Metalloproteinase-2 in failed back surgery syndrome caused by epidural fibrosis: can it play a role in persistent pain?

PurposeFailed Back Surgery Syndrome (FBSS) occurs in 10–40% of patients treated surgically due to disk herniation (DH). There are several factors that can cause a predisposition to FBSS, but the exact pathomechanism has not been elucidated. The aim of this study was to investigate Metalloproteinase-2 (MMP-2) and Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) activities in a homogeneous group of FBSS patients with epidural fibrosis in comparison to its activity in patients with surgically treated DH.MethodsDH, FBSS, and control (CG) groups consisted of 30 subjects. The patients were assessed clinically by the Numerical Rating Scale (NRS), McGill Pain Questionnaire (SF -MPQ), Oswestry Disability Index (ODI), and Beck Depression Inventory (BDI). Serum concentrations of MMP-2 and TIMP-2 were measured by using the immunoenzymatic method.ResultsThere was a significantly higher MMP-2 expression (medians: 4797.49 vs. 2656.65; p < 0.0001) and TIMP-2 concentration (medians: 166.40 vs. 109.60; p < 0.0001) in the DH compared to the CG. Significantly higher MMP-2 expression (4219.95 vs. 2656.65; p < 0.0001) and TIMP-2 concentration (medians: 150.17 vs. 109.60; p = 0.0003) were also found in the FBSS compared to the CG. The activity of MMP-2, measured as MMP-2/TIMP-2, did not significantly change between the DH, FBSS, and CG. MMP2 expression (p < 0.0001) and TIMP-2 concentration (p < 0.0001) were significantly higher in the DH than FBSS.ConclusionResults indicate the presence of a contribution of MMP-2 and TIMP-2 in DH and FBSS. Unchanged activity of MMP-2 can indicate an insufficiency in the MMP-2 repair system in both diseases. Lower MMP-2 expression and TIMP-2 concentration in the FBSS group can reflect the chronicity of the process

