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W niniejszym artykule omówiono przypadek samobójczyni, kobiety w wieku 40 lat, zdrowej somatycznie, nieleczonej dotychczas psychiatrycznie, która dokonała zabójstwa dwójki własnych dzieci. Była ona badana przez trzy niezależne zespoły biegłych psychiatrów i psychologów dla potrzeb opiniowania sądowego. Autorzy, którzy wchodzili w skład trzeciego zespołu biegłych, po przeprowadzeniu dwukrotnych badań opiniowanej, a także analizy dokumentów z akt sprawy, w tym przebiegu obserwacji sądowo-psychiatrycznej, rozpoznali objawy osobowości zależnej i ostrą reakcję na stres, które to były przyczyną całkowitej utraty zdolności opiniowanej do rozpoznania znaczenia dokonanego czynu i pokierowania swoim postępowaniem. W pracy omawiany jest proces diagnostyczny, a także analiza zaburzeń psychotycznych w odniesieniu do konkretnych rozpoznań klinicznych zgodnych z obowiązującą klasyfikacją chorób i zaburzeń psychicznych. Zwrócono również uwagę na problem w różnicowaniu poszczególnych zaburzeń i sposób definiowania zaburzeń psychotycznych. Podkreśla się istnienie znacznych trudności w zakreśleniu konkretnej granicy między zaburzeniami psychotycznymi a niepsychotycznymi, co jest niezwykle ważne w kontekście opiniowania sądowo-psychiatrycznego.

Cardiovascular diseases, including coronary heart disease still consititute the main reason for deaths and permanent disabilities all over the world. The role of somatic factors in the process of their development is very well- -researched thus cogent and the knowledge on the influence of behavioural and personality-related factors is often underappreciated. There is, however, successive influx of information about the relationship of personality and development, course of cardiovasular diseases lately. The aim of the work is to depict the relationship between the type D personality and coronary heart disease with special emphasis on the influence of type D personality traits on how the disease progresses and its prognosis.

Background: The revascularization of carotid arteries minimizes the risk of future cerebral stroke and usually improves cognitive functions. The aim of this study was to assess changes in cognitive function and verify the hypothesis assuming an improvement of selected cognitive functions—psychomotor speed, visuospatial episodic memory, executive function and verbal fluency—in patients after carotid artery stenting during a 12-month follow-up. Methods: 47 persons subject to CAS, including 13 symptomatic persons, were examined before and 12 months after a procedure with a psychological test battery (digit symbol test—DS, Rey–Osterrieth complex figure test—ROCF, Wisconsin Card Sorting Test—WCST, letter verbal fluency—LVF). Sociodemographic data and clinical parameters were acquired from an author questionnaire. Results: The one-year follow-up, after the performed CAS procedure, demonstrated a significant improvement of psychomotor speed, visuospatial episodic memory, and executive function. No changes in the area of verbal fluency or decline in any of cognitive functions under analysis were observed. Conclusions: Carotid artery stenting improves cognitive functioning, both in the area of basic and more complex cognitive functions in persons with carotid atherosclerosis.

Computed tomography is a modern technique producing high quality image of scanned organs. It plays a significant role in diagnostic work-up on orthopedics wards. This paper presents an analysis of management of two cases of Hawkins type I talar neck fracture with ankle joint rotation. In both patients, the diagnosis was based on conventional radiographs of the ankle joint in two projections and was subsequently verified with CT scans. The findings of a CT scan of the talus had a significant impact on further treatment and physiotherapy. Non-surgical treatment consisting in immobilization with a short leg cast combined with medication and magnetic field therapy produced a positive therapeutic outcome. A follow-up CT scan of the talus revealed bone union with remodelling in both patients. The functional outcome according to the AOFAS scale should be regarded good. Computed tomography is the radiological modality for detecting talar neck fractures and determining the presence of displacement. Follow-up CT scans evaluate the natural process of bone healing, which is crucial for treatment decisions regarding weight-bearing status. A correct diagnosis based on CT helps to prevent the development of necrosis and posttraumatic (secondary) degenerative changes as well as advanced physical disability, especially among youn­ger patients, in whom the injury is most common, consequently helping to avoid a long and costly treatment.

