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Biomedicine

The first clinical trial of hypothermic machine perfusion of human liver grafts prior to transplantation: A critical comment

The Skeptik 2013;2:43-45.

Kukan M

Slovak Medical University, emeritus, Bratislava, Slovakia

Hepatic grafts can be preserved in University of Wisconsin solution by the static preservation for less than 12 hours for good outcome of liver transplantation surgery (1). For prolongation hepatic graft presevartion, implementation of ex vivo extraportoreal graft perfusion into clinical practice was suggested (2).

published by Slovak Society of Skeptics

The first clinical trial of hypothermic machine perfusion of human liver grafts prior to transplantation: A critical comment

The Skeptik 2013;2:43-45.

Kukan M

Slovak Medical University, emeritus, Bratislava, Slovakia

Hepatic grafts can be preserved in University of Wisconsin solution by the static preservation for less than 12 hours for good outcome of liver transplantation surgery (1). For prolongation hepatic graft presevartion, implementation of ex vivo extraportoreal graft perfusion into clinical practice was suggested (2).

publikované Slovenskou spoločnosťou skeptikov

Pathological gambling in context of developmental tendencies of psychiatric classification systems

The Skeptik 2013;2:46-62.

Nábělek L

Department of Psychiatry, F.D.Roosevelt Hospital, emeritus, Banská Bystrica, Slovakia

Summary
Although both main diagnostic and statistical classification systems (ICD-10 and DSM-IV) define pathological gambling as a disorder of impulse control, diagnostic criteria, characteristics of course and outcome and methods of treatment are more similar to psychoactive substance dependencies. Neurobiological studies postulate the dysregulation of dopamin, serotonin and noradreneline systems in this disorder. The neurobehavioral model of pathological gambling supports the opinion of a close similarity of pathological gambling (and other so-called non-substance addictions) and psychoactive substance dependence with all theoretical and therapeutic consequ-ences. The gambling behavior can be viewed as an addictive disorder – without the confounding variables usually involved in addictions to exogenous substance. The dopaminergic system has been associated with reward and is involved in drug and alcohol addiction. Dopaminergic function is changed in pathological gamblers. Noradrenaline may play a role in the arousal and novelty-seeking behavior associated with pathological gambling. It has long been reported that pathological gamblers have a higher rate of suicidal ideation and suicide attempts than the general population. The relationship between disorders of the central seroto¬nergic function and impulsive and aggressive behavior draw attention to a mutual relationship between reduced serotonin metabolism and suicidal behavior among pathological gamblers. Indeed, pathological gamblers are treated in programs modeled on addictive disorders or in the same programs as addicts. The forensic assessment of criminal offenders with diagnosis pathological gambling could not be difficult. Neither the ability to recognize the common danger nor the ability to control the patient`s behavior is not significantly diminished in pathological gamblers without another comorbid diagnosis. A logical conclusion of the ongoing conceptualization of pathological gambling can be the suggested concept of the common category of addiction disorders including both substance and non-substance addictions, which should be implemented in the upcoming revisions of psychiatric classification systems.

published by Slovak Society of Skeptics

Patologické hráčstvo v kontexte vývojových tendencií psychiatrických klasifikačných systémov

The Skeptik 2013;2:46-62.

Nábělek L

Department of Psychiatry, F.D.Roosevelt Hospital, emeritus, Banská Bystrica, Slovakia

Súhrn
Napriek aktuálne platnému klasifikačnému zaradeniu vykazuje patologické hráčstvo nepochybne prítomnosť podstatne komplexnejšej psychopatologickej symptomatológie v porovnaní s (inými) poruchami kontroly impulzov. Popri fenomenologickej analýze poukazujú na nespornú príbuznosť patologického hráčstva a závislostí od psychoaktívnych látok aj ďalšie faktory (rozšírenie, priebeh, komorbidita, neurobiologické a genetické súvislosti, suicidalita, kriminálne delikty). Konštatovanie, že patologické hráčstvo predstavuje psychickú poruchu porovnateľnú s alkoholizmom a inými závislosťami, prináša významné teoretické i praktické implikácie. Z teoretického hľadiska môže patologické hráčstvo predstavovať modelový príklad “čistej” závislosti zbavenej interferujúcich vplyvov konkrétnych exogénnych látok. Praktická aplikácia uvedených východísk determinuje stratégiu liečebných postupov. Neurobiologické štúdie poukazujú na dysreguláciu v dopamínovom, serotonínovom a noradrenalínovom systéme pri patologickom hráčstve. Zmenená dopamínergná funkcia sa spája s insuficienciou systému odmeny, dysregulácia v seroronínovom systéme ovplyvňuje okrem závislostného správania aj zvýšenú pohotovosť k suicidálnemu konaniu, zvýšená aktivita noradrenergného systému stimuluje vyhľadávanie silných podnetov a zážitkov. Najvýznamnejšie praktické konzekvencie vyplývajúce z tesnej príbuznosti patologického hráčstva a závislostí od psychoaktívnych látok predstavujú stratégia a metódy liečby tejto psychickej poruchy zamerané na dosiahnutie úplnej a trvalej abstinencie od hrania. Na druhej strane, forenznopsychiatrický význam patologického hráčstva ostáva neveľký. Zavŕšením naznačených trendov by mohli byť odporúčania odborných komisií pre prípravu revízií psychiatrických klasifikačných systémov, aby v ich nových verziách nebolo patologické hráčstvo naďalej súčasťou zvyškových kategórií porúch kontroly impulzov, ale bolo zaradené pod názvom závislosť od (hazardného) hrania resp. syndrom závislosti od (hazardného) hrania v spoločnej kategórii s ďalšími látkovými aj nelátkovými závislosťami.

publikované Slovenskou spoločnosťou skeptikov

New guidelines for modification of liver transplantation process

The Skeptik 2013;2:84-86.

Kukan M

Slovak Medical University, emeritus, Bratislava, Slovakia

At present, hepatic grafts can be preserved in UW solution by the static preservation for less than 12 hours for good outcome of liver transