Kardiowersja elektryczna migotania przedsionków - 40 lat od wprowadzenia metody do praktyki klinicznej

Migotanie przedsionków jest najczęściej występującą arytmią w praktyce klinicznej. Mimo 4 dekad od wprowadzenia kardiowersji elektrycznej do praktyki klinicznej metoda ta pozostaje najbardziej skutecznym sposobem przywrócenia rytmu zatokowego. Niniejsze opracowanie przedstawia aktualne poglądy dotyczące zastosowania i przeprowadzenia kardiowersji elektrycznej, właściwego przygotowania chorego do zabiegu oraz potencjalnych zagrożeń związanych z wykonywaniem tej procedury medycznej. Omówiono również możliwości nowych defibrylatorów wyposażonych w funkcję aplikacji prądu o morfologii dwufazowej. (Folia Cardiologica Excerpta 2006; 1: 473-478

Childhood adversities are not a predictors of SSTR4met in alcoholics

Genome methylation may modulate synaptic plasticity, being a potential background for mental disorder. Adverse childhood experiences (ACEs), known to be frequently reported by patients with alcohol dependence (AD), have been proposed as one of environmental inequities influencing DNA methylation. The study is aiming 1.To assess a promoter region methylation in gene for somatostatin receptor subtype-4 (SSTR4), a receptor for somatostatin, a neurotransmitter engaged in neuroplasticity and memory formation, in patients with AD; 2. To verify if SSTR4 promoter methylation is associated with ACEs and other selected environmental factors. Methodology: 176 patients with AD and 127 healthy controls were interviewed regarding 13 categories of ACEs; a structured self-reported questionnaire - to measure the sociodemographic and clinical characteristics; a module of Catalogue of Healthy Behavior – to assess nutritional health habits; the Alcohol Use Disorders Identification Test – to assess drinking severity. The SSTR4 promoter region methylation status was performed via methylation-specific PCR, and the genotyping for the SSTR4 rs2567608 functional polymorphism - according to the manufacturer’s standard PCR protocol

SSTR4, childhood adversity, self-efficacy and suicide risk in alcoholics

Patients with alcohol dependence (AD) are known to develop poor social skills, to report a higher number of adverse childhood experiences (ACEs) and to attempt suicide more frequently than the general population. The background for the association between ACEs and a higher risk of suicide still remains understudied. SSTR4 rs2567608 is a functional polymorphism of the gene for somatostatin receptor subtype 4, predominantly found in the CA1 hippocampus area and involved in memory formation. We hypothesize that the functional polymorphism SSTR4 rs2567608, general self-efficacy, and adverse childhood experiences influence the risk of suicide attempt in patients with AD

Creutzfeldt-Jakob disease in the psychiatric practice -case reports of the ataxic and Heidenhain variant

Summary Objectives. Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare fatal neurodegenerative brain disorder of variable clinical manifestation. Making right diagnosis still remains challenging. First symptoms are vague and differ between clinical subtypes of the disease. This is to present the symptoms variability and diagnostic difficulties in sCJD based on case reports of two female patients examined at time of the disease duration by psychiatrists. Methods. Data of our patients were collected from hospital medical records. Results. The case of patient A. P.' ataxic sCJD is an example of clinical picture suggesting neurological background of the disease almost from the symptoms' onset and being referred by psychiatrist to the neurological ward, where the right diagnosis of probable sCJD was established. In the opposite is the case of patient I. W.' Heidenhain variant of sCJD, misdiagnosed with dissociative disorder and delivering huge diagnostic difficulties, even to neurologists. In both patients the certain diagnosis was confirmed at autopsy. Conclusions. In patients with visual disturbances of unknown etiology, even if the ophthalmological and neurological background is excluded, sCJD should be taken into consideration in the differential diagnosis

Psychiatric History and Overactive Bladder Symptom Severity in Ambulatory Urogynecological Patients

Introduction and hypothesis: A link between psychiatric comorbidities and overactive bladder symptomatology has been suggested by preclinical and clinical studies. Given this, we hypothesized that a psychiatric history and current treatment with psychotropic medications could be related to the severity of overactive bladder and incontinence symptoms in patients referred to a tertiary care urogynecological center. Methods: One hundred and twenty-seven female patients diagnosed with an overactive bladder were screened for a lifetime history of psychiatric disorders and the type and number of psychotropic medications currently taken. The overall severity of overactive bladder symptoms was assessed using the Indevus Urgency Severity Scale. The severity and impact of urinary incontinence on the quality of life were quantified with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Urinary incontinence was further quantified with the aid of the Urinary Distress Inventory-6. The patients were screened for stress urinary incontinence using the Stamey Incontinence Score. Results: A psychiatric history, as well as current use of at least two psychotropic medications, was associated with increased severity of overactive bladder symptoms. A history of depression and current treatment with any selective serotonin reuptake inhibitor was associated with increased severity of stress urinary incontinence symptoms. Current treatment with other psychotropic medications, including sedative-hypnotics and drugs with anticholinergic properties was not related to the severity of overactive bladder and incontinence symptoms