[Brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) blood levels in patients with acute carbon monoxide poisoning - a preliminary observations].

Background: Neurotrophins are the family of proteins which stimulate and regulate the process of neurogenesis. Several factors belong to the family, mainly nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT 3), and neurotrophin-4/5 (NT-4/5). Acute poisoning with carbon monoxide (CO), which usually is accompanied by neurologic symptoms, can potentially change the secretion profile of neurotrophins. Aim of the study. The main goal of the study is to assess the changes of NGF and BDNF plasma levels during an acute phase of CO poisoning as well as immediately after recovery. Additionally, the relationship among neurotrophin levels and selected aspects of clinical course of CO poisoning were studied. Materials and Methods: The study group consisted of 18 patients (mean age: 31.8±10.3 years) hospitalized in Toxicology Department of University Hospital in Cracow because of acute CO poisoning. There were 10 women (mean age: 30.2±6.9 years) and 8 men (mean age 33.9±13.7 years) in the group. The levels of NGF and BDNF were evaluated using immunoenzymatic method (ELISA) in plasma samples taken thrice in each patient. The sample 1. was taken during hospital admission, the sample 2. about 12-36 hours after admission, and the sample 3. just before the hospital discharging (usually, on the 3rd-4th day). The clinical data were collected from patients' anamnesis, physical examination and neuropsychological evaluation. The statistical analysis were performed using tools comprised in STATISTICA 12.0 PL (StatSoft Polska, Cracow, Poland) software. Results: The majority of NGF plasma levels were less than 14 pg/mL (values below the limit of quantification), contrary to the sole case of 34.3 pg/mL. BDNF plasma levels ranged from 4.8 ng/mL to above 48 ng/mL, i.e. they were higher than the upper limit of measurement range for the plasma dilution which had been used. The comparison of NGF and BDNF plasma levels in the study group with their analogues in healthy volunteers taken from the literature indicates that NGF level declines and BDNF level rises in patients with CO poisoning. The profile of BDNF concentrations in the majority of patients formed the characteristic pattern: BDNF sample 1. > BDNF sample 2. < BDNF sample 3. Taking all the values of BDNF higher than 48 ng/mL as equal to 48 ng/ mL, the statistically significant difference among 3 sample series was found according to BDNF levels. Maintaining the above mentioned assumption, the statistically significant negative correlation between the number of higher cognitive functions disturbed in one patient at the same time and the BDNF levels in sample series 2 was discovered, as well as the weak correlations between BDNF level in sample series 1 and carboxyhaemoglobin or lactate level. Moreover, weak but statistically significant correlations were present between the duration of CO exposure and BDNF levels in each sample series. Conclusions: The NGF plasma level is probably declined, while the BDNF plasma level is increased in patients with acute CO poisoning. The concentration­time curve for the plasma BDNF may sometimes undergo fluctuations with two peaks on its course. Plasma BDNF level may serve as a biological marker of disturbed higher cognitive functions in acute CO poisoning. Some clinical aspects of CO poisoning (duration of exposure, HbCO and lactate blood levels) may influence BDNF level.

[Evaluation of pituitary-gonadal axis in alcohol dependent males]. / Ocena osi przysadkowo-gonadalnej u mezczyzn uzaleinionych od alkoholu.

UNLABELLED: Chronic alcoholism leads to organic damages of nervous system, the liver and the endocrine system. The aim of the study is to evaluate pituitary-gonadal axis in males chronically dependent with alcohol. MATERIAL AND METHODS: The study group consisted of 50 alcohol dependent men aged 27 to 53 years (40.7 +/- 6.6) treated at the Ward of Toxicology and Environmental Diseases (Detoxification Unit). Al-cohol dependence was diagnosed according to ICD-10 criteria. The intensity of withdrawal syndrome was measured using CIWA-A scale. In all the patients anthropometrical measurements and abdominal ultrasonography were performed as well as blood pressure was measured. Levels of gonadotropin, total testosteron, PRL were determined, thyroid and adrenal gland function were assessed and oral glucose tolerance test (OGTT) was performed in all patients. Activity of the liver enzymes, urea and creatine concentration were determined. Erectile dysfunction was assessed using IIEF. 5 questionnaire: in those patients who received < or =21 points an incidence of diabetes mellitus, thyroid gland and cardiovascular diseases was assessed using standardized questionnaire. RESULTS: Alcohol dependency longer than 15 years was stated in 25, longer than 10 years in 9, and longer than 5 years in 16 of examined patients. The moderate withdrawal syndrome was diagnosed in 22, severe withdrawal syndrome in 26 and very severe withdrawal syndrome in 2 of the patients. BMI ranged from 15.8 to 33.8 kg/m2 (mediane 24.67; +/- 0.54 kg/m2). In 24 men erectile dysfunction was diagnosed using IIEF5 questionnaire. No significant difference was noted between level of total testosterone and PRL in the group with or without erectile dysfunction (testosterone: 5.07 +/- 2.41 vs. 4.54 +/- 2.74; PRL: 330.2 +/- 214.2 vs. 307.4 +/- 258.2). Gonadropine level in the group of men with erectile dysfunction was significantly higher than that without erectile dysfunction (LH: 7.4 +/- 5.2 vs. 4.38 +/- 2.23, p < 0.01; FSH: 13.3 +/- 29.3 vs. 4.59 +/- 19.92, p < 0.05). CONCLUSION: The results obtained confirm that secondary stimulation of pituitary-gonadal axis in alcoholic men depends on liver function and ethanol toxic effect on gonads.

