Biomedical subjects

Krystyna Pierzchała

Publications and source records attributed to Krystyna Pierzchała.

At least 19 recordsLinked to original sources

PubMed2006

[Analysis of cerebrovascular risk factors in patients with stroke treated in the stroke unit].

Stroke is one of the major public health problems worldwide. Determining the cerebrovascular risk factors (RF) is very important in the efforts of primary and secondary stroke prevention. The aim of the study was to establish the frequency of RF in patients with ischaemic (IS) or haemorrhagic stroke (HS) hospitalized in the stroke unit in the Department of Neurology of the Silesian Medical University from August 2000 to June 2002. We analysed data of 229 patients (29 with HS and 200 with IS). Functional outcome was evaluated by use of modified Rankin scale, Barthel Index and Scandinavian Neurological Stroke Scale at discharge. Statistical analysis was performed with Student's t-test, coefficient of correlation and multivariate logistic regression. 94.8% (n = 217) of all the patients had one or more RF. The most common RF were: hypertension (78.2%), coronary heart disease (54.2%), obesity (29.2%), diabetes mellitus (24.8%) and dyslipidaemia (24%). No correlation between the number of RF and functional outcome at discharge was observed. Cigarette smoking (p < 0.01) and alcohol abuse (p < 0.005) were more frequent in young patients (< 55 years). Previous ischaemic stroke was more common in older patients (>55 years). In male patients cigarette smoking and alcohol abuse were found more frequently than in female (p < 0.001). The mortality in examined patients was 22.2% (20.4% in patients with IS and 45.8% with HS). Male gender (p < 0.05), history of previous cardiac infarction (p < 0.05) and previous ischaemic stroke (p < 0.01) were associated with increased mortality. The other variables studied did not show significant differences.

Aged↗

PubMed2004

[Frequency of sleep apnea syndrome in patients with acute stroke].

AIM: The association between sleep apnea syndrome (SAS) and cerebrovascular diseases although widely investigated in last years remains still unclear. The aim of our study was to determine the frequency of SAS in patients with stroke admitted to our stroke unit. MATERIAL AND METHODS: The examined group consisted of 27 patients with stroke confirmed by computed tomography (mean age: 66+/-10 years, mean BMI: 24.4+/-4.4). In all cases a sleep study was performed in the acute phase of stroke (1-10 days) using a portable respiratory recording device (Poly Mesam) which measures nasal and oral air flow, chest wall movements, heart rate, oxygen saturation and snoring. RESULTS: The frequency of SAS (apnea/hypopnea index--AHI > or = 10/h) among patients in acute phase of stroke in our unit was 59% (15 persons). Mean AHI in SAS patients was 25.8+/-4.94. We observed mostly obstructive (53.3% of all) and mixed apneas (40%). Central apneas constituted only 6.6% of all recorded respiratory disorders. We did not observe any relationship between SAS and stroke localization. CONCLUSION: The frequency of SAS is high in patients with stroke. Screening for respiratory disorders during sleep should be a routine practice because it could help in decreasing stroke mortality.

Aged↗

PubMed2004

[Doppler duplex ultrasound applications in cerebrovascular diseases].

Cerebrovascular diseases are still common cause of patient mortality and disability. New methods of treatment and prevention are still searched for. Ultrasound examinations of extra- and intracranial arteries allow stroke course monitoring, evaluation of treatment and prevention of new cases. This article is a review of ultrasound techniques and their clinical applications, referred to factors involved in stroke prevalence, clinical management of and possibilities of prevention.

Cerebrovascular Disorders↗

PubMed2003

[Increased cerebrovascular reactivity and risk factors for ischaemic stroke in patients with inadequate circulation in the posterior circle of Willis].

UNLABELLED: Since ischaemic stroke (IS) is very widespread, a rapid development of ultrasound diagnostic techniques searching the relationship between cerebral circulation efficiency and pathophysiology of ischemic lesions is observed. The aim of our study was to evaluate blood flow velocity (BFV) and cerebrovascular reactivity (CVR) of some anterior circulation arteries (MCA) and posterior circulation arteries (PCA, VA) in relation of IS risk factors in patients with posterior circulation insufficiency. MATERIAL AND METHODS: The study group consisted of 40 patients (13 female, 27 male) of mean age 56.9 +/- 12.9 yr. Neurological examination, brain CT and TCD were performed in each patient. All patients underwent TCD examination including evaluation BFV of both MCA's, PCA's and VA's using TC 2020 Pioneer (EME). Control group consisted of 22 healthy volunteers of mean age 59.6 +/- 6.3 yr. RESULTS AND CONCLUSIONS: BFV and CVR of MCA, PCA, VA in examined patients were similar compared to controls. CVR of MCA's were not significant different compared to CVR of PCA's and VA's. Impaired CVR may be connected with ischaemic heart disease and TIA, while coexisting arterial hypertension may cause increased CVR.

