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Brain tumors account for 1% of all cancers diagnosed de novo. Due to the specificity of the anatomical area in which they grow, they can cause significant neurological disorders and lead to poor functional status and disability. Regardless of the results of biochemical markers of intracranial neoplasms, they are currently of no diagnostic significance. The aim of the study was to use LC-ESI-MS/MS in conjunction with multivariate statistical analyses to examine changes in amino acid metabolic profiles between patients with glioblastoma, meningioma, and a group of patients treated for osteoarthritis of the spine as a control group. Comparative analysis of amino acids between patients with glioblastoma, meningioma, and the control group allowed for the identification of statistically significant differences in the amino acid profile, including both exogenous and endogenous amino acids. The amino acids that showed statistically significant differences (lysine, histidine, α-aminoadipic acid, phenylalanine) were evaluated for diagnostic usefulness based on the ROC curve. The best results were obtained for phenylalanine. Classification trees were used to build a model allowing for the correct classification of patients into the study group (patients with glioblastoma multiforme) and the control group, in which cysteine turned out to be the most important amino acid in the decision-making algorithm. Our results indicate amino acids that may prove valuable, used alone or in combination, toward improving the diagnosis of patients with glioma and meningioma. To better assess the potential utility of these markers, their performance requires further validation in a larger cohort of samples.

Brain tumors cause widespread apprehension in society, associated with poor prognosis and death. Laymen most often associate them with glioblastoma multiforme which is in fact the most common malignant primary brain tumor (formerly it was considered the most common primary brain tumor, now it is thought that meningiomas are the most common). The interest of both the public and physicians is aroused by potential brain tumors risk factors. The only evidence based risk factor is ionizing radiation of head and neck. Other risk factors are also under consideration, however are not conclusive and different studies give different results. Given the widespread apprehension of brain tumors, knowledge of the risk factors seems obvious. In this manuscript, we have reviewed the current state of knowledge aboutf risk factors based on research. They confirm that apart from ionizing radiation, the existence of other risk factors is considered: cell phones, electromagnetic field, occupational exposure to raw meat, viruses. However, all these risk factors are not confirmed by reference results.

We present the case of a 54-year-old patient with long-term type 2 diabetes, treated with intensive insulin therapy, who was considered to be ordinary diabetes. In a random imaging examination it turned out to be a phaeochromocytoma. The patient underwent surgical treatment. It turned out that after the surgery, the diabetes resolved. It is a casuistic curiosity that the patient was "cured" of the disease after diagnosis and treatment for pheochromocytoma, and on the second day after the surgery. It is also a valuable guide when looking for all possible causes of "secondary" diabetes.

We present a brief report on the different types of skull bone prostheses used in cranioplasty. Skull defects, most often resulting from severe head injuries, have been known since the times of Ancient Egypt. Ethnographic reports indicate that at that time the skull defects were restored with golden plates. In the following centuries of medical development, especially in modern centuries, cranioplasty has been performed more widely. Cranioplasty began to be performed also in defects after craniectomy. Such craniectomies have been performed for treatment brain hemorrhages, strokes, tumors with severe edema. A common dilemma is whether artificial prostheses are better or own bone material. We present a brief historical overview and the actual state based on the procedures performed in our neurosurgical department in Collegium Medicum in Bydgoszcz.

We present a short article on the actual state of functioning of neurosurgical departments, performing neurosurgical procedures during the COVID-19 pandemic on the example of our department - Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery of Ludwik Rydygier Collegium Medicum of Nicolaus Copernicus University. The pandemic disrupted so far, proper work of neurosurgical departments and put neurosurgeons in a new reality. Despite the widespread exacerbation of spine diseases, they were pushed to the background. Many neurosurgical departments have been converted into COVID-19 isolation departments. We present a brief report on the actual state of the work of neurosurgeons and that a year after the pandemic began, the work of neurosurgical departments is still disrupted and the prospect of performing non-urgent neurosurgical procedures is uncertain.

We present the current state of affairs regarding the legal claims of patients after cranioplasty operations who are dissatisfied with the treatment effect and have claims that the perioperative course is unfavorable. In the period of 11 years (2010-2020), 2 legal claims were submitted in our neurosurgical center after cranioplasty. Both are civil claims. One of them about purulent infection of the bone prosthesis was found by the judgment to be unfounded. The second one concerning the alleged general condition deterioration as a consequence of cranioplasty has been declared obsolete. A cranioplasty is a surgical procedure used to correct a defect in a bone of the skull. It is not urgent sugery and is performed in patients who had been previously in serious condition. The same medical staff who previously saved the live of patients by performing brain decompression may be subject of legal claims in the case of cranioplasty. Thus, according to authors, claims of patients regarding the alleged negative effects of cranioplasty is an interesting psychological phenomenon. Authors epmhasized that cranioplasty should be considered as a procedure of increased risk of potential legal claims for medical staff.

