The impact of subthalamic deep brain stimulation on polysomnographic sleep pattern in patients with Parkinson's disease – Preliminary report

Aim of the study We present the preliminary results of the study focused on the impact of subthalamic deep brain stimulation (DBS-STN) on sleep and other non-motor symptoms (NMS). Materials and methods Ten patients with advanced PD, underwent two-night polysomnography (PSG) mean 1.1 week before surgery and 6.2 months post DBS programming. NMS were assessed with a set of scales before surgery and 6 months and 12 months following DBS programming. Results Contrary to previous studies, we noted deterioration of sleep pattern in the follow-up PSG. We found a decrease in total sleep time, duration of the stage N2, with prolongation of stage N1 and wakefulness after sleep onset. We did not detect any impact of DBS-STN on subjective severity of restless legs syndrome. REM – sleep behavior disorder, however reported was not observed in any patient during PSG evaluations. We also found statistically significant correlations between severity of sleep disturbances and quality of life, as well as, between severity of motor symptoms and worse objective sleep quality. Conclusions We found that DBS-STN improved quality of life, subjective quality of sleep and sleepiness, however, contrary to the previous studies the objective parameters of sleep worsened after the surgery

Prevalence and predictors of post-stroke spasticity and its impact on daily living and quality of life

Background and aims. The present study aimed to assess the frequency of spasticity in a single-centre cohort of stroke patients in a one-year follow-up, its predictors, and its impact on the activities of daily living (ADL) and health-related quality of life (HRQoL).Material and methods. A group of 121 consecutive patients with hemiparesis (aged 73 ± 11 years) was selected for further observation, out of 381 Stroke Department patients during one year. At three follow-up assessments three, six and 12 months after stroke, muscle tone and muscle weakness were rated using Modified Ashworth Scale (MAS) and Medical Research Council (MRC); Activities of Daily Living (ADL) and Health Related Quality of Life (HRQoL) were evaluated using the Barthel Index (BI), Modified Rankin Scale (mRS) and an SF-36 questionnaire.Results. Fifty five of 121 (45%) patients after three months had developed spasticity (MAS ≥ 1), and in 19 of the 121 (15%) this spasticity was severe. After one year, 33/94 (35%) patients showed spasticity, and in 19/94 (20%) it was severe. Baseline muscle weakness (MRC), stroke severity as measured by the National Institutes of Health Stroke Scale (NIHSS), and greater disability (BI), were the most significant predictors of persistent post-stroke spasticity. Patients with spasticity had worse HRQoL in terms of their physical functioning, role limitations, physical pain, and vitality.Conclusion. Spasticity, which affects a significant proportion of stroke survivors, was present in 35% of our patients at 12 months after stroke. It has a major impact on both ADL and HRQoL. Severe disability and muscle weakness are the most important predictors of persistent post-stroke spasticity

PO-030 Oxidative phosphorylation in response to high intensity interval training

Objective The aim of our study was to investigate  the adaptive effect of six sessions of high intensity interval training (HIIT) on changes in the amount and activity of mitochondrial enzymes. Methods Twenty seven students (age 21.2±0.9) were assigned to HIIT (n=10) and control (CON, n=17) group and performed six training sessions for 14 days:  6 × 90 s intervals at 80% maximal aerobic power (MAP) output separated by 180 s rest. Pre and post interventions anthropometric measurements, maximal activity of citrate synthase (CS) and 3-HydroxyacylCoA (HADH) was determined in muscle samples. The effect of HIIT on proteins involved in oxidative phosphorylation (OXPHOS) in the skeletal muscle was used via proteomic analysis’s. We took into consideration 89 identified subunits from the mitochondrial respiratory chain complexes and the ATP synthase complex. For these proteomic tests a muscle biopsy samples from the three representative participants HIIT and three CON before and after training were collected.  Results Training induced the moderate and large effects in maximal enzymes activities CS and HADH. The HIIT caused the increase of level proteins involved in oxidative phosphorylation. Conclusions HIIT can be an optimal strategy for the prevention of certain civilization diseases or for the rehabilitation of diseases, especially cardiovascular disease

