No abstract

Background and Objectives: Phonoholism is the excessive and harmful use of a smartphone. We are now observing this phenomenon among adults more often. Using a smartphone for several hours may lead to somatic and psychological symptoms, such as headaches and depression. The aim of this study is to assess the prevalence of phonoholism and to assess the association between smartphone overuse and neuropsychiatric disorders. Materials and Methods: A total of 368 people (70.1% were woman), aged between 19 and 82 years (average age 26.1), took part in an anonymous questionnaire consisting of the following elements: Hospital Anxiety and Depression Scale (HADS), Mobile Phone Problem Use Scale (MPPUS-9), and original questions regarding headaches and sleep quality, along with a subjective assessment of the use of smartphones and an objective evaluation based on data from the applications “Stay Free” and “Screen Time”. Results: A total of 61 respondents (16.6%) obtained a score on the MPPUS-9 scale, which revealed their problematic use of mobile devices. Patients with phonoholism had significantly more headaches (85% vs. 58.7%, p = 0.027). Subjects with phonoholism had significantly shorter mean sleep duration (7.14 h vs. 7.42 h, p = 0.0475) and were less likely to feel sleepy during the day (43.33% vs. 59.73%, p = 0.0271). The group with phonoholism had significantly higher scores on the HADS-A anxiety scale (8.29 vs. 10.9, p = 0.015), but a statistical significance was not confirmed for depressive symptoms. Conclusions: The excessive use of the telephone negatively affects both somatic and mental health and can pose a significant clinical problem.

Severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, causes acute respiratory disease (coronavirus disease 2019; COVID-19). However, the involvement of other mechanisms is also possible, and neurological complications are being diagnosed more frequently. Here, we would like to present a case of a Polish patient with Guillain–Barré syndrome (GBS), after a documented history of COVID-19: A 50-year-old man, 18 days after the onset of COVID-19 symptoms, had progressive quadriparesis preceded by 1-day sensory disturbances. Based on the clinical picture, the results of diagnostic work-up including a nerve conduction study (ENG) that revealed a demyelinating and axonal sensorimotor polyneuropathy, and cerebrospinal fluid (CSF) analysis that showed albumin–cytological dissociation, an acute inflammatory demyelinating polyneuropathy was confirmed, consistent with GBS. Upon a therapeutic plasma exchange (TPE), the patient’s condition improved. The presented case of GBS in a patient after mild COVID-19 is the first case in Poland that has supplemented those already described in the global literature. Attention should be drawn to the possibility of GBS occurring after SARS-CoV-2 infection, even when it has a mild course.

Background Parkinson’s disease (PD) is a synucleinopathy, which presents dysautonomia, as its common non-motor symptom. Some research suggests the existing interplay between the autonomic nervous system dysfunction and glucose metabolism dysregulation in PD. Objective To determine the prevalence of metabolic disorders with particular emphasis on glucose metabolism in patients with PD and atypical parkinsonism (AP). Patients and Methods A retrospective study was performed by analyzing 461 clinical data of consecutive patients diagnosed with PD, multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) hospitalized from 2019 to 2021 in the authors’ institution. The study group included 350 patients (303 PD, 14 MSA, 33 PSP), aged 65.8 ± 9.7 years (42% were female). Laboratory results (fasting glycemia, lipid parameters, TSH, homocysteine and vitamin D3 levels) were collected. The patient’s clinical condition was assessed in III part of Unified Parkinson’s Disease Rating Scale (UPDRS p. III), Hoehn–Yahr scale, Mini Mental State Examination (MMSE) and Beck Depression Inventory (BDI). Results Impaired fasting glycemia (IGF) was more prevalent in PD than in the PSP (43.43% vs 18.18%; p = 0.043). Similarly, PD presented a higher level of fasting glycemia (102.4 ± 16.7 mg/dl vs 92.2 ± 16.1mg/dl; p = 0.042). According to lipid parameters, patients with PD showed lower LDL cholesterol (92.3 ± 44.3mg/dl vs 119 ± 61.0mg/dl; p = 0.016) and lower BMI compared to patients with PSP (26.1 ± 4.0kg/m 2 vs 29.3 ± 4.4 kg/m 2 ; p = 0.024), but there were no statistically significant differences in triglycerides (TG) and HDL cholesterol levels. Males with PD presented greater frequency of IFG (35.05% vs 50.6%; p = 0.042), higher fasting glycemia (99.1 ± 14.3mg/dl vs 103.7 ± 14.7mg/dl; p = 0.006), lower total cholesterol, HDL cholesterol, and BMI compared to women with PD. Conclusion Our investigation supports an association between synucleinopathies and glucose metabolism dysregulation.

