not affect the results. Conclusion Craniosacral therapy is an efficient pain reduction method in patients with tension-type headaches.

9

Selected forms of therapy for individuals with autism spectrum disorder

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Dudzinska E., Szymona K., Pacian A., Kulik T.

Current Issues in Pharmacy and Medical Sciences

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2015

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vol. 28

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issue 1

21-23

EN

Autism spectrum disorder (ASD) is a condition of multiple origins. It is characterised by a range of behaviour patterns, in addition to disturbed social and emotional functioning. Of note, early therapy is conducive to better treatment results. A few recently discussed therapies have a particularly positive impact on children with ASD. Corbett et al. [2] proposed Sense Theatre. This involves instilling appropriate behaviours and communication patterns into the afflicted individual through acting. Role-playing and other similar techniques also offer an opportunity for children with ASD to improve their areas of empathy and social cooperation. With regard to bio-feedback-related techniques, Friedrich et al. [3] was noted for developing the Brain-computer method, a system of game interface connected to an external device. The method targets the mirror neuron system (MNS) in order to enhance cognitive, emotional and behavioural functions through neurofeedback. An approach put forward by Solomon et al. [10] is called ‘Play and Language for Autistic Youngsters (PLAY) Project Home Consultation’. Herein, volunteers visit patients’ homes on a regular basis to engage the children in play and games, after which they discuss with parents, the issues that came up. The PLAY reduces guardians’ stress levels and improves children’s skills. A pharmacological method is that of administering sulphoraphane [9], which reduces damaging effects. As others claim [8,1,7], other dietary approaches prove efficient as well. In summation, an early intervention and the employment of a multimodal treatment approach can be of importance for enhancing the life of ASD-affected children.

10

VISUAL ART IN APHASIA THERAPY: THE LOST AND FOUND SELF

88%

Pąchalska M., Góral-Półrola J.

Acta Neuropsychologica

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2020

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vol. 18(2)

149-181

EN

Recently, the relationship between visual art and brain function and disease has raised considerable interest among neurologists, neuroscientists, and artists themselves. Visual art production involves multiple processes including basic motor skills, such as the coordination of movements, visual-spatial processing, emotional output, a socio-cultural context, as well as obviously creativity. Thus, the relationship between artistic output and brain diseases is particularly complex, and brain disorders may lead to an impairment of artistic production in multiple domains. Understanding the nature of aphasia, which leads to significant changes in human life in the physical, psychological, social and professional sphere, makes us aware of the importance of the individual (objective and subjective) and the social (collective and cultural) self system in the process of creation, especially in artists. Observing the works of artists with aphasia, we notice that each of them perceives the surrounding world differently. One wonders what makes them present reality in one way and not in another. It is true that all works of art show reality in thousands of different ways, and only an unoriginal artist will employ someone else's vision - one already used in a work. It should not be forgotten, however, that the work of artists with aphasia often takes on features resulting from the nature of the problems they face and is initially unoriginal, as they have to overcome fundamental technical difficulties and problems of technique. In this article, we present the possibilities for rehabilitation, of strengthening artists with aphasia, in order for them to find the self lost as a result of illness.

11

microRNA-based diagnostic and therapeutic opportunities in lung cancer

88%

Zhao J., Cai Y., Liu X.

microRNA Diagnostics and Therapeutics

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2014

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vol. 1

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issue 1

EN

microRNAs (miRNAs) are a class of non-coding RNA which suppress target gene expression. miRNAs are involved in most physiological and pathological process, including carcinogenesis. miRNA expression profiles help to improve lung cancer diagnosis, classification and prognostic information. Tumor suppressive and oncogenic miRNAs have been discovered and their functions have been investigated. Emphasis is placed on the development of miRNA-based methods for lung cancer diagnosis and therapy and future directions are proposed.

12

The effectiveness of physical therapy in children with autism

88%

Sroka R.