[Analysis of personality and psychosocial development of adolescent patients in relation to family dysfunction]. / Analiza rozwoju i osobowosci pacjenta-adolescenta dokonujacego próby samobójczej na tle objawów dysfunkcji w rodzinie.

The aim of the study was to analyse an individual psychosocial development and personality of adolescents in relation to family dysfunction. 36 patients who committed suicide attempt treated at the Department of Clinical Toxicology Jagiellonian University Medical College in 2004 and 2005 were included. The Adjective Check List (ACL) by H.G. Gough and A.B. Heilbrun was used. The parents of each of the adolescents were interviewed and responded to questions according to special author's designed Questionnaire. Some phenomenon who can influence the personality and may be recognised as a predictors of suicide attempt were found in most of the examined patients. Prophylactic and therapeutic programs for individual patient and his family member should be constructed.

The characteristics of suicide attempts based on the suicidal intent scale scores.

The aim of the work was to present the characteristics of suicide attempts, distinguished on the basis of the scores in the Suicidal Intent Scale questionnaire (SIS), created by Aaron Beck, professor of psychiatry from Philadelphia. The group examined comprised 238 patients (63 males and 175 females) hospitalised in the Department of Clinical Toxicology CMUJ in Kraków in the years 2000-2001, after a suicidal self-intoxication with xenobiotics. The examination was conducted by means of the Suicidal Intent Scale (SIS)--a psychological test created by Aaron Beck. In the case of about 65% of the patients examined, their suicide attempts most frequently were acts of impulsive behaviour, rarely planned for longer than three hours before the realization and usually made in another person's presence or in a situation in which another person's intervention was highly probable. Such attempts had the character of "a cry for help", and were aimed at effecting some change or at manipulating the environment. Nevertheless, the patients acted in a conviction that their act was a serious attempt at ending life, and, most frequently, they maintained such opinions during the examination. On the other hand, they rarely expressed further suicidal intents, and more frequently accepted the fact that their lives had been saved. By contrast, the remaining 35% of the patients examined had attempted suicide with the evident intention to kill themselves; they had taken full precautions against being discovered and had planned suicide carefully to eliminate the smallest possibility of intervention. In the majority of cases, they still maintained the wish to die after the attempt. As the results of the examination indicate, the Suicidal Intent Scale, and, especially, the Precautions subscale, point at the important aspect of suicidal intentions, which, being of vital importance for the diagnostic purposes and suicide prevention, requires further investigation.

[Risk factors for suicide attempts in elderly and old elderly patients]. / Czynniki ryzyka usilowania samobójstwa u osób starszych i w okresie póznej starosci.

The aim of the study was to assess the phenomenon of suicide attempt in the elderly inhabitants of Kraków. Special attention has been paid to the group of "seniors"--aged 75 years or over. The authors have analyzed all the 136 cases of suicide attempts by individuals aged over 60 years, selected from the cases of suicide attempts by self-intoxications by patients hospitalized in the Department of Clinical Toxicology, CMUJ in Kraków in the years 2000-2002. The group concerned included 45 males and 91 females. A large number of subjects (over a half of the total) ranged in age from 60 to 65 years. The group of seniors comprised 35 individuals (aged 75 years or over), including 7 males and 28 females. On the basis of the data from medical documentation, the subjects were analysed from the point of view of their health condition and in the psycho-social context. In the majority of cases the subjects are pensioners residing in Kraków, often living alone. In the case of 98% of the subjects, it was their first suicide attempt. Pharmaceuticals used for self-poisoning were most frequently psychotropic, or mixed-type drugs. The assessment of the severity of poisoning indicates that in about 20% patients poisoning was severe. 70% of the subjects suffered from depressive, reactive, or situational disorders, affective depression or organic brain disorders, often with dementive signs. A significant number of subjects suffered from hypertension, coronary artery disease, arteriosclerosis, or alimentary tract diseases. In the group of the seniors, the most conspicuous problems included serious somatic diseases (malignant diseases and chronic respiratory system diseases), depression, organic dementia, loneliness, and bad family situation. Taking into consideration the scantiness of research into attempted and completed suicide in the elderly and in the old elderly, the present authors stress the importance of the continuation of the research to prevent suicide in the aforesaid age group.

[Connection between personality and emotional intelligence in groups of patients after suicidal attempts and ethanol dependent persons]. / Zwiazek cech osobowosci i poziomu inteligencji emocjonalnej w grupach pacjentów po próbie samobójczej oraz uzaleznionych od alkoholu.

The aim of the study was to examine relationship between personality and emotional intelligence in two groups. The first group included patients hospitalized for suicide attempts in the Department of Clinical Toxicology CMUJ, the second one included ethanol dependent patients hospitalized in detoxification unit. The study included 103 persons: 52 in the study group of patients after suicidal attempt and 51 in the ethanol dependent patients group. Personality was described according to the one of most popular concepts--Costa and McCrae's Big Five Model, including five major factors: neuroticism, extraversion, openness to experience, agreeableness and conscientiousness. The second problem discussed in this study was emotional intelligence understood as ability to follow one's own and others' emotions, differentiate them and use this information in directing one's own thinking and action. In this study Costa and McCrae's Five-Factor Inventory (NEO) and N. S. Schutte's Emotional Intelligence Questionnaire were used. The analysis of their results in our two groups confirmed the hypothesis of relationship between emotional intelligence and personality.