Background and Objectives: Carotid web (CaW) is an intimal variant of fibromuscular dysplasia and may constitute as one of rare causes of acute ischemic stroke (AIS). The objective of this study was to determine the prevalence of CaW in patients with AIS or transient ischemic attack (TIA) based on head/neck CT angiography (CTA) in a Polish cohort study. Materials and Methods: A retrospective study was performed by analyzing 1480 electronic clinical and imaging data regarding patients with AIS or TIA, hospitalized in the years 2018–2020 in the authors’ institution. The final sample consisted of 181 patients who underwent head/neck CTA; aged 67.81 ± 13.51 years (52% were women). All head/neck CTA studies were independently evaluated by two radiologists. The patient’s clinical condition was assessed with the National Institutes of Health Stroke Scale (NIHSS, 5.76 ± 4.05 and 2.88 ± 3.38 at admission and at discharge, respectively). Results: 27 patients were identified with CaW. The prevalence of CaW in the final sample (181 pts with good quality CTA) was 14.9%. In the CaW group, 89% patients had AIS, including 26% diagnosed with recurrent and 11% with cryptogenic strokes. There were no significant differences between the presence of CaW and gender, age, NIHSS score, recurrent or cryptogenic stroke. Conclusions: Our study demonstrated that CaW may be an underrecognized entity leading to cerebrovascular events. The diagnosis of CaW depends on a high level of awareness and a comprehensive analysis of the neuroimaging studies. Our findings support the hypothesis that it is worthwhile to perform CTA to determine the etiology of ischemic stroke, particularly if predicting factors were not identified.

Cel pracyCelem niniejszej pracy była ocena wiedzy i postaw oraz zasad postępowania lekarzy podstawowej opieki zdrowotnej (POZ) w Polsce w zakresie przesiewowej diagnostyki w kierunku zaburzeń funkcji poznawczych u osób w wieku podeszłym.MetodaBadaniem objęto 175 lekarzy zatrudnionych w POZ. Wykorzystano walidowaną autorską ankietę. Badanie przeprowadzono metodą PAPI (bezpośredni wywiad z wykorzystaniem papierowej wersji kwestionariusza) oraz CAWI (wspomagany komputerowo wywiad przy pomocy strony internetowej).WynikiZdecydowana większość badanych (n=159; 91,4%) widziała celowość prowadzenia badań przesiewowych w kierunku zaburzeń poznawczych w grupie wiekowej >65 r.ż., jednak tylko 53 osoby (30,29%) uważały, że badania te powinny być prowadzone przez lekarzy POZ. Wg ankietowanych lekarzy główną przeszkodą w diagnostyce funkcji poznawczych jest brak czasu – tak uważało 142 (81,14%) respondentów. W sytuacji podejrzenia otępienia ankietowani zwykle zlecali badania laboratoryjne oraz kierowali pacjentów do specjalisty neurologa (n=111; 63,4%). Najbardziej znanymi skalami oceniającymi funkcje poznawcze były w badanej grupie Krótka Skala Oceny Stanu Psychicznego (ang. Mini Mental Status Examination, MMSE), którą znało 120 lekarzy (68,57%), oraz Test Rysowania Zegara (ang. Clock Drawing Test, CDT), który był znany 122 ankietowanym (69,71%).WnioskiLekarze POZ mają świadomość konieczności badań przesiewowych w kierunku zaburzeń poznawczych u seniorów. W chwili obecnej nie funkcjonują w ramach POZ mechanizmy umożliwiające właściwy wczesny screening w kierunku otępienia u osób z grupy ryzyka (tj.> 65 r.ż.). Opracowanie standardów wczesnego wykrywania zaburzeń poznawczych w ramach POZ w Polsce wydaje się pilną potrzebą.

