[Diabetic neuropathy]. / Neuropatia cukrzycowa.

Diabetic neuropathy is most common chronic complication of diabetes mellitus. It is responsible for substantial morbidity, increased mortality and impaired quality of life. Patogenesis of diabetic neuropathy is complex. Chronic hyperglycemia is a major factor induces nerve fibers injury. High level of glucose stimulate the polyol pathway causing osmotic stress and enhance reactive oxygen species generation, as well as it play an important role in diabetic angiopathy development. Distal symmetric polineuropathy is most common type of diabetic neuropathy. Many patient may develop combinations of neuropathies concerning somatic and autonomic system. Early diagnosis and administered suitable treatment are necessary to reduce severe complication of diabetic neuropathy as well as strict glycemic control and risk factor increased.

[Central pontine myelinolysis--case report]. / Centralna mielinoliza mostu--opis przypadku.

Central pontine myelinolysis (CPM) is a neurologic disorder, consists of demyelinisation without inflammation in the base of pons, with a relative sparing of the axons and the nerve cells. Clinical symptoms have various manifestations. They include pseudobalbular paralysis, tetraparesis, locked-in syndrome, coma. Rapid correction of persistence hyponatremia is a well recognized factor predisposing to CPM and nutritional deficiency is a commonly evoked cause of CMP as well. In more than half the cases it appeared in the late stages of chronic alcoholism. Among other medical conditions conjoined with CMP are liver failure and transplantation, electrolyte disturbances, cachexia from various causes, carcinoma, and severe bacterial infections. The autors report the cases of 31 year old patient with 4 year history of alkohol abuse in whom CPM developed with mild tetraparesis.

[Statins and stroke]. / Statyny a udar mózgu.

The occurrence of stroke increases with age, particularly affecting the older elderly, a population also at higher risk for coronary heart disease (CHD). Epidemiological and observational studies have not shown a clear association between cholesterol levels and all causes of stroke. Nevertheless, large, long-term statin trials in patients with established CHD or et high risk for CHD (diabetes, hypertension) have shown that statins decrease stroke incidence in these populations even with a normal baseline cholesterol concentration. In patients with previous stroke statins reduce the incidence of coronary events, but whether they actually reduce the incidence of recurrent strokes in secondary prevention is unproved. In this review we discuss the potential reason for the effects of statins on stroke and the mechanisms of action. Statins probably reduce stroke by a variety of mechanisms. Several studies indicate that statins have multiple effects beyond lowering the cholesterol level. There is evidence that statins have neuroprotective properties for the acute ischaemic brain. Statins interfere with platelet aggregation and have anti-inflammatory and antioxidative properties. Also statins promote stabilisation of atherosclerotic plaques and improve blood flow to the ischaemic brain. The protective effects of statins might be due to their direct effect on endothelial cells leading to improved nitric oxide (NO) bioavailability. However further studies are needed to understand the full role of statins in the prevention of stroke in patients without established cardiovascular disease, representative of the typical stroke population.