Paweł Sokal - Academia.edu (original) (raw)

Papers by Paweł Sokal

Research paper thumbnail of Full spinal cord regeneration after total transection is not possible due to entropy change

Medical Hypotheses, Sep 1, 2016

Transected spinal cord regeneration is a main challenge of regenerative medicine. The mainstream ... more Transected spinal cord regeneration is a main challenge of regenerative medicine. The mainstream of research is focused on the promotion of spinal axons growth, which is strongly inhibited in mammals. Assuming that the inhibition of the axonal growth may be ever overcome, the complexity of neural reconnections may be the second serious stand to overcome. Peripheral nerve axons regeneration seem to form a random pattern of their targets reconnections. The hypothesis is that due to the laws of entropy or irreversible information loss the full spinal cord restoration after the transection is not possible. The hypothesis is discussed based on several assumptions. Simplifying the dissertation spinal cord is represented by 2millions of pyramidal axons. After the transection each of these axons has to make a growth and reconnect with exactly matching targets below the transection, in the same number. Axons are guided by neurotrophic factors and afterwards reconnected with neuroplasticity mechanisms. Assuming random reconnections, there are 2,000,000! permutations [Formula: see text] , therefore the chance of ideally random but correct reconnection of pyramidal axons with adequate targets is 1/2,000,000!. Apart from pyramidal axons, there are other axons, like extrapyramidal, sensory and associative. Empirical data and analysis of neurotrophic factors and organogenesis mechanisms may seem to slightly contradict the hypothesis, but strictly adhering to the second law of thermodynamics and entropy laws the full restoration of the transected cord may never be possible.

Research paper thumbnail of Wyniki leczenia lekoopornej depresji stymulacją lewego nerwu błędnego – opis dwóch przypadków

Neurologia I Neurochirurgia Polska, 2012

Research paper thumbnail of Health Behaviours and Spine Pain among Nursing Staff

Pielęgniarstwo Neurologiczne i Neurochirurgiczne, Dec 30, 2021

Introduction. Diseases of the musculoskeletal system are often caused by long-term and often simu... more Introduction. Diseases of the musculoskeletal system are often caused by long-term and often simultaneous influence of the work environment and individual physical factors of each human being. Healthcare workers are most at risk of suffering from musculoskeletal pain. Aim. Assessment of health behaviours and back pain among professionally active nursing team. Material and Methods. 123 active nurses participated in the study. The method of diagnostic survey was used, using standardized research tools: VAS pain scales, Oswestry questionnaire, IZZ questionnaire. Results. According to the conducted analysis, 79.7% of people experience pain; 17.1% reported ailments on an average level. The highest results were obtained by the respondents in terms of questions concerning a positive mental attitude (average value: 3.45 ± 0.59), and the lowest in terms of health practices (average value: 2.89 ± 0.64). In the case of questions about preventive behaviours, women had statistically significantly (p = 0.010) higher results than men. Conclusions. Pain in the spine concerns the majority of the surveyed nurses. In terms of their own health behaviours, the respondents paid the least attention to proper health habits. There was no correlation in pain, functional capacity and personal health behaviour.

Research paper thumbnail of Relevance of Routine Postoperative CT Scans Following Aneurysm Clipping—A Retrospective Multicenter Analysis of 423 Cases

Journal of Clinical Medicine, Nov 29, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Earthing modulates glucose and erythrocytes metabolism in exercise

International journal of physical education, sports and health, May 1, 2016

Earthing is a direct contact with the earth or indirect with the use of a metal conductor. The ea... more Earthing is a direct contact with the earth or indirect with the use of a metal conductor. The earthing eliminates potentials on body and influences physiological processes. We examined whether the earthing influences glucose, lactate and bilirubin concentration in exercise and relaxation. In a double-blind, crossover study, 42 participants divided into two groups basing on their utilization oxygen were earthed during exercise and recovery sessions. In the first experiment group A was earthed, group B unearthed, in the second experiment in the opposite way. The mean weight of participants in group A was 77, 1 and 72,8 in group B. For the earthed group, after 15min of exertion we observed a rise, after 30min decrease in glucose concentration, and in the 40min of relaxation a secondary rise. For unearthed participants, we noted a decrease in glucose concentration after 15min of exertion and a gradual rise later on. The baseline concentration of bilirubin was higher after earthing (p=0,006) in group A (0,91±0,50) than in group B (0,55±0,22) and without earthing the difference was not significant (p=0,13) in group A (0,85±0,46) and in group B (0,65±0,35). Earthing caused elevation of bilirubin concentration in group A and reduction in group B both in exercise and relaxation. It indicates that earthing modulates metabolism of erythrocytes and adjusts it to level of proper body mass as a functional dielectric. Earthing during exercise helps the training organism to mobilize plasma glucose for its muscular uptake and facilities more effective utilization in energetic processes.

