Krzysztof Zboralski

Oxidative stress parameters after combined fluoxetine and acetylsalicylic acid therapy in depressive patients.

There are numerous reports indicating disturbed equilibrium between oxidative processes and antioxidative defense in patients with depression. Moreover, depressive patients are characterized by the presence of elements of an inflammatory process, which is one of the sources of reactive oxygen species (ROS). In view of the above, it was decided to study both the effect of fluoxetine monotherapy and that of fluoxetine co‐administered with acetylsalicylic acid on lipid peroxidation and antioxidative defense in patients with the first depressive episode in their life.

Auditory-verbal declarative and operating memory among patients suffering from depressive disorders - preliminary study.

PURPOSE Dysfunctions of auditory-verbal declarative and working memory are observed in patients with depressive disorders (DD). The authors wanted to see, whether antidepressive therapy improved the efficiency of cognitive processes among patients suffering from DD and determine possible associations between auditory-verbal declarative and working memory performance, evaluated before treatment vs. remission degree after treatment. MATERIAL AND METHODS The study was carried out in 87 subjects, patients with depressive disorders (n=30, DD) and healthy subjects (n=57, CG, control group). The AVLT (Auditory Verbal Learning Test) and the Stroop Test were used. RESULTS CG obtained higher results vs. DD-I (the evaluation started on the therapy onset) in the Stroop Test-RCNb (Reading Colour Names in Black)/time, NCWd (Naming Colour of Word - Different)/time, NCWd/errors, AVLT: the number of words after 30 minutes. CG demonstrated higher results than DD-II (following eight weeks of pharmacological treatment) in RCNb/time, NCWd/time, AVLT: the number of words in the first trial, the number of words after 30 minutes. Compared to DD-I, DD-II achieved better results in NCWd/errors. No statistically significant differences were observed in both tests between the patients with remission and without remission. Statistical analysis revealed the lack of significant dependences among HDRS after treatment and cognitive functions before treatment. CONCLUSIONS Depressive disorders are associated with deteriorated efficiency of auditory-verbal declarative and working memory. No improvement was observed in the efficiency of auditory-verbal declarative or working memory after 8-week therapy. The performance level of cognitive processes before pharmacotherapy has no effect on the intensity of depression symptoms after therapy.

Normalization of the Verbal Fluency Test on the basis of results for healthy subjects, patients with schizophrenia, patients with organic lesions of the chronic nervous system and patients with type 1 and 2 diabetes

Introduction Verbal fluency is the ability to form and express words compatible with required criteria. Verbal fluency is necessary for optimal communication and for normal social and occupational functioning. The Verbal Fluency Test is a good indicator of frontal lobe dysfunction, particularly of the left frontal cortex. Material and methods The aim of the study was to compare verbal fluency in healthy subjects (n = 50), patients with paranoid schizophrenia (n = 36), patients with organic lesions of the central nervous system (CNS) (n = 33), and patients with diabetes (n = 62) – type 1 diabetes (n = 31) and type 2 diabetes (n = 31). Results Healthy subjects and patients with diabetes achieved the highest results in all categories of the Verbal Fluency Test. Patients with paranoid schizophrenia achieved significantly lower results. Sten norms of the Verbal Fluency Test were developed for the general population. Using these norms it was found that subjects with schizophrenia or with organic lesions of the CNS had very poor results more often and very high results less frequently compared to healthy subjects and also to patients with diabetes. Conclusions This observation is consistent with the neurodevelopmental hypothesis of schizophrenia, in which cognitive functions of the frontal lobe (e.g. verbal fluency) play a major role in the psychopathological picture. We have also demonstrated that in patients with type 1 and 2 diabetes verbal fluency is comparable with healthy subjects.

Cognitive functions and clinical features among diabetic patients in Polish population

Diabetes is a chronic metabolic disease which can lead to numerous complications. One of these disturbances is cognitive function impairment. A group of 62 patients with type 1 and type 2 diabetes. There is a correlation between certain clinical features among diabetic patients and cognitive functions. Negative influence on cognitive functions have a higher level of total cholesterol, a higher level of LDL cholesterol, a lower level of HDL cholesterol concentration in the blood, a higher level of glucose after meals, a higher level of basic insulin dose and insulin dose taken just before the examination, longer duration of the diabetes and a lot of hypoglycemic episodes. There is no influence on cognitive functions from glucose levels before meals, the type of the insulin therapy, or the number of hyperglycemic episodes and value rate of hemoglobin HbA1C.

The Heidenhain variant of Creutzfeldt-Jakob disease – two patients initially misdiagnosed with dissociative disorder

Summary Background: The Heidenhain variant of sporadic Creutzfeldt-Jakob disease is characterized by prominent visual complaints that last in isolation for some weeks and are often misdiagnosed until rapid cognitive decline with suggestive neurological symptoms appear. The treatment is only symptomatic, but correct diagnosis established at the time of visual symptom isolation helps to avoid needless diagnostic or treatment procedures and may give time to patients and their families to prepare for the worst. Case Report: We report on 2 cases based on available medical documentation. Written informed consents for publication were obtained from the patients’ families after the patients’ deaths. We report on the cases of 2 men with sporadic Creutzfeldt-Jakob disease first manifested with visual symptoms in which ophthalmological and neurological background was excluded and misdiagnoses of dissociative disorder were made. Further diagnosis in a psychiatry ward suggested probable sporadic Creutzfeldt-Jakob disease, which was confirmed at postmortem examination. Conclusions: Although visual symptoms are listed in the World Health Organization diagnostic criteria for sporadic Creutzfeldt-Jakob disease, initial symptoms can be vague enough to be misdiagnosed even by neurologists. We conclude that in visual disturbances in which ophthalmological and neurological background is at first excluded, a differential diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD) should be considered. In patients with a diagnosis of visual dissociative disturbances, the Heidenhain variant of sCJD should be considered in the differential diagnosis. Repeated EEG in patients with visual disturbances of unknown cause can detect abnormalities suggestive of sporadic Creutzfeldt-Jakob disease.