Taekwondo has become a very popular sport in Poland and around the world, and training in this martial art begins with young children. Taekwondo trainings are organized in kindergartens and schools, clubs and master classes are organized in sports schools, and children take part in competitions. Taekwondo, like any martial art, carries a potential risk of injury. According to the literature, lower limb injuries are the most common, as in taekwondo the lower limbs are mainly used. Head and spine injuries as a result of falls are also described. The author emphasizes that despite the injuries described in the literature and the frequency of occurrence defined as about 2.5 - 8%, injuries in the sports school in Bydgoszcz are significantly less frequent. The author also points out that there are also injuries (fractures) of the upper limbs, which are ignored by numerous international publications. Despite this, it should be emphasized that taekwondo is a safe sport discipline. Its prevalence among school children is a favorable phenomenon.

The authors present a comparative analysis of the issue of legal consents for surgical procedures between Ethiopia and Poland. The analysis is based on the procedures performed as part of the Polish medical mission "Polish Medical Team Helping Hand". As part of this project, the authors performed ten surgical procedures for percutaneous spine stabilization in soldiers injured during the war with gunshots of the spine and after falling from a height. All soldiers signed informed written consent to the procedure. However, the authors noticed a significant role of additional oral/ verbal (not written) information in discussing the details of the procedure, which in Polish hospitals must be in writing for formal and legal reasons. The authors conclude that while the written consent for surgical treatment is key and necessary both in Poland and in Ethiopia, in the case of medical procedures performed in Ethiopia, oral communication between the doctor and patients and oral explanations are more binding even regardless of the language barrier.

We present a short article on the actual state of education and didactics in the Department of Neurosurgery during the COVID-19 pandemic. The pandemic disrupted the education of students in the 2019/2020 and 2020/2020 academic years. From March 2020, there are no traditional classes with students and they have been deprived the possibility of patients examining and participating in surgical procedures. Only on-line classes are conducted by the use of Microsoft Teams and by e-mail contact. We emphasize that this is unprecedented situation in history of clinical medicine education. We also affirm difficulty of surgical medical specializations training by e-learning. Due to the practical nature of neurosurgery, we provide numerous neuroimaging and videos of surgical procedures using Microsoft Teams. The effects of on-line education of surgical sciences, including neurosurgery, can be assessed after a longer period of time. Currently, in the new reality that surprised unexpectedly medical academics in 2020, we are unable to interpret it.

Brain tumors are often manifested by mental disorders. Changes in personality, behavior and logical functions are often the dominant pathological symptoms in patients with brain tumors. There are also cases where brain tumors occur in patients with psychotic disorders or mental retardation and in these particular cases, they aggravate the already advanced mental disability. As a result, patients with brain tumors are often intellectually disabled and it is not possible to perform informed consent to treatment. In clinical practice, those patients who require neurosurgical treatment must give their informed consent, and when it is not possible, the judicial consent must be adjudicated. In urgent cases, medical decision on surgery is necessary in algorithm of life saving surgery, due to size of tumor and brain edema. We present the current state of knowledge and the facts about neurosurgical prcedures performed in patients with brain tumors without obtaining informed consent. We analyze the medical, legal and organizational status, pay attention to the nuances and the need for outstanding clinical experience in such a delicate matter. Clinical experience and legal awareness is essential for a qualifying neurosurgeon.

Extensive ossification of the falx cerebri occur rarely however are described in the world literature references. Ossifications may concern both cerebral falx and other dural structures: tentorium. They are most often incidental findings and occurrence frequency in the population is remains unclear. The authors of the study are reviewing references on this subject, based on a case of extensive falx ossification. Manuscript describes the case of incidental detected of extensive calcification of the anterior brain sickle in a patient after head injury. Computed tomography revealed no pathology, but extensive ossification of falx was described. The patient did not complain of any significant complaints or neurological symptoms. The described calcification constituted a median and sagittal bone or calcium plate separating the frontal lobes of the brain. Analyzing references did not identify such extensive ossification of falx cerebri in human, however dural ossifications are reported in the references.

Cervical discopathy is an important medical problem widespread in society. Symptoms are often upper limbs radicular pain, local pain in the cervical spine, and vetrebrobasilar cerebrovascular insufficiency. In the case of ineffective conservative treatment and severe pressure on nerve structures, surgical treatment is indicated. Cervical discopathy is most common at the age of 30 - 60 with a predominance of women. The authors of this manuscript analyzed the medical data of patients operated on due to cervical discopathy on their own material. Cervical discopathy was found to be more common in women, which is consistent with world references. A relationship was found between cervical myelopathy and critical spinal canal stenosis and C4-C5 stenosis. Stenosis on C3-C4 has also been rare in female patients and more common in men. Obtained data on own material are generally consistent with reports from world literature and constitute its complement in reference to the region of the Kuyavian-Pomeranian Voivodeship.

People over the age of 90 are hospitalized in neurosurgical departments, and the increase of life expectancy is conducive to such cases. Surgical treatment in older people is always at high risk, which may be due to the frailty syndrome that occurs. Qualification for surgical treatment of neurosurgical disorders in the elderly is not undertaken in the same way as in the younger population. This manuscript analyzes the patients in the 10th decade of life who were surgically treated at the neurosurgery clinic in 2019. It was shown that most of them were life threatening conditions. The most frequently operated disease was acute subdural hematoma, slightly less often chronic subdural hematoma and only a few cases of lumbar spine procedures. The analysis of patients treated surgically in comparison to patients not qualified for surgery because of other potenially neurosurgical diseases clearly indicates that surgical treatment of these patients is definitely rare.

