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Drozdowicz-Jastrzębska E, Mach A, Skalski M, Januszko P, Jabiry-Zieniewicz Z, Siwek M, Wawrzyniak ZM, Radziwoń-Zaleska M. Depression, anxiety, insomnia and interleukins in the early postpartum period. Front Psychiatry 2023; 14:1266390. [PMID: 37840785 PMCID: PMC10569220 DOI: 10.3389/fpsyt.2023.1266390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Background Some new mothers have been shown to suffer from anxiety and depression associated with insomnia during the postpartum period. Our study assessed the impact of demographic, psychopathological, and biochemical factors on the incidence of depression in women during the early postpartum period. Methods A total of 119 women were evaluated at 24-48 h postpartum with the following psychometric scales: Hamilton Depression Rating Scale (HDRS), Edinburgh Postnatal Depression Scale (EPDS), Hamilton Anxiety Rating Scale (HARS) and Athens Insomnia Scale (AIS). In addition, blood was drawn to assay interleukin 6 (IL-6) and interleukin 10 (IL-10). Results The factors that had the greatest impact on the risk of postpartum depression detected with the HDRS were high HARS scores and evidence of insomnia in the AIS. There were no significant differences in IL-6 or IL-10 levels in women with and without depression (based on either HDRS or EPDS scores) and insomnia (based on AIS) after childbirth. Considering demographic factors, divorced and single women were shown to be at higher risk of postpartum depression (based on EPDS scores). Limitations Small sample size and short observation span. Conclusion This study highlights the relationship between postpartum depression and both anxiety and insomnia and emphasises the importance to assess symptoms of anxiety and sleep quality as part of screening in women at risk of postpartum depression.
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Affiliation(s)
| | - Anna Mach
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Michał Skalski
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Januszko
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | | | - Marcin Siwek
- Department of Affective Disorders, Jagiellonian University Medical College, Cracow, Poland
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Kruk E, Kalinowski P, Gibiński K, Dudek K, Skalski M, Przybysz M, Zhylko A, Nazarewski Ł, Morawski M, Grąt M. Stapled Anastomosis for Side-to-Side Cavo-Cavostomy in Orthotopic Liver Transplantation. J Clin Med 2023; 12:5289. [PMID: 37629332 PMCID: PMC10455895 DOI: 10.3390/jcm12165289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 07/26/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
In liver transplantation, a side-to-side anastomosis is one of the commonly performed techniques of the inferior vena cava reconstruction. The authors report a case of an application of an endoscopic vascular linear stapler for a side-to-side caval anastomosis during deceased-donor liver transplantation. The back table procedure was performed in a standard fashion for a side-to-side anastomosis. The linear vascular stapler was introduced during the temporary clamping of the recipient's inferior vena cava and the anastomosis was created without problems. Suturing of the resulting defect completed the anastomosis. The use of the stapler resulted in a shortening of the anastomosis time. The staple line after the reperfusion of the graft was completely sealed. The patient's postoperative course was uncomplicated and post-operative ultrasound and computed tomography confirmed the patency of the anastomosis. This case demonstrates a novel approach to a side-to-side caval reconstruction during liver transplantation that enables a shortening of the implantation time and may improve the quality of anastomoses.
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Affiliation(s)
- Emilia Kruk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.K.); (M.G.)
| | - Piotr Kalinowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.K.); (M.G.)
| | - Krzysztof Gibiński
- 2nd Department of Clinical Radiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Krzysztof Dudek
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.K.); (M.G.)
| | - Michał Skalski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.K.); (M.G.)
| | - Marta Przybysz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.K.); (M.G.)
| | - Andriy Zhylko
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.K.); (M.G.)
| | - Łukasz Nazarewski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.K.); (M.G.)
| | - Marcin Morawski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.K.); (M.G.)
| | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.K.); (M.G.)
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Witkowski G, Januszko P, Skalski M, Mach A, Wawrzyniak ZM, Poleszak E, Ciszek B, Radziwoń-Zaleska M. Factors Contributing to Risk of Persistence of Positive and Negative Symptoms in Schizophrenia during Hospitalization. Int J Environ Res Public Health 2023; 20:4592. [PMID: 36901603 PMCID: PMC10001938 DOI: 10.3390/ijerph20054592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
The aim of the study was to evaluate factors that may contribute to the persistence of positive, negative and other psychopathological symptoms of schizophrenia. All patients were treated in general psychiatric wards between January 2006 and December 2017. The initial study sample comprised of the medical reports of 600 patients. The main, specified inclusion criterion for the study was schizophrenia as a discharge diagnosis. Medical reports of 262 patients were excluded from the study due to no neuroimaging scans being available. The symptoms were categorised into three groups: positive, negative, and other psychopathological symptoms. The statistical analysis comprised modalities such as demographic data, clinical symptoms, as well as neuroimaging scans linking them to a potential impact of sustaining the mentioned groups of symptoms during the period of hospitalization. The analysis revealed that statistically significant risk factors of persistence of the three groups of symptoms are the elderly age, the increasing toll of hospitalizations, suicidal attempts in medical history, a family history of alcohol abuse, the presence of positive, negative and other psychopathological symptoms on admission to the hospital, as well as the absence of cavum septi pellucidi (CSP). The study showed that addiction to psychotropic drugs and a family history of schizophrenia were more frequent in patients with persistent CSP.
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Affiliation(s)
- Grzegorz Witkowski
- Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, 02-004 Warsaw, Poland
| | - Piotr Januszko
- Department of Psychiatry, Medical University of Warsaw, 00-665 Warsaw, Poland
| | - Michał Skalski
- Department of Psychiatry, Medical University of Warsaw, 00-665 Warsaw, Poland
| | - Anna Mach
- Department of Psychiatry, Medical University of Warsaw, 00-665 Warsaw, Poland
| | - Zbigniew Maciej Wawrzyniak
- Faculty of Electronics and Information Technology, Warsaw University of Technology, 00-665 Warsaw, Poland
| | - Ewa Poleszak
- Laboratory of Preclinical Testing, Chair and Department of Applied and Social Pharmacy, Medical University of Lublin, 20-093 Lublin, Poland
| | - Bogdan Ciszek
- Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, 02-004 Warsaw, Poland
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Chrobak AA, Przydacz M, Chłosta M, Machalska K, Turek A, Popiół M, Skalski M, Arciszewska-Leszczuk A, Chłosta P, Siwek M, Dudek D. Bipolar spectrum in prostate cancer patients and its role in stress related symptoms. Psychooncology 2023; 32:438-445. [PMID: 36631917 DOI: 10.1002/pon.6096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/11/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND Studies show significant co-occurrence of bipolar disorder and prostate cancer, as well as the presence of shared genes associated with both diseases. Our aim was to evaluate whether prostate cancer patients present bipolar spectrum symptoms and to establish their possible associations with stress related symptoms during diagnosis and the course of the cancer therapy. METHODS 200 participants were enrolled to this study: 100 prostate cancer patients and 100 healthy males. Bipolar spectrum symptoms were measured with the use of Mood Disorder Questionnaire and Hypomania Checklist-32 (HCL-32). Stress related symptoms were rated with The Impact of Events Scale-Revised (IES-R), Perceived Stress Scale-10 (PSS-10) and Generalised Self-Efficacy Scale (GSES). RESULTS In comparison to healthy controls group, prostate cancer patients have shown higher HCL-32 scores. Mood Disorder Questionnaire measures were associated with more severe stress related to prostate cancer diagnosis and treatment reflected by higher scores of IES-R and its subscales (Avoidance, Intrusions and Hyperarousal). Mood Disorder Questionnaire, HCL-32, PSS-10, IES-R and GSES measures were not associated with clinical characteristics of prostate cancer severity. LIMITATIONS Cross-sectional study model precluded identification of causal relationship among variables. Bipolar spectrum symptoms and stress related measures were based on auto-questionnaires. CONCLUSIONS To our best knowledge, this is the first study evaluating bipolar spectrum symptoms in prostate cancer patients. We have shown that this clinical group presents increased bipolarity traits compared to healthy individuals. Moreover, bipolar spectrum symptoms were associated with more severe stress related to the prostate cancer diagnosis and its treatment, reflected in avoidance, hyperarousal, and intrusions.
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Affiliation(s)
| | - Mikołaj Przydacz
- Department of Urology, Jagiellonian University in Cracow, Kraków, Poland
| | - Marcin Chłosta
- Department of Urology, Jagiellonian University in Cracow, Kraków, Poland
| | - Karolina Machalska
- Student's Scientific Association of Affective Disorders, Jagiellonian University Medical College, Kraków, Poland
| | - Aleksander Turek
- Student's Scientific Association of Affective Disorders, Jagiellonian University Medical College, Kraków, Poland
| | - Maja Popiół
- Student's Scientific Association of Affective Disorders, Jagiellonian University Medical College, Kraków, Poland
| | - Michał Skalski
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kraków, Poland
| | | | - Piotr Chłosta
- Department of Urology, Jagiellonian University in Cracow, Kraków, Poland
| | - Marcin Siwek
- Department of Affective Disorders, Jagiellonian University Medical College, Kraków, Poland
| | - Dominika Dudek
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kraków, Poland
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Krasnodębski M, Morawski M, Borkowski J, Grąt K, Stypułkowski J, Skalski M, Zhylko A, Krawczyk M, Grąt M. Skin Autofluorescence Measurement as Initial Assessment of Hepatic Parenchyma Quality in Patients Undergoing Liver Resection. J Clin Med 2022; 11:jcm11185341. [PMID: 36142988 PMCID: PMC9503381 DOI: 10.3390/jcm11185341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/01/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Skin autofluorescence (SAF) can detect advanced glycation end products (AGEs) that accumulate in tissues over time. AGEs reflect patients’ general health, and their pathological accumulation has been associated with various diseases. This study aimed to determine whether its measurements can correlate with the liver parenchyma quality. This prospective study included 186 patients who underwent liver resections. Liver fibrosis and/or steatosis > 10% were found in almost 30% of the patients. ROC analysis for SAF revealed the optimal cutoff point of 2.4 AU as an independent predictor for macrovesicular steatosis ≥ 10% with an AUC of 0.629 (95% CI 0.538−0.721, p = 0.006), 59.9% sensitivity, 62.4% specificity, and positive (PPV) and negative (NPV) predictive values of 45.7% and 74.1%, respectively. The optimal cutoff point for liver fibrosis was 2.3 AU with an AUC of 0.613 (95% CI 0.519−0.708, p = 0.018), 67.3% sensitivity, 55.2% specificity, and PPV and NPV of 37.1% and 81.2%, respectively. In the multivariable logistic regression model, SAF ≥ 2.4 AU (OR 2.16; 95% CI 1.05−4.43; p = 0.036) and BMI (OR 1.21; 95% CI 1.10−1.33, p < 0.001) were independent predictors of macrovesicular steatosis ≥ 10%. SAF may enhance the available non-invasive methods of detecting hepatic steatosis and fibrosis in patients prior to liver resection.