Research concepts use in the diagnosis and treatment of urinary incontinence

Olszak Cecylia, Nowicka Elżbieta, Baczewska Bożena, Łuczyk Robert Jan, Kropornicka Beata, Krzyżanowska Ewa, Daniluk Jadwiga. Research concepts use in the diagnosis and treatment of urinary incontinence. Journal of Education, Health and Sport. 2017;7(12):248-261. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1127709 http://ojs.ukw.edu.pl/index.php/johs/article/view/5158 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.12.2017. Revised: 15.12.2017. Accepted: 22.12.2017. Attitude of patients with type 2 diabetes towards the disease versus chosen sociodemographic and medical factors – psychometric properties of the DAS-3 scale in the Polish version Postawa wobec choroby osób chorych na cukrzycę typu 2 a wybrane czynniki socjodemograficzne i medyczne –właściwości psychometryczne skali DAS-3 w wersji polskiej Cecylia Olszak1, Elżbieta Nowicka1, Bożena Baczewska1, Robert Jan Łuczyk1, Beata Kropornicka1, Ewa Krzyżanowska1, Jadwiga Daniluk1 1Katedra Interny z Zakładem Pielęgniarstwa Internistycznego Wydział Nauk o Zdrowiu Uniwersytetu Medycznego w Lublinie 1Department of Internal Medicine and Department of Internal Medicine in Nursing, Faculty of Nursing and Health Sciences, Medical University of Lublin Abstrakt Wstęp: Celem badania była wstępna ocena właściwości psychometrycznych skali Badania Postawy wobec Cukrzycy (DAS-3P) w wersji polskiej w grupie osób chorych na cukrzycę typu 2 oraz określenie wpływu wybranych czynników socjodemograficznych i medycznych na postawę wobec choroby. Materiał and Metody: Badania przeprowadzono w grupie 227 osób chorych na cukrzycę typu 2, które były leczone w Poradni Diabetologicznej i w Klinice Endokrynologii w Samodzielnym Publicznym Szpitalu nr 4 w Lublinie. Oceniono trafność teoretyczną za pomocą konfirmacyjnej i eksploracyjnej analizy czynnikowej metodą osi głównych skali DAS-3. Rzetelność skali DAS-3 określono poprzez zbadanie wewnętrznej spójności testu i analizę wartości współczynnika alpha Cronbacha. Do oceny różnic między średnimi wykorzystano test t i jednoczynnikową analizę wariancji. Wyniki: Po weryfikacji współczynnik zgodności wewnętrznej alfa Cronbacha, dla całej skali DAS-3P osiągnął  = 0,79. Normalność rozkładu skali DAS-3P nie odbiega znacząco od rozkładu symetrycznego. Wykazano różnicę statystycznie istotną (p < 0,05) pomiędzy płcią, miejscem zamieszkania, poziomem wykształcenia, zapotrzebowaniem na wsparcie rzeczowe oraz udziałem w szkoleniach a wynikiem średniej skali DAS-3P. Natomiast wiek, obecność partnera życiowego, aktywność zawodowa, BMI, czas trwania choroby metoda leczenia, poziom stężenia HbA1C nie różnicowały statystycznie istotnie (p > 0,05) wyników skali DAS-3P. Wnioski: 1.Występuje konieczność kontynuowania prac nad właściwościami psychometrycznymi skali DAS-3 w wersji polskiej na dużej próbie osób chorych na cukrzycę typu 2; 2. Badaną grupę chorych na cukrzycę typu 2 ogólnie cechuje pozytywna postawa wobec choroby oceniana skalą DAS-3P; 3.Wyższe wartości na skali Badania Postawy wobec Cukrzycy (DAS-3P) osiągnęły osoby płci męskiej, mieszkające w mieście, legitymujące się wykształceniem wyższym, oczekujące wsparcia rzeczowego oraz biorące udział w szkoleniach na temat cukrzycy. Słowa kluczowe: cukrzyca typu 2, postawa, czynniki socjodemograficzne, czynniki kliniczne, właściwości psychometryczne Abstract Background: The objective of the study was to develop the initial assessment of psychometric properties in the Polish version of the Diabetes Attitude Scale (DAS-3P) for a group of people with type 2 diabetes and to determine the impact of the selected sociodemographic and medical factors on the patients’ attitude towards the disease. Materials and Methods: The study was conducted on a group of 227 people with type 2 diabetes who were treated at the Diabetes Outpatient Clinic and the Endocrinology Clinic of the Independent Public Clinical Hospital No 4 in Lublin. The theoretical accuracy was assessed by means of confirmatory and exploratory factor analysis and the method of scale DAS- 3 major axis. The accuracy of the DAS-3 scale was determined by examining the internal test congruity and analysing the value of Cronbach’s alpha coefficient. The differences between the mean values was determined by the t test and the single factor analysis of variance. Results: Following the revision, Cronbach’s alpha internal congruence coefficient reached a = 0.79 for the whole DAS-3P and the normality of the DAS-3P distribution does not deviate significantly from the symmetrical distribution. However, the study showed a statistically important difference (p < 0.05) between gender, place of residence, level of education, need for material support, participation in training and the mean DAS-3P score. The age, the presence of a domestic partner, job activity, BMI, duration of the disease, the treatment method, the concentration level of HbA1C were not of statistical importance (p > 0.05) for the DAS-3P scores. Conclusions: 1.There is a need to continue with the study into the psychometric properties of the DAS-3 scale in the Polish version on a large study population with type 2 diabetes, 2. The survey group of patients with type 2 diabetes shows a positive attitude towards their disease assessed by the DAS-3P, 3. Higher scores in the Diabetes Attitude Scale (DAS-3P) were obtained by males living in the city, with higher education background, in need of material support and participating in training on diabetes. Keywords: type 2 diabetes, attitude, sociodemographic factors, clinical factors, psychometric properties

