Biomedical subjects

E Kolibás

Publications and source records attributed to E Kolibás.

At least 19 recordsLinked to original sources

PubMed2004

[Complex therapy of chronic hepatic encephalopathy supplemented with probiotic: comparison of two studies].

BACKGROUND: Several reports about usefulness of probiotics, including Enterococcus faecium in the treatment of chronic hepatic encephalopathy in patients with liver cirrhosis have been recently published. The results obtained by the administration of Enterococcus faecium M-74 + selenium will be evaluated and compared with those published by Loguercio et al. for Enterococcus faecium SF 68. METHODS AND RESULTS: Fifteen patients with liver cirrhosis, portal hypertension and chronic hepatic encephalopathy were treated, beside the standard therapy, also with one capsule of probiotic "Enterococcus faecium M-74 + Selenium" per day in three four-week periods, separated by two fortnight pauses. During the treatment, every patient was examined 9-times. The severity of chronic hepatic encephalopathy was evaluated with the aid of the portal systemic encephalopathy index, calculated from 5 parameters (mental stage, asterixis, number connecting test, blood ammonia, EEG). The indexes of initial and final values were compared. The time course of blood ammonia levels and that of results from number connecting test in either study were mutually compared on the basis of interval estimates of quadratic regression function. Significant improvement of the portal systemic encephalopathy index after the treatment was found: it decreased in average by 70% (55 to 85%, interval 95% confidence interval). The mental stage improved and the asterixis disappeared. The blood ammonia levels as well as the results from the number-connecting test after 8-9 weeks significantly approached the normal pattern. EEG findings improved and they were often normalised. Our starting blood ammonia levels (increased by 31% above norm) and results from the connecting test (increased by 60%) were significantly lower accordingly the Loguercio et al. (increased by 243 and 238%, respectively). During the treatment, the values in our study decreased by 25% and 30%, in the compared study by 50% and 70%. CONCLUSIONS: Our results proved the hypothetical favourable effect of probioticum Enterococcus faecium M-74 + Selenium on chronic hepatic encephalopathy. Interestingly, a markedly higher relative therapeutic effect has been achieved in more serious disorder in comparison with the less severe disorders in the present study.

Adult↗

PubMed1999

Selegiline in the treatment of Alzheimer's disease: a long-term randomized placebo-controlled trial. Czech and Slovak Senile Dementia of Alzheimer Type Study Group.

OBJECTIVE: To evaluate the efficacy and adverse effects of the type B monoamine oxidase inhibitor selegiline (also known as I-deprenyl) in the treatment of Alzheimer's disease. DESIGN: Long-term, double-blind, placebo-controlled trial. SETTING: Seven cities (1 or 2 nursing homes in each city) in the Czech and Slovak Republics. PATIENTS: A total of 173 nursing-home residents fulfilling the DSM-III criteria for mild to moderate Alzheimer's disease. INTERVENTIONS: Selegiline (10 mg per day) or placebo (both including 50 mg ascorbic acid) administered for 24 weeks. OUTCOME MEASURES: Clinical Global Impressions scale and Nurses Observation Scale for Inpatient Evaluation at baseline and at weeks 6, 12 and 24; Clock Drawing Test at baseline and 24 weeks, results of which were evaluated as normal or pathologic, and quantitatively on a modified 6-point scale; Sternberg's Memory Scanning test at baseline and at weeks 6, 12 and 24; Mini Mental State Examination, and electroencephalogram at baseline and 24 weeks; Structured Adverse Effects Rating Scale; physical, laboratory, hematological and electrocardiographic examinations at baseline and weeks 12 and 24. RESULTS: A total of 143 subjects completed enough of the trial to be entered in the analysis. Subjects were analyzed by 2 subgroups depending on whether they had a normal or pathologic result of the Clock Drawing Test. Analysis of variance showed significant improvement with selegiline versus placebo among those with a normal result of the Clock Drawing Test on the Mini Mental Status Examination (total score and orientation-place subscale) and among those with a pathologic result of the Clock Drawing Test of Sternberg's Memory Scanning test (for both speed and accuracy), on the Clinical Global Impressions scale as well as in terms of the dominant frequency on electroencephalograms. CONCLUSION: Selegiline has a long-term beneficial effect in Alzheimer's disease on memory modalities that reflect the function of the prefrontal areas of the brain, which are rich in dopamine receptors. The delayed appearance of differences between selegiline and placebo supports the notion that the mechanism of action is through neuronal rescue or neuroprotection. The differential response of patients with normal and pathologic results of the Clock Drawing Test may reflect the fact that the evaluation methods' sensitivity to change depends on the severity of dementia.