Research paper thumbnail of Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent Segments

Journal of Pain Research, Jul 1, 2022

Interspinous process device (IPD) placement is an attractive treatment option for lumbar spinal a... more Interspinous process device (IPD) placement is an attractive treatment option for lumbar spinal and foraminal stenosis. The goal of the treatment is to release the stress on facets joints as well as decompress the nerve roots by enlarging the intervertebral foramina and narrowed canal recesses. Purpose: To evaluate possible structural changes in the lumbar spine after implantation of an IPD on operated and adjacent segments. Patients and Methods: Twenty-two patients were enrolled in the study. Preoperative MRI scans of the lumbar spine evaluated recess and foraminal stenosis prior to the application of an IPD. CT exams were performed and morphometric measurements were made to assess the size of intervertebral foramina after implantation on the operated and adjacent segments. Results: Statistically significant enlargements in diameter and surface area of the intervertebral foramen were seen at the operating level. On the right and left sides, foraminal enlargement after the procedure was 1 mm in diameter. The average enlargement of the foramina surface area at the level of implantation was 10 mm 2. The median interspinous distance was significantly enlarged by 3.5 mm. No significant changes in adjacent segments were observed. Clinical improvement was confirmed by the Oswestry Disability Index (ODI) and visual analog scale (VAS). Preoperative disability was reduced (mean ODI from 70.5 (12.25) to 49.5 (23.75)), as well as back pain (mean VAS from 8.0 (1.7) to 4.4 (2.6)) and pain in lower limbs (mean VAS from 7.4 (1.9) to 3.8 (2.9)). Conclusion: Decompression surgery using an IPD is effective in the treatment of lumbar foraminal and canal stenosis. It provides relief of symptoms in short-term observation through enlargement of intervertebral foramina and decompression of neural roots. It reduces overload of facet joints of the operated segment and does not decrease the size of the intervertebral foramina and disc heights of adjacent segments.

Research paper thumbnail of MGMT Promoter Methylation as a Prognostic Factor in Primary Glioblastoma: A Single-Institution Observational Study

Biomedicines

Glioblastoma is the most malignant central nervous system tumor, which represents 50% of all glia... more Glioblastoma is the most malignant central nervous system tumor, which represents 50% of all glial tumors. The understanding of glioma genesis, prognostic evaluation, and treatment planning has been significantly enhanced by the discovery of molecular genetic biomarkers. This study aimed to evaluate survival in patients with primary glioblastoma concerning O6-methylguanine–DNA methyltransferase (MGMT) promoter methylation and other clinical factors. The study included 41 newly diagnosed glioblastoma patients treated from 2011 to 2014 in the 10th Military Research Hospital and Polyclinic, Poland. All patients underwent surgical resection followed by radiation and chemotherapy with alkylating agents. The MGMT promoter methylation was evaluated in all patients, and 43% were found to be methylated. In 26 and 15 cases, gross total resection and subtotal resection were conducted, respectively. Patients with a methylated MGMT promoter had a median survival of 504 days, while those without ...

Research paper thumbnail of Reconstruction of the Frontal Aslant Tract (FAT) in patients with different types of frontal lobe tumors, considering diverse methods of delineation

The Frontal Aslant Tract (FAT) is a bundle of nerve fibers located in the brain that connects the... more The Frontal Aslant Tract (FAT) is a bundle of nerve fibers located in the brain that connects the frontal lobe to the pars aslant of Broca's area. It serves as a crucial neural pathway involved in language regulation, speech, and motor control. The FAT is part of the broader cingulo-fronto-parietal network, facilitating communication between the frontal and posterior regions of the brain. The objective of this study is to investigate the connectivity of the Frontal Aslant Tract using diffusion tensor imaging-based fiber tractography analysis. We compared the fiber count, tract length, shape, and projections of the FAT in patients with frontal tumors to a control group. Among patients diagnosed with brain tumors, we observed a reduction in the number of nerve fibers within the FAT and a decrease in pathway volume. When delineating the FAT using ROIs encompassing the superior frontal gyrus and endpoint in the pars opercularis of the inferior frontal gyrus, we obtained the highest ...

Research paper thumbnail of The application of 3D printing in neurosurgery: present and future

European Journal of Translational and Clinical Medicine

This is Open Access article distributed under the terms of the Creative Commons Attribution-Share... more This is Open Access article distributed under the terms of the Creative Commons Attribution-ShareAlike 4.0 International.

Research paper thumbnail of Comparison of the O-arm and C-arm guided pedicle screws placement

European Journal of Translational and Clinical Medicine, Dec 7, 2022

Background: Transpedicular screw placement remains the gold standard technique for stabilization ... more Background: Transpedicular screw placement remains the gold standard technique for stabilization of the lumbar spine. Material and methods: This is a retrospective study that analyzes patients that underwent the spinal stabilization surgical procedure. We compared results from two independent neurosurgical centers. In the years 2012-2015, the O-arm and StealthStation neuronavigation system was used for implantation of transpedicular screws. From 2018 to 2020 the transcutaneous pedicle screw placement procedure was performed using a standard C-arm device. Results: In 208 procedures performed with the O-arm device, the accuracy of screw position was 98.08%. Screw repositioning was necessary in 1.92% of all cases. In the 30 procedures that were performed using the C-arm, the accuracy of the screws was 86.7% and the screw reposition procedure accounted for 10% (in one case screws were not replaced due to clinical sequelae). Conclusions: Our data show that the spinal fusion with the O-arm tool has more accuracy, thus might be more indicated in procedures that require minimally invasive spinal stabilization.

