Analysis of CT and MRI investigations of patients with lumbar discopathy treated conservatively or surgically

Background: Imaging investigations (radiculography, X-ray, CT, MRI) constitute an integral part of the therapeutic process in the treatment of patients suffering from lumbar discopathy. The results obtained with the imaging techniques provide the crucial data concerning the stage of disease development; assist the choice of optimal therapy method and the evaluation of the therapeutic actions efficiency. The aim of the study was to analyze the results of CT and MRI investigations carried out on patients suffering from lumbar discopathy, who had been treated with conservative or surgical methods. Material/Methods: 665 patients aged between 16 and 76 years with discopathy at L4-L5, L5-S1 levels were enrolled to the study. In the analyzed group, 348 patients received only conservative therapy whereas 317 patients underwent surgical procedures. CT and MRI investigations were applied at the beginning of the observation (W), after three years (III) and after ten years (X) since the operation (or exclusively conservative treatment). The results obtained with imaging techniques were divided into three categories: intradiscal, peridiscal and disc-related changes caused by herniation of vertebral discs. Results: During the subsequent periods of inspection, the rising number of degenerative changes was found. The progression of the imaging technique results concerned both the L4-L5, L5-S1 spaces, which showed distortion initially, and the L3-L4, L2-L3 levels, which were not degenerated in the preliminary examination. The remote examination showed that the number of degenerations in the two examined groups was substantially higher than it had been during the preliminary examination. The total number of degenerative changes among the patients operated on was higher than among the patients in conservative treatment. Conclusions: The number of degenerative changes of the spine grows from level L2-L3 to level L5-S1. The stage of spinal degenerative changes rises along with the duration of the disease. The patients operated on show more degenerative changes than those in conservative treatment

Aktywność fizyczna pacjentów w starszym wieku – doniesienie wstępne

Background. The recent increase in the number of people over 60 forces the public opinion to take an interest in the problems of this group of people. One of those problems is physical activity, as it is one of the factors that will influence their health. It should be considered if the elderly have a positive attitude to exercise, what type of exercise is performed and whether they practiced any sport in their youth and what will be the most important goal of exercise. Aim of the study. The aim of this study was an initial self-assessment of their physical activity of the elderly patients. Material and methods. The study involved 50 patients from the Geriatric Clinic, University Hospital No. 1 in Bydgoszcz who were above 60 years of age. The subjects took part in an anonymous questionnaire on physical activity. Results. 32 (64%) of the patients declared a positive attitude toward exercise, 11 (22%) had a negative attitude, 5 (10%) connected it to their well-being, and 2 (4%) said that they must force themselves to perform physical activity. 16 (32%) of the respondents actively practiced sport in their youth, 28 (56%) did not, and 6 (12%) were not able to remember. The disciplines practiced by the respondents were: running (8, 44%), swimming (5, 28%), football (3, 17%) and gymnastics (2, 11%). The current preferred mode of physical activity in the free time of the respondents is: walking (26, 52%), cycling (18, 36%), Nordic walking (4, 8%), fishing (2, 4%). According to the patients, the purpose of physical exercise is: general fitness (30, 60%), fitness in everyday activities (9, 18%) and independence from others (11, 22%). Conclusions. Elderly patients mostly speak positively of exercise and they state that the primary goal of exercise is maintaining overall fitness, regardless of sex, age, place of residence, marital status or education.Wstęp. Zwiększająca się w ostatnich latach liczba osób powyżej 60 roku życia wymusza na społeczeństwie zainteresowanie się problemami tej grupy osób. Jednym z nich jest aktywność fizyczna, gdyż to ona będzie między innymi rzutować na późniejszy stan zdrowia. Zastanowić się można zatem czy osoby w starszym wieku są pozytywnie ustosunkowane do ćwiczeń fizycznych, jaki typ ćwiczeń wykonują najchętniej oraz czy w młodości trenowali sport oraz co będzie najważniejszym celem ćwiczeń. Celem pracy była wstępna samoocena aktywności fizycznej pacjentów w starszym wieku. Materiał i metody. W badaniu wzięło udział 50 pacjentów Poradni Geriatrycznej Szpitala Uniwersyteckiego Nr 1 im. dr A. Jurasza w Bydgoszczy powyżej 60 roku życia. Badani zostali poddani anonimowej ankiecie na temat aktywności fizycznej. Wyniki. Spośród 50 pacjentów 32 (64%) pacjentów deklarowało pozytywny stosunek do ćwiczeń fizycznych, 11 (22%) było do nich ustosunkowanych negatywnie, 5 (10%) uzależniało je od swojego samopoczucia, a 2 (4%) opowiedziało, że musi się zmuszać do wykonania aktywności fizycznej. Czynnie sport w młodości trenowało 16 (32%) ankietowanych, 28 (56%) nie wykonywało, natomiast 6 (12%) nie jest w stanie sobie przypomnieć. Dyscyplinami trenowanymi w młodości przez ankietowanych było: bieganie 8 (44%), pływanie 5 (28%), piłka nożna 3 (17%) oraz gimnastyka 2 (11%). Aktywnością fizyczną preferowaną obecnie w wolnych chwilach przez ankietowanych są: spacery 26 (52%), jazda na rowerze 18 (36%), 4 (8%) nordic walking, 2 (4%) wędkarstwo. Celem ćwiczeń fizycznych w opinii pacjentów jest całkowita sprawność fizyczna 30 (60%), sprawność na poziomie życia codziennego 9 (18%) oraz niezależność od osób drugich 11 (22%). Wnioski. Pacjenci w starszym wieku w większości pozytywnie wypowiadają się na temat ćwiczeń fizycznych, a za cel główny ćwiczeń stawiają utrzymanie całkowitej sprawności fizycznej bez względu na płeć, wiek, miejsce zamieszkania, stan cywilny czy wykształcenie

