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Cognitive impairment is a common disease. Many studies attempt to explain the mechanisms of these dysfunctions formation, including correlations between cognitive functions and biochemical parameters. Scientists search for substances that would be indicators of cognitive functions and which could be determined in the cerebrospinal fluid or blood of the subjects. To date, they have isolated a few of such substances; however, research on their specificity, validity and the possibility of their use in diagnostics and prognostic assessment is still ongoing. However, there have been only few reports in the literature systematizing the existing knowledge on this subject, and they are mostly related to Alzheimer’s disease, not cognition in general, or referring only to a specific group of substances. This article discusses the most important biochemical exponents of cognitive functions.

Prostate cancer (PC) is one of the most common malignancies in men. The increase in the number of PC survivors is associated with many problems including cognitive impairment. Early detection of such problems facilitates timely protective intervention. This study examined the association between prostate-specific antigen (PSA) or testosterone (T) levels and cognitive function in patients undergoing radical prostatectomy. Such a correlation could help identify patient groups at risk of cognitive impairment. Participants underwent clinical (demographic data, medical history, physical examination, and blood analyses) and neuropsychological assessment (cognitive test battery). Preoperative PSA or T levels were not associated with cognitive function. However, long-term follow-up after prostatectomy showed a strong correlation between PSA levels and the results of verbal memory and executive function tests. A trend toward significance was also observed for visuospatial memory. The levels of free T and total T were not correlated with cognitive function. Only the levels of free T after hormonal treatment were significantly correlated with executive functions. Comorbid diabetes affected these correlations. In conclusion, PSA levels at a distant postoperative time and free T level after hormonal treatment may be biomarkers of cognitive function.

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A 28-year-old man was admitted to the hospital due to strongly expressed dyspnoea, cough and peripheral oedema. The above symptoms started about 4 weeks before the admission and had significantly increased in the last 2 days. In addition, he reported the occurrence of papulopustular, itchy rash for several months. In 2013 and 2014, the patient underwent chemotherapy and radiotherapy for Hodgkin's lymphoma (HL) which resulted in obtaining a remission. No other medical history was presented. At the admission, for a screening test, a transthoracic echocardiography was made which revealed a large amount of pericardial fluid and pathological mass in the heart. A pericardiocentesis was performed promptly to decompress the cardiac tamponade and to collect material for histopathological examination. Unfortunately, immunohistochemistry did not allow to make a diagnosis. After the pericardial drainage, the patient's condition was stabilized, enabling further diagnostic processes. Initially, we decided to perform a full echocardiographic examination, that showed irregular, heterogeneous masses which were encompassing the base of the heart, filling the right ventricle and the majority of the right atrium. Subsequently, we utilized imaging studies to determine the size of the lesion and the extent of its infiltration. Computed tomography scan and magnetic resonance imaging of the chest revealed the presence of fluid in pleural cavities and pericar-dial sac, as well as the distorted image of the heart due to advanced infiltration. The pathological mass was extending from upward and downward of the cardiac wall, penetrating the interventricular septum, and growing into the right heart cavities. The lesion adhered tightly to the anterior chest wall, causing the mass effect on the left atrium. Moreover, the tumour was covering and pressing on big vessels, such as lung trunk, the aorta, left carotid artery and subclavian artery. In addition, numerous enlarged lymph nodes were observed in the mediastinum. Subclavian and cervical lymph nodes were palpable during the physical examination. Regarding the history of HL, the lymph node biopsies were evaluated in the histopathological examination, which described findings typical to HL. Immediate standard treatment was started with adriamycin, bleomycin, vinblastine and dacarbazine. PET-CT scan, conducted after two treatment cycles, revealed numerous, enlarged, diseased lymph nodes, and the patient had been qualified for chemotherapy with brentuximab vedotin and bendamustin. After two treatment cycles, the PET-CT study was repeated. The image of nodal lesions corresponded to the significant metabolic and morphological regression, and significant reduction of cardiac lesions was described. The patient's condition has normalized, all symptoms have disappeared and the physical capacity has returned. The patient continues haematological treatment.

Background. Atrial fibrillation (AF) may cause worsening of haemodynamic function of the heart, occurrence of peripheral embolism, emotional disorders, and secondary occurrence of cognitive deterioration. It seems that patients with AF constitute a heterogeneous group in terms of features characterising both the arrhythmia itself and their psychophysical efficiency. Taking this into account, the aim of the work was to assess the psychophysical condition of patients with various forms of AF. Methods. The study included 80 subjects diagnosed with AF. Patients underwent a clinical and neuropsychological evaluation, including clinical interview and physical examination, biochemical and echocardiographic parameters, physical performance (6MWT), cognitive and executive functions (TMT A and B, Stroop 1 and 2, RAVLT), and severity of depressive symptoms (BDI). Results. Analysis of the results of neuropsychological tests revealed significantly worse performance of TMT B and RAVLT A3 by patients with long-standing persistent AF than among patients with non-permanent AF. The subjects with long-standing persistent arrhythmia also walked a significantly shorter distance in 6MWT. In 55% of subjects, clinically significant depressive symptoms were observed. However, there were no significant differences in the values of echocardiographic parameters between particular groups. Conclusions. Long-standing persistent type of AF was associated with worse results of psychophysical efficiency, and exercise performance, likewise in cognitive and executive functioning. More than half of patients with AF presented features of depressive disorders.

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