Przegla̧d lekarski
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ADHD occurs in 3% of school-age children (and in 70% of them in adulthood) and represents an important medical and social problem. It is characterized by attention deficits, hyperactivity and impulsiveness. Neurofeedback therapy (EEG biofeedback, NF) is carried out based on the analysis of EEG. ⋯ Neurofeedback therapy is a valuable tool with beneficial impact on children with ADHD and accompanying disorders. Characteristics of brain bioelectric activity provides a reliable basis to establish individual EEG bio-feedback protocols of therapy in children and monitor the effectiveness of treatment. In the last 4 years the number of children with ADHD and cooccurring tics who applied for neurofeedback therapy has increased significantly.
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Despite the signs of involvement of autonomic nervous system (ANS) in the pathomechanism of migraine, the significance of its dysfunction was not fully explained. One of parameters serving to establish a balance of both ANS parts is relation of low frequency (LF) to high frequency (HF) heart rate variability (HRV), LF/ HF ratio. HF reflects parasympathetic activity, whereas LF both sympathetic and parasympathetic as well as respiratory rhythm. ⋯ Predominance of sympathetic nervous system activity during passive head-up tilt test, as well as more common postural orthostatic tachycardia syndrome in patients with migraine with sensory aura as compared with children with migraine with visual aura and healthy volunteers indicate differential autonomic reactivity. False positive result of passive tilting in healthy children may suggest a higher risk of syncope recurrence. In spite of poor orthostatic tolerance reported by patients with migraine, active standing did not reveal differences between migraine patients and healthy volunteers.
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Epidemiology of acquired valvular heart diseases has changed significantly over last decades. Degenerative aortic valve stenosis is the most common acquired valvular disease with high prevalence in elderly population. Another common disorder is ischemic mitral regurgitation secondary to myocardial infarction. ⋯ Discussion about pregnancy should be a part of management of young women with valvular heart disease. Severe valve disorders should be corrected when planning pregnancy. The final management should always be based on collaborative decision made by the patient and health professionals.
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One of the frequently encountered problems in the statistical analysis of the data is the correct interpretation of the effects occurring under the influence of some kind of treatment used by the researcher or appearing without its share of action. In the first case we are dealing with an experimental study, in the second with the observational study. ⋯ In the case of an observational study, also called a retrospective study there are often additional factors that modify both assigned to the same groups as well as specific actions for the test results. The article presents an example of the cause of this phenomenon and selected methods of minimizing the mentioned influence.
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Randomized Controlled Trial
[Preemptive local anesthetic infiltration in hallux valgus one-day surgery].
The surgical treatment of hallux valgus deformity is connected with significant postoperative pain. Spinal and general anesthesia as well as peripheral blocks are successfully used in foot surgery. The purpose of this study was to evaluate the influence of local anesthetic infiltration before hallux valgus one-day surgery on postoperative pain and the need for analgesics. ⋯ Preemptive local anesthetic infiltration in one-day hallux valgus surgery significantly decreases postoperative pain. It is safe, efficient and allows fast discharge.