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Aim of the study. To evaluate the clinical and radiological consequences of delayed escalation of therapy in patients with relapsing-remitting multiple sclerosis (RRMS), in whom, despite finding platform therapy ineffective, high-efficacy drugs were introduced with a delay. Material and methods. We performed a single-centre, observational study evaluating patients with RRMS for ineffectiveness of disease-modifying therapies (DMTs). Depending on the time of therapy escalation to high-efficacy drugs, the patients were divided into an early escalation or a late escalation group, both of which were then observed for 48 months. All patients underwent a neurological examination every six months and a brain magnetic resonance imaging (MRI) every 12 months. The primary endpoint was a change in the Expanded Disability Status Scale (EDSS) score during the observation period. The secondary endpoint was the time to 6-month confirmed disability progression (6mCDP). In addition, we analysed the annualised relapse rate and the cumulative number of new Gd+ and T2 lesions on brain MRI. Results. 165 patients were qualified for the analysis. On treatment initiation, mean age was 38 years (± 10.9), and mean EDSS was 1.41 ± 0.38. After 48 months, there was a statistically insignificant decrease in the EDSS score in the early escalation group (-0.17 ± 0.35; p > 0.05), while in the late escalation group there was an increase in the EDSS score. The highest increase was noted in the group in which the escalation was performed with a delay of more than two years (1.2 ± 0.63; p < 0.001), and moreover 80% of patients in this group met the 6mCDP criteria. The median time to 6mCDP was 4.6 years (LESC1) and 4.5 years (LESC2) in the late escalation groups. In the early escalation group, zero subjects met the 6mCDP criteria after 48 months of observation. Conclusions. In everyday practice, the long-term outcomes in patients with RRMS and disease activity, despite DMT being used, are more favourable after early implementation of high-efficacy drugs. Delaying therapy escalation results in the accumulation of permanent disability in patients with RRMS. [ABSTRACT FROM AUTHOR]

Introduction and aim. There are no available objective tools for assessing dysarthric disorders in the course of multiple sclerosis (MS). The aim of the study is to analyse a case of mixed dysarthria in a 55-year-old female patient in the course of secondary progressive MS and to present the severity of the patient's dysarthric disorder in contrast with the control group as evaluated by means of an IT tool based on respiratory and phonatory examination. Description of the case. A 55-year-old patient was admitted to the Clinic of Neurology with the Stroke Unit due to a worsening condition in the course of MS. She was examined with an objective tool for respiratory and phonatory disorders. Her results were, then, compared to those of 24 healthy individuals from the control group, matched in terms of sex and age. Following speech parameters were analysed: phonetics of utterances, number of produced syllables per breath during the execution of individual texts, sound quality, intonation, and the total performance time of each. Conclusion. The analysed case indicates that the developed objective IT tool is a promising diagnostic method that can facilitate diagnosis and can be used in clinical practice. [ABSTRACT FROM AUTHOR]

Copyright of Current Neurology / Aktualno?ci Neurologiczne is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Current Neurology / Aktualno?ci Neurologiczne is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The complexity of the associations between religiosity and indicators of well-being suggests the presence of a mediating mechanism. Previous studies indicate that religion may influence subjective well-being because it helps to find meaning and purpose. Therefore, the aim of our study was to examine the mediating role of the presence and search dimensions of meaning in life in the relationship between religious meaning system and life satisfaction in patients with multiple sclerosis (MS)., Methods: This cross-sectional study included 600 MS patients recruited from Poland who completed the Satisfaction with Life Scale (SWLS), the Religious Meaning System Questionnaire (RMS) and the Meaning in Life Questionnaire (MLQ). Model 6 of Hayes PROCESS was used to test the hypotheses., Results: The results of our research indicate that there was a significant indirect effect of religious meaning system on life satisfaction through the presence of meaning in life. The specific indirect effect of religious meaning system on life satisfaction through searching for meaning in life was not significant., Discussion: The results of our study are relevant because they show that religion as a meaning system is positively related to the presence of meaning in life, which in turn positively predicts life satisfaction. This is particularly important in the case of incurable illness, where finding meaning in life is one of the natural stages of adaptation. By incorporating these findings into mental health practice, professionals can enhance the holistic well-being of people coping with MS and contribute to a more comprehensive and effective approach to mental health care., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wilski, Wnuk, Brola, Szcześniak, Żak, Sobolewski, Kapica-Topczewska, Tarasiuk, Czarnowska, Kułakowska, Zakrzewska-Pniewska, Bartosik-Psujek, Kubicka-Bączyk, Morawiec, Adamczyk-Sowa, Stepien, Jacek, Ratajczak, Ratajczak, Szałachowski, Kroplewski, Lech, Perenc, Popiel and Potemkowski.)

