Strokes in paroxysmal atrial fibrillation have more favorable outcome than in permanent atrial fibrillation.

OBJECTIVE: Our aim was to compare the course of IS due to ptAF and pxAF. METHODS: A prospective, single-center study was conducted in patients with AF and acute IS with 6-month follow-up. RESULTS: We included 178 patients: 70 (39%) with pxAF and 108 (61%) with ptAF. Compared with patients with ptAF, patients with pxAF more often presented with subcortical, mainly lacunar strokes (21% vs 8%, P = 0.01) and were less frequently dependent at discharge (16% vs 42%, P < 0.001) and after 6 months (16% vs 20%, P < 0.001). Strokes in patients with pxAF were more frequently categorized as non-cardioembolic (35% vs 18%, P = 0.01). In the multivariate analysis, after adjustment for confounding factors (diabetes, chronic heart failure, high risk of thromboembolism and lack of prestroke anticoagulation), ptAF was an important risk factor for unfavorable short-term (OR 5.4; P < 0.01) and long-term outcomes (OR 2.6, P = 0.01) of IS. In all patients with AF, the occurrence of non-cardioembolic stroke was related to a reduced risk of dependence or death in short-term outcome (OR 0.4, P = 0.04) and marginally influenced long-term outcome (OR 0.49, P = 0.09). CONCLUSIONS: The present study suggests that, compared with patients with ptAF, ISs in patients with pxAF have better outcomes.

Treatment of alcoholic polyneuropathy with vitamin B complex: a randomised controlled trial.

AIMS: To evaluate the therapeutic efficacy and safety of BEFACT Forte 'new formulation' and BEFACT Forte 'old formulation' in the treatment of sensory symptoms of alcoholic polyneuropathy. METHODS: A multi-centre, randomised, double-blind, placebo-controlled study was conducted on 325 patients with sensory symptoms and signs of alcoholic polyneuropathy. Patients were randomised to the 'old formulation' (i.e. vitamins B1, B2, B6, and B12), 'new formulation' [i.e. identical to the 'old formulation' with additional folic acid (vitamin B9)], or placebo in a 1:1:1 ratio. One tablet of the study medication ('new formulation' or 'old formulation') or placebo was taken orally, three times a day, over a 12-week treatment period. RESULTS: Therapeutic efficacy was assessed in 253 patients by measuring vibration perception threshold (biothesiometry), intensity of pain, sensory function, co-ordination, and reflex responses. Patients treated with the 'new formulation' or 'old formulation' showed significant improvement in the primary efficacy endpoint (vibration perception threshold at the big toe) and secondary efficacy endpoints in comparison to placebo. The active treatment groups were comparable to placebo in terms of safety. CONCLUSIONS: A specific vitamin B complex (with and without folic acid) significantly improved symptoms of alcoholic polyneuropathy over a 12-week treatment period.

[Neurologic symptoms as the first manifestation of Addison-Biermer disease]. / Objawy neurologiczne jako pierwsza manifestacja choroby Addisona-Biermera.

A patient was observed who came with the following symptoms persisting for six months: paraesthesia in the lower and upper limbs, weakening of muscle strength, difficulties in walking. The high value of the mean cell volume in blood morphologic examination called attention to the possibility of vitamin B12 deficiency which had not yet manifested itself as anaemia. Further studies confirmed this suggestion. As the result of the treatment with vitamin B12 full normalization of the nervous system condition and results of examinations was achieved.

[Vertigo: its clinical and electrophysiological correlations]. / Zawroty glowy--badania kliniczne i elektrofizjologiczne.

In 41 cases of vertigo without abnormalities in neurological examinations BAEP examination, specialistic otological examination, X-ray of the cervical spine were done. In most cases Doppler USG examination of the carotid and vertebral arteries and EEG and CT of the head were obtained. The most frequent abnormality in these examinations were changes in cervical spine found in 30 cases (90%) and in BAEP--36.5%. BAEP changes were most frequently found in patients with known factors for dizziness--41.2%, followed by those with CT changes--33.3%, cervical spine changes--28.6% and changes in USG of the arteries supplying the brain from the neck.

[Clinical, CT and electrophysiologic studies of alcoholics with special reference to the cerebellum]. / Badania kliniczne, CT i elektrofizjologiczne u przewleklych alkoholików ze szczególnym uwzglednieniem mózdzku.

Comprehensive clinical examinations and laboratory investigations were carried out in 20 alcoholics (Group III according to Jellinek's classification) with particular reference to the cerebellum. Clinical cerebellar signs were found in 4 cases, and in 3 of them atrophic changes of the cerebellum and cerebrum were demonstrated in CT examinations, and in 3 electrophysiological changes compatible with neuropathy were found. Evoked auditory potential from the brainstem was changed in 12 cases, which might be explained as impairment of the cerebellar function. In 12 cases signs of polyneuropathy were disclosed, in 5 of them they were evident clinically and electrophysiologically, and in 7 they were found only in EMG. Changes in somatosensory and visual evoked potentials were less evident, but in connection with abnormalities in other investigations they suggested presence of diffuse or disseminated nervous system damage. These investigations suggest that cerebellar signs in alcoholics are not isolated and are a manifestation of a more generalized damage to the nervous system.

[Attempt at treating multiple sclerosis by means of ultrasound stimulation of the lymphatic system]. / Próba leczenia stwardnienia rozsianego przy pomocy stymulacji ultradzwiekami ukladu limfatycznego.

The authors tried to apply ultrasound stimulation of the lymphatic system in patients with multiple sclerosis. This trial was undertaken in view of reports of German authors on favourable results of this therapeutic method. The treated group included 24 patients aged 20--54 years with steady or slowly progressive course of this disease in whom spastic paraparesis predominated in the clinical picture. Before starting and after the completion of this treatment each patient was examined and graded according to a 65-point scoring system taking into account the most important clinical parameters. After 4--6 months in 15 patients the course of treatment was repeated. One course of treatment included 24 procedures performed once daily. The procedure and technical data are described. The results obtained were as follows: 80% of patients reported subjective improvement, the objective status was improved by a mean value of 19% after the first course of treatment and 5% after the second treatment in relation to the initial state. Apart from some somnolence in the initial period of the course, no other side effects were observed. This report is regarded by the authors as a preliminary communication since for a better evaluation of this method the courses of treatment should be repeated several times and in a greater number of patients.