Cardiac amyloidosis: a review

Cardiac amyloidosis is a type of amyloidosis in which one of the affected organs is the heart. The disease is characterized by the formation of protein aggregates between the cells of the organ, namely amyloid, which disables its function. The following types of amyloidosis can be distinguished: systemic senile amyloidosis (wild-type ATTR), light chain amyloidosis (AL) and hereditary transthyretin-related amyloidosis. The symptoms include, e.g., systolic dysfunction or arrhythmia. The treatment is focused on the therapy with melphalan and, additionally, stem cells transplant and chemotherapy with dexamethasone or cyclophosphamide. In the advanced stage of the disease, a heart transplant is necessary. The diagnosis is made on the basis of laboratory testing, electrocardiogram changes, and echocardiography

Haloperidol and extrapyramidal symptoms: selected recent reports

Antipsychotic therapy by haloperidol is used from many decades and it still occupies a key place in the treatment ofsymptoms and prevention of recurrence of schizophrenia, mainly paranoid. It is also used in the treatment of bipolardisorder and behavioral disorders as well. It is also effective as an antiemetic and in drug-resistant hiccups. It can beused by both adults and children. The purpose of this review is to show selected articles describing methods, which mayreduce or even eliminate the risk of developing extrapyramidal syndrome, which is unavoidably accompanied by pharmacotherapywith this drug. These symptoms are a frequent cause of withdrawal of psychiatric medications by patientsand thus, they are the reasons of the therapy’s failure. This review includes interpretations of articles that present theresults of research on new methods for predicting the risk of extrapyramidal syndrome caused by haloperidol treatment.In this article we discussed predictive values of such factors as arterial blood lactate levels, creatine kinase activity, serumselenium level or early antipsychotic effect. In search of new methods of prevention of the extrapyramidal syndrome, weanalyzed the effect of caffeine, naproxen and cystamine. Evaluation of the clinical and morphological effects of chronichaloperidol administration has been based on results of patients who were suffering from paranoid schizophrenia froma minimum of 30 years. The results of experiments comparing the new form of administration of haloperidol with thepreviously known ones are also presented. The ideas presented in these works often require further clinical trials, whichmay be the reason for exploring these problems.Terapia przeciwpsychotyczna haloperidolem jest stosowana od wielu dekad i wciąż zajmuje kluczowe miejsce w leczeniu objawów i zapobieganiu nawrotom schizofrenii, głównie paranoidalnej. Jest stosowany również w terapii choroby afektywnej dwubiegunowej, jak również zaburzeń zachowania. Skuteczny też jako środek przeciwwymiotny i w opornej na leki czkawce. Dopuszcza się używanie zarówno u osób dorosłych jak i dzieci. Celem tego przeglądu jest ukazanie wybranych prac opisujących metody, które mogą w przyszłości zmniejszyć lub nawet wyeliminować ryzyko wywoływania zespołu pozapiramidowego, który nieodzownie towarzyszy farmakoterapii tym lekiem. Objawy te są częstą przyczyną odstawiania medykamentów psychiatrycznych przez pacjentów i tym samym niepowodzenia terapii. W niniejszym przeglądzie zawarte są interpretacje artykułów, które prezentują wyniki badań nad nowymi metodami przewidywania ryzyka wystąpienia zespołu pozapiramidowego wywołanego leczeniem haloperidolem. Omówiono wartości predykcyjne takich czynników jak stężenia mleczanów we krwi tętniczej, aktywność kinazy kreatynowej, poziom selenu w surowicy czy wczesny efekt przeciwpsychotyczny. W poszukiwaniu nowych sposobów prewencji zespołu pozapiramidowego przeanalizowano efekt działania kofeiny, naproksenu oraz cystaminy. Ocenie skutków klinicznych i morfologicznych przewlekłego stosowania haloperidolu zostali poddani pacjenci chorujący na schizofrenię paranoidalną od minimum 30 lat. Przedstawione zostały też wyniki doświadczeń porównujących nową formę podawania haloperidolu z dotychczas znanymi. Idee przedstawione w tych pracach nierzadko wymagają dalszych badań klinicznych, co może stać się przyczyną do zgłębiania tych problemów

Delusional Misidentification Syndrome: dissociation between recognition and identification processes

Delusional misidentification syndrome (DMS) is an umbrella term for syndromes of intermetamorphosis, Fregoli, and Capgras. DMS) is thought to be related to dissociation between recognition and identification processes. DMS was described for the first time in 1932 as a variant of the Capgras syndrome and is currently on the DSM-V list of diseases as an independent disease entity. Patients affected by DMS believed that people around them, most often family, have changed physically (appearance) and mentally (character). Other symptoms include confabulation, derealization or depersonalization. In patients, aggressive behavior is often observed, aimed at alleged doppelgangers resulting from the sense of being cheated and manipulated. With the intermetamorphosis syndrome, for example, schizophrenia, depression, bipolar disorder or other misidentification syndromes (Fregoli's, Capgras) may coexist. There is also a reverse intermetamorphosis, where the object of the changed appearance or character becomes the patient himself. One of its forms may be lycanthropy. The etiology of the intermetamorphosis has not been fully understood, one of the reasons may be brain damage and changes in the parietal and/or temporal lobes of the right hemisphere. It may then damage long neuronal connections to the frontal areas of the brain, disturbances of working memory (WM) accountable for the keep and online management of data, so that it is available for further processing, and the patient's will be uncritical. The basic method of diagnosis of this delusion is a medical interview with the patient. Other diagnostic methods include computed tomography, magnetic resonance imaging, EEG and ERPs. Experimental methods include searching for the neuromarker of DMS. Currently, there are no treatment guidelines of this delusional disorder, and pharmacotherapy experimental, but the drugs from the group of neuroleptics and lithium seem effective. Some hope for the treatment is created by neurotherapy, but it is also experimental