Biomedical subjects

Ryszard Podemski

Publications and source records attributed to Ryszard Podemski.

12 recordsLinked to original sources

PubMed2006

[Lance-Adams syndrome in patient with anoxic encephalopathy in the course of bronchial asthma].

Lance-Adams syndrome, described in 1963, is caused by anoxia of central nervous system, generally in the course of primary respiratory failure. It is characterized mainly by action myoclonus, associated cerebellar ataxia and very mild intellectual deficit. Occurrence of Lance-Adams syndrome is rare; about 100 cases have been described yet. The authors present the case of Lance-Adams syndrome in 36-year-old woman with many years' bronchial asthma. Three times acute cardiopulmonary arrest appeared during status asthmaticus. After successful cardiopulmonary resuscitation action myoclonus developed with cerebellar syndrome, aphonia, dysphagia and generalized convulsive seizures of tonic-clonic type. Electroencephalography showed polyspikes and complex of polyspikes-slow wave, synchronized with myoclonus. CT of the brain was normal. Action myoclonus responded appropriately to sodium valproate. The authors indicate the importance of the correct diagnosis and proper treatment.

Adult↗

PubMed2003

Modality-specific changes in P300 parameters in patients with dementia of the Alzheimer type.

BACKGROUND: The relationship between the parameters of the P300 potential and the degree or profile of cognitive decline remains controversial. The aim of our study was to evaluate parameters of auditory and visual P300 in patients with mild and moderate dementia of the Alzheimer type (DAT) and to correlate these with neuropsychological test results. MATERIAL/METHODS: The study group comprised 13 patients with DAT and 13 healthy, age-matched controls. Auditory and visual event-related potentials were evoked using a basic oddball paradigm. P300 latency and amplitude were compared in patients with DAT and controls and between subgroups of patients with mild and moderate DAT. Correlations between P300 parameters and the results of the Mini-Mental State Examination (MMSE), the Global Deterioration Score (GDS), and the Alzheimer's Disease Assessment Scale (ADAS-cog) were also analyzed. RESULTS: The mean latency of auditory P300 was significantly prolonged, and the mean amplitude of visual P300 was significantly lower in the DAT patients. 4 patients with DAT (31%) had a prolonged latency of auditory P300. No significant differences in P300 parameters were found between mildly demented and controls or between mildly and moderately demented. A positive correlation was found between MMSE score and auditory P300 latency in Fz and visual P300 amplitude in Cz. CONCLUSIONS: P300 parameters undergo significant, modality-specific changes in patients with DAT. However, they are not sensitive enough to differentiate early dementia from normal aging.

Aged↗

PubMed2003

[Fas receptor expression on peripheral blood T lymphocytes in patients with secondary progressive multiple sclerosis].

The percentages of CD4, CD8 subsets and Fas co-expression on them were assessed in secondary progressive multiple sclerosis (MS) patients and in control group. The MS patients were subdivided into two groups. The first group--active, consisted of patients who progressed by one or more degrees on EDSS scale in the preceding year, while the second group--stable, consisted of patients who showed no progression of the disease in the same period of time. Quantitative assessment of the individual subsets and Fas co-expression was carried out with the use of monoclonal anti-CD4, anti-CD8, as well as anti-CD95 antibodies, and Pas/Dako, Galaxy flow cytometer. There were no significant differences in CD4, CD8 subsets among the active, stable MS patients, and the control group. In the active MS group Fas co-expression on both subsets was significantly higher, as compared to controls. In the stable MS group, as compared to controls, a significantly higher Fas co-expression on CD8 subsets was observed. The investigation of Fas receptor expression on T lymphocytes in peripheral blood may be useful in order to monitor the progression of clinical activity in secondary progressive MS.

Antibodies, Monoclonal↗

PubMed2003

[Speech disorders in extrapyramidal diseases].

In patients with extrapyramidal diseases speech disturbances (dysarthria) are frequent. Dysarthria could have hypokinetic-hypertonic or hyperkinetic-hypotonic pattern. The frequency of them hesitates from 70 to 100% in patients with extrapyramidal symptoms. Clinimetric analysis of type and severity of dysarthria could be done by means of different scales useful in extrapyramidal diseases; Webster--Score Disability Rating Scale, Columbia Rating Scale or North Western University Disability Scale. The results obtained in these scales are subjective. Computer speech analysis could be useful in identification of speech disturbances. The waveforms and spectograms are used in assessment of speech intensity and frequency. The authors indicated to the usefulness of computer acoustic analysis in evaluations of speech disturbances in patients with extrapyramidal diseases as a repeatable and precise method.

Aged↗

PubMed2003

[Cortico-basal degeneration: the rare form of tau protein disease].

Cortico-basal degeneration is a rare degenerative disease connected with Tau protein pathology. Epidemiology of cortico-basal degeneration is unknown. The authors present a case of 59 years old woman with suspicion of cortico-basal degeneration. The extrapyramidal symptoms mainly on the right side with "alien limb phenomenon" and dystonia of lower limb is observed in our patient. Cortico-subcortical brain atrophy was present in MRI scans. EEG was asymmetrical. No improvement was noticed after L-Dopa. Treatment of amantidine caused the transient improvement.

Antiparkinson Agents↗

PubMed2002

An open-label study to evaluate the safety, tolerability and efficacy of rivastigmine in patients with mild to moderate probable Alzheimer's disease in the community setting.

BACKGROUND: Long-term safety and efficacy of Exelon (rivastigmine) was evaluated in a multi-center open-label study of 62 patients with probable mild to moderate Alzheimer's disease living in community setting. MATERIAL/METHODS: The patients started treatment with 1.5 mg bid (3 mg/day) Exelon and were scheduled to receive doses of 1.5 mg bid Exelon escalating on a biweekly basis. The patients were maintained on the highest tolerated dose within the assigned dose range 1.5-6.0 mg bid (3-12 mg/day) for the rest of the study. Evaluations were scheduled at biweekly intervals for the first 8 weeks and subsequently at study weeks 12, 18 and 26. Effects of Exelon on cognition were evaluated using the mini-mental state examination (MMSE) and selected items of Alzheimer's disease assessment scale (ADAS-cog) and the staging of the disease was measured using the global deterioration scale (GDS). Safety was monitored by physical examinations, vital signs, laboratory tests, ECG recording and by the assessment of adverse events. RESULTS: 55 patients completed the study (89%). Patients treated for 26 weeks showed the mean MMSE, ADAS-cog and GDS scores close to baseline values (p=NS) with no improvement and no deterioration. Exelon was generally well tolerated with 11% of patients withdrawing due to adverse events. The most frequently reported adverse events related to the gastrointestinal tract. CONCLUSIONS: In conclusion, the study data indicate that treatment with Exelon is safe, generally well tolerated and inhibits the progression of cognitive decline in patients with mild to moderate Alzheimer's disease over 26 weeks of treatment.

Aged↗

PubMed2002

Serum levels of sTNFR-1 and sFas in patients with relapsing-remitting multiple sclerosis.

BACKGROUND: During the relapse of multiple sclerosis (MS), activated T cells, T cells autoreactive against myelin antigens as well as antigen-nonspecific lymphocytes and monocytes produce a number of proinflammatory cytokines such as TNF (Tumor Necrosis Factor). For a proinflammatory effect to take place TNF must bind together with appropriate receptors. The aim of the study was to assess value of serum sTNFR-1 and sFas levels with reference to clinical activation of disease. MATERIAL/METHODS: Thirty-three patients with clinically documented diagnosis of relapsing-remitting MS and 22 healthy subjects were included in the study. In 15 patients the measurements of sTNFR-l and sFas levels were performed at the beginning of MS relapse and in 18 subjects--they were taken in MS remission. 'I'he levels of both soluble molecules were determined with the use of enzyme-linked immunosorbent assay (ELISA). RESULTS: Mean serum sTNFR-1 levels in patients with MS relapse did not differ significantly from mean sTNFR-1 level in patients with MS remission and a control group. Mean serum sFas level in patients with MS relapse was significantly higher comparing with the results obtained in patients with MS remission and in control group. CONCLUSIONS: The absence of changes in serum sTNFR-1 levels relative to clinical activation of the disease makes this measurement ineffective in the assessment of MS status. On the other hand, the measurement of serum sFas levels may be a valuable parameter for the monitoring of both MS clinical course and immune response to treatment when the symptoms of neurological deficit aggravate.