Aged↗

PubMed2003

[Late onset of epilepsy].

Epilepsy is one of the most common chronic neurological conditions. The prevalence of epilepsy is estimated at 0.5-5% of population. The etiology of seizures is in a great extent age-related. It is multifactorial in any given individual and is a result of a combination of acquired and genetic factors. The epidemiological studies indicate an increasing number of patients who suffer from active epilepsy with the first epileptic fit in the elderly. In that age range epilepsy, after stroke and dementia, is the third most frequent disease of nervous system. The most frequent causes of the late-onset epilepsy, especially in the elderly, seem to be: cerebrovascular disease, head trauma and alcoholism. On the basis of literature the authors present the epidemiology, clinical and electroencephalographical features and treatment of different kinds of epilepsy: vascular, posttraumatic and related to alcohol abuse.

Age of Onset↗

PubMed2002

[Multimodal evoked potentials for evaluation of diabetic encephalopathy].

UNLABELLED: The consequences of chronic diabetes mellitus in the brain are less known than peripheral nerves lesion. Despite of the progress in research the connections between these consequences and metabolic or vascular disorders which accompany diabetes are not univocally determined. The aim of the study is assessment of conduction in central afferent tracts and the velocity of blood flow in pre- and intracerebral arteries in patients chronically treated because of diabetes mellitus. We examined 63 diabetic patients at the age 48.9 +/- 12.9, treated with hypoglycaemic drugs for 13.5 +/- 8.2 years. The symptoms of cranial diabetic neuropathy (CDN) mainly in the form of eyeball motor disturbances were observed in 26 patients. The others had neither signs of central nervous system lesions nor other chronic disease. We estimated patient clinical condition of visual evoked potentials [VEP(s)], brainstem auditory evoked potentials [BAEP(s)] latency, somatosensory evoked potentials [SSEP(s)] and evaluated ultrasonically the mean blood flow velocity in pre- and intracerebral arteries. It was ascertained that the patients with CDN were older and their treatment duration was shorter. Moreover diabetes mellitus type 2 (76.9% p < 0.001) and insufficient metabolic control of the disease (80.8% p < 0.001) were significantly more frequently found in this group. The latencies of assessed multimodal evoked potentials [MEP(s)] in all patients were significantly longer than in the control group. In patients with CDN the lengthening of SSEP(s) latency occurred significantly more frequently than in the other patients. Diabetic retinopathy, arterial hypertension and the changes in blood flow velocity in pre- and intracerebral arteries were more frequently noted in the subgroup of patients with CDN. The difference in flow velocity in pre- and intracerebral arteries between both examined groups was significant. CONCLUSIONS: 1. High frequency of lengthened MEP(s) latency in patients suffering from diabetes indicates the presence of subclinical diabetic encephalopathy. 2. Cranial diabetic neuropathy not necessarily influence on central conduction time assessed by the EP method. 3. Diabetic encephalopathy seems to be dependent both on metabolic disorders and vascular changes.

Blood Flow Velocity↗

PubMed2002

[Blood flow in ophthalmic artery and visual evoked potentials in diabetic patients].

Diabetes despite the progress in therapy causes various complications including the visual impairment. The evaluation of Visual Evoked Potentials (VEP) gives the possibility to detect subclinical features of visual tract damage whereas Transcranial Doppler Sonography enables non-invasive vessel assessment including Ophthalmic Artery (OA). The assessment of VEP and Blood Flow Velocities (BFV) of carotid and ophthalmic artery in diabetics with various changes in retinal arteries was the purpose of this investigation. 26 diabetics, at the average age of 43.7 +/- 12.1 years and average diabetes treatment duration of 9.4 +/- 4.9 years, and 43 healthy controls were examined. In each patient ophthalmoscopy, doppler examination of carotid and ophthalmic arteries (CCA, ICA, ECA, OA) and evaluation of VEP was performed. BFV of ICA and ECA was significantly greater (p < 0.001) whereas BFV of OA was greater in diabetics in comparison to the controls. VEP latency was significantly prolonged (p < 0.01) in diabetic patients compared to control group. BFV of ICA and OA in retinopathy patients was significantly lower comparing to angiopathy patients (p < or = 0.02; p < or = 0.01 respectively) whereas VEP amplitude was similar in examined subgroups of diabetics. The correlation between BFV of OA and VEP latency was not observed in diabetics. The obtained results suggest that diabetes affects negatively blood flow velocities of important for visual organ vessels as well as visual tract conduction.

Adult↗

PubMed2002

[Dynamics of the changes of blood and plasma rheological properties in ischaemic stroke].

The aim of the study was to establish relation between hemorheological disturbances and the degree of pathological changes in patients with ischaemic cerebral stroke as well as to examine the dynamics of changes in blood and plasma viscosity during hospitalization and treatment. The patients were divided into two groups according to ischaemic changes extent recognized on the basis of tomogram and clinical examination: group I--ten patients at the age of 64 +/- 11.8 years with hemiparesis and with hypodense cerebral foci several mm in diameter; group II--eight patients at the age of 65 +/- 10 years with hemiplegia and more severe course of disease. The hypodense foci in the brain were several centimetres Blood viscosity measurements were carried out by Brookfild's viscometer using cone-plate system and plasma viscosity by Ubbelohd's capillary viscometer at the temperature of 37 degrees C. Apart from rheological examinations, blood morphological measurements, ESR and biochemical examinations, such as sugar blood concentration, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides and total serum proteins were performed. It was found that in patients in the group II both viscosity of whole blood and plasma as well as corrected viscosity were significantly higher. What is more, degree of rheological disturbances of blood and plasma was related to severity of the course of the disease. Observation of the dynamics of changes in rheological parameters showed that rheological parameters of blood and plasma during hospitalization and treatment improved along with recovery.

Aged↗

PubMed2002

[Selected methods for evaluating the autonomic nervous system].

Dysfunction of autonomic nervous system, accompanying different diseases of central and peripheral nervous system, is manifested by cardiovascular, gastrointestinal, genitourinary, thermoregulatory, respiratory and pupillary disorders. In the paper the methods of autonomic nervous system evaluation are reviewed, in particular the most popular cardiovascular and thermoregulatory tests.

Autonomic Nervous System Diseases↗

PubMed2002

[Neurophysiological investigations in patients with sleep apnoea syndrome].

UNLABELLED: The untreated sleep apnoea syndrome (SAS) is associated with cardiovascular complications (arterial hypertension, coronary heart disease, cardiac arrhythmia) and increased morbidity and mortality. Disorders of the autonomic nervous system function are probably responsible for cardiac arrhythmia. Most researchers evaluated autonomic function using cardiovascular tests. The aim of our study was to assess whether neurophysiological method--sympathetic skin response (SSR)--could be useful in testing function of the autonomic nervous system in patients with SAS. MATERIAL AND METHODS: The examined group consisted of 26 patients with SAS recognised by polysomnography (mean apnoea index: 42 +/- 31, mean age: 52 +/- 9 years). The control group consisted of 27 healthy volunteers (mean age: 50.5 +/- 3 years). SSR was recorded simultaneously from the right palm and right foot. Latencies and amplitudes of SSR were measured. Recordings were carried out using an electromyograph (Counterpoint). Statistical analysis was performed using student's t-test. RESULTS: We could not obtain SSR in 10 patients with SAS (38.5%). In the remaining patients the SSR amplitudes in the upper limb were significantly lower (250.6 +/- 131 uV) than in the control group (582.8 +/- 76.7 uV) (p < 0.001). The SSR amplitudes in the lower limb were also decreased (128.1 +/- 77 uV), but not significantly, in comparison to control group (156.9 +/- 28.3 uV). We did not observe changes in latencies between the groups. CONCLUSIONS: Results of our study provide evidence for autonomic disorders in patients with SAS. Sympathetic skin response (SSR) is a simple and fast neurophysiological method useful in testing function of the autonomic nervous system in patients with SAS.

Adult↗

PubMedDate not supplied

[Evaluation of blood flow velocity and cerebrovascular reactivity in patient with posterior circulation stroke].