Research paper thumbnail of Health-promoting Behaviours and Positive Orientation Assessment among Nurses of Neurology and Rehabilitation Departments

Pielęgniarstwo Neurologiczne i Neurochirurgiczne, Jun 30, 2022

Introduction. Health behaviours of nurses depend on external and personality factors, they are co... more Introduction. Health behaviours of nurses depend on external and personality factors, they are constantly changing under the influence of experience and acquired knowledge. Presenting the right attitudes towards health can have an impact on conducting effective health education. Aim. Assessment of health-promoting behaviour and positive orientation among nurses. Material and Methods. The research was carried out on a group of 79 nurses of the neurology and rehabilitation departments. The method of diagnostic survey was used with the use of the Health Behaviour Inventory (HBI) questionnaire, the Positive Orientation Scale questionnaire and the self-authored questionnaire. Results. In the analysis of the HBI survey, sten 5 and 4 (36 people) obtained the highest number of respondents, which define the average level of health behaviours on the border of low; the highest rated were positive mental attitude and preventive behaviour, the lowest were health practices. In the Positive Orientation Scale, the greatest number of people obtained sten 4 and 6 (31 people)-the average level of positive orientation, the majority of respondents obtained average results in terms of attitude to the future (57 people). The positive orientation results remained in a statistically significant mean correlation with the results of health behaviours and positive mental attitude, and in a low correlation with the results of health practices (p < 0.05). Conclusions. The respondents present an average level of health behaviours. Positive mental attitude and preventive behaviour were the most preferred. Most of the nurses showed a moderate level of positive orientation and an indifferent attitude to the future.

Research paper thumbnail of Structural Connectivity Reorganization Based on DTI after Cingulotomy in Obsessive–Compulsive Disorder

Brain Sciences

Bilateral cingulotomy is a procedure applied to patients with obsessive–compulsive disorder (OCD)... more Bilateral cingulotomy is a procedure applied to patients with obsessive–compulsive disorder (OCD). This report presents the structural changes occurring within the forceps minor and arcuate fascicles nerve fibers after a successful bilateral anterior cingulotomy in the patient with refractory OCD. Cingulotomy mainly affects the values of FA, MD, and ADC in the treatment of the examined nerve bundles. This structural reorganization coexists with a good clinical effect. However, it is necessary to expand the study group and to investigate the correlation between the parameters of diffusion and anisotropy and the patient's clinical condition (Y-BOCS scale).

Research paper thumbnail of Deep Brain Stimulation in Pathological Aggression

Stereotactic and Functional Neurosurgery, 2015

Background: We describe a case of deep brain stimulation in a patient with severe aggression refr... more Background: We describe a case of deep brain stimulation in a patient with severe aggression refractory to conservative treatment. The targets of the stimulation were set bilaterally in the posteromedial hypothalamus and - in a second procedure due to its ineffectiveness - in the nucleus accumbens (NAcc) bilaterally. Methods: In the first stage, we implanted electrodes into the posteromedial hypothalamus, after obtaining consent of the Bioethics Committee. In the early postoperative period, we observed significant improvement in the range of 50-90% in terms of quantity and quality of the attacks of aggression. After about 3 weeks, attacks of aggression started to return. Despite changes in the stimulation parameters there was no improvement. For this reason, based on the experience of surgery in patients with obsessive-compulsive disorder, Tourette syndrome and with morbid obesity, we decided to implant electrodes into the NAcc. Results: After 15 months of follow-up, the patient has...

Research paper thumbnail of Neurologia wieku podeszłego

Research paper thumbnail of Wyniki neuromodulacyjnego leczenia bólu przewlekłego

Background and purpose Neuromodulative treatment of chronic pain syndromes is a modern mode of tr... more Background and purpose Neuromodulative treatment of chronic pain syndromes is a modern mode of treatment of neuropathic and ischaemic pain. Its effectiveness is well documented in the literature. The objective of this work is to present the results of treatment of chronic pain syndromes on the basis of eight-year experience in our department. Material and methods Since 2002, we have conducted 9 operations of motor cortex stimulation (MCS), 2 of deep brain stimulation (DBS), 45 of spinal cord stimulation (SCS) and 5 of sacral root stimulation (SRS) in the treatment of chronic pain. Results We obtained good long-term results of neuromodulation in the form of clinical improvement (> 50%) in 4 of 9 patients with MCS (44%), in 13 diagnosed with failed back surgery syndrome (FBSS), 8 with other neuropathic pain, and 11 with angina pectoris from a group of 45 treated with SCS. Sacral root stimulation has been successful in 3 of 5 patients with perianal pain. The best treatment results i...

Research paper thumbnail of Endovascular Treatment of Stroke Caused by Carotid Artery Dissection

Brain Sciences

Ischemic stroke due to large vessel occlusion (LVO) is a devastating condition. Most LVOs are emb... more Ischemic stroke due to large vessel occlusion (LVO) is a devastating condition. Most LVOs are embolic in nature. Arterial dissection is responsible for only a small proportion of LVOs, is specific in nature and poses some challenges in treatment. We describe 3 cases where patients with stroke caused by carotid artery dissection were treated with mechanical thrombectomy and extensive stenting with good outcome. We believe that mechanical thrombectomy and stenting is a treatment of choice in these cases.