Adolescent↗

PubMed2002

[Pathophysiology and treatment of hiccup].

Hiccup is defined as involuntary, paroxysmal inspiratory movements of the thoracic wall, together with contraction of the diaphragm and additional respiratory muscles. The clinical problem is connected mainly with pathological chronic hiccup. The authors discuss pathophysiology of hiccup and diagnostic possibilities, as well as various therapeutical options.

Hiccup↗

PubMedDate not supplied

[Open trial of the effectiveness of interferon beta 1a (Avonex) in multiple sclerosis. Clinical assessment using motor coordination tests].

OBJECTIVE: The aim of the study was to evaluate clinical efficacy and safety of interferon beta 1A (Avonex) in the Polish population of remitting-relapsing multiple sclerosis (RR MS) patients. MATERIAL AND METHODS: The study was organized as an open, multi-center trial with 126 RR MS patients. Intramuscular Avonex was administered once a week in the dose of 30 mcg. The treatment duration was 24 months. The annual relapse rate (ARR), proportion of relapse-free patients, the average change in EDSS scores between the baseline and the study completion, and the proportion of patients who deteriorated on the EDSS scale during the treatment were used as evaluation parameters. Additionally, to obtain quantitative data, the 9HPT and 25 FW test results were taken into account. RESULTS: A significant decrease in the ARR was noted in the course of treatment (from 1.47 in the 2-year period preceding the study to 0.38). The mean EDSS score for the whole group was higher by 0.13 on the study completion. However, patients without motor deficits (EDSS < 2.0) at baseline improved by 0.25 on the EDSS during the treatment, while those with motor deficits (EDSS 2.0 to 4.0)--deteriorated by 0.65. In the period under study 45.8% of the patients remained stable, 26.7% improved and 27.5% deteriorated on the EDSS. The mean duration of the 9HPT test performance increased by 0.67 sec for the dominant, and by 0.97 sec for the non-dominant hand from the baseline to post-treatment evaluation. But again, in patients without any motor deficits the mean time of 9HPT test performance was shorter post-treatment than at baseline for the dominant and non-dominant hand, while in those with motor deficits it was longer for both hands on the study completion. The mean performance time on the 25 FW test was longer by 0.74 sec on the study completion for the whole group, but in patients without motor deficits the increase in the 25 FW performance time was significantly smaller than in those with baseline EDSS scores ranging from 2.0 to 4.0. Avonex did not cause any significant abnormalities in laboratory parameters monitored during the treatment, and no significant side effects were observed except for flu-like symptoms following an Avonex injection. CONCLUSION: Results of this study confirmed a beneficial effect of 1FNb 1A (Avonex) in the dose of 30 mcg per week on the clinical status of MS patients. The findings indicate a better treatment outcome in patients with less pronounced neurological deficits at baseline.

Adjuvants, Immunologic↗

PubMedDate not supplied

[Open trial of the effectiveness of interferon beta 1a (Avonex) in the treatment of multiple sclerosis in Poland: MRI results].

