[Generalized anxiety and neuroticism in patients suffering from somatic diseases]. / Lek uogólniony i neurotyzm u pacjentów chorych somatycznie.

AIM: The aim of this research is to present the severity of the generalized anxiety disorder (GAD) symptoms and its correlation with neuroticism among patients suffering from somatic diseases. METHODS: 184 subjects participated in the study: 45 inpatients undergoing haematological treatment (group 1), 46 inpatients from the internal ward (group 2), 48 patients infected with HCV prior to treatment (group 3) and 45 healthy persons from the control group (group 4). The patients' level of generalized anxiety was measured by means of the Present State Examination Questionnaire (PSE), whereas the level of neuroticism was measured by means of Eysenck's Personality Questionnaire (EPQ-R). RESULTS: The GAD was found to affect more patients with somatic diseases than people from the control group (group 1: 11%, 2: 8.7%, 3: 8.7% and 4: 6.7%). 14 out of 16 persons with GAD had the neuroticism value above median. Median scores of neuroticism were similar in all groups except for the control group in which the median value was slightly lower. The correlation between the level of neuroticism and the increase of generalized anxiety symptoms did not depend on the gravity of the somatic diseases. The value of correlation was found to be the highest among patients infected with HCV (0.73) and lower in the remaining two groups (0.54 and 0.58). The increase of generalized anxiety symptoms was proportional to the level of neuroticism, the regression line slope depended on subjective evaluation of gravity of the diseases. The regression line slope was found to be the highest amongst haematologically treated patients (1.54), smaller among patients from the general practice ward (0.84) and those infected with HCV (1.04), and the smallest among patients from the control group (0.15). CONCLUSIONS: Patients suffering from internal illnesses are much more vulnerable to GAD and have a higher level of GAD symptoms, especially ones with an elevated level of neuroticism. The regression line slope between GAD scores and neuroticism scores can be understood as an indicator of psychological stress.

[Giant coronary artery aneurysm successfully treated with surgery--a case report]. / Znacznych rozmiarów tetniak naczynia wiencowego skutecznie leczony kardiochirurgicznie. Opis przypadku wraz z omówieniem etiologii, diagnostyki i leczenia.

We report a case of a 54-year-old woman presenting with nonspecific chest pain and clinical symptoms of heart failure. Various diagnostic tools, including both noninvasive methods and coronary angiography, revealed the presence of a giant aneurysm of the right coronary artery. The aneurysm formed a mediastinal mass of a huge size, with blood flow in it, and caused cardiac displacement within the thorax cavity. Surgical management of this anomaly was effective. Aetiology, clinical symptoms, diagnostic tools and treatment options of coronary artery aneurysms are discussed.

[Correlation between depressive and anxiety symptoms, distress and functioning]. / Zwiazek objawów lekowych i depresyjnych z cierpieniem psychicznym i funkcjonowaniem.

AIM: The aim of the study was to define the correlation between anxiety/depressive symptoms, distress and functioning. METHOD: The research is based on the analysis of 104 persons (65 women, 39 men), who were patients of psychiatrists (42 persons), or general physician attenders (62 persons) complaining of anxiety or depressive symptoms. Distress was estimated with the General Health Questionnaire (GHQ-30), psychopathological symptoms and diagnoses were evaluated with the Present State Examination (PSE) and the level of functioning with Global Assessment of Functioning (GAF). The intensity of ICD-10 symptoms was calculated for: generalized anxiety disorder, agoraphobia, social phobia, panic disorder, depressive disorder and dysthymia. RESULTS: The lowest score of distress was found in the group with sub-clinical, sole anxiety or depressive symptoms. An intermediate level was present in the group with anxiety and mixed anxiety-depressive disorders, and the highest in the group with depression. The functioning scores were in an inverse order. CONCLUSIONS: The differences in scores of distress and functioning between groups of patients with anxiety disorders, mixed anxiety-depressive disorders and depression are dependent on the intensity of depressive symptoms and are independent of the intensity of anxiety symptoms.

[Familial incidence of myelodysplastic syndromes]. / Rodzinne wystepowanie zespolów mielodysplastycznych.