UNLABELLED: The aim of our study was to determine the type of blood flow disturbances and cerebrovascular reactivity of major anterior and posterior circulation cerebral vessels in patients with posterior stroke (POCI). The examined group consisted of 17 patients, mean age 57 +/- 12 yr, with posterior circulation infarct. Neurological examination, brain CT and Doppler examination including evaluation of BFV and CVR of MCA, PCA and VA was performed in each patient. Doppler examination was done using Pioneer TC 2020 and capnograph Tidal Wave sp Novametrix. RESULTS: BFV of ICA's, MCA's, ACA's and PCA's were diminished while BFV of VA's were significantly diminished in the examined patients compared to healthy controls. CVR of MCA in posterior circulation stroke patients was significantly lower compared to controls. CVR of PCA and VA was significantly lower compared to CVR of MCA in patients with posterior circulation stroke. CONCLUSION: Impairment of CVR, especially in posterior circulation, plays an important role in posterior circulation stroke pathogenesis.

Adult↗

PubMedDate not supplied

[Dynamic assessment of blood flow in pre-cranial and intracranial arteries in patients with mild head injuries].

Mild head injury constitutes about 75% of all head injury cases. The post-concussion syndrome usually following a mild head injury is connected with numerous symptoms and not very severe signs. Research findings indicate that the symptoms related to mild head injuries persist for over 6 months in most patients. Accumulating evidence provided by neuropathological, physiological, psychological and neuroimaging studies pointing to an organic substrate of the postconcussion syndrome invalidates the "Hollywood head injury myth". No information is available on Doppler evaluation in patients with mild head injury. The aim of the study was to evaluate blood flow in selected precranial and intracranial vessels using Doppler ultrasonography in patients at various stages after mild head injuries. The dynamic assessment of blood flow velocity and pulsatility index was carried out in 51 patients on the day of the injury, on the third day, and the sixth day. Moreover, 22 patients were assessed at a follow-up six months to five years the injury. The control group consisted of 61 healthy volunteers. Obtained results show an increase in the blood flow velocity in the middle cerebral artery on the day of the injury and a decrease within the following days in younger patients (aged < 30 yrs). In older persons (aged > 30 yrs) and patients with injuries sustained in a distant past, the indices of blood flow velocity in precranial and intracranial arteries did not significantly differ from these in the control group of comparable age. In our opinion mild head injury affects the blood flow velocity in cerebral arteries. The haemodynamic disturbances noted in younger patients with mild head injuries seem to be connected with changes in the autonomous nervous system activity.

Adolescent↗

PubMedDate not supplied

[Cerebrovascular reactivity in patients with mild head injury].

Transcranial Doppler sonography (TCD) is a non-invasive method that can be repeated to measure blood flow velocity in intracranial arteries and to assess cerebrovascular reactivity in patients with a variety of neurological diseases. The aim of this study was Doppler sonography evaluation of blood flow and reactivity in the middle cerebral artery in patients at different stages after mild head injuries. The dynamic assessment of blood flow velocity and pulsatility index both at rest and after hyperventilation in 73 patients with mild head injuries was carried out on the day of injury, the third day, sixth day and after 6 months to 5 years. The control group consisted of 61 healthy volunteers. Obtained results indicate an increase in blood flow velocity in the middle cerebral artery on the day of injury and a decrease within the following days in younger patients (aged xleq 30 yrs). Also their cerebrovascular reactivity was significantly lower. In older persons (age > 30 yrs) and in patients with remotely suffered injuries, neither blood flow velocity in the middle cerebral arteries nor cerebrovascular reactivity differed significantly from the results of the respective age control groups. The findings justify a conclusion that mild head injury is followed by changes both in the blood flow and cerebrovascular reactivity. In younger patients with mild head injuries these haemodynamic disturbances seem to be connected with altered activity of the autonomic system.

Adolescent↗

PubMedDate not supplied

[Fractal analysis of MCA blood flow velocity fluctuations in migraine--preliminary report].

