Ischemic strokes in children

Autorka przedstawiła aktualne poglądy na temat udarów niedokrwiennych u dzieci. Omówiła ich czynniki ryzyka, objawy kliniczne, diagnostykę oraz leczenie.The author reviews current opinions on etiopathogenesis of ichemic stroke in childhood. Risk factors clinical picture, diagnostic procedures and treatment are discussed

Salinity-induced changes in plastoquinone pool redox state in halophytic Mesembryanthemum crystallinum L.

We have analyzed the effect of salinity on photosystem II (PSII) photochemistry and plastoquinone (PQ) pool in halophytic Mesembryanthemum crystallinum plants. Under prolonged salinity conditions (7 or 10 days of 0.4 M NaCl treatment) we noted an enlarged pool of open PSII reaction centers and increased energy conservation efficiency, as envisaged by parameters of the fast and slow kinetics of chlorophyll a fluorescence. Measurements of oxygen evolution, using 2,6-dichloro-1,4-benzoquinone as an electron acceptor, showed stimulation of the PSII activity due to salinity. In salt-acclimated plants (10 days of NaCl treatment), the improved PSII performance was associated with an increase in the size of the photochemically active PQ pool and the extent of its reduction. This was accompanied by a rise in the $NADP^{+}$/NADPH ratio. The presented data suggest that a redistribution of PQ molecules between photochemically active and non-active fractions and a change of the redox state of the photochemically active PQ pool indicate and regulate the acclimation of the photosynthetic apparatus to salinity

Zawroty głowy u dzieci - najważniejsze aspekty kliniczne

Zawroty głowy są dolegliwością zgłaszaną często zarówno przez dorosłych, jak i przez dzieci. Mogą występować w różnych chorobach - wymagających szybkiej diagnostyki i leczenia (guzy mózgu) i wynikających z zaburzeń emocjonalnych. W codziennej praktyce lekarskiej rodzice z dziećmi skarżącymi się na zawroty głowy zgłaszają się przede wszystkim do lekarzy podstawowej opieki zdrowotnej. Lekarze ci powinni ustalić, czy dziecko wymaga natychmiastowej hospitalizacji lub należy skierować je do odpowiedniego specjalisty (otolaryngologa lub neurologa), czy też można prowadzić dalsze leczenie we własnym zakresie. W niniejszej pracy autorki przedstawiły najważniejsze zagadnienia dotyczące zawrotów głowy u dzieci. Forum Medycyny Rodzinnej 2010, tom 4, nr 3, 204-20

Impact of the -174G/C interleukin-6 (IL-6) gene polymorphism on the risk of paediatric ischemic stroke, its symptoms and outcome

Ischemic stroke remains one of the top ten causes of death in children. There is evidence for the role of pro-inflammatory cytokines, such as IL-6 and the -174G>C promoter polymorphism of the IL-6 gene, in the occurrence and outcome of stroke in adults. The aim of the present study was to determine a possible association between the -174G>C IL-6 polymorphism and occurrence of paediatric stroke, its symptoms and outcome. The study group consisted of 340 individuals: 80 stroke children, 122 parents of patients and 138 controls. The -174G/C polymorphism was genotyped using the RFLP method. For the analysis of the relationship between genotypes and stroke we used two alternative methods: the case-control model and the transmission test for linkage disequilibrium using data from families. We observed no differences in the transmission of alleles from parents to children. We also did not find any statistical differences in distribution of genotypes and alleles between patients and controls. However, the analysis showed that post-stroke epilepsy was genotype-dependent. All children with epilepsy were G allele carriers and none of them was a CC homozygote whereas about 25% of children without epilepsy had the CC genotype. Our study did not show any associations between the IL-6 -174 G>C polymorphism and the occurrence of stroke but we observed a relation between post-stroke epilepsy and the G allele carrier-state

A different pattern of production and scavenging of reactive oxygen species in halophytic Eutrema salsugineum (Thellungiella salsuginea) plants in comparison to Arabidopsis thaliana and its relation to salt stress signaling

