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Background: An objective determination of the range of vocal efficiency is rather difficult. The aim of the study was to assess the possibility of application of short-term acoustic efficiency analysis in diagnosing occupational voice disorders., Material and Methods: The study covered 98 people (87 women and 11 men) diagnosed with occupational dysphonia throuigh videostroboscopic examination. The control group comprised 100 people (81 women and 19 men) with normal voices. The short-term acoustic analysis was carried out by means of DiagnoScope software, including classical parameters (Jitter group, Shimmer group and the assessment of noise degree NHR), as well as new short-term efficiency parameters determined in a short time period during sustained phonation of the vowel "a." The results were then compared. Results: The values of all the examined classical parameters were considerably higher in the study group of pathological voices than in the control group of normal voices (p = 0.00). The aerodynamic parameter, maximum phonation time, was significantly shorter by over 0.5 s in the study group than in the control group. The majority of the acoustic efficiency parameters were also considerably worse in the study group of subjects with occupational dysphonia than in the control group (p = 0.00). Moreover, the correlation between the efficiency parameters and most of the classical acoustic parameters in the study group implies that for the voices with occupational pathology the decreased efficiency of the vocal apparatus is reflected in the acoustic voice structure., Conclusions: Effliciency parameters determined during short-term acoustic analysis can be an objective indicator of the decreased phonatory function of the larnx, useful in diagnosing occupational vocal pathology.

Fibromyalgia is a disorder of the pain perception, which may, but need not be associated with depression. Modern science does not allow to put an equal sign between the two diseases. However, at least in some people, can be seen as a variant of depression, fibromyalgia. Studies indicate that 50-80 per cent, people with fibromyalgia can recognize depression. The article discusses the current state of knowledge on the role of physical activity, psychosomatic health treatments, physical therapy, relaxation techniques and education for patients with fibromyalgia. The best results, combine different therapies. The use of drugs is to reduce pain, improve mood and improve sleep quality. Various forms of drug-free treatment and help to restore the efficiency of dealing with complaints. In the treatment of fibromyalgia using different forms of therapy, tailored to the individual needs of the patient. The most common are: balneotherapy, exercise, cryotherapy, cognitive-behavioral psychotherapy and other forms of psychotherapy--in order to develop methods to combat stress and depressed mood, relaxation techniques, acupuncture, massage.

"Dual diagnosis"is usually understood as the co-occurrence of mental illness and addiction to psychoactive substances. In the last two decades can be seen an increased interest of researchers and practitioners in theoretical aspects of dual diagnosis, their means of diagnosis and planning treatment programs. Establishing a medical diagnosis may be questioned whether psychopathological symptoms are due to psychoactive substance use or are caused by mental illness. Difficulty in recognizing the problem of dual diagnosis may be questioned whether psychopathological symptoms are due to psychoactive substance use or are caused by mental illness. Mental disorders coexisting with substance use are: schizophrenia, delusional disorder, bipolar one and disorder, anxiety disorders, personality disorders. The consumption of alcohol can cause a recurrence of mental illness and contribute to the need for rehospitalization. It is important to take the history of a patient who are suspected of co-occurrence of mental illness and addiction to psychoactive substances.

Unlabelled: For optimalisation glottis morphology and its phonatory function after frontolateral laryngectomy (FLL) the reconstruction of larynx is made; in Clinic of Otolaryngology the most common is using epiglottis wit or without its vertical incision., Aim of the Study: the influence of widening laryngeal resection and epiglottis incision on shape of reconstructed glottis, level and degree of phonatory closure and perceptive--acoustic characteristic of voice and speech., Material: 39 patients (38 M and 1 F) after FLL widened of false vocal cord (n = 11), false vocal cord and part of cricoid cartilage (n = 22), whole cricoid cartilage (n = 6). Vertical incision of epiglottis was made in 31 cases. Mean age was 52 (min.-39, max.-70) years. METHODICS: videolaryngoscopic examination, subjective voice estimation using GRBAS scale, objective phonetic--acoustic voice analysis., Results: In videolaryngoscopic examination the most common shape of glottis was irregular triangle (n = 24), rhombus (n = 7), half--moon (n = 2), irregular (n = 6). 2 patients were using whisper. In spectrographic recordings (n = 39) only noise character of stimulation source was in 2 patients, noise--periodic with noise component present in whole acoustic spectrum in 37. F0 for single word and sentence vocalized in affirmative and interrogative form had the value of male voices and its changes during speaking were well noted. In subjective and objective estimation, the worse voice quality was after FLL widened of false vocal cord, part or whole cricoid cartilage., Conclusion: 1) FLL with subsequent epiglottoplasty in 94% of patients makes satisfactory morphologic and biophysical conditions for production of voice and sociological efficient speech. 2) Widening resection of false vocal cord, part or whole cricoid cartilage has unbeneficial influence on perceptive--acoustic characteristic of voice and speech.

