The influence of frailty syndrome on quality of life in elderly patients with type 2 diabetes.

INTRODUCTION: There have been no comprehensive studies that assess the impact of frailty syndrome on quality of life (QoL) of patients with diagnosed type 2 diabetes. The purpose of the study was to assess the impact of frailty syndrome on QoL and depression symptoms of patients with type 2 diabetes. METHODS: The study included 148 consecutive patients (aged ≥ 60y). The patients were divided into two groups according to the prevalence of the frailty syndrome: robust and frailty. For all of the patients that were included in the study, we used the Polish version of validated instruments: ADDQoL, TFI and BDI. RESULTS: In the study group, 43.2% had been diagnosed with frailty syndrome. An analysis of QoL assessment depending on the prevalence of the frailty syndrome showed that patients who were robust (without recognized frailty syndrome) assessed QoL significantly better than patients with coexisting frailty syndrome. Robust patients did not have any severe depressive symptoms, whereas in the group of patients with the frailty syndrome 43.8% of the patients had a depression. 70.2% of the patients without any depressive symptoms were robust patients, meanwhile only 14% of the patients had frailty syndrome recognized. CONCLUSIONS: Frailty syndrome occurred in 43 percent of the patients with type 2 diabetes. This has a negative impact on QoL of patients. Depression is more common in patients with the frailty syndrome and diabetes.

Factors that affect the assessment of the quality of life of rheumatoid arthritis patients depending on the prevalence of frailty syndrome.

Rheumatoid arthritis (RA) has a large and varied impact on the quality of life as associated with patient health including both physical and mental well-being. The aim of the study was to assess the factors that affect the assessment of the quality of life of RA patients depending on the prevalence of frailty syndrome. MATERIAL AND METHODS: The study involved 106 patients with RA (82 women; mean age 65.83 ± 5.01), who had been hospitalized in the Silesian Centre for Rheumatology, Rehabilitation and Disability Prevention in Ustron, Poland. The patients that were included in the study were divided into two groups depending on the incidence of frailty syndrome: Group 1 - robust patients and Group 2 - patients with frailty syndrome. RESULTS: Frailty syndrome was identified in 34.9% of the patients with recognized/diagnosed RA; in women, it was 36.14% and in men, it was 25.92%. The average TFI value was 4.11 ± 2.05; in the physical domain, it was 3.39 ± 1.66; in the mental domain, it was 0.41 ± 0.55 and in the social domain, it was 0.31 ± 0.48. The robust patients assessed their quality of life associated with sleep as being worse compared to patients with recognized frailty syndrome. CONCLUSION: Frailty syndrome has no significant impact on the assessment of the quality of life of patients with diagnosed RA. The factors that determine quality of life are different in robust patients and in patients with frailty syndrome. The assessment of the quality of life is affected by the degree of an individual's fitness regardless of the occurrence of frailty syndrome.

Influence of short-time application of a low sodium diet on blood pressure in patients with hyperthyroidism or hypothyroidism during therapy.

Hyperthyroidism or hypothyroidism are commonly associated with altered blood pressure (BP). Restriction of sodium in the diet produces a decrease in BP in some individuals. It is also well known that hormones other than thyroid affect BP. The present study was designed to evaluate the influence of a low sodium diet on BP in patients with hyperthyroidism or hypothyroidism during therapy. The occurrence of salt-sensitive or salt-nonsensitive BP was compared with hormonal levels (plasma renin activity, aldosterone, atrial natriuretic peptide, and arginine vasopressin). Patients with hyperthyroidism (75 subjects) were investigated before the initiation of treatment, 2 weeks after the treatment, and after the attainment of euthyroid state. Patients with hypothyroidism (31 subjects) were studied before the treatment and in the euthyroid state. Control values were obtained from 37 healthy individuals. Blood pressure, changes of plasma volume, serum aldosterone, atrial natriuretic peptide, vasopressin levels, and plasma renin activity were measured in all investigated subjects after application of a normal sodium diet and after 3 days on a low sodium diet. Elevated systolic BP was found in patients with hyperthyroidism and hypothyroidism. Mean arterial BP was higher only in the untreated hypothyroid patients. The high incidence of salt-sensitive BP was found only in untreated hypothyroid patients. Also in hypothyroid patients the application of a low sodium diet led to a lower increase in plasma renin activity in subjects with salt-sensitive BP than in individuals with salt-resistant BP. Therefore, different mechanisms are responsible for BP elevation in patients with hyperthyroidism or hypothyroidism.

