Why Nonlinear Biomedical Physics?

The two goals of Nonlinear Biomedical Physics are: firstly to show how nonlinear methods can shed new light on biological phenomena and medical applications and secondly to bridge the technical, mathematical, and cultural divides between the physical disciplines where these methods are being developed and the audience for their use in the biological and medical sciences

Repetitive transcranial magnetic stimulation in treatment of post polio syndrome

Background Post polio syndrome is a rare disease that occurs decades after polio virus infection. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option with proved effectiveness in drug resistant depression. Possibly it can be helpful in therapy of other neurological diseases including post polio syndrome. Objective To describe a case of patient diagnosed with post polio syndrome who was treated with rTMS stimulation with a good effect. Methods Patient had rTMS stimulation of left prefrontal cortex twice a week for an eight weeks. Patient's health status was evaluated before treatment, after last rTMS session and after three months from the end of the treatment. Results Improvement of fatigue score, mood disturbances and motor functions was observed after treatment. Conclusion rTMS can be an effective method in treatment of post polio syndrome but further studies with larger group need to be done to confirm that data

How does early decompressive craniectomy influence the intracranial volume relationship in traumatic brain injury (TBI) patients?

Background. Decompressive craniectomy (DC) is a common neurosurgical procedure involving the removal of part of the skull vault combined with subsequent duroplasty. The goal of DC is to produce extra space for the swollen brain and/or to reduce intracranial pressure. In the present study, DC was performed in order to create space for the swollen brain. Aim of the study: to compare the volume alteration of selected intracranial fluid spaces before and after DC, to evaluate the volume of post-decompressive brain displacement (PDBD) and the largest dimension of oval craniectomy (LDOC), and to assess the early clinical effects of DC. Material and methods. The study group consisted of 45 patients with traumatic brain injury (four females and 41 males, mean age 54.5 years) who underwent DC (not later than five hours after admission to hospital) due to subdural haematomas and/or haemorrhagic brain contusions localised supratentorially and diagnosed by computed tomography (CT). The mortality rate in the study group was 40%. Study calculations were performed using Praezis Plus software by Med Tatra, Zeppelin and Pax Station by Compart Medical Systems. For statistical analysis, IBM SPSS Statistics software was used. Results. The DC-related additional space was responsible for a statistically significant increase in the volume of preoperatively compressed intracranial fluid spaces. The mean volume of extra space filled by the swollen brain was 42.2 ml ± 40.7. The best early treatment results were achieved in patients under the age of 55. Conclusions. DC has limited effectiveness in patients aged over 70 years. In every patient with clamped basal cisterns, a skin incision enabling appropriate LDOC should be planned before surgery. DC should be as large as possible, and the limits of its dimensions should be the limits of anatomical safety

Stabilizacja potyliczno-szyjna u chorego w przebiegu szpiczaka. Modyfikacja metody operacyjnej. Nota techniczna

W pracy przedstawiono dokonaną śródoperacyjnie modyfikację zastosowania i mocowania systemu Axon (Synthes) do stabilizacji potyliczno-szyjnej w szczególnej sytuacji klinicznej u chorego leczonego onkologicznie z powodu szpiczaka. Patologiczne złamanie, rozległość procesu oraz uszkodzenie zespolenia przedniego w odcinku szyjnym kręgosłupa spowodowało konieczność zastosowania stabilizacji potyliczno–szyjnej. Stwierdzono odmienne warunki anatomiczne w obrębie łuski kości potylicznej w postaci jej ścieńczenia. Budowa kości uniemożliwiała zastosowanie mocowania za pomocą wprowadzanych śrub, dlatego dokonano modyfikacji mocowania za pomocą techniki opracowanej ad hoc (otwory trepanacyjne w łusce kości potylicznej i mocowanie drutem tytanowym). Omówiono modyfikacje i szczególne wskazania związane z przebiegiem klinicznym szpiczaka

