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Biomedical subjects

J Rybakowski

Publications and source records attributed to J Rybakowski.

157 records · Page 9Linked to original sources
PubMedDate not supplied

[Biological mechanisms of drug-resistant depression].

The authors review recent findings concerning biological mechanisms of drug-resistant depression. Treatment-resistant depression may result from the inability of antidepressants to normalize serotonergic transmission. Efficacy of therapeutic strategies enhancing serotonergic function such as potentiation of tricyclic antidepressants with lithium or fluoxetine as well as effectiveness of selective serotonin reuptake inhibitors in drug-resistant depression may support this hypothesis. Limbic-hypothalamic-pituitary-adrenal axis hyperactivity may be also an important factor of the persistence of depression, and so treatment with inhibitors of steroid biosynthesis may bring about readjustment of this axis and remission of depression in some cases of drug-resistant depression with hypercortisolemia. Another subtype of drug-resistant depression may be related to a dysfunction of hypothyroidism. Some evidence suggests also a relationship between drug resistance in depression and changes in the immune system. Research on biological mechanisms of drug-resistant depression may help clinicians to decide on the most appropriate treatment strategy in resistant depression as well as to shed light on the pathomechanism of depression.

Depressive Disorder↗
PubMedDate not supplied

[Long-term administration of lithium carbonate: experience based on a case of 25-year-long treatment with lithium].

In the beginning of 1960s, initial reports appeared pointing to a possibility of preventing depressive and manic recurrences in affective illness by means of long-term administration of lithium salts. Subsequent several years of controlled studies confirmed such prophylactic effect of lithium in affective illness beyond any doubt. Some patients in whom lithium administration was started in the beginning of 1970s may, by now, have received lithium for more than twenty years. The patient reported in the present paper, had began lithium treatment on April 1, 1971, after her third depressive episode since 1965. During 25 years of uninterrupted lithium carbonate administration in daily dose 1000 mg (for 5 years-750 mg) and with mean serum lithium concentration 0.6 mmol/l, the recurrences have not been observed, mental status was normal and professional (physician-ophthalmologist) and family functioning was good. Either somatic or mental side-effects have not occurred. Twenty five years of the patient's lithium treatment, was paralleled by important events for lithium therapy such as, i.a., autobiographies of prominent persons receiving lithium for porphylactic purposes, definition of a new category of psychotropic drugs (normothymic) with lithium as a prototype, establishing some mechanism of lithium action on intracellular transmission, discovery of antiviral and immunomodulatory effect of lithium as well as finding of decreased mortality of patients receiving long-term lithium therapy.

Depressive Disorder↗
PubMedDate not supplied

[Limbic-hypothalamic-pituitary-adrenal axis in depression: literature review].

A review of the literature has been presented concerning pathogenetic role of limbic-hypothalamic-pituitary-adrenal axis (LHPA) in depression and the therapeutic possibility obtained by influencing this axis. Increased cortisol concentration has until now been the best documented biochemical abnormality in depression. Pathological results of the Dexamethasone Suppression Test pointing to hyperactivity of LHPA axis are found in about half of depressive patients. According to most recent research, primary disturbance of LHPA axis concerns hypothalamus (excessive secretion of corticotropin releasing factory) and limbic system (insufficiency of glucocorticoid receptor). An association was found between disturbances of LHPA axis in depression and immune system abnormalities in this illness. Disturbances of serotonergic and noradrenergic neurotransmission in depression may also partially result from LHPA axis dysfunction. In recent years, the attempts have been made to use drugs acting on LHPA axis for therapeutic purposes in depression, such as ketoconazole, within the framework of antiglucocorticoid strategy. Influencing LHPA axis may underlie the mechanism of new antidepressant drug, tianeptine. Recently, it was found that classical tricyclic antidepressant drugs as well as electroconvulsive may also act on LHPA in regulatory way.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

[Immune activation in endogenous depression].

Serum concentration of three positive acute phase proteins: C-reactive protein (CRP), alpha-1-acid glycoprotein (AGP), alpha-1-antychymotrypsin (ACT) were measured in 81 patients with endogenous depression during acute episode and in 20 matched controls. Determination was also made of glycosylation types of AGP and ACT as well as of the concentration of interleukin-6 (IL-6) and its soluble receptor (sIL-6R). In patients with depression, the mean values of all parameters studied except for AGP glycosylation were significantly elevated compared with the group of control healthy persons, what may suggest an excessive immune activation in these patients in the form of acute phase response. Particularly intense were the indies of the immune activation in the subgroup of patients (1/3 of population studied) having pathologically elevated coefficient of AGP glycosylation (Type I glycosylation). Patients with Type I glycosylation had longer duration of illness and were characterized by recent depressive episode of greater severity and chronicity as well as refractoriness to pharmacological treatment. The results obtained corroborate the existence of excessive immune activation during acute depressive episode and suggest the possible role of this phenomenon in the pathogenesis and course of affective illnesses.

Adult↗
PubMedDate not supplied

[Changes of humoral and cellular immunity in schizophrenia].