The systolic function of the left ventricle of the heart in patients with hyperthyroidism during therapy.

Hyperthyroidism is associated with enhanced systolic function. The present study was designed to evaluate systolic cardiac function in patients with hyperthyroidism during a short-term and a long-term pharmacotherapy. The diagnostic value of various indices of the left ventricle function was analysed. Fifty-one hyperthyroid patients were investigated before initiation of the treatment, after 14 days of therapy with thiamazol (mean dose 54 mg/24 hr), a short-term treatment and after attainment of normal thyroid function, a long-term treatment (mean period 9 months). Control values were obtained from 30 healthy individuals. All investigated subjects were aged 18-50 yr. The following indices were determined with ultrasonocardiographic method: preejection period (PEP), left ventricle ejection time (LVET), preejection period index (PEPI) and left ventricle ejection time index (LVETI), index PEP/LVET, left ventricle shortening fraction (LVSF), left ventricle ejection fraction (LVEF), mean velocity of the circumferential fiber shortening (mVcf), contractility index (CIx), stroke volume (SV), cardiac index (CI), output-pressure index (OPI) and end-systolic wall stress (ESWS). Additionally, total peripheral resistance index (TPRI) and double product (DP) were calculated. In patients with untreated hyperthyroidism, a significant shortening of PEP, PEPI, LVET and low PEP/LVET index and TPRI as well as increased LVSF, LVEF, mVcf, CIx, CI, OPI and DP were shown. There was no changes in LVETI, SV and ESWS. A short-term treatment resulted in changes in PEP, PEPI, LVET, mVcf, CI and OPI in direction of normal values. After a long-term treatment all altered indices were normal with an exception of OPI, CI and DP. It is concluded that enhanced systolic function of the heart in patients with hyperthyroidism becomes normal after pharmacological control of the thyroid gland. Some changes are seen after a short-term treatment with thiamazol. The indices which reverse early are PEP, PEPI, LVET, mVcf and CI. Changes in ejection function of the left ventricle in patients with hyperthyroidism are resulted from increased heart rate and were found to be related to total peripheral vascular resistance.

Changes of plasma arginine-vasopressin level in patients with hyperthyroidism during treatment.

BACKGROUND: Hyperthyroidism is associated with several kinds of changes in the circulatory system, including alterations in blood volume. Arginine-vasopressin (AVP) is known to be one of the major factors regulating plasma volume. The present study was designed to evaluate the plasma AVP level in patients with hyperthyroidism during treatment. MATERIAL AND METHODS: AVP was measured under basal conditions and after stimulation with a low-sodium diet and upright position. Seventy-four patients with hyperthyroidism and 37 controls were investigated. Measurements were taken before treatment, two weeks after pharmacological treatment, and after attaining euthyroid status. The following indices were determined: AVP, total and free thyroxin and triiodothyronine, thyrotropin, sodium, potassium, hematocrit, arterial blood pressure, cardiac index, and total peripheral resistance index. Plasma osmolality and changes in plasma volume were calculated indirectly. RESULTS: Plasma AVP was higher in patients with hyperthyroidism before treatment. After normalization of thyroid status, the AVP level was similar to that of the controls. The application of a low-sodium diet and upright position resulted in a greater decrease in plasma volume than the controls. AVP correlated with thyroxin level and plasma osmolality in patients with hyperthyroidism. CONCLUSION: Enhanced AVP level in patients with hyperthyroidism is suggested to be the result of alterations in plasma volume and is relatively independent of changes in plasma osmolality.