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Affiliation(s)
- Maciej Krasnodębski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-599-25-45
| | - Marcin Morawski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Jan Borkowski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Karolina Grąt
- Second Department of Clinical Radiology, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Jan Stypułkowski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Michał Skalski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Andriy Zhylko
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Michał Grąt
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
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Krasnodębski M, Grąt K, Morawski M, Borkowski J, Krawczyk P, Zhylko A, Skalski M, Kalinowski P, Zieniewicz K, Grąt M. Skin autofluorescence as a novel predictor of acute kidney injury after liver resection. World J Surg Oncol 2021; 19:276. [PMID: 34526025 PMCID: PMC8444415 DOI: 10.1186/s12957-021-02394-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/03/2021] [Indexed: 11/25/2022] Open
Abstract
Abstract Background Skin autofluorescence (SAF) reflects accumulation of advanced glycation end-products (AGEs). The aim of this study was to evaluate predictive usefulness of SAF measurement in prediction of acute kidney injury (AKI) after liver resection. Methods This prospective observational study included 130 patients undergoing liver resection. The primary outcome measure was AKI. SAF was measured preoperatively and expressed in arbitrary units (AU). Results AKI was observed in 32 of 130 patients (24.6%). SAF independently predicted AKI (p = 0.047), along with extent of resection (p = 0.019) and operative time (p = 0.046). Optimal cut-off for SAF in prediction of AKI was 2.7 AU (area under the curve [AUC] 0.611), with AKI rates of 38.7% and 20.2% in patients with high and low SAF, respectively (p = 0.037). Score based on 3 independent predictors (SAF, extent of resection, and operative time) well stratified the risk of AKI (AUC 0.756), with positive and negative predictive values of 59.3% and 84.0%, respectively. In particular, SAF predicted AKI in patients undergoing major and prolonged resections (p = 0.010, AUC 0.733) with positive and negative predictive values of 81.8%, and 62.5%, respectively. Conclusions AGEs accumulation negatively affects renal function in patients undergoing liver resection. SAF measurement may be used to predict AKI after liver resection, particularly in high-risk patients.
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Affiliation(s)
- Maciej Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
| | - Karolina Grąt
- Second Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Morawski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Jan Borkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Andriy Zhylko
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Skalski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Kalinowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
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Skalski M, Mach A, Januszko P, Ryszewska-Pokraśniewicz B, Biernacka A, Nowak G, Pilc A, Poleszak E, Radziwoń-Zaleska M. Pharmaco-Electroencephalography-Based Assessment of Antidepressant Drug Efficacy-The Use of Magnesium Ions in the Treatment of Depression. J Clin Med 2021; 10:3135. [PMID: 34300299 PMCID: PMC8306926 DOI: 10.3390/jcm10143135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022] Open
Abstract
Pharmaco-electroencephalography (pharmaco-EEG) is a technique used to assess the effects of psychotropic medications on the bioelectrical activity of the brain. The purpose of this study was to assess the treatment response with the use of the Hamilton Depression Rating Scale (HDRS) and via EEG. Over an 8-week period, we analyzed electroencephalographic tracings of 91 patients hospitalized for major depression at the Medical University of Warsaw. Thirty-nine of those patients received tricyclic antidepressants (TCAs), 35 received fluoxetine, and 17 received fluoxetine augmented with magnesium (Mg) ions. All patients had their serum drug levels monitored. The highest proportion of patients (88.2%) who showed adequate responses to treatment was observed in the fluoxetine+Mg group, whereas the lowest rates of treatment response were observed in the TCA group (58.3%). This difference was statistically significant (p = 0.029, Phi = 0.30). Our study demonstrated a relationship between achieving remission (HDRS ≤ 6 at week 8 of treatment) and obtaining a positive pharmaco-EEG profile 6 h after administration of the first dose in the group receiving fluoxetine augmented with Mg ions (p = 0.035, Phi = 0.63).
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Affiliation(s)
- Michał Skalski
- Department of Psychiatry, Medical University of Warsaw, 00-665 Warsaw, Poland; (M.S.); (P.J.); (M.R.-Z.)
| | - Anna Mach
- Department of Psychiatry, Medical University of Warsaw, 00-665 Warsaw, Poland; (M.S.); (P.J.); (M.R.-Z.)
| | - Piotr Januszko
- Department of Psychiatry, Medical University of Warsaw, 00-665 Warsaw, Poland; (M.S.); (P.J.); (M.R.-Z.)
| | | | | | - Gabriel Nowak
- May Institute of Pharmacology, Polish Academy of Sciences, 31-343 Kraków, Poland; (G.N.); (A.P.)
| | - Andrzej Pilc
- May Institute of Pharmacology, Polish Academy of Sciences, 31-343 Kraków, Poland; (G.N.); (A.P.)
| | - Ewa Poleszak
- Faculty of Pharmacy, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Maria Radziwoń-Zaleska
- Department of Psychiatry, Medical University of Warsaw, 00-665 Warsaw, Poland; (M.S.); (P.J.); (M.R.-Z.)
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Krawczyk M, Ziarkiewicz-Wróblewska B, Podgórska J, Grzybowski J, Gierej B, Krawczyk P, Grąt M, Kornasiewicz O, Skalski M, Wróblewski T. Intraductal papillary neoplasm of the bile duct - A comprehensive review. Adv Med Sci 2021; 66:138-147. [PMID: 33556909 DOI: 10.1016/j.advms.2021.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/14/2020] [Accepted: 01/21/2021] [Indexed: 02/09/2023]
Abstract
BACKGROUND Intraductal papillary neoplasm of the bile ducts is a rare tumor type. Management decisions are currently based upon a small case series. The authors have large own experience with IPNB. OBJECTIVE The review aims at reporting on clinicopathological features of IPNB in order to provide guidance for management. METHODS We searched PubMed, Medline, Microsoft Academic and Embase databases to identify studies of relevance. The analysis of own experience was also included. RESULTS We analyzed 59 retrospective series and 25 cases from authors' clinical experience. The main sign was jaundice and cholangitis, 33% and 48%, respectively. CT's were performed in 63-76% and MR in 40-56%. Intraductal mass was found in 31-32% and duct dilatation in 27-30%. Endoscopic Retrograde Cholangio-Pancreatography (ERCP) was performed in 48-62%. IPNB with invasive carcinoma was found in 35.7-60% and IPNB with intraepithelial neoplasia in 36-60%. Histopathological confirmation before surgery was rare. The main treatment of IPNB is resection, in our material, both, hepatectomy and hepatectomy plus bile duct resections were performed in 40% of patients. The percentage of postoperative complications was 20%. The 5-year survival rate of all IPNB's patients was 53.6%; in patients with associated invasive carcinoma - 22.2% and without invasive carcinoma - 100% (p = 0.001). CONCLUSIONS Early surgery is advisable for radiologically suspected IPNB. The results of treatment depend on histopathology. They are worse at intraductal invasive carcinoma than at neoplasm with neoplasia.
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Skalski M, Szczęsna M. Modern standards for pharmacological treatment of insomnia. Pediatr Med Rodz 2019. [DOI: 10.15557/pimr.2019.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Klasa K, Sobański JA, Skalski M, Gołąbek T, Świerkosz A, Przydacz M, Dembińska E, Mielimąka M, Cyranka K, Dudek D, Chłosta PL, Rutkowski K. Neurotic personality and lower urinary tract symptoms in day hospital patients diagnosed at pretreatment between 2004 and 2014. Psychiatr Pol 2019; 53:915-938. [PMID: 31760417 DOI: 10.12740/pp/97835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Evaluation of the association between the occurrence of lower urinary tract symptoms in patients qualified for psychotherapy and the severity and profile of their neurotic personality disorders. MATERIAL AND METHODS Retrospective analysis of questionnaires included in the medical records of 2,450 patients qualified for psychotherapy in 2004-2014 in terms of correlations between the symptoms of pollakiuria and unconscious urinary incontinence, and the global severity of neurotic symptoms (OWK), global severity of neurotic personality disorders (XKON) and abnormal values of 24 scales of the KON-2006 questionnaire. Correlations in the form of OR coefficients with 95% confidence intervals were estimated using logistic regression analyzes. RESULTS Lower urinary tract symptoms are associated with a significantly greater severity of neuroticism, both described by the global severity of symptoms (OWK) as well as by the global neurotic personality disorder index (XKON) and abnormal values of the KON-2006 questionnaire scales. The occurrence of both symptoms was associated with the following scales: 'Negative self-esteem' and 'Envy', the occurrence of pollakiuria - with the scales 'Feeling of being dependent on others', 'Demobilization', 'Conviction of life helplessness' and 'Feeling of lack of influence', the occurrence of unconscious urinary incontinence - with the scales 'Feeling of being alienated' and 'Exaltation' for both genders, and only in men 'Risk avoidance' (low 'Risk tendencies'), 'Conviction of life helplessness', 'Difficulties in interpersonal relations'. Extreme severity of pollakiuria was more strongly associated with many of the mentioned scales, and also slightly differently with other scales, e.g., in men - with the 'Sense of overload' and 'Imagination, fantasizing'. CONCLUSIONS Neurotic personality traits described by abnormal values of the KON-2006 questionnaire scales are associated with the presence (and also to some extent with the severity) of psychogenic lower urinary tract symptoms. Connections may be bi-directional - in some cases experiencing and self-description of personality traits may be secondary to suffering associated with pollakiuria and incontinence.
