Study of Polyphenol Content and Antioxidant Properties of Various Mix of Chocolate Milk Masses with Different Protein Content.

The aim of the study was to analyze the antioxidant character of conched chocolate milk masses, taking into account different protein content in milk. For the study, cocoa liquor obtained from roasted and unroasted cocoa beans from different regions, as well as milk powder obtained by spray and cylindrical drying were used. The analysis that was carried out showed that the protein content of powdered milk products ranged from about 11.6% (w/w) to over 31% (w/w). Lower content of polyphenols and lower antioxidant activity were shown in the masses to which the addition of milk with higher protein content was applied. The analysis of antioxidant character of chocolate milk masses showed higher total polyphenols content in masses prepared from unroasted cocoa beans liquor.

Psychiatric manifestations in Wilson's disease: possibilities and difficulties for treatment.

Wilson's disease (WD) is an inherited metabolic disorder related to disturbances of copper metabolism, and predominantly presents with liver and neuropsychiatric symptoms. In most cases it can be successfully treated with anti-copper agents, and both liver function and neuropsychiatric symptoms typically improve. Treatment guidelines for WD include recommendations for anti-copper treatment as well as for the treatment of liver failure symptoms. Recently, recommendations for treatment of the neurological symptoms of WD have also been proposed. Although most WD patients present with psychiatric symptoms at some stage of the disease, currently there are no guidelines for the treatment of the psychiatric manifestations. Treatment of the psychiatric symptoms of WD is often guided by general psychiatric experience, which typically glosses over the specificity of WD, and can result in severe neurological and/or hepatic complications. Here we review and discuss the possible treatments available for the mood disturbances, psychosis, behavioral and cognitive disorders that can occur in WD, as well as their efficacy.

Psychiatric disturbances as a first clinical symptom of Wilson's disease - case report. / Zaburzenia psychiatryczne jako pierwszy objaw choroby Wilsona - opis przypadku.

OBJECTIVES: Wilson's disease (WD) is an inherited disorder of copper metabolism with wide spectrum of clinical symptoms, mainly hepatic or neurological. Psychiatric disorders occur less frequently and are not pathognomonic for WD. However, in almost 20% of cases they are in fact the first clinical manifestation of WD. The aim of this paper is to emphasise the importance of including WD in differential diagnosis of psychiatric disorders in young adults, as well as caution in initiating psychiatric treatment for patients with already established diagnosis of WD. METHODS: Case report of a patient with primarily psychiatric manifestation of WD. RESULTS: The authors present the case of a 26-year-old patient treated for 3 years due to depressive syndrome who was diagnosed as WD in the differential diagnosis shortly after extrapyramidal symptoms developed. During the further WD treatment the manic episode occurred. The patient was treated with atypical neuroleptics and anxiolytics, with good psychiatric effect, but with severe neurological deterioration. However, long term use of valproic acid and olanzapine combined with continuation of anti-copper treatment and rehabilitation resulted in good psychiatric and neurological outcome. CONCLUSIONS: WD should be always considered in differential diagnosis of psychiatric disorders in young patients, especially if they present additional extrapyramidal or hepatic symptoms. It is also extremely important to remain cautious when drugs with high affinity to dopamine D2 receptors need to be initiated in patients already diagnosed with WD, as they may result in severe and often irreversible neurological complications.

[Herbal remedies in depression--state of the art]. / Leki ziolowe w leczeniu depresji--aktualny stan wiedzy.

Recent decades have seen development of research and an increased interest in the psychopharmacology of natural remedies. More than 20 herbal remedies have been identified that may potentially be applied in medicine as antidepressive, anxiety relieving or sleep-inducing agents. Patients often prefer to take herbal remedies and often take them on their own, without consulting a physician. The aim of the study is to present the state of the art concerning the use of natural remedies in the treatment of depression. Following a literature review, 7 herbal remedies for which preclinical and clinical trials suggest their antidepressive influence have been identified: hypericum, lavender, borage, roseroot, chamomile, saffron and ginseng. For two of these, i.e. hypericum and saffron extracts, antidepressive effect in subjects with mild or moderate depression has been confirmed in controlled randomized clinical trials.

