Włodzimierz Samborski

The serum zinc, copper, iron, and chromium concentrations in epileptic children

To assess whether epileptic children have abnormal values of some trace elements, the aim of this preliminary study was to assess the serum zinc (Zn), copper (Cu), iron (Fe), and chromium (Cr) concentrations in 23 children with initial recognition of epilepsy before beginning of pharmacological therapy in comparison with a healthy control group of 25 children, according to the gender. The study demonstrated that epilepsy decreases levels of Zn and Cr concentrations in all patients, and Fe level in girls, and increases level of Cu in all patients. The frequency distribution of these metals was significantly different in epileptic patients than in healthy subjects. There is a conclusion that status of trace elements in epileptic children needs to be monitored.

Predictors of caregiving satisfaction in informal caregivers of people with dementia

OBJECTIVE The prevalence of dementia is increasing and consequently the demands from families, institutions and healthcare system. Although a substantial amount of research on caregiving has emphasized the negative aspects of caregiving, specifically on caregiver burden and depression, less attention has been paid to the positive aspects of caregiving. The aim of the present work was to study the phenomenon of caregiving satisfaction in informal caregivers of people with dementia by assessing their likely predictors. METHODS A stress process model was used to study caregivers satisfaction (measured using the Revised Caregiving Satisfaction Scale) on 101 informal caregivers of patients with dementia in relation to the caregivers background and context, stress-related factors, and mediators. RESULTS The regression model has an adjusted R(2) of 0.20, which indicates that having a consanguinity relationship with the care recipient, suffering from lower levels of subjective burden, and managing individuals with severe cognitive impairment are the most important predictors of higher caregiving satisfaction. CONCLUSION Interventions focused on the enhancement of the caregiving satisfaction by increasing the understanding of the disease, should be especially addressed to caregivers without a consanguinity relationship and with high levels of subjective burden, and to those managing care recipients with mild or moderate stages of dementia.

The effect of early isometric exercises on clinical and neurophysiological parameters in patients with sciatica: An interventional randomized single-blinded study

Objective: To determine the effects of early introduction of isometric exercises on pain intensity and trunk and lower extremity muscles strength in patients with sciatica. Methods: Fifty two patients treated for disc herniation with sciatica were included in this randomized controlled single-blinded study. They were examined twice, before and after twenty days of rehabilitation, with neuroimaging, visual analog scale (VAS), straight leg rising test (SLR), range of spine movement in a saggital plane, muscle strength, electromyography (EMG), electroneurography (ENG) and intensity of current vs stimulus duration tests (IC-SD). Twenty-six patients, selected randomly, were ordered to reduce the physical activity and frequent loading of the spine (conventional [C] group) while 26 patients underwent a program of supervised isometric exercises (intervention [I] group). A control group of healthy subjects performed once the same examination. Results: Following treatment the muscle strength and flexibility of the spine showed significant (P < 0.05) improvement in I group with a significantly lower pain level and number of positive SLR tests. The same tests performed in C group indicated no parallel improvement. EMG Parameters increased in almost all muscles, but only in the I group were they associated with simultaneous improvement in ENG examinations of peroneal nerves. Conclusion: Early introduction of isometric exercises, 14 days after the incidence, is a relevant choice in cases of patients with sciatica caused by the disc herniation.

Obesity, physical fitness, and inflammatory markers in Polish children

Background The relationship between obesity, physical fitness, and inflammation was analyzed in a Polish population aged 12 to 18 years. Material/Methods Body mass index measurements and Eurofit physical fitness tests were undertaken to assess the adiposity and physical fitness status, respectively, of subjects. Serum samples were collected to measure standard inflammatory markers, including interleukin 6; and the acute-phase proteins alpha1-acid glycoprotein and alpha1-antichymotrypsin. In addition, the glycosylation profiles of alpha1-acid glycoprotein and alpha1-antichymotrypsin were analyzed to further evaluate immune statuses. Results The physical fitness of individuals was negatively influenced by obesity. Obese subjects were characterized by an abnormal immune balance, including increased levels of alpha1-acid glycoprotein, as well as alpha1-antichymotrypsin, and altered glycosylation profiles indicative of an underlying inflammatory condition. Older age, male sex, and a large body mass index appeared to correlate with poor physical fitness scores and a disturbed immune status. Conclusions Impaired physical fitness is indicative for non-compensated overweight and affects mainly males aged 15 to 18 years. Female subjects seemed to cope better with increased body mass.