Aim of the Study: To evaluate the clinical and radiological consequences of delayed escalation of therapy in patients with relapsing-remitting multiple sclerosis (RRMS), in whom, despite finding platform therapy ineffective, high-efficacy drugs were introduced with a delay., Material and Methods: We performed a single-centre, observational study evaluating patients with RRMS for ineffectiveness of disease-modifying therapies (DMTs). Depending on the time of therapy escalation to high-efficacy drugs, the patients were divided into an early escalation or a late escalation group, both of which were then observed for 48 months. All patients underwent a neurological examination every six months and a brain magnetic resonance imaging (MRI) every 12 months. The primary endpoint was a change in the Expanded Disability Status Scale (EDSS) score during the observation period. The secondary endpoint was the time to 6-month confirmed disability progression (6mCDP). In addition, we analysed the annualised relapse rate and the cumulative number of new Gd+ and T2 lesions on brain MRI., Results: 165 patients were qualified for the analysis. On treatment initiation, mean age was 38 years (± 10.9), and mean EDSS was 1.41 ± 0.38. After 48 months, there was a statistically insignificant decrease in the EDSS score in the early escalation group (-0.17 ± 0.35; p > 0.05), while in the late escalation group there was an increase in the EDSS score. The highest increase was noted in the group in which the escalation was performed with a delay of more than two years (1.2 ± 0.63; p < 0.001), and moreover 80% of patients in this group met the 6mCDP criteria. The median time to 6mCDP was 4.6 years (LESC1) and 4.5 years (LESC2) in the late escalation groups. In the early escalation group, zero subjects met the 6mCDP criteria after 48 months of observation., Conclusions: In everyday practice, the long-term outcomes in patients with RRMS and disease activity, despite DMT being used, are more favourable after early implementation of high-efficacy drugs. Delaying therapy escalation results in the accumulation of permanent disability in patients with RRMS.

We describe a 39-year-old man with premature atrial contractions at rest, in whom tachycardia was exacerbated by exercise into long-lasting atrial tachycardia of 150 beats/min with changeable grade of AV conduction. The feeling of irregular heart beating was the only symptom of arrhythmia and was well tolerated for many years. However, the signs of tachycardia-mediated cardiomyopathy with heart failure developed over several years. Successful RF ablation of focal atrial tachycardia using the CARTO system was performed. After 5 months of follow-up the patient is free from arrhythmia with a significant improvement of the HF.

Unlabelled: The aim of our study was to define a predictive value of ST-segment resolution after coronary reperfusion for early and late left ventricular (LV) function. We also studied its relation to angiographic marker of myocardial reperfusion, myocardial blush grade (MBG)., Materials and Methods: Study population consisted of 105 patients (75 men, 30 women, mean age 62+/-13 years) treated with primary PTCA for anterior myocardial infarction (AMI) within 12 hours from symptoms onset. ECG was performed before - and 30 min. after PTCA. We evaluated angiographic markers of recanalization (TIMI, corrected TIMI frame count) and myocardial reperfusion - MBG. Echocardiography was performed 3 days and 6 months after AMI. Patients were divided into 2 groups regarding reduction -50% in ST segment elevation after recanalization (rST): group I (n=37) with rST, and group 2 (n=68) without rST RESULTS: In group I we noticed higher CPK level (2890,2+/-2404,2 U/I vs. 3980,9+/-2812,2 U/I, p<0,01). MB grade 3 was significantly more often found in group 1 at 29 pts (78,4%) than in group 2 at 18 pts (23,5%), p<0,0001. MG grade 0 or 1 were more often in group 2 (57,3% vs. 2,7%, p<0,01). Ejection fraction (EF) was higher in group 1 after 3 days (48,9+/-9,5% vs. 44,2+/-14,3%, p<0,01), as well as after 6 months (56,4+/-14,4% vs. 49,5+/-14,3%, p=0,001). After 6 months end-diastolic volume (EDV) was higher in group 2 (128,1+/-46,1 ml vs. 110,2+/-49,7 ml, p<0,008)., Conclusions: ST-resolution after successful PTCA is a simple and effective marker of myocardial reperfusion after recanalization which correlates with angiographic markers of tissue reperfusion. Early ST-segment resolution is connected with better early and late LV function. Patients without early ST-segment elevation resolution have a higher risk of LV remodelling.

Unlabelled: The benefit of thrombolysis in acute myocardial infarction (AMI) is time dependent, but there is lack of evidence of such a close correlation in patients undergoing primary percutaneous transluminal coronary angioplasty (pPTCA). The aim of this study was to evaluate the importance of delay of treatment for myocardial reperfusion and early and late ventricular function in patients with anterior AMI treated with pPTCA., Methods: 106 consecutive patients (76 men, 30 women, age 63 +/- 11 years) treated with pPTCA for anterior AMI was included in this study. We evaluated angiographic (myocardial blush grade (MBG), TIMI flow, corrected TIMI frame count) and electrocardiographic (resolution of ST segment elevation--nST) markers of myocardial reperfusion. Echocardiography was performed 3 and 180 days after pPTCA. End-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction were calculated. Patients were divided into three groups: group A (41 pts.) reperfused within 3 hours, group B (40 pts.) reperfused between 3-6 hours, group C (25 pts.) reperfused between 6-12 hours from symptoms onset., Results: MBG 0-1 (lack of myocardial reperfusion) was significantly more common in group B and C, compared with group A (p = 0.002). The incidence of nST was higher in group A (p < 0.0001). The EF after 3 days (p = 0.03) and after 6 months (p = 0.04) was better in group A in comparison to group C. There was not significant difference in EDV after 3 days, but after 6 months EDV was significantly higher in group C (p = 0.02)., Conclusions: The delay of treatment over 3 hours is associated with decreasing of myocardial reperfusion efficacy and deterioration of the early and late LV function.