Neuropathic pain after spinal cord injury resistant to conventional therapies - case report. / Ból neuropatyczny po urazie rdzenia kregowego niepoddajacy sie konwencjonalnej terapii - opis przypadku.

OBJECTIVES: There are patients with neuropathic pain in whom the treatment is ineffective, despite the fact that is conducted with adherence to the current guidelines. In these patients alternative treatment methods such as hypnosis could be effective. METHODS: The paper presents a case of a 58-year-old man with central neuropathic pain after cervical spinal cord injury. The conservative treatment with antiepileptics including gabapentoids), antidepressants (tricyclic and selective noradrenaline and serotonin inhibitor - SNRI) and opioids was not effective. In the pain management centre the celiac plexus stimulation and neuromodulation was performed, however, with no positive results. The patient was referred to the psychiatrist using hypnosis in his medical practice. RESULTS: The psychiatrist qualified the patient to pain treatment with hypnosis. After several hypnotic sessions the pain intensity score in numeric rating scale (NRS) decreased from NRS 7 to NRS 5 points and became acceptable for the patient. CONCLUSIONS: Hypnosis can be considered an effective method of neuropathic pain treatment in some patients.

Relationships between various temperament dimensions, levels of selected cytokines and Posttraumatic Stress Disorder (PTSD) in males, incurred as a result of mechanical injuries of lower extremities.

OBJECTIVES: This analysis addresses the relationships between various temperament dimensions, levels of selected cytokines and PTSD in males, incurred as a result of mechanical injuries of lower extremities. METHODS: PTSD was assessed with a PTSD Factorial Version Inventory. Temperamental traits were evaluated by means of Formal Characteristics of Behaviour - Temperament Inventory (FCB-TI). Cytokine levels were determined using ELISA kits. The study population was selected from among a larger population of 80 persons. 15 persons with signs of inflammation were excluded. PTSD group included 33 persons, 32 subjects were included in the control group. RESULTS: Positive statistical correlation with PTSD was observed for: perseverance and emotional reactivity. On the other hand, negative relationship was shown between PTSD and: briskness, endurance and activity. No statistically significant correlations were revealed between the levels of selected cytokines (sIL-2, IL-6, IL-10, TNF-alpha & IFN-gamma) and temperamental traits. Moreover, this study investigates the relationships between temperamental traits, PTSD and various personality dimensions. CONCLUSIONS: 1. Patients with temperamental traits such as high perseverance and emotional reactivity had a greater risk of PTSD. 2. Patients with temperamental traits such as high briskness, endurance and activity had lower risk of PTSD. 3. The level of cytokines (sIL-2, IL-6, IL-10, TNF-alpha, IFN-gamma) was not dependent on the temperamental traits.

The prevalence of burnout syndrome in Polish anaesthesiologists.

BACKGROUND: Burnout syndrome is a psychological response to chronic work-related stress characterized by low enthusiasm towards the job, high psychological exhaustion, indolence and guilt. Being a medical doctor, both in Poland and in other countries, is one of the most stressful occupations and anaesthesiology is considered one of the most stressful specializations, which justify carrying out of the study on Polish anaesthesiologists. The aim of the study was to determine the prevalence of burnout syndrome in Polish anaesthesiologists METHODS: Non-randomized cross-sectional study was carried out and data were gathered through a self-administrated questionnaire. The sample consisted of 373 Polish anaesthesiologists, 57.6% were women and 42.4% were men. A 66% response rate was achieved. The Burnout Syndrome was measured by the Spanish Burnout Inventory. RESULTS: The prevalence burnout risk was almost 70%. The percentage of participants who indicated very high levels of burnout was 18%; 5.9% of whom fell into profile 2 considered to be clinical. The instrument applied was reliable with Cronbach's alphas exceeding 0.70. CONCLUSIONS: The sample is characterized by high burnout risk with 5.9% of clinical cases. Participation in prevention programs is recommended.

[Gender identity disorders or andromimetic behaviour in a victim of incest--a case study]. / Zaburzenia identyfikacji plciowej czy zachowania andromimetyczne u ofiary kazirodztwa--studium przypadku.

Nowadays, it is becoming increasingly difficult to clearly classify the issues associated with the phenomenon of gender dysphoria due to the fact that one identifies oneself in the context of increasingly fluid categories of gender identity-- an intrinsic sense of being a woman or a man. The authors present a woman whose internal problems connected with her sexuality and incomplete identification with the role attributed to her gender originate from her family history. Long-lasting, traumatic experiences of incestuous abuse and violence on the part of close relatives disturbed her development in many areas of personality and functioning. The aim of the study was to verify the hypothesis of the existence of gender identity disorder accompanied by depressive disorders. In addition to the medical history, the study of patient's problems included the following diagnostic tools: the Minnesota Multiphasic Personality Inventory (MMPI) and the Rorschach Inkblot Test in a CSR Exner system (TPA). The study revealed that as for sexual identification, the patient unambiguously identifies herself as a woman. Her behaviour to become like a man does not deny her sex, or even involve a temporary need of belonging to the opposite sex. It should be interpreted in the broader context of her traumatic experiences, not just sexual, but also concerning different aspects of a female gender role.

Therapeutic efficacy assessment of weak variable magnetic fields with low value of induction in patients with drug-resistant depression.

BACKGROUND: The aim of this prospective study was to verify whether magnetostimulation with weak variable magnetic fields with low value of induction could enhance the effects of pharmacological therapy in drug-resistant depression. MATERIALS AND METHODS: Thirty patients, 26 women and 4 men, with drug-resistant depression were enrolled in the study. The subjects from Group No. I (14 patients) were given fluvoxamine and treated with weak variable magnetic field using the VIOFOR JPS device; the subjects from Group No. II (16 patients) were also given fluvoxamine but they were treated with the VIOFOR JPS device in placebo mode. Changes in depressive symptoms were estimated with the 21-point Hamilton Depression Scale (HDRS), Montgomery-Asberg Depression Scale (MADRS) and Beck Depression Inventory (BDI) questionnaire. RESULTS: After 15 days of treatment highly significant differences were revealed between the patients treated with magnetic field and the patients treated with placebo: the final HDRS score was 53% of the initial value for the group receiving combined treatment, and 86% in the placebo group (p<0.001); for MADRS score the values were 51% and 88% (p<0.001), respectively, and for BDI 60% and 87% (p<0.001). Thus, the average effect of placebo applied with fluvoxamine was a ca. 15% reduction of symptoms, while the concurrent application of magnetic field and SSRI treatment resulted in a 40-50% improvement. CONCLUSION: Our study indicates that adding a two-week low-induction variable magnetic field stimulation to a classical pharmacologic therapy reduces the intensity of symptoms in patients with drug-resistant depressive disorders.