Central European Journal of Sport Sciences and Medicine

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2014

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vol. 7

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issue 3

107-112

EN

The main aim of the work was to evaluate the effectiveness of physical therapy conducted with autistic children from the kindergarten at Krzemienna 42B in Szczecin. The research was conducted in the first halves of 2009 and 2010. The diagnostic tool used in order to evaluate gross motor skills was psycho-educational profile – revised (PEP-R). The research group included 8 boys with medically certified autism spectrum disorder. In 2009, out of 126 tasks given, all the tested students performed 104 tasks evaluated as completed, 16 tasks evaluated as promising and 6 tasks evaluated as uncompleted. Only one boy performed all tasks properly. In 2010 the students performed 120 tasks evaluated as completed, 5 as promising and 1 as uncompleted. Four of the autistic boys performed the tasks they were given perfectly. In 2009 the biological age of most tested children was higher than the developmental age in the scope of gross motor skills. Implementing new, individual therapeutic programs based, among other things, on TEEACH tasks, helped to significantly level out the differences.

13

The role of microRNA in metastatic colorectal cancer and its significance in cancer prognosis and treatment

75%

Tokarz P., Blasiak J.

Acta Biochimica Polonica

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2012

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vol. 59

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issue 4

467-474

EN

microRNAs (miRNAs) are small, non-coding RNA molecules that regulate gene expression by targeting specific mRNAs. microRNAs play a role in several physiological processes in the cell, including migration, proliferation, differentiation and apoptosis. Apart from their role in regular metabolism, abnormal profiles of miRNA expression accompany cancer transformation, including colorectal cancer (CRC) metastasis. microRNAs may play a role in each phase of CRC metastasis including angiogenesis, invasion, intravasation, circulation, extravasation and metastatic colonization. microRNA levels may serve as a predictive CRC marker, which was confirmed by the serum level of miR-29a targeting KLF4, a marker of cell stemness, and the plasma level of miR-221 down-regulating c-Kit, Stat5A and ETS1, which are signal transducers and transcription factor, respectively. In turn, the level of miR-143 in CRC cells decreasing the amount of MACC1 (metastasis-associated in colon cancer-1) and oncogenic KRAS protein, may be utilized as a prognostic marker. Also, single nucleotide polymorphisms of genes encoding miRNAs, including miR-423 and miR-608, which correlate with tumor recurrence, may be useful as diagnostic, prognostic and predictive indicators in CRC metastasis. Pre-miR-34a and pre-miR-199a decreased the level of Axl, a tyrosine-protein kinase receptor, so they can be considered as drugs in antimetastatic therapy. On the other hand, miR-222 targeting ADAM-17, a disintegrin and metalloproteinase, and miR-328 interacting with ABCG2, an ABC transporter, may overcome drug resistance of cancer cells. microRNAs may be considered in wide-range application to facilitate CRC metastasis diagnosis, prognosis, prediction and therapy, however, further clinical, epidemiological and in vitro studies should be conducted to verify their utility.

14

The pathomechanism of visuo-spatial neglect within the context of therapies

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Polanowska K. E., Seniów J. B.

Medical Rehabilitation

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2011

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vol. 15(3)

