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Objectives. To evaluate the spectrum of neurological symptoms in patients with COVID-19 during the first 14 days of hospitalisation and its association with in-hospital mortality. Material and methods.We included 200 patients with RT-PCR-confirmed COVID-19 admitted to University Hospital in Krakow, Poland. In 164 patients, a detailed questionnaire concerning neurological symptoms and signs was performed prospectively within 14 days of hospitalisation. In the remaining 36 patients, such questionnaires were completed retrospectively based on daily observations in the Department of Neurology.Results. During hospitalisation, 169 patients (84.5%) experienced neurological symptoms; the most common were: fatigue (62.5%), decreased mood (45.5%), myalgia (43.5%), and muscle weakness (42.5%). Patients who died during hospitalisation compared to the remainder were older (79 [70.5-88.5] vs. 63.5 [51-77] years, p = 0.001), and more often had decreased level of consciousness (50.0% vs. 9.3%, p < 0.001), delirium (33.3% vs. 4.4%, p < 0.001), arterial hypotension (50.0% vs. 19.6%, p = 0.005) or stroke during (18.8% vs. 3.3%, p = 0.026) or before hospitalisation (50.0% vs. 7.1, p < 0.001), whereas those who survived more often suffered from headache (42.1% vs. 0%, p = 0.012) or decreased mood (51.7% vs. 0%, p = 0.003). www.journals.viamedica.pl/neurologia_neurochirurgia_polska Marcin Wnuk et al., Neurological symptoms in COVID-19 Conclusions. Most hospitalised patients with COVID-19 experience neurological symptoms. Decreased level of consciousness, delirium, arterial hypotension, and stroke during or before hospitalisation increase the risk of in-hospital mortality.

A significant number of patients with Gaucher disease (GD) suffer from chronic or acute pain that reduces their quality of life. A mutation in lysosomal enzyme β‐glucosidase (GCase) leads to an accumulation of glucocerebroside in the macrophage‐lineage cells, causing the development of clinical symptoms. Novel studies have revealed that ambroxol (trans‐4‐(2‐amino‐3,5‐dibromobenzylamino)‐cyclohexanol), the well‐known mucolytic drug, acts as a chaperone for the mutant, misfolded enzyme. In addition, as has recently been shown, ambroxol is a Nav1.8 channel blocker in Aβ, Aδ and unmyelinated C fibres, and therefore reduces the transmission of sensory stimuli from the primary afferent neurons to the dorsal spinal cord. In this way, it can act analgetically. Thus, in addition to broncholytic properties, ambroxol combines two other important functions: it enhances enzyme replacement therapy (ERT) and pain management in patients with GD. We present a 38‐year‐old female patient with type 3 GD who had reported permanent bone pain in the lumbar‐sacral part of the spine for over a year without any pathology evidenced in the undertaken, recommended diagnostic tests. The pain was partly controlled with standard analgesics, that is, paracetamol and tramadol. Ambroxol was introduced at a dose of 150mg/d without a noticeable effect. However, when the dose was increased up to 450mg/d, the intensity of pain diminished and subsided within the following months. Two of three attempts to reduce the dose of ambroxol resulted in a pain relapse within a week, which subsided after resetting the previous, higher dose. This observation of the effects of ambroxol in a GD patient is worth considering for other GD patients with chronic pain.

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Introduction: Long-term poor metabolic control promotes the occurrence of microvascular complications, such as cardiovascular autonomic neuropathy (CAN) and atherogenic hyperlipidaemia, which translates into increased mortality in patients with type 1 diabetes mellitus (T1DM). The aim of the study was to assess the prevalence of CAN in patients with T1DM in relation to treatment method (continuous subcutaneous insulin infusion, CSII, versus multiple daily injections using pens, MDI) and metabolic control. Material and methods: The study group comprised 93 adults (60 women, 33 men), mean age 31 years, with T1DM being treated at a local clinical centre from 2011 to 2015. The presence of CAN, the results of laboratory tests, and anthropometric data were analysed. The subjects were divided into two groups according to treatment method (CSII, MDI). Results: The median duration of diabetes was 16 years. 61% of the subjects used MDI and 39% used CSII. 41% of the subjects presented with CAN (confirmed with the Ewing test using ProSciCard apparatus), with a significantly lower prevalence in the group of patients treated with CSII (15.4% vs. 60.4%; p < 0.001). The mean HbA 1c level in the CSII-treated group was noticeably lower (7.44 ± 1.67% vs. 8.55 ± 1.1%, p < 0.001), and these patients also had lower triglyceride levels (0.71 vs. 1.32 mmol/L, p < 0.001). Regardless of the treatment method, 72% of all patients under 40 years of age achieved their therapeutic target of LDL cholesterol level < 2.6 mmol/L, whereas only 13% of all those over 40 years old achieved an LDL cholesterol level < 1.8 mmol/L. Conclusions: The presented results draw attention to the high prevalence of CAN among T1DM patients. The study reveals the need for more intensive monitoring and treatment of hyperlipidaemia, despite good glycaemic control, especially in those over the age of 40 years. (Endokrynol Pol 2019; 70 (4): 323-329)