Isolated thylakoids from halophytic Eutrema salsugineum (Thellungiella salsuginea) produces more H2O2 in comparison to glycophytic Arabidopsis thaliana. The first objective of this study was to verify whether this feature is relevant also to the intact chloroplasts and leaves. Enhanced H2O2 levels in chloroplasts and leaves of E. salsugineum were positively verified with several methods (electron microscopy, staining with Amplex Red and with diaminobenzidine). This effect was associated with a decreased ratio of O2.-/H2O2 in E.s in comparison to A.thaliana as detected by electron paramagnetic resonance (EPR) method. As a next step, we tested how this specific ROS signature of halophytic species affect the antioxidant status and down-stream components of ROS signaling. Comparison of enzymatic antioxidants revealed a decreased activity of ascorbate peroxidase (APX), enhanced activity of glutathione peroxidase (GPX), and the presence of thylakoid-bound forms of iron superoxide dismutase (FeSOD) and ascorbate peroxidase (APX) in E.s.. These cues were, however, independent from application of salt stress. The typical H2O2-dependent cellular responses, namely the levels of glucosinolates and stress-related hormones were determined. The total glucosinolate content in E.s water-treated leaves was higher than in A.t. and increased after salinity treatment. Treatment with salinity up-regulated all of tested stress hormones, their precursors and catabolites (abscisic acid, dihydrophaseic acid, phaseic acid, 1-aminocyclopropane-1-carboxylic acid, salicylic acid, jasmonic acid, cis-(+)-12-oxo-phytodienoic acid and jasmonoyl-L-isoleucine) in A.t., whereas in E.s. only a stimulation in ethylene synthesis and abscisic acid catabolism was noted. Obtained results suggest that constitutively enhanced H2O2 generation in chloroplasts of E.s. might be a crucial component of stress-prepardeness of this halophytic species. It shapes a very efficient antioxidant protection (in which glucosinolates might play a specific role) and a fine tuning of hormonal signaling to suppress the cell death program directed by jasmonate pathway

Polimorfizm C242T genu kodującego cytohrom b-245 alfa nie jest związany z udarem niedokrwiennym mózgu u dzieci: analiza wewnątrzrodzinna i badanie kliniczno-kontrolne

Background and purpose Reactive oxygen species play an important role in the physiology and pathology of cerebral arteries, including ischaemic stroke. The cytochrome b-245 alpha gene (CYBA) encodes cytochrome b-245 alpha light chain (p22phox peptide), a critical element of NAD(P)H oxidases, the most important source of superoxide anion in the cerebral arteries. To search for genetic factors associated with paediatric ischaemic stroke, the possible association between CYBA gene C242T polymorphism and the disease was evaluated. Material and methods The study group consisted of 238 individuals: children with ischaemic stroke (n = 70), their biological parents (n = 118) and children without any symptoms of stroke (n = 50). The C242T polymorphism was genotyped using polymerase chain reaction – restriction fragment length methodology. To evaluate the possible association between polymorphism and stroke, the transmission disequilibrium test and the case-control method were applied. Results The C242 allele was transmitted more frequently than 242T (62.2% vs. 37.8%) but observed frequencies did not differ significantly from expected (p = 0.10). There were also no significant differences in allele and genotype distribution between patients and control subjects (patients: CC – 50.0%, CT – 38.6%, TT – 11.4% vs. controls: CC – 52.0%, CT – 36.0%, TT – 12.0%). Conclusions The study did not show that the C242T polymorphism of the CYBA gene is a risk factor of ischaemic stroke in children.Wstęp i cel pracy Reaktywne formy tlenu pełnią istotną funkcję zarówno w fizjologii, jak i patologii tętnic mózgowych, także w patogenezie udaru niedokrwiennego mózgu. Gen cytochromu b-245 alfa (gen CYBA) koduje lekki łańcuch cytochromu b-245 (białko p22phox), kluczowy składnik oksydaz NAD(P)H, najważniejszego źródła anionorodnika ponadtlenkowego w obrębie tętnic mózgowych. W niniejszej pracy, poszukując genetycznych czynników ryzyka predysponujących do udaru mózgu u dzieci, oceniano możliwe związki pomiędzy polimorfizmem C242T genu CYBA i chorobą. Materiał i metody W badaniu wzięło udział 238 osób: 70 dzieci z udarem niedokrwiennym mózgu, 118 ich biologicznych rodziców oraz 50 dzieci bez żadnych objawów udaru. Polimorfizm C242T genu CYBA genotypowano metodą polimorfizmu długości fragmentów restrykcyjnych w reakcji łańcuchowej polimerazy. Do oceny możliwych związków pomiędzy polimorfizmem i udarem zastosowano dwie niezależne metody: wewnątrzrodzinny test transmisji i badanie kliniczno-kontrolne. Wyniki Allel C242 był częściej przekazywany chorym dzieciom przez heterozygotycznych rodziców niż allel 242T (62,2% w porównaniu z 37,8%), jednak obserwowane częstości nie odbiegały znamiennie od oczekiwanych (p = 0,10). Nie wykazano także znaczących różnic w rozkładzie alleli i genotypów pomiędzy pacjentami i dziećmi z grupy kontrolnej (pacjenci: CC – 50,0%, CT – 38,6%, TT – 11,4%; grupa kontrolna: CC – 52,0%, CT – 36,0%, TT – 12,0%). Wnioski Wyniki badań nie wykazały, aby polimorfizm C242T genu CYBA był czynnikiem ryzyka udaru niedokrwiennego u dzieci

Acute fading velatopharyngeal incompetence in a five year old child

Autorzy przedstawiają przypadek 5-letniego dziecka, u którego nagle wystąpiły objawyniewydolności podniebienno-gardłowej (niewyraźna mowa, krztuszenie się w czasie spożywaniapokarmów). Trwająca 10 dni rehabilitacja foniatryczna doprowadziła do ustąpieniadolegliwości.The authors present a case of a five year old child who experienced symptoms of velatopharyngealincompetence (slurred speech, choking during food consum ption). A tenday long phoniatric rehabilitation led to abatement of the symptoms