Legal and economic identification and assessment of pharmacy substitution in narrow therapeutic index drugs, on the example of epileptic medications in Poland

Currently in Poland there is neither regulation aiming at framing the complexity of substitution process arising at pharmacy level, nor further guidelines depending on drug category. FDA describes a narrow therapeutic index drug (NTI) in the 21 Code of Federal Regulations 320.33(c) and highlights that safe and effective use of such drug products require careful titration and patient monitoring. In major therapeutic areas disadvantages of the generic substitution are irrelevant or minor in comparison to the economic benefit. In epilepsy, a number of experts and professional bodies have recommended caution with generic substitution of drugs used in this condition. Aim of the study is to legally and economically identify and assess drug sub-stitution occurrence in Polish background among selected narrow therapeutic index drugs used in epilepsy. Paper is divided into two sections: first is retrospective based and tackles the data received from the National Health Fund; whereas second section takes under consideration questionnaire based results gained during medical history being collect-ed with the patients. Basing on most commonly substituted substance in epilepsy: carbamazepine, the maximum single difference in cost in substitution at the pharmacy was identified around the level of 1.7 PLN, and maximum extra pay at the same level. Ob-served/reported changes, ADRs, discomfort were provided based on the question-naire. The study highlights the necessity of planning process and evaluation of cur-rent market regulations

Legitimacy and potential savings in automatic substitution of biological products in Poland, the example of insulin

Currently in Poland there is no regulation aiming at framing the complexity of substitution process arising at pharmacy level. In practice such process exists in variety type of products, both generic and biological scope. Lack of integrity in terms of this process between authorised medical professions who held it, might lead to further costs both for the health care system and patients. The aim of the study is to explain, that the economic advantage, which very often is the result of performed substitution process, in some types of products such as bio-logical ones, should be preceded with the decision of the treating physi-cian. Only then, in the cooperation between persons prescribing and dispensing certain medicinal product the process of substitution may fully use its potential of money saving along with the control over a certain patient. The study brings the yet unknown classification of dif-ferences in costs between actually performed automatic substitution of products containing human insulin in the pharmacy setting in Poland in four year period in five Voivodeships

Little auks under the midnight sun: diel activity rhythm of a small diving seabird during the Arctic summer

Many animal species exhibit a diel, 24-hr pattern of activity, which is steered by timing cues, with the daily light–dark cycle considered the most powerful. This cue, however, is reduced in polar zones under continuous daylight conditions associated with the midnight sun. The rhythm of animal behaviour under such conditions is poorly understood. Here, we examine periodicity and patterns of daily activity (colony attendance and foraging) in a High-Arctic seabird, the little auk (Alle alle). We demonstrated a regular rhythm of colony attendance at the population level, with birds being the most abundant in the colony during hours of relatively low sun elevation. This pattern is likely to be associated with predation pressure that may be perceived by birds as lower during hours with low sun elevation, because of better predator detectability. Regarding rhythms at an individual level, however, we found the most common periodicity to be 23.2 hr (range from 19.9 hr to 30.8 hr) but no clear pattern of daily colony attendance of individuals. Such a flexibility in daily rhythms indicates that individuals may become arrhythmic in regard to the 24-hr environmental cycle, despite regularities observed at the population level. Finally, we compared males and females in terms of daily activity patterns but we did not find significant sex differences

Present Status And Tendencies In Docking Systems’ Development

The process of the ships docking, especially very large ships, is an very risky operation in confined and busy port waters. The similar difficult is the task to pass along any channel, river, strait or similar water road. The basic difficulty causes maneuvering with the great mass of the ship in situation of small space to maneuvers, the large inertia of the object and poor maneuvering properties at small speeds occurring in such circumstances. An additional factor, which make this task more difficult is the influence of the wind and the sea current on the hull of the inert ship as well as consequences of the limited visibility. The bad weather can cause the necessity to delay the maneuver. However this joins with heavy costs. An alternative is usage of systems supporting this process