In 64 individuals with dementia (26 Alzheimer type, 34 of vascular origin and 4 other types of dementia) apolipoprotein E genotype was identified. Frequency of ε4 allele was 36.5% in Alzheimer patients and 32.4% in vascular dementia ones. In a group of 39 nondemented individuals of the same age the ε4 frequency was 11.5%. In demented patients, carriers of ε4, a tendency to higher plasma levels of atherogenic lipids (total cholesterol and low-density lipoprotein cholesterol) as compared with noncarriers was observed. It is possible that the ε4 form may aggravate the course of dementia through a moderate influence on the atherogenic lipoprotein level. The results showed that both Alzheimer disease and vascular dementia shared the same risk factors which is consistent with current opinion about a link existing between these two types of dementia.
The aim of the study was to summarize the efficacy and tolerability of paliperidone palmitate, an atypical long-acting antipsychotic drug. Paliperidone is a 9-hydroxy metabolite of risperidone with a slightly different receptor profile and significantly different pharmacokinetic profile. After the short review of its pharmacological properties, the efficacy of the drug in comparison to placebo or to an active comparator was described. The studies revealed the effectiveness of paliperidone palmitate in the treatment of psychotic symptoms, mainly schizophrenia. The drug proved to be efficacious in both acute psychotic symptoms treatment and long-term treatment. Its efficacy in patients with schizophrenia was similar and sometimes even better than the efficacy of other long-acting drugs, such as risperidone or olanzapine. In the pharmacoeconomic studies, paliperidone proved to be cost-effective in comparison to risperidone or olanzapine. The review of the literature also underlined that paliperidone palmitate is well tolerated, compared with placebo. Frequency and severity of side-effects such as extrapyramidal symptoms, hyperprolactinemia and weight gain, was similar or less than those found in treatment with other atypical antipsychotics, including long-acting ones.
Cel pracyPóźna rozpoznawalność choroby afektywnej dwubiegunowej (CHAD) może skutkować m. in. prowadzeniem nie w pełni adekwatnego leczenia, zwiększeniem cierpienia związanego z chorobą oraz ryzyka zachowań suicydalnych, a także wzrostem kosztów prowadzonej terapii. Brak sprawdzonych w warunkach klinicznych biomarkerów dwubiegunowości kieruje uwagę klinicystów na analizę przebiegu choroby i symptomatologii depresji w przebiegu CHAD. Celem niniejszej pracy była retrospektywna analiza różnic występowania i powtarzalności objawów depresyjnych u pacjentów z chorobą afektywną jednobiegunową (CHAJ) i chorobą afektywną dwubiegunową (CHAD) w trakcie trzech kolejnych epizodów depresji w warunkach szpitalnych.MetodaRetrospektywna analiza dokumentacji leczenia 99 pacjentów z CHAJ i CHAD w trakcie trzech kolejnych epizodów depresji. W analizie występowania objawów zastosowano test Chi-kwadrat oraz regresję logistyczną, do analizy powtarzalności występowania objawów współczynnik powtarzalności kappa Cohena.WynikiRóżnice istotne statystycznie obserwowano dla 7 spośród 22 objawów depresyjnych. Częściej u pacjentów z CHAJ obserwowano objawy somatyzacyjne (bólowe i nie-bólowe), pobudzenie psychomotoryczne i patologiczne poczucie winy. Częściej u pacjentów z CHAD obserwowano anhedonię, zaburzenia koncentracji uwagi i myśli suicydalne. W grupie CHAJ relatywnie najwyższą powtarzalnością cechowało się występowanie objawów somatyzacji, zaburzeń II fazy snu, wczesnego porannego wybudzania, zaburzeń koncentracji uwagi. W grupie CHAD natomiast występowanie urojeń, objawy somatyzacyjne, zaburzenia I i II fazy snu, zaburzenia pamięci, spowolnienie psychomotoryczne oraz patologiczne poczucie winy.WnioskiObserwowane różnice symptomatologiczne mogą być dodatkowym klinicznym czynnikiem różnicującym pacjentów z CHAJ i CHAD. Niższa w grupie badanej niż uprzednio donoszono w literaturze powtarzalność występowania objawów depresji, wskazuje na konieczność analizowania profilu objawów w oparciu o więcej niż jeden epizod depresji.
BackgroundElectrodermal reactivity has been successfully used as indicator of interest, curiosity as well as depressive states. The measured reactivity depends on the quantity of sweat secreted by those eccrine sweat glands that are located in the hypodermis of palmar and plantar regions. Electrodermal hyporeactive individuals are those who show an unusual rapid habituation to identical non-significant stimuli. Previous findings suggested that electrodermal hyporeactivity has a high sensitivity and a high specificity for suicide. The aims of the present study are to test the effectiveness and the usefulness of the EDOR (ElectroDermal Orienting Reactivity) Test as a support in the suicide risk assessment of depressed patients and to assess the predictive value of electrodermal hyporeactivity, measured through the EDOR Test, for suicide and suicide attempt in adult patients with a primary diagnosis of depression.Methods and design1573 patients with a primary diagnosis of depression, whether currently depressed or in remission, have been recruited at 15 centres in 9 different European countries. Depressive symptomatology was evaluated through the Montgomery-Asberg Depression Scale. Previous suicide attempts were registered and the suicide intent of the worst attempt was rated according to the first eight items of the Beck Suicide Intent Scale. The suicide risk was also assessed according to rules and traditions at the centre. The EDOR Test was finally performed. During the EDOR Test, two fingers are put on gold electrodes and direct current of 0.5 V is passed through the epidermis of the fingers according to standards. A moderately strong tone is presented through headphones now and then during the test. The electrodermal responses to the stimuli represent an increase in the conductance due to the increased number of filled sweat ducts that act as conductors through the electrically highly resistant epidermis. Each patient is followed up for one year in order to assess the occurrence of intentional self-harm.DiscussionBased on previous studies, expected results would be that patients realizing a suicide attempt with a strong intent or committing suicide should be electrodermally hyporeactive in most cases and non-hyporeactive patients should show only few indications of death intent or suicides.Trial registrationThe German Clinical Trials Register, DRKS00010082. Registered May 31st, 2016. Retrospectively registered.
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