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Oglodek E.,Medical University of Bydgoszcz | Araszkiewicz A.,Medical University of Bydgoszcz
Polski Merkuriusz Lekarski | Year: 2011

The American Psychiatric Association (APA) provides guidelines in which it recommends applying pharmacotherapy in order to take under control the symptoms developing in the period of acute decompensation, as well as those connected with the susceptibility of an afflicted individual to an injury resulting from the basic disorder. The guidelines of the APA include in particular what follows: in case of affective deregulation, administering anti-depressive drugs (LDP), mainly SSRIs, as well as IMAOs; in order to take under control the disorders of impulsive-behavioural control, administering SSRIs and normothymic drugs, whilst in the treatment of infirm with perceptivecognitive disorders, administering antipsychotic medicines (LPP). Cunrently, upon the basis of existing evidence, one may claim that in the treatment of the borderline personality disorders, psychotherapy is much more effective than pharmacology. An obstacle on the road to make psychotherapy more widespread is relatively high cost, which is connected with the necessity of remunerating highly-qualified psychotherapists, involved in the wonk with the infinv, suffering from the borderline personality disorders, and the time, needed to conduct a successful psychotherapy, as well as the phenomenon of the premature discontinuation of therapy by patients who are emotionally unstable. In turn, pharmacotherapy seems to be necessary in the period of more acute disorders, i.e. in the states of increased affective lability, in dysphoric states, in impulsive behaviours and in the periods of the occurrence of pseudo-psychotic symptoms. Source


Oglodek E.,Medical University of Bydgoszcz | Araszkiewicz A.,Medical University of Bydgoszcz
Polski Merkuriusz Lekarski | Year: 2011

Yung was of an opinion that the borderline personality as a pathology results from the experiences of a frightened and violence-experiencing child who is left to their own devices in the hostile world. In that situation, the child, longing for safety, simultaneously experiences fear of abuse, hurt and rejection and remains distrustful. In order to understand the dramatic changes in the individual's behaviour, in case of the borderline personality disorders, Yung developed the concept, presented by Aaron Beck at the therapeutic workshops in the 1980s. Beck's concept was based upon the assumption that some pathological states expressed strong emotional states, experienced in childhood on the basis of regression. Yung presented them in the form of conceptualization in the categories of the active styles of schema. Apart from the states of regression, he also differentiated less regressive styles of schema. The style of schema should be interpreted as a pattern of experiencing, thinking and behaviour, based upon a determined set of schema, and characterized by independence from other styles. Source


Madry K.,Medical University of Warsaw | Machowicz R.,Medical University of Warsaw | Waszczuk-Gajda A.,Medical University of Warsaw | Drozd-Sokolowska J.,Medical University of Warsaw | And 24 more authors.
Acta Haematologica | Year: 2015

Epidemiological studies on myelodysplastic syndromes (MDS) in Middle-Eastern Europe are scarce. No data about the demographic, clinical, and laboratory features of Polish MDS patients have been published. The aim of this study was to assess the epidemiological data and toxic exposure of Polish MDS patients and their association with hematological parameters and clinical outcomes. For 15 months, 966 living MDS patients were enrolled at 24 centers (12 university and 12 community hospitals). Follow-up was conducted for the next 55 months. The percentage of patients older than 80 years (16%) was between the values for Eastern and Western countries. In patients younger than 55 years, a female predominance was observed (male/female ratio 0.70:1 vs. 1.29:1; p < 0.001). Female patients had higher platelet counts (160 × 109/l vs. 111 × 109/l; p < 0.001). Patients exposed to chemicals were younger than patients without such exposure; their median age at MDS diagnosis was 66 vs. 70 years (p = 0.037). Smokers had significantly lower hemoglobin concentrations (8.6 vs. 9.1 g/dl; p = 0.032) and lower platelet counts (99 × 109/l vs. 137 × 109/l; p < 0.001) than nonsmokers. We provide the first description of the characteristics of Polish MDS patients. Females predominated in the group aged <60 years and they had higher platelet counts. The course of the disease is affected by toxic exposure and smoking. © 2015 S. Karger AG, Basel. Source


Oglodek E.,Medical University of Bydgoszcz | Araszkiewicz A.,Medical University of Bydgoszcz
Polski Merkuriusz Lekarski | Year: 2012

As civilization advanced, the number of disasters, including their types and size of the threat to humanity. In addition to natural disasters and wars, there are currently a disaster communication, environmental and technological. Disasters "newgeneration"include increasingly frequent bombings and terrorist attacks. These events are an impediment to long-lasting and deep impact on the mental functioning of the victims of the event. This represents a potential risk of a variety of psychopathoiogical symptoms, which go beyond the limits of human suffering. ICD-10 classification includes individuals sickness arising as a consequence of pathological after surviving the disaster, which include: acute stress disorder (ASD), post-traumatic stress disorder (PTSD), post-traumatic stress disorder linked to depression, symptoms anxiety, addictions, dissociative disorders and personality changes and permanent after the disaster. Source


Bien E.,Medical University of Gdansk | Kazanowska B.,Wroclaw Medical University | Dantonello T.,Paediatrics 5 Oncology | Adamkiewicz-Drozynska E.,Medical University of Gdansk | And 11 more authors.
Annals of Surgical Oncology | Year: 2010

Background. The rarity of malignant and intermediate vascular tumors in children means that little is known about their clinical course, optimal treatment, and variables predicting survival. Methods. A total of 32 children with malignant vascular tumors (14 angiosarcomas [AS], 5 epithelioid hemangioendotheliomas, and 13 intermediate vascular tumors, including other hemangioendotheliomas plus adult-type hemangiopericytomas), registered in the German and Polish Paediatric Soft Tissue Sarcomas Study Groups, were treated following the Cooperative Weichteilsarkom Studiengruppe (CWS)-81,-86,-91, and-96 protocols. Results. Male sex, AS histology, tumor size>5 cm, and T2 invasiveness were independent predictors of inferior 5-year overall survival, while AS histology and T2 invasiveness were predictors of inferior 5-year event-free survival. AS histology was the most important negative prognostic factor for overall survival and event-free survival. Completeness of primary tumor excision was a good prognostic factor for survival in univariate, but not multivariate, analysis. Local therapy (radiotherapy and delayed surgery) were provided to the minority of patients (28% and 38%, respectively) late in the course of disease (after a mean of 9 and 6 months, respectively) and did not prevent local relapses. Response to systemic treatment was poor (44%) and did not prevent local and distant relapses. Conclusions. The clinical course and outcome in childhood epithelioid HE seems to be similar to intravascular tumors and less aggressive than AS. RTX and delayed surgery should be performed more frequently and earlier in the disease course. An urgent need for modification of systemic therapy is needed because of the development of many metastatic and/or combined relapses and poor response to classic chemotherapy. The problem of effective therapy for childhood AS is the most appaling: 13 of 14 patients died of progression despite multimodal treatment. © Society of Surgical Oncology 2010. Source

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