Aged↗

PubMed1996

[Lactilol (Importal, 10g in powder made by ZYMA) in the treatment of portal systemic encephalopathy].

In a group of 15 patients with portal systemic encephalopathy (PSE) associated with cirrhosis of the liver with portal hypertension and spontaneous systemic shunt of the portal circulation the authors administered Lactitol (Importal, powder à 10 g Zyma), in amounts up to 40 g/day for a period of 56 days. In the course of treatment every patient was repeatedly examined before the onset of treatment and three times during treatment. The grade of PSE was assessed on the basis of the score of the neuropsychiatric examination from which the PSE index was worked out. In the investigated group of patients with PSE the authors found a significant improvement of the PSE index during treatment with Importal Zyma. The mental condition of the patients improved, the NCT period was reduced, asterixis receded, on the EEG the delta and theta activity receded and normal alpha activity developed. The serum ammonia levels declined but did not reach statistical significance. During treatment the authors did not record changes of normal values of glucose, sodium and potassium in serum and did not detect any adverse side effects. Based on the assembled results the authors conclude that lactitol treatment extends possibilities of PSE treatment.

Adult↗

PubMed1995

[Use of behavioral scales in the diagnosis of dementia in the aged].

The authors present their own experience with the use of the behavioural scale elaborated by Blessed, Tomlinson and Roth usually called Blessed Dementia Scale-BS. They examined 76 patients (59 dementia, 17 with major depression, aged 57 - 87 years (mean age 70.3 +/- 7.2 years). The results obtained by BS were compared with WAIS-R, Wechsler's memory scale (WMS) and the MSE cognitive scale (Knopman et al., 1985). They found that BS differentiates satisfactorily patients with dementia and major depression (dementia X = 8.16 +/- 5.4, depression X = 4.41 +/- 2.41, t = 4.07, p < 0,001). The results of examinations by means of BS correlate significantly inversely with the results of examinations of cognitive functions. The closest correlation is between the total BS score and MSE (r = -0.705, p < 0,001). It was confirmed that BS can be used in the diagnosis of dementia for the differential diagnosis of dementia and depressions. Evaluation of partial BS scores (associated with instrumental ADL, basic ADL and personality changes, drives and interests) provides information important for evaluation of the functional capacity of the patient and for the procedure after termination of in-patient treatment. It is important that the total BS score and the partial BS score is not influenced by the patients' age.

Aged↗

PubMed1994

[Heroin addiction--a new type of drug dependence in Slovakia (personal experience)].

The authors present their initial experience with patients reporting contact with heroin. For the authors this is a new type of dependence. They present a group of 33 patients (only two women), mean age 26 years, hospitalized at two psychiatric clinics in Bratislava. The majority of patients were single, and had only elementary education. Only in 10 patients the diagnosis of fully developed dependence on heroin confirmed, in 12 patients sign of dependence were lacking. The authors draw attention to the discrepancy between subjective data of the patients and objectively assessable signs of dependence. Most frequently heroin was inhaled, only in five patients i.v. administration of the drug was recorded. For treatment available psychopharmaceutical preparations were used (anxiolytics, neuroleptics). Opium administration was not necessary.

Adolescent↗

PubMed1994

[Homicidal activity directed against parents (forensic-psychiatric aspect)].

The authors present an account of four men where orders were given to examine their mental state because of murderous activity focused on a parent. In three instances murder was involved, in one case attempted murder. Three of the subjects were youths 13-19 year old, one was 61-year-old at time of murder. In three instances the activity occurred in a state of affect, incl. one case of simple affect of anger and mild drunkenness, in another case (except simple affect of fear) a short-out activity, and in the last case a pathic affect with impaired consciousness at the climax. In one case (the 13-year-old boy) the parent was killed during sleep obnubilation. The temporary mental disorder at the time of the crime led in three of the murders to severe impairment of differentiating and control abilities. In another of the men (61 years old) in the impaired control and differentiating abilities in addition to the affect of anger and simple drunkenness--slight impairment of cognitive functions participated. The authors emphasize the exceptional character of aggression in cases of murderous activities focused on parents. They compare their own experience with data in the literature and draw attention to the frequent occurrence of major forensic mental disorders. The diagnosis of mental disorders must respect general diagnostic principles. An important part is played by auxiliary examination methods.

Adolescent↗

PubMed1994

[Depressive states in old age and their therapy--1983-1993 survey].

