The specificity of the use of bibliotherapy as an element of psychiatric rehabilitation in a group of patients suffering from schizophrenia.

Purpose: This article emphasizes the characteristics of the application of bibliotherapy in psychiatric rehabilitation of people suffering from chronic schizophrenia. The role of the bibliotherapist and methodology for conducting bibliotherapy for people with chronic schizophrenia are also described. Views: The characteristic symptoms are connected to a patient's perception of the surrounding reality differing from the norm. This may be due to the symptoms of schizophrenia and its course, in which psychoticism can become a regulative part of a patient's personality. The academic definition of bibliotherapy proposed by Ewa Tomasik says that "bibliotherapy is an intentional activity that uses books or non-printed materials to fulfil rehabilitative, re-socializing, prophylactic and developmental aims for people from varying social backgrounds, in different age and with diverse needs". This article focuses on and discusses the structure and course of bibliotherapy sessions embedded in individual and group rehabilitation process. An additional goal is to explain bibliotherapy as an element of the entire system of rehabilitation and therapeutic interactions which has a therapeutic effect for this system, not only in terms of individual classes. Attention is paid to the narrative nature of bibliotherapy, in combination with behavioral-cognitive, humanistic and psychodynamic interactions. Conclusions: Bibliotherapy can help people suffering from chronic schizophrenia to organize their self-narrative and narratives about other people, to make them real and to organize their statements, so that the content and manner of thinking can be regulated.

Positive psychotherapy for psychosis - a new approach in the rehabilitation of patients suffering from schizophrenia. / Pozytywna Psychoterapia Psychoz ­ nowe podejscie w rehabilitacji pacjentów cierpiacych na schizofrenie.

This paper describes the positive psychotherapy for psychosis (PPP) - a new approach for psychiatric rehabilitation for patients with chronic schizophrenia. Unlike some traditional methods of psychotherapy, PPP focuses on positives rather than on problems. PPPwas shown in the context of other therapeutic approaches used in psychiatric rehabilitation and a mechanism of changes in the functioning and thinking of patients using this approach was described. PPP strengthens the patients'resources, including positive emotions, positive features of character, sense of life, positive relationships, and internal motivation. PPPdoes not suggest that other approaches are inappropriate and it is not intended to replace well-established treatments. A program of 13 PPP sessions adapted for patients with schizophrenia was also described. PPP sessions were divided into 3 thematic groups and according to the degree of difficulty: "the easiest" (savoring, positive things - sessions 1-4), "medium" (strong character traits, recognition of strengths in oneself, perceiving strengths in other people, positive communication - sessions 5-7) and "the most difficult" (bad vs. good memories, gratitude, forgiveness, hope, optimism and posttraumatic growth - sessions 8-13). The PPP has been introduced in the Day Care Department of Psychiatric Rehabilitation of the Institute of Psychiatry and Neurology in Warsaw. After 13 weeks, the initial observations were collected. They indicated that PPP can be successfully used in psychiatric rehabilitation.

Expression profile of genes encoding allatoregulatory neuropeptides in females of the spider Parasteatoda tepidariorum (Araneae, Theridiidae).

Allatoregulatory neuropeptides are multifunctional proteins that take part in the synthesis and secretion of juvenile hormones. In insects, allatostatins are inhibitors of juvenile hormone biosynthesis in the corpora allata while allatotropins, act as stimulators. By quantitative real-time PCR, we analyzed the gene expression of allatostatin A (PtASTA), allatostatin B (PtASTB), allatostatin C (PtASTC), allatotropin (PtAT) and their receptors (PtASTA-R, PtASTB-R, PtASTC-R, PtAT-R) in various tissues in different age groups of female spiders. In the presented manuscript, the presence of allatostatin A, allatostatin C, and allatotropin are reported in females of the spider P. tepidariorum. The obtained results indicated substantial differences in gene expression levels for allatoregulatory neuropeptides and their receptors in the different tissues. Additionally, the gene expression levels also varied depending on the female age. Strong expression was observed coinciding with sexual maturation in the neuroendocrine and nervous system, and to a lower extent in the digestive tissues and ovaries. Reverse trends were observed for the expression of genes encoding the receptors of these neuropeptides. In conclusion, our study is the first hint that the site of synthesis and secretion is fulfilled by similar structures as observed in other arthropods. In addition, the results of the analysis of spider physiology give evidence that the general functions like regulation of the juvenile hormone synthesis, regulation of the digestive tract and ovaries action, control of vitellogenesis process by the neuropeptides seem to be conserved among arthropods and are the milestone to future functional studies.