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Affiliation(s)
- Katarzyna Klasa
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychoterapii
| | - Jerzy A Sobański
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychoterapii
| | - Michał Skalski
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Klinika Psychiatrii Dorosłych
| | - Tomasz Gołąbek
- Uniwersytet Jagielloński Collegium Medicum, Klinika Urologii
| | - Agata Świerkosz
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Klinika Psychiatrii Dorosłych
| | | | - Edyta Dembińska
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychoterapii
| | - Michał Mielimąka
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychoterapii
| | - Katarzyna Cyranka
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Klinika Psychiatrii Dorosłych
| | - Dominika Dudek
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Klinika Psychiatrii Dorosłych
| | - Piotr L Chłosta
- Uniwersytet Jagielloński Collegium Medicum, Klinika Urologii
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Skalski M, Przydacz M, Sobański JA, Cyranka K, Klasa K, Datka W, Gołąbek T, Chłosta P, Dudek D. Coexistence of lower urinary tract symptoms (LUTS) with depressive symptoms in patients suffering from depressive disorders. Psychiatr Pol 2019; 53:939-953. [PMID: 31760418 DOI: 10.12740/pp/onlinefirst/94704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate the correlation between lower urinary tract symptoms (LUTS) and severity of depressive symptoms in patients treated for depression. METHODS 102 patients (43 males, 59 females) aged 20-67 (M = 46.1) treated for depression were included in this cross-sectional analysis. Depressive symptoms were assessed with the 17-item Hamilton Depression Rating Scale (HDRS) and Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR). LUTS were examined with the International Prostate Symptom Score (IPSS). In order to analyze the impact of presented symptoms, both urological and psychiatric, on quality of life of analyzed individuals the 30-item General Health Questionnaire (GHQ-30) was used. RESULTS The average IPSS score in women was significantly higher than in men (9.59 vs. 6; p = 0.04). Patients suffering from at least moderate depression assessed with QIDS-SR had significantly higher scores in IPSS (9.76 vs. 4.1; p = 0.002). Severity of all LUTS assessed with IPSS correlated with QIDS-SR score in examined men (p < 0.05). In women, the total IPSS score correlated with the QIDS-SR score (p < 0.05) and with the total GHQ-30 score (p < 0.05). Anumber of other significant (p < 0.05) correlations were observed between the total IPSS score and certain items' scores in the GHQ-30 both in men and women. CONCLUSIONS LUTS are common among patients with depression. There is a correlation between severity of depressive symptoms and LUTS. LUTS affect quality of life and well-being as well as cause marked distress in depressed patients. Comorbidity of LUTS and depression should draw attention of both psychiatrists and urologists and enhance interdisciplinary treatment approach. Further prospective and cohort studies are essential to reveal more details of the correlation between LUTS and depression.
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Affiliation(s)
- Michał Skalski
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Klinika Psychiatrii Dorosłych
| | - Mikolaj Przydacz
- Uniwersytet Jagielloński Collegium Medicum, Oddział Kliniczny Urologii
| | - Jerzy A Sobański
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychoterapii
| | - Katarzyna Cyranka
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Klinika Psychiatrii Dorosłych
| | - Katarzyna Klasa
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychoterapii
| | - Wojciech Datka
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Zakład Zaburzeń Afektywnych
| | - Tomasz Gołąbek
- Uniwersytet Jagielloński Collegium Medicum, Oddział Kliniczny Urologii
| | - Piotr Chłosta
- Uniwersytet Jagielloński Collegium Medicum, Oddział Kliniczny Urologii
| | - Dominika Dudek
- Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Klinika Psychiatrii Dorosłych
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Skalski M, Przydacz M, Sobański J, Cyranka K, Klasa K, Datka W, Golabek T, Chlosta P, Dudek D. Symptoms of overactive bladder (OAB) in patients treated for depressive disorders. Arch Psych Psych 2019. [DOI: 10.12740/app/111340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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13
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Ryszewska-Pokraśniewicz B, Mach A, Skalski M, Januszko P, Wawrzyniak ZM, Poleszak E, Nowak G, Pilc A, Radziwoń-Zaleska M. Effects of Magnesium Supplementation on Unipolar Depression: A Placebo-Controlled Study and Review of the Importance of Dosing and Magnesium Status in the Therapeutic Response. Nutrients 2018; 10:nu10081014. [PMID: 30081500 PMCID: PMC6115747 DOI: 10.3390/nu10081014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 07/29/2018] [Accepted: 07/31/2018] [Indexed: 01/08/2023] Open
Abstract
Animal studies using tests and models have demonstrated that magnesium exerts an antidepressant effect. The literature contains few studies in humans involving attempts to augment antidepressant therapy with magnesium ions. The purpose of our study was to assess the efficacy and safety of antidepressant treatment, in combination with magnesium ions. A total of 37 participants with recurrent depressive disorder who developed a depressive episode were included in this study. As part of this double-blind study, treatment with the antidepressant fluoxetine was accompanied with either magnesium ions (120 mg/day as magnesium aspartate) or placebo. During an 8-week treatment period, each patient was monitored for any clinical abnormalities. Moreover, serum fluoxetine and magnesium levels were measured, and pharmaco-electroencephalography was performed. The fluoxetine + magnesium and fluoxetine + placebo groups showed no significant differences in either Hamilton Depression Rating Scale (HDRS) scores or serum magnesium levels at any stage of treatment. Multivariate statistical analysis of the whole investigated group showed that the following parameters increased the odds of effective treatment: lower baseline HDRS scores, female gender, smoking, and treatment augmentation with magnesium. The parameters that increased the odds of remission were lower baseline HDRS scores, shorter history of disease, the presence of antidepressant-induced changes in the pharmaco-EEG profile at 6 h after treatment, and the fact of receiving treatment augmented with magnesium ions. The limitation of this study is a small sample size.
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Affiliation(s)
| | - Anna Mach
- Department of Psychiatry, Medical University of Warsaw, 00-685 Warsaw, Poland.
| | - Michał Skalski
- Department of Psychiatry, Medical University of Warsaw, 00-685 Warsaw, Poland.
| | - Piotr Januszko
- Department of Psychiatry, Medical University of Warsaw, 00-685 Warsaw, Poland.
| | - Zbigniew M Wawrzyniak
- Faculty of Electronics and Information Technology, Warsaw University of Technology, 00-685 Warsaw, Poland.
| | - Ewa Poleszak
- Faculty of Pharmacy, Medical University of Lublin, 20-093 Lublin, Poland.
| | - Gabriel Nowak
- Institute of Pharmacology, Polish Academy of Sciences, 31-343 Kraków, Poland.
| | - Andrzej Pilc
- Institute of Pharmacology, Polish Academy of Sciences, 31-343 Kraków, Poland.
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Skalski M, Gierej B, Nazarewski Ł, Ziarkiewicz-Wróblewska B, Zieniewicz K. Prostate Cancer in Deceased Organ Donors: Loss of Organ or Transplantation With Active Surveillance. Transplant Proc 2018; 50:1982-1984. [PMID: 30177093 DOI: 10.1016/j.transproceed.2018.02.129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 02/19/2018] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Prostate cancer has become an important clinical issue within deceased organ donors. There is still a considerable number of undiagnosed cancers, especially in early stage, despite frozen section analysis. The aim of the study was to evaluate outcomes of orthotopic liver transplants (OLTx) with organs from donors with prostate cancer. MATERIAL AND METHODS A retrospective analysis was performed in deceased liver donors whose prostate glands were harvested for histologic examinations because of prostate cancer suspicion. The study group consisted of 72 men reported as potential liver donors between 2011 and November 2017. Prostate glands were primarily assessed by frozen sections and afterward in routine examination. Generally cancer diagnosed in frozen specimen was not considered for OLTx. Recipients who received an organ from the donor with prostate cancer were actively surveilled. RESULTS There were 19 cases (26.40%) of prostate cancer diagnosed among the study group. In 12 cases diagnosis was made by frozen section assessment, of which 11 organs were disqualified from OLTx and 1 was transplanted. In 7 cases prostate cancer was diagnosed after OLTx in final routine histologic examination. Finally, 8 recipients (5 men and 3 women) received a new organ. Only 1 died during the perioperative period. In the remaining 7 patients the perioperative period was uneventful and no disease transmission was observed during follow-up. CONCLUSIONS Diagnosis of prostate cancer in donors should not be treated as a contraindication for OLTx because the risk of disease transmission is low. Potential recipients must be fully informed and kept under oncological surveillance.
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Affiliation(s)
- M Skalski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
| | - B Gierej
- Department of Pathology, Medical University of Warsaw, Warsaw, Poland
| | - Ł Nazarewski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | | | - K Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
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Drozdowicz-Jastrzębska E, Skalski M, Gdańska P, Mach A, Januszko P, Nowak RJ, Węgrzyn P, Wielgoś M, Radziwoń-Zaleska M. Insomnia, postpartum depression and estradiol in women after delivery. Metab Brain Dis 2017; 32:1913-1918. [PMID: 28791548 DOI: 10.1007/s11011-017-0079-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 07/20/2017] [Indexed: 12/26/2022]
Abstract
After childbirth, women may develop symptoms of depression with the associated sleep disturbances. This study assessed the relationship between insomnia and both depression symptoms and blood estradiol levels in women during the early postpartum period. 84 patients were assessed 24-48 h after labor. The main assessment methods were the following psychometric scales: Beck Depression Inventory (BDI), Edinburgh Postnatal Depression Scale (EPDS) and Athens Insomnia Scale (AIS). Serum estradiol levels were measured using ELISA assay. Women who developed postpartum insomnia significantly more often reported insomnia during pregnancy (P = 0.001), were more likely to have suffered from depression in the past (P = 0.007) and had significantly higher BDI (P = 0.002) and EPDS (P = 0.048) scores. Our study demonstrated no significant association between Restless Legs Syndrome (RLS) during pregnancy and postpartum insomnia. The groups of women with and without postpartum RLS showed no significant differences in the incidence of postpartum insomnia. No significant differences in estradiol levels were observed in women with and without postpartum insomnia. The study showed the following factors to play a major role in development of postpartum insomnia: an increase in Beck Depression Inventory score, a history of depression and a history of insomnia during pregnancy.
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Affiliation(s)
| | - Michał Skalski
- Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska str, 00-665, Warsaw, Poland.
| | - Paulina Gdańska
- 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
- Department of Obstetrics and Perinatology, Medical University of Warsaw, Warsaw, Poland
| | - Anna Mach
- Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska str, 00-665, Warsaw, Poland
| | - Piotr Januszko
- Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska str, 00-665, Warsaw, Poland
| | - Rafał J Nowak
- Department of Drug Management, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Węgrzyn
- Department of Obstetrics and Perinatology, Medical University of Warsaw, Warsaw, Poland
| | - Mirosław Wielgoś
- 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
| | - Maria Radziwoń-Zaleska
- Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska str, 00-665, Warsaw, Poland
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Wichniak A, Jankowski K, Skalski M, Skwarło-Sońta K, Zawilska J, Żarowski M, Poradowska E, Jernajczyk W. Treatment guidelines for Circadian Rhythm Sleep – Wake Disorders of the Polish Sleep Research Society and the Section of Biological Psychiatry of the Polish Psychiatric Association, part II: Diagnosis and treatment. Psychiatr Pol 2017; 51:815-832. [DOI: 10.12740/pp/68918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
Insomnia presents an increasing and significant health issue in paediatric population. As the problem had grown over past decade, it became recognised by the specialists dealing with children and adolescents. In a recent study American Academy of Child and Adolescent Psychiatry members were asked about their experience with patients complaining about sleep disturbances. Doctors reported that sleep was a problem for 1/3 of their patients out of which 1/4 required pharmacotherapy [1]. Multiple studies concerning adults confirmed significance of healthy sleep in optimal cognitive, emotional, social and biological functioning. Adequate sleep is important in prophylaxis of many chronic diseases such as obesity, diabetes, hypertension, myocardial infarction, stroke [2]. Due to increasing prevalence of insomnia in children and adolescents growing attention is paid to its short and long term consequences in this group. This review summarises available data on chronic insomnia prevalence and its consequences in population under 18 years old.
