Postepy psychiatrii neurologii最新文献

Purpose: The aim of the study was to evaluate the mobility of the cervical spine, pain and function according to Neck Disability Index (NDI) scores among dental assistants and hygienists. Comparison between dental professionals and a control group was also performed.

Methods: In the study, 338 dental assistants and hygienists with a mean age of 35.8 were evaluated. Of these, 195 were measured with the CROM 3 device, and 143 with a classic tape measure, for the range of motion of their cervical spine. A non-dental professional group consisting of 60 women (whose work was not related to repetitive movements of cervical spine) was also tested, 30 with the CROM 3 device, and 30 with a classic tape measure. The dental and control groups were also surveyed with the NDI questionnaire and Visual Analogue Scale (VAS).

Results: Dental assistants and hygienists had significantly reduced functional ROM in all directions in comparison to the control group. Among the 338 volunteers form the study group the VAS pain score was higher than in the control group. NDI scores were also worse in the study group, compared to the control group. Functional results in all subgroups of the NDI questionnaire were better in the control group. Among dental workers the cervical spine typically demonstrated significantly greater mobility in right-rotation, resulting from the position occupied at the unit at which they work.

Conclusions: Our findings confirm a decrease in the mobility of the cervical spine, lower functional scores involving various everyday activities and greater intensity of pain among dental assistants and hygienists in comparison to participants whose work does not involve cervical spine overuse.

Purpose: The main aim of the study was to compare the effectiveness of the dietary patterns studied in the context of multiple sclerosis (MS), including anti-inflammatory, Mediterranean diet (MD), Mediterranean-DASH intervention for neurodegenerative delay (MIND), intermittent fasting (IF), gluten-free and ketogenic diets. In addition, another aim was to verify or otherwise the efficacy of other alternative dietary models, which include the Paleo diet, the Wahls diet, the McDougall diet and the Swank diet. Whether and to what extent the use of different dietary regimens can affect the course and reduction of individual MS symptoms was also examined. The advantages and disadvantages of selected diets and dietary patterns in the context of MS are discussed.

Views: Autoimmune diseases are estimated to affect more than 3% of the world's people, the majority of whom are of working age. Therefore, delaying the first manifestation of the disease, reducing the number of relapses and alleviating symptoms are particularly welcome developments. In addition to finding effective pharmacotherapy, high hopes for patients lie in nutritional prevention and diet therapy. For years the medical literature has discussed supporting the treatment of diseases caused by an impairment of the body's immune system with the help of nutrition.

Conclusions: An appropriate and balanced diet can be extremely helpful in improving the condition and well-being of patients with MS, and effectively support drug therapy.

Purpose: Firefighting is a profession associated with a high risk of elevated levels of occupational stress and burnout. The aim of this cross-sectional study was to explore the mediating effects of insomnia, depressive symptoms, loneliness and alcohol misuse in the relationship between two dimensions of burnout (i.e., exhaustion and disengagement) and work ability among firefighters.

Methods: A total of 460 firefighters from various regions of Poland completed a set of self-report questionnaires to assess constructs of interest. A mediation model was constructed to verify hypothesized paths, adjusted for socio-demographic and work-related background characteristics. Model parameters were estimated using a bootstrapping procedure, with sampling set at N = 1000.

Results: The proposed model explained 44% of variance in work ability. Higher levels of both exhaustion and disengagement predicted worsened work ability. When mediators were controlled for, these effects remained statistically significant. Depressive symptoms and feelings of loneliness were found to be partial mediators of the association between exhaustion and work ability, and between disengagement and work ability. The mediating effects of insomnia and alcohol misuse were non-significant.

Conclusions: Interventions aimed at counteracting the decrement in work ability among firefighters should target not only occupational burnout, but also depressive symptoms and a sense of loneliness as factors mediating its detrimental effects.

Purpose: The heritability of ischemic stroke is a complex mechanism, involving the contribution of genetic traits and environmental factors, which is why in everyday practice clinicians often rely on the broad term "family history of stroke", defined as the case of any first-degree relative who has had a stroke. The aim of this review is to update the available data regarding family history of stroke in primary and secondary stroke prevention by searching the electronic Scopus database for the phrase TITLE-ABS-KEY ("family history" AND "stroke").

Views: A total of 140 articles met the pre-specified criteria and were included in the review. The prevalence of family history of stroke ranged from 37% in stroke-free individuals to 52% in patients with ischemic stroke. In primary prevention, family history of stroke was associated with increased risk of stroke, transient ischemic attack, stroke risk factors and stroke-like symptoms. In patients with ischemic stroke, it was more often associated with small- and large-vessel disease, though not with a cardioembolic etiology. Family history of stroke did not influence long-term functional outcomes after rehabilitation. In young stroke victims, it was related to symptom severity and the risk of a second stroke.