OBJECTIVE: To assess the effect of interferon-beta 1A (IFNb 1A, Avonex) treatment on magnetic resonance (MR) image in patients with remitting-relapsing multiple sclerosis (RR MS) who participated in the Polish Avonex trial. PATIENTS AND METHODS: RR MS patients (N = 126) participated in a two-year randomized open trial of Avonex treatment administered in the dose of 30 mcg once a week. MRI was performed twice in each case: shortly before the patient's enrollment in the study and within a month from the study completion. Changes in T2-weighted lesion volume and T1-weighted gadolinium-enhanced lesion volume, as well as the number of new T2-weighted and T1-weighted gadolinium-enhanced lesions were measured. RESULTS: Over the two-year treatment period the mean volume of T2-weighted lesions decreased by 3.9% (p = 0.83) while that of T1-weighted gadolinium-enhanced lesions decreased by 79% (p = 0.084%) as compared to the baseline MRI evaluation. The mean number of enhanced lesions after two years of Avonex therapy was reduced by 46.1% (p = 0.0035). The total number of enhanced lesions decreased by 49.8% (p = 0.0078). Both the number of new T2-weighted lesions, 3.7 per patient, and that of new T1-weighted gadolinium-enhanced lesions, 0.7 per patient, were comparable with the results obtained in other Avonex trials. CONCLUSION: The results confirmed that interferon beta-1a (Avonex) has a significant effect in MS patients, slowing down the progress of their disease. This effect is particularly visible in T1-weighted contrast-enhanced images, indicating an impact of the treatment particularly on the inflammatory stage of the demyelination process.

Adjuvants, Immunologic↗

PubMedDate not supplied

[Influence of nocturnal hypoxemia on the function of the visual tract in the course of the obstructive sleep apnea syndrome].

BACKGROUND AND PURPOSE: In patients with obstructive sleep apnea (OSA) syndrome the episodes of upper airway obstruction lead to hypoxemia during sleep. The aim of the study was to establish the influence of sleep hypoxemia on the function of the visual tract in OSA patients. MATERIAL AND METHODS: The latency and amplitude of wave P100 of visual evoked potentials have been studied in 35 patients with OSA syndrome (mean apnea index 48+/-19). The diagnosis of OSA was established on the basis of continuous recordings of the respiratory function during sleep with additional full polysomnography in 17 patients. RESULTS: Mean absolute latency of P100 was longer in OSA patients than in healthy controls (117.0+/-8.8 ms vs. 104.3+/-4.6 ms, p<0.001). The differences in the amplitude of P100 were not significant (5.9+/-2.6 mV in OSA patients and 7.62+/-3.04 mV in healthy persons). In 60% of patients the latency of P100 exceeded 118 ms; in this group of patients the mean SaO2 during sleep apneas was lower than in patients with normal P100 latency (46+/-15% vs. 69+/-10%, p<0.05). Full polysomnographic studies revealed that in patients with prolonged latencies as compared with patients with normal P100 latencies there were lower: minimal SaO2 during NREM sleep (63+/-12% vs. 78+/-8%, p<0.05), as well as mean and minimal SaO2 during REM sleep (53+/-15% vs. 80+/-5% and 46+/-15% vs. 69+/-10%, p<0.05), without differences in apnea index or apnea duration. CONCLUSIONS: In patients with OSA syndrome the electrophysiological abnormalities suggesting damage of the optical tract may develop probably as a consequence of profound sleep hypoxemia.

Adult↗

PubMedDate not supplied

[Electrophysiological estimation of the peripheral nerves conduction parameters and the autonomic nervous system function in the course of amyotrophic lateral sclerosis].

BACKGROUND AND PURPOSE: The aim of the study was to electrophysiologically examine the peripheral nervous system, mainly its autonomic part in the course of amyotrophic lateral sclerosis (ALS). MATERIAL AND METHODS: 19 patients with clinically definite or probable ALS were examined twice (group A and B). 20 healthy subjects were included in the study (group C). Motor conduction study (ulnar, peroneal nerve) with F wave examination, sensory conduction study (ulnar, sural nerve), EMG from 4 muscles, sympathetic skin response (SSR) and heart rate variability test at rest were performed. RESULTS: In the motor conduction study we revealed a significant lowering of the muscle action potential amplitude in the patient group compared with controls and its lowering in the course of ALS. F wave latencies were significantly longer in patients when compared with controls with no progression in the course of ALS. Sensory conduction parameters and heart rate variability parameters at rest did not differ significantly in groups A, B and C. SSR amplitudes were significantly lower and SSR latencies were significantly longer in the patient group in comparison with the control group. There was a significant progression of these parameters during the ALS course. CONCLUSIONS: Loss of motor fibres creating ventral roots and sudomotor fibres lesion are the integral parts of the ALS clinical picture. They tend to worsen during the ALS course.

Adult↗