Andrzej Brodziak

The role of human endogenous retroviruses in the pathogenesis of autoimmune diseases

Summary This paper presents a new, recently formulated theory, which concerns the etiopathological process of autoimmune diseases. This theory takes into account the existence in the human genome, since approximately 40 million years, of so-called human endogenous retroviruses (HERVs), which are transmitted to descendants “vertically” by the germ cells. It was recently established that these generally silent sequences perform some physiological roles, but occasionally become active and influence the development of some chronic diseases like diabetes, some neoplasms, chronic diseases of the nervous system (eg, sclerosis multiplex), schizophrenia and autoimmune diseases. We present a short synopsis of immunological processes involved in the pathogenesis of autoimmune diseases, such as molecular mimicry, epitope spreading and activation of the superantigen. We then focus on experimental findings related to systemic lupus erythematosus, rheumatoid arthritis, Sjögren’s syndrome and some diseases of hepar and otorhinal tissues. We conclude the outline of this new model of the development of chronic diseases and indicate the conclusions important for the teaching of the basis of pathology.

Clinical significance of knowledge about the structure, function, and impairments of working memory

A review of contemporary research on the working memory system (WMS) is important, both due to the need to focus the discussion on further necessary investigations on the structure and function of this key part of the human brain, as well as to share this knowledge with clinicians. In our introduction we try to clarify the actual terminology and provide an intuitively understandable model for 3 basic cognitive operations: perception, recognition, imagery, and manipulation of recalled mental images. We emphasize the importance of knowledge of the structure and function of the WMS for the possibility to demonstrate the links between genetic polymorphisms and the prevalence to some mental disorders. We also review current knowledge of working memory dysfunction in the most common diseases and specific clinical situations such as maturation and aging. Finally, we briefly discuss methods for assessment of WMS capacity. This article establishes a kind of compendium of knowledge for clinicians who are not familiar with the structure and operation of the WMS.

Medical and Mental Target Risk Factors for Dementia Prevention

The authors draw attention to two current trends in search for relevant risk factors of cognitive impairment and dementia. They discuss whether the most important risk factors are somatic conditions such as hypertension, hyperlipidemia, obesity, diabetes. The authors indicate arguments, found in the literature that the impaired cognitive performance could be caused partly by the previous cognitive impacts. The authors point out that these two lines of research is combined by the occurrence of depression. They postulate, therefore, that assessment of the health of the older people should take into account the data of stressful events in childhood and youth. Important are also data about current living conditions, social conditions and the current mental and physical activity.

Guidelines for prevention and treatment of cognitive impairment in the elderly.

The aim of this study is to present the available and verified methods of prevention of cognitive decline in healthy older adults and to review clinical trials of therapies to improve impaired cognitive performance. We discuss data about the actual possibility of pharmacological treatment, usefulness of physical exercises, and effectiveness of different cognitive training methods. In a separate chapter we discuss why older people cope much better in life challenges then it would appear from the measurements made by use of neuro-psychological tests. We also discuss the so-called issue of transfers, ie, the question of how certain cognitive characteristics, improved through cognitive training, are transferred to other mental skills. We distinguish between simple and sophisticated (usually computerized) forms of cognitive training and pay particular attention to methods that are simple and easy to use. In particular, we discuss the so-called “learning therapy”, which amounts to “reading aloud and simple arithmetic calculations”, the method based on “switching between words and imagination”, and also the method consisting of personal counseling, support, and assistance in learning, especially in the form of home visits. In the final chapter we formulate practical advice, not only for individuals who want to undertake the preventing or correction activities alone with eventual help of medical professionals, but also for the members of health institutions that wish to implement preventive and therapeutic actions directed to a chosen population. We also discuss the indications and rationale for further research and clinical trials.

How to Arrange the Remembrance of Own Life for the Benefit of Successful Aging

The development of medicine caused that for some time taking with patients is not only to establish the diagnosis but also often to determine the state of health, to assess their quality of life and environmental determinants of health. In the field of geriatrics conversation with the patient has other additional targets. We try to assess the cognitive performance of patients and determine the risk factors which lead to the impaired mental capacity and to estimate so-called resilience, which has impact on the positive course of aging. One of the factors contributing to the favorable course of aging is so called balanced perception of own life. Therefore, the authors decided to formulate rules to support patients in obtaining a balanced, memorized assessment of own live. For this purpose, they discuss first several types of data sets related to the course of personal life and then formulate the general guidelines how to assist the patient to reorganize memories, so that remembered autobiography could have a positive connotation. The authors argue that the guidance provided to patients in this respect are, in fact use of some type of cognitive behavioral therapy. Since the use of these methods is very time consuming they propose their own supplementary method acting by recommendation of so-called therapeutic tasks.

Letter to Editor. Is it possible to support cognitive behavioral therapy, led remotely, by determining so-called therapeutic tasks?