The Hepatocyte Growth Factor is a strong mitogenic factor and seems to play important role in tumor angiogenesis. The purpose of this study was to analyse the plasma concentration of this factor in patients treated surgically because of intracranial tumors. The study included 47 patients, both sexes treated surgically for intracranial tumors and 30 adult volunteers of both sexes, without cancer diagnosis. In study group 4 measurements of plasma HGF were taken: measurement 1: within 24 hours to 1 hour before the operation (preoperative), measurement 2: on the first day after the operation, i.e. after 24 hours, measurement 3: between the third and fifth day following the treatment, i.e. within 72–120 hours, and measurement 4: on the seventh day after the operation, i.e. after 840 hours. In control group only one measurement was taken. The distribution of the analyzed parameters was different from the normal distribution, therefore nonparametric statistics were used. The result values are presented in the form of a median (Me). The analysis revealed that HGR plasma levels in the patients with intracranial tumors in all 4 measurements (Me1 = 543.16 pg/ml, Me2 = 762.59 pg/ml, Me3 = 819.82 pg/ml, Me4 = 804.82 pg/ml) in the perioperative period were elevated in comparison to healthy subjects (Me = 361.04 pg/ml). The association has been shown to exist between postoperative HGF plasma levels and the clinical condition of patients with intracranial tumors (p = 0.0342). Postoperative HGF levels correlated negatively with the patients’ postoperative condition. It was also found that in patients with supratentorial tumors HGF plasma levels were higher (Me = 557.74 pg/ml) in comparison to patients with posterior fossa tumors (Me = 325.00 pg/ml). These results suggest increased angiogenic and mitogenic activity in patients with intracranial tumors and its even greater intensity in the postoperative period. Greater angiogenic activity appears to occur in patients with supratentorial tumors.

We present a short preliminary report about the use of vacuum - assisted closure in infected and purulent wounds treatment after neurosurgical spinal procedures. Our report is based on the currently treated patients and points out to other neurosurgeons this therapeutic possibility. We are currently treating two severely injured patients in bad functional state. These patients had severe spine injuries and were therefore treated surgically by decompression and fusion. Patient No. 1 had C5 burst fracture treated by anterior and posterior stabilization, while patient No. 2 had Th4 burst fracture treated with posterior transpedicular stabilization. The patients developed purulent surgical site infection. Revision and wounds irrigation were ineffective. Desire to leave titanium implants in patient’s spines (which is important for future rehabilitation), it was decided to use V.A.C® in wounds healing. We find that vacuum - assisted closure appears to be of significant benefit in such treatment. It is a good therapeutic option in the management of such patients; however, this issue requires more extensive research in the future.

Horse riding (equestrianism) is a very old form of physical activity, and today it has become a very popular sport and recreation. Similarly to other sports, equestrianism carries potential risk of injuries, most often caused by a fall from a horse back. Horse riding can cause spine and brain injuries, which are treated by neurosurgeons. Both brain and spine injuries can potentially be life - threatening or cause severe disability. In our neurosurgical center, horse - related injuries accounted for 7.69% of all sports - related injuries. We treated 4 girls in total: 3 with spinal injuries, 1 with brain injuries. Girls with spine injuries were treated conservatively, and girls with brain injuries - surgically. All patients had good prognosis. We have reviewed the literature about horse - related trauma. Literature showed that they occurred more often in young age patients and mainly in girls, which was consistent with our observations. Numerous authors emphasized the protecting role helmets. The authors emphasized the key role of education and proper care of coach. Although the literature described some fatal horse - related injuries, in our material all patients were healed and returned to a perfect clinical state.

Herbal medicine has accompanied man since the dawn of time. For various ailments and health problems, help was sought in the surrounding nature. Ancient civilizations have greatly contributed to the development of phytotherapy, identifying and describing numerous species of medicinal plants. Plant raw materials have become the foundation of medieval medicine. The revival in herbal medicine has been observed since the sixth century with the emergence of monasteries, where the gardens in which the medicinal plants were grown were established. Monastic schools were also established, monks broadened their skills by studying and copying ancient books, preparing medicines of natural origin according to secret prescriptions used to heal the sick. Although the Middle Ages are often considered dark ages, many achievements of the then phytotherapy have been recorded on the pages of history and a man use them to this day.

So-called nootropics include a diverse group of drugs whose idea is to improve brain function. They are quite commonly accepted among the elderly. Although currently available data from the literature do not show unequivocally the efficacy of these drugs, in practice a large number of patients are in practice. These drugs are prescribed to patients fairly commonly and the range of indications for their use is wide and non-specific. This publication presents the mechanism of action of these nootropic drugs, historical outline of their use and epidemiological data on their use in elderly patients on the basis of patients treated in the Department of Geriatrics of Medical University in Bydgoszcz.