[Renin-angiotensin-aldosterone system in thyroid disorders]. / Uklad renina-angiotensyna-aldosteron w stanach zaburzonej czynnosci tarczycy.

Alterations of the renin-angiotensin-aldosterone system activity occur in patients with thyroid disfunction. This paper is a review of the effect of hyperthyroidism or hypothyroidism in human beings and experimental animals on changes of the renin, angiotensinogen, angiotensin converting enzyme, angiotensin II and aldosterone concentrations and plasma renin activity.

Free radical activity and antioxidant defense mechanisms in patients with hyperthyroidism due to Graves' disease during therapy.

Free radical-mediated oxidative stress has been implicated in the etiopathogenesis of several autoimmune disorders. We investigated the prooxidant-antioxidant status in order to evaluate the possible deleterious role of oxidative phenomena in patients with Graves' disease. Thirty patients with hyperthyroidism due to Graves' disease were investigated. Thirty age-matched healthy subjects were studied as a control group. Free radical activity indices, antioxidant defense systems, and thyroid and pituitary hormone levels were measured in fasting blood samples. Blood samples were taken before initiation of therapy and after attainment of euthyroid state. A significant increase in lipid peroxidation activity indices, i.e., conjugated dienes and thiobarbituric acid-reacting substances, was found in blood serum of the patients with untreated Graves' disease. These changes were accompanied by a decrease in plasma thiol and erythrocyte lysate thiol groups concentrations. Hyperthyroidism resulted in a marked increase in intracellular antioxidant enzymes, i.e., superoxide dismutase, catalase and glutathione peroxidase activities as compared to the controls. Extracellular anti-free radical scavenging systems potential, measured by glutathione reductase activity and total antioxidant status level, was found to be significantly decreased in untreated Graves' patients. Treatment with thiamazole resulted in normalization of the free radical and antioxidant activity indices. The obtained results indicate an enhanced generation of reactive oxygen species and impairment of cellular and extracellular antioxidant systems potential in patients with Graves' disease. The attainment of euthyroid state led to an improvement in oxidative stress indices and antioxidant potential parameters.

[The respiratory system of workers employed in the casting and processing of copper]. / Uklad oddechowy u pracowników zatrudnionych przy odlewaniu i przetwarzaniu miedzi.

The aim of the study was to examine the influence of work in exposure to copper on the respiratory system. The study was carried out in 267 men aged (x +/- SD) 40.6 +/- 7.2 yrs, workers of a colour metal mill. 134 of them dealt with casting and processing of copper (the mean weighed concentration of copper on work posts was below 0.05 mg x m-3) and 133, not employed in a contaminated environment, comprised the control group. The subjects were divided into five groups according to the degree of energy expenditure at work and, additionally cigarette smoking was taken into account. All subjects underwent medical examination and spirometry. However the mean values of the ventilatory parameters in the compared groups did not significantly differ (p > 0.05), the multivarious regression analysis has shown a decreasing trend of FEV1 and FVC with relation to the exposition to copper and tobacco smoking. The frequency of chronic bronchitis as well as of radiological changes was not increased. The authors conclude: 1. At copper concentration not exceeding the MAC, and an advantageous microclimate, this exposition only slightly diminishes the pulmonary ventilation and does not cause other comprehensible pulmonary pathological sequelae, especially chronic bronchitis. 2. Tobacco smoking is a favourable factor for the occurrence of chronic bronchitis.

Gastric emptying in hyperthyroidism.