Ocena zaburzeń językowych na poziomie świadomym i nieświadomym u pacjentów z afazją po usunięciu guza lewej półkuli mózgu. Wyniki wstępne

Background and purpose Classical definitions of aphasia describe deficits of different language levels (syntactic, semantic, phonologic) hindering the ability to communicate. Recent studies indicate, however, that impairment of particular aspects of linguistic competencies in aphasia differs in severity. Contemporary approach to the aphasic symptoms presents them as disturbed access of linguistic representations to the awareness system. Accordingly, such an approach requires different types of tasks: direct, involving explicit language processes, and indirect, based on implicit language representations. The aim of our study was to examine explicit and implicit language processes in patients with aphasia after resection of the tumour of left cerebral hemisphere along with characterization of relationships between explicit and implicit language processes. Material and methods Our cohort included 28 right-handed patients who were divided into four equal groups: two clinical (brain tumours) and two control (lumbar disc disease). Four tasks that assess and compare language processes: lexical decisions (at explicit and implicit levels), sorting of picture captions and word monitoring were implemented. Results In direct tasks, patients with aphasia provided less correct lexical decisions at word level, but did not show deficits in sentence comprehension. In both groups, no priming effect was observed in tasks requiring implicit lexical decisions. The longest time was found in non-primed words, the shortest in pseudowords. The differences between groups regarding word monitoring were also observed. Patients with aphasia obtained longer reaction times in all types of sentences (of different grade of language correctness), with respect to low- and high- frequency words. Conclusions Patients with aphasia after brain tumour resection show more pronounced impairments of explicit than implicit linguistic behavior; the same effect was found in studies on forgetting in amnestic syndrome.Wstęp i cel pracy W klasycznych opisach afazji występują deficyty różnych poziomów języka (syntaktyczny, semantyczny, fonologiczny), utrudniające komunikację chorych. Nowsze badania wskazują, że zaburzenia poszczególnych aspektów kompetencji językowych w afazji mają różną głębokość. Współcześnie objawy afatyczne traktowane są jako zakłócenia dostępu reprezentacji językowych do systemu świadomości, co wymaga zastosowania odmiennych typów zadań: bezpośrednich, angażujących uświadamiane (jawne, explicite) procesy językowe, i pośrednich – bazujących na nieuświadamianych (utajonych, implicite) reprezentacjach językowych. Celem pracy jest ocena uświadamianych i nieuświadamianych procesów językowych u pacjentów z afazją po usunięciu guza lewej półkuli mózgu oraz charakterystyka relacji między procesami językowymi typu explicite i implicite. Materiał i metody Badano 28 praworęcznych pacjentów, tworzących cztery równoliczne grupy: dwie kliniczne (nowotwory mózgu) i dwie kontrolne (dyskopatia lędźwiowa). Zastosowano cztery zadania oceniające i porównujące procesy językowe: decyzje leksykalne na poziomie jawnym i utajonym, sortowanie podpisów do obrazków oraz monitorowanie słów. Wyniki W zadaniach bezpośrednich pacjenci z afazją podawali mniej prawidłowych decyzji leksykalnych na poziomie wyrazu, lecz nie wykazywali deficytów w zakresie rozumienia zdań. W obydwu grupach, w zadaniu wymagającym decyzji leksykalnych na poziomie utajonym nie stwierdzono efektu torowania. Najdłuższy czas notowano przy słowach nietoro-wanych, najkrótszy przy pseudosłowach. Stwierdzono różnice między grupami w zadaniu monitorowania słów. Osoby z afazją uzyskały dłuższe czasy reakcji we wszystkich rodzajach zdań (o różnej poprawności językowej), dla słów niskoi wysokofrekwencyjnych. Wnioski Pacjenci z afazją po resekcji guza mózgu wykazują w większym stopniu zaburzenia procesów językowych o charakterze świadomym (kontrolowanym) niż nieświadomym (zautomatyzowanym). Taki sam efekt stwierdzono w badaniach nad zapominaniem w zespole amnestycznym