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Affiliation(s)
| | - Michał Skalski
- Katedra i Klinika Psychiatryczna, Warszawski Uniwersytet Medyczny
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18
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Sobański JA, Skalski M, Gołąbek T, Świerkosz A, Przydacz M, Klasa K, Rutkowski K, Dembińska E, Mielimąka M, Cyranka K, Chłosta PL, Dudek D. Occurrence of selected lower urinary tract symptoms in patientsof a day hospital for neurotic disorders. Psychiatr Pol 2016; 50:1181-1205. [PMID: 28211556 DOI: 10.12740/pp/onlinefirst/61109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES To assess the occurrence of selected lower urinary tract symptoms in the population of patients with neurotic and personality disorders. METHODS This was a retrospective analysis of occurrence, co-existence and severity of two selected lower urinary tract symptoms in 3,929 patients in a day hospital for neurotic disorders. The KO "O" symptom checklist was used to measure the study variables. RESULTS Although the symptoms associated with micturition are not the most prevalent symptoms of neurotic disorders, neither are they the most typical ones, the prevalence of urinary frequency referring to the last week before psychotherapy evaluated among the patients of a day hospital, was approximately 50%. Involuntary micturition, a symptom with a significant implication on the self-esteem and social functioning was much less common; it was reported by approximately 5% relatively healthy and young group of patients. Major bother from urinary frequency was reported by 9-14% of patients, whereas from involuntary micturition by only 0.6%-1% of the surveyed patients. CONCLUSIONS Selected urological symptoms seem to be prevalent among the patients with neurotic and personality disorders, and are independent of the specific diagnosis or patients' gender. Their co-existence with other symptoms of neurotic disorders reported by the patients indicates their strongest relationship with the somatoform, dissociative, sexual and agoraphobic disorders.
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Affiliation(s)
| | - Michał Skalski
- Klinika Psychiatrii Dorosłych Szpitala Uniwersyteckiego w Krakowie
| | | | - Agata Świerkosz
- Klinika Psychiatrii Dorosłych Szpitala Uniwersyteckiego w Krakowie
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Skalski M, Sobański JA, Golabek T, Świerkosz A, Klasa K, Przydacz M, Rutkowski K, Dembińska E, Mielimąka M, Cyranka K, Chłosta P, Dudek D. Associations of selected lower urinary tract symptoms with biographical context in patients of a day hospital for neurotic disorders. Psychiatr Pol 2016; 50:1207-1234. [PMID: 28211557 DOI: 10.12740/pp/61583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES To assess the correlation of subjectively estimated biographical context and lower urinary tract symptoms reported by patients with neurotic and personality disorders. METHODS This was a retrospective analysis of the biographical context of co-existence of urinary frequency and urinary incontinence reported by 3,929 patients in a day hospital for treatment of neurotic disorders. The symptom checklists KO "0" were completed by patients prior to any treatment. RESULTS Urinary frequency reported by patients in a day hospital for treatment of neurotic disorders was associated with the difficulties from their childhood and adolescence (i.e. with perception of inferiority with regard to one's family and among siblings, parents' low education level), as well as the disparities in terms of sexual education and troubled relationships. CONCLUSIONS In the studied group of patients with neurotic and personality disorders, selected lower urinary tract symptoms were associated with adverse life circumstances from childhood and adolescence (which can show the tendency towards regression and protracted character to experience of family's dysfunction due to feeling of being neglected or abandoned), as well as, to a larger or a smaller degree, their consequences - dysfunctions in adulthood, relationship/marriage, functioning at work and dealing with finances. These associations indicated the probable significance of experiencing these aspects of life in patients, not only in day hospitals or psychiatric hospitals which reported "pseudo-urological complaints", but also in at least part of urological patients - going to hospitals due to neurotic disorders, particularly those occurring in a somatic form.
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Affiliation(s)
- Michał Skalski
- Klinika Psychiatrii Dorosłych Szpitala Uniwersyteckiego w Krakowie
| | | | | | - Agata Świerkosz
- Klinika Psychiatrii Dorosłych Szpitala Uniwersyteckiego w Krakowie
| | | | | | | | | | | | | | | | - Dominika Dudek
- Zakład Zaburzeń Afektywnych Katedry Psychiatrii, Collegium Medicum UJ
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Skalski M, Gierej B, Ziarkiewicz-Wróblewska B, Hołówko W, Krawczyk M. Prostate Cancer in Deceased Liver Donors. Transplant Proc 2016; 48:1378-80. [DOI: 10.1016/j.transproceed.2016.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/16/2016] [Accepted: 03/01/2016] [Indexed: 11/30/2022]
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21
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Kaczor M, Skalski M. Treatment of behavioral sleep problems in children and adolescents – literature review. Psychiatr Pol 2016; 50:571-84. [DOI: 10.12740/pp/41294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Skalski M, Patkowski W, Grąt M, Zieniewicz K, Wróblewski T, Hołówko W, Krawczyk M. Utilization of Donors with Hepatitis B Core Antibodies in Liver Transplantation. Ann Transplant 2015; 20:667-75. [PMID: 26552722 DOI: 10.12659/aot.894127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND At present, the scarcity of organs is one of the major problems in transplantation. We present our own experience in expanding the acceptance criteria for deceased donors. We aimed to evaluate the potential impact of using hepatitis B virus (HBV) core antibody (anti-HBc)-positive donor grafts on the long-term liver transplantation results. MATERIAL AND METHODS We retrospectively analyzed data from 324 consecutive liver transplantation procedures performed in the largest transplant center in Poland, between January 2007 and February 2012. These patients included 36 who had received a liver from anti-HBc-positive donors. RESULTS The presence of anti-HBc antibodies in the donor did not have a significant negative impact on the overall 3-year patient or graft survival rates. Among recipients with pre-transplant HBV infection, patients who received an organ from an anti-HBc-positive donor tended to have an improved survival rate compared with patients who received liver transplants from seronegative donors (p=0.080). However, there was a statistically significant reduction in graft survival (p=0.035) in the recipients without serological markers of HBV infection who received liver transplants harvested from anti-HBc-positive donors. CONCLUSIONS These results confirm the validity of extending the acceptance criteria to anti-HBc-positive donors, particularly for patients with a prior HBV infection. Despite the increased risk of graft loss, liver transplantation from anti-HBc-positive donors among recipients not infected with HBV may also be considered in appropriate cases.
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Affiliation(s)
- Michał Skalski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Waldemar Patkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Tadeusz Wróblewski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Wacław Hołówko
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
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23
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Krawczyk M, Grąt M, Grąt K, Wronka K, Krasnodębski M, Stypułkowski J, Masior Ł, Hołówko W, Ligocka J, Nyckowski P, Wróblewski T, Paluszkiewicz R, Patkowski W, Zieniewicz K, Pączek L, Milkiewicz P, Ołdakowska-Jedynak U, Najnigier B, Dudek K, Remiszewski P, Grzelak I, Kornasiewicz O, Kotulski M, Smoter P, Grodzicki M, Korba M, Kalinowski P, Skalski M, Zając K, Stankiewicz R, Przybysz M, Cieślak B, Nazarewski Ł, Nowosad M, Kobryń K, Wasilewicz M, Raszeja-Wyszomirska J, Piwowarska J, Giercuszkiewicz D, Sańko-Resmer J, Rejowski S, Szydłowska-Jakimiuk M, Górnicka B, Wróblewska-Ziarkiewicz B, Mazurkiewicz M, Niewiński G, Pawlak J, Pacho R. Evolution Of The Results Of 1500 Liver Transplantations Performed In The Department Of General, Transplant And Liver Surgery Medical University Of Warsaw. Pol Przegl Chir 2015; 87:221-230. [PMID: 26172161 DOI: 10.1515/pjs-2015-0046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Indexed: 09/25/2023]
Abstract
UNLABELLED Liver transplantation is a well-established treatment of patients with end-stage liver disease and selected liver tumors. Remarkable progress has been made over the last years concerning nearly all of its aspects. The aim of this study was to evaluate the evolution of long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery (Medical University of Warsaw). MATERIAL AND METHODS Data of 1500 liver transplantations performed between 1989 and 2014 were retrospectively analyzed. Transplantations were divided into 3 groups: group 1 including first 500 operations, group 2 including subsequent 500, and group 3 comprising the most recent 500. Five year overall and graft survival were set as outcome measures. RESULTS Increased number of transplantations performed at the site was associated with increased age of the recipients (p<0.001) and donors (p<0.001), increased rate of male recipients (p<0.001), and increased rate of piggyback operations (p<0.001), and decreased MELD (p<0.001), as well as decreased blood (p=0.006) and plasma (p<0.001) transfusions. Overall survival was 71.6% at 5 years in group 1, 74.5% at 5 years in group 2, and 85% at 2.9 years in group 3 (p=0.008). Improvement of overall survival was particularly observed for primary transplantations (p=0.004). Increased graft survival rates did not reach the level of significance (p=0.136). CONCLUSIONS Long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery are comparable to those achieved in the largest transplant centers worldwide and are continuously improving despite increasing recipient age and wider utilization of organs procured from older donors.
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Serefko A, Szopa A, Wlaź P, Nowak G, Radziwoń-Zaleska M, Skalski M, Poleszak E. Magnesium in depression. Pharmacol Rep 2014; 65:547-54. [PMID: 23950577 DOI: 10.1016/s1734-1140(13)71032-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Revised: 01/08/2013] [Indexed: 12/15/2022]
Abstract
Magnesium is one of the most essential mineral in the human body, connected with brain biochemistry and the fluidity of neuronal membrane. A variety of neuromuscular and psychiatric symptoms, including different types of depression, was observed in magnesium deficiency. Plasma/serum magnesium levels do not seem to be the appropriate indicators of depressive disorders, since ambiguous outcomes, depending on the study, were obtained. The emergence of a new approach to magnesium compounds in medical practice has been seen. Apart from being administered as components of dietary supplements, they are also perceived as the effective agents in treatment of migraine, alcoholism, asthma, heart diseases, arrhythmias, renal calcium stones, premenstrual tension syndrome etc. Magnesium preparations have an essential place in homeopathy as a remedy for a range of mental health problems. Mechanisms of antidepressant action of magnesium are not fully understood yet. Most probably, magnesium influences several systems associated with development of depression. The first information on the beneficial effect of magnesium sulfate given hypodermically to patients with agitated depression was published almost 100 years ago. Numerous pre-clinical and clinical studies confirmed the initial observations as well as demonstrated the beneficial safety profile of magnesium supplementation. Thus, magnesium preparations seem to be a valuable addition to the pharmacological armamentarium for management of depression.
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Affiliation(s)
- Anna Serefko
- Chair and Department of Applied Pharmacy, Medical University of Lublin, Lublin, Poland
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Grąt M, Kornasiewicz O, Lewandowski Z, Skalski M, Zieniewicz K, Pączek L, Krawczyk M. The impact of surgical technique on the results of liver transplantation in patients with hepatocellular carcinoma. Ann Transplant 2013; 18:448-59. [PMID: 24008493 DOI: 10.12659/aot.884005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although piggyback technique has gained widespread acceptance for liver transplantation in general, there is an exceptional lack of data on the choice of appropriate surgical technique for patients with hepatocellular carcinoma (HCC). The purpose of this study was to evaluate the impact of surgical technique on outcomes after liver transplantation for HCC. MATERIAL AND METHODS We conducted a retrospective cohort study on 90 HCC patients who underwent liver transplantation with the conventional (n=19) or piggyback (n=71) technique. Both techniques were compared with respect to intraoperative variables and long-term outcomes, determined by 3-year overall (OS) and recurrence-free (RFS) survival. The potential role of confounding factors was excluded in a series of Cox proportional regression models. RESULTS The piggyback technique was associated with shorter procedure duration (p=0.0005), shorter anatomical anhepatic phase (p<0.0001), shorter duration of total (p=0.018) and warm ischemia (p<0.0001), and fewer blood transfusions (p=0.006). Three-year OS was 89.1% after piggyback and 49.9% after conventional transplantation (p=0.0008), with 3-year RFS of 89.4% and 56.0% (p=0.0006), respectively. Piggyback transplantations provided outcomes superior to conventional procedures both in patients within (p=0.019 for OS; p=0.003 for RFS) and beyond (p=0.023 for OS; p=0.031 for RFS) Milan criteria. Multivariate analysis of the risks of death and recurrence confirmed the benefits of piggyback technique. CONCLUSIONS Given its superior long-term outcome, piggyback transplantation might be considered primarily for HCC patients.
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Affiliation(s)
- Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
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Petit G, Kornreich C, Noel X, Verbanck P, Campanella S, Choi J, Park SM, Park CB, Gwak AR, Hwang JY, Lee JY, Jung HY, Maurage P, Noel X, Joassin F, Philippot P, Hanak C, Verbank P, Luminet O, de Timary P, Campanella S, Grynberg D, Maurage P, Noel X, Joassin F, Hanak C, Verbank P, Luminet O, de Timary P, Campanella S, Philippot P, Grynberg D, Nyssen L, Quertemont E, Noel X, Doallo S, Gomez-Suarez A, Malkowska A, Topolewska-Wochowska A, Bamburowicz-Klimkowska M, Matsumoto H, Szutowski M, Wojnar M, Corral M, Mateos P, Porras C, Garcia-Moreno LM, Cadaveira F, Rubio G, Libman-Sokolowska M, Matsumoto H, Sygitowicz G, Filipek A, Piwowarska J, Dziklinska A, Radziwon-Zaleska M, Ryszewska-Pokrasniewicz B, Skalski M, Naruszewicz M, Biecek P, Tyce M, Zwierzchowska K, Nasierowski T, Sitkiewicz D, Wojnar M, Kalk N, Cherian R, Naveed M, Newson M, Cavanagh J, Rabiner E, Dar K, McInnes I, Lingford-Hughes A, Neumann A, Vande Weghe N, Philippot P, Luminet O, de Timary P, Vilenne A, Kreusch F, Quertemont E, Brkic S, Soderpalm B, Soderpalm-Gordh A, Oswald L, Wand G, Kuwabara H, Wong D, Brown C, Hutchison KE, Karoly H, Bryan AD, Thayer R, Weiland B, Harlaar N, Bryan AD, Thayer R, Weiland B, Montanaro E, Hutchison K, Lason W, Walecki P, Gorzelanczyk EJ, Walecki P, Gorzelanczyk EJ, Feit J, Pasgreta K, Lason W, Ziolkowski M. PSYCHOLOGY AND MARKERS. Alcohol Alcohol 2013. [DOI: 10.1093/alcalc/agt117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Grąt M, Hołówko W, Lewandowski Z, Kornasiewicz O, Barski K, Skalski M, Zieniewicz K, Krawczyk M. Early post-operative prediction of morbidity and mortality after a major liver resection for colorectal metastases. HPB (Oxford) 2013; 15:352-8. [PMID: 23557408 PMCID: PMC3633036 DOI: 10.1111/j.1477-2574.2012.00596.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 09/10/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND An early prediction of poor outcomes is essential in the management of patients after a liver resection. The aim of this study was to evaluate the role of selected biochemical parameters on post-operative day 1 (POD 1) in the prediction of morbidity and mortality after a liver resection for colorectal metastases. METHOD This retrospective study was based on 236 major liver resections for colorectal metastases performed between 2006 and 2011. Results of biochemical tests of blood samples obtained on POD 1 were assessed as predictors of primary outcome measures (hepatic and overall morbidity, 90-day mortality) using multiple regression and receiver-operating characteristics (ROC). RESULTS Hepatic morbidity, overall morbidity and 90-day mortality rates were 18.6%, 28.0% and 4.7%, respectively. On the basis of multiple regression analysis and comparisons of the prediction models, serum bilirubin was selected for the prediction of hepatic (>2.05 mg/dl, sensitivity 69.2%, specificity 71.2%) and overall (>2.05 mg/dl, sensitivity 61.1% and specificity 71.2%) morbidity, and aspartate aminotransferase (AST) was selected for the prediction of 90-day mortality (>798 U/l, sensitivity 62.5% and specificity 90.4%). DISCUSSION Biochemical analyses of blood on POD1 enables stratification of patients into low- and high-risk groups for negative outcomes, with serum bilirubin associated with overall and hepatic morbidity and AST associated with mortality.
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Affiliation(s)
- Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of WarsawWarsaw, Poland
| | - Wacław Hołówko
- Department of General, Transplant and Liver Surgery, Medical University of WarsawWarsaw, Poland
| | | | - Oskar Kornasiewicz
- Department of General, Transplant and Liver Surgery, Medical University of WarsawWarsaw, Poland
| | - Krzysztof Barski
- Department of General, Transplant and Liver Surgery, Medical University of WarsawWarsaw, Poland
| | - Michał Skalski
- Department of General, Transplant and Liver Surgery, Medical University of WarsawWarsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of WarsawWarsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of WarsawWarsaw, Poland
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Grąt M, Ligocka J, Lewandowski Z, Barski K, Hołówko W, Skalski M, Kornasiewicz O, Usarek P, Zieniewicz K, Młynarczyk G, Krawczyk M. Incidence, pattern and clinical relevance of microbial contamination of preservation fluid in liver transplantation. Ann Transplant 2013; 17:20-8. [PMID: 23018252 DOI: 10.12659/aot.883454] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Transmission of pathogens via preservation fluid (PF) is a potential cause of infection among liver transplant recipients. Here, we evaluated the incidence and pattern of microbial contamination of PF and its impact on postoperative graft function after liver transplantation. MATERIAL/METHODS This longitudinal study included data from 41 primary liver transplantations and 5 re-transplantations performed between December 2010 and September 2011. Results of microbiological analyses of 92 PF samples collected before and after the back-table procedure were evaluated in order to establish the incidence and pattern of contamination. The impact of positive PF cultures on early graft function and rate of pathogen transmission was assessed. Post-transplant antibiotic protocol was based on piperacillin/tazobactam administration for a minimum of 10 days. RESULTS The incidence of contamination was 84.8% (39/46), both for samples collected before and after the back-table procedure. Gram-positive low-virulence organisms typical for superficial saprophytic flora, mainly coagulase-negative staphylococci, were predominant. There were no cases of pathogen transmission from PF to the recipient. Positive cultures of PF samples obtained after the back-table procedure were associated with significant elevation of aspartate (p=0.034) and alanine aminotransferase (p=0.048) on the first 5 postoperative days. No significant differences were found regarding serum bilirubin concentration (p=0.335) and international normalized ratio (p=0.137). CONCLUSIONS Despite high incidence of PF contamination, infections caused by pathogens isolated from PF were not observed. However, presence of pathogens in PF might lead to temporary impairment of graft function.
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Affiliation(s)
- Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
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Krawczyk M, Grat M, Kornasiewicz O, Lewandowski Z, Barski K, Ligocka J, Grat K, Antczak A, Skalski M, Patkowski W, Nyckowski P, Zieniewicz K, Grzelak I, Pawlak J, Alsharabi A, Wróblewski T, Paluszkiewicz R, Najnigier B, Dudek K, Remiszewski P, Smoter P, Grodzicki M, Korba M, Kotulski M, Cieślak B, Kalinowski P, Gierej P, Fraczek M, Rdzanek Ł, Stankiewicz R, Kobryń K, Nazarewski Ł, Giercuszkiewicz D, Piwowarska J, Brudkowska A, Andrzejewska R, Niewiński G, Kilińska B, Zarzycka A, Nowak R, Kosiński C, Korta T, Ołdakowska-Jedynak U, Sańko-Resmer J, Foroncewicz B, Ziółkowski J, Mucha K, Senatorski G, Paczek L, Habior A, Lechowicz R, Polański S, Pacho R, Andrzejewska M, Rowiński O, Kozieł S, Ziarkiewicz-Wróblewska B, Górnicka B, Hevelke P, Cianciara J, Wiercińska-Drapało A, Michałowicz B, Karwowski A, Szczerbań J. Results of liver transplantation in the Department of General, Transplant and Liver Surgery at the Medical University of Warsaw in patients with chronic hepatitis B and C viruses infection. Przegl Epidemiol 2013; 67:5-97. [PMID: 23745368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Cirrhosis related to hepatitis C virus (HCV) and hepatitis B virus (HBV) infection is the most frequent indication for liver transplantation worldwide. Progress in prophylaxis of posttransplant HBV recurrence has led to major improvements in long-term outcomes of patients after liver transplantation. Conversely, impaired posttransplant survival of patients with HCV infection was reported in several studies, mainly due to recurrence of viral infection. The purpose of this study was to compare long-term results of liver transplantation between patients with HBV monoinfection, HCV monoinfection and HBV/HCV coinfection. MATERIAL AND METHODS A total of 1090 liver transplantations were performed in the Department of General, Transplant and Liver Surgery in cooperation with the Department of Immunology, Internal Medicine, and Transplantology at the Transplantation Institute Medical University of Warsaw between December 1994 and May 2012. After exclusion of patients with cirrhosis of non-viral etiology, patients with malignant tumors, and patients with acute liver failure, the final study cohort comprised 209 patients with HBV (HBV+/HCV- subgroup; n = 56) or HCV (HBV-/HCV+ subgroup; n = 119) monoinfection or HBV/HCV coinfection (HBV+/HCV+; n = 34). These subgroups of patients were compared in terms of long-term results of transplantations, defined by 5-year patient and 5-year graft survival estimates. RESULTS Overall and graft survival rates after 5-years for the whole study cohort were 74.5% and 72.6%, respectively. Five-year overall survival was 70.4% for patients within the HBV+/HCV- subgroup, 77.8% for patients within the HBV-/HCV+ subgroup, and 68.5% for patients within the HBV+/HCV+ subgroup. The corresponding rates of graft survival were 67.0%, 76.3%, and 68.5% for patients within the HBV+/HCV-, HBV-/ HCV+, and HBV+/HCV+ subgroups, respectively. Observed differences were non-significant, both in terms of overall (p = 0.472) and graft (p = 0.461) survival rates. CONCLUSIONS Both overall and graft survival rates after liver transplantations performed in the Department of General, Transplant and Liver Surgery in cooperation with the Department of Immunology, Internal Medicine, and Transplantology at the Transplantation Institute Medical University of Warsaw in patients with HBV and HCV infection are comparable to those reported by other European and American centers. In contrast to other studies, obtained results do not confirm the negative impact of HCV infection on long-term outcomes of patients.
