A debate: Can we recommend electronic cigarettes to our patients? Opinion 2

Electronic cigarettes are more and more frequently used to deliver nicotine. They are used both by the users of regular cigarettes and those who to date have not smoked. The literature about potential impact of electronic nicotine delivery systems on health is constantly growing. Particular concern is expressed about toxicity of chemical compounds and elements delivered with the vapour of electronic cigarettes. It turns out that products that have positive image in media, actually are not so beneficial. Furthermore, they not only may cause damage to health but also death.Electronic cigarettes are more and more frequently used to deliver nicotine. They are used both by the users of regular cigarettes and those who to date have not smoked. The literature about potential impact of electronic nicotine delivery systems on health is constantly growing. Particular concern is expressed about toxicity of chemical compounds and elements delivered with the vapour of electronic cigarettes. It turns out that products that have positive image in media, actually are not so beneficial. Furthermore, they not only may cause damage to health but also death

Nauczanie i wychowanie w pracy z pacjentami chorymi na schizofrenię

The purpose of this paper is to discuss the role of pedagogical work in the rehabilitation of patients with schizophrenia. The article discusses ways of rehabilitation of patients with schizophrenia taking into account the importance of teachers work. This model developed G. Thornicroft and coworkers and it is called the matrix model.The purpose of this paper is to discuss the role of pedagogical work in the rehabilitation of patients with schizophrenia. The article discusses ways of rehabilitation of patients with schizophrenia taking into account the importance of teachers work. This model developed G. Thornicroft and coworkers and it is called the matrix model

The -463G/A and -129G/A myeloperoxidase-encoding gene polymorphism in chronic obstructive pulmonary disease

Introduction: Neutrophils are involved in the pathogenesis of chronic obstructive pulmonary disease (COPD). Myeloperoxidase is an important bactericidal granulocytic enzyme. It is of interest to question whether or not the polymorphic variants of the myeloperoxidase-encoding gene are associated with the risk of developing COPD. Material and methods: The study determined the risk of COPD development in 186 COPD patients and 220 healthy subjects in the context of two selected polymorphic sites of the promoter region of the myeloperoxidase-encoding gene. Results: It has been demonstrated that the AA genotype of locus -463 in the myeloperoxidase-encoding gene increases the risk of developing COPD (OR: 2.87; CI: 1.651–4.997). This genotype also correlates with a higher gene expression in patients (0.56  ± 0.12 vs 0.31 ± 0.18 in patients with AG genotype and 0.29 ± 0.17, p < 0.01 in those with GG genotype). In healthy indivi-duals, the AA genotype was also characterized by increased expression of the myeloperoxidase-encoding gene (0.41 ± 0.16 vs 0.29 ± 0.15 for AG genotype, p < 0.01 and 0.25 ± 0.16 for GG genotype p < 0.01). Patients with the AA genotype had  a significantly higher gene expression than healthy subjects with this genotype. Conclusions: The polymorphic site -129 of the myeloperoxidase-encoding gene was unrelated to the development of COPD. The gene expression did not differ for the individual genotypes. Our studies indicate that the polymorphism of the myeloperoxidase--encoding gene may be related to chronic obstructive pulmonary disease

Erection disturbances in young men with mood disorders receiving no pharmacological treatment and body weight