Polimorfizm C242T genu kodującego cytochrom b-245 alfa nie jest związany z udarem niedokrwiennym mózgu u dzieci : analiza wewnątrzrodzinna i badanie kliniczno-kontrolne

Background and purpose: Reactive oxygen species play an important role in the physiology and pathology of cerebral arteries, including ischaemic stroke. The cytochrome b-245 alpha gene (CYBA) encodes cytochrome b-245 alpha light chain (p22phox peptide), a critical element of NAD(P)H oxidases, the most important source of superoxide anion in the cerebral arteries. To search for genetic factors associated with paediatric ischaemic stroke, the possible association between CYBA gene C242T polymorphism and the disease was evaluated. Material and methods: The study group consisted of 238 in - dividuals: children with ischaemic stroke (n = 70), their biological parents (n = 118) and children without any symptoms of stroke (n = 50). The C242T polymorphism was genotyped using polymerase chain reaction – restriction fragment length methodology. To evaluate the possible association between polymorphism and stroke, the transmission disequilibrium test and the case-control method were applied. Results: The C242 allele was transmitted more frequently than 242T (62.2% vs. 37.8%) but observed frequencies did not differ significantly from expected (p = 0.10). There were also no significant differences in allele and genotype distribution between patients and control subjects (patients: CC – 50.0%, CT – 38.6%, TT – 11.4% vs. controls: CC – 52.0%, CT – 36.0%, TT – 12.0%). Conclusions: The study did not show that the C242T polymorphism of the CYBA gene is a risk factor of ischaemic stroke in childre

Polish recommendations for diagnosis and therapy of paediatric stroke

Stroke remains one of the greatest health challenges worldwide, due to a high mortality rate and, despite great progress in its treatment, the significant disability that it causes. Studies conducted around the world show that the diagnosis of stroke in children is often significantly delayed. Paediatric ischaemic arterial stroke (PAIS) is not only a problem that varies greatly in frequency compared to the adult population, it is also completely different in terms of its risk factors, clinical course and outcome. The main reason for the lack of a rapid diagnosis of PAIS is a lack of access to neuroimaging under general anaesthesia. The insufficient knowledge regarding PAIS in society as a whole is also of great importance. Parents and carers of children should always bear in mind that paediatric age is not a factor that excludes a diagnosis of stroke. The aim of this article was to develop recommendations for the management of children with acute neurological symptoms suspected of ischaemic stroke and further treatment after confirmation of the ischaemic aetiology of the problem. These recommendations are based on current global recommendations for the management of children with stroke, but our goal was also to match them as closely as possible to the needs and technical diagnostic and therapeutic possibilities encountered in Poland. Due to the multifactorial problem of stroke in children, not only paediatric neurologists but also a neurologist, a paediatric cardiologist, a paediatric haematologist and a radiologist took part in the preparation of these recommendations

Burnout syndrome among caregivers of children suffering from epilepsy

Zespół wypalenia jest to stan fizycznego i psychicznego wyczerpania powstający w wyniku działania długotrwałych uczuć negatywnych. Na zespół wypalenia narażone są osoby długotrwale zaangażowane w udzielanie pomocy (lekarze, terapeuci, pielęgniarki, opiekunowie). Celem niniejszej pracy była ocena nasilenia zespołu wypalenia wśród opiekunów dzieci chorujących na padaczkę. W ankietowym badaniu oceniono 99 opiekunów dzieci chorych na padaczkę, którzy wypełnili Kwestionariusz Wypalenia Maslach i Inwentarz Depresji Becka. U żadnego z badanych opiekunów nie zaobserwowano objawów depresji. Stwierdzono, że istnieje dodatnia korelacja pomiędzy czasem trwania choroby, wiekiem dziecka oraz wiekiem opiekuna a poziomem wyczerpania emocjonalnego. Osoby opiekujące się chorym dzieckiem samotnie, bez wsparcia rodziny, cechowały się wyższymi wartościami wyczerpania emocjonalnego oraz depersonalizacji, a także niższą samooceną.Burnout syndrome is a condition of physical and mental exhaustion resulting from chronic exposure to negative emotions. Subjects involved in helping others for a long time (e.g. doctors, nurses, caregivers etc.) are at risk of developing burnout syndrome. The aim of this study was to assess the intensity of the burnout syndrome among caregivers of children suffering from epilepsy. We assessed 99 caregivers of children. They were asked to fill in the Maslach Burnout Inventory and Beck’s Depresion Index. We have found no symptoms of depression in any of the caregivers. There is a positive correlation between time passed from the diagnosis, age of the child , age of the caregiver and the level of emotional exhaustion. Subjects taking care of a child lonely, without any familial support had higher results in subscales of emotional exhaustion and depersonalisation. They were also characterised by lower self-esteem as well