Cel pracyCel badania: Celem badania była analiza konsultacji psychiatrycznych u pacjentów Oddziału Neurologii i Oddziału Udarowego (ON/OU) w latach 2017-2018.MetodaDokonano retrospektywnej analizy konsultowanych psychiatrycznie chorych, ustalanych przez konsultanta rozpoznań (wg ICD-10) oraz zalecanej terapii.WynikiW analizowanym okresie odbyło się we wszystkich oddziałach szpitala 719 konsultacji psychiatrycznych, zdecydowana większość, tj. 488 (67,87%) odbyła się w oddziale neurologii i oddziałem udarowym. Najwięcej porad psychiatry wymagali pacjenci z rozpoznaniem choroby Huntingtona (n=25; 37,31%), choroby Parkinsona (n=60; 23,9%) oraz padaczki (n=40; 22,73%). Najczęściej stawianą diagnozą były psychiczne zaburzenia organiczne (n=229; 55,85%), a w szczególności organiczne zaburzenia nastroju (n=73; 14,96%) i organiczne zaburzenia lękowe (n=32; 6,56%), zaś w chorobach naczyniowych - zaburzenia świadomości w przebiegu majaczenia (n=30; 40,54%). Większość konsultacji (n=388; 79,51%) zakończyła się rozpoczęciem lub modyfikacją leczenia farmakologicznego. Grupami najczęściej zalecanych leków były neuroleptyki (n=174; 35,66%), w większości atypowe (n=152; 87,36%), oraz leki przeciwdepresyjne (n=230; 47,13%), w większości SSRI (n=216; 93,91%). U pacjentów >60 r.ż. w porównaniu z chorymi <60 r.ż częściej rozpoznawano zaburzenia organiczne (n=179; 66,30% vs. n=49; 35,0%) i częściej zalecano neuroleptyki (n=131; 42,12% vs. n=44; 24,86%).WnioskiPacjenci oddziału neurologii i oddziału udarowego byli najczęściej konsultowaną psychiatrycznie grupą chorych. Optymalizacja opieki nad osobą ze schorzeniem neurologicznym wymaga ścisłej współpracy neurologa i psychiatry oraz opracowania i aktualizacji wspólnych stanowisk dla postępowania w wybranych jednostkach chorobowych.

Current data emphasize the immunomodulating role of vitamin D in enhancing the anti-inflammatory response. Vitamin D deficiency is an established risk factor for developing multiple sclerosis—the autoimmune demyelinating and degenerative disease of the central nervous system. Several studies confirmed that higher vitamin D serum level is associated with better clinical and radiological outcomes in patients with multiple sclerosis, whereas vitamin D supplementation benefits in multiple sclerosis remain inconclusive. Despite that, many experts suggest regular measurements of vitamin D serum levels and supplementation in patients with multiple sclerosis. In this study, 133 patients with multiple sclerosis (relapsing–remitting subtype) were prospectively observed in a 0-, 12- and 24-month time span in a clinical setting. The study group consisted of 71.4% of patients (95 out of 133) supplementing vitamin D. The associations between vitamin D serum levels, clinical outcomes (disability status expressed by EDSS, number of relapses and time to relapse) and radiological outcomes (new T2-weighted lesions and number of gadolinium-enhanced lesions) were evaluated. There were no statistically significant correlations between clinical outcomes and vitamin D serum levels or supplementations. Fewer new T2-weighted lesions were observed in patients with vitamin D supplementations (p = 0.034) in 24 months of observation. Moreover, an optimal or higher level of vitamin D (>30 ng/mL) maintained throughout the entire observation period was associated with a lower number of new T2-weighted lesions in 24 months of observation (p = 0.045). These results support vitamin D implementation commencement and amelioration in patients with multiple sclerosis.