21-28

PL

W artykule dokonano przeglądu najbardziej znanych koncepcji teoretycznych dotyczących patomechanizmu zespołu zaniedbywania i ich implikacji terapeutycznych. Najczęstszym i najbardziej inwalidyzującym wariantem tego zespołu jest lewostronne zaniedbywanie wzrokowo-przestrzenne, wynikające zwykle z uszkodzenia okolic skroniowo-ciemieniowych prawej półkuli mózgu. Przejawia się ono trudnościami w wykrywaniu, a nawet wyobrażaniu sobie przez chorych bodźców wzrokowych pochodzących z lewej części przestrzeni, czego nie można wytłumaczyć podstawowymi ubytkami sensorycznymi, jak np. niedowidzeniem połowiczym. Zaniedbywanie wzrokowe wiązane jest najczęściej z patologią uwagi przestrzennej oraz innymi dysfunkcjami uwagowymi, a także ze zniekształceniem tzw. wewnętrznej (mózgowej) reprezentacji przestrzeni. Odmienność poglądów, co do przyczyn tego zaburzenia przyczyniła się do rozwoju różnych metod terapii: począwszy od stosowania interwencji typowo behawioralnych aż po wprowadzanie technik neuromodulacji i stymulacji mózgu oraz próby leczenia farmakologicznego. Mimo to, jedynie trening przeszukiwania wzrokowego uzyskał dotąd status „praktycznego standardu” w postępowaniu terapeutycznym. Pozostałe interwencje są zalecane jako opcja terapeutyczna bądź mają charakter eksperymentalny i wymagają dalszych badań nad ich skutecznością. Analizie poddaje się też metody kombinowane, powstałe z połączenia różnych podejść terapeutycznych. Wydaje się, że dla dalszego rozwoju metod terapii chorych z zaniedbywaniem wzrokowo-przestrzennym ważne jest wiązanie patomechanizmu tego zaburzenia nie z jednostkową dysfunkcją, lecz zbiorem współzależnych dysfunkcji poznawczych mogących bezpośrednio powodować lub pośrednio nasilać asymetrię we wzrokowym przeszukiwaniu przestrzeni.

EN

This article reviews the most wide-spread theoretical underpinnings of the pathomechanism of hemineglect syndrome and their therapeutic implications. The most frequent and disabling form of the syndrome, left visuo-spatial neglect, arises usually as a consequence of damage to the temporo-parietal regions of the right hemisphere of the brain. It manifests itself with difficulties in detecting or even imagining visual stimuli coming from the left side of space, that cannot be explained by primary sensory loss such as hemianopia. Visual neglect is most often associated with pathologies of spatial attention and of other attentional components, but also with distortion of the mental representation of space. The different views on the causes of this disorder have contributed to the development of various therapeutic approaches: ranging from the use of typical behavioral interventions to the application of specific neuro-modulation, and stimulation techniques as well as drug treatment attempts. Despite this, only the training of visual scanning has been so far recognized as “good practice standard”. Other interventions are recommended as a therapeutic option or are experimental and require further research on their effectiveness. Combined treatments which include various therapy approaches, are also being analyzed. It seems that for the further development of the treatment methods of hemineglect the most important is consideration of its pathomechanism not as a single entity, but as a set of interrelated cognitive dysfunctions which can directly cause or indirectly exacerbate the asymmetry in the visual scanning of space.

15

Kiedy włączać leczenie II linii w stwardnieniu rozsianym?

75%

Losy J.

Aktualności Neurologiczne

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2015

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vol. 15

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issue 3

124-129

EN

The aim of relapsing-remitting multiple sclerosis therapy is to achieve the maximum clinical effect of reducing the number of or eliminating relapses of the disease and achieving the lack of progression of physical disability with a minimum or nonexistent disease activity observed in magnetic resonance imaging. Treatment should be started as soon as possible in order to limit the inflammatory and autoimmune process which leads to neurodegenerative lesions. There are a number of first-line medicines which are used at the beginning of the disease such as interferon beta and glatiramer acetate. Oral drugs have recently been introduced into this group such as dimethyl fumarate and teriflunomide, among others. They are characterised by a good safety profile and moderate efficacy. If first-line therapies turn out to be ineffective, second-line medicines are used such as, for example, natalizumab or fingolimod. The views on when second-line therapy should be started and what substances to use have been constantly evolving and the recommendations sometimes differ depending on the country. For instance, fingolimod was approved by the European Medicines Agency as a second-line therapy for relapsing-remitting multiple sclerosis, while Food and Drug Administration approved it as a first-line therapy for this disease. When selecting a medicine one should take into account disease activity, the efficacy of the treatment used so far, comorbidities as well as potential side effects.