Polymerase chain reaction based detection of bacterial 16S rRNA gene in the cerebrospinal fluid in the diagnosis of bacterial central nervous system infection in the course of external cerebrospinal fluid drainage. Comparison with standard diagnostics currently used in clinical practice

Background and purpose External drainage of cerebrospinal fluid (CSF) is a commonly used neurosurgical procedure. Complications of the procedure comprise central nervous system (CNS) bacterial infections, the frequency of which is estimated at around 6–10%. Detection of these infections is ineffective in many cases. The aim of the study was to evaluate the usefulness of a polymerase chain reaction (PCR)-based detection of bacterial 16S rRNA gene (16S rDNA) in the CSF. Material and methods The study group consisted of 50 patients. Clinical signs of CNS infection were monitored and routine laboratory and microbiological tests were performed. The results of standard methods were compared with the bacterial 16S rDNA detection. Results Using cultures, CNS infection was diagnosed in 8 patients, colonization of the drainage catheter in 6 patients, and sample contamination in 7 patients. In the group of the remaining 29 patients, no positive CSF culture was obtained and 13 of these patients also had all negative results for 16S rDNA detection. For the remaining 16 patients of this group, CNS infection, colonization of the catheter and sample contamination were diagnosed via PCR alone. Routine biochemical CSF tests and blood inflammatory parameters had a supporting value. Conclusions Routine hospital tests do not provide rapid and efficient detection of the external drainage related bacterial CNS infection. It is justified to use several diagnostic methods simultaneously. The16S rDNA determination in CSF can increase the probability of detection of possible pathogens

Malignant middle cerebral artery (MCA) infarction in people over 85 years old – Diagnosis, management and risk factors

Introduction Malignant ischemic stroke of the middle cerebral artery (MCA) territory causes neurological deterioration due to the effects of space occupying cerebral edema. The prognosis is poor, and death usually occurs as a result of brainstem compression. There is no information on ischemic stroke, especially the malignant ones, in patients over 85 years old. Aim The aim of this retrospective study was to evaluate the disease course, risk factors, survival rate and treatment of MCA malignant infarction in people over 85 years old. Method The medical history of 66 patients with malignant MCA stroke was analyzed. The frequency of the occurrence of the risk factors like hypertension, hyperlipidemia, atrial fibrillation, heart failure, diabetes was evaluated. Disability was measured with the use of the National Institutes of Health Stroke Scale (NIHSS). Safety and effectiveness of the anticoagulants used in the group of patients with atrial fibrillation were analyzed. Chi-quadrat test and Mann–Whitney U test were used for statistical analysis of data. We also described 85 year-old patient with malignant brain stroke who was treated neurosurgically with a positive effect. Results Atrial fibrillation was diagnosed in 65% of patients of the investigated group. There were no statistically significant changes in the survival rate between the group of patients treated with the use of mannitol and patients without this treatment. Conclusion The key risk factor in this group is the atrial fibrillation. The elderly patients require an intensive monitoring of the health condition by reference to brain stroke risk factors, especially atrial fibrillation

Importance rating of risk factors of ischemic stroke in patients over 85 years old in the polish population

Introduction The European population is aging and the number of elderly patients suffering from ischemic brain stroke increases. A better knowledge of the correlation between the risk factors and the course of the disease in old people may be useful for planning medical care and prophylactic strategies. Aim This prospective study aimed to perform a demographic and clinical analysis of the etiology of ischemic stroke, survival rate and severity of post-stroke disability in patients who developed ischemic stroke at the age of over 85 years in the Polish population. Method The study group consisted of 159 patients over 85 years old with ischemic stroke. The prevalence of risk factors such as sex, hypertension, hyperlipidemia, atrial fibrillation, heart failure and diabetes was evaluated. The outcome was assessed using the Barthel scale and the National Institutes of Health Stroke Scale. Results The most common risk factors of ischemic stroke were hypertension and atrial fibrillation. Patients with atrial fibrillation had a more severe course of ischemic stroke. Conclusion The course of brain stroke in the Polish population is more severe in patients over 85 years old than in younger ones. The key risk factor in this group is atrial fibrillation