The myelodysplastic syndromes (MDS) are heterogeneous group of clonal disorders of hematopoietic stem cells, which manifestation is cytopenia and hypercellular, dysplastic bone marrow, often with increased amount of blasts. The pathogenesis of majority of MDS remains unexplained. It is regarded that genetic predisposition and exposure to toxic environmental agents contribute to genetic mutations in MDS. Molecular abnormalities have attracted interest over past years because of their presence in most cases of MDS, even without noticeable disorders in kariotype. Familial incidence of myelodysplastic syndromes may be helpful in understanding genetic factors of the disease. We describe two families in which MDS occurred in siblings (3 brothers; sister and brother). Kariotype abnormalities have been noted only in one person of each family. The rest of patients had a normal kariotype. This suggests that molecular abnormalities are the cause of their disease. The occupational exposure to precise mutagens (aluminium, greases, diesels, petrol, metals) was noted in two persons in the first family and correspondingly in one person in the second. There was absence of one mutagen common for every member of two reported families.

[Effect of metals, benzene, pesticides and ethylene oxide on the haematopoietic system]. / Wplyw narazenia na metale, benzen, pestycydy i tlenek etylenu na uklad krwiotwórczy.

The hematopoietic system, due to intensive cells proliferation, is very sensitive to toxic substances. Many chemicals, including benzene, pesticides (dithiocarbamines), ethylene oxide and metals (mercury, cadmium, chrome, cobalt, lead, aluminum) exert their toxic effect on the hematopoietic system. Exposure to each of these substances may occur in the work place due to environmental pollution and in municipal or residential areas. Exposure to lead, aluminum, cadmium, and benzene results in the incidence of anemia. In addition, exposure to benzene and its metabolites leads to myelodysplastic syndromes, leukemia, lymphomas and bone marrow aplasia. Ethylene oxide induces neoplasm of the hematopoietic system and lymphomas, especially non-Hodgkin lymphoma. Arsenic compounds act like immunosuppressants. Mercury and chrome affect the immune system by immunosuppression and by evoking autoimmune reactions. Dithiocarbamates are suspected to induce leukemia. An analysis of the pathophysiology of individual substances reveal universal toxic mechanisms. In this paper, the authors discuss the pathomechanism of toxic effects of the aforesaid chemicals on the haematopoietic system and peripheral blood cells from the viewpoint of mutagenesis, apoptosis, myelotoxicity, anemia, immunomodulation, and individual sensitivity.

[Anxiety and depressive symptoms in patients treated due to haematologic malignancies]. / Objawy lekowe i depresyjne u pacjentów leczonych na nowotwory hematologiczne.

BACKGROUND: Haematological treatment is associated with excessive distress due to side effects of cytostatics and due to severe life consequences of the illness. It could be a cause of anxiety or depressive states in vulnerable persons. AIM: The purpose of the study was to assess prevalence of depression, anxiety disorders, and distress among patients treated due to haematologic malignancies. METHODS: 45 patients with leukaemia or lymphoma, 29 treated due to other internal diseases and 28 healthy persons were assessed. The following research instruments were used: the Present State Examination (PSE), the General Health Questionnaire (GHQ-30), criteria scales (ICD-10) for depression and anxiety. RESULTS: Depression was diagnosed in 29% of the patients with hematological illnesses and in 11% of patients with other internal illnesses. Prevalence of GAD was appropriately 11% and 9%. Generally, psychiatric disorders were present in a half of the patients in every group. About 1/4 th of the haematologic patients had much more severe depressive symptoms than others. CONCLUSION: The groups of patients have much higher, depressive and distress scores than controls. Psychiatric or psychotherapeutic treatment could be considered as part of the treatment of malignant haematologic cancers.

[Extramedullary hematopoiesis in inguinal lymph nodes in the course of osteomyelofibrosis--case report]. / Pozaszpikowa hematopoeza w wezlach chlonnych pachwinowych w przebiegu osteomielofibrozy--opis przypadku.

Osteomyelofibrosis (OMF) is a chronic myeloproliferative disorder characterized by bone marrow fibrosis, suppression of hematopoiesis and extramedullary hematopoiesis. Extramedullary hematopoiesis usually occurs in spleen and liver, however it may be observed in another sites. We present a patient with OMF accompanied by myeloid metaplasia in inguinal lymph nodes.