Ischemic strokes in children – review of the related literature

Udary niedokrwienne mózgu są rzadko występującym zespołem chorobowym u dzieci. Konstelacja objawów klinicznych zależy od lokalizacji i rozległości uszkodzenia ośrodkowego układu nerwowego, a także od wieku pacjenta. Nowoczesne i obecnie rozpowszechnione metody neuroobrazowania wpływają na zwiększenie wykrywalności udarów niedokrwiennych. Wczesne rozpoznanie ma istotne znaczenie, ponieważ umożliwia szybkie wprowadzenie terapii. Potwierdzenie niedokrwiennego udaru mózgu w badaniu obrazowym to dopiero początek procesu diagnostycznego, który ma na celu identyfikację czynników etiologicznych. Postępowanie terapeutyczne powinno być również ukierunkowane etiotropowo. Opracowane do tej pory standardy leczenia farmakologicznego w ostrej fazie udaru niedokrwiennego mózgu oraz profilaktyki wtórnej u dzieci nie są jednoznaczne. Należy dążyć do zmniejszenia stopnia niepełnosprawności poprzez odpowiednio zaprogramowaną rehabilitację. Artykuł ma charakter poglądowy. Zawiera najnowsze informacje na temat patogenezy, postępowania diagnostycznego i terapeutycznego oraz powikłań w udarach niedokrwiennych mózgu u dzieci.Ischemic strokes are syndromes which appear seldom in children. The constellation of clinical symptoms depends on the location and the extent of damage of the central nervous system and also on a patient’s age. Modern and widely spread neuroimaging methods have an influence on the increase in recognizing ischemic strokes. An early recognition is of great importance because it enables the quick administration of treatment. The confirmation of an ischemic cerebral stroke in medical imaging is the beginning of a diagnostic process which aims at the identification of etiological factors. A therapeutic procedure is also supposed to be directed in an etiotropic way. The standards of pharmacological treatment, compiled so far, in an acute phase of a stroke and secondary prevention in children are not unambiguous. One ought to aim at decreasing the degree of disability by means of appropriately planned rehabilitation. The article is of a review character. It contains the latest information related to pathogenesis, a diagnostic and therapeutic procedure and also complications in ischemic cerebral strokes in children

Heterogeneity of etiological factors in pathogenesis of cerebral strokes in children

Zachorowania na udar mózgu w populacji dziecięcej są uznawane za zjawisko rzadkie, chociaż zwraca się uwagę na zwiększającą liczbę przypadków. Problemy zbyt dużego upływu czasu od wystąpienia objawów klinicznych do rozpoznania udaru mózgu u dzieci, opracowania skutecznej profilaktyki oraz standardów leczenia, obniżenia śmiertelności i minimalizowania trwałych uszkodzeń są nadal otwarte. Zrozumienie złożoności i różnorodności czynników etiologicznych udarów mózgu może ułatwić rozwiązywanie tych problemów. Artykuł zawiera próbę usystematyzowania dostępnych w piśmiennictwie danych na temat różnorodności czynników etiologicznych w patogenezie udarów mózgu u dzieci. Omówiono: arteriopatie niezapalne i zapalne; tętniaki wewnątrzczaszkowe i malformacje wewnątrznaczyniowe; choroby serca; stany krytyczne; zaburzenia hemostazy i zatorowość; nieprawidłowości w składzie morfotycznym krwi; zatory: tłuszczowe, powietrzne, komórkami nowotworowymi, azotem, ciałami obcymi; choroby metaboliczne, endokrynologiczne, w tym genetycznie uwarunkowane; inne czynniki ryzyka; udary mózgu a okres prenatalny i okołoporodowy; leki a udary mózgu. Zwrócono uwagę na współwystępowanie czynników ryzyka ze sobą oraz na możliwość modyfikowania niektórych z nich. Udar mózgu jest zespołem o etiologii wieloczynnikowej, stąd po ustaleniu jednego czynnika nie należy odstępować od poszukiwania innych. Znajomość różnorodności czynników odgrywających rolę w etiopatogenezie udarów mózgu u dzieci jest punktem wyjściowym do ustalenia profilaktyki pierwotnej i wtórnej mających na celu obniżenie ryzyka zapadalności oraz nawrotów, jak i leczenia. Najbardziej celowym postępowaniem zawsze pozostają działania profilaktyczne.The incidence of a cerebral stroke in the population of children is considered to be a rare phenomenon, although an increasing number of cases is noticeable. The problems of an excessive time lapse from the occurrence of clinical symptoms to the cerebral stroke recognition in children, the elaboration of effective prophylaxis and treatment standards, decrease in mortality as well as minimizing permanent damages, still remain open. By understanding the complexity and diversity of etiological factors of cerebral strokes the solution to the above problems may be facilitated. The publication is an attempt to systematize the data available in literature, concerning the diversity of etiological factors in pathogenesis of cerebral strokes in children. The following have been discussed: inflammatory and non-inflammatory arteriopathies, intracranial aneurysms, intravascular malformations; cardiac diseases; critical states; disorders of haemostasis and embolism; irregularities in the morphotic composition of blood; embolisms: fat embolisms, air embolisms, cancer embolisms, nitrogen embolisms, foreign body embolisms; metabolic diseases; endocrine diseases, including those genetically determined; other risk factors; cerebral strokes and the prenatal and perinatal periods; drugs and cerebral strokes. Co-occurrence of the risk factors and the possibility of modifying some of them have been highlighted. A cerebral stroke is a multifactorial etiological syndrome, thus having established one factor, searching for others should be continued. The knowledge of the diversity of factors which play a role in the cerebral stroke etiopathogenesis in children is a starting point to establish primary and secondary prophylaxes which aim for lowering the incidence and recurrence risks, as well as the treatment. The preventive activities are always the most effective