Research paper thumbnail of Wyniki monitorowania neurofizjologicznego operacji kanału kręgowego

Background and purpose Spine surgery carries the risk of neurological complications. Neurophysiol... more Background and purpose Spine surgery carries the risk of neurological complications. Neurophysiological intraoperative monitoring (NIOM) plays some role in preventing adverse events. NIOM is a young technique, and because of its costs and additional personnel it requires constant evaluation of indications. Nowadays, it is generally assumed that if available, NIOM should be used in every intracanal surgical procedure. This study aimed to evaluate the efficacy and indications for NIOM in spine surgery in relation to procedure location. Material and methods Effectiveness of NIOM in spinal canal surgery was evaluated by comparison of the number of neurological complications in patients treated surgically with and without NIOM. A total of 74 consecutive patients were surgically treated for spinal canal pathology at the Department of Neurosurgery, 10th Military Hospital in Bydgoszcz. Thirty-eight patients operated on with the use of NIOM were compared to a historic population of 36 patien...

Research paper thumbnail of The Impact of Electrical Stimulation of the Brain and Spinal Cord on Iron and Calcium-Phosphate Metabolism

Brain Sciences, 2021

Background: Deep-brain stimulation (DBS) electrically modulates the subcortical brain regions. Un... more Background: Deep-brain stimulation (DBS) electrically modulates the subcortical brain regions. Under conditions of monopolar cerebral stimulation, electrical current flows between electrode’s contacts and an implantable pulse generator, placed in the subclavicular area. Spinal cord stimulation (SCS) delivers an electrical current to the spinal cord. Epidural electrical stimulation is associated with the leakage of current, which can cause a generalized reaction. The aim of our study was to investigate whether the electrical stimulation of the cerebrum and spinal cord could have generalized effects on biochemical parameters. Materials and methods: A total of 25 patients with Parkinson’s disease (PD, n = 21) and dystonia (n = 4), who underwent DBS implantation, and 12 patients with chronic pain, who had SCS, received electrical stimulation. The blood levels of selected biochemical parameters were measured before and after overnight stimulation. Results: After DBS, the mean ± interquar...

Research paper thumbnail of Endovascular and Thrombolytic Therapy and the Functional Status of Patients after Ischemic Stroke

Pielęgniarstwo Neurologiczne i Neurochirurgiczne, Mar 29, 2019

Introduction. Stroke is treated as a direct threat to life. Mechanical thrombectomy used as an in... more Introduction. Stroke is treated as a direct threat to life. Mechanical thrombectomy used as an independent treatment or in combination with systemic thrombolysis is currently the standard care in the treatment of ischemic stroke. Aim. Evaluation of the functional status of patients after ischemic stroke treated with thrombolysis or thrombectomy. Material and Methods. The study involved 50 patients hospitalized due to ischemic stroke. Standardized research tools were used: the Rankin scale, the Barthel scale and the Functional Index "Repty" (WFR). The study was conducted twice in one patient: on the first and ninth day after the treatment. The collected material was developed statistically. Results. Most of the respondents were men-62%. Thrombolytic treatment was used in all subjects, and thrombectomy in 26% people. Analyses showed that there were differences in the Barthel scale level Z = 4.87; p < 0.001, Rankin Z = 4.80; p < 0.001 and WFR Z = 4.83; p < 0.001. The age of the respondents was related negatively to the Barthel scale score on the 1 st day ρ =-0.51; p < 0.001 and the 9 th day ρ =-0.53; p < 0.001 and the result in the WFR scale on the 1 st day ρ =-0.54; p < 0.001 and the 9 th day ρ =-0.52; p < 0.001. Conclusions. The performance of the subjects on the 1st day of treatment was worse than on the 9th day. People who were only treated with thrombolysis had better results in fitness tests and had a lower level of disability than people treated with thrombolysis and thrombectomy.

Research paper thumbnail of Does ASTRAL score at hospital admission predict symptomatic haemorrhagic transformation in acute ischaemic stroke after revascularisation? A pilot single-centre study

Neurologia i Neurochirurgia Polska, 2022

Introduction. Accurately predicting outcomes after acute ischaemic stroke (AIS) is a major clinic... more Introduction. Accurately predicting outcomes after acute ischaemic stroke (AIS) is a major clinical goal. The aim of this pilot study was to evaluate the prognostic validity and accuracy of the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) score in predicting symptomatic haemorrhagic transformation (sHT) in patients with AIS who have undergone revascularisation. Material and methods. Consecutive patients hospitalised for AIS who underwent treatment with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) were identified, and their ASTRAL scores at hospital admission were estimated. The study endpoint was sHT within 24 hours of stroke onset. The predictive performance of the ASTRAL score was investigated through logistic regression analysis and discrimination and calibration tests. Results. Sixty-eight AIS patients, with a median age of 69 (58-79) years, were included. sHT occurred in 20 (29.4%) of the 68 patients. The ASTRAL score was significantly higher in patients who developed sHT compared to non-sHT patients [36 (34-38) versus 24 (17-32); p<0.001]. The ASTRAL score was an independent predictor of sHT, and showed good discriminative power (area under the curve 0.88; 95% confidence interval, 0.789-0.965). Conclusions and clinical implications. ASTRAL score is an independent predictor of sHT and shows high predictive accuracy in patients with AIS. Future studies are warranted to confirm these results.

