[Visual hallucinations in mentally healthy persons--the Charles Bonnet syndrome]. / Vizuelne halucinacije kod psihicki zdravih osoba--Charles Bonnet-ov sindrom.

Charles Bonnet syndrome is described as complex visual hallucinations that are known to occur in individuals with impaired vision whose emotional and intellectual functions are within normal range. This paper presents a case of a 82 years old woman who experienced an individual hallucinatory episode during three days: seeing, alert and with her eyes open, different figures and images, static and moving in lovely colors that disappeared with closing her eyes and appeared as new with opening it. The diagnostic procedure comprised EEG and ophthalmologic examination. Vitamins and hemorrheologically active therapy were administrated and accompanied with explaining the nature of her problem.

Phospholipid content and fatty acid composition in the rat heart after chronic diazepam treatment.

The effects of chronic diazepam treatment (10 mg/kg/day for 180 days) on the fractional distribution and fatty acid composition of heart phospholipids were studied in male Wistar rats. It was found that diazepam treatment increased the content of phosphatidylcholine and cardiolipin in the heart and slightly increased its phosphatidylcholine fraction. There were no significant changes in fatty acid composition after diazepam treatment in heart phospholipids, with the exception of significant decrease of 20:3n-6 and 20:5n-3 fatty acids. Our findings suggest that diazepam, probably through peripheral benzodiazepine binding sites, altered the content of heart cardiolipin and caused changes in the flux of oxidative phosphorylation in the heart.

Heart phospholipid content and fatty acid composition in the rat after feeding different lipid supplemented diets.

The heart phospholipid content and fatty acid composition were examined in adult rats after four weeks of feeding lipid-supplemented diets (20 g % w/w) containing sunflower oil-lard (1:1) mixture (SL group) or margarine (M group). Our results showed a decreased cardiolipin content and distribution in both experimental groups and an increased lysophosphatidylcholine and phosphatidylcholine content and distribution in the SL group with a tendency to lower phosphatidylcholine/phospatidylethanolamine ratio in both experimental groups. In the SL group, the content of saturated fatty acids was higher and that of monounsaturated fatty acids was lower than in the control group. The M group showed inverse results. The content of saturated fatty acids was lower and that of monounsaturated was higher than in the control group. Polyunsaturated n-6 fatty acids were decreased in both experimental groups and n-3 fatty acids were increased in the M group. Feeding lipid-supplemented diets reduced n-6/n-3 and 20:4/22:6 ratios in the M group. The polyunsaturated/saturated fatty acid ratio was lower in the SL and higher in indicating the M group than in the control group. Our results are in agreement with the other reports indicating that the heart is sensitive to diet-induced lipid alterations.

[Apolipoproteins as risk factors in patients on a regular hemodialysis program]. / Apolipoproteini kao faktori rizika kod bolesnika na hronicnom programu hemodijalize.

Apolipoprotein abnormalities in patients undergoing permanent hemodialysis programme appear to be risk factors for development of cardiovascular diseases. Our aim was to determine the presence of risk factors of lipidic origin in these patients. We examined a group of 45 patients on hemodialysis--26 males (average age of 52.4 years) and 19 females (average age of 51.3 years). The patients were divided into normolipemic (n = 23) and hyperlipemic group (n = 22). The control group consisted of nine men (average age of 55.7 years) and nine women (average age of 58.3 years). The values of triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol (computatively), apolipoprotein AI and apolipoprotein B were determined. There was not statistically significant difference of atherosclerosis index (LDL-cholesterol/HDL-cholesterol) between normolipemic and hyperlipemic group of patients, as well as in relation to the control group. The relation between apo B/apo AI in both groups was significantly different in relation to the control group (p = 0.0001, p = 0.0001); difference found between normolipemic and hyperlipemc group was also important (p = 0.003). The obtained results show that examination of apolipoprotein AI and apolipoprotein B in case of patients on hemodialysis, both noromolipemic and hyperlipemic, indicates the presence of risk factors for coronary diseases and atherosclerosis.

[Hyperinsulinism in hyperlipoproteinemia in patients on a chronic hemodialysis program]. / Hiperinsulinizam u hiperlipoproteinemiji kod bolesnika na hronicnom programu hemodijalize.

The aim of this study was to establish possible hyperinsulinemia, as a consequence of insulin resistance in chronic hemodialysis patients. We examined 45 HD (hemodialysis) patients and 18 healthy subjects. On an empty stomach the following parameters were established: glucose, insulin, triglycerides, total cholesterol, HDL (high-density lipoprotein)-cholesterol and LDL (low-density lipoprotein)-cholesterol. Body mass index and waist-hip ratio were also examined. Hyperlipoproteinemia was established in 22 patients (21 with type IV and 1 with type II b), while 23 patients were normolipidemic. Insulinemia was significantly increased in the group of patients with hyperlipoproteinemia, both comparing normolipidemic patients and healthy subjects (x1 = 20.7; p = 0.0001; x2 = 13.2, p = 0.0001; x3 = 11.3, p = 0.0001). In the group with hyperlipoproteinemia there was a positive correlation between levels of insulinemia and triglyceridemia (r = 0.41, p = 0.05). It can be concluded that hyperinsulinemia in the group of patients with hyperlipoproteinemia, on hemodialysis, is an imperative for treating insulin resistance, and in that way causes of lipoprotein metabolism disorders.