PL

Celem leczenia stwardnienia rozsianego w postaci rzutowo-remisyjnej jest uzyskanie maksymalnego efektu klinicznego w postaci zmniejszenia liczby lub ustąpienia rzutów choroby i braku progresji niewydolności ruchowej przy minimalnej bądź zerowej aktywności obserwowanej w tomografii rezonansu magnetycznego. Leczenie należy rozpocząć jak najwcześniej, tak aby udało się ograniczyć proces zapalno-autoimmunologiczny, prowadzący do zmian neurodegeneracyjnych. Istnieje szereg leków I linii, które stosuje się na początku choroby, takich jak interferon beta i octan glatirameru. Do tej grupy w ostatnim czasie zostały wprowadzone leki doustne, m.in. fumaran dimetylu i teriflunomid. Cechują się one dobrym profilem bezpieczeństwa i umiarkowaną skutecznością. W przypadku braku skuteczności leków I linii stosuje się leki II linii, np. natalizumab czy fingolimod. Poglądy na to, kiedy należy włączać kurację lekami II linii i jakie substancje stosować, nieustannie ewoluują, a zalecenia niekiedy różnią się w zależności od kraju. Przykładem może być fingolimod – zaaprobowany przez European Medicines Agency jako lek II linii, podczas gdy Food and Drug Administration zaaprobowała go jako lek I linii w rzutowo-remisyjnej postaci stwardnienia rozsianego. Wybór konkretnego leku powinien uwzględniać aktywność choroby, skuteczność dotychczasowej terapii, współistniejące schorzenia oraz potencjalne objawy uboczne.

16

Chronic cough: new concepts and therapeutic possibilities

75%

Arcimowicz M., Niemczyk K.

Polski Przegląd Otorynolaryngologiczny

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2016

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vol. 5(1)

22-29

EN

Cough is the most common symptom of the upper and lower airway diseases. In its nature, cough is a defence re-flex mechanism of the respiratory tract that is used to clear the upper and lower airways. Chronic cough, defined as cough lasting for more than 8 weeks, is reported in 3–40% of the general population and has an important impact on patients’ quality of life, by causing anxiety, physical discomfort, social isolation and personal emabarrassment, be-ing an often medical complaint and one of the most common reasons for outpatient visits. Upper airway cough syn-drome, asthma, eosinophilic bronchitis and gastroesophageal reflux diseases account for most chronic cough after excluding somking, angiotensin-converting enzyme inhibitor use and chronic bronchitis. Many patients have more than one reason for chronic cough. Some complex diagnostic procedures, in many individuals are necessary to rec-ognized the cause/causes of chronic cough and to establish the accurate diagnosis, which implies a higher chance of effective treatment. Despite detailed diagnostic procedures, in many cases, the efficacy of chronic cough treatment is questionable and ambiguous. We observe not always satisfactory response to therapy. There are some coughs that seem refractory despite an extensive work-up. The possibility of hypersenitive cough reflex response, defining pa-tients with Cough Hypersensitivity Syndrome has been proposed to explain these cases, rather resistant to cough treatment, previously known as idioapthic cough or refractory, unexplained cough. The concept of Cough Hypersen-sitivity Syndrome helps us to understand the mechanisms underlying cough and provides better therapeutic options to treat chronic cough, like neuromodulating drugs, and speech therapy.

17

Thromboembolic recurrence frequency analysis in patients with deep vein thrombosis of lower extremities.

75%

Vasyliuk S., Atamaniuk V.

