The aim of this study is the assessment of the regional cerebral oximetry - NIRS (near infrared spectroscopy) as an intraoperative monitoring system to protect the patient against the incidents of brain desaturations. We hypothesize that patients monitored with NIRS present a smaller range of postoperative cognitive dysfunctions (POCD) in comparison with those without NIRS monitoring during lumbar spine surgery in a prone position. This study was performed at the Clinical Department of Neurosurgery and Oncology of the Central Nervous System, Medical University of Lodz, Poland. The study completed 43 adult patients qualified for the surgical treatment of lumbar spondylosis. Before the procedures they were randomized into two subgroups: one monitored intraoperatively by means of NIRS cerebral oximetry (INVOS 5100), which numbered 13 patients – 30.2% (13 NIRS devices were made available to the authors) and the other without NIRS intraoperative monitoring, totaling 30 people – 69.8%. The patients who presented a history of psychiatric, neurological and cardiovascular disorders which impair cognitive processes were disqualified from the study. A comprehensive battery of neuropsychological tests was preoperatively performed on all patients. The subjects were then divided into two groups: with and without NIRS monitoring. Both groups were statistically homogeneous. Computerized anesthesia records were used to obtain intraoperative data: mean arterial pressure, heart rate, pulsoximetry and cerebral regional oxygenation. The depth of anesthesia monitor was not used. Besides, all the patients passed the same battery of neurocognitive tests 7 days and 1 month postoperatively. The Mann-Whitney test was performed to compare POCD and therefore assess the usefulness of NIRS as a monitoring mechanism during anesthesia in the prone position. There was a significant (p < 0.05) difference in the presence of cognitive deficiencies between the subgroup monitored with NIRS and the subgroup without NIRS. It included: Digit Span Test overall score and forward repetition score 7 days after operation, N- back Test results after 30 days in version 0 "back" - time, N-back Test version 1 "back" results in the number of correct answers and the number of errors. NIRS cerebral oximetry may be useful in reducing postoperative cognitive complications in patients operated on in the prone positioning. RNN/556/08/KB – approval of the ethics committee at Medical University of Lodz, Poland.

The assessment of risk factors is a crucial step in the prevention and treatment of affective disorders and should encompass personal dispositions. The aim of this study was to assess the value of chronotype and temperament as independent predictors of depressive symptoms among medical students. The study surveyed 140 students of the Faculty of Medicine with a battery of questionnaires: the Beck Depression Index (BDI), Hypomania Checklist 32 (HCL-32), Pittsburgh Sleep Quality Index (PSQI), Chronotype Questionnaire and Eysenck Personality Questionnaire Revised. The results were tested using Pearson’s correlation quotient and general linear model. Ten percent of the participants demonstrated a BDI score suggestive of clinically significant depressive symptoms. BDI score correlated positively with HCL-32 score. A rise in BDI was independently predicted by elevated Neuroticism and PSQI scores and morningness. Those effects were independent from each other and from other parameters of the model. The presence of depressive symptoms might be associated with bipolar features among medical students. Poor sleep quality predicted depressive symptoms, similarly to Neuroticism and independently of temperament and chronotype. Future studies on the associations between personal dispositions and mood disorders among medical students are required to help identify those at greater risk of developing affective illness. Effective prophylaxis and early intervention are warranted to ensure better treatment results.

Burnout is a pathological syndrome in which emotional exhaustion (EE), depersonalization (DEP), and a reduced sense of personal accomplishment (PA) develop in response to prolonged occupational stress. Those working in the physiotherapy profession appear to be at risk for professional burnout brought on by the specific character of the medical professions, involving continuous contact with patients and associated stress, as well as poor working conditions. However, literature data concerning the scale of professional burnout and its psychosocial correlates remain scarce. The aim of the present study was to assess the scale of professional burnout among physiotherapists and to determine the interrelationships between coping styles and burnout symptoms. The sample consisted of 117 professionally active physiotherapists (90 women and 27 men) aged 21 to 55 years (mean [M] 31.88, standard deviation [SD] = 9.14, responsiveness rate of 80.6%) from randomly selected medical institutions of the Lodz Region. The study was conducted using the Maslach Burnout Inventory (MBI) and Coping Inventory for Stressful Situations (CISS) by Endler and Parker. Demographic and job-related data on the respondents were also collected. Task-oriented coping correlated negatively with DEP, EE, and low PA, in contrast to emotion-oriented coping. No correlation was found between avoidance-oriented coping and burnout symptoms. Similarly, no interactive correlations between coping styles and particular burnout symptoms were confirmed. Coping styles correlate independently with professional burnout, without any mutual correlations. Physiotherapists employing a wider spectrum of task-oriented strategies are slightly more satisfied with their job. The incidence of burnout syndrome in the analyzed group is similar to that observed in other medical professions and requires the adoption of preventive measures.

Niepełnosprawność wzrokowa doświadczana od urodzenia lub najmłodszych lat życia może prowadzić do zaburzeń emocjonalnych i psychospołecznych. Istnieją doniesienia opisujące obecność symptomów charakterystycznych dla autyzmu u 11-40% dzieci z dysfunkcjami wzroku. Celem pracy jest przedstawienie dotychczasowych wyników badań dotyczących współwystępowania cech autystycznych i niepełnosprawności wzrokowej u dzieci oraz opis wybranych narzędzi do diagnozy autyzmu w tej grupie. Dotychczas nie potwierdzono jednoznacznie związku między zaburzeniami widzenia u dzieci a występowaniem cech autystycznych. W diagnozowaniu psychiatryczno-psychologicznym dzieci z niepełnosprawnością wzrokową istnieją duże trudności w odróżnieniu blindyzmów od cech typowych dla zachowań autystycznych, wynikające m.in. z braku standaryzowanych narzędzi diagnostycznych dostosowanych dla dzieci z niepełnosprawnością wzrokową. Kolejnymi trudnościami, na jakie napotykają praktycy w diagnozowaniu opisywanych problemów to współwystępowanie innych niepełnosprawności w przypadku większości dzieci z dysfunkcją wzroku. Dodatkowo poza trudnościami w diagnozowaniu zaburzeń autystycznych u dzieci z dysfunkcją wzroku pojawiają się pytania, jakie narzędzia wykorzystać w terapii i rehabilitacji tej grupy.

Eveningness has been associated with poor sleep quality and depression. However, chronotype has also been shown to be a multidimensional construct, not limited to a merely morningness-eveningness orientation. It has also been proposed that other factors may also mediate the relationship between chronotype and its mental health sequelae. This pilot study explores the role of rumination as a mediator between chronotype and sleep quality, chronotype and depressive symptoms. A sample of 144 participants completed The Morningness-Eveningness-Stability-Scale Improved (MESSi), Pittsburgh Sleep Quality Index (PSQI), Rumination-Reflection Questionnaire (RRQ) and Center for Epidemiologic Studies Depression Scale (CES-D)). The results were tested using Spearman's rank correlation coefficient, multiple linear regression and the Sobel test. Rumination was linked to poor sleep quality and increased depression. Morning affect and Distinctness (i.e. rigidity, or the subjective amplitude of the circadian rhythm) correlated with rumination. Rumination was a partial mediator of the associations between Morning Affect and sleep quality, Morning Affect and depression. Rumination may play a role in the association between chronotype (particularly Morning Affect and Distinction) and sleep quality and depression. The recognition of this association might serve as a basis for clinical psychoeducational and therapeutic programs targeting both adjustment of the circadian rhythm and rumination as a psychopathological sign.