According to results of the census of gerontopsychiatric patients, on June 30, 1993 there were 741 hospitalized patients. In the submitted paper the authors follow up data on 207 patients treated with antidepressants. In 73% endogenous depressions were involved another third of the patients suffered from reactive conditions, organic mental disorders and dependence. Coexistence of organic and affective syndromes was frequently encountered (44.4%); in the majority of the group three nad more somatic diseases were present concurrently. As to antidepressants, even after 10 years tricyclic antidepressants are frequently used; the most frequently used drug was dosulepine. Antidepressants of the second generation are also used (maprotiline, viloxazine), less frequently selective inhibitors of serotonin uptake were administered (SSRI) and reversible monoaminooxidase inhibitors (RIMA). As compared with 1983 in 1993 more rarely Amitriptyline was used and the authors found that the spectrum of antidepressants used was extended and that these drugs were used also in other disorders than depressions.

Aged↗

PubMed1992

[Adverse effects of antidepressive agents in hospitalized geriatric patients].

The frequency, intensity and profile of adverse effects of antidepressants was studied in elderly patients. The series consisted of 102 patients with depression admitted to hospitals in Bratislava and Moscow. The adverse effects of amitriptyline (Amitriptylin Spofa) and maprotiline (Ludiomil Ciba-Geigy) were compared. The assessment done on days 0, 7, and 28 of treatment showed that xerostomia had the highest occurrence rate with both preparations studied. In patients treated with amitriptyline adverse effects were more severe and were recorded more frequently, requiring treatment withdrawal in 3 patients. The overall intensity of adverse effects was significantly higher with amitriptyline (p < 0.05). In the group of patients treated with amitriptyline the adverse effects were more marked in those with severe somatic pathology. The risk of amitriptyline treatment in elderly patients is being emphasized along with the need for monitoring and correcting adverse effects of the treatment. Although maprotiline exhibited a lower occurrence rate of adverse effects, cardiac functions should be regularly checked in patients with preexisting cardiac pathology. (Tab. 2, Fig. 3, Ref. 6.).

Age Factors↗

PubMed1992

[A short questionnaire as a means of screening for psychiatric disorders in the aged].

The authors elaborated a brief questionnaire of mental health of old people. They discuss the the suitability of the self-evaluating part of the questionnaire for detection of mental disorders. Hundred and forty subjects above 65 years of age were examined: living in their homes or hospitalized at the psychiatric clinic. The mean score of the self-evaluating part of the questionnaire in the group of healthy and mentally ill differs significantly. The sensitivity of the self-evaluating part for the non-differentiated group of patients is 62.07% and the specificity is 73.08%. Self-evaluation with the best reliability differentiates from healthy subjects the group of depressive patients (sensitivity 82.76%). It was revealed that self-evaluation can help also with detection of dementia (sensitivity (61.11%). An enhanced discriminating sensitivity of the questionnaire is expected from a combination of self-evaluation with items expressing objective evaluation. The authors emphasize the possibility to entrust the questionnaire to paramedical workers, and its non-pretentious character which makes it suitable for old people.

Aged↗

PubMed1992

[Use of automated quantitative analysis of electroencephalograms in the diagnosis of dementia].

The submitted paper demonstrates the differential diagnostic value of automatic quantitative analysis of electroencephalograms in the diagnosis of dementia and functional mental disorders in old age. By quantitative autoregression analysis of electric activity of the brain in a group of 53 hospitalized patients (incl. 33 cases of dementia) the conclusions of visual analysis were confirmed as well as the comparability of results obtained by other methods of automatic analysis. Signs characterizing the electroencephalogram in dementia (reduced ratio of alpha activity and increase of slow activity, low value of A/T index, shift of the peak frequency towards slow activity) make differential diagnosis of dementia in organic diseases from pseudodementia possible. Analysis of the results indicates that automatic analysis can be very successful in the detection of Alzheimer's disease.

Aged↗

PubMed1992

[Use of the MSE scale in geriatric psychiatry].

In preliminary research the authors tested the congruent validity of MSE by comparison with results of the MMSE scale which previously proved useful. In 155 probands of senior age they used MSE, WAIS-R. They found a close correlation of the MSE score and the results. of psychomotor examination of the intellect and memory. As regards different factors of the intellect the MSE performance correlated most closely with the social intelligence and practical instructive solution of problems. The scale has a satisfactory sensitivity but low specificity. The score is influenced by the promorbid intelligence, education and age. MSE differentiates clinically demented and not demented patients and patients with endogenous depression from dementia. The differences between groups of dementia with a different aetiology--multiinfarction and dementia of Alzheimer's type--were not statistically significant.

Aged↗

PubMed1989