Vitellogenins in the spider Parasteatoda tepidariorum - expression profile and putative hormonal regulation of vitellogenesis.

BACKGROUND: Knowledge about vitellogenesis in spiders is rudimentary. Therefore, the aim of study was to check the vitellogenin (Vg) presence in various tissues of the female spider Parasteatoda tepidariorum, determine when and where vitellogenesis starts and takes place, and the putative role of selected hormones in the vitellogenesis. RESULTS: Here we show two genes encoding Vg (PtVg4 and PtVg6) in the genome of the spider P. tepidariorum. One gene PtVg4 and three subunits of Vg (250 kDa, 47 kDa and 30 kDa) are expressed in the midgut glands, ovaries and hemolymph. Heterosynthesis of the Vg in the midgut glands and autosynthesis in the ovaries were observed. Vitellogenesis begins in the last nymphal stage in the midgut glands (heterosynthesis). However, after sexual maturity is reached, Vg is also synthesized in the ovaries (autosynthesis). Changes in the PtVg4 expression level and in the Vg concentration after treatment with 20-hydroxyecdysone, a juvenile hormone analog (fenoxycarb) and an antijuvenoid compound (precocene I) were observed. Therefore, we propose a hypothetical model for the hormonal regulation of vitellogenesis in P. tepidariorum. CONCLUSIONS: Our results are the first comprehensive study on spider vitellogenesis. In our opinion, this work will open discussion on the evolutionary context of possible similarities in the hormonal control of vitellogenesis between P. tepidariorum and other arthropods as well as their consequences.

Sterile Capsule-Egg Cocoon Covering Constitutes an Antibacterial Barrier for Spider Parasteatoda tepidariorum Embryos.

Coexistence of organisms and pathogens has resulted in the evolution of efficient antimicrobial defense, especially at the embryonic stage. This investigation aimed to substantiate the hypothesis that the layers of silk in a spider cocoon play a role in the immunity of the embryos against microorganisms present in the external environment. A two-step interdisciplinary attempt has been made. First, the eggs and empty cocoons of the spider Parasteatoda tepidariorum were incubated on lysogeny broth agar media for 3 d. In the samples of eggs, no growth of bacteria was detected. This indicated that the eggs inside cocoons were sterile. Therefore, in the second step, the cocoons and egg surface were analyzed using SEM, TEM, and LM. The obtained images demonstrated that both inner and outer layers of the silk are built of threads of the same diameter, set in an irregular manner, and randomly clustered into groups. The threads in the outer layer were packed more densely than in the inner one. TEM analysis revealed threads of two types of fibrils and their arrangement. The resultant thread tangle of the cocoon, possibly correlated with the ultrastructure of the fibers, seems to be an example of a structure-function relationship playing a crucial ecoimmunological role in spider embryonic development.

The current state of knowledge on the neuroactive compounds that affect the development, mating and reproduction of spiders (Araneae) compared to insects.

The neuroendocrine system of insects, including the presence of the main neuroactive compounds, and their role in ontogenesis are probably best understood of all the arthropods. Development, metamorphosis, the maturation of the gonads, vitellogenesis and egg production are regulated by hormones (juvenile hormones, ecdysteroids) and neuropeptides. However, knowledge about their presence and functions in spiders is fragmentary. In this paper, we present a summary of the current data about the juvenile hormones, ecdysteroids and neuropeptides in selected groups of arthropods, with particular emphasis on spiders. This is the first article that takes into account the occurrence, action and role of hormones and neuropeptides in spiders. In addition, the suggestions for possible ways to study these compounds in Araneomorphae spiders are unique and cannot be found in the arachnological literature.

Modulation of the response to stress factors of Xerolycosa nemoralis (Lycosidae) spiders living in contaminated environments.

The rapid development of industry has caused widespread pollution in the environment, which has a negative impact on living organisms. Spiders belong to the group of animals that can exist in these anthropogenically changed areas. This is probably due to the development of tolerance mechanisms in these organisms. The impact of long-term pollution on the development of the pre-adaptation to various stress factors in spiders is unknown. In this paper, we show that living in polluted areas affects the modulation of the response to other stress factors through changes in the Hsp70 level. We observed a positive reaction to heat shock in all of the experimental groups, which was expressed by an increase in Hsp70 synthesis compared to the control. The analysis of the protein level, which was a manifestation of the pre-adaptation, was dependent on the degree of pollution on the study sites, the sexes and the type of bioassay that was performed. Our results demonstrate the reaction of spiders living in contaminated areas to the presence of additional stressors. We anticipate our results will be another voice in the discussion on the use of Hsp70 as a stress biomarker in environmental biomonitoring.