Conclusions: Consideration of family history of stroke in everyday practice may carry useful information both for primary care physicians and stroke neurologists.

Purpose: In this review, we have highlighted a new class of drugs, Bruton's tyrosine kinase (BTK) inhibitors, and summarized the results of recent clinical trials in the treatment of multiple sclerosis.

Views: Multiple sclerosis (MS) is considered an autoimmune disease of the central nervous system, in which B-lymphocytes and myeloid cells, such as macrophages and microglia, play an important role in the pathogenesis. B-cells induce pathological processes by presenting autoantigens to T-lymphocytes, secreting pro-inflammatory cytokines, and forming ectopic lymphoid follicle-shaped clusters. Accordingly, the activation of microglia contributes to the development of chronic inflammation due to the production of chemokines, cytokines, reactive oxygen, and nitrogen species. BTK is an enzyme important in the activation and function of both B-lymphocytes and microglia. The demand for highly effective and well-tolerated drugs still remains at all stages of MS despite the availability of a number of effective drugs against the disease. Thus, in recent years BTK inhibitors have been the newest approach in the treatment of MS, since they affect the leading links of the pathogenesis of this disease and are able to pass through the blood-brain barrier.

Conclusions: The study of new mechanisms of the development of MS continues in combination with the elaboration of new treatment methods, i.e., Bruton's tyrosine kinase inhibitors. The review provided the analysis of core studies evaluating the safety and efficacy of these drugs. In the future, positive results of these studies will be able to greatly expand the therapy for various forms of MS.

Purpose: Access to electroneurographic/electromyographic (ENG/EMG) examinations and the number of patients referred for electrodiagnostic (EDX) examination are increasing. We aimed to determine the accuracy of the initial clinical diagnosis made by outpatient medical care physicians who referred patients to the EMG laboratory.

Methods: We analyzed referrals and EDX results of all patients who visited EMG laboratory of the Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology in Warsaw in 2021. Examinations were performed in accordance with the standards and norms adopted in our laboratory by EMG-certified neurologists, regarding the initial diagnosis stated by referring physicians.

Results: A total of 454 EDX results from 412 patients were analyzed. Most of patients (54.6%) were referred with diagnosis of carpal tunnel syndrome (CTS), followed by single nerves damage (18.7%), polyneuropathy (18.1%), tetany (7.0%), myasthenia gravis (1.3%) or myopathy (0.2%). The result of the ENG/EMG examination was: diagnosis confirmation (61.9%), a new clinically significant diagnosis or additional asymptomatic nerve damage (32.4%), and normal examination result (25.1%) of patients. Electrophysiological examination most often confirmed the referral diagnosis in patients with suspected CTS (75.4%), followed by single nerves damage (51.8%), polyneuropathy (48.8%), tetany (31.3%) and the least for myasthenia gravis and myopathy (0%).

Conclusions: Our study showed frequent inconsistency of the EDX results with the clinical diagnosis formed by the referring physician. A high percentage of normal test results was noted. Initial diagnosis and the scope of EDX examination should be determined by detailed interview and physical examination.

Purpose: A survey of epilepsy patients' experiences of and attitudes towards the pharmacy switching of anti-epileptic medications.

Methods: A structured questionnaire was administered to a group of epilepsy patients treated at the Institute of Psychiatry and Neurology and the Medical University of Silesia, Poland. Two hundred and eleven patients (mean [± SD] age: 41.0 ± 15.6 years) were recruited; 60.6% were women. 68.2% had been treated for over 10 years.

Results: Most individuals (63%) claimed that they had never bought a generic substitute medication. Among the patients who declared that a switch had been proposed to them at a pharmacy (~40%), only 68.7% received any explanation at all from a pharmacist. Some reported positive emotions mostly related to a lower price of the new drug but also to the explanations received. Most respondents who accepted the pharmacy switch (67.4%) did not notice any significant changes in the efficacy or tolerability of treatment, while the remaining subjects reported an increase in seizure frequency (23.2%) and deterioration in treatment tolerance (9%).

Conclusions: Around 40% of Polish epilepsy patients have been confronted with a proposal to switch their anti-epileptic medications at a pharmacy. More of them report negative attitudes towards the pharmacist's proposal than do not. It is possible that one of the major reasons for this is the insufficient information provided by pharmacists. It remains to be established whether the reported decrease in seizure control could be accounted for by a low concentration of the anti-epileptic drug in the blood after the switch.