The Mediating Role of Dysfunctional Coping in the Relationship between Beliefs about the Disease and the Level of Depression in Patients with Rheumatoid Arthritis

Aim. Rheumatoid arthritis is one of the most severe chronic diseases. In many cases it leads to disability and results in a decreased quality of life and increased levels of anxiety and depression. The problem that needs to be addressed is the following: which mental processes lead to increased levels of depression in patients with rheumatoid arthritis? Methods. 210 patients with rheumatoid arthritis hospitalized in rheumatology wards took part in the research. They filled in illness perception questionnaires (IPQ-R) and questionnaires for testing strategies of handling stress (Mini-COPE) and the level of depression (CES-D). Results. The observed correlation coefficients indicate that several elements of the perception of ones disease moderately contribute to a high level of depression. Moreover, frequent use of dysfunctional coping strategies contributed to high levels of depression. Dysfunctional coping was moderately linked to depression. Conclusion. The conducted analyses confirmed the links between the beliefs about the disease and levels of depression and showed that the use of dysfunctional coping strategies mediates the relationship between the following elements of the representation of the disease: illness coherence, emotional representation, psychological attribution, risk factors, and the level of depression.

Delays in Motor Development in Children with Down Syndrome

Background Children with Down syndrome (DS) present with delays in motor development. The reduced size of the cerebrum, brain maturation disorders, and pathophysiological processes lead to motor development delay. The aim of this study was to examine the gross motor function and estimate what motor abilities are significantly delayed in children with Down syndrome even if they attend physical therapy sessions. Another purpose of the study was to assess the functional balance. Material/Methods The study group consisted of 79 children with DS (42 boys, 37 girls), average age 6 years and 3 months ±4 years and 6 months. Participants were divided into 3 groups according to (i) age: <3 years old, 3–6 years old, and >6 years old; and (ii) motor impairment scale: mild (SNR 1), moderate (SNR 2), and severe (SNR 3). Children were assessed using the Gross Motor Function Measure-88 (GMFM-88) and Pediatric Balance Scale (PBS). Results None of the assessed children developed all the functions included in GMFM-88. The standing position was achieved at the specified age by 10% of children in the first age group (<3 years old) and 95% of children aged 3–6 years. Similarly, the walking ability was performed by 10% of children under 3 years old and by 95% of children aged 3–6 years. The median score of PBS was 50 points (min. 34 p. – max. 56 p.). There was a statistically significant correlation between PBS scores and GMFM-88 scores, r=0.7; p<0.0001, and between balance scores and GMFM – 88 E (walking, running, jumping) (r=0.64; p<0.0001). Conclusions Motor development, especially standing position and walking ability, is delayed in children with Down syndrome. Balance and motor functions are correlated with each other, so both aspects of development should be consider together in physical therapy of children with Down syndrome.

Trigger point-related sympathetic nerve activity in chronic sciatic leg pain: a case study

Sciatica has classically been associated with irritation of the sciatic nerve by the vertebral disc and consequent inflammation. Some authors suggest that active trigger points in the gluteus minimus muscle can refer pain in similar way to sciatica. Trigger point diagnosis is based on Travel and Simons criteria, but referred pain and twitch response are significant confirmatory signs of the diagnostic criteria. Although vasoconstriction in the area of a latent trigger point has been demonstrated, the vasomotor reaction of active trigger points has not been examined. We report the case of a 22-year-old Caucasian European man who presented with a 3-year history of chronic sciatic-type leg pain. In the third year of symptoms, coexistent myofascial pain syndrome was diagnosed. Acupuncture needle stimulation of active trigger points under infrared thermovisual camera showed a sudden short-term vasodilatation (an autonomic phenomenon) in the area of referred pain. The vasodilatation spread from 0.2 to 171.9 cm2 and then gradually decreased. After needling, increases in average and maximum skin temperature were seen as follows: for the thigh, changes were +2.6°C (average) and +3.6°C (maximum); for the calf, changes were +0.9°C (average) and +1.4°C (maximum). It is not yet known whether the vasodilatation observed was evoked exclusively by dry needling of active trigger points. The complex condition of the patient suggests that other variables might have influenced the infrared thermovision camera results. We suggest that it is important to check if vasodilatation in the area of referred pain occurs in all patients with active trigger points.