Skin Resistivity Value of Upper Trapezius Latent Trigger Points.

INTRODUCTION: The skin resistivity (SkR) measurement is commonly recommended for acupoints measurement, but for trigger points (TrPs) only one study is available. The purpose of the study was to evaluate SkR for latent TrPs compared to non-TrPs and the surrounding tissue. MATERIAL AND METHODS: Forty-two healthy volunteers with unilateral latent upper trapezius TrPs (12 men, 30 women) aged 21-23 (mean age: 22.1 ± 0.6 y) participated in the study. Keithley electrometer 610B was used for measuring SkR (Ag/AgCl self-adhesive, disposable ground electrode: 30 mm diameter). SkR was measured for latent TrPs and compared to opposite non-TrPs sites and the surrounding tissue. RESULTS: The SkR decrease of TrPs-positive sites as compared to TrPs-negative sites and the surrounding tissue was confirmed. However, no statistically significant difference in the SkR value occurred when all data were analyzed. The same was confirmed after gender division and for TrPs-positive subjects examined for referred pain and twitch response presence. CONCLUSION: SkR reactive changes at latent TrPs are possible but the results were not consistent with the previous study. Thus, caution in applying SkR to latent TrPs isolation is recommended and its clinical use should not be encouraged yet. Further studies, especially on active TrPs, are yet required.

Case report on a patient with lupus panniculitis.

Lupus panniculitis is a rare variant of lupus erythematosus. It may occur as a separate disease or coexist with systemic or discoid lupus erythematosus. It is characterized by persistent, tender and hard nodules localised on the face, arms, shoulders, breast and buttocks. Healing of lesions is associated with scarring, lipoatrophy and rarely ulceration. Treatment of lupus panniculitis depends on disease advancement or concomitance of additional lupus erythematosus symptoms. We report a case of a 44-year-old patient with lupus panniculitis treated with chloroquine and glucocorticosteroids, including high dose infusions. Despite intense treatment, the patient developed symptoms that suggested a diagnosis of systemic lupus erythematosus.

X-ray microtomography for imaging of developing spiders inside egg cocoons.

Embryogenesis is especially sensitive to external factors. The changes in its course are often used as biomarkers of environmental impact. Since spider embryogenesis takes place inside cocoons, it is crucial to find a reliable tool to analyze this developmental phase with no intrusion into the cocoons. The aim of this study was to verify the efficacy of X-ray microtomography for non-invasive analysis of embryonic morphology and egg quantity in the cocoons of Xerolycosa nemoralis and Agelena labyrinthica from polluted and reference sites. X-ray microtomography slice images as well as 3D images and animations obtained from digital visualization of those slides were used to study the morphology of embryos and egg arrangement in the cocoons. Any disorders in embryogenesis or malformation of embryos in relation to site of origin have not been found, but inside an egg cocoon of X. nemoralis from the polluted site embryos differing form each other by one developmental stage were identified. Egg calculation revealed a K- reproductive strategy of X. nemoralis from polluted sites. Finally, future prospects and benefits, and weaknessess of this method for the study of spider cocoons have presented.

Intensive short-term vasodilation effect in the pain area of sciatica patients--case study.

BACKGROUND: Varied and complicated etiology of low back pain radiating distally to the extremities is still causing disagreement and controversy around the issue of its diagnosis and treatment. Most clinicians believe that the source of that pain is generally radicular. While some of them postulate the clinical significance of the sacroiliac joint syndrome, others demonstrate that almost one in five people with back pain experience symptoms indicative of the neuropathic pain component. To date, neuropathic involvement has not been completely understood, and different mechanisms are thought to play an important role. It has been established that muscle pain (myofascial pain) e.g. active trigger points from the gluteus minimus, can mimic pain similar to sciatica, especially in the chronic stage. This paper describes patients presenting with radicular sciatica (case one and two) and sciatica-like symptoms (case three). For the first time, intensive short-term vasodilation in the pain area following needle infiltration of the gluteus minimus trigger point was recorded. CASE PRESENTATION: Three Caucasian, European women suffering from radicular sciatica (case one and two) and sciatica-like symptoms (case three) at the age of 57, 49 and 47 respectively underwent infrared camera observation during needle infiltration of the gluteus minimus trigger point. The patients were diagnosed by a neurologist; they underwent magnetic resonance imaging, electromyography, neurography and blood test analysis. Apart from that, the patients were diagnosed by a clinician specializing in myofascial pain diagnosis. CONCLUSION: In the examined cases, trigger points-related short-term vasodilation was recorded. Confirmation of these findings in a controlled, blinded study would indicate the existence of a link between the pain of sciatica patients (radicular or sciatica-like pain) and the activity of the autonomic nervous system. Further studies on a bigger group of patients are still needed.

