Models of activity in the narratives of people with schizophrenia

OBJECTIVES

This article presents an analysis of the narratives of people with schizophrenia from the perspective of descriptions of activities. The goal is to look for changes in activity models under the influence of a psychotic crisis experience.

METHODS

Three fragments of auto-narratives concerning periods: prior to illness, during illness and during remission periods, were compared. These were created after psychotic crisis. The narratives of 26 people with schizophrenia about their lives and self-perception during the aforementioned periods made up the research material. Linguistics textual analysis was conducted, distinguishing the determinants of six selected models of activity relating to sense of agency and intentionality of action. Frequency analysis and multivariable methods were applied to compare the relative frequency of their occurrence in narratives.

RESULTS

Descriptions of activities during the illness are more strongly saturated with models of an extrinsic control site, impersonal control over action, avoidance, individual actions, states in comparison to the remission period, and in particular, descriptions of activity prior to the illness.

CONCLUSIONS

The results of analysis of schizophrenia patients' narratives indicate a decreased sense of agency related to experiencing states of disorder (subjectively defined). This motivational deficit also concerns remission periods after the active phase of the illness, though to a lesser extent. Analysis of motivational models reveals differences of descriptions of own activity, indicating alterations in auto-narration and narrative identity under the influence of a psychotic crisis in a retrospective approach. These changes pertain to deep layers hidden in the relationship between the form of the narrative and its content. They indicate other images of oneself (self-positions or self-narrative voices) as a healthy, sick and in remission person - especially in terms of the perception of their own agency.

Impact of alcohol consumption on the health of pregnant women and their children – a review of studies

Introduction: Alcohol is one of the strongest teratogens. Since the 1960s, information campaigns have been conducted to address its harmful effect and promote quitting drinking, especially by pregnant women. The aim of this paper includes a review of literature concerning research on alcohol use by pregnant women and learning about their knowledge of the detrimental effects of ethanol on the health of themselves and their unborn children. This paper shall also assess social campaigns devoted to informing this group of women about the harmful effects of alcohol consumption. Description of state of knowledge: The review explicitly confirmed data on the harmful effect of alcohol on the formation of morphological and behavioural changes stigmatising children, which are not always visible from birth, and often take the form characteristic of foetal alcohol syndrome only in schoolchildren. The results of molecular and psychological tests have raised the question as to whether the acceptable limits for blood alcohol content in pregnant women should be established. The toxic effects of alcohol and its metabolites depend not only on the amount consumed, but also on the body condition, style of drinking, and age. Summary: Studies covering 11 European countries have shown that drinking alcohol during pregnancy is more and more common, especially in better-educated women with higher earnings and from larger cities. Therefore, information campaigns that stress the harmfulness of the so-called risky drinking by pregnant women should be targeted primarily at this group.

[Twenty years long experience in the breast conserving treatment of women with preinvasive breast cancer. Evaluation of long term results and analysis of prognostic factors.]

AIM

The aim of the study was to analyze long term results and prognostic factors in women with preinvasive breast cancer (DCIS - ductal carcinoma in situ) who underwent breast conserving surgery with subsequent radiotherapy.

MATERIALS AND METHODS

A total number of 106 patients was analyzed aged 29-78 years; mean age was 54,3 years and median 55 years. In 78 (73,5%) patients the tumor was diagnosed incidentally on mammography or ultrasound scan, 28 (26,5%) had palpable lesion. 57 patients had the tumor in the left breast and 49 in the right one. Most often the tumor was localized in external quadrants, namely in 56 (52,8%) patients. All patients had breast conserving surgery and then adjuvant radiotherapy of the breast in typical doses. For evaluation of survival we used the Kaplan-Meier test and for evaluation of cumulated loco-regional recurrence we have applied the method of competing risks.

RESULTS

At present 101 patients are still alive, 85 have no relapse. 15 patients had local recurrence and 8 had another cancer. Five patients died during follow-up period. Overall 15-years survival in analyzed group was 88% and disease free survival was 74%. Of all prognostic factors only the value of Van Nuys index was relevant. Patients who had the index value less than 7 had significantly worse prognosis than patients with value 7 or more (p=0,043).

CONCLUSIONS

At present 101 patients are still alive, 85 have no relapse. 15 patients had local recurrence and 8 had another cancer. Five patients died during follow-up period. Overall 15-years survival in analyzed group was 88% and disease free survival was 74%. Of all prognostic factors only the value of Van Nuys index was relevant. Patients who had the index value less than 7 had significantly worse prognosis than patients with value 7 or more (p=0,043).