[Tardive dyskinesia in patients with schizophrenia treated with olanzapine - results from a 20-month, prospective, open study under naturalistic conditions]. / Pózne dyskinezy wsród chorych na schizofrenie leczonych olanzapina - wyniki prospektywnego, 20-miesiecznego, otwartego badania w warunkach naturalistycznych.

OBJECTIVES: The objective of the study was to assess the prevalence and incidence of tardive dyskinesia in patients treated with olanzapine during the follow-up period of 20 months. METHODS: It was a prospective, observational, non-interventional study under naturalistic conditions, without a control group. The evaluation of the severity and presence of tardive dyskinesia was performed with the Abnormal Involuntary Movement Scale and research criteria by Schooler and Kane. RESULTS: The study included 573 patients (woman 43,3%) with the diagnosis of schizophrenia (ICD-10), the mean age of 41.8 (± 12) years. The mean dose of olanzapine was 15.9 (± 4.2) mg. The prevalence of tardive dyskinesia was 16.4%. The cumulative incidence assessed in the group of 479 patients was 6.47%. The annual incidence was 3.9%. An increased risk of tardive dyskinesia was observed in smokers - RR of 1.99 (CI 0.88-4.49), those taking higher doses of olanzapine 1.57 (CI 0.91-2.7) and in those who used polytherapy: 3.55 (CI 1.43-8.82). Only in the case of polytherapy a multidimensional analysis confirmed that this factor had a significant influence on the risk of tardive dyskinesia (p=0.006). CONCLUSIONS: The study demonstrated high (16,4%) prevalence of tardive dyskinesia, and the annual incidence (3,9%) comparable to the results of a meta-analysis by Corell et al. In the case of olanzapine in monotherapy the annual incidence was lower (1.96%) but the use of antipsychotics in polytherapy more than tripled the risk of tardive dyskinesia.

Treatment of depression in first episode of schizophrenia: results from EUFEST.

Depressive symptomatology is an important target of treatment in first episode schizophrenia. This reanalysis of the European First Episode Schizophrenia Trial (EUFEST) describes the depressive symptomatology and the effect of antipsychotic treatment in patients suffering from first episode schizophrenia and schizophreniform disorder randomized to treatment with low dose haloperidol (n=103), amisulpride (n=104), olanzapine (n=105), quetiapine (n=104) or ziprasidone (n=82) for one year. At baseline, the mean score on the Calgary Depression Scale for Schizophrenia (CDSS) was 5.1 (±4.9) with 38.3% of patients having a CDSS score≥6, i.e. clinically relevant depressive symptom severity. During treatment depression scores decreased, the mean CDSS score being 1.1 (±2.1) and 3.0% of patients having a CDSS≥6 at 52 weeks. The proportion of patients using antidepressants during the complete trial was 18.5% in the haloperidol group, 28.6% in the olanzapine group compared to 5.8% in the quetiapine group, 12.5% in the amisulpride group, and 9.8% in the ziprasidone group. There were no differences over time in the probability of being depressed (CDSS≥6) between the 5 treatment groups after adjustment for antidepressant use, nor in a sub analysis of patients who did not take any antidepressant. Depression scores at baseline or during the trial had no effect on treatment discontinuation or on the reduction of positive symptoms. In summary, the results of EUFEST did not demonstrate a differential effect of the antipsychotics studied on depressive symptomatology in patients with first episode schizophrenia.

[Transcranial Doppler sonography study in schizophrenia--review]. / Przezczaszkowe badanie dopplerowskie w schizofrenii--przeglad pismiennictwa.