Physical activity in elderly patients – preliminary report

Background. The recent increase in the number of people over 60 forces the public opinion to take an interest in the problems of this group of people. One of those problems is physical activity, as it is one of the factors that will influence their health. It should be considered if the elderly have a positive attitude to exercise, what type of exercise is performed and whether they practiced any sport in their youth and what will be the most important goal of exercise. Aim of the study. The aim of this study was an initial self-assessment of their physical activity of the elderly patients. Material and methods. The study involved 50 patients from the Geriatric Clinic, University Hospital No. 1 in Bydgoszcz who were above 60 years of age. The subjects took part in an anonymous questionnaire on physical activity. Results. 32 (64%) of the patients declared a positive attitude toward exercise, 11 (22%) had a negative attitude, 5 (10%) connected it to their well-being, and 2 (4%) said that they must force themselves to perform physical activity. 16 (32%) of the respondents actively practiced sport in their youth, 28 (56%) did not, and 6 (12%) were not able to remember. The disciplines practiced by the respondents were: running (8, 44%), swimming (5, 28%), football (3, 17%) and gymnastics (2, 11%). The current preferred mode of physical activity in the free time of the respondents is: walking (26, 52%), cycling (18, 36%), Nordic walking (4, 8%), fishing (2, 4%). According to the patients, the purpose of physical exercise is: general fitness (30, 60%), fitness in everyday activities (9, 18%) and independence from others (11, 22%). Conclusions. Elderly patients mostly speak positively of exercise and they state that the primary goal of exercise is maintaining overall fitness, regardless of sex, age, place of residence, marital status or education.Wstęp. Zwiększająca się w ostatnich latach liczba osób powyżej 60 roku życia wymusza na społeczeństwie zainteresowanie się problemami tej grupy osób. Jednym z nich jest aktywność fizyczna, gdyż to ona będzie między innymi rzutować na późniejszy stan zdrowia. Zastanowić się można zatem czy osoby w starszym wieku są pozytywnie ustosunkowane do ćwiczeń fizycznych, jaki typ ćwiczeń wykonują najchętniej oraz czy w młodości trenowali sport oraz co będzie najważniejszym celem ćwiczeń. Celem pracy była wstępna samoocena aktywności fizycznej pacjentów w starszym wieku. Materiał i metody. W badaniu wzięło udział 50 pacjentów Poradni Geriatrycznej Szpitala Uniwersyteckiego Nr 1 im. dr A. Jurasza w Bydgoszczy powyżej 60 roku życia. Badani zostali poddani anonimowej ankiecie na temat aktywności fizycznej. Wyniki. Spośród 50 pacjentów 32 (64%) pacjentów deklarowało pozytywny stosunek do ćwiczeń fizycznych, 11 (22%) było do nich ustosunkowanych negatywnie, 5 (10%) uzależniało je od swojego samopoczucia, a 2 (4%) opowiedziało, że musi się zmuszać do wykonania aktywności fizycznej. Czynnie sport w młodości trenowało 16 (32%) ankietowanych, 28 (56%) nie wykonywało, natomiast 6 (12%) nie jest w stanie sobie przypomnieć. Dyscyplinami trenowanymi w młodości przez ankietowanych było: bieganie 8 (44%), pływanie 5 (28%), piłka nożna 3 (17%) oraz gimnastyka 2 (11%). Aktywnością fizyczną preferowaną obecnie w wolnych chwilach przez ankietowanych są: spacery 26 (52%), jazda na rowerze 18 (36%), 4 (8%) nordic walking, 2 (4%) wędkarstwo. Celem ćwiczeń fizycznych w opinii pacjentów jest całkowita sprawność fizyczna 30 (60%), sprawność na poziomie życia codziennego 9 (18%) oraz niezależność od osób drugich 11 (22%). Wnioski. Pacjenci w starszym wieku w większości pozytywnie wypowiadają się na temat ćwiczeń fizycznych, a za cel główny ćwiczeń stawiają utrzymanie całkowitej sprawności fizycznej bez względu na płeć, wiek, miejsce zamieszkania, stan cywilny czy wykształcenie