[Visceral protein status and hyperlipoproteinemia in patients on hemodialysis]. / Visceralni proteinski status i hiperlipoproteinemije kod bolesnika na hemodijalizi.

Long-term therapy and inadequate diet regimens in terminal phase patients with renal insufficiency lead to loss of body weight which causes changes in anthropometric indexes. The occurrence of hypoalbuminemia in chronic hemodialysis patients without nephrotic syndrome, is a clear sign of malnutrition. The aim of this study was to establish the visceral protein status in these patients as well as to find if there is a difference in this status in regard to hyperlipemic and normolipemic patients. 45 chronic dialysis patients were examined: 26 males with a mean age of 52.4 years and 19 females with a mean age of 51.3 years. They were divided into two groups: the first group of 22 hyperlipemic patients and the second group of 23 normolipemic patients. The control group consisted of 18 healthy subjects (9 females with a mean age of 58.3 years and 9 males with a mean age of 55.7 years). In regard to lipid fractions we determined the total cholesterol, HDL (high density lipoprotein), LDL (low density lipoprotein) cholesterol and triglycerides. The following anthropometric indexes have been used: BMI (body mass index) and muscle mass index (triceps). Albuminemia was performed in all subjects as an indicator of undernutrition. There was a significant difference in albumin level in hyperlipemic and healthy subjects (p = 0.0001), as well as normolipemic and healthy subjects (p = 0.0001), whereas no significant difference was established between hyperlipemic and normolipemic subjects. Values for triceps as a muscle mass index significantly differed in the group of normolipemic subjects (p = 0.03). Body mass index did not significantly differ among groups. In the group of normolipemic subjects BMI was significantly in correlation with values for triceps (p = 0.001). Significant correlation between albumin level and anthropometric indexes was not established. Gathered results indicate that in the group of normolipemic hemodialysis patients malnutrition can be dangerous.

[Lipid status in patients on a chronic hemodialysis program]. / Lipidni status bolesnika na hronicnom programu hemodijalize.

Dyslipidemia causes development of atherosclerosis in chronic hemodialysis patients. The goal of this study was to determine values of serum lipids in hemodialysis patients. The study comprised 45 patients, whereas the control group consisted of 45 healthy persons of corresponding age and sex. We determined triacyglycerols, total cholesterol, HDL (high density lipoprotein) and LDL (low density lipoprotein) cholesterol in the serum of patients on an empty stomach. There were 51% of patients with normal findings, and 49% with hyperlipoproteinemia type IV. In regard to the control group triacyglycerol was increased both in patients with hyperlipoproteinemia type IV and in patients with normolipemia. Levels of total cholesterol were higher in patients with hyperlipoproteinemia type IV, while values of HDL cholesterol were decreased in both subgroups of patients in regard to the control group. Values of total cholesterol in relation to HDL cholesterol > 4.5 occurred in 38% of patients. Lipid profile of hemodialysis patients, including those with normolipidemia, points to high risk of cardiovascular diseases.

[Serum phospholipids in patients in a chronic hemodialysis program]. / Fosfolipidi seruma u bolesnika na hronicnom programu hemodijalize.

The aim of this investigation was to determine concentrations of total and single phospholipids and to examine distribution of phospholipid fractions in serum of chronic hemodialysis patients. The investigation included 21 patients, 10 with normal lipid level in serum and 11 with hyperlipoproteinemia type IV. The control group consisted of 17 healthy normolipidemic persons. The gathered results show that in hemodyalisis patients the level of phospholipids (3.10 +/- 0.66 mmol/L) is higher than the level of phospholipids in the control group (2.25 +/- 0.35 mmol/L). Dialysis patients with hyperlipoproteinemia type IV have an increased level of serum phospholipids (3.51 +/- 0.43 mmol/L) in regard to dialysis patients with normolipidemia (2.46 +/- 0.57 mmol/L). The distribution of phospholipid fractions, that is proportional occurrence of lysophosphatidylcholine, sphingophospholipids and phosphatidylcholine is disturbed in dialysis patients no matter what their lipid status is.

Liver, plasma and erythrocyte phospholipid content after chronic diazepam treatment in the rat.

Male Wistar rats were maintained on a nutritionally adequate diet and diazepam was administered in a dose of 10 mg/kg/day. Control animals were pair-fed an adequate diet. Feeding was continued for 180 days, and the effects on the liver, plasma and erythrocyte phospholipid content were studied. It was found that the contents of sphingophospholipids and phosphatidylinositol + phosphatidylserine were significantly reduced in the erythrocytes of diazepam-treated rats. There was a significantly increased content of phosphatidylcholine in the liver an erythrocytes after 180 days of diazepam treatment. Such treatment did not cause statistically significant changes in the plasma of diazepam-treated rats. These investigations are in agreement with the hypothesis that extended or chronic use of drugs such as diazepam may alter membrane-dependent processes.