The Effectiveness of the Conservative Versus Myofascial Pain Physiotherapy in Tennis Elbow Patients: Double-Blind Randomized Trial of 80 Patients

Objective The aim was to check usefulness of a conservative [C] or myofascial pain [MFP] approach in low-level laser therapy [LLLT] or ultrasound [US] therapy for patients with tennis elbow [TE], independent of the presence of trigger points [TrPs]. Methods Eighty patients [38 males, 42 females] with TE, in acute or subacute states, were randomly divided into four groups: LLLT-C, LLLT-MFP, US-C, or US-MFP. Doses of LLLT were 1 J/cm2 in the conservative group and 5 J/cm2 for each TrP related to TE in the MFP group. US: 0.5 W/cm2 3 MHz for conservative and 0.7 W/cm2 1 MHz on each TrP and each taut band. Evaluations of each patient at baseline and at the end of therapy [10 interventions] included: the presence and sensitivity of TrPs [algometer], level of pain [VAS], Disabilities of the Arm, Shoulder and Hand [DASH] questionnaire, and hand grip strength [dynamometer]. After one year of therapy, the patients were rechecked. Results Improvement of the VAS was 36.7 percent with LLLT-C, 36.9 percent with US-C, 48.4 percent with LLLT-MFP, and 55.4 percent with US-MFP [P < 0.005]. The Outcome of Disabilities of the Arm, Shoulder and Hand correlated with the VAS [r = 0.464]. Improvement of the grip strength was, respectively, 5.1 percent, 16.0 percent, 9.5 percent, and 109.0 percent for US-MFP [only US-MFP P < 0.01]. The only worsening of grip strength was after classic LLLT [−2.8 percent] among TrP-positive patients. TrPs were confirmed in 35 percent of patients. In that group, MFP methods were more effective than were conservative measures. After one year symptoms reappeared in 37.5 percent of patients. Conclusion We suggest that though both agents and both approaches for therapy of TE patients are equally effective, but the authors still favor US-MFP.

Supervised versus uncontrolled rehabilitation of patients after rotator cuff repair-clinical and neurophysiological comparative study.

Purpose The purpose of this study was the evaluation of the effectiveness of supervised rehabilitation in comparison to uncontrolled exercise therapy after surgical reconstruction of rotator cuff interrupted tendons. Methods Twenty two patients with comparable level of disability after the same type of surgery were randomly divided into two equal groups. The first group took part in a supervised therapy and the second one performed simple exercises without supervision. Clinical and neurophysiological examinations were performed prior to rehabilitation and after 20 and 40 days of treatment. The evaluation included the assessment of the pain level with visual analog scale, active range of motion with goniometer, activity of muscles motor units at rest and during maximal effort with electromyography and transmission of motor fibers in brachial plexus with electroneurography (M-wave stimulation studies). Results In the group of supervised patients the active range of movement changed significantly from 26.4° to 101.5° on average for flexion with adduction while flexion with abduction improved from 21° to 95.5°. Pain sensation changed from 6.4 to 3.2. The mean resting electromyogram amplitude decreased to the greatest degree from 80.9μV to 36.8μV in trapezius muscle while maximal effort electromyogram amplitude increased in this muscle from 381.8μV to 790.9μV. The mean values of amplitudes in electroneurographical suprascapular nerve examinations increased from 536.4μV to 1691μV. No significant differences at P=0.05 were found in these parameters recorded in the patients performing uncontrolled exercises. Conclusion The supervised exercise therapy is more effective than uncontrolled one after the rotator cuff surgical reconstruction.

Serotonin antibodies in relation to immune activation in major depression

Serum antibodies against serotonin and gangliosides, the serum concentration of serotonin in addition to indicators of immune activation, such as acute phase proteins (apps) and interleukin‐6 (IL‐6), were investigated in 20 major depressed patients and 32 normal controls. Antibody‐positive sera against serotonin and gangliosides were increased in patients with major depression in comparison to normal controls. Serum concentrations of serotonin were significantly lower in depressed patients. These changes were accompanied by acute phase response characterized by elevated concentration of apps and IL‐6. Compared with patients showing positive response to antidepressant treatment, patients with treatment‐resistant depression (TRD) had antibodies against serotonin and gangliosides that were twice as high, as well as a significantly higher IL‐6 concentration. The results suggest that alterations in the serotoninergic system may be related to immune activation in major depression and especially in treatment‐resistant depression.