AimsThe research work was conducted to find new biomarkers and potential drug targets in Gaucher disease type 1 (GDt1) by analysing the serum proteins.MethodsThis study was an observational, cross-sectional analysis of a group of 12 adult participants: six Gaucher disease (GD) patients and six healthy control. Fasting venous blood underwent proteomics analysis and molecular tests. Over 400 proteins were analysed, and in case of significantly different concentrations between the study and control group, we checked corresponding genes to confirm changes in their expression and consistency with protein alteration.ResultsWe found 31 proteins that significantly differed in concentration between GDt1 patients and a control group. These were mostly proteins involved in the regulation of the inflammatory processes and haemostasis. The levels of proteins such as alpha-1-acid glycoprotein 2, S100-A8/A9, adenyl cyclase-associated protein 1, haptoglobin or translationally controlled tumour protein related to inflammation process were significantly higher in GD patients than in control group, whereas the levels of some proteins such as heavy constant mu and gamma 4 or complement C3/C4 complex involved in humoral response like immunoglobulins were significantly decreased in GD patients. Alteration in two proteins concentration was confirmed in RNA analysis.ConclusionsThe work revealed few new targets for further investigation which may be useful in clinical practice for diagnosis, treatment and monitoring GDt1 patients.

transduction 11. The induction of gp130 family of cytokines parallel axonal injury, in the experimentally induced diabetic mice, significantly decreased axonal regeneration 12. This study's goal is to follow, by microarray, the possible alteration of blood cell molecular pathways which may be altered to initiate the process of nervous tissue destruction in the course of T1D. Material and Methods Patients were selected from those attending the diabetic clinic at JUMC Department of Metabolic Disorders. The study group consisted of 60 patients with T1D, confirmed with a positive anti-GAD test result. These patients were treated with a standard therapeutic regimen: multiple daily injections (MDI) or continuous subcutaneous insulin infusions (CSII). The patients were randomized into two subgroups depending on the presence or absence of symptoms of autonomic neuropathy. The control group (n = 20) consisted of healthy non-obese volunteers recruited in accordance to age, gender and body weight. The exclusion criteria for all participants were: age under 20 and above 65 years; metabolic syndrome, cardiovascular diseases, cancer, chronic inflammation; severe liver or kidney failure, iron deficiency anaemia; pregnancy, breast feeding, hormone replacement therapy; anticoagulant treatment; usage of anti-inflammatory drugs and lack of the patient's written consent to participate in the study. The study protocol was approved by the Jagiellonian University Bioethical Committee and was in accordance with the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study. Evaluation of autonomic neuropathy (CAN). The presence of CAN was based on the outcome of the reference method using the ProSciCard apparatus (Ewing test) 13. The severity of the cardiovascular neuropathy in the investigated group was determined by the number of abnormal results (from 3 up to 5) of Ewing test and pathological blood pressure variability [the guidelines for 2018 year of Polish Society of Diabetes] 13. Fasting venous blood was sampled from each participant for further tests. Part of the sample was sent for a routine laboratory diagnostic test, and another part was immediately centrifuged for serum isolation, and then transferred into sterile eppendorfs and stored at −20 °C. Whole blood samples were collected for mRNA isolation using PAXgene Blood RNA Tubes (Becton Dickinson) for material stabilization and transport. Each study participant underwent laboratory tests assessing the level of metabolic control, including: HbA1c level, lipidogram, renal markers, liver function tests and TSH levels. Biochemical tests were performed at the main Laboratory Diagnostics Department in the University Hospital, in accordance with standard procedures. RNA isolation. Purification of total RNA from human whole blood was performed using the PAXgene Blood RNA Kit, following producer protocol. The RNA quality was analysed using the Tapestation 2200 instrument (Agilent, USA) and quantified by spectrophotometry on the NanoDrop