Psychological Predictors of Seeking Help from Mental Health Practitioners among a Large Sample of Polish Young Adults

Although the corresponding literature contains a substantial number of studies on the relationship between psychological factors and attitude towards seeking professional psychological help, the role of some determinants remains unexplored, especially among Polish young adults. The present study investigated diversity among a large cohort of Polish university students related to attitudes towards help-seeking and the regulative roles of gender, level of university education, health locus of control and sense of coherence. The total sample comprised 1706 participants who completed the following measures: Attitude Toward Seeking Professional Psychological Help Scale-SF, Multidimensional Health Locus of Control Scale, and Orientation to Life Questionnaire (SOC-29). They were recruited from various university faculties and courses by means of random selection. The findings revealed that, among socio-demographic variables, female gender moderately and graduate of university study strongly predict attitude towards seeking help. Internal locus of control and all domains of sense of coherence are significantly correlated with the scores related to the help-seeking attitude. Attitudes toward psychological help-seeking are significantly related to female gender, graduate university education, internal health locus of control and sense of coherence. Further research must be performed in Poland in order to validate these results in different age and social groups

Psychopathic personality disorder and cybercriminality: an outline of the issue

The rapid development of information and communication technologies has created a new dimension in interpersonal rela-tionships, which is commonly called cyberspace. Structural features of cyberspace such as anonymity, the lack of non-verbal indicators of interaction, their asynchrony, a sense of impunity and the lack of specific norms of conduct cause that the behavior of some people online may differ significantly from their behavior in real life. Individuals with psychopathic personality disorder can use cyberspace for criminal activities such as cyberbullying, trolling, digital piracy, cybervandalism or data theft. This is a very significant problem, as some researchers predict that as digital communication develops, ‘cy-berpsychopaths’ will become the dominant form of criminals. Currently, there is a lack of research on the relationship be-tween the structural features of cyberspace and the expression of psychopathic personality traits and their role in commit-ting cybercrimes

Genotypic and phenotypic variability in the ring chromosome 21 syndrome

Wprowadzenie. Zespół pierścieniowego chromosomu 21 należy do grupy chorób zależnych przede wszystkim od konstytucji genetycznej. Cel. Celem tej pracy jest usystematyzowanie i synteza wiadomości dotyczących różnorodności genotypowej i fenotypowej występującej w tym zespole. Materiał i metoda. Dokonano systematycznego przeglądu najnowszego piśmiennictwa odnoszącego się do etiopatogenezy oraz obrazu klinicznego zespołu pierścieniowego chromosomu 21. Wniosek. Zespół pierścieniowego chromosomu 21 charakteryzuje się zarówno różnorodnością genotypową, jak i fenotypową. U podłoża zespołu leży złożony i przypadkowy proces rearanżacji genomu. Posiada on równocześnie cechy zespołu malformacyjnego i dysplastycznego.Introduction. The ring chromosome 21 belongs to a group of diseases dependent on the genetic constitution of an individual. Aim. The aim of this paper is systematization and synthesis of the knowledge related to genotypic and phenotypic variability occurring in this syndrome. Material and method. The author has carried out a systematic review of current literature related to etiopathogenesis and clinical picture of the ring chromosome 21 syndrome. Conclusion. The ring chromosome 21 syndrome is characterized by genotypic and phenotypic variability. It possesses traits of both the malformed and dysplastic syndrome

