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Biomedical subjects

M Jarema

Publications and source records attributed to M Jarema.

At least 37 records · Page 2Linked to original sources
PubMed1968

[Results of craniometric, electroencephalographic and neuroradiologic studies in cerebral palsy].

The authors first of all mentioned four characteristic features that are indispensable to the diagnosis of cerebral palsy. The deformations of the skull which are quite frequently found in these cases were examined by means of a craniometric method of measurement and divided into five groups. The majority of the patients examined showed pathological electroencephalograms characterized by diffuse, generalized variations, lateralization, and variations in attacks. The x-ray examination did not show an adhesion of cranial sutures, which is in contradiction to the views held heretofore. In the majority of cases the pneumoencephalography yielded pathological results which were divided into groups: uni- and bilateral cerebral atrophies, bilateral cortical atrophy, and generalized cerebral and cortical atrophy. Cerebral angiography could not contribute any essential data to the pneumoencephalographically established diagnosis.

Atrophy↗
PubMedDate not supplied

[The risk of neuroleptic discontinuation in schizophrenia].

The most effective method to maintain clinical improvement in the course of schizophrenia is the continuation of neuroleptic therapy. Sometimes we face the dilemma whether neuroleptic administration could be discontinued. There are some unconditional indications for treatment cessation (signs of intolerance, complications, general medical conditions); all other situations can be considered as relative indications. The risk and benefit of treatment discontinuation should be carefully evaluated. Neuroleptic withdrawal seems to be safer among older patients, with single episode of the psychosis of mild severity, with no family history of schizophrenia. It is necessary to achieve a stable clinical improvement before neuroleptic withdrawal. Worsening of the clinical status creates the most important risk of treatment discontinuation. Other risk factors include unacceptable threatening behavior, increase of family burden. The appearance of withdrawal symptoms such as nausea, vomiting, dyskinesia, insomnia, anxiety, etc. are to be considered. These symptoms are rare, and the risk of relapse is smaller when patients were treated with depot neuroleptics before treatment discontinuation than in the case of treatment with oral neuroleptics. Neuroleptic discontinuation and introduction of placebo cause more risk of relapse than continuation of active treatment.

Adult↗
PubMedDate not supplied

[Treatment of catatonic syndrome with fluoxetine. Case report].

The case of catatonic syndrome in 34-years old male patient is described. The patient's initial complaints regarded somatic distress. Previously, because of persistence of somatic complaints and depressed mood, the patient was treated with classic antidepressants with no clinical effect. Consequently, before admission to our clinic, the patient received neuroleptic treatment without any improvement. To our clinic he was referred as drug-resistant schizoaffective psychosis. He was completely inactive, had hipochondriac delusions and blunted affect. Further on, severe psychomotor inhibition and negativism prevailed. Initial treatment with fluphenazine did not bring any clinical effect. Because of presence of depressed mood and lack of activity, fluoxetine was administered concomitantly with fluphenazine. After 8 weeks administration of fluoxetine 20 mg daily showed substantial clinical improvement, especially in regard to the patient's mood and activity. The dose of fluoxetine was increased to 40 mg daily, and the patient was discharged from the clinic. The follow-up revealed that the patient reassumed his professional career. He was still on fluoxetine 20 mg daily and showed substantial clinical improvement. His overall tolerance of fluoxetine 20-40 mg daily was very good.

Adult↗
PubMedDate not supplied

[Quality of life in schizophrenic patients treated with classic and "old" atypical neuroleptics].

Subjective health-related quality of life was evaluated in 100 patients from day-hospital, treated for schizophrenia with classical (perazine, perphenazine, zuclopenthixol) or "old" atypical (klozapine, sulpiride) neuroleptics. No correlation was found between the clinical improvement (PANSS scale) and the quality of life (SF-36). After the treatment the improvement of the quality of life was significantly better in female than in male patients. In women more correlations were found between clinical improvement after treatment and the of quality of life domains. The general subjective health-related quality of life after treatment with classical and "old" atypical drugs did not differ. After the treatment those patients who received classical neuroleptics reported more physical complains but better improvement in the domain "role-emotional" than the subjects treated with "old" atypical drugs. Significant clinical improvement was found in patients treated with perazine, perphenazine and zuclopenthixol but not with clozapine or sulpiride. The presence and intensity of neuroleptic side-effects did not correlate with the quality of life. In patients who had more pronounced neuroleptic side-effects less favorable improvement was found in regard to those quality of life domains which included physical status as well as the evaluation of patients' mental health.

Adult↗
PubMedDate not supplied

[Practical aspects of drug resistance in schizophrenia].

About 30-60% of patients with schizophrenia show resistance to neuroleptic treatment. In about 5-20% of them the resistance to antipsychotic treatment appears during the first therapy (primary resistance), however in the rest of patients, treatment resistance develops during 5 to 10 years of the illness (secondary resistance). In addition, another group of 5 to 20% of schizophrenics shows intolerance of therapeutic dosages of neuroleptic drugs. Before the diagnose of treatment resistance has been made, there is the need to reconfirm the diagnosis of schizophrenia, exclusion of other psychiatric disorders, assessment of patients' compliance, drug dosing, as well as pharmacokinetic and pharmacodynamic factors which have an impact on the therapeutic effect of antipsychotic treatment. Clozapine seems to be a "gold standard" for treatment of drug-resistant schizophrenic patients, however new atypical antipsychotics should be considered as a new therapeutic strategy, even before clozapine. The use of adjunctive treatment with carbamazepine, lithium, valproic acid, benzodiazepines and others, is a reasonable strategy, however dangerous drug interaction has to be taken into account.

Antipsychotic Agents↗
PubMedDate not supplied

[Subjective and objective evaluation of treating schizophrenia with classic or atypical drugs].

Subjective and objective evaluation of pharmacological treatment was made in 105 schizophrenic in-patients. PANSS and Calgary scale as well as Van Putten scale were used. Fifty-four percent of subjects received classic neuroleptics and 46%--new atypical drugs for an average period of 8 weeks. The severity of schizophrenic symptoms during treatment as well as subjective evaluation of first effects of the drug did not differ among subjects treated with classic or atypical drugs. Depressive symptoms decreased significantly during treatment with atypicals but not with classic drugs. Also a significant decrease of depression was found under olanzapine treatment. The severity of neuroleptic-induced side-effects did not differ in both groups. Neurological side effects were more prominent in subjects after 4 weeks of therapy with risperidone, in comparison to patients receiving olanzapine. Forty-seven per-cent of patients showed a dysphoric reaction to the first dose of medication. After treatment with atypical drugs, better subjective evaluation of pharmacotherapy correlated with less severe general and depressive schizophrenia symptoms. Patients' better evaluation of olanzapine treatment correlated with less severe schizophrenic general symptomatology. The subjective evaluation of treatment was better in patients with less severe neurological side-effects of atypical drugs (including olanzapine but not risperidone) and less severe autonomic side-effects of classic drugs. The evaluation of pharmacotherapy made by patients' family members did not correlate with subjects' opinions after distribution of the first dose of the drugs, but correlated significantly with patients' opinion after 8-weeks of treatment. The treatment received by the patients was judged better by the family members if less severe neurological side-effects were present.

Adult↗
PubMedDate not supplied

[Neurologic changes in the white matter of the brain in dementia].

Neuroradiologic white-matter lesions (WML) found in CT and NMR were evaluated in 30 demented patients and 12 dementia-free subjects aged over 65 years. NMR revealed more WML signs than CT. All NMR results of demented patients demonstrated abnormalities (brain atrophy and/or WML), while 15.4% patients with dementia had normal CT scan. WML in CT were found more often among male than female demented patients. No dependence between the intensity of dementia symptoms, age of subjects, age of onset of cognitive impairment, risk for vascular diseases, and the presence of WML in CT and NMR was found.

Aged↗