Neuropsychological assessment in mixed connective tissue disease: comparison with systemic lupus erythematosus.

OBJECTIVE: The aims of the study were to assess cognitive functions (CF) in patients with mixed connective tissue disease (MCTD) and to compare MCTD patients with systemic lupus erythematosus patients with and without neuropsychiatric manifestations (NP-SLE and non-NP-SLE, respectively) in terms of CF. METHODS: Neuropsychological examination was performed in 141 patients: 30 with MCTD (24 women, 6 men), mean age: 48.07 years, 37 with non-NP-SLE (36 women, 1 man), mean age: 40.76 years and 74 with NP-SLE (68 women, 6 men), mean age: 41.97 years. Neuropsychological tests and structured interview were used. Emotional state was assessed by Hospital Anxiety and Depression Scale and clinical review. RESULTS: We observed cognitive impairment in six MCTD patients (20%); in one (3%) the impairment was severe. MCTD patients achieved significantly higher results in seven out of 11 tests compared with patients with NP-SLE. MCTD and non-NP-SLE patients did not differ significantly. The differences were irrespective of premorbid IQ, education, disease duration and steroid treatment. CONCLUSIONS: In the majority of MCTD patients, CF were not impaired and severe impairment was unusual. Cognitive functioning was most disturbed in NP-SLE. The cognitive deficits observed in connective tissue diseases can be connected with nervous system involvement.

The impact of tramadol and dihydrocodeine treatment on quality of life of patients with cancer pain.

BACKGROUND: Tramadol and dihydrocodeine (DHC) are analgesics of step 2 WHO analgesic ladder (opioids for mild to moderate pain, weak opioids) frequently used in the treatment of cancer pain of moderate intensity. The aim of the study was to assess the impact of tramadol and DHC treatment on quality of life (QL) and performance status (PS) of patients with cancer pain. PATIENTS AND METHODS: Randomised, cross-over, clinical study of 40 opioid-naive patients with nociceptive cancer pain who received tramadol or DHC controlled release tablets for 7 days, and then drugs were switched and administered for another 7 days. Pain was assessed by visual analogue scale (VAS), QL by EORTC QLQ C 30, and PS by Eastern Cooperative Oncology Group (ECOG) and Karnofsky. RESULTS: From 40 patients recruited, 30 completed the study. DHC treatment provided better analgesia (VAS). In QL functional scales, better emotional functioning in tramadol group and better global QL and cognitive functioning in DHC group were observed. In symptom scales, less fatigue, pain and sleep disturbances, less nausea and vomiting and better appetite in DHC group were noted. In tramadol group, less constipation and less financial problems were observed. No differences in dyspnoea and diarrhoea were noted. ECOG and Karnofsky PS were low and did not differ between tramadol and DHC groups. CONCLUSIONS: Dihydrocodeine treatment was associated with better global QL, cognitive functioning, analgesia and appetite, less fatigue, sleep disturbances, nausea and vomiting. Tramadol therapy was connected with better emotional functioning, less constipation and financial problems. PS deteriorated in both tramadol and DHC groups.

Comparison of the quality of life in hemodialysed (HD) and peritoneally dialysed (CAPD) patients using the EORTC QLQ-C30 questionnaire.

BACKGROUND: The aim of the paper was to assess reliability and validity of the QLQ-C30 questionnaire in studying the quality of life in dialysed patients, and then to compare the life quality in patients on hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD) and healthy controls. The present study included 65 HD patients, 22 CAPD patients and a group of 76 healthy volunteers. METHODS: Quality of Life Questionnaire (QLQ-C30), Hospital Anxiety and Depression Scale (HADS), Cantrill ladder. RESULTS: The EORTC QLQ-C30 questionnaire appeared to be a reliable and valid tool for assessing the quality of life in dialysis patients. HD patients had significantly poorer quality of life in the areas of physical, social, cognitive and emotional functioning in comparisons to the controls. CAPD patients were not significantly different life quality-wise from controls, except for their social and professional life.