Critical Care Innovations

|

2020

|

vol. 3

|

issue 1

1-8

EN

INTRODUCTION: To estimate the incidence of thromboembolic recurrence in patients whose deep vein thrombosis (DVT) during the initial and long-term anticoagulation and after its termination was treated. MATERIAL AND METHODS: There were examined and treated 98 patients with deep vein thrombosis of various locations. Patients were observed during anticoagulation therapy (n=98) and after its perfor-mance (n=76) for between 7 and 120 months. Depending on the scheme of anticoagulation therapy patients were divided into three groups: the first group (n=32) received warfarin, the second group (n=34) – rivaroxaban, the third one (n=32) – dabigatran etexilate. RESULTS: In terms of initial and long-term anticoagulant therapy, regardless of the choice of treatment regimens, DVT recurrence or pulmonary embolism cases we have not observed. After the treatment, during the first year, recurrence of DVT was more frequent in patients of all groups. In patients of the first group their frequency was 15.38±7.08%, the second group – 8.7±5.88%, the third one – 3.7±3.63%, which did not differ significantly (p=0.33). In general, the overall observation period showed a recurrence rate among the patients of the first group was 10 cases, 4 cases in the second group, and three cases in the third group (p<0.05). There was no signifi-cant difference in the incidence of thrombosis recurrence was observed between patients taking rivaroxaban and dabigatran etexilate, whereas there was a significant difference between the first and third groups (p<0.05). CONCLUSIONS: Long-term anticoagulation with warfarin is the least predictable as for the risk of re-currence of DVT (p<0.05), when the application of Rivaroxaban and dabigatran etexilate showed no significant difference in the incidence of DVT recurrence. Patients with provoking persistent risk factors and non-triggering factors require continued anticoagulation therapy indefinitely, or until this risk factor has been eliminated.

PL

WSTĘP: Oszacowanie częstości nawrotów zakrzepowo-zatorowych u pacjentów z zakrzepicą żył głębokich (eng. deep vein thrombosis - DVT) w trakcie wstępnego i długoterminowego leczenia przeciwzakrzepowego oraz po jego zakończeniu. MATERIAŁ I METODY: Przebadano i leczono 98 pacjentów z zakrzepicą żył głębokich w różnych lokalizacjach. Pacjentów obserwowano podczas leczenia przeciwzakrzepowego (n = 98) i po jego wykonaniu (n = 76) przez okres od 7 do 120 miesięcy. W zależności od schematu leczenia przeciwzakrzepowego pacjentów podzielono na trzy grupy: pierwsza grupa (n = 32) otrzymała warfarynę, druga grupa (n = 34) - rywaroksaban, trzecia (n = 32) - eteksylan dabigatranu. WYNIKI: Pod względem początkowej i długotrwałej terapii przeciwzakrzepowej, niezależnie od wyboru schematów leczenia, nie zaobserwowano nawrotów DVT lub przypadków zatorowości płucnej. Po leczeniu w pierwszym roku nawrót DVT był częstszy u pacjentów ze wszystkich grup. U pacjentów w pierwszej grupie ich częstość wynosiła 15,38±7,08%, w drugiej grupie - 8,7±5,88%, w trzeciej - 3,7±3,63%, co nie różniło się istotnie (p = 0,33). Ogólnie rzecz biorąc, ogólny okres obserwacji wykazał, że odsetek nawrotów u pacjentów z pierwszej grupy wynosił 10 przypadków, 4 przypadki w drugiej grupie i trzy przypadki w trzeciej grupie (p <0,05). Nie stwierdzono istotnej różnicy w częstości nawrotów zakrzepicy między pacjentami przyjmującymi rywaroksaban i eteksylan dabigatranu, podczas gdy istniała znacząca różnica między pierwszą a trzecią grupą (p <0,05). WNIOSKI: Długoterminowe leczenie przeciwzakrzepowe warfaryną jest najmniej przewidywalne, jeśli chodzi o ryzyko nawrotu DVT (p <0,05), gdy stosowanie rywaroksabanu i eteksylanu dabigatranu nie wykazało istotnych różnic w częstości nawrotów DVT. Pacjenci z prowokującymi uporczywymi czynnikami ryzyka wymagają ciągłej terapii przeciwzakrzepowej przez czas nieokreślony lub do momentu wyeliminowania tego czynnika ryzyka.

18

Padaczka jako problem wieku podeszłego

63%

Klimek A.