Research paper thumbnail of Full spinal cord regeneration after total transection is not possible due to entropy change

Medical Hypotheses, Sep 1, 2016

Transected spinal cord regeneration is a main challenge of regenerative medicine. The mainstream ... more Transected spinal cord regeneration is a main challenge of regenerative medicine. The mainstream of research is focused on the promotion of spinal axons growth, which is strongly inhibited in mammals. Assuming that the inhibition of the axonal growth may be ever overcome, the complexity of neural reconnections may be the second serious stand to overcome. Peripheral nerve axons regeneration seem to form a random pattern of their targets reconnections. The hypothesis is that due to the laws of entropy or irreversible information loss the full spinal cord restoration after the transection is not possible. The hypothesis is discussed based on several assumptions. Simplifying the dissertation spinal cord is represented by 2millions of pyramidal axons. After the transection each of these axons has to make a growth and reconnect with exactly matching targets below the transection, in the same number. Axons are guided by neurotrophic factors and afterwards reconnected with neuroplasticity mechanisms. Assuming random reconnections, there are 2,000,000! permutations [Formula: see text] , therefore the chance of ideally random but correct reconnection of pyramidal axons with adequate targets is 1/2,000,000!. Apart from pyramidal axons, there are other axons, like extrapyramidal, sensory and associative. Empirical data and analysis of neurotrophic factors and organogenesis mechanisms may seem to slightly contradict the hypothesis, but strictly adhering to the second law of thermodynamics and entropy laws the full restoration of the transected cord may never be possible.

Research paper thumbnail of Wyniki leczenia lekoopornej depresji stymulacją lewego nerwu błędnego – opis dwóch przypadków

Neurologia I Neurochirurgia Polska, 2012

Research paper thumbnail of Health Behaviours and Spine Pain among Nursing Staff

Pielęgniarstwo Neurologiczne i Neurochirurgiczne, Dec 30, 2021

Introduction. Diseases of the musculoskeletal system are often caused by long-term and often simu... more Introduction. Diseases of the musculoskeletal system are often caused by long-term and often simultaneous influence of the work environment and individual physical factors of each human being. Healthcare workers are most at risk of suffering from musculoskeletal pain. Aim. Assessment of health behaviours and back pain among professionally active nursing team. Material and Methods. 123 active nurses participated in the study. The method of diagnostic survey was used, using standardized research tools: VAS pain scales, Oswestry questionnaire, IZZ questionnaire. Results. According to the conducted analysis, 79.7% of people experience pain; 17.1% reported ailments on an average level. The highest results were obtained by the respondents in terms of questions concerning a positive mental attitude (average value: 3.45 ± 0.59), and the lowest in terms of health practices (average value: 2.89 ± 0.64). In the case of questions about preventive behaviours, women had statistically significantly (p = 0.010) higher results than men. Conclusions. Pain in the spine concerns the majority of the surveyed nurses. In terms of their own health behaviours, the respondents paid the least attention to proper health habits. There was no correlation in pain, functional capacity and personal health behaviour.

Research paper thumbnail of Relevance of Routine Postoperative CT Scans Following Aneurysm Clipping—A Retrospective Multicenter Analysis of 423 Cases

Journal of Clinical Medicine, Nov 29, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Earthing modulates glucose and erythrocytes metabolism in exercise

International journal of physical education, sports and health, May 1, 2016

Earthing is a direct contact with the earth or indirect with the use of a metal conductor. The ea... more Earthing is a direct contact with the earth or indirect with the use of a metal conductor. The earthing eliminates potentials on body and influences physiological processes. We examined whether the earthing influences glucose, lactate and bilirubin concentration in exercise and relaxation. In a double-blind, crossover study, 42 participants divided into two groups basing on their utilization oxygen were earthed during exercise and recovery sessions. In the first experiment group A was earthed, group B unearthed, in the second experiment in the opposite way. The mean weight of participants in group A was 77, 1 and 72,8 in group B. For the earthed group, after 15min of exertion we observed a rise, after 30min decrease in glucose concentration, and in the 40min of relaxation a secondary rise. For unearthed participants, we noted a decrease in glucose concentration after 15min of exertion and a gradual rise later on. The baseline concentration of bilirubin was higher after earthing (p=0,006) in group A (0,91±0,50) than in group B (0,55±0,22) and without earthing the difference was not significant (p=0,13) in group A (0,85±0,46) and in group B (0,65±0,35). Earthing caused elevation of bilirubin concentration in group A and reduction in group B both in exercise and relaxation. It indicates that earthing modulates metabolism of erythrocytes and adjusts it to level of proper body mass as a functional dielectric. Earthing during exercise helps the training organism to mobilize plasma glucose for its muscular uptake and facilities more effective utilization in energetic processes.