Many reports confirm the existence of long-range correlations between fluctuations of various physiological signals in healthy subjects and demonstrate disappearance of these correlations in pathological conditions. Blood flow velocity in intracranial vessels is changeable over time and depends on complex physiological regulatory mechanisms. The character of blood flow velocity fluctuations may indicate the presence of vascular disorders associated with various diseases. The aim of our study was to establish whether fluctuations in MCA blood flow velocity are fractal in physiological conditions and if so, whether this feature is lost in migraine, as the role of vasomotoric disturbances has been already evidenced in pathophysiology of this disease. The axial flow velocity changes averaged over a cardiac beat interval were monitored continuously via two channels through the temporal windows using a DWL Multi-DopT TCD device with 2-MHz probes. The examinations were performed in supine rest in two-hour periods in two groups: of 7 patients with clinically confirmed migraine with aura during headache-free intervals (15 recordings), and in the control group of 4 young, healthy volunteers (10 recordings). The results in the form of time series were analysed using the methods of fractal statistics. Multifractality in the recordings in physiological conditions was clearly confirmed, as well as its absence in the averaged recordings in the group of migraneurs. The findings justify a supposition that the breakdown of multifractal properties of MCA blood flow time series in migraine may result from the vasomotor disturbances present even during headache-free intervals. However, possible usefulness of this method in the diagnostics of migraine requires further investigation.

Adolescent↗

PubMedDate not supplied

[Fractal analysis of intracranial blood flow velocity fluctuations in continuous TCD recordings].

Many physiological signals fluctuate in an apparently irregular and complex manner. The fractal analysis of these changes often confirms the existence of long-range correlations in healthy subjects and demonstrate a lack of such correlations in pathological conditions. The authors discuss usefulness of the fractal statistics methods in the analysis of intracranial blood flow velocity changes averaged over a cardiac beat interval measured in humans, using transcranial Doppler ultrasonography (TCD). An assumption was made that fractal properties of blood velocity time series in healthy individuals result from a proper autoregulation of their cerebral blood flow and that in cases of vascular disturbances fractuality may disappear. A review of the literature is presented to provide a theoretical rationale for the proposed method.

Blood Flow Velocity↗

PubMedDate not supplied

[Guillain-Barré syndrome with central nervous system symptoms. Report of two cases].

Guillain-Barré syndrome - acute inflammatory demyelinating polyradiculoneuropathy - is characterized by symmetrical flaccid paresis of limbs and areflexia or hyporeflexia which progress over a few days, up to 4 weeks. The central nervous system lesion is rarely reported in the course or treatment of the disease. In the paper two cases of patients with diagnosed Guillain-Barré syndrome with the central nervous system manifestations were discussed. A case of a 55-year-old woman was presented, who during hospitalization, on the last day of intravenous immunoglobulin therapy developed a hallucinatory syndrome. Furthermore, a case of a 18-year-old female patient with classic features of Guillain-Barré syndrome was described, because of its atypical initial presentation (headache, drowsiness and meningismus).

Adult↗

PubMedDate not supplied

[Contemporary opinions on osteoporosis in neurological disorders].

Osteoporosis is a generalized skeletal disease characterized by low bone mass and leading to an increased fracture risk. It is classified by the World Health Organization as one of the main civilization diseases. Given the aging society, its significance is continuously increasing. There is also a number of neurological disorders predisposing to osteoporosis, such as poor mobility, exposure to corticosteroids, epilepsy and some rare congenital diseases. The present paper reviews literature concerning osteoporosis in the mentioned disorders and gives a diagnostic and therapeutic algorithm in chronic therapy with corticosteroids. Quoted studies show poor neurologists' vigilance regarding the possibility of osteoporosis in their patients and the need for improvement.

Algorithms↗

PubMedDate not supplied

[Current opinions on migraine pathophysiology].

Headache is one of the most common medical complaints of civilized humans; migraine, according to the IHS classification, is most often a primary episodic headache disorder. The pathophysiology of migraine is still unclear. The authors reviewed the literature and discussed mechanisms of pain, aura and other migraine symptoms. The last century has brought the shift from the vascular theory (that cranial vessels are the prime movers of the disorder) to a more integrated neurovascular theory, which takes the view that vascular change is secondary to neural activation. The most current concept of migraine pathophysiology describes migraine as a manifestation of the hereditary or predisposed sensitivity of neurovascular reaction to certain stimuli or to cyclic changes in the central nervous system. The initiation of migraine attack involves primary CNS dysfunction with subsequent activation of the trigeminovascular system. In this complex reaction a variety of biochemical factors take place. Detailed studies of this pathological pathway enable proper treatment methods to be applied.

Brain↗