Life orientation and chosen sociomedical indicators of women suffering from type 2 diabetes

The aim of the study: In the process of dealing with diabetes every day the sense of coherence plays an important role. This construct in the salutogenesis theory determines the ability ofan individual to skilfully utilize the available resources for their own wellbeing. In many works the influence of demographic, social and clinical factors on the sense of coherence of people suffering from diabetes was analysed. However, little attention was paid to the detailed description of this issue among women suffering from diabetes. The aim of the study was to determine the relationship between the sense of coherence and the chosen sociomedical variables among women suffering from type 2 diabetes. Material and methods: In total 131 women suffering from type 2 diabetes treated at the Endocrinology Hospital and the Diabetes Outpatient Clinic were the subject of this research. The women who were selected for this research were 40 years old, had suffered from diabetes for over one year and gave permission to take part in the study.The study was conducted based on the original questionnaire comprising the data concerning: age, educational background, place of residence, marital status and professional activity. The questionnaire allowed gathering medical data like: duration of the disease, BMI index, HbA1c value or the method of diabetes treatment.Life Orientation Questionnaire (SOC-29) by A. Antonovski [4] in a Polish language version was used to determine the rating of the sense of coherence. Results. The level of the sense of coherence of the surveyed women suffering from diabetes was between 47 and 197 points. Statistically significant differences were not observed (p > 0.05) in the ratings of the sense of coherence versus the place of residence, education or marital status. There were no significant relationships (p > 0.05) between the sense of coherence, its components and the method of treatment, HbA1c value and the disease duration time. A statistically relevant difference (p < 0.05) between the sense of coherence, its components and the age of respondents was demonstrated. Moreover, a statistically relevant difference was proven (p < 0.05) between the sense of coherence and Body Mass Index. Furthermore, a statistically significant difference (p < 0.05) between the sense of coherence, its components and the professional activity of the research subjects was found. Conclusions: 1.The level of sense of coherence was lower than the standard average norms as applied by A. Antonovsky (133-160 points) among women suffering from type 2 diabetes. 2. Women who were professionally active and mature stood out with a high level of the sense of coherence and its components. 3. Women suffering from type 2 diabetes with normal body weight had high a level of the sense of coherence

Rozumienie humoru przez osoby starsze i jego poznawcze uwarunkowania

W ostatnich latach wzrasta zainteresowanie zdolnością rozumienia humoru przez osoby z różnych grup wiekowych. Wciąż niewiele jest danych dotyczących tego, w jaki sposób starzenie się wpływa na percepcję treści humorystycznych. Literatura wskazuje, że osoby starsze wykazują wzrastające trudności w rozumieniu żartów. Celem podjętych badań była analiza porównawcza poziomu rozumienia treści humorystycznych przez osoby w okresie wczesnej i późnej starości oraz ustalenie jego uwarunkowań. W badaniach uczestniczyło 109 osób z fizjologicznym starzeniem, podzielonych na dwie grupy wiekowe: grupa < 70 roku życia oraz grupa ≥ 71. Zastosowano wywiad, Krótką Skalę Oceny Stanu Umysłowego oraz Baterię Testów do Badania Funkcji Językowych i Komunikacyjnych Prawej Półkuli Mózgu. W Teście Humoru starsi seniorzy udzielili istotnie mniej poprawnych odpowiedzi niż młodsi. Kobiety wskazywały więcej prawidłowych odpowiedzi i mniej odpowiedzi absurdalnych niż mężczyźni. Istotnymi predyktorami umiejętności tworzenia humoru w starości są ogólny stan funkcji umysłowych i wyższe wykształcenie. Wyniki Testu Humoru korelowały z wynikami Krótkiej Skali Oceny Stanu Umysłowego, a także z rezultatami większości testów baterii. Zdolność rozumienia treści humorystycznych wydaje się uzależniona od wieku, płci, a także od poziomu funkcji językowych, myślenia pojęciowego, wrażliwości na elementy prozodyczne czy zdolności dyskursywnych. Wyniki potwierdzają pogarszanie się wraz z wiekiem procesów istotnie angażujących obszary prawej półkuli mózgu