Lumbar pain syndromes of the spine can also be referred to as the pain of the cross. These ailments have now become epidemics of our time. In literature, these pain are referred to as localized ailments that are located in the lumbar, lumbosacral, and cross-iliac areas. Cross pains are a very general term because there are a multitude of factors that cause lumbar disc herniation. This problem poses great diagnostic difficulties. [4]. The nature of these ailments is often difficult to pinpoint by the patient, but it can be the pain that describes patients from blunt, piercing, biting, baking, to those that are termed cold feeling. Keep in mind that the location of the lumbar pain symptoms varies. Patients report pain that is located throughout the lumbar-sacral area or only on one side of the spine, or occurs only in the area of the hip joints. These complaints often radiate along the lower limb. They are often the result of a lack of proper spine prevention: they contribute to this poor body posture, improper sleep positioning, as well as lack of coping skills, as well as a bad diet. In daily life, it is important to remember to do your daily activities in the correct position as well as to use prevention to avoid pain in the lumbar area.

Entrapment neuropahies of upper limbs can cause mainly nocturnal neuropathic pain and impaired manual dexterity. The most common entrapment neuropathy is carpal tunnel syndrome and ulnar groove syndrome - ulnar nerve entrapment at the elbow. Treatment of entrapment neuropathies is both analgetic therapy and physiotherapy. In the cases of conservative treatment inefficiencies surgical decompression of nerves is performed. Authors of this oublication present results of both conservative and surgical of entrapment neuropathies in patients over 65 years old. Among the 17 patients with entraoment neuropathies 12 of them underwent surgical treatment. Achieved partial improvement in pain, mostly nocturnal and improving the quality of life and dexterity. In comparison, however, a group of younger patients who underwent surgery for the improvement was less spectacular, which may testify advancement and irreversibility of changes in older patients.

Siminska Joanna, Przybylska Sara, Ratuszek–Sadowska Dorota, Siedlecki Zygmunt, Grzyb Sebastian, Nowacka Krystyna, Hagner Wojciech. Wysokościowy obrzęk płuc oraz wysokościowy obrzęk mózgu w chorobie wysokogórskiej - rozpoznanie, postępowanie i leczenie = High altitude pulmonary edema and high altitude cerebral edema in high-mountain disease - diagnosis, proceedings and treatment. Journal of Education, Health and Sport. 2016;6(11):390-397. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.168416 http://ojs.ukw.edu.pl/index.php/johs/article/view/4012 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.11.2016. Revised 12.11.2016. Accepted: 24.11.2016. Wysokościowy obrzęk płuc oraz wysokościowy obrzęk mózgu w chorobie wysokogórskiej - rozpoznanie, postępowanie i leczenie High altitude pulmonary edema and high altitude cerebral edema in high-mountain disease - diagnosis, proceedings and treatment Joanna Siminska1, Sara Przybylska2, Dorota Ratuszek – Sadowska1, Zygmunt Siedlecki3, Sebastian Grzyb3, Krystyna Nowacka1, Wojciech Hagner1 1 Katedra i Klinika Rehabilitacji Collegium Medicum im. L. Rydygiera w Bydgoszczy Uniwersytet Mikołaja Kopernika w Toruniu 2 Studenckie Koło Naukowe Dydaktyki Ratownictwa i Fizjoterapii Pourazowej Collegium Medicum im. L. Rydygiera w Bydgoszczy Uniwersytet Mikołaja Kopernika w Toruniu 3 Klinika Neurochirurgii, Neurotraumatologii i Neurochirurgii Dziecięcej Collegium Medicum im. L. Rydygiera w Bydgoszczy Uniwersytet Mikołaja Kopernika w Toruniu Streszczenie W obecnych czasach dość dużą popularnością cieszy się wspinaczka wysokogórska. Coraz więcej osób chce zostać zdobywcami wysokich szczytów. Zapominają przy tym o odpowiednim przygotowaniu i zachowaniu zasad które nierzadko kończą się pojawieniem u nich choroby wysokogórskiej oraz towarzyszącym jej wysokościowemu obrzękowi płuc i wysokościowemu obrzękowi mózgu. Wszystkie trzy choroby związane są z niewłaściwą adaptacją organizmu do ciśnienia panującego na dużych wysokościach. Pojawiają się symptomy które początkowo bagatelizowane z czasem stają się stanem zagrożenia życia. Chcąc w bezpieczny i odpowiedni sposób zdobyć coraz to wyższe pułapy należy odpowiednio przygotować się do tego. Należy także poznać podstawowe objawy chorób które mogą się pojawić oraz czas i wysokość w jakiej występują. Słowa klucze: choroba wysokogórska, wysokogórski obrzęk płuc, wysokogórski obrzęk mózgu. Abstract In the present time quite popular is climbing. More and more people want to be winners of high peaks. Forget the right preparation and principles which often end with the advent of high-mountain disease with them, and accompanying it high altitude and high-mountain of the brain. All three diseases are related to incorrect adaptation of the body to the pressure of high altitudes. Appear symptoms that initially underestimated the time become a life-threatening condition. If you want to in a safe and appropriate manner to get ever higher ceilings you should prepare for this. You must also learn basic symptoms of diseases that can occur, and the time and the amount in which they appear. Key words: disease of the Alpine mountain, pulmonary edema, high mountain swelling of the brain.