[The influence of 5-week relaxation therapy on arterial blood pressure in patients with borderline hypertension]. / Wplyw 5-tygodniowej terapii relaksacyjnej na wysokosc cisnienia tetniczego u chorych na nadcisnienie tetnicze graniczne.

The present study was performed to evaluate the influence of 5-week relaxation therapy on office and ambulatory blood pressure in young borderline hypertensives. Thirty patients were studied. The office blood pressure decreased significantly after 5 weeks of relaxation therapy (P < 0.001 for both systolic and diastolic blood pressure). Ambulatory monitoring revealed only a slight decrease of 24-hour blood pressure (P = 0.02). Our results indicate limited efficacy of relaxation therapy in treatment of borderline hypertensives.

[The influence of 5-week relaxation therapy on psychological state of patients with borderline hypertension]. / Ocena wplywu 5-tygodniowej terapii relaksacyjnej na stan psychiczny chorych na nadcisnienie tetnicze graniczne.

The aim of the present was to evaluate the influence of 5-week relaxation therapy on psychic state of patients with borderline hypertension. The study group consisted of 30 hypertensives. We observed significant changes in anxiety scale, defensiveness, self-confidence, intraception, nurturance, affiliation, heterosexuality, change and succorance scales. In conclusion, 5-week relaxation changes significantly psychological status of patients with borderline hypertension.

[Psychiatric and psychological aspects of anorexia nervosa]. / Anorexia nervosa w aspekcie psychiatrycznym i psychologicznym.

A group of 38 patients treated in the Department of Psychiatry, Medical Academy of Gdansk, from 1972 to 1988, because of anorexia nervosa (0.33% patients treated in the Department) was studied. There was 36 women and 2 men aged 14 to 39 years (average 21 years). Half of the patients finished only secondary school, the others started university education--most of them were still students. Except one, they presented good intellectual abilities; 6 women were married. In 42% cases a conflict situation at school or family was found (adaptational problems, competition at home); in 18% cases problems with acceptance of the role of woman. In 25% cases minimal brain damage symptoms were found in the EEG and psychologic tests. In the rest of the cases neurotic traits were present--the schizophrenic process was not found at all. Frequently the patients did show fearful attitude, difficulties with emotional relation towards other persons, egocentrism; a tendency to use regression, resignation, repression, over intellectualism and conversion as defence mechanisms. The pharmacological and psychotherapeutic treatment did results in clinical improvement (weight gain, mood and sleep normalization, reduced anxiety) in all cases studied.

[Evaluation of psychomotor performance of professionally active alcoholics]. / Ocena sprawnosci psychomotorycznej osób uzaleznionych od alkoholu, czynnych zawodowo.

The subjects were 100 alcohol addicted persons and 117 non-addicted (according to CAGE criteria). The sociodemographic characterization of each person was done. The parameters of psychomotor performance were estimated: the simple reaction time task, the simple performance test, the tapping test and a visual-motoric coordination. The following conclusions were established: 1) the alcohol addiction makes the psychomotoric performance worse, 2) the CAGE test is proposed to be included as a routine method to qualify for a job demanding high psychomotor performance, 3) the persons suspected of alcohol addiction should be sent to the specialist +psychotechnical examinations, 4) the building trade workers are the high risk group for alcohol addiction.

[Occupational interests of epileptic children and possibilities of their realization]. / Zainteresowania zawodowe dzieci z padaczka i mozliwosc ich realizacji

The purpose of this study was an analysis of occupational interests and their relationship to the intellectual capacities of epileptic children. Thirty-three children (20 girls and 13 boys) from the 8th class of elementary school were studied. They had been under treatment for 3 years, at least. The study was performed using the General Classification Test and the Technical Thinking Test. The investigations demonstrated that the girls were interested in humanistic fields while the boys in agriculture and technique. In relation to healthy children the level of occupational aspiration was lower in these children, particularly the boys. The children explained lowering of their occupational aspirations with low intellectual abilities. This motivation has, however, not been confirmed by the results of tests. The authors put forward the hypothesis that lowering aspirations may be also caused by erroneous attitude of the community towards these children.