The brain stem stroke in the course of obliteration of basilar artery in 8-year-old boy

Przedstawiono problemy kliniczne związane z udarem niedokrwiennym mózgu na przykładzie ośmioletniego chłopca z udarem niedokrwiennym pnia mózgu. Podkreślono wagę rehabilitacji w zmniejszeniu stopnia niepełnosprawności dzieci po udarze niedokrwiennym mózgu u dziecka.Authors present clinical problems related to ischaemic cerebral stroke occurred in 8-year-old boy. This paper emphasizes the role of rehabilitation in improvement of health condition of children after cerebral ischaemic strok

Prevalence of psychopathic traits in a large sample of Polish adolescents from rural and urban areas

Objective The primary aim of the study was to assess the prevalence of psychopathic traits in a large sample of Polish adolescents representing both the rural and urban social milieu. An additional aim was to compare the results with similar studies conducted in other countries. Material and Methods The study was conducted on a sample of 9,415 secondary school students (4,808 boys, 4,607 girls) aged 13 – 16. Psychopathic traits were measured by teacher-report ratings with the Antisocial Process Screening Device scale (APSD). Results and conclusions Only a marginal part of the Polish adolescents demonstrated clinically significant symptoms of psychopathic disorder (N=253; 2.68%). There was a statistically significant difference between subjects from the rural (2.12%) and urban (3.45%) social milieu. Respective comparison showed that Polish youngsters scored much lower on total psychopathy scores than Chinese (Hong Kong) and American adolescents. The authors encourage replication of this research in other East European countries

Psychological Predictors of Seeking Help from Mental Health Practitioners among a Large Sample of Polish Young Adults

Although the corresponding literature contains a substantial number of studies on the relationship between psychological factors and attitude towards seeking professional psychological help, the role of some determinants remains unexplored, especially among Polish young adults. The present study investigated diversity among a large cohort of Polish university students related to attitudes towards help-seeking and the regulative roles of gender, level of university education, health locus of control and sense of coherence. The total sample comprised 1706 participants who completed the following measures: Attitude Toward Seeking Professional Psychological Help Scale-SF, Multidimensional Health Locus of Control Scale, and Orientation to Life Questionnaire (SOC-29). They were recruited from various university faculties and courses by means of random selection. The findings revealed that, among socio-demographic variables, female gender moderately and graduate of university study strongly predict attitude towards seeking help. Internal locus of control and all domains of sense of coherence are significantly correlated with the scores related to the help-seeking attitude. Attitudes toward psychological help-seeking are significantly related to female gender, graduate university education, internal health locus of control and sense of coherence. Further research must be performed in Poland in order to validate these results in different age and social groups

Prosocial competencies among adolescent siblings of the physically disabled

Background The current study examined possible prosocial benefits of having a disabled sibling. Until now research has mainly focused on the negative effects of having a sibling with a disability. We hypothesized that regular and frequent interactions with a disabled person should result in an increase of positive attitude and empathy toward other people who are in a disadvantageous situation. Participants and procedure A sample of 208 students from public secondary schools (middle and high schools) completed the Polish version of the Prosocial Tendencies Measure (PTM) in order to assess the tendencies to prosocial behaviors in different conditions. Participants were between 13 and 18 years old. Ninety-six adolescents had a disabled sibling (group T) and 112 constituted the control group (group C). Results Results showed that group T generally scored higher than group C in the number of helping behaviors. Furthermore, girls scored higher than boys in anonymous prosocial behaviors. The older adolescents are more inclined to use helping behaviors both in anonymous and compliant situations than their younger colleagues. Conclusions Presence of disabled children in a family context may facilitate prosocial behavior in their non-disabled siblings. Older participants less frequently described themselves as prosocial in public situations. In contrast, younger adolescents reported weaker prosocial tendencies in anonymous and compliant situations. The effect of gender on prosocial tendencies was significant for public prosocial behavior, with a higher level achieved by males in this domain. Data analysis also showed significantly greater emotional and altruistic tendencies in females than in males