Cancer Care to Ukrainian War Refugees in Poland.

This cohort study evaluates cancer care provided to Ukrainian war refugees in Poland.

[Anxiety and depressive symptoms in epilepsy in the context of defense mechanisms and electrodermal activity]. / Objawy leku i depresji w padaczce w kontekscie mechanizmów obronnych i aktywnosci elektrodermalnej.

Depressive and anxiety disorders among people with epilepsy are more common than in general population and they are associated with less efficient emotion regulation and reduced quality of life. Unfortunately, these disorders are not always correctly diagnosed or treated. Some studies suggest that the electrodermal activity may serve as a marker for depression. AIM: The aim of the study was to measure and compare depressive and anxiety symptoms, defense mechanisms and electrodermal activity in response to cognitive stimulation in patients with epilepsy with the control group, and to test the correlations between symptoms of anxiety and depression, defense mechanisms and the electrodermal activity. MATERIALS AND METHODS: 64 patients diagnosed with epilepsy and 66 people from the control group were assessed with following psychological questionnaires: State-Trait Anxiety Inventory, Beck Depression Inventory, Defense Styles Questionnaire 40. MindLAB Set was used to measure electrodermal activity. RESULTS: The study showed that people with epilepsy tend to have increased levels of anxiety and depressive symptoms compared with the control group. Patients also tend to use neurotic defense mechanisms what may be associated with poorer emotion regulation. Electrodermal activity was lower among people with epilepsy after cognitive stimulation. There was no statistically significant correlation between electrodermal activity, anxiety and depressive symptoms. CONCLUSIONS: The results indicate the need for assessment of anxiety, depressive symptoms and types of defense mechanisms among patients with epilepsy, as appropriate psychotherapeutic and/or pharmacological intervention could significantly improve the quality of life of these patients.

Repetitive transcranial magnetic stimulation for the treatment of cognitive impairment in frontotemporal dementia: an open-label pilot study.

BACKGROUND: Frontotemporal dementia (FTD) is one of the most frequent dementia types in patients under 65 years of age. Currently, no therapy can effectively improve the cognitive deficits associated with FTD. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive method of inducing brain plasticity with therapeutic potential in neurodegenerative diseases. The purpose of this study was to evaluate the effect of rTMS on cognitive, behavioral, and emotional function in FTD. METHODS: Nine patients (seven women, four men, mean age 61.7±10.1 years) with the behavioral variant of FTD, one with nonfluent/agrammatic variant primary progressive aphasia, and one with progressive nonfluent aphasia (subtypes of FTD) underwent 10 daily sessions of 10 Hz rTMS over the bilateral dorsolateral prefrontal cortex. Cognitive and behavioral assessments were administered before and after therapy. RESULTS: After rTMS, the Montreal Cognitive Assessment and letter and digit cancellation test scores, as well as reading time and error number in the Stroop test improved. The caregivers' impression of the daily functioning of patients improved in the Frontal Behavioral Inventory scores. These changes were not paralleled by an improvement of mood. CONCLUSION: The results indicate that rTMS may improve the cognitive performance of patients with FTD and warrant sham-controlled trials.

The efficiency of botulinum toxin type A for the treatment of masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache.

BACKGROUND: Temporomandibular joint dysfunction are often accompanied by symptoms of headache such as tension-type headache which is the most frequent spontaneous primary headache. Masseter muscle pain is commonly reported in this group. The purpose of the study was to assess the efficiency of intramuscular botulinum toxin type A injections for treating masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache. METHODS: This prospective outcome study consisted of 42 subjects of both genders aged 19-48 years diagnosed with masseter muscle pain related to temporomandibular joint dysfunction and tension-type headache. The subjects were treated by the intramuscular injection of 21 U (mice units) of botulinum toxin type A (Botox, Allergan) in the area of the greatest cross-section surface of both masseter bellies. Pain intensity was evaluated using visual analogue scale (VAS) and verbal numerical rating scale (VNRS) 1 week before the treatment and 24 weeks after the treatment. The obtained data were analyzed using the Wilcoxon matched pairs test (p ≤ 0,005). RESULTS: The results of this study showed a decrease in the number of referred pain episodes including a decrease in pain in the temporal region bilaterally, a reduction of analgesic drugs intake as well as a decrease in reported values of VAS and VNRS after injections (p = 0,000). CONCLUSIONS: The intramuscular botulinum toxin type A injections have been an efficient method of treatment for masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache.