OBJECTIVES: We undertook a prospective study to survey gastric emptying of a solid meal in patients with hyperthyroidism until euthyroidism was reached after pharmacological treatment with thiamazole. METHODS: Eleven women (aged 33.2 +/- 3.2 SE yr) with recently diagnosed hyperthyroidism participated in the study. Thyroid function parameters and gastric emptying were examined on three occasions, before treatment, during the third week of treatment, and after euthyroidism was restored. The control group was composed of 12 age-matched healthy women (aged 34.5 +/- 2.3 yr). Gastric emptying of a 390-kcal 99mTc-labeled solid meal was continuously recorded under a gamma camera over 90 min. A power-exponential model was used for analysis of the gastric emptying course. Three gastric emptying parameters were computed: t1/2, the gastric half-emptying time, S, the curve shape parameter, and K, the slope of the curve. RESULTS: Pretreatment solid phase gastric emptying of the patients was not statistically significantly different from that of the healthy control subjects: t1/2, 82.8 +/- 4.9 vs 93.5 +/- 6.0 min; S, 0.996 +/- 0.103 vs 1.032 +/- 0.064; and K, 8.42 +/- 0.47 vs 7.64 +/- 0.39 min(-1) x 10(-3). Gastric emptying during the third week of treatment did not change in comparison with pretreatment gastric emptying: t1/2, 84.3 +/- 8.2 min; S, 1.014 +/- 0.123; and K, 8.92 +/- 1.12 min(-1) x 10(-3). On the other hand, a slight increase in rate of gastric emptying was observed after the restoration of euthyroidism (t1/2, 74.6 +/- 5.8 min, and K, 9.65 +/- 0.76 min(-1) x 10(-3), p < 0.05 vs healthy control subjects for both parameters), but no significant change was observed in the shape parameter (S, 0.980 +/- 0.066). CONCLUSIONS: In women with hyperthyroidism, gastric emptying of solids does not differ significantly from that observed in age-matched healthy control subjects and remains unaffected during pharmacological treatment. After restoration of euthyroidism, a slight but statistically significant increase in the rate of gastric emptying occurs in patients as compared with healthy control subjects.

Gastric emptying in hypothyreosis.

The purpose of this study was to compare the solid phase gastric emptying (GE) in hypothyreotic patients before treatment and after euthyreosis has been reached. Ten female patients (aged 44.8 +/- 9.5[SD] y) with recently diagnosed hypothyroidism were included in the study. Their thyrometabolic state and GE were examined before treatment and after a median of 5 1/2 months (range 2 1/2-12 1/2), i.e., when euthyreosis was achieved. The control group consisted of 12 healthy women (aged 34.5 +/- 8.1y). GE of a 390-kcal 99mTc-labelled solid meal was continuously recorded under a gamma camera during 90 min. A power-exponential model was used for the analysis of the GE course. Compared to the controls, the solid phase GE of the hypothyreotics was characterized by a significantly lower curve shape parameter S (0.745 +/- 0.217 vs. 1.032 +/- 0.223, p < 0.01) and slope of the curve K (4.8 +/- 2.2 min-1.10(-3) vs. 7.6 +/- 1.3 min-1.10(-3), p < 0.01). Restoration of euthyreosis resulted in an increase of both parameters, making the GE pattern no longer statistically significantly different from that encountered in healthy subjects. The treatment did not affect the gastric half emptying time T1/2 (median: 125 min and 130 min before and after the treatment, respectively; healthy controls: 94 min). A wide variation of individual GE data was found either before or after the treatment, and in a few cases delayed GE persisted despite an effective substitutive treatment. The GE kinetics was, however, in no way related to the severity of the disease. Further research on the pathogenesis of this phenomenon is warranted.

Markers of tissue response to thyroid hormones in patients with hyperthyroidism or hypothyroidism.

Changes in serum cholesterol and aminoterminal type III procollagen propeptide (PIIIPN) were compared in 33 patients with hyperthyroidism, 16 patients with hypothyroidism, and 23 healthy individuals. An increase in PIIIPN was found in patients with hyperthyroidism and an increase in serum cholesterol level was associated with hypothyroidism. There was no correlation between investigated indices. It is suggested that PIIIPN changes were a result of altered connective tissue metabolism, while serum cholesterol was related to the intensity of body metabolism.

