New data on the occurrence of terrestrial true bugs (Hemiptera: Heteroptera) in Pieniny Mountains

The results on studies of the fauna of true bugs are presented. The research was conducted in the years 2005–2008 in the Pieniny Mountains. A list of 71 species, mainly belonging to the family Miridae, is presented. Among the identified specimens such rare species in Poland as Eurycolpus flaveolus, Stenodema sericans and Berytinus signoreti deserve a special interest. Features that distinguish very similar species, such as Lygus wagneri and L. punctatus, are given

Pre-stroke apathy symptoms are associated with an increased risk of delirium in stroke patients

Neuropsychiatric symptoms can be interrelated to delirium. We aimed to investigate an association between pre-stroke neuropsychiatric symptoms and the risk of delirium in stroke patients. We included 606 patients (median age: 73, 53% female) with stroke or transient ischemic attack admitted within 48 hours from symptoms onset. We assessed delirium on a daily basis during the first 7 days of hospitalization. To make diagnosis of delirium we used DSM-5 criteria. We used Neuropsychiatric Inventory to assess neuropsychiatric symptoms occurring within 4 weeks prior to stroke. We diagnosed delirium in 28.2% of patients. On univariate analysis, higher score of pre-stroke depression (OR: 1.58, 95% CI: 1.04–2.40, P = 0.03), apathy (OR: 2.23, 95% CI: 1.44–3.45, P < 0.01), delusions (OR: 2.00, 95% CI: 1.09–3.68, P = 0.03), hallucinations (OR: 2.39, 95% CI: 1.19–4.81, P = 0.01) and disinhibition (OR: 2.10, 95% CI: 1.04–4.25, P = 0.04) was associated with the increased risk of delirium. On multivariate analysis adjusted for age, atrial fibrillation, diabetes mellitus, stroke severity, right hemisphere lesion, pre-stroke cognitive decline, pre-stroke disability and infections, higher apathy score (OR: 2.03, 95% CI: 1.17–3.50, P = 0.01), but no other neuropsychiatric symptoms, remained independent predictor of delirium. We conclude that pre-stroke apathy symptoms are associated with increased risk of delirium in stroke patients

PRospective Observational POLIsh Study on post-stroke delirium (PROPOLIS) : methodology of hospital-based cohort study on delirium prevalence, predictors and diagnostic tools

BACKGROUND: Between 10 % to 48 % of patients develop delirium in acute phase of stroke. Delirium determinants and its association with other neuropsychiatric disturbances in stroke are poorly understood. The wildly accepted predictive model of post-stroke delirium is still lacking. METHODS/DESIGN: This is a prospective, observational, single-center study in patients with acute phase of stroke. We aim to include 750 patients ≥18 years with acute stroke or transient ischemic attack admitted to the stroke unit within 48 hours after stroke onset. The goals of the study are: 1) to determine frequency of delirium and subsyndromal delirium in Polish stroke patients within 7 days after admission to the hospital; 2) to determine factors associated with incidence, severity and duration of delirium and subsyndromal delirium and to create a predictive model for post-stroke delirium; 3) to determine the association between delirium and its cognitive, psychiatric, behavioral and functional short and long-term consequences; 4) to validate scales used for delirium diagnosis in stroke population. Patients will be screened for delirium on daily basis. The diagnosis of delirium will be based on DSM-V criteria. Abbreviated version of Confusion Assessment Method and Confusion Assessment Method for the Intensive Care Unit will be used for delirium and sub-delirium screening. Severity of delirium symptoms will be assessed by Delirium Rating Scale Revised 98 and Cognitive Test for Delirium. Patients who survive will undergo extensive neuropsychological, neuropsychiatric and functional assessment 3 and 12 months after the stroke. DISCUSSION: This study is designed to provide information on clinical manifestation, diagnostic methods and determinants of delirium spectrum disorders in acute stroke phase and their short and long-term consequences. Collected information allow us to create a predictive model for post-stroke delirium

The role of neoadjuvant chemotherapy in the management of advanced ovarian cancer in geriatric patients

It is increasingly common for ovarian cancer to affect older women, with over half of all cases involving patients aged 65 years and older. Unfortunately, elderly patients with ovarian malignancy tend to be treated less aggressively than younger patients, with less extensive surgery and less intensive chemotherapy regimens. This is due to a variety of factors, such as overall medical fitness and the function of specific organs. Moreover, multiple morbidities are typical for geriatric patients and affect their eligibility for certain forms of cancer therapy as well as their treatment outcomes, which are commonly less satisfactory than in younger patients. Additionally, for fear of complications, treating physicians sometimes limit the extent of the necessary surgery, or adjust chemotherapy doses, even though such a course of management tends to be largely misguided. One available management option is neoadjuvant chemotherapy followed by a surgical treatment known as interval debulking surgery. This type of combination therapy is associated with fewer postoperative complications, thus increasing the patient's chances of receiving a full course of adjuvant treatment. The decision to begin treatment with neoadjuvant chemotherapy tends to restrict later surgical therapy; however, under certain circumstances, this therapy can be a valid therapeutic option and, in fact, facilitate surgery. Prior to initiating therapy in elderly patients, their eligibility for combination therapy must be evaluated and the geriatric assessment of their performance and condition must be considered during the course of interdisciplinary preoperative management

Delirium post-stroke-influence on post-stroke dementia (research study-part of the PROPOLIS study)

Background: Previous research confirmed association between delirium and subsequent dementia in different clinical settings, but the impact of post-stroke delirium on cognitive functioning is still under-investigated. Therefore, we aimed to assess the risk of dementia among patients with stroke and in-hospital delirium. Methods: A total of 750 consecutive patients admitted to the stroke unit with acute stroke or transient ischemic attacks were screened for delirium, during the first seven days after admission. At the three- and twelve-month follow-up, patients underwent cognitive evaluation. The DSM-5 definition for dementia was used. Cases with pre-stroke dementia were excluded from the analysis. Results: Out of 691 included cases, 423 (61.22%) and 451 (65.27%) underwent cognitive evaluation, three and twelve months after stroke; 121 (28.61%) and 151 (33.48%) patients were diagnosed with dementia, respectively. Six (4.96%) patients with dementia, three months post-stroke did not meet the diagnostic criteria for dementia nine months later. After twelve months, 37 (24.50%) patients were diagnosed with dementia, first time after stroke. Delirium in hospital was an independent risk factor for dementia after three months (OR = 7.267, 95%CI 2.182&ndash;24.207, p = 0.001) but not twelve months after the stroke. Conclusions: Patients with stroke complicated by in-hospital delirium are at a higher risk for dementia at three but not twelve months post-stroke