Predictors of depressive symptoms in patients with stroke - a three-month follow-up.

BACKGROUND AND PURPOSE: Depression is one of the most common post-stroke complications, which could impair rehabilitation outcome and quality of life, and could also increase mortality after stroke. The aim of the present study was to assess the association between demographic, socioeconomic and clinical (stroke risk factors, type of stroke, location of vascular lesion, cognitive functions) factors on the presence and severity of post-stroke depressive symptoms in patients after first ever stroke as well as on their social functioning. MATERIAL AND METHODS: A prospective, cohort study with a three-month observation period was performed in seven centres. Severity of depressive symptoms was assessed with the help of a short, 15-item version of the Geriatric Depression Scale (GDS), 3 months after stroke onset. RESULTS: On the basis of GDS (GDS L 5 points or > 5 points) patients were allocated to a group without (n = 160) or with symptoms suggestive of depression (n = 82). The study groups did not differ with respect to age, sex or place of residence. Univariate logistic regression analysis showed that independent predictors for the presence of symptoms suggestive of depression at 3 months after stroke were: low level of education, low income, greater severity of stroke, worse functional status, self-reported problems with daily-living activities and need of help in daily living activities. More than 60% of patients with depressive symptoms limited their social contacts. Patients with depressive symptoms were unsatisfied with their relations with life partners and friends. CONCLUSIONS: Our study showed a complex aetiology of post-stroke depressive symptoms with an important role of socioeconomic factors. Depressive symptoms after stroke worsen existing health, social and economic problems, and cause social isolation of patients.

Stroke attack rates and case fatality in the Krakow Stroke Registry.

BACKGROUND AND PURPOSE: Previous epidemiological studies of stroke in Poland completed more than 10 years ago reported moderate incidence rates but very high case fatality rates due to stroke. We used the data of the Krakow Stroke Registry to calculate the attack rates as well as short- and long-term case fatality rates from stroke in hospitalized inhabitants of Krakow, Poland. MATERIAL AND METHODS: We prospectively recorded all cases of stroke (defined according to the ICD-10) in adult permanent residents of Krakow, who were admitted to hospitals in that city. The registration took one year (between 1 July 1999 and 30 June 2000). The vital status of participants was established on days 30, 90 and 180 and at one year after their stroke. RESULTS: 1096 strokes occurred in a population of 589,820. Attack rate standardized for the European population was 180.0 per 100,000 (218.3 in men and 151.9 in women). Ischaemic stroke was diagnosed in 532 (48.6%), stroke not specified as haemorrhagic or ischaemic in 406 subjects (37.0%), intracerebral haemorrhage in 86 (7.8%), and subarachnoid haemorrhage in 72 (6.6%). The 30-day, 90-day, 180-day and one-year case fatality rates for all strokes were 17.8%, 28.1%, 30.8% and 39.7%, respectively. Case fatality rates for ischaemic stroke were 9.8%, 19.0%, 21.6% and 31.2%, respectively and for intracerebral haemorrhage 44.2%, 55.8%, 55.8% and 60.5%, respectively. CONCLUSIONS: The attack rates of stroke in urban areas of Poland are similar to the average European rates. Short- and long-term case fatality rates are much lower than previously reported.

[Carotid artery stenting with different cerebral protection systems]. / Stentowanie tetnic szyjnych z uzyciem róznych systemów protekcji mózgu.

Carotid angioplasty with stent implantation (CAS) has become an alternative for carotid endarterectomy in treatment of carotid arteries atherosclerosis due to low procedural injury and comparable procedural risk. Wide application of cerebral protection devices decreased the procedural risk. The aim of the study was to estimate the procedural safety of CAS procedures with application of different cerebral protection systems. CAS procedures were performed in 48 patients. One procedure was unsuccessful, in this patient stroke occurred. Distal occlusion balloon system was used in 5 patients, proximal occlusion balloons for common carotid artery was used in 21 pts and filter systems in 22 pts. During 6-months follow-up, we observed no death nor stroke (40 pts). In one patient we revealed TIA. Moreover we found restenosis in one patient 6 months after CAS (total occlusion). In our experience CAS procedures were safe and incidence of major cerebro-vascular complications comparable to other centers.