[Evaluation of stomach emptying in patients with hyperthyroidism]. / Ocena kinetyki oprózniania zoladka u chorych z nadczynnoscia tarczycy.

The study aimed at the evaluation of the kinetics of gastric emptying (GE) of a solid meal in hyperthyroid patients during a pharmacological treatment with thiamazole until the moment of euthyroid restoration. Fourteen female patients ((33.4 +/- 2.6 y, mean +/- SE) with recently diagnosed hyperthyreosis took part in the study. Twelve age matched healthy women (34.5 +/- 2.3 y) constituted a control group (C). Every patient underwent the GE examination before treatment (I). In 12 patients the GE was reexamined on the 3rd treatment week (II). After the achievement of euthyroid, which happened after 4.5 mo (median; interquartile range 2.0 to 7.3 mo), a third GE measurement was taken in 13 patients (III). The GE of a 99mTc-labelled solid meal was measured with the use of a gamma camera. Time-activity curves from the gastric region of interest were used, after subjection to appropriate corrective procedures, to calculate the mean gastric transit time (MTT 90) and the fraction of the test meal retained in the stomach after 90 min (F90). Before the treatment and on the third week of management the GE of hyperthyroidism was not statistically significantly different from that of healthy controls (MTT90:39.44 +/- 0.30 min [I] 39.31 +/- 0.64 min [II] and 40.06 +/- 0.29 [C]; F90:46.6 +/- 1.9% [I], 47.9 +/- 3.7% [II] and 50.8 +/- 2.4% [C]). The restoration of euthyreosis was accompanied by a slight but statistically significant increase in the GE -p < 0.05 in the case of F90 vs the pre-treatment situation. Also the patients' GE was found then to be slightly but statistically faster than in healthy controls (MTT90:38.72 +/- 0.39 min [III], and F90: 42.2 +/- 2.3% [III] -p < 0.05 vs [C] for both parameters). We conclude that in hyperthyreotic women the GE of solids does not differ significantly from age-matched healthy female controls and remains unchanged during a pharmacological treatment. After achievement of euthyreosis a slightly but statistically significantly faster GE is observed in the patients when compared to healthy controls.

[Evaluation of gastric emptying in patients with hypothyroidism]. / Ocena kinetyki oprózniania zoladka u chorych z niedoczynnoscia tarczycy.

The study aimed at the evaluation of the gastric emptying (GE) kinetics in hypothyroid patients before and after a substitutive treatment with L-thyroxin. Twelve female hypothyroid (aged 45.3 +/- 8.7 years, mean +/- SD) and a control group of 12 healthy women (aged 34.5 +/- 8.1 years) were examined. The GE of a 99mTc-labelled solid meal was measured with the use of a gamma camera in every patient before the treatment, and in 10 of them a repeat GE examination was performed after the restoration of euthyroid; the median duration of the treatment was 5.5 mo (range 2.5 to 12 mo). The mean gastric transit time (MTT90) and the fraction of the test meal retained in the stomach after 90 min (F90) were statistically significantly greater in untreated hypothyroid than in healthy controls (MTT90: 42.01 +/- 1.86 min patients vs 40.06 +/- 1.00 min controls, p = 0.0043; F90: 64.3 +/- 15.4% patients vs 50.8 +/- 8.2% controls, p = 0.0173). In ten patients in whom a second GE measurement was taken after the achievement of euthyroid, a slight increase of the GE was observed (MTT90:41.46 +/- 1.49 min before vs 41.04 +/- 1.81 min after the treatment, NS) which was then no longer statistically significantly different from that of the healthy controls. No relationship was found between the GE and the severity of clinical symptoms of hypothyroidism. GE remained, however, slowed in some patients despite the restoration of euthyreosis. We conclude that: (I) long-lasting hypothyreosis is accompanied by a slightly slowed GE of solids, and (II) restoration of euthyreosis does not imply a parallel improvement of the hypothyroidism-associated delay in GE.