Osteoarthritis is the most frequently diagnosed disease of the musculoskeletal system. Growing number of patients waiting for surgical treatment and the possible negative consequences resulting from long-term pharmacological therapy lead to the search for non-pharmacological methods aimed at alleviating pain and reducing doses of analgesics, among them physical therapy with use of magnetic fields. The study involved 30 men aged 49 to 76 (mean age, 61.7 years) treated for idiopathic osteoarthritis of the hip joint. The subjects were divided into 2 groups (15 patients each) and underwent a cycle of magnetostimulation and magnetoledtherapy procedures, respectively. During the exposure cycle concentrations of β-endorphin were assessed 3 times and the mood was assessed 2 times. In addition, the assessment of pain intensity and the dose of analgesic drugs was performed before and after the end of therapy. Statistically significant increase in plasma β-endorphins concentration was observed in both groups of patients (magnetostimulation—P

To evaluate the incidence and severity of the impairment of selected cognitive functions in patients after sudden cardiac arrest (SCA) in comparison to patients after myocardial infarction without SCA and healthy subjects and to analyze the influence of sociodemographic and clinical parameters and the duration of cardiac arrest on the presence and severity of the described disorders.The study group comprised 30 cardiac arrest survivors, the reference group comprised 31 survivors of myocardial infarction without cardiac arrest, and the control group comprised 30 healthy subjects. The Mini-Mental State Examination (MMSE), the Digit Span test from the Wechsler Adult Intelligence Scale, Lauretta Bender's Visual-Motor Gestalt Test, and the Benton Visual Retention Test (BVRT) were used to assess the presence of cognitive impairment. An original questionnaire developed by the author was used for overall mental state assessment.The Bender test demonstrated a significant difference in the presence and severity of visual-motor skills between the study group and the control group, while BVRT and MMSE revealed increased incidence of cognitive impairment in the study group. The Bender and BVRT (D/D)/SS (version D, method D, scaled score) scales indicated cognitive impairment in 53.3% of these patients, while the BVRT (C/A)/SS test indicated cognitive impairment in 40%. For the reference group, the values were 32.3% and 12.9%, respectively. No correlation was found between the severity of cognitive impairment and the duration of cardiac arrest.Impairment of visual-motor skills, short-term visual memory, concentration, and visual-motor coordination occurs much more frequently and is more severe in individuals after SCA than in healthy individuals. Impairment of memory trace storage and recall after delay occurs more frequently in patients after SCA than in patients after myocardial infarction without cardiac arrest and in healthy individuals. SCA duration did not have any influence on the severity of the described disorders.Ocena częstości występowania i nasilenia zaburzeń wybranych funkcji poznawczych u pacjentów po nagłym zatrzymaniu krążenia (NZK) w odniesieniu do osób po przebytym zawale mięśnia sercowego bez NZK i osób zdrowych oraz analiza wpływu niektórych parametrów socjodemograficznych i klinicznych oraz czasu trwania NZK na obecność i nasilenie opisywanych zaburzeń poznawczych.Grupę badaną utworzyło 30 osób po NZK, grupę odniesienia – 31 osób po zawale serca bez NZK, a grupę kontrolną – 30 osób zdrowych. Do oceny obecności zaburzeń wybranych funkcji poznawczych użyto Krótkiej skali oceny stanu psychicznego (MMSE), Testu powtarzania cyfr ze Skali inteligencji Wechslera dla dorosłych, Testu zdolności wzrokowo-motorycznych Lauretty Bender oraz Testu pamięci wzrokowej Bentona (BVRT). Oryginalnie opracowany kwestionariusz posłużył do ogólnej oceny stanu psychicznego.W teście Lauretty Bender stwierdzono istotną różnicę w występowaniu i nasileniu zaburzeń zdolności wzrokowo-motorycznych w grupie badanej w stosunku do grupy kontrolnej, a w teście BVRT i MMSE – częstsze występowanie zaburzeń poznawczych w grupie badanej. U tych osób zaburzenia poznawcze mierzone skalami Bender i BVRT (D/D)/WP występowały u 53,3% badanych, a testem BVRT (C/A)/WP – u 40% osób. Dla grupy odniesienia wartości te wynosiły odpowiednio 32,3% i 12,9%. Nie wykazano zależności nasilenia zaburzeń poznawczych od czasu trwania NZK.Zaburzenia zdolności wzrokowo-motorycznych, krótkotrwałej pamięci wzrokowej, koncentracji oraz koordynacji wzrokowo-ruchowej u osób po przebytym NZK występują znacznie częściej i są bardziej nasilone niż u osób zdrowych. Zaburzenia zdolności przechowywania śladu pamięciowego i odtwarzania go po odroczeniu występują u chorych po przebytym NZK częściej niż u pacjentów po przebytym zawale mięśnia sercowego bez NZK i u osób zdrowych. Czas trwania NZK nie miał wpływu na nasilenie opisywanych zaburzeń.