In this letter to the Editor, the authors comment recent publications about the attempts to remote realizations of Cognitive Behavioral Therapy (CBT) in the treatment of anxiety disorders in elderly. The distinguished clinical situation is a part of a wider problem that can be named as global crisis of aging populations. The use of CBT in many geriatric clinical situations is very effective, however, such therapy is very time-consuming, what hamper its widespread utilizations in practice. The authors therefore propose to support this form of treatment by determining so-called therapeutic tasks. They derive the rationale for the proposed method from the analysis of the acting elements of various, new forms of CBT in combination with the analysis of sources of psychological resistance (resilience) of those older people who are doing well. The essence of the method proposed by the authors is assigning tasks which facilitate to patients remembering of their trajectory of life. The patients are then much more aware of unresolved psychological conflicts. The next tasks aid the patients to search for solutions to such mental problems and create a balanced imagery of their lives.

In Search of Memory Tests Equivalent for Experiments on Animals and Humans

Older people often exhibit memory impairments. Contemporary demographic trends cause aging of the society. In this situation, it is important to conduct clinical trials of drugs and use training methods to improve memory capacity. Development of new memory tests requires experiments on animals and then clinical trials in humans. Therefore, we decided to review the assessment methods and search for tests that evaluate analogous cognitive processes in animals and humans. This review has enabled us to propose 2 pairs of tests of the efficiency of working memory capacity in animals and humans. We propose a basic set of methods for complex clinical trials of drugs and training methods to improve memory, consisting of 2 pairs of tests: 1) the Novel Object Recognition Test – Sternberg Item Recognition Test and 2) the Object-Location Test – Visuospatial Memory Test. We postulate that further investigations of methods that are equivalent in animals experiments and observations performed on humans are necessary.

Letter to Editor. How to understand the fundamentalism and acts of terrorism

In the light of the known definition of mental health the fundamentalist attitude and associated acts of terrorism, sometimes in the form of suicidal attacks are not normal behaviours. Although they are complex phenomena, described by psychologists and sociologists , it seems that the essence of the causes of fundamentalist attitudes and acts of terrorism should also be discussed by psychiatrists. This is important, in particular by reason of diffusion by the mass-media of fears, which increases prevalence of the anxiety syndromes. In face of the recent spread of these phenomena, any theoretical considerations, which bring closer the explanation of the essence of these occurrences, can be important because it can contribute to effective countermeasures. It is necessary to distinguish the trails of explanation of the nature of a fundamentalist attitude from theories related to the coexisting acts of terrorism. There are two different approaches to interpret the causes of terrorism. Activities that can be termed terrorism happened always. The well-known researcher of these phenomena Jerrold M. Post, outlining historical transformations notes that the first such actions in the twentieth century was the attack on the Israeli Olympic Village in Munich in 1970 [1–4]. J.M. Post proposes classification of all acts of terrorism and the distinction of: 1) Political; 2) Criminal; and 3) Pathological terrorisms. Among the Political Terrorism he distinguishes: A) Sub-state terrorism; B. State supported terrorism; C) Regime or state terrorism. Among the sub-state terrorism he discerns: 1. Social revolutionary terrorism (Left); 2. Right wing terrorism; 3. National-separatist terrorism; 4. Religious extremist terrorism, with categories of: 4a. Religious fundamentalist; and 4b. New religion terrorism. There is also 5. Single issue terrorism. J.M. Post cites many authors advocating his view that the vast majority of so-called terrorists do not show known significant psychopathological disorders [5–7]. It stresses that a typical psychological common feature of these people is their

The Publication of Data on Trajectories of Depressive Symptoms in Older Adults and Risk of Dementia Gives Rise to Broadening this Issue on Problems of Patient's Overall Life Trajectories

Recent publications of data on the trajectories of depressive symptoms prompted the authors to consider the advisability of widening the debate on the possibilities of setting and recording general, overall trajectories of life. The authors set themselves the goal of formulating the outline of a method for determining the overall trajectory of life and ways of presenting such a data set. The authors argue that if the trajectory of life concerns aspects related to the estimation of health, then the most concise and useful way of its presentation is to formulate the so-called Sequence of adverse life events that led to the illness or health disaster. The authors cite an example of such a record. They also emphasize that considering the general trajectory of life requires not only the use of methods arising from neural sciences (autobiographic memory) and various schools of psychology, but that it is very useful to refer to distinguished literary (cultural) works.

Theoretical Background and Procedure for Life Review Psychotherapy Conducted by Nurses in Relation to Older People

The aim of this short communication is to stimulate the discussion on the question whether, indeed, as some say authors suggest-nurses are able to perform so called life review psychotherapy. The authors of this short communication claim that this therapy has already the well-established theoretical background done in the realm of neural sciences. They present here a brief review of these findings. nThe authors propose next a practical working procedure for the application of this form of psychotherapy by trained nurses. They emphasize that the proposed practical procedure becomes comprehensible only if the interested readers begin to try to apply it in their personal practice. This postulate of authors of necessity of personal experimentations with the proposed practical procedure is analogous to so-called therapeutic tasks which they proposed in their earlier papers.