[Sense of coherence and ways of coping in the relationship with brother or sister in healthy siblings of mentally ill persons]. / Poczucie koherencji i sposoby radzenia sobie ze stresem w relacji z bratem lub siostra u zdrowego rodzenstwa osób chorych psychicznie.

AIM: The aim of the present study was to investigate sense of coherence in healthy siblings of persons suffering from schizophrenia as well as their ways of coping in the relationship with ill brother or sister. METHODS: 40 healthy brothers and sisters of persons with ICD- 10 diagnosis of F20 to F29 participated in the present study. Orientation to Life Scale (SOC- 29) was used to assess sense of coherence and Ways of Coping with Stress questionnaire (SRSS) was used to examine stress coping strategies. RESULTS: Mean global score of siblings of persons with schizophrenia was 111 points. Subjects used coping strategies focused on problem significantly more often than those focused on emotions. CONCLUSIONS: Therapeutic work with healthy siblings should focus on strengthening sense of personal competence, development of personal resources and different ways of coping with stress, investigation of emotions that healthy siblings experience in the relationship with ill brother or sister as well as supporting the process of accepting changes in the relationship with the ill sibling.

Trigger point-related sympathetic nerve activity in chronic sciatic leg pain: a case study.

Sciatica has classically been associated with irritation of the sciatic nerve by the vertebral disc and consequent inflammation. Some authors suggest that active trigger points in the gluteus minimus muscle can refer pain in similar way to sciatica. Trigger point diagnosis is based on Travel and Simons criteria, but referred pain and twitch response are significant confirmatory signs of the diagnostic criteria. Although vasoconstriction in the area of a latent trigger point has been demonstrated, the vasomotor reaction of active trigger points has not been examined. We report the case of a 22-year-old Caucasian European man who presented with a 3-year history of chronic sciatic-type leg pain. In the third year of symptoms, coexistent myofascial pain syndrome was diagnosed. Acupuncture needle stimulation of active trigger points under infrared thermovisual camera showed a sudden short-term vasodilatation (an autonomic phenomenon) in the area of referred pain. The vasodilatation spread from 0.2 to 171.9 cm(2) and then gradually decreased. After needling, increases in average and maximum skin temperature were seen as follows: for the thigh, changes were +2.6°C (average) and +3.6°C (maximum); for the calf, changes were +0.9°C (average) and +1.4°C (maximum). It is not yet known whether the vasodilatation observed was evoked exclusively by dry needling of active trigger points. The complex condition of the patient suggests that other variables might have influenced the infrared thermovision camera results. We suggest that it is important to check if vasodilatation in the area of referred pain occurs in all patients with active trigger points.

[The perception of authorship in schizophrenia - the analysis of activity patterns in autonarrations]. / Postrzeganie wlasnego sprawstwa przez osoby chore na schizofrenie - analiza wzorców aktywnosci w autonarracjach.

AIM: The paper presents the study of narrations of schizophrenic patients focused on the description of activities characteristics. The aim is to answer the question of how experiencing of psychotic crisis influences the perception of their authorship. Do the inherent characteristics of the activity differ with reference to the period of life which they relate to: the time before getting sick, or after falling ill with schizophrenia? METHODS: The material consisted of narrations of 26 people with schizophrenia about their life prior to the illness and after the psychotic crisis. Linguistic categories that make up the patterns of activity have been distinguished. The frequency of the occurrence was compared in both narrations. RESULTS: Self-descriptions after falling ill are more saturated with patterns of avoidance, motivation internally localized connected with attempts of coping with the disease and externally localized action control connected with a decreased sense of authorship in relation to experiencing symptoms and reduction of social competence. CONCLUSIONS: The change of self-image after psychotic experience concerns the deeper planes of narrative, i.e. the patterns of activity hidden in connection between the content and narrative form. The research showed the decrease of the sense of agency associated with the disease experience.

[The comparison of self image before and after the psychotic crisis --the analysis of schizophrenic patients' narration]. / Porównanie obrazu siebie przed i po wystapieniu kryzysu psychotycznego poprzez analize narracji osób chorych na schizofrenie.