Research paper thumbnail of Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent Segments

Journal of Pain Research, Jul 1, 2022

Interspinous process device (IPD) placement is an attractive treatment option for lumbar spinal a... more Interspinous process device (IPD) placement is an attractive treatment option for lumbar spinal and foraminal stenosis. The goal of the treatment is to release the stress on facets joints as well as decompress the nerve roots by enlarging the intervertebral foramina and narrowed canal recesses. Purpose: To evaluate possible structural changes in the lumbar spine after implantation of an IPD on operated and adjacent segments. Patients and Methods: Twenty-two patients were enrolled in the study. Preoperative MRI scans of the lumbar spine evaluated recess and foraminal stenosis prior to the application of an IPD. CT exams were performed and morphometric measurements were made to assess the size of intervertebral foramina after implantation on the operated and adjacent segments. Results: Statistically significant enlargements in diameter and surface area of the intervertebral foramen were seen at the operating level. On the right and left sides, foraminal enlargement after the procedure was 1 mm in diameter. The average enlargement of the foramina surface area at the level of implantation was 10 mm 2. The median interspinous distance was significantly enlarged by 3.5 mm. No significant changes in adjacent segments were observed. Clinical improvement was confirmed by the Oswestry Disability Index (ODI) and visual analog scale (VAS). Preoperative disability was reduced (mean ODI from 70.5 (12.25) to 49.5 (23.75)), as well as back pain (mean VAS from 8.0 (1.7) to 4.4 (2.6)) and pain in lower limbs (mean VAS from 7.4 (1.9) to 3.8 (2.9)). Conclusion: Decompression surgery using an IPD is effective in the treatment of lumbar foraminal and canal stenosis. It provides relief of symptoms in short-term observation through enlargement of intervertebral foramina and decompression of neural roots. It reduces overload of facet joints of the operated segment and does not decrease the size of the intervertebral foramina and disc heights of adjacent segments.

Research paper thumbnail of MGMT Promoter Methylation as a Prognostic Factor in Primary Glioblastoma: A Single-Institution Observational Study

Biomedicines

Glioblastoma is the most malignant central nervous system tumor, which represents 50% of all glia... more Glioblastoma is the most malignant central nervous system tumor, which represents 50% of all glial tumors. The understanding of glioma genesis, prognostic evaluation, and treatment planning has been significantly enhanced by the discovery of molecular genetic biomarkers. This study aimed to evaluate survival in patients with primary glioblastoma concerning O6-methylguanine–DNA methyltransferase (MGMT) promoter methylation and other clinical factors. The study included 41 newly diagnosed glioblastoma patients treated from 2011 to 2014 in the 10th Military Research Hospital and Polyclinic, Poland. All patients underwent surgical resection followed by radiation and chemotherapy with alkylating agents. The MGMT promoter methylation was evaluated in all patients, and 43% were found to be methylated. In 26 and 15 cases, gross total resection and subtotal resection were conducted, respectively. Patients with a methylated MGMT promoter had a median survival of 504 days, while those without ...

Research paper thumbnail of Reconstruction of the Frontal Aslant Tract (FAT) in patients with different types of frontal lobe tumors, considering diverse methods of delineation

The Frontal Aslant Tract (FAT) is a bundle of nerve fibers located in the brain that connects the... more The Frontal Aslant Tract (FAT) is a bundle of nerve fibers located in the brain that connects the frontal lobe to the pars aslant of Broca's area. It serves as a crucial neural pathway involved in language regulation, speech, and motor control. The FAT is part of the broader cingulo-fronto-parietal network, facilitating communication between the frontal and posterior regions of the brain. The objective of this study is to investigate the connectivity of the Frontal Aslant Tract using diffusion tensor imaging-based fiber tractography analysis. We compared the fiber count, tract length, shape, and projections of the FAT in patients with frontal tumors to a control group. Among patients diagnosed with brain tumors, we observed a reduction in the number of nerve fibers within the FAT and a decrease in pathway volume. When delineating the FAT using ROIs encompassing the superior frontal gyrus and endpoint in the pars opercularis of the inferior frontal gyrus, we obtained the highest ...

Research paper thumbnail of The application of 3D printing in neurosurgery: present and future

European Journal of Translational and Clinical Medicine

This is Open Access article distributed under the terms of the Creative Commons Attribution-Share... more This is Open Access article distributed under the terms of the Creative Commons Attribution-ShareAlike 4.0 International.

Research paper thumbnail of Comparison of the O-arm and C-arm guided pedicle screws placement

European Journal of Translational and Clinical Medicine, Dec 7, 2022

Background: Transpedicular screw placement remains the gold standard technique for stabilization ... more Background: Transpedicular screw placement remains the gold standard technique for stabilization of the lumbar spine. Material and methods: This is a retrospective study that analyzes patients that underwent the spinal stabilization surgical procedure. We compared results from two independent neurosurgical centers. In the years 2012-2015, the O-arm and StealthStation neuronavigation system was used for implantation of transpedicular screws. From 2018 to 2020 the transcutaneous pedicle screw placement procedure was performed using a standard C-arm device. Results: In 208 procedures performed with the O-arm device, the accuracy of screw position was 98.08%. Screw repositioning was necessary in 1.92% of all cases. In the 30 procedures that were performed using the C-arm, the accuracy of the screws was 86.7% and the screw reposition procedure accounted for 10% (in one case screws were not replaced due to clinical sequelae). Conclusions: Our data show that the spinal fusion with the O-arm tool has more accuracy, thus might be more indicated in procedures that require minimally invasive spinal stabilization.

