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Adriamycin - efficacy and possible adverse effects


Adriamycin (doxorubicin) is a chemical substance in the anthracycline class with a wide range of applications in oncology and hematology. The mechanism of action of Adriamycin is related to formation of irregular bonds between nucleobases of DNA and inhibition of key enzymes of DNA synthesis - topoisomerase I and II as well as to formation of free radicals damaging DNA.

A major limitation in the drug use is associated with its adverse effects such as cardiotoxicity and hepatotoxicity.

The mechanism of myocardial injury by Adriamycin is linked to an increase in oxidative stress associated with impaired mitochondrial function and structure.

Cardiotoxicity of anthracyclines is classified as: acute, chronic or late (delayed).

Hepatotoxicity of Adriamycin as a damage of the liver is associated with a dysfunction of this organ. Adriamycin studies have shown increased level of transaminase present in 40% of patients treated with Adriamycin. The state was transient and asymptomatic, returning to the initial level even when treatment continued.

Knowledge of cancer diseases contributed to a successive creation of two improved forms of Adriamycin (doxorubicin) – nonpegylated and pegylated formulas of the drug.

The mechanism of anticancer effects of liposomal Adriamycin is similar to the mechanism of conventional Adriamycin, but placement of the molecules of active substance in liposomes has significant influence on the distribution of the drug.

In order to increase the distribution of the drug, a special form of liposomal Adriamycin has been created by covering the surface of the liposomes with a hydrophilic polymer - (MPEG). This process, known as pegylation, decreases the interactions between the lipid bilayer membrane and the plasma components. Pegylated form of the drug is associated with a higher incidence of acute complications.

Open access
The case of inorganic hypersomnia treated with light therapy in the course of schizoaffective disorder


According to ICD 10, nonorganic hypersomnia is defined as “a condition of either excessive daytime sleepiness and sleep attacks (not accounted for by an inadequate amount of sleep) or prolonged transition to the fully aroused state upon awakening. When no definite evidence of organic etiology can be found, this condition is usually associated with mental disorders”. The severe hypersomnia in the course of schizoaffective disorder is rather a rare phenomenon. The paper presents the case of 41-year-old female patient with severe hypersomnia during the course of the schizoaffective disorder. The course of hypersomnia was severe. The patient slept constantly day and night and was awoken by her family for about three-hour period of time. The duration of hypersomnia was about one year until the onset of treatment. The patient was successfully treated with light therapy that caused gradual resolution of the symptoms of hypersomnia. The patient is also treated as prior to the onset of hypersomnia with antipsychotics and the mood stabilizers for schizoaffective disorder. Since that time there were six-year-period of follow up when the patient was free of any symptoms of hypersomnia.

Open access
Extraordinary system of delusions and the social functioning - a case study


Schizophrenic psychoses are a heterogeneous group of diseases that affect about 1% of the world’s population. The first symptoms of the disease usually manifest between ages 20 and 30. The diagnostic criteria for schizophrenia and its subtypes are characterized in detail in ICD-10. Diagnosis is based primarily on the presence of productive symptoms such as delusions or hallucinations occurring for at least one month which cannot be explained in another way. Schizophrenia is a disease which largely affects social functioning of patients, such as occupational performance, family life, interpersonal relationships or housing situation. Apart from the sociological aspect, social lives of schizophrenia sufferers are significantly impoverished due to cognitive impairment associated with improper functioning of NMDA receptors. The study describes a case of a patient suffering from paranoid schizophrenia which sheds light on the social functioning of this group of patients.

Open access
The history of hysteria and what’s next…


From the ancient times up till now hysteria has been a mysterious and intriguing issue. The authors of this article using mainly the work of Etienne Trillat of the same title, present the most important facts from the history of hysteria. Our work shows how notions of hysteria known initially as uterine dyspnoea, which was the term used by Hippocrates in the seventh tome of his “Collected Works” evolved step by step. At the end of 1st century AD a newcomer to Rome, Soranus of Ephesus, as an experienced anatomist in his “Treatise on midwifery and the diseases of women” moved away from the old ideas of Plato and Hippocrates equating uterus to an animal. How did views on hysteria develop throughout Middle Ages, Renaissance or World Wars period? In this article the authors are trying to determine the nature of hysteria as well as what remained from hysteria in the contemporary times, depicting hysteria’s elusiveness as a disease, many difficulties with its definition and connection with many shocking events in history of mankind. From the ancient sages, through Kramer, Sprenger, Wier, Harvey, Willis, Sydenham, Blackmore up until Mesmer, Freud and many others. From hysteric witches, beings suffering from vapors, through sensitive, fragile and musing women up until mythomaniacs, nymphomaniacs and what we define today as histrionic personality disorder. In the words of French neurologist and a creator of psychiatry – Charcot – hysteria existed forever, everywhere and all-time. Why did it vanish though? Authors of this article will address this problem in the final part, trying to determine the cause.

Open access
Hospitalization of a child in the Neonatal Intensive Care – parents’ experiences


Introduction. Significant progress in the perinatal and intensive care therapy resulted in a meaningful increase of survival of extremely immature, and burdened with severe diseases neonates. Although infants are the patients of the Neonatal Intensive Care Unit, the needs of their parents should also be noticed and realized. The aim of the study was the analysis of the parents’ experiences of children hospitalized in the NICU.