Główczewska-Siedlecka Emilia, Mądra-Gackowska Katarzyna, Nowacka Krystyna, Siedlecki Zygmunt, Szostak Mateusz, Kędziora‑Kornatowska Kornelia. Przewlekły krwiak podtwardówkowy u chorej przyjętej do Kliniki Geriatrii z powodu postępującego otępienia - opis przypadku = Chronic subdural hematoma in patient admitted to Geriatric Department because of progressive dementia - case report. Journal of Education, Health and Sport. 2016;6(11):398-403. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.168426 http://ojs.ukw.edu.pl/index.php/johs/article/view/4015 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.11.2016. Revised 12.11.2016. Accepted: 25.11.2016. Przewlekły krwiak podtwardówkowy u chorej przyjętej do Kliniki Geriatrii z powodu postępującego otępienia - opis przypadku Chronic subdural hematoma in patient admitted to Geriatric Department because of progressive dementia - case report Główczewska-Siedlecka Emilia1, Mądra-Gackowska Katarzyna1, Nowacka Krystyna2, Siedlecki Zygmunt3, Szostak Mateusz3, Kędziora-Kornatowska Kornelia1 1. Katedra i Klinika Geriatrii, Collegium Medicum im. L. Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu 2. Katedra i Klinika Rehabilitacji, Collegium Medicum im. L. Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu 3. Klinika Neurochirurgii, Neurotraumatologii i Neurochiurgii Dziecięcej, Collegium Medicum im. L. Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu Streszczenie Przewlekłe krwiaki podtwardówkowe są schorzeniem typowym dla osób wieku podeszłym, objawiać się mogą zaburzeniem funkcji poznawczych, co u starszych chorych wymaga różnicowania z postępującym otępieniem. W niniejszej publikacji przedstawiony jest przypadek 85-letniej chorej przyjętej do Kliniki Geriatrii CM UMK w Bydgoszczy z powodu objawów postępującego otępienia. Badania psychologiczne wykazały istotne odchylenia w zakresie funkcji poznawczych. W badaniu TK głowy wykazano obecność rozległego przewlekłego krwiaka przymózgowego. Chora została poddana leczeniu operacyjnemu drogą trepanacji otworkowej. Przebieg okołooperacyjny był niepowikłany. Dwa tygodnie po zabiegu zaobserwowano poprawę w zakresie funkcji poznawczych. Opisany przypadek dowodzi znaczenia, jakie przewlekłe krwiaki podtwardówkowe odgrywają wśród chorych leczonych na oddziałach geriatrycznych. Słowa kluczowe: przewlekły krwiak podtwardówkowy, otępienie, geriatria Abstract Chronic subdural hematomas (CSDH) are typical for elderly people, its symptoms can be cognitive impairment, which in older patients require differentiation of the progressive dementia. In this publication, we presented a case of 85-year-old patient admitted to the Department of Geriatrics of CM UMK in Bydgoszcz with symptoms of progressive dementia. Psychological tests showed significant cognitive impairment. The CT scan revealed the presence of extensive CSH. The patient underwent surgical treatment through burrhole. Perioperatively no complitations happened. Two weeks later improvement in cognitive function was observed. This case improved the importance of CSDH in geriatrics. Key words: CSDH, dementia, geriatrics