Research paper thumbnail of Health-promoting Behaviours and Positive Orientation Assessment among Nurses of Neurology and Rehabilitation Departments

Pielęgniarstwo Neurologiczne i Neurochirurgiczne, Jun 30, 2022

Introduction. Health behaviours of nurses depend on external and personality factors, they are co... more Introduction. Health behaviours of nurses depend on external and personality factors, they are constantly changing under the influence of experience and acquired knowledge. Presenting the right attitudes towards health can have an impact on conducting effective health education. Aim. Assessment of health-promoting behaviour and positive orientation among nurses. Material and Methods. The research was carried out on a group of 79 nurses of the neurology and rehabilitation departments. The method of diagnostic survey was used with the use of the Health Behaviour Inventory (HBI) questionnaire, the Positive Orientation Scale questionnaire and the self-authored questionnaire. Results. In the analysis of the HBI survey, sten 5 and 4 (36 people) obtained the highest number of respondents, which define the average level of health behaviours on the border of low; the highest rated were positive mental attitude and preventive behaviour, the lowest were health practices. In the Positive Orientation Scale, the greatest number of people obtained sten 4 and 6 (31 people)-the average level of positive orientation, the majority of respondents obtained average results in terms of attitude to the future (57 people). The positive orientation results remained in a statistically significant mean correlation with the results of health behaviours and positive mental attitude, and in a low correlation with the results of health practices (p < 0.05). Conclusions. The respondents present an average level of health behaviours. Positive mental attitude and preventive behaviour were the most preferred. Most of the nurses showed a moderate level of positive orientation and an indifferent attitude to the future.

Research paper thumbnail of Structural Connectivity Reorganization Based on DTI after Cingulotomy in Obsessive–Compulsive Disorder

Brain Sciences

Bilateral cingulotomy is a procedure applied to patients with obsessive–compulsive disorder (OCD)... more Bilateral cingulotomy is a procedure applied to patients with obsessive–compulsive disorder (OCD). This report presents the structural changes occurring within the forceps minor and arcuate fascicles nerve fibers after a successful bilateral anterior cingulotomy in the patient with refractory OCD. Cingulotomy mainly affects the values of FA, MD, and ADC in the treatment of the examined nerve bundles. This structural reorganization coexists with a good clinical effect. However, it is necessary to expand the study group and to investigate the correlation between the parameters of diffusion and anisotropy and the patient's clinical condition (Y-BOCS scale).

Research paper thumbnail of Deep Brain Stimulation in Pathological Aggression

Stereotactic and Functional Neurosurgery, 2015

Background: We describe a case of deep brain stimulation in a patient with severe aggression refr... more Background: We describe a case of deep brain stimulation in a patient with severe aggression refractory to conservative treatment. The targets of the stimulation were set bilaterally in the posteromedial hypothalamus and - in a second procedure due to its ineffectiveness - in the nucleus accumbens (NAcc) bilaterally. Methods: In the first stage, we implanted electrodes into the posteromedial hypothalamus, after obtaining consent of the Bioethics Committee. In the early postoperative period, we observed significant improvement in the range of 50-90% in terms of quantity and quality of the attacks of aggression. After about 3 weeks, attacks of aggression started to return. Despite changes in the stimulation parameters there was no improvement. For this reason, based on the experience of surgery in patients with obsessive-compulsive disorder, Tourette syndrome and with morbid obesity, we decided to implant electrodes into the NAcc. Results: After 15 months of follow-up, the patient has...

Research paper thumbnail of Neurologia wieku podeszłego

Research paper thumbnail of Wyniki neuromodulacyjnego leczenia bólu przewlekłego

Background and purpose Neuromodulative treatment of chronic pain syndromes is a modern mode of tr... more Background and purpose Neuromodulative treatment of chronic pain syndromes is a modern mode of treatment of neuropathic and ischaemic pain. Its effectiveness is well documented in the literature. The objective of this work is to present the results of treatment of chronic pain syndromes on the basis of eight-year experience in our department. Material and methods Since 2002, we have conducted 9 operations of motor cortex stimulation (MCS), 2 of deep brain stimulation (DBS), 45 of spinal cord stimulation (SCS) and 5 of sacral root stimulation (SRS) in the treatment of chronic pain. Results We obtained good long-term results of neuromodulation in the form of clinical improvement (> 50%) in 4 of 9 patients with MCS (44%), in 13 diagnosed with failed back surgery syndrome (FBSS), 8 with other neuropathic pain, and 11 with angina pectoris from a group of 45 treated with SCS. Sacral root stimulation has been successful in 3 of 5 patients with perianal pain. The best treatment results i...

Research paper thumbnail of Endovascular Treatment of Stroke Caused by Carotid Artery Dissection

Brain Sciences

Ischemic stroke due to large vessel occlusion (LVO) is a devastating condition. Most LVOs are emb... more Ischemic stroke due to large vessel occlusion (LVO) is a devastating condition. Most LVOs are embolic in nature. Arterial dissection is responsible for only a small proportion of LVOs, is specific in nature and poses some challenges in treatment. We describe 3 cases where patients with stroke caused by carotid artery dissection were treated with mechanical thrombectomy and extensive stenting with good outcome. We believe that mechanical thrombectomy and stenting is a treatment of choice in these cases.