ALMA as a prominence thermometer: First observations

We present first prominence observations obtained with ALMA in Band 3 at the wavelength of 3 mm. High-resolution observations have been coaligned with the MSDP H$\alpha$ data from Wroclaw-Bialk\'{o}w large coronagraph at similar spatial resolution. We analyze one particular co-temporal snapshot, first calibrating both ALMA and MSDP data and then demonstrating a reasonable correlation between both. In particular we can see quite similar fine-structure patterns in both ALMA brightness temperature maps and MSDP maps of H$\alpha$ intensities. Using ALMA we intend to derive the prominence kinetic temperatures. However, having current observations only in one band, we use an independent diagnostic constraint which is the H$\alpha$ line integrated intensity. We develop an inversion code and show that it can provide realistic temperatures for brighter parts of the prominence where one gets a unique solution, while within faint structures such inversion is ill conditioned. In brighter parts ALMA serves as a prominence thermometer, provided that the optical thickness in Band 3 is large enough. In order to find a relation between brightness and kinetic temperatures for a given observed H$\alpha$ intensity, we constructed an extended grid of non-LTE prominence models covering a broad range of prominence parameters. We also show the effect of the plane-of-sky filling factor on our results.Comment: 9 pages, 3 figures, accepted for publication in the The Astrophysical Journal Letter

Recommendations for neurological, obstetrical and gynaecological care in women with multiple sclerosis: a statement by a working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society

Introduction. Multiple sclerosis (MS) is the most common non-traumatic neurological cause of disability in young adults, affecting women 1-3 times more often than men. Several specific challenges arise from the fact that young women diagnosed with MS often have to make decisions related to treatment and family planning at the same time. These issues are connected with fertility, the impact of pregnancy on disease course, the choice of pregnancy timing, and the optimal mode of disease-modifying therapy in the context of a planned pregnancy, contraception, urological complaints, and sexual dysfunction.State of the art. While MS does not in itself adversely affect fertility, pregnancy or childbirth, pregnancy needs to be carefully planned. This requires the interdisciplinary co-operation of a neurologist, gynaecologist and psychologist. Data on the impact of disease-modifying drugs on foetal development are very limited, and none of these drugs is 100% safe during pregnancy. In the second and third trimesters, MS relapse rate decreases. Unfortunately, it increases within the first 3-6 months after delivery. Adequate disease control should be achieved before pregnancy, as relapse rate in the period of two years preceding pregnancy is one of the strongest predictive factors for post-partum relapses.Clinical implications. The following is a statement by a working group of experts in neurology, gynaecology, obstetrics and urology, convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society, addressing the issues that are specific to the female MS population. The aim of this statement is to provide guidance in pregnancy planning and disease management, both during pregnancy and post-partum.Future directions. This statement reflects expert opinion and is not intended to be read as guidelines. It rather provides up-to-date information on how to optimise care of female MS patients of childbearing age