Główczewska-Siedlecka Emilia, Mądra-Gackowska Katarzyna, Nowacka Krystyna, Simińska Joanna, Siedlecki Zygmunt, Szostak Mateusz, Kędziora-Kornatowska Kornelia. Zastosowanie plastrowania dynamicznego u chorych wieku podeszłym po leczeniu operacyjnym stenozy zwyrodnieniowej kanału kręgowego i dyskopatii lędźwiowej = The application of Kinesio Taping in eldery patients after surgical treatment of lumbar spinal stenosis and disc herniation. Journal of Education, Health and Sport. 2016;6(12):222-229. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.197908 http://ojs.ukw.edu.pl/index.php/johs/article/view/4051 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 22.11.2016. Revised 28.11.2016. Accepted: 09.12.2016. Zastosowanie plastrowania dynamicznego u chorych wieku podeszłym po leczeniu operacyjnym stenozy zwyrodnieniowej kanału kręgowego i dyskopatii lędźwiowej The application of Kinesio Taping in eldery patients after surgical treatment of lumbar spinal stenosis and disc herniation Główczewska-Siedlecka Emilia1, Mądra-Gackowska Katarzyna1, Nowacka Krystyna2, Simińska Joanna2, Siedlecki Zygmunt3, Szostak Mateusz3, Kędziora‑Kornatowska Kornelia1 1. Katedra i Klinika Geriatrii, Collegium Medicum im. L. Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu 2. Katedra i Klinika Rehabilitacji, Collegium Medicum im. L. Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu 3. Klinika Neurochirurgii, Neurotraumatologii i Neurochiurgii Dziecięcej, Collegium Medicum im. L. Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu Streszczenie Plastrowanie dynamiczne (ang. Kinesio Taping) jest coraz bardziej popularną metodą leczenia zespołów bólowych mięśniowo - szkieletowych oraz kręgosłupa. Może być to pojedyncza metoda leczenia zachowawczego oraz wspomaganie innych. Plastrowanie można stosować jako uzupełnienie kinezyterapii, terapii manualnej oraz po zabiegach neurochirurgicznych kręgosłupa, jako uzupełnienie postępowania pooperacyjnego. Niniejsza praca przedstawia wyniki plastrowania chorych w wieku podeszłym po operacjach z obrębie kręgosłupa lędźwiowego. Pacjentom w grupie badanej naklejono plastry Kinesio Taping w pierwszej dobie po zabiegu. Uzyskano zmniejszenie bólu po zabiegu operacyjnym w grupie stosującej plastrowanie dynamiczne. W grupie kontrolnej dolegliwości bólowe po zabiegu były większe niż w grupie badanej, co dowodzi że Kinesio Taping może być stosowany z powodzeniem u chorych w wieku podeszłym po leczeniu operacyjnym w obrębie kręgosłupa lędźwiowego. Słowa kluczowe: Kinesio Taping, geriatria, dyskopatia lędźwiowa, stenoza zwyrodnieniowa, zespoły bólowe kręgosłupa Abstract Kinesio Taping is popular method of treating musculo - skeletal pain and low back pain. This can be a single method of conservative treatment or can support other methods like physiotherapy, manual therapy or after neurosurgical spine procedures. The study presents results of Kinesio Taping in eldery, geriatric patients after surgical treatment of lumbar spine comparing to eldery patients after neurosurgical procedures without Kinesio Taping. Patients in the study group had applied Kinesio Taping the first day post op. The pain relief after surgery in the group using Kinesio Taping was observed. In the control group pain after surgery they were greater than those in the study group, which proves that Kinesio Taping can be used successfully in eldery patients after surgery of lumbar spine. Key words: Kinesio Taping, geriatrics, lumbar discopathy, lumbar spinal stenosis, low back pain

Główczewska-Siedlecka Emilia, Mądra-Gackowska Katarzyna, Jaroch Alina, Nowacka Krystyna, Siedlecki Zygmunt, Szostak Mateusz, Kędziora‑Kornatowska Kornelia. Zespół słabości powikłany złamaniami kompresyjnymi kręgów i silnymi zespołami bólowymi kręgosłupa - analiza przypadków z propozycją postępowania terapeutycznego = Frailty syndrome with compression spine factures and severe back pain - the clinical analysis and suggested treatment. Journal of Education, Health and Sport. 2016;6(12):536-542. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.213480 http://ojs.ukw.edu.pl/index.php/johs/article/view/4086 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 754 (09.12.2016). 754 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.12.2016. Revised 12.12.2016. Accepted: 19.12.2016. Zespół słabości powikłany złamaniami kompresyjnymi kręgów i silnymi zespołami bólowymi kręgosłupa - analiza przypadków z propozycją postępowania terapeutycznego Frailty syndrome with compression spine factures and severe back pain - the clinical analysis and suggested treatment Główczewska-Siedlecka Emilia1, Mądra-Gackowska Katarzyna1, Jaroch Alina1, Nowacka Krystyna2, Siedlecki Zygmunt3, Szostak Mateusz3, Kędziora‑Kornatowska Kornelia1 1. Katedra i Klinika Geriatrii, Collegium Medicum im. L. Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu 2. Katedra i Klinika Rehabilitacji, Collegium Medicum im. L. Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu 3. Klinika Neurochirurgii, Neurotraumatologii i Neurochiurgii Dziecięcej, Collegium Medicum im. L. Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu Streszczenie Niniejsza praca omawia przypadki 8 chorych hospitalizowanych w Klinice Geriatrii CM UMK z rozpoznanym wg kryteriów Fried zespołem słabości. U badanych chorych zaobserwowano spadek masy ciała w ciągu ostatniego roku, cechy depresji wg skali CES-D, spowolnienie chodu oraz, osłabienie siły mięśniowej oraz bóle kręgosłupa o nasileniu 9 VAS. W badaniach obrazowych kręgosłupa rozpoznano złamania kompresyjne kręgów, które poddano zabiegowi wertebroplastyki uzyskując poprawę w zakresie bólu, następnie u chorych wdrożono rehabilitację ambulatoryjną oraz dietę wysokobiałkową, po około 3 miesiącach u każdego chorego uzyskano istotną poprawę stanu klinicznego. Chorzy przestali spełniać kryteria Fried, co dowodzi tego że kompleksowe i często wielodyscyplinarne postępowanie korzystnie wpływa na leczenie starszych chorych z zespołem słabości. Słowa kluczowe: zespół słabości, złamanie kompresyjne kręgu, dieta, rehabilitacja, wertebroplastyka Abstract Authors present the cases of 8 patients treated in the Department of Geriatrics of CM UMK with frailty syndrome diagnosed. Patients showed a weight loss during the last year, signs of depression in CES-D scale, gait downturn, muscle weakness and severe back pain - 9 VAS. By imaging study the spinal fractures were diagnosed and patients underwent vertebroplasty obtaining good recovery in pain. Then patients have been implemented rehabilitation and high-protein diet. After about 3 months for each patient a significant clinical improvement was achieved. Patients no longer meet the Fried’s criteria for frailty. This proves that this complex and often multi-disciplinary proceeding is beneficial for the treatment of elderly patients with frailty syndrome. Key words: frailty, spine copression fracture, diet, rehabilitaion, vertebroplasty