Humor appreciation in elderly people and its cognitive determinants

Recent years have witnessed a growing interest in humor appreciation exhibited by people from various age groups. There are still few data on how aging affects the perception of humorous contents. The literature suggests that elderly people exhibit increasing difficulties in understanding jokes. The aim of the study was to analyze and compare the level of humorous content comprehension in people in early and late old age and to identify its determinants. The participants were 109 individuals with physiological aging, divided into two age groups: group < 70 y.o. and group ≥ 71 y.o. We used interview, Mini-Mental State Examination, and the Right Hemisphere Language Battery. In the Verbal Humor Appreciation test, older seniors gave significantly fewer correct answers than younger seniors. Women indicated more correct answers and fewer absurd ones than men. The ability to produce humor in old age is significantly predicted by the general state of mental functions and higher education. The scores on Verbal Humor Appreciation correlated with scores in Mini-Mental State Examination and with scores in the remaining tests on the RHLB battery. The ability to appreciate humorous contents appears to be dependent on age, gender, and the level of linguistic functions, conceptual thinking, sensitivity to prosodic elements, and discursive abilities. The results confirm the deterioration of processes significantly involving the right hemisphere with age

TRENDS AND CHALLENGES IN TECHNOLOGY DEVELOPMENT FOR DEFENSE PURPOSES

The article presents an analysis of the selected, considered key, technologies development affecting the military area. The authors of the analysis started from the assumption that nowadays, it is the commercial technology that should determine the development of technology used for military purposes. This is due to the fact that the biggest driver of technology development is the market game - that is, competition. The greatest market potential lies in the diversity and scale that characterizes the civilian market. Only from the set of solutions used commercially can policy-makers and military decision-makers choose the right ones for military applications. The analysis presented here drew heavily on examples of this phenomenon which can be seen in the ongoing war in Ukraine. The set of emerging tendencies is defined in 4 trends - dispersion, sharing, convergence and miniaturization. They provide timeless guidelines for the way of thinking in the light of exponentially occurring changes in the field of technology. Such a change in commanders' thinking should be the challenge of the RMA (Revolution of Military Affairs) implementation process. This means new challenges for commander education where knowledge of tactics becomes as important as understanding the capabilities of network technologies

Phantom limb phenomenon as an example of body image distortion

Introduction: The perception of one’s own body, its mental representation, and emotional attitude to it are the components of so-called “body image” [1]. The aim of the research was to analyse phantom pain and non-painful phantom sensations as results of limb loss and to explain them in terms of body image distortion

Significance of the Diagnosis of Executive Functions in Patients with Relapsing-Remitting Multiple Sclerosis

Multiple sclerosis (MS) is a progressive chronic disease of the Central Nervous System (CNS). Cognitive decline occurs rather rarely in relapsing–remitting multiple sclerosis (RRMS) compared to other types. The present study aimed to assess executive functions (EF) in relation to clinical and demographic variables in patients with RRMS. The study involved 22 individuals with RRMS (aged 23 to 49 years) and 22 matching controls. All the individuals with RRMS were in the remission phase. The assessments were carried out using MoCA, BDI-II, Halstead Category Test, Porteus Maze Test, verbal fluency tasks and Stroop Colour-Word Interference Test. The findings show that the two groups differed significantly in all the tests. All patients with RRMS in the remission phase presented at least one cognitive deficit, observed in general cognitive functioning, abstract reasoning or other executive functions, i.e., fluency, interference suppression, planning, or ability to modify activity in response to feedback. The deficits in most cases (except for those measured with the MoCA, Category Tests and phonemic fluency), are not related to intensity of depression and duration of the disease. Findings suggest that the diagnostic process in the case of patients with RRMS may include psychological assessment focusing on potentially existing cognitive, mainly executive, deficits and their severity