[Influence of energy expenditure and other factors on the incidence of arterial hypertension in employees with some types of employment in Tychy]. / Wplyw wydatku energetycznego i innych czynników na czestosc wystepowania nadcisnienia tetniczego u pracowników niektórych tyskich zakladów pracy.

The aim of the work was to evaluate the incidence of arterial hypertension in the inhabitants of Tychy, a city polluted by ecotoxins, in relation to the energy expenditure of professional work, in consideration of overweight, cholesterolaemia, uricemia, alcohol consumption, age and sex. Investigations were carried out on 1964 individuals (1392 men, 572 women) divided in 5 groups with different intensity of professional work. Serum uric acid and cholesterol levels were determined in all examined persons. Incidence of the obesity was also considered. The authors conclude that the risk of arterial hypertension in the examined individuals of Tychy is average 17.4% for both men and women, and it decreases with enhanced energy expenditure at professional work for men. Arterial hypertension appears in subjects from obesity, hyperuricaemia and drinking more than 4.0 dl of pure ethanol per week.

[Influence of prolonged application of captopril upon pulmonary ventilation in patients with chronic congestive heart failure]. / Wplyw przedluzonego stosowania kaptoprylu na wentylacje pluc u chorych na przewlekla zastoinowa niewydolnosc serca.

Study was designed to investigate the effect of prolonged application of captopril on pulmonary ventilation in patients with chronic congestive heart failure (CCHF) without hypertension. Studies were carried out in 13 men aged 54-65 yrs with CCHF due to ischaemic heart disease. They were classified hemodynamically as III or IV stage according to the NYHA classification. Two periods of management were investigated. In the 1st period, lasting at least one month, cardiac glycosides, diuretics, nitrates, as well as diet and restricted physical activity were applied. In the 2nd period, lasting 21 days, additionally captopril was given in a daily dose of 2 x 12.5 or 2 x 25 mg depending on the drug tolerance. When the periods were terminated pulmonary ventilation was measured. The following indices were determined: FEF25, FEF50, FEF75, FEF25-75, FEV1, FVC,FEV1/FVC, SVC, FIVC, FIF25, FIF50, FIF75, FIF25-75. No significant effect of captopril upon pulmonary ventilation was found (p < 0.05). In any of the patients captopril-induced cough was not observed. It is concluded that prolonged management with captopril in patients with CCHF without hypertension has no disadvantageous influence upon pulmonary ventilation with exception of patients who are hypersensitive to the drug.

[Non-atrial natriuretic peptides]. / Pozaprzedsionkowe czynniki natriuretyczne.

This paper described newly discovered peptides, brain natriuretic peptide and C-type natriuretic peptide. Their structure and metabolism as well as peptides participation to many physiological and pathological states have been reviewed with a special emphasis to their role in blood pressure regulation and mineral and fluid balance.

Serum amino-terminal propeptide of type III procollagen in patients with hyperthyroidism or hypothyroidism during therapy.

Changes in serum amino-terminal type III procollagen propeptide (PIIIPN) and hydroxyproline were compared with indices of thyroid function in 33 patients with hyperthyroidism and 16 patients with hypothyroidism before and after treatment. Control values were obtained from 26 healthy individuals. Hyperthyroidism was shown to be associated with an increased level of PIIIPN and hypothyroidism with a decreased PIIIPN level. An increase in PIIIPN was found in 100% of hyperthyroid patients and a decrease in 31% of those with hypothyroidism, while hydroxyproline increased in only 54% of patients with hyperthyroidism and its level was decreased in only 6% of patients with hypothyroidism. Correlation between PIIIPN and thyroxine and triiodothyronine levels was shown. The results obtained suggest that PIIIPN is a valuable index of tissue response to thyroid hormones.

[Effect of maprotiline on bronchodilation in patients with bronchospasm]. / Wplyw maprotyliny na rozkurcz oskrzeli u chorych z stanem skurczowym oskrzeli.