The prognostic significance of thrombocytosis in ovarian cancer

Ovarian cancer makes up 25-30% of all cases of cancers of the female genital tract. It has the highest mortality rate of any condition in oncological gynaecology. Early diagnosis is associated with a favourable 5-year survival prognosis. Many solid tumours have been detected with concomitant thrombocytosis. The tumour cell-induced platelet aggregation is a result of a direct integration of tumour cells with blood platelets. The aim of the present paper is an evaluation of platelet count as a prognostic parameter for ovarian cancer. Between 2000 - 2005, 349 patients with ovarian tumour (aged 12 - 88-years-old) underwent primary surgical treatment at a clinic. Ninety-seven patients with ovarian carcinomas underwent chemotherapy in the Oncology Centre. The control group comprised 252 women diagnosed with a histopathological lesion of mild intensity, whereas the cancer group constituted 97 women with a histopathologically-diagnosed malignant neoplasm. Thrombocytopaenia was assumed with a platelet count below 150G/L and thrombocythaemia at 350G/L and higher. Thrombocytosis often coincides with ascites and the cytoreduction decreases platelet count. There is a positive correlation between platelet count and tumour grading. Thrombocytosis was more frequently found in high grade tumours. There is also a positive correlation between platelet count and tumour stage according the International Federation of Gynaecology and Obstetrics (FIGO). Thrombocytosis was more frequently found in stage III and IV cancers. Patients with co-occurring thrombocytosis were found to have shorter survival periods and shorter time free from disease. This seems to give grounds for measuring platelet count before the primary surgical intervention, and suggests that the platelet count should be included in the panel of prognostic factors for patients with ovarian tumours.

Assessment of the tumor-associated trypsin inhibitor (TATI) marker in patients with carcinoma of the uterine body 17 years after treatment

On the basis of literature review, the structure of the tumor-associated trypsin inhibitor (TATI) marker and its usefulness in diagnosing and monitoring of various malignant neoplasms has been described. The authors' own experiences are presented stemming from evaluation of TATI levels in a group of 305 patients suffering from carcinoma of the uterine body, who were primarily operated and then subjected to supplementary therapy in the Center of Oncology in Warsaw, classified in accordance with the FIGO 1988 protocol in the years 1994-1995, and who were observed for 17 years after discontinuation of treatment. A statistical analysis of the level of the TATI marker was carried out in the group of patients with unfavorable prognostic factors, that is the presence of cancerous infiltration in the uterine body, also found in the parametrium, ovaries, as well as diagnosed metastases to the lymphatic nodes found on the basis of postoperative histopathological protocol. The marker was determined three to seven times in serum after each stage of supplementary treatment, and at the beginning of the follow-up. Strong significance and elevation of the TATI marker were affirmed for the mean of four initial collections in patients, who had a relapse or metastases within one month to 11 years after termination of therapy.

Carcinomas and sarcomas of Bartholin gland. A report of nine cases and review of the literature

The greater vestibular gland, also called Bartholin's gland after the Danish anatomist Caspar Bartholin the Younger who first described it in the 17th century, is the site of tumours arising from different types of epithelium and characterized by a different clinical course. In the years 1980-2009, 1,296 patients with vulvar carcinoma were treated at the Oncology Centre in Warsaw, Poland and nine of them had carcinoma of Bartholin's gland, including three patients with squamous cell carcinoma (SCC), three patients with adenoid cystic carcinoma (ACC) and three patients with sarcoma. In this paper the authors present the signs and symptoms, clinical course, treatment outcomes, and recurrence of these three malignant tumours of different histopathology. Own observations and evaluation of treatment results are compared with published reports from other centres. Interestingly, there is no consensus regarding diagnostic criteria or a uniform approach to management. Relatively poor knowledge of malignant tumours of Bartholin's gland seems to be responsible for delays in proper diagnosis and hence optimal management. When instituted, the treatment is usually aggressive and involves adjuvant radio- and chemotherapy, while the chances of longer disease-free survival after treatment may be compromised.

CONCLUSION

Bartholin sarcomas grow fast and invasive, SCC, and ACC infiltrate slowly and systematic. All types are curable at high interest rates if they are originally from the surgically removed lymph nodes on both sides and irradiated.