Przezczaszkowa ultrasonografia dopplerowska (TCD) u chorych z poszerzonym układem komorowym : poszukiwanie dodatkowych wskaźników kwalifikacji do zabiegu implantacji układu zastawkowego

Background: Ventriculomegaly without increased intracranial pressure is observed both in normal-pressure hydrocephalus (NPH) and idiopathic cerebral atrophy (CA). Investigating additional parameters to differentiate these diseases is important for a good qualification of shunt implantation. The study presents the influence of intravenous administration of acetazolamide on cerebral blood flow velocity (BFV) and cerebrovascular reactivity (CVR) in 23 patients with ventriculomegaly and symptoms of cognitive function disorders. The aim was to establish the differences in the dynamic cerebral hemodynamics parameters in NPH and CA patients. Material/Methods: Measurement of BFV was performed in 23 patients using transcranial Doppler (TCD) ultrasonography before and 20 minutes after intravenous administration of 1000 mg acetazolamide. CVR was calculated as the percent change from the baseline mean BFV value and assessed bilaterally in the middle (MCA), anterior (ACA), posterior (PCA), and internal carotid cerebral (ICA) arteries in the intracranial part. Additionally, BFV was evaluated in selected patients during a lumbar infusion test. The patients were divided into 2 groups: those with NPH and those with CA. Results: BFV values were decreased both in the NPH and the CA group compared with the control group (healthy volunteers of the same age). There were no significant differences between the two groups. In the CA group a complete lack of CVR was observed in all examined arteries. In the NPH group, CVR was maintained, while mean BFV (MFV) changed 37±4% in the MCA, 26±6% in the ACA, 33±5% in the PCA, and 30±4% in the ICA. There were statistically significant differences in CVR values between the groups. A decrease in initial BFV in all examined intracranial arteries and a complete lack of CVR is characteristic of the CA group. Conclusions: Maintenance of CVR and a simultaneous decrease in BFV is a characteristic of the NPH group, but among the patients in that group we found differences in cerebrovascular response to acetozolamide, In both groups there were no significant differences in BFV in the MCA during the lumbar infusion test. The acetazolamide test appears as an additional factor in the differential diagnosis of NPH and CA

Nerwiak osłonkowy nerwu strzałkowego wspólnego w obrębie dołu podkolanowego. Różnicowanie z torbielami zwyrodnieniowymi

W pracy przedstawiono przypadek pacjenta z objawami neuralgii nerwu strzałkowego wspólnego i postępującym deficytem neurologicznym wywołanym przez międzypęczkowy wzrost guza o charakterze nerwiaka osłonkowego (schwannoma). W badaniu ultrasonograficznym zmianę określono jako torbiel podkolanową. W badaniu za pomocą rezonansu magnetycznego stwierdzono cechy nietypowego położenia torbieli. Podejrzewano też ganglion lub krwiak. Z uwagi na przebieg kliniczny zdecydowano o odbarczeniu pnia nerwu. Śródoperacyjnie stwierdzono guz międzypęczkowy. Metodą mikrochirurgiczną odpreparowano poszczególne pęczki nerwu i usunięto guz o morfologii nerwiaka osłonkowego. W przebiegu pooperacyjnym stwierdzono ustąpienie neuralgii i poprawę funkcji nerwu strzałkowego. Omówiono diagnostykę różnicową procesów zlokalizowanych w obrębie dołu podkolanowego. Badania obrazowe wskazywały raczej na nietypowe położenie torbieli, a nie na lity morfologicznie guz, dlatego w określeniu charakteru zmiany istotny był przebieg kliniczny. Wykonywanie dekompresji nerwu strzałkowego wspólnego w technice mikrochirurgicznej pozwala przeciwdziałać dodatkowym objawom neurologicznym w przebiegu pooperacyjnym