The bronchodilatory effect of maprotiline (Ludiomil, firm Ciba-Geigy) was investigated in 20 patients with bronchospasm (FEV %below 60%). The effect of a single dose of 75 mg maprotiline was compared with that produced by 500 mg of aminophylline, applied each time in 500 ml normal saline during 90 min, on two different days, in randomized sequence, always at the same day time. Prior to and at 5, 10, 20, 30, 60, 90, 120, 150 and 180 minutes after commencement of the infusion the following parameters of pulmonary ventilation have been determined: VC, FEV1, FEV1%., MEFR and MBC. The stated differences between the efficacy of maprotiline and aminophylline were statistically not significant (p > 0.05). In 18 patients maprotiline caused sedation and even somnolence. The authors conclude that maprotiline is an efficacious bronchodilator in patients with bronchospasm and is well tolerated by the patients.

[Volume of the functioning gallbladder and its emptying in patients with progressive systemic sclerosis]. / Objetosc miedzyposilkowa pecherzyka zólciowego oraz jego opróznianie u chorych na postepujaca twardzine ukladowa.

UNLABELLED: The aim of the study was to measure the gallbladder volume (GV) and its emptying after meal stimulus in patients with progressive systemic sclerosis (PSS). 18 women with PSS, aged 49.8 +/- 9.5 yr, participated in the study. Control values were obtained from 30 healthy women aged 26.5 +/- 3.5 yr. The duration of PSS symptoms ranged from 2 to 25 yr. Subjects with gallstones or cholecystitis as well those receiving drugs affecting the gastroduodenal motor function were excluded from the study. GV was measured according to Dodds et all (1985) with the real-time sonographic apparatus (Sonoline SL Siemens, Germany), after an overnight fast and after a test meal. Measurements were repeated in 10 min intervals through a 40 min duration of the study. Similar volumes of fasted gallbladder were found in the PSS group and in the control group: 25.4 cm3, SEM 3.0 (PSS), vs. 20.9 cm3, SEM 1.6 (control), p > 0.05. There was not any correlation between the fasted GV and duration of the disease symptoms. The test meal evoked in both groups a similar trend of the decrease in the GV during 40 min and the increase in the ejection fraction at this time. Although the changes observed were statistically not significant (p > 0.05) there were small differences in the gallbladder ejection fraction in two patients, not exceeding 14% and 18%, and being apparently below of any individual value in the control group. CONCLUSION: the gallbladder motor function is very rarely disturbed in patients with PSS.

[Influence of treating hypothyroidism and hyperthyroidism upon psychical reaction time]. / Wplyw leczenia niedoczynnosci i nadczynnosci tarczycy na czas reakcji psychicznej.

The aim of the study was answering the question whether determination of psychical reaction time may be useful for the monitoring of treatment of hypothyreosis and hyperthyreosis. The correlation of disease symptoms (diagnostic index for hypothyroidism after Murray and for hypothyroidism according to Crooks), concentration of triiodothyronine, thyroxine, index of free thyroxine in blood serum and Achilles tendon reflex--with the simple reaction time (srt) as well as with the choice reaction time (chrt) before and during treatment was investigated in 18 patients with primary hypothyroidism and in 24 with hyperthyroidism caused by Graves-Basedow's disease. Two control groups comprised 84 healthy persons. Either in hypothyroidism or in hyperthyroidism the srt and chrt was significantly prolonged. The substitution therapy in hypothyroidism resulted in a normalization of both parameters. On the other hand, administration of thiamazole, especially in the early period of treatment of hyperthyroidism, further prolonged the srt and chrt. A shortening of the time of each of the two reactions occurred, however, when the restoration of euthyroidism was achieved, which was accompanied by reduction of thiamazole dosage. The obtained data point to the usefulness of srt and chrt determination for the diagnosis and therapy monitoring of functional disturbances of the thyroid gland.