In this review, the authors describe the Transcranial Doppler sonography technique (TCD). They also make an analysis of the up-to-date publications on the use of TCD in the studies on schizophrenia. The current studies show a promising potential of TCD. Its benefits are connected with high time-output, low-cost and only slightly invasive character. The difficulty of using TCD lies in the experience of the technician and the quality of the equipment. What should be kept in mind, is the fact that the data received in the TCD study is only an indirect indication of CNS activity. The research described here shows two potential directions of applying TCD to schizophrenia studies. One of them concerns the intensity of psychotic symptoms as well as the medications given on the changes in transcranial blood-flow. The second connects the search for cognitive function disorders and the activity of certain brain regions with the transcranial blood-flow changes resulting from them. In such a protocol of research, where TCD technique is simultaneously applied along with an evaluation through neuropsychological tests, one could speak of a functional transcranial study--fTCD. The studies mentioned here, have only a pilot character owing to a low number of subjects studied. However, a picture of subtle differences in cerebral blood flow of schizophrenic patients does appear. The use of TCD requires further, deeper studies with the participation of a larger group of patients, along with a neuropsychological tool application.

[Stevens-Johnson syndrome in the literature and authors' own studies]. / Zespól Stevensa-Johnsona w swietle danych z pismiennictwa i badan wlasnych.

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (Lyell Syndrome) are severe, multisystem disease caused mainly by reaction to drugs. The clinical features include: changes on the skin and mucosa as well as lesions in the internal organs. There are no standards of treatment in this diesease group. There are ongoing trials in various groups of drugs. Apart from providing the appriopriate conditions and symptomatic treatment, immunoglobulins, cytostatics and plasmapheresis are used. The authors present the clinical course of a patient with Stevens-Johnsons Syndrome, probably caused by klaritromycin. The 13 y.o. boy was admitted to a Department of Paediatric Surgery specializing in treatment of burns. Immunoglobulin, cytostatics, antibacterial and antiviral drugs were used as well as topical medicines routinely applied in burns. The method proved to give good results. The treatment of Stevens-Johnsons Syndrome is difficult and expensive. Due to lack of standards, the treatment depends on one's own experience and up to date literature.

[Antipsychotics in clinical practice. The refractory schizophrenic patients treatment]. / Leki przeciwpsychotyczne w praktyce lekarza psychiatry. Leczenie pacjentów z rozpoznaniem schizofrenii lekoopornej.

AIM: The aim of this paper is to present and to discuss the results of an investigation conducted among Polish psychiatrists in 2007, especially its part relating to the practice of therapeutic patterns in refractory schizophrenia. METHOD: Structured individual interviews were conducted from 100 psychiatrists chosen at random in 9 larger cities in Poland. The interviews were followed by a questionnaire consisting of 52 questions relating to the principles of treatment and a perception of the features of antipsychotics. One part of the interview focused on refractory schizophrenia treatment. The perception of antipsychotics was interpreted with the use of the Pin Points Analysis method. RESULTS: In-patient schizophrenic patients are treated most often with clozapine (57%), but olanzapine (38%) and risperidone (32%) are the most common in out-patients. Other neuroleptics are prescribed considerably seldom. According to the doctors' declaration, their choices of medicines would be different, if there were no external limitations in drug prescription. In spite of this, the psychiatrists' claim, that their choice of antipsychotics is based on their own knowledge (44%), to a smaller degree it is based on the experts' recommendations (32%) and the currently valid reimbursement rules (24%). CONCLUSIONS: The Refractory schizophrenia treatment that is applied in practice, is generally convergent with the principles of the treatment. Clozapine still has a significant place in therapy. Use of all the remaining atypicals, besides risperidone and the olanzapine, they are limited by the high price for patient.

[A study on the occurrence of the deletion 22q11.2 in patients affected with a psychiatric disease]. / Badania nad wystepowaniem delecji 22q11.2 u osób z choroba psychiczna.