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Affiliation(s)
- Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland.
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Skowerska A, Wichniak A, Skalski M. [Sleep and circadian rhythm disturbances in schizophrenia]. Psychiatr Pol 2010; 44:621-631. [PMID: 21452499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM In this study we investigated sleep and circadian rhythm, functioning and psychopathological symptoms in patients with schizophrenia. We looked for answers to the following questions: What percentage of patients with schizophrenia after a therapeutic process in the daily psychiatric ward suffers from insomnia and excessive daytime sleepiness? What factors influence the functioning of patients with schizophrenia. METHODS 23 patients and 23 healthy controls matched for age and sex (14 women, 9 men; mean age 40.5 +/- 13.66) were examined. All subjects filled out sleep diaries, underwent actigraphy for 7 days, and ratings with scales for the assessment of sleep quality, daytime sleepiness, general clinical state and the degree of improvement, presence and severity of psychopathological symptoms and depression, drug side effects. RESULTS Moderate insomnia was found in 6 (26%), severe insomnia in 2 (8%) patients. Four patients (17%) suffered from severe daytime sleepiness. Actigraphy showed a low activity level that had influence on the functioning of patients. The functioning of the patients was most negatively influenced by negative symptoms of schizophrenia and drug side effects. Older patients and those who were ill for a longer time presented more drug side effects and they were more depressive. The patients spent more time in bed and had longer sleep time than healthy controls. The patients presented highest activity at the time of therapeutic activities. CONCLUSIONS Despite improvement of psychopathological symptoms, many patients with schizophrenia still present low daytime activity and clinically significant insomnia and/or daytime sleepiness, which deteriorates their functioning.
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Patkowski W, Skalski M, Zieniewicz K, Nyckowski P, Smoter P, Krawczyk M. Orthotopic liver transplantation for cholestatic diseases. Hepatogastroenterology 2010; 57:605-610. [PMID: 20698235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND/AIMS According to the data of the European Liver Transplant Registry (ELTR), liver transplantations (LTx) as a result of bile duct diseases were reported in 12.0% of cases. The aim of this study was to overview retrospective indications for operation and results of patients who underwent LTx for cholestatic diseases. METHODOLOGY 725 LTx were performed between January 1989 to December 2008, including 173 (23.9%) patients with cholestatic diseases. 80 pts (46.2%) were operated because of PBC, 63 pts (36.4%) with PSC and 12 pts (6.9%) with SBC as a result of iatrogenic bile ducts injuries. In 6 pts (3.5%) Caroli's disease was the reason for transplantation and another 11 pts (6.4%) were operated because of infiltration of alveococcosis into the bile duct. Cholangiocarcinoma (CCC) developed in 6 pts with PSC (9.5%) undergoing LTx. The last patient (0.6%) of our group was operated because of mucoviscidosis. 24 pts (13.9%) underwent unsuccessful surgical treatment prior to the LTx. RESULTS 142 pts (82.1%) presented good outcome, but complications in postoperative period were present in 31 pts (17.9%). 8 pts (4.6%) required re-laparotomy: 6 pts due to intraperitoneal bleeding and hematoma in the first postoperative week and 2 pts due to liver abscess, 1 month and 3 months after LTx respectivelly. 4 patients (2.3%) died in the first week after LTx (septic complications, acute rejection). 5 patients with CCC died in the period of 7 to 26 months after LTx. This was caused by the recurrence of the cancer. The overall mortality was 8.1% (14 pts). 4 pts (2.3%) underwent ReLTx due to various origins--one case due to hepatic artery thrombosis, another was ischemic type biliary lesion (ITBL) and two patients due to recurrence of PBC and PSC. Cumulative 1, 5 and 10 year recurrence-free survival rates after LTx were: 94.6% / 88.7% / 72.1% in PBC group, 95.3% / 86.5% / 70.2% in PSC group and 73.9% / 69.2% / 59.3% in SBC group of patients. CONCLUSION There is no doubt that LTx is a good and effective option of treatment for patients with cholestatic diseases. Nevertheless the long-term benefits of LTx depend on precise indications and timing of the operation.
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Affiliation(s)
- W Patkowski
- Department of General, Transplant & Liver Surgery, Medical University of Warsaw, Poland.
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Patkowski W, Zieniewicz K, Skalski M, Krawczyk M. Correlation between selected prognostic factors and postoperative course in liver transplant recipients. Transplant Proc 2010; 41:3091-102. [PMID: 19857685 DOI: 10.1016/j.transproceed.2009.09.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM The objective was to identify the major prognostic factors influencing liver function after transplantation that predict the postoperative course and long-term survival among liver transplant recipients. We analyzed the results of biochemical, microbiological, serologic, and pathologic studies of the donor and recipient, as well as intraoperative data. MATERIALS AND METHODS Of 542 liver transplant recipients, 215 (39.7%) were analyzed in the period from 1989 to 2006. Patients were divided according to the mechanism leading to the liver disease: group I, hepatitis C virus (HCV) infection (n = 80, 37.0%); group II, hepatitis B virus (HBV) infection (n = 33, 15.0%); group III, HBV and HCV infection (n = 13, 6.0%); group IV, alcoholic liver disease (ALD) (n = 66, 31.0%); and group V, autoimmune hepatitis (AIH) (n = 23, 11.0%). RESULTS Prediction of patient survival based on clinical parameters showed a better prognostic value than that based only on liver function tests. Transplant urgency scores-Model for End-Stage Liver Disease (MELD), delta MELD and United Network for Organ Sharing (UNOS)-enabled us to predict early and long-term patient survival after liver transplantation. Update of these scores, reflecting the patient's condition, enabled us to evaluate pretransplant life-threatening factors and urgency level. Organ donation predictive factors were age, viral status, and degree of liver steatosis. Cold and warm ischemia times still were major prognostic factor. Routine biliary drainage resulted in worse long-term survival than non-drained patients. Liver transplantation for ALD showed the highest complication rate. Chronic liver rejection occurred more frequently in the AIH transplanted group. The most useful predictive factors for 1-year survival were urea/creatinine and liver function tests: aspartate and alanine aminotransferases, gamma-glutamyl transpeptidase the International normalized ratio, and Quick. CONCLUSION The prognosis of patient outcomes after liver transplantation based on clinical parameters showed greater value than evaluation of the laboratory data.
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Affiliation(s)
- W Patkowski
- Department of General, Transplant & Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
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Skalski M. [Sleep medicine]. Przegl Lek 2010; 67:721-725. [PMID: 21387812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Approximately one third of adults report difficulty sleeping, and 10% to 15% have the clinical disorder of insomnia. Among primary care patients, approximately half have sleep difficulties, but these difficulties often are undetected. Sleep disorders, especially chronic insomnia, results in impaired occupational performance and diminished quality of life. Insomnia is associated with higher healthcare usage and costs, including a 2-fold increase in hospitalizations and physician visits. Insomnia is also a risk factor for a number of other medical and psychiatric disorders, such as depression, hypertension. This presentation describes different sleep disorders (insomnia, hypersomnia, obstructive sleep apnea, sleep related movement disorders, circadian rhythms sleep disorders, parasomnias), diagnostic methods available in sleep medicine. The various treatment options for these sleep disorders are also identified.
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Affiliation(s)
- Michał Skalski
- Katedra i Klinika Psychiatryczna Poradnia Leczenia Zaburzeń Snu, Warszawki Uniwersytet Medyczny, Warszawa.
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Maczka G, Siwek M, Skalski M, Dudek D. [Patients' and doctors' attitudes towards bipolar disorder--do we share our beliefs?]. Psychiatr Pol 2009; 43:301-312. [PMID: 19725423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM The aim of the presented study was an analysis and comparison of patients and psychiatrists beliefs regarding the most important aspects of bipolar disorder (BD) treatment. METHOD A group of 100 psychiatrists (with at least 5 years professional experience) and a group of 100 remitted patients fulfilling ICD-10 and DSM IV-TR BD criteria (aged 18-65) were enrolled. Their beliefs were investigated with a 41-item structuralized questionnaire (doctors group) and 27-item self evaluation inventory (patients group). The construction of both tools made it possible to compare the results and was based on hierarchical ranking of answers included in each item. RESULTS A number of important concordances were indicated between doctors and patients beliefs e.g. both groups considered that: 1) the depression is the most burdensome episode in the course of BD; 2) the pharmacotherapy is the most crucial element of treatment; 3) the improvement of life quality is the most important aspect of recovery. On the other hand the results revealed that patients are convinced that doctors consider improving their life quality as much less important than alleviating symptoms severity. The hierarchy of problems proposed by the patients as the main obstacles in taking drugs appeared to be the exact antithesis of doctors beliefs in this issue. The patients indicated drug side effects as the main cause whereas doctors considered compliance as a crucial problem. Discrepancies in beliefs were also observed regarding the perceived importance of different psychoeducation topics: coping abilities and life quality improvement--two most important issues in patients opinion, were placed on the remote rank in doctors hierarchy, giving place to early recognition of relapse symptoms and suicidality prevention. CONCLUSION Discrepancies of psychiatrists and patients beliefs regarding crucial aspects of BD treatment that were revealed in the study may be responsible for worsening of compliance quality.