Siminska Joanna, Pietkun Katarzyna, Siedlecki Zygmunt, Grzyb Sebastian, Nowacka Krystyna, Hagner Wojciech, Grobelska Kinga, Beuth Wojciech. Znaczenie diagnostyki i leczenia trombolitycznego w udarze nieokrwiennym mózgu = The importance of diagnosis and treatment thrombolytic in ischemic stroke. Journal of Education, Health and Sport. 2016;6(8):363-374. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.60602 http://ojs.ukw.edu.pl/index.php/johs/article/view/3766 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.08.2016. Revised 08.08.2016. Accepted: 19.08.2016. ZNACZENIE DIAGNOSTYKI I LECZENIA TROMBOLITYCZNEGO W UDARZE NIEOKRWIENNYM MÓZGUTHE IMPORTANCE OF DIAGNOSIS AND TREATMENT THROMBOLYTIC IN ISCHEMIC STROKE Siminska Joanna1, Pietkun Katarzyna1,2, Siedlecki Zygmunt3, Grzyb Sebastian3, Nowacka Krystyna1,6, Hagner Wojciech1,6, Grobelska Kinga4, Beuth Wojciech5,6 1 Katedra i Klinika Rehabilitacji Collegium Medicum w Bydgoszczy 2 Katedra Kosmetologii i Dermatologii Estetycznej Collegium Medicum w Bydgoszczy3 Klinika Neurochirurgii i Neurotraumatologii i Neurochirurgii Dziecięcej Collegium Medicum w Bydgoszczy 4 Klinika Medycyny Ratunkowej Collegium Medicum w Bydgoszczy 5 Wojewódzki Szpital Specjalistyczny we Włocławku 6 Kujawska Szkoła Wyższa we Włocławku Streszczenie W pracy przedstawiono aktualne zasady postępowania przedszpitalnego podejmowanego przez zespół ratownictwa medycznego i postępowania wczesnoszpitalnego, które ma wpływ na dalszy proces leczenia. Przedstawiono również zastosowanie leczenia trombolityczego w tzw. Złotej godzinie udarowej. Należy mieć na uwadze, że każde minuty, które odraczają podjęcie właściwego leczenia udaru niedokrwiennego mózgu przyczyniają się do uniemożliwienia wdrożenia nowoczesnych, specyficznych metod leczenia ( leczenie trombolityczego). Słowa kluczowe: badania diagnostyczne, postępowanie ratunkowe, udar mózgu. Summary The paper presents the current rules of conduct undertaken by a team of prehospital emergency medical services and conduct prehospital, which has an impact on the further process of treatment. It also presents the use of the treatment thrombolysis. Golden time of impact. It should be noted that every minute that defer taking the proper treatment of ischemic stroke contribute to preventing the implementation of modern, specific treatment (treatment thrombolysis.) Key words: diagnostic tests, emergency procedures, stroke.