Osteoarthritis of the talocrural joint accounts for only 4% of cases of degenerative disease of the musculo­skeletal system. Unlike other joints, idiopathic OA of the ankle joint is identified in only 7% of patients. Until the end of the 1960’s, arthrodesis was the treatment of choice in advanced OA of ankle joint. Absolute indi­ca­tions for arthrodesis include irreversible loss of joint anatomy, neurological conditions, advanced osteoporosis and chronic inflammation. Currently, the surgical treatment of ankle joint OA relies on third-generation endo­prostheses of the ankle. Arthroplasty is indicated in patients under 60 years of age with no history of non-ortho­paedic co-morbidities, engaging in little physical activity, with an intact joint axis and satisfactory mobility and non-smoking. This article analyzes the available literature on the results of surgical treatment in patients with osteoarthritis of the talocrural joint treated with arthrodesis or arthroplasty, taking into consideration the strict indications for each of these surgical methods.

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.

The aim of this study was to assess the mental status and sociodemographic data as well as their influence on the quality of life in schizophrenic patients.SF-36, Soc-29, CDS, PANSS, AIS and sociodemographic questionnaire were given to a cohort of 64 subjects who participated in this study (28 female, 36 male), with age range of 21-58 (Mean 33.4 +/- 10.8). Questionnaires were administered to all patients in partly-remission or remission time.Patients showed significant positive correlation of summary scales of PCS and MCS with SOC and AIS and negative correlation with depression symptoms estimated by CDS. There were no significant differences in MCS and sociodemographic factors. The values of the PCS were negatively associated with the number of hospitalisations, disease duration time and negative syndromes estimated by PANSS-N.Sense of coherence, acceptance of illness and depressive syndromes influence quality of life.

The activity and selectivity of Me 2+ NaX zeolites (Me = Cd, Zn, Ni, Co) and free and supported heteropoly acids (HPA) for hydrosulfurization of n - and i-PrOH have been investigated. The influence of concentration and strength of Bronsted acid centers on the yield of thiols is discussed on the basis of comparative measurements carried out on zeolites and HPA. The effect of H 2 S chemisorption on the selectivity of hydrosulfurization process is considered.

The aim of this study was to evaluate the influence of sociodemographic and clinical factors on symptoms of depression in 90 female patients awaiting coronarography.The factor dividing the patients into two groups: those without significant atheromatosis - 48 women and those with coronary atheromatosis - 42 women, was the result of invasive diagnostics of coronary heart disease. BDI (Beck Depression Inventory), HAM-D (Hamilton Depression Rating Scale) and sociodemographic and clinical data questionnaire were used in the study.It was proved that there was a connection between the appearance of increased parameters of depression and more frequent number of annual visits in the Primary Care or Cardiologic Clinic, higher level of depressiveness and anxiety, fear of obtaining information applying to the necessity of coronarography, lack of hormonal replacement therapy and of support from other people. Additionally, it was noticed that the intensity of symptoms were higher for those less educated, those waiting shorter for coronarography and those with hypertension. There were no statistically significant differences in the estimation of depressive states in both groups, neither in prevalence, nor in the intensity.Patients with increased parameters of depression need special therapies and multidisciplinary care.

Summary The influence of the alkali cation exchange in faujasite type zeolites on the zeolite acidity and electronegativity is presented. Correlations between the changes of these parameters and the activity and selectivity of zeolites in the nydrosul-phurization of alcohols are discussed. It was stated that for these processes in which the dissociatively adsorbed H 2 S takes part, the increase of the zeolite electronegativity causes the decrease in the activity.