Wstęp. Zaburzenia wzwodu stanowią ważne zagadnienie z zakresu seksuologii i psychologii stosunków międzyludzkich. Kluczowym objawem zaburzeń nastroju jest zmniejszenie potrzeb seksualnych. Z drugiej strony leczenie depresji lekami przeciwdepresyjnymi nasila zaburzenia seksualne u pacjentów. Celem niniejszej pracy jest określenie częstości zaburzeń wzwodu u chorych na depresję pierwszorazowo zgłaszających się do poradni zdrowia psychicznego i po 12 miesiącach leczenia. Materiał i metody. W pracy przebadano 56 mężczyzn w wieku 19-45 lat zgłaszających się pierwszorazowo do poradni zdrowia psychicznego z rozpoznaniem epizodu depresji łagodnego lub umiarkowanego. Rozpoznanie depresji zoperacjonalizowano przy użyciu badawczych kryteriów Międzynarodowej Klasyfikacji Dziesiętnej Zaburzeń Psychicznych i Zaburzeń Zachowania. U wszystkich badanych oceniano nasilanie depresji za pomocą Skali Depresji Hamiltona w wersji proponowanej przez Pużyńskiego i Wciórkę. Stopień nasileń wzwodu oceniano za pomocą 4-punktowej skali (0 - brak zaburzeń, 1 - pełna zdolność do uzyskania i utrzymania erekcji łagodnie obniżona, 2 - pełna zdolność do uzyskania i utrzymania erekcji umiarkowanie obniżona, 3 - brak możliwości odbycia stosunku z powodu dysfunkcji erekcji). Wyniki. W pracy wykazano, że epizod depresyjny jest czynnikiem ryzyka wystąpienia zaburzeń wzwodu u mężczyzn. Wykazano także, że wskaźnik masy ciała koreluje z zaburzeniami wzwodu w badanej grupie. Stwierdzono ponadto, że zarówno w grupie osób chorych na depresję, jak i zdrowych częstość zaburzeń wzwodu zwiększa się z wiekiem. Wnioski: 1. Depresja jest czynnikiem ryzyka wystąpienia zaburzeń wzwodu u mężczyzn. 2. Wskaźnik masy ciała koreluje z zaburzeniami wzwodu w badanej grupie. 3. Zarówno w grupie osób chorych na depresję, jak i zdrowych częstość zaburzeń wzwodu zwiększa się z wiekiem.Introduction. Erection disturbances are an important problem of sexology and psychology of human relations. The key symptom of mood disturbances is reduction of sexual needs. On the other hand, the treatment of depression with antidepressants aggravates sexual dysfunctions in the patients. The aim of the presented study was to determine the prevalence of erection disturbances among depressive patients at the time of their first visit at the Mental Health Department and after 12 months of treatment. Material and methods. The study was based on examinations of 56 males aged 19-45 years seen for the first time in the outpatient department of mental health, diagnosed with a mild or moderate depressive episode. The diagnosis of depression was established on the basis of ICD-10 criteria. In all the patients, the severity of depression was assessed using Hamilton Depression Scale in the version proposed by Pużyński and Wciórka. The magnitude of erection was assessed according to a 4-grade scale (0 — no disturbances, 1 - mild impairment of the ability to obtain and maintain erection, 2 - moderate impairment of the ability to obtain and maintain erection, 3 - sexual intercourse impossible because of erective dysfunction. Results. The study demonstrated that a depressive episode is a risk factor for erection disturbances in male patients. The body mass index was also demonstrated to correlate with erection disturbances in the analyzed group. Additionally, the incidence of erective dysfunctions was observed to increase with age, both in the group of depressive patients and in healthy subjects. Conclusions: 1. Depression episode is a risk factor for erection disturbances in male patients. 2. Body mass index correlates with erection disturbances in the analyzed group. 3. The incidence of erective dysfunctions increases with age, both in the group of depressive patients and in healthy subjects

Debata. Czy możemy polecać e-papierosy naszym pacjentom? Opinia 2

Elektroniczne papierosy są coraz częściej używanym sposobem dostarczania nikotyny. Sięgają po nie zarówno użytkownicy papierosów tradycyjnych, jak i osoby do tej pory niepalące. Cały czas pojawiają się nowe artykuły traktujące o potencjalnym wpływie elektronicznych systemów dostarczających nikotynę na zdrowie. Szczególne obawy budzi toksyczność związków chemicznych i pierwiastków dostarczanych wraz z dymem z tych urządzeń. Okazuje się, że produkty, których kreowany medialnie wizerunek jest pozytywny, wcale takimi nie są. Co więcej, ich używanie może skutkować nie tylko uszczerbkiem dla zdrowia, ale i śmiercią.Elektroniczne papierosy są coraz częściej używanym sposobem dostarczania nikotyny. Sięgają po nie zarówno użytkownicy papierosów tradycyjnych, jak i osoby do tej pory niepalące. Cały czas pojawiają się nowe artykuły traktujące o potencjalnym wpływie elektronicznych systemów dostarczających nikotynę na zdrowie. Szczególne obawy budzi toksyczność związków chemicznych i pierwiastków dostarczanych wraz z dymem z tych urządzeń. Okazuje się, że produkty, których kreowany medialnie wizerunek jest pozytywny, wcale takimi nie są. Co więcej, ich używanie może skutkować nie tylko uszczerbkiem dla zdrowia, ale i śmiercią

The utility of selected questionnaires in the assessment of fatigue, depression and health quality in post-sarcoidosis fatigue syndrome