Introduction: The authors showed findings concerning glottis morphology and perceptual-acoustic characteristics of voice and speech after partial classical (PCGLg) and extended glottic partial laryngectomy (PEGLg)., Material and Methods: 10 patients (9 M., 1 F. average age 56 (min. 47 max. 65) were examined. All patients were undergone glottic partial laryngectomy: a) classical (n = 5) b) extended of vocal process (n = 3) with (n = 2) or without (n = 1) the removal of the mucous false folds, c) extended of part of arytenoid cartilage with (n = 2) or without (n = 1) the removal of the mucous of the false folds. The following examinations were executed: phoniatric, videolaryngoscopic and perceptual-acoustic analysis., Results: After PCGLg and one extended of vocal process, voice and speech has mostly characterized of features of hypofunction dysphonia. Hyperfunction was found in patients after removal of the mucous of the false folds due to leucoplakia. In case of removing of a part of arythenoid cartilage the notable or entire standstill or lack of full phonatory closure were found. The phonetical-acoustic analysis showed that in patients using melodious voice, the character of the source of actuating was periodically-noise, with the component of noise in all range of the course of the acoustic signal of voice. The parameters such as F0, jitter, shimmer does not make coherent conclusions and are less useful in the assessment of the quality of voice., Conclusions: In case of the resection of the part of the arythenoid cartilage during glottis laryngectomy, we take into account lack of full phonatory closure and using whisper by the patients. Obtaining the reliable conclusions needs continuations of the investigations and increasing number of patients. These researches are in progress.

The aim of the study was to evaluate dynamics of selected acute phase proteins in serum and cerebrospinal fluid (CSF) in children with viral meningitis and to assess diagnostic power of protein determination for detection and treatment monitoring. 51 children with viral meningitis caused by ECHO 30 virus were included in the study group. Concentration of C-reactive protein (CRP), alpha 1-antitrypsin (AAT), alpha1-acid glycoprotein (AAG), alpha2-haptoglobin (HPT) and C3 complement fragment were determined in serum and CSF at entry and at day 14 after admittance to hospital. Control group for serum determination consisted in 30 healthy children (Group K1) and control group for CSF determination consisted in 19 hospitalized children in whom the diagnosis of meningitis was not confirmed (group K2). The greatest rise of acute phase proteins concentration was observed in children in case of HPT, AAG and C3 complement when determined in serum. Meningitis in children that was caused by ECHO 30 virus produces slight acute phase reaction that is more evident in serum than in CSF. It is confirmed by remarkable increase of AAG, HPT, C3 complement in serum and HPT in CSF either at entry or at the day 14. The determination of AAG, HPT and C3 complement in serum have diagnostic power that is strong enough to meningitis diagnostics and monitoring of treatment.

Clinical picture of Borrelia burgdorferi infection has been presented in 45 children, aged 2-16 years from Łódź region. The analysis showed significant domination of cases with affected central and peripheral nervous system (44.4%) and rather unspecific symptoms such as: fever (20%) or headache (13.3%). Peripheral cranial nerves paralysis and symptoms of cerebrospinal meningitis dominated among children with neuroborreliosis. Unlike descriptions concerning adults, majority of the observed symptoms were changes characteristic for I and II stage of the disease. Dermatosis was found only in 1 child and symptoms of arthritis in 2 of them. Contact with tick was stated in 52% of the analysed children. Incidence of the disease occurred throughout the whole year, more frequently in summer and autumn months.