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Zieniewicz K, Patkowski W, Nyckowski P, Alsharabi A, Michałowicz B, Pawlak J, Paluszkiewicz R, Wróblewski T, Najnigier B, Smoter P, Hevelke P, Skwarek A, Remiszewski P, Kotulski M, Skalski M, Paczek L, Krawczyk M. Results of liver transplantation for hepatocellular cancer. Ann Transplant 2007; 12:11-14. [PMID: 17953137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Liver transplantation (LTx) for hepatocellular carcinoma (HCC) in cirrhotic liver is nowadays generally accepted treatment modality. AIM OF STUDY Overview of the indications and results of the LTx in the patients with HCC, the first one performed in 2001. MATERIAL/METHODS Among 357 adult liver transplant recipients in the period 1994-04.2005, in 26 (7%) the indication was HCC (16 men: 10 women, age 20-65, mean 46.5 years). HCC developed in cirrhotic liver in 25 pts. 12 (48%) were Child C, 10 (30%)--Child B and 3 (12%)--Child A patients. As underlying disease in 2 patients (8%) was alcoholic cirrhosis, in 7 (28%)--HBV cirrhosis, in 12 (48%)--HCV cirrhosis and in 4 (16%)--HBV/HCV cirrhosis. Milano criteria were met in 20 patients (77%). The mean waiting list time was 2.9 months (range 1-6 months). Seven patients underwent liver resection and 1 transarterial chemoembolization prior to LTx. 11 patients (42%) were operated on with use of veno-venous bypass, in 15 patients (58%) the piggy back technique was applied. Rapamycine based immunosuppression was preferred in post-LTx treatment. RESULTS Operative mortality was 0.4 patients required relaparotomy for intraperitoneal bleeding. 21 patients (81%) are alive in good general condition, 19--free of the disease. 5 patients died 7-28 months after LTx (mean 16.7). The mean survival time is 20 months (range 1-38). CONCLUSIONS Liver transplantation is safe and effective method of treatment of the selected patients with HCC in cirrhotic liver. Further investigations concerning the precise indications, timing of the transplantation and adjuvant treatment are necessary.
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Affiliation(s)
- Krzysztof Zieniewicz
- Department of General, Transplant & Liver Surgery, Medical University of Warsaw, Poland.
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Radziwoń-Zaleska M, Matsumoto H, Skalski M, Wilkowska J, Januszko P, Matoszko D, Dziklińska A, Gmaj B, Szelenberger W. Therapeutic tricyclic antidepressant drug monitoring in younger and older depressive patients. Pharmacol Rep 2006; 58:501-6. [PMID: 16963795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2004] [Revised: 03/08/2006] [Indexed: 05/11/2023]
Abstract
The present study shows the evaluation of clinical state and serum level of tricyclic antidepressants in thirty-eight depressive younger and elderly patients during 8-week observation. We observed no statistically significant differences, neither in psychometric scale scores nor in drug serum levels in both groups of patients.
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Affiliation(s)
- Maria Radziwoń-Zaleska
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, PL 00-665 Warszawa, Poland.
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Radziwoń-Zaleska M, Matsumoto H, Skalski M, Dziklińska A, Androsiuk W, Wakarow A, Wilkowska J, Matoszko D, Kuczyńska J, Goluch J. [Therapeutic drug monitoring in depression--new perspectives]. Psychiatr Pol 2002; 36:71-80. [PMID: 12647424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
UNLABELLED 34 patients with diagnosis of depressive episode (ICD-10) were treated for 8 weeks with tricyclic antidepressants (TCA) 22 patients were treated with clomipramine 75-175 mg daily, 11 with imipramine 75-150 mg and 1 with amitriptyline 150 mg. Following parameters were analysed: plasma concentration (FPIA, HPLC), pharmaco-EEG (spectrum power for delta, theta, alfa1, 2, beta 1, 2, 3 by the use of FFT), clinical improvement (HAMD, HARS, SGI, SERS). 50% reduction in HAMD was regarded as improvement. RESULTS No relationship between mental state and plasma concentration of TCA was found, initial results in SERS were prognostic for the course of treatment, pharmaco-EEG was typical for antidepressants after two weeks of treatment and reflects clinical improvement and stabilization of plasma concentration. Comparing the plasma concentration of TCA measured by the use of FPIA and HPLC method may be useful for the implementation of monitoring therapy.
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Abstract
BACKGROUND Lactacidemia is often seen under stress conditions including septic shock in the newborn. Under stress conditions, plasma catecholamine concentrations are increased and play an important role in lactate metabolism. Our previous study shows that perinatal feeding of omega-3 polyunsaturated fatty acid enriched diet (omega-3PUFA) attenuates lactacidemia of endotoxic shock in 10-day-old rats. In the omega-6 fatty acids series, decosapentanoic acid, two series prostaglandins and four series leukotrienes are synthesized through linoleic acids. As plasma lactate concentration correlates with the outcome of septic shock in the newborn, it is important to understand the effects of omega-3PUFA on lactate metabolism. Thus, we tested the hypothesis that perinatal feeding of omega-3 polyunsaturated fatty acid enriched diet (omega-3PUFA) alters responses to catecholamines and attenuates the stress-induced lactacidemia in 10-day-old rats. METHODS Ten-day-old rats which perinatally fed omega-3PUFA. Lactacidemia was induced by swimming for 5 min. Ten-day-old rats which perinatally fed omega-6PUFA were controls. Omega-6 fatty acids series are contained in animal fats and corn oil. Adrenergic blockers were used to assess roles of catecholamines in swimming-induced lactacidemia. RESULTS Swimming increased plasma lactate concentration less (P<0.05) in rats fed omega-3PUFA than rats fed omega-6PUFA. Swimming increased plasma concentrations of glucose and glucagon, cyclic adenosine monophosphate (cAMP) concentration and phosphoenolypruvate carboxykinase mRNA in the liver, and cAMP concentration in the hindlimb muscle more (P<0.05) in rats fed omega-3PUFA than in rats fed omega-6PUFA. Phentolamine and propranolol enhanced swim-induced lactacidemia in the omega-3PUFA group, while they decreased the lactacidemia in the omega-6PUFA group. Propranolol enhanced swimming-induced hyperglycemia in the omega-6PUFA group more than in the omega-3PUFA group. CONCLUSIONS Omega-3PUFA might increase beta-adrenergic response in the liver and increase gluconeogenesis in response to stress, resulting in decreased lactacidemia.
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MESH Headings
- Animals
- Animals, Newborn
- Cyclic AMP/analysis
- Dietary Supplements
- Fatty Acids, Omega-3/pharmacology
- Fatty Acids, Omega-3/therapeutic use
- Fatty Acids, Omega-6
- Fatty Acids, Unsaturated/pharmacology
- Fatty Acids, Unsaturated/therapeutic use
- Lactates/blood
- Liver/chemistry
- Muscle, Skeletal/chemistry
- Physical Conditioning, Animal
- Rats
- Rats, Sprague-Dawley
- Stress, Physiological/physiopathology
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Affiliation(s)
- M Skalski
- The Ronald McDonald Children's Hospital at Loyola, Illinois, USA
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39
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Niemcewicz S, Szelenberger W, Skalski M, Androsiuk W, Piotrowski T, Myszka DM, Moskwa M. [Psychophysiological correlates of primary insomnia]. Psychiatr Pol 2001; 35:583-91. [PMID: 11760459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Psychophysiological differences between 16 patients with primary insomnia, 7 men and 9 women, of mean age 40.8 years, and 16 controls, matched according to age, sex and education, were studied. Insomniacs differed from controls in the following results: their motor activity level was higher during night, sleep efficiency was lower and complexity in slow wave sleep was higher. The Hyperarousal Scale score was higher in insomniacs and it correlated with severity of insomnia in Athens Insomnia Scale. Sleep latency in MSLT was not shorter in patients group. Reaction time was shorter, moreover, the number of presentations necessary to memorize all items of Selective Reminding Test was greater in these patients. Degree of the learning disturbance correlated with the Athens Insomnia Scale score. No correlations were found between Selective Reminding Test and standard polysomnographic parameters. To sum up, the hypothesis on 24-hour hyperarousal in primary insomnia has been confirmed and learning impairment has been documented in the present study, independent of standard polysomnographic parameters.
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Affiliation(s)
- S Niemcewicz
- Katedry i Kliniki Psychiatrycznej AM w Warszawie
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40
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Goltzené F, Skalski M, Wolff CM, Meyer D, Mager-Heckel AM, Darribère T, Remy P. Heterotopic expression of the Xl-Fli transcription factor during Xenopus embryogenesis: modification of cell adhesion and engagement in the apoptotic pathway. Exp Cell Res 2000; 260:233-47. [PMID: 11035918 DOI: 10.1006/excr.2000.5005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In the Xenopus laevis embryo, the overexpression of the Xl-FLI protein, a transcription factor of the ETS family, provokes severe developmental anomalies, which affect anteroposterior and dorsoventral polarities, optic cup formation, head cartilage morphogenesis, and erythrocyte differentiation. It has been proposed that these effects could be correlated to modifications of cell adhesion properties and/or to an increased engagement of cells in the apoptotic pathway during early development (Remy et al., Int. J. Dev. Biol. 40, 577-589, 1996). To address these questions, we have first analyzed the behavior of cells overexpressing the protein in both aggregation and adhesion assays. We observe perturbations of cell-cell interactions as well as perturbations of cell adhesion and spreading on fibronectin and extracellular matrix (ECM). Second, we have analyzed apoptosis of cells overexpressing the Xl-FLI protein, by testing DNA fragmentation, caspase-3 activity and by performing TUNEL assay. We show that Xl-Fli overexpression results in the appearance of hallmarks of apoptosis, including exclusion of cells from the interior of the embryo, internucleosomal fragmentation of DNA and dose-dependent induction of caspase-3, resulting in the hydrolysis of poly(ADP-ribose) polymerase. In addition, a dominant-negative mutation of BMPs receptors decreases the effects of Xl-Fli overexpression, suggesting that a modification of the BMP signalling could be responsible for increased apoptosis. The latter appears to affect predominantly ventral and ventrolateral regions of the embryo.
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Affiliation(s)
- F Goltzené
- FRE 2168 du CNRS "MMDCD,", Institut de Physiologie et Chimie Biologique, 21 rue René Descartes, Strasbourg-cedex, 67084, France
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41
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Radziwoń-Zaleska M, Matsumoto H, Skalski M, Androsiuk W, Dziklińska A, Kunicki PK. Therapeutic drug monitoring in depression. Pol J Pharmacol 2000; 52:255-66. [PMID: 11345481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The difference between Therapeutic Drug Monitoring (TDM) and uncontrolled therapy consists in the fact that in TDM we can predict a certain scheme of treatment according to clinical and laboratory results. It is a method which serves to increase the efficacy and safety of pharmacotherapy in an individual patient. This paper presents the results of the treatment with tricyclic antidepressants based on the monitoring of serum drug level in 32 patients with indications for using pharmacogenetic as well as pharmacoelectroencephalographic tests. Clinical status of the patients was evaluated according to: Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Clinical Global Impression Scale (CGIS), and TCA concentration in serum was determined using Fluorescence Polarization Immunoassay (FPIA). Hydroxylation phenotype was determined using debrisoquine as a model drug. EEG was recorded in four leads: F3-C3, F4-C4, P3-O1, P4-O2. In the present study, we did not found any significant correlation between clinical status and serum TCAs concentrations measured by FPIA method. Efficacy of antidepressant treatment and stabilization of serum TCA concentrations depended largely upon the time course of the treatment. Debrisoquine phenotyping revealed the presence of one poor metabolizer (MR = 15) in the examined group of patients. A significant improvement in the clinical status of the patients, the stabilization of therapeutic drug concentrations, the appearance of antidepressive profiles in the pharmaco-EEG profile after 14 days of therapy, as well as the starting value determined by SERS were shown to be prognostic factors for the further antidepressant therapy.