Aktualności Neurologiczne

|

2010

|

vol. 10

|

issue 4

221-226

EN

Epilepsy in the elderly differs from that in younger people. It is an important and increasingly common clinical problem. Old age is the most common time to develop seizures and around 25% of new cases of epilepsy occur in elderly people. In people of 70 years and above, the prevalence of epilepsy has been estimated two times more to compered with the general population. The epidemiological studies showed that the value of incidence and prevalence in elderly epilepsy are similar in many countries. About one-half of cases of epilepsy in elderly cannot be linked to an identifitable cause, in the rest – 33% cerebrovascular disturbances, 12% dementia. In the elderly partial epilepsy dominated on tonic-clonic seizures. In connection to elongation of average age of population in Poland the number of the elderly epilepsy will be increase. Especially of the number of ischemic stroke in connection with epilepsy is typical in this age. To realize of scale of this problem the author according to the generally accepted the value of prevalence and incidence of epilepsy estimates suitable accounts with reference to our country.

PL

Padaczka w późnym wieku cechuje się wieloma odrębnościami, stwarzając istotne trudności diagnostyczne i terapeutyczne. Badania wykazały, że liczba zachorowań na padaczkę u osób po 50. r.ż. wyraźnie wzrasta – jej występowanie u osób w wieku 70-75 lat jest dziś ważnym problemem społecznym. Badania epidemiologiczne prowadzone w wielu krajach wykazują zbliżone wskaźniki rozpowszechnienia i zachorowalności na padaczkę w wieku starczym. Etiologia napadów w tym wieku jest różna: u 50% chorych stwierdza się padaczkę idiopatyczną, u 33% będącą skutkiem uszkodzenia naczyniowego mózgu, zaś w 12% padaczkę w przebiegu procesów otępiennych. Pozostałe przyczyny są o wiele rzadsze. W wieku starczym napady częściowe złożone (50%) i proste (13%) przeważają nad napadami toniczno-klonicznymi (27%). W rozpoznaniu różnicowym należy przede wszystkim wykluczyć kardiogenne tło utrat przytomności oraz otępienie. W związku z wydłużającą się w ostatnich latach średnią długością życia w Polsce problem padaczek wieku starczego będzie narastał. Jest on także związany z występowaniem w tym wieku udarów niedokrwiennych. W artykule przedstawione zostały odpowiednie wyliczenia w odniesieniu do naszego kraju oparte na powszechnie przyjętych wskaźnikach zachorowalności i rozpowszechnienia padaczki.

19

Psylocybina jako alternatywny lek dla osób cierpiących na depresję

63%

Dydak K., Śliwińska-Mossoń M., Milnerowicz H.

Psychiatria i Psychologia Kliniczna

|

2016

|

vol. 16

|

issue 3

165-170

EN

Psilocybin is a psychodysleptic substance of natural origin present in the Psilocybe type mushrooms. Psychodysleptics are psychoactive substances which strongly affect the perception, mood and cognitive processes of a human. The mind-altering operation of psilocybin is based on stimulating the serotoninergic receptors, which leads to the increase in the concentration of serotonin in the brain and contributes to the intensification of the sensorimotor activity and perception. The effect of the operation of psilocybin on the human body are various changes in behaviour – frequent euphoria, cheerfulness, the feeling of lightness and unity with the surrounding world. Additionally, psilocybin causes perception modification not imitating reality, often mistaken for hallucinations. The operation of psilocybin may be compared to the operation of LSD (lysergic acid diethylamide), yet many times weaker. Psilocybin may be found on the list of intoxicants in the I-P group, namely substances with no medical applications and with a high potential of overusing, which are excluded from the pharmaceutical trade and may be used solely for scientific purposes. However, the properties of psilocybin make it possible to consider its use in medicine. Ailments, in which the use of this substance brings measurable effects, include depression. Studies conducted on volunteers show that psilocybin may be a good alternative to the currently available antidepressants – its effectiveness was observed and very low toxicity confirmed.