Purpose: This article provides an overview of current treatment options for adults and adolescents suffering from eating disorders (ED).

Views: ED are prevalent public health problems that considerably impair physical health and disrupt psychosocial functioning. In primary care settings, anorexia nervosa, bulimia nervosa, and binge eating disorder represent the most frequently seen types of eating disorders, in both adults and adolescents. To address these maladaptive eating-related behaviors and concurrent psychiatric symptoms, various pharmacological interventions and specialized psychological treatments have been evaluated and received support to varying degrees by controlled research.

Conclusions: The current literature regarding children and adolescents with eating disorders mainly supports the use of psychological interventions, such as family-based treatment and cognitive behavioral therapy. Due to the lack of robust evidence, the use of psychotropic medications is neither recommended nor approved in this population. For adults with eating disorders, an array of behaviorally focused psychotherapies, along with integrative and interpersonal approaches, can lead to the improvement of symptoms and the achievement of a healthy weight. Moreover, aside from psychotherapy, several pharmacological agents can contribute to the alleviation of eating disorders' clinical characteristics in the adult population. At the moment, the recommended psychotropic medication for eating disorders is represented by fluoxetine for bulimia nervosa and lisdexamfetamine for binge eating disorder.

Purpose: In patients with epilepsy (PWE), cognitive and behavioural dysfunctions are associated with abnormalities in various brain areas. The aim of the study was to compare the volume of the hippocampus (VHIP), amygdala (VAMG) and parahippocampal gyrus (VPHG) with the results of neuropsychological assessment in patients with temporal lobe epilepsy (TLE) and genetic generalized epilepsy (GGE).

Methods: 33 PWE were enrolled in the study (mean age 37.3), 10 with TLE and 23 GGE (12 with GGE with tonic-clonic seizure [GGE-GTCS], and 11 with juvenile myoclonic epilepsy). 19 healthy persons (mean age 32.2) were enrolled as the control group (CG). Measurements of VHIP, VAMG and VPHG were made with 3D completely balanced steady state (CBASS) and 3D T1-weighted sequence. All participants underwent a neuropsychological assessment using a multi-domain cognitive battery and emotional state questionnaires.

Results: The left hippocampus was significantly smaller in patients with left TLE (LTLE) and with GGE-GTCS, compared to the CG (p = 0.0069). In LTLE a significant enlargement of the right amygdala in comparison to the CG and other types of epilepsy were found (p = 0.0015). Among patients with LTLE and GGE-GTCS, impairment of attention and executive functions was statistically more common than in the CG. VHIP right (r = 0.25 p < 0.01) and VHIP left (r = 0.26 p < 0.04) were positively correlated with phonetic verbal fluency.

Conclusions: PWE showed changes in the volume of selected medial temporal lobe (MTL) structures. Selective impairment of attention and executive functions was found. Some neuropsychological findings correlate with volume changes in MTL structures. Antiseizure medications therapy could have an impact on the severity of neuropsychological dysfunctions.

Purpose: Healthcare workers (HCWs) are more than others likely to be exposed to a viral overload regardless of the protective equipment and systems. Recent studies have reported that quarantine time is stressful for healthcare workers. We explored the impact of quarantine time as an external stressor on distress, sleep, healthy lifestyle behaviors, and familial relations among HCWs during the COVID-19 pandemic.

Methods: A surgery team (n = 12) were working on a patient with confirmed thyroid cancer. This team was quarantined for 14 days as per the criteria of the local health government after the patient tested positive for COVID-19. We included and interviewed this team through a purposive technique in this qualitative study in Iraqi Kurdistan in 2020. Using the Graneheim and Lundman method, we analyzed the data via thematic content analysis with a deductive approach.

Results: The participants experienced distress with mental health burdens during these difficult times. Some of them had to stay away from their families and friends for the first time. The first and last days were stressful for them due to fear of infection. The HCWs attempted to maintain their healthy lifestyles, including getting sufficient sleep, reducing stress levels, and creating a positive relationship with their families. The HCWs used the following coping strategies to alleviate the effects of COVID-19: beliefs, habits, and familial support. Familial and social support were their main strategies for maintaining a healthy lifestyle. The intensity level of familial and social relations was found to be a positive experience for HCWs during this stressful period.

Conclusions: This study showed that HCWs experienced psychological stress during the quarantine time of the COVID-19 outbreak. The HCWs' quality of sleep was affected adversely along with negative effects on their lifestyles. However, the level of support from familial and social relations increased during the COVID-19 outbreak. This was the major means for them to deal with stress during this difficult time of their lives.