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42
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Abstract
Integrins are heterodimeric transmembrane glycoproteins involved in cell-cell and cell-extracellular matrix adhesion. They also participate in cytoskeletal rearrangements, co-regulation of growth factor activities and activation of signal transductions. This review describes experimental approaches that have given new insights into the integrin functions during embryogenesis. Using anti-functional antibodies, peptide inhibitors of integrin-ligand interactions and genetic ablation of integrins results, this review will show that integrins are key molecules during early development of both invertebrates and vertebrates.
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Affiliation(s)
- T Darribère
- Université P.-et-M.-Curie, U.M.R.-CNRS 7622, Laboratoire de Biologie Moléculaire et Cellulaire du Développement, Equipe Adhesion et Migration Cellulaires, Paris, France
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43
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Skalski M, Alfandari D, Darribère T. A key function for alphav containing integrins in mesodermal cell migration during Pleurodeles waltl gastrulation. Dev Biol 1998; 195:158-73. [PMID: 9520332 DOI: 10.1006/dbio.1997.8838] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
During cleavage of Pleurodeles waltl amphibian embryos, inner cells of the blastocoel roof (presumptive ectodermal and mesodermal cells) organize a fibrillar extracellular matrix (ECM) containing fibronectin on their basal surface by a beta1-integrin-dependent process. This matrix is used as a migratory substrate by mesodermal cells during gastrulation. While alpha5beta1 integrin is expressed on both ectodermal and mesodermal cell surface, we have shown previously that alphav containing integrins are essentially restricted to the surface of mesodermal cells (Alfandari, D., Whittaker, C. A., DeSimone, D. W., and Darribère, T., Dev. Biol. 170, 249-261, 1995). To investigate the function of alphav integrins during gastrulation, we have generated a function blocking antibody directed against the extracellular domain of the Pleurodeles integrin alphav subunit. The antibody did not prevent fibronectin fibril formation, whereas an antibody against the alpha5beta1 integrin did. When injected into the blastocoel, the antibody against integrin alphav subunit perturbed gastrulation and further development in a stage-dependent manner. Developmental defects were correlated to an abnormal positioning of the mesoderm layer. In vitro, the antibody blocked spreading of mesodermal cell to fibronectin or blastocoel roof ECM but not their attachment. In contrast, the antibody directed against the alpha5beta1 integrin inhibited both cell attachment and spreading to the same substrates. We propose that the alpha5beta1 integrin is required for fibronectin assembly into fibrils and mesodermal cell attachment to the blastocoel roof ECM, while the alphav containing integrins are necessary for cell spreading, and possibly migration, on this complex network.
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Affiliation(s)
- M Skalski
- Equipe Adhesion et Migration Cellulaires, Université P. et M. Curie, CNRS UMR 7622, 9 Quai Saint-Bernard, Paris Cedex 05, 75252, France
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44
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Matsumoto H, Szelenberger W, Skalski M, Wilczak H, Krysa G, Abramowska M, Radziwoń-Zaleska M. 122 LITHIUM HAND TREMOR. Ther Drug Monit 1997. [DOI: 10.1097/00007691-199710000-00133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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45
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Wasilewski D, Matsumoto H, Kur E, Dziklińska A, Woźny E, Stencka K, Skalski M, Chaba P, Szelenberger W. Assessment of diazepam loading dose therapy of delirium tremens. Alcohol Alcohol 1996; 31:273-8. [PMID: 8844033 DOI: 10.1093/oxfordjournals.alcalc.a008147] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The efficacy of the diazepam loading dose method of treatment of delirium tremens was assessed in comparison with the traditional therapy. The experimental group and the control group comprised 51 and 45 patients respectively. The clinical institute withdrawal assessment for alcohol (CIWA-A) scale was applied to assess the intensity of the symptoms. Diazepam doses in the experimental group oscillated from 40 to 210 mg (mean 86.9 +/- 47.2 mg). The control group was receiving diazepam and other psychotropic drugs in divided doses. In the experimental group deliric symptoms were present from 2 to 24 h (mean 6.9 +/- 4.8 h), and in the control group from 2 to 123 h (mean 33.8 +/- 25.7 h). The results show a large efficacy of the loading dose method corresponding to substantial reduction of the psychosis duration (fivefold in comparison to the control group). The method proved to be safe, with no significant complications.
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Affiliation(s)
- D Wasilewski
- I Department of Psychiatry, Warsaw Medical Academy, Poland
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46
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Szelenberger W, Wackermann J, Skalski M, Drojewski J, Niemcewicz S. Interhemispheric differences of sleep EEG complexity. Acta Neurobiol Exp (Wars) 1996; 56:955-9. [PMID: 9033131 DOI: 10.55782/ane-1996-1203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Complexity of EEG (omega), a global measure reflecting degree of spatial synchronization, was computed for whole night recordings of sleep EEG of 10 healthy volunteers, 9 males and 1 female (age 21-53) and 6 depressive patients, 5 males and 1 female (age 23-64). Sleep was scored visually in 20 s epochs, omega was calculated in 2.5 s segments and the median from 8 segments (20 s) was calculated. omega was calculated for the whole field of 21 electrodes and for the left and right hemisphere separately (2 x 8 electrodes). Measure of global power (sigma) and generalized frequency (phi) were also computed for the same data. In healthy subjects the complexity was higher over the right hemisphere during waking, and the difference shifted to higher complexity over the left hemisphere in slow wave sleep (F = 5.15, df1 = 4, df2 = 6856, P < 0.0005). The opposite trend was found in depressives (F = 10.51, df1 = 4, df2 = 3960, P < 0.0001).
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Affiliation(s)
- W Szelenberger
- Department of Psychiatry, Medical Academy, Warsaw, Poland.
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47
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Szelenberger W, Wackermann J, Skalski M, Niemcewicz S, Drojewski J. Analysis of complexity of EEG during sleep. Acta Neurobiol Exp (Wars) 1996; 56:165-9. [PMID: 8787170 DOI: 10.55782/ane-1996-1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
New multichannel descriptors of EEG activity: complexity (omega), total power (zeta) and generalized frequency (phi) were applied to whole night sleep analysis in 11 healthy subjects. The values of omega and phi decreased systematically from waking to slow wave sleep, and increased systematically in consecutive NREM-REM sleep cycles. The changes of zeta were opposite to omega and phi. These descriptors may be an alternative approach to the EEG sleep analysis.
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Affiliation(s)
- W Szelenberger
- Department of Psychiatry, Warsaw Medical Academy, Poland
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48
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Wasilewski D, Matsumoto H, Kur E, Dziklińska A, Woźny E, Stençka K, Skalski M, Chaba P, Szelenberger W. [Treatment of delirium tremens with quick administration of diazepam]. Psychiatr Pol 1995; 29:675-86. [PMID: 8577908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In this efficacy the study of diazepam loading-dose treatment of delirium tremens was evaluated in comparison with traditional therapeutic methods. Experimental and control groups consisted of 42 and 40 patients respectively. The severity of the withdrawal symptoms was evaluated from clinical status, in the experimental group CIWA-A score was also employed. Study results suggest high efficacy of the loading-dose method, which was characterized by significant shortening of psychosis duration (five times shorter in experimental vs. control group). The method turned out to be safe, no complications were observed during and after the treatment.
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49
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Rybakowa M, Tylek D, Ratajczak R, Antoń A, Skalski M, Przybylik-Mazurek E, Huszno B, Gołkowski F, Tarnawski A, Szybiński Z. Goiter incidence and urinary iodine excretion in children of age group 6-13 years living in south-eastern Poland (Kraków coordinating center). Endokrynol Pol 1993; 44:249-58. [PMID: 8055794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The study included 4103 school children attending randomly selected schools localized in towns and villages of 3 geographically distinct regions: mountainous, (Carpathian endemia), upland, lowland. The children were divided into four age-related groups. The incidence of goiter as detected by palpation was 38.1% in all the children studied, the value being similar in all three regions (38.1, 37.3 and 38.6%, respectively). Goiter incidence differs slightly among urban and rural children, amounting to 40.5 and 34.5%, respectively, in the two groups. In about 60% of children urinary iodine excretion was lower than 50 micrograms/l, while in about 30% it was normal. In about 10% of children studied urinary iodine excretion was lower than 20 micrograms/l. The results obtained indicate the occurrence among children of the studied region of goiter endemy of moderate degree. It was found that the percentage of children excreting more than 50 micrograms/l of urinary iodine was higher among those consuming iodized salt as compared to those consuming non-iodized salt. The first effects of resumption of common salt fortification with iodide in southern Poland can already be noted. There is, however, a need for optimization and steady control over this prophylactic action.
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Affiliation(s)
- M Rybakowa
- Department of Endocrinology of Children and Adolescents, Polish-American Children's Hospital, Kraków
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50
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Szybiński Z, Korzeniowska D, Przybyszowski A, Przybyłowski J, Skalski M, Gołkowski F, Stanuch H, Wiśniowski Z. [Results of epidemiologic studies performed after the disaster in Czernobyl among the adult part of the population in the region of Krakow]. Endokrynol Pol 1991; 42:263-71. [PMID: 1364478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Epidemiologic studies following the Czernobyl accident were performed in region Kraków, including Kraków, Nowy Sacz and Kielce district. 1426 males and 2495 females were selected according to the random sample on the whole population of Kraków and Nowy Sacz, as well as in some selected areas in Swietokrzyski Mountains, and in Kielcecity. The aim of the study was to assess the results of the prophylaxis with Kalium iodine after the radiation and the incidence of the goiter in the population. It was stated, that 19.2% of the population in Kraków district, 16.9% in Nowy Sacz and 20% in Kielce received the prophylactic dosis of K.J. 80% took mainly the Lugol solution, between May, the 1st and 5th, 1986. Among 18 of person showing side effects like gastrointestinal disturbances, 16 were of female sex. Goiter incidence according to WHO classification was 50.7%, 67.3% and 49.9% in Kraków, Nowy Sacz and Kielce respectively. The difference between the incidence of goiter in males and females was 1:3. In women it was rather Ist and IInd degree of goiter, in men OB and Ist. Nodules of thyroid gland in the rural region of Kraków, Nowy Sacz and Kielce were seen in women in 10.8%, 1.7%, add 12.3% consecutively. Hormonal studies i.e T3, T4, TSH serum concentration showed normal results in all groups studied. TSH concentration was the highest in the group OB. The microsomal and antithyroglobulin antibodies level was the same independently on the prophylactic dosis of Lugol solution. The high incidence of thyroid diseases not related to the accident was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- Z Szybiński
- Katedra i Klinika Endokrynologii AM w Krakowie
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