Research paper thumbnail of Wyniki monitorowania neurofizjologicznego operacji kanału kręgowego

Background and purpose Spine surgery carries the risk of neurological complications. Neurophysiol... more Background and purpose Spine surgery carries the risk of neurological complications. Neurophysiological intraoperative monitoring (NIOM) plays some role in preventing adverse events. NIOM is a young technique, and because of its costs and additional personnel it requires constant evaluation of indications. Nowadays, it is generally assumed that if available, NIOM should be used in every intracanal surgical procedure. This study aimed to evaluate the efficacy and indications for NIOM in spine surgery in relation to procedure location. Material and methods Effectiveness of NIOM in spinal canal surgery was evaluated by comparison of the number of neurological complications in patients treated surgically with and without NIOM. A total of 74 consecutive patients were surgically treated for spinal canal pathology at the Department of Neurosurgery, 10th Military Hospital in Bydgoszcz. Thirty-eight patients operated on with the use of NIOM were compared to a historic population of 36 patien...

Research paper thumbnail of The Impact of Electrical Stimulation of the Brain and Spinal Cord on Iron and Calcium-Phosphate Metabolism

Brain Sciences, 2021

Background: Deep-brain stimulation (DBS) electrically modulates the subcortical brain regions. Un... more Background: Deep-brain stimulation (DBS) electrically modulates the subcortical brain regions. Under conditions of monopolar cerebral stimulation, electrical current flows between electrode’s contacts and an implantable pulse generator, placed in the subclavicular area. Spinal cord stimulation (SCS) delivers an electrical current to the spinal cord. Epidural electrical stimulation is associated with the leakage of current, which can cause a generalized reaction. The aim of our study was to investigate whether the electrical stimulation of the cerebrum and spinal cord could have generalized effects on biochemical parameters. Materials and methods: A total of 25 patients with Parkinson’s disease (PD, n = 21) and dystonia (n = 4), who underwent DBS implantation, and 12 patients with chronic pain, who had SCS, received electrical stimulation. The blood levels of selected biochemical parameters were measured before and after overnight stimulation. Results: After DBS, the mean ± interquar...

Research paper thumbnail of Endovascular and Thrombolytic Therapy and the Functional Status of Patients after Ischemic Stroke

Pielęgniarstwo Neurologiczne i Neurochirurgiczne, Mar 29, 2019

Introduction. Stroke is treated as a direct threat to life. Mechanical thrombectomy used as an in... more Introduction. Stroke is treated as a direct threat to life. Mechanical thrombectomy used as an independent treatment or in combination with systemic thrombolysis is currently the standard care in the treatment of ischemic stroke. Aim. Evaluation of the functional status of patients after ischemic stroke treated with thrombolysis or thrombectomy. Material and Methods. The study involved 50 patients hospitalized due to ischemic stroke. Standardized research tools were used: the Rankin scale, the Barthel scale and the Functional Index "Repty" (WFR). The study was conducted twice in one patient: on the first and ninth day after the treatment. The collected material was developed statistically. Results. Most of the respondents were men-62%. Thrombolytic treatment was used in all subjects, and thrombectomy in 26% people. Analyses showed that there were differences in the Barthel scale level Z = 4.87; p < 0.001, Rankin Z = 4.80; p < 0.001 and WFR Z = 4.83; p < 0.001. The age of the respondents was related negatively to the Barthel scale score on the 1 st day ρ =-0.51; p < 0.001 and the 9 th day ρ =-0.53; p < 0.001 and the result in the WFR scale on the 1 st day ρ =-0.54; p < 0.001 and the 9 th day ρ =-0.52; p < 0.001. Conclusions. The performance of the subjects on the 1st day of treatment was worse than on the 9th day. People who were only treated with thrombolysis had better results in fitness tests and had a lower level of disability than people treated with thrombolysis and thrombectomy.

Research paper thumbnail of Does ASTRAL score at hospital admission predict symptomatic haemorrhagic transformation in acute ischaemic stroke after revascularisation? A pilot single-centre study

Neurologia i Neurochirurgia Polska, 2022

Introduction. Accurately predicting outcomes after acute ischaemic stroke (AIS) is a major clinic... more Introduction. Accurately predicting outcomes after acute ischaemic stroke (AIS) is a major clinical goal. The aim of this pilot study was to evaluate the prognostic validity and accuracy of the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) score in predicting symptomatic haemorrhagic transformation (sHT) in patients with AIS who have undergone revascularisation. Material and methods. Consecutive patients hospitalised for AIS who underwent treatment with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) were identified, and their ASTRAL scores at hospital admission were estimated. The study endpoint was sHT within 24 hours of stroke onset. The predictive performance of the ASTRAL score was investigated through logistic regression analysis and discrimination and calibration tests. Results. Sixty-eight AIS patients, with a median age of 69 (58-79) years, were included. sHT occurred in 20 (29.4%) of the 68 patients. The ASTRAL score was significantly higher in patients who developed sHT compared to non-sHT patients [36 (34-38) versus 24 (17-32); p<0.001]. The ASTRAL score was an independent predictor of sHT, and showed good discriminative power (area under the curve 0.88; 95% confidence interval, 0.789-0.965). Conclusions and clinical implications. ASTRAL score is an independent predictor of sHT and shows high predictive accuracy in patients with AIS. Future studies are warranted to confirm these results.