The paper is a review of the literature on cellular and humoral immunity in schizophrenic patients. The reports have revealed that there are manifestations of autoimmunological process in a subgroup of schizophrenics (among others: increased serum level of specific and non-specific autoantibodies, decreased lymphocyte interleukin-2 production, increased soluble IL-2 receptor concentration, increased serum IL-6 level, presence of lymphocyte abnormalities and association with HLA antigens. It is suggested that virus infection may provoke the appearance of autoimmunological reaction, while genetic factors might increase some predisposition to this reaction. The reports have also revealed that autoimmunity may play a role in pathogenesis of schizophrenia in a subgroup of schizophrenic patients who have immunological abnormalities.

Antibody Formation↗
PubMedDate not supplied

[Anorexia nervosa in monozygotic twins: case report].

The case of monozygotic female twins simultaneously concordant for anorexia nervosa is reported. The mechanisms of interaction between psychological factors and genetic predisposition playing a role in the onset and the course of disease in twin sisters are discussed.

Adult↗
PubMedDate not supplied

[Alprazolam in the treatment of anxiety disorders and mixed anxiety and depressive disorders. Results of multicenter clinical trial].

Alprazolam is one of the most commonly prescribed psychotropics drug all over the world. This suggests that alprazolam is very effective and safe. A multicentre clinical trial was carried out for assessing its efficacy and side effects. 130 patients suffering from anxiety disorders, mixed anxiety and depressive disorders and dysthtymia were involved in the trial. During 6 weeks they used to take from 1.5 to 2.5 mg. of alprazolam daily. Mental state has been assessed with Hamilton rating scales of anxiety and depression, Montgomery Asberg scale of depression and CGI scales. At the endpoint good recovery was found in 75% of the patients, mild recovery in 19%, and 6% got worse. The effect of treatment depends on individual patients' traits rather than on initial mental state. Adverse events were noted in a half of patients, were not severe and were going down during the treatment. 4.6% of patients dropped out because of adverse events, the others tolerated alprazolam well.

Adolescent↗
PubMedDate not supplied

[Progress in research on etiopathogenesis of schizophrenia in recent decades].

In this paper, a progress in research on etiopathogenesis of schizophrenia made in the recent decade was presented. Two main etiopathogenetic factors in this illness include genetic predisposition and brain damage in early period of life, leading to a disorder of brain development and lateralization, and to an increased susceptibility to stress. The use of new methods of genetic studies brought about a significant progress as to identification of relationship between schizophrenia and various changes within genotype. In the 1990s, many data have been obtained concerning possible brain damaging factors as well as the existence of structural and functional brain abnormalities in this illness. Impaired brain development in schizophrenia results in disturbances of neuronal connection in the cortical structures and in cortical-limbic transmission, what may underlie the appearance of psychopathological symptoms. New neuroleptic drugs introduced in the recent years show more complete therapeutic action against schizophrenic symptoms compared with drugs used so far. This may result from their broader influence on the pathogenetic processes of schizophrenia, which may be due, apart from their effect on dopaminergic system, also to their action on some elements of serotonergic neurotransmission.

Antipsychotic Agents↗
PubMedDate not supplied

[The case of central pontine myelinolysis in an alcohol dependent male].

Long-term alcohol abuse can lead to numerous central nervous system lesions, among them central pontine myelinolysis. In this paper, the first in Polish literature case of central pontine myelinolysis in an alcohol dependent male, clinically diagnosed, and confirmed by nuclear magnetic resonance with one year follow-up has been presented. The patient, 49 years old, was admitted to Addiction Treatment Unit, Department of Psychiatry in Bydgoszcz. After admission he manifested clouded consciousness, dysphasia, hyponatremia and neuropsychological abnormalities which showed brain stem lesion. He had no significant abnormalities in CT. Nuclear magnetic resonance revealed triangular hypointensive lesion 10 x 5 mm in central pontine region. One year after admission to Addiction Treatment Unit he still has troubles with walking and swallowing. He has bilateral pyramidal symptoms and emotional lability. He was treated with vinpocetine (0.075 g per day), piracetam (4.8 g per day) and chlorprotixen (0.09 g per day). He was admitted to Psychiatric Ward because of a suicidal attempt as a manifestation of mood disorder due to general medical condition.

Alcoholism↗
PubMedDate not supplied

[A case of Lyell's syndrome caused by carbamazepine].

A case is described of Lyell syndrome in a female patient with schizoaffective psychosis which developed several days after addition of carbamazepine to the psychotropic treatment used. After withdrawal of the drug and three weeks of treatment with prednisone in dose 60 mg daily, antibiotic therapy and intensive dermatological-nursing care, full remission of skin lesions and oral mucosa lesions was obtained.

Anticonvulsants↗
PubMedDate not supplied

[Prodromal period of the first episode of schizophrenia].

The article is a review of the literature on the prodromal period of the first episode of schizophrenia. According to the literature, the first episode of schizophrenia is usually preceded by a few years of prodromal period including non-specific behavioural and affective disturbances as well as psychotic-like and prepsychotic symptoms. The concepts formulated so far concerning a definition of prodromal symptoms were discussed. The data were summarized on clinical characteristics of the prodromal period such as symptomatology, frequency of symptoms, dynamics of changes and the period of occurrence of the prodromal symptoms. Four hypothetical models of transformation of prodromal symptoms into psychotic process were described. Also, the importance of the prodromal symptoms of the first episode of schizophrenia for early diagnosis and therapy of schizophrenia was discussed with regard to currently performed programs of early interventions in schizophrenia.

Disease Progression↗