AIM: The aim of the study was an estimation of the rate of deletion 22q11.2 among psychiatric patients and an attempt at the assessment of the degree in which this rate is influenced by the coexistence of dysmorphic features and congenital defects. METHODS: Cytogenetic examination was performed in 255 patients with psychosis. Patients were divided into two groups. Group I was composed of 61 patients with psychosis and at least two phenotypic features characteristic of 22q11.2 deletion syndrome (22q11DS), group II was composed of 194 patients with psychosis without phenotypic features of 22q11DS. Banding and fluorescence in situ hybridization (FISH) techniques were applied. RESULTS: 22q11.2 deletion was found in 3/61 patients of group I (4.9%) and in 3/255 among all psychiatric patients (1.2%). This incidence was significantly higher than in the general population (p < 0.001). The frequency of the deletion was even higher among psychiatric patients revealing phenotypic features of 22q11DS: 3/61 (4.9%) (p < 0.0001). In all the cases with the deletion, the phenotype features were characteristic of 22q11DS. Three other psychiatric patients had sex chromosomes' aberrations: 47, XYY, 47, XXY and 47, XXX. Moreover one case of balanced translocation t(2;10) (q10; q10) was detected. Conclusions. (1) 22q11.2 deletion was found to be 40 times more common among psychiatric patients than in the general population; sex chromosome aberrations are also significantly more common than in the general population. (2) The presence of dysmorphic features and some congenital defects in psychiatric patients increases the rate of deletion 22q11.2 significantly.

Electroencephalogram slowing, sleepiness and treatment response in patients with schizophrenia during olanzapine treatment.

Electroencephalogram (EEG) slowing is associated with clozapine side effects, e.g., sedation, and may predict treatment response during clozapine treatment. As olanzapine and clozapine share many pharmacological properties, we investigated whether EEG slowing during olanzapine treatment was related to therapy outcome and sleepiness in patients with schizophrenia. Participants were age- and gender-matched schizophrenic patients treated with olanzapine (n 54), receiving no pharmacological treatment (n 54), or cotreated with olanzapine and some other psychotropic drug (n 38). Their EEG recordings were assessed visually by the same rater blind to clinical data. The EEG scores were categorized using standardized forms. Patients with a poor treatment response did not differ significantly from those with a good response to treatment either in EEG patterns or in frequency of sleepiness. Olanzapine treatment was associated with increased rates of slow (70.4% vs. 22.3%) and sharp waves (22.2% vs. 7.4%), as well as of paroxysmal slow wave discharges (14.8% vs. 1.9%), but did not induce spike- or sharp-slow-wave complexes. Cotreatment with another antipsychotic further increased EEG abnormalities, whereas benzodiazepine administration diminished the olanzapine-induced EEG changes. The results show that olanzapine inducing both slow and sharp waves, as well as paroxysmal discharges, has a strong impact on EEG. However, as no spike- or sharp-slow-wave complexes were observed, the risk of epileptic seizure during olanzapine treatment can be regarded as low, as long as olanzapine is not combined with some other antipsychotic.

Side effects after phototherapy implementation in addition to fluoxetine or sertraline treatment: a report of two cases.

Serotonergic-type side effects (like diarrhoea, hyperthermia, nausea, confusion) were seen after phototherapy in patients receiving fluoxetine or sertraline. Phototherapy was discontinued and symptoms completely resolved. In the authors' opinion, the symptoms were likely to be associated with specific interaction (serotonin effect potentialisation). To the authors' knowledge this is the first report concerning such an effect.

[The change of quality of life and clinical picture in schizophrenia]. / Zmiana jakosci zycia i obrazu klinicznego w schizofrenii.

The aim of the study was to determine how the quality of life changes during antipsychotic treatment in schizophrenia and whether there is any correlation between the change of quality of life and the change of clinical picture in 232 patients with the diagnosis of schizophrenia treated for 8 weeks with antipsychotic medication. The mental status improved significantly during treatment while patients' quality of life improved insignificantly. Severity of schizophrenic symptoms correlated negatively with patients' quality of life before treatment but not after treatment. Clinical improvement of schizophrenic symptomatology correlated negatively with the improvement of patients' quality of life. After treatment the quality of life was significantly worse in patients who had distinct depression before treatment, than in those without depression or with only slight depression before treatment.