Siminska Joanna, Pietkun Katarzyna, Głowacka Iwona, Beuth Wojciech, Nowacka Krystyna, Hagner Wojciech, Siedlecki Zygmunt. Przegląd zaleceń postępowania fizjoterapeutycznego stosowanego w bólu kręgosłupa w odcinku lędźwiowym = Overview of recommendations physiotherapy used for spinal pain in the lumbar region. Journal of Education, Health and Sport. 2016;6(8):454-466. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.60914 http://ojs.ukw.edu.pl/index.php/johs/article/view/3780 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.08.2016. Revised 08.08.2016. Accepted: 19.08.2016. PRZEGLĄD ZALECEŃ POSTĘPOWANIA FIZJOTERAPEUTYCZNEGO STOSOWANEGO W BÓLU KRĘGOSŁUPA W ODCINKU LĘDŹWIOWYM OVERVIEW OF RECOMMENDATIONS PHYSIOTHERAPY USED FOR SPINAL PAIN IN THE LUMBAR REGION Siminska Joanna1, Pietkun Katarzyna1,2, Głowacka Iwona1, Beuth Wojciech4,5, Nowacka Krystyna1,5, Hagner Wojciech1,5, Siedlecki Zygmunt3 1 Katedra i Klinika Rehabilitacji Collegium Medicum w Bydgoszczy 2 Katedra Kosmetologii i Dermatologii Estetycznej Collegium Medicum w Bydgoszczy 3 Klinika Neurochirurgii i Neurotraumatologii i Neurochirurgii Dziecięcej Collegium Medicum w Bydgoszczy 4 Wojewódzki Szpital Specjalistyczny we Włocławku 5 Kujawska Szkoła Wyższa we Włocławku Streszczenie Zespoły bólowe lędźwiowego odcinka kręgosłupa określane są również jako bóle kręgosłupa/ krzyża. Obecnie dolegliwości bólowe kręgosłup szczególnie w odcinku lędźwiowym stały się epidemią naszych czasów. Według A. Nowakowskiego określa się nimi dolegliwości, które zlokalizowane w okolicy lędźwiowej, lędźwiowo- krzyżowej i krzyżowo- biodrowej. Bóle krzyża jest to nazwa ogólna, gdyż występuje mnogość czynników, które powodują schorzenia odcinka lędźwiowego. Dolegliwość ta stwarza duże trudności diagnostyczne i jest obecnie ,,krzyżem dla lekarza” a co za tym idzie także fizjoterapeuty.[11] Charakter bólowy dolegliwości jest często trudny do określenia dla pacjenta. Charakterystycznie występują bóle począwszy od tępych, przeszywających, świdrujących, piekących, po takie, które wywołują odczucie lodowatego zimna. Lokalizacja objawów bólowych bywa różna. Chorzy zgłaszają bóle, które zlokalizowane są w całej okolicy lędźwiowo- krzyżowej lub tylko po jednej stronie kręgosłupa, bądź w okolicy stawów krzyżowo- biodrowych. Często promieniują wzdłuż jednej kończyny dolnej.[11] Większość ludzi, nie zdając sobie sprawy z przykrych konsekwencji, codziennie naraża swój kręgosłup na niebezpieczeństwo. Najczęściej schorzenia te są wynikiem braku dbałości o swój kręgosłup : złej postawy, nieodpowiedniego ułożenia podczas snu , braku umiejętności radzenia sobie ze stresem, złej diety. Nie można przecież jednak przestać dźwigać czy wykonywać czynności dnia codziennego, nie unikniemy też stresu. Słowa kluczowe: ból kręgosłupa, odcinek lędźwiowy kręgosłupa, rehabilitacja. Summary Pain syndromes of the lumbar spine are also referred to as back pain / cross. Currently, pain spine especially in the lumbar region have become epidemic of our time. According to A. Nowakowski defines them problems, which are located in the lumbar region, lumbar and sacral iliac cross flow. Low back pain is a generic name, because there is a multitude of factors that cause the disease of the lumbar. This condition creates great difficulties in the diagnosis and is now ,, cross for the doctor, "and thus also a physiotherapist. [11] The nature of pain symptoms is often difficult to determine the patient. Characteristically they are pain from the blunt, piercing, piercing, stinging, to those which produce the feeling of glacial cold. Location pain symptoms sometimes vary. Patients report pain, which are located throughout the area lumbar sacral or only on one side of the spine, or in the vicinity of the hip joint cross flow. Often radiate along one lower limb. [11] Most people unaware of the unpleasant consequences, every day puts your spine at risk. The most common diseases are the result of lack of attention to your spine: bad posture, improper alignment during sleep, lack of ability to cope with stress, poor diet. We can not, however, stop to carry or perform activities of daily life, not avoid or stress. Key words: pain in the spine, lumbar spine, rehabilitation.

Miszewski Waldemar, Miszewska Agnieszka, Śniegocki Maciej, Siedlecki Zygmunt, Grzyb Sebastian, Siminska Joanna, Pietkun Katarzyna, Głowacka Iwona, Nowacka Krystyna, Hagner Wojciech. The comparison of the therapeutic massage with the craniosacral method in treating the pain syndrome of the cranial part of the spine. Journal of Education, Health and Sport. 2016;6(4):249-270. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.50158 http://ojs.ukw.edu.pl/index.php/johs/article/view/3467 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.03.2016. Revised 17.04.2016. Accepted: 17.04.2016. The comparison of the therapeutic massage with the craniosacral method in treating the pain syndrome of the cranial part of the spine Waldemar Miszewski1, Agnieszka Miszewska3, Maciej Śniegocki2, Zygmunt Siedlecki2, Sebastian Grzyb2, Joanna Siminska1, Katarzyna Pietkun1, Iwona Głowacka1, Krystyna Nowacka1, Wojciech Hagner1 1 Department of Rehabilitation CM UMK Bydgoszcz 2 Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery 3 University of Bydgoszcz, Bydgoszcz Key words: classic massage, craniosacral therapy, pains, of the cervical part of the spine. Summary Massage has been used for several thousand years at least, aiming at relief in suffering and decreasing all kinds of ailments, including health problems with the cervical vertebrae. Craniosacral therapy is quite a new method of treatment since it was founded in the first half of the 20th century. It is different from other methods because it treats energetic changes and lessens the pathological tension in the fascia. Whereas, other methods used by physiotherapists begin working with the patient much later, after functional changes have advanced – contractures or structural degenerations, which cannot be fully removed. And the organism will not be able to come back to full efficiency. Pains of the cervical part of the spine occur quite often in modern societies, including the Polish one. What is more, this troubles younger and younger people. The results of the research conducted on two groups of twenty people, which were described by Method T – Student, proved that both the therapeutic massage and the craniosacral therapy are effective ways of treating the pain syndrome of the cranial part of the spine.