PL

Psylocybina jest substancją psychodysleptyczną pochodzenia naturalnego, występuje w grzybach rodzaju Psilocybe. Psychodysleptyki są środkami psychoaktywnymi, które silnie wpływają na percepcję, nastrój i procesy poznawcze człowieka. Psychodeliczne działanie psylocybiny opiera się na pobudzaniu receptorów serotoninergicznych, co prowadzi do wzrostu stężenia serotoniny w mózgu oraz przyczynia się do intensyfikacji czynności sensomotorycznych i percepcyjnych. Skutkiem działania psylocybiny na ludzki organizm są różne zmiany w zachowaniu – często stany euforyczne, rozweselenie, poczucie lekkości i jedności z otaczającym światem. Dodatkowo psylocybina powoduje modyfikację percepcji nieudającą rzeczywistości, często błędnie określaną mianem halucynacji. Działanie psylocybiny można porównać do działania LSD (dietyloamidu kwasu D-lizergowego), jednak wielokrotnie osłabionego. Psylocybina znajduje się w wykazie środków odurzających w grupie I-P, czyli substancji bez zastosowań medycznych i o dużym potencjale nadużywania, które są wyłączone z obrotu farmaceutycznego i mogą być używane wyłącznie do badań naukowych. Jednak właściwości psylocybiny pozwalają rozważać jej wykorzystanie w lecznictwie. Do schorzeń, w których zastosowanie tej substancji przynosi wymierne efekty, należy depresja. Badania prowadzone na ochotnikach dowodzą, że psylocybina może być dobrą alternatywą dla dostępnych obecnie leków przeciwdepresyjnych – wykazano jej skuteczność i potwierdzono bardzo niską toksyczność.

20

Psychologia gier wideo – zarys problematyki i jej akademicka legitymizacja

63%

Klimczyk P.

Polskie Forum Psychologiczne

|

2022

|

vol. XXVII

|

issue 3

351-368

EN

Despite the clarification of the cyberpsychology subdiscipline, its area of interest, which is video game research, seems to be absent in Polish psychological thought, which contrasts with the trends observed in the global scientific circulation. Nevertheless, they still constitute a small part of it. The issue of video games concerns such phenomena specific to the virtual environment as the identification of the player with the avatar. Research results suggest that the experience of playing games for many people is non-ludic in nature, and the emotions accompanying them are not always pleasant, despite the perceived satisfaction with the experience. Video games can be a source for satisfying basic needs, which determines mental well-being. Their practical application can be observed in areas such as education or health care and therapy, and in these contexts, video games are referred to as serious games, a term coined to emphasise their non-fun functions. Perhaps the marginal nature of research on games in Poland is related to the omission by Polish psychologists of the issue of ludic behaviour among adolescents and young adults.

PL

Pomimo wyklarowywania się subdyscypliny cyberpsychologii, jej obszar zainteresowań jakim są badania gier wideo wydaje się być nieobecny w polskiej myśli psychologicznej, co kontrastuje z trendami obserwowanymi w ogólnoświatowym obiegu naukowym. Mimo to, nadal stanowią one niewielką jego część. Problematyka gier wideo dotyczy specyficznych dla środowiska wirtualnego fenomenów takich jak identyfikacja gracza z awatarem. Wyniki badań sugerują, że doświadczenie grania w gry dla wielu osób ma charakter poza ludyczny, a emocje im towarzyszące nie zawsze są przyjemne, pomimo odczuwanej satysfakcji z tego doświadczenia. Gry wideo mogą stanowić źródło zaspokajania podstawowych potrzeb, co warunkuje dobrostan psychiczny. Ich praktyczne zastosowanie zaobserwować można w takich obszarach jak edukacja czy opieka zdrowotna i terapia, a w tych kontekstach gry określane są mianem serious games, co ma stanowić podkreślenie ich poza zabawowej funkcji. Być może marginalny charakter badań nad grami w Polsce związany jest z pomijaniem przez polskich psychologów problematyki zachowań ludycznych wśród adolescentów i młodych dorosłych.

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