Material. The research material comprises 39 written contributions of parents of children hospitalized in the NICU.

Method. A qualitative analysis of the text was used. Quotes of parents were classified in three categories: emotions, thoughts and support.

Results. Fear, happiness, joy, uncertainty, stress and shock are the most frequently emotions appearing in the parents’ reports. The most frequently mentioned areas of cognitive reactions of parents include: realization of child’s mortality, realizing problems of the premature birth, search for the guilty, and the reformulation of looking at the world. Parents often described support they received, but also pointed to the areas where support lacked.


  1. As a result of intense emotions, both positive and negative tint that parents experience at birth of a premature or sick child, multi-disciplinary care is necessary in order to reduce the negative effects of experienced emotions.
  2. Support, including information support for parents of critically ill newborns is a key skill in the practice of doctors taking care of children hospitalized in NICU.
  3. Psychological support is an essential element of the holistic care of the neonate’s family.

Open access
Mechanisms promoting and inhibiting the process of proteasomal degradation of cells


Defects in the process of degradation of unneeded cellular proteins underlie many diseases. This article discusses one of the most important systems of removal of abnormal proteins. It describes the process of ubiquitination of proteins for proteasome degradation. It also describes the structure of the 26S and 20S proteasomes and the mechanism of ubiquitin-proteasome system. Proteasome proteolytic system is highly specialized and organized. Protease-proteasome 26S is particularly important for proper cell functioning. It recognizes and degrades marked proteins. Inhibition of proteasome pathway leads to cell cycle arrest and apoptosis.

Efficient degradation of cellular proteins by UPS (the ubiquitin - proteasome system) - is important for signal transduction, transcriptional regulation, response to stress and the activity control of cell receptors.

The development of many diseases has its origin in the dysfunction of the UPS route. This group includes diseases such as cancer, neurodegenerative disorders, immune-mediated diseases and infectious diseases. Development of effective methods for pharmacological intervention in the functioning of this system has become a great challenge. The use of specific, low molecular-weight proteasome inhibitors and enzymes catalyzing the ubiquitination gives hope for new, targeted therapies.

Open access
Use of psychoactive substances, body image and characteristics of personality traits in bodybuilders


The aim of the study was to determine the prevalence of psychoactive substances use as well as the characteristics of body image, self-image, narcissism and stress coping strategies in the group of male professional bodybuilders.

Material and method. The study comprised a group 30 male bodybuilders practising bodybuilding professionally for over 7 years and 30 men who did not practise any sport.

The following research methods were used in the study: Socio-demographic Questionnaire and Eating Disorders and Self-image Survey Questionnaire in Men designed by Pawłowska and Staniewicz, Coping with Stress Questionnaire by Janke, Erdmann, Boucsein, Narcissism Questionnaire by Deneke, Hilgenstock, Müller, Adjective Check List by Gough and Heilbrun in the authorised translation by Płużek.

Results. As compared to the control group, bodybuilders significantly more often use psychoactive agents and have a more negative body image and self-image and show intensified narcissism.

Conclusions: In comparison to the control group:

  1. Significantly more bodybuilders use psychoactive agents: marijuana, amphetamine and ephedrine.
  2. Bodybuilders are characterised by a significantly more negative body image related to the impression of having excessive fat tissue and not sufficient muscle tissue and intensified pursuing to obtain social acceptance.
  3. Bodybuilders are characterised by a significantly more intensified need for dominance, aggression, competitiveness, breaking social rules, being rebellious, impulsive and confrontational.
  4. Bodybuilders are characterised by significantly more intensified narcissistic traits.
  5. Bodybuilders, while in a stressful situation, express compensatory conviction of having better than other people skills to cope with difficulties.

Open access
As patients get older, we should be aware of salt levels in factor products


Hypertension is a well-known risk factor for ischaemic heart disease and cerebrovascular events. Globally, there is a drive to try to reduce salt intake. In an older population, where hypertension is likely to have a high prevalence, are health care professionals aware of the sodium content in replacement factor?

Open access
Dental considerations in a patient with haemophilia


Haemophilia is a rare blood clotting disorder, characteristic features of which include extemporaneous and post-traumatic subcutaneous bleeding and mucosal haemorrhages. Genetic deficiency of coagulation factor VIII results in haemophilia A, while deficiency of factor IX leads to haemophilia B. The most common treatment for haemophilia A is administration of recombinant or plasma-derived factor VIII concentrate, to raise the levels of the deficient factor VIII. Tranexamic acid is also used as an anti-fibrinolytic agent that inhibits plasminogen activators present in oral secretion and stabilises the clot. Administration of factor IX is required in haemophilia B. Treatment leads to increased longevity and quality of life for patients. Dental conditions and treatments are more complicated and uncertain in patients with haemophilia due to bleeding risk, thus restorative dental care is of paramount importance for those with haemophilia. The fear of bleeding during treatment procedures is the primary cause of lack of proper dental care for people with haemophilia in countries with limited health care resources. This case report highlights the significance of clinical examination and investigation, and the importance of proper interaction between a haematologist and the periodontist for correct multidisciplinary and uneventful management of periodontal health of a patient with haemophilia.

Open access