Introduction: The nature of post-sarcoidosis fatigue syndrome (PSFS) is unknown and tools for the assessment of health quality (HQ) in these patients have not been fully assessed. The aim was to validate the Polish version of sarcoidosis health questionnaire (SHQ) and verify the association of HQ with fatigue and depressive symptoms among Polish patients with PSFS. Material and methods: 71 patients with sarcoidosis (34 women, the mean age 47) were divided to: PSFS (n = 21), active sarcoidosis (S-A, n = 27) and sarcoidosis with complete remission (S-R, n = 23) groups. Fatigue Assessment Scale (FAS) was used to define significant fatigue (≥ 22 points). Polish version of SHQ was prepared by the authors and validated. Beck Depression Index (BDI) and Patient Health Questionnaire 9 (PHQ-9) were used to evaluate self-reported depressive symptoms. Results: Polish version of SHQ was proved reliable and valid. HQ was worse and depressive symptoms were more frequent in PSFS and S-A when compared with S-R group. SHQ total score correlated negatively with depressive symptoms (r = -0.787 for BDI and r = -0,755 for PHQ-9, p < 0.01). A negative correlation between SHQ and FAS score was found (r = –0.784, p < 0.01). FAS score correlated with depressive symptoms (r = 0.726 for BDI and r = 0.755 for PHQ-9, p < 0.01). Conclusion: Polish version of SHQ is a valuable tool for the assessment of HQ in sarcoidosis. HQ is impaired in PSFS comparing to patients with complete remission, but is comparable to active sarcoidosis. Depressive symptoms impact HQ and may influence perception of fatigue. Both fatigue and depression have a negative impact on HQ in sarcoidosis

The coincidence of diabetes mellitus and asthma, their probable causal relationships and therapeutic opportunities

Both the epidemiological data and the everyday medical practice demonstrate the coincidence of various types of diabetes mellitus (DM) in patients with asthma. Specific correlations between the risk of DM in pregnancy, asthma and the consequences of these diseases to the mother and her baby are also explored. The discussion concerning, on the one hand, the impact of asthma-related inflammatory condition on the metabolism of carbohydrates, and, on the other, the presence of chronic hyperglycemia and inflammatory markers observed in patients with asthma, is still ongoing. In the case of asthma and type 1 diabetes mellitus (T1DM), a correlation with the dysfunction of the immune system and the genetic background has been suggested, and in the case of type 2 (T2DM), the vital role of obesity and insulin resistance (IR) to promote excessive proinflammatory immune response. The data indicate that both asthma and DM affect mutually their clinical presentations, including the prognostic values and therapeutic possibilities. The ongoing controversy concerning the effective and safe anti-asthma and hypoglycemizing therapy does not allow for a definitive therapeutic consensus in this group of patients, despite the suggested role of metformin and hyperglycemizing effects of glucocorticoids. Therefore, the objective of the presented paper is a review of the knowledge in the field of DM and asthma coincidence, their probable causal relationships and therapeutic opportunities

Diagnosis and management of hyperglycaemia in patients treated with antipsychotic drugs

Research results indicate the presence of an association between mental disorders, certain antipsychotics, and the risk of developing prediabetes (preDM) and specific type diabetes mellitus (DM). However, there are no precise recommendations for their diagnosis and treatment. The obtained data suggest the necessity to perform diagnostics of carbohydrate disorders at the onset of the first symptoms of psychosis, even before the implementation of antipsychotic drugs, and the oral glucose tolerance test (OGTT) seems to be the optimal tool. There is a lot of controversy regarding the timing of control tests addressing the development of dysglycaemia during the use of antipsychotic drugs. We suggest that it should be carried out during the first 4–8 weeks, and in the absence of disorders it should be repeated once a year or with a change in antipsychotic treatment. The diagnostic regimen should then include the need for OGTT supportedby routine determination of the percentage of glycated haemoglobin. If dysglycaemia is diagnosed, the therapeutic management should include non-pharmacological management and hypoglycaemic agents. These recommendations should be individually tailored to each patient and take into account the presence of obesity, which is often found in this group of patients. Weight reduction can be achieved with a properly balanced diet, physical effort, and in justified situations also with drugs effectively reducing body weight. For this reason, drugs are recommended that, if preDM and DM are diagnosed, simultaneously lower glucose levels and reduce body weight. So far, effectiveness in this area has been demonstrated for 2 incretinomimetics: exenatide and liraglutide. Due to the mechanism of preDM/DM development in patients using antipsychotics, the usefulness of other hypoglycaemic drugs with insulin-sensitizing potential — metformin and pioglitazone — has also been suggested. To date, there has been no research on the benefits of other hypoglycaemic drugs in this group of patients