AIM: The aim of this study was to show the influence of schizophrenia on the individual system of meanings--the way in which the persons describe themselves and their life story. In order to achieve this goal, the analysis of narration of patients suffering from schizophrenia was conducted. METHOD: We examined 20 patients suffering from schizophrenia. We interviewed the patients with a structured narrative questionnaire. The persons described their life and themselves--in the time before and after the psychotic crisis. The interviews were analysed according to different literary methods and the knowledge of formal linguistics. The demographic variables and the clinical state of patients were also controlled. RESULTS: Persons suffering from schizophrenia used more positive attributes and less negative attributes while describing themselves before illness. They reported more positive episodes from their life, before the psychotic crisis. CONCLUSIONS: The psychotic crisis causes the dramatic decrease of self esteem and breakdown of the life story. The patients described themselves and their life in negative, pessimistic optics. The trauma of mental illness is reflected in narration by breakdown of "good story" about the person and her/his life. This change of self image concerns the persons who both cooperate in psychotherapy and are critical to illness.

[Rituximab for rheumatoid arthritis refractory to anti-tumor necrosis factor therapy in Poland]. / Rytuksymab w leczeniu chorych na reumatoidalne zapalenie stawów po niepowodzeniu terapii inhibitorami TNF-alpha.

UNLABELLED: Results of a multicenter, non-interventional, observational study assessing efficacy and safety of 1st course rituximab treatment with methotrexate in patients with rheumatoid arthritis and a history of inadequate response to anti-TNF-therapies, in the routine clinical settings in Poland (MIRACLE-POL 1). The aim of the study was to determine the efficacy and safety of treatment with rituximab and methotrexate in patients with active rheumatoid arthritis (RA) who had inadequate response to anti-TNF-therapies in routine clinical settings in Poland. MATERIAL AND METHODS: We evaluated effectiveness and safety of RTX and MTX therapy in 73 patients enrolled in the multicenter, non-interventional, observational study. Patients with active RA had a history of an inadequate response to 1 or more anti-TNF-alpha agents received 1st course of rituximab consisting of 2 intravenous infusions of 1000 mg each. The end points were: EULAR response criteria at 180 days, changes of Disease Activity Scores in 28 joints (DAS28) from the original baseline at 180 days, rate of remission, rate of low disease activity according to EULAR criteria and rate of adverse events (AEs) during treatment. RESULTS: At 180 days 22% of treated patients demonstrated good-to-moderate EULAR response and 12% of patients demonstrated moderate response. In 77% of cases DAS28 decreased > 1.2. 16% of patients achieved remission according to EULAR criteria and 23% of patients achieved low disease activity. After 180 days mean DAS28 score decreased from 6.33 to 4.06. In 16% of patients AEs occurred with the first rituximab infusion, in 12% of patients with the second rituximab one, and in 43% of patients afterwards. All AEs were mild or moderate in severity. There were no serious AEs including serious infections. Infusion-associated AEs occurred in a higher proportion during the first infusion. CONCLUSIONS: Results of this multicenter, non-interventional, observational study confirm efficacy and safety of 1st course rituximab treatment with concomitant methotrexate in patients with rheumatoid arthritis who had inadequate response to anti-TNF-therapies in the routine clinical settings in Poland.

[Disorders of locomotor system and effectiveness of physiotherapy in coal miners]. / Choroby ukladu ruchu a skutecznosc leczenia fizjoterapeutycznego u górników kopalni wegla kamiennego.

BACKGROUND: The aim of the survey was to analyze the efficacy of physiotherapy applied in coal miners as well as to assess their locomotor system load and the effects of working conditions in mines. MATERIALS AND METHODS: The questionnaire survey covered a group of 51 miners, aged 28-76 years (mean, 54 years), undergoing physiotherapeutic procedures in the mine out-patient clinic during the first quarter of 2003. RESULTS: The survey revealed that lumbosacral disorders were the most frequent locomotor system complaints reported by miners, especially those who work in a bending down position. According to the clinical data, spondylosis and allied disorders were the main reasons for pain in this part of the body. Having analyzed the relationship between age and occurrence of back pains, the majority of complaints were found in the 46-55 age group (two complaints per one respondent). The analysis of the association between back pains and duration of employment revealed that the complaints for the locomotor system occurred already after a five-year employment. CONCLUSIONS: The survey showed that the application of physiotherapeutic procedures diminished the back pain in the study group by 2.83 on average on the 0-10 scale. It was also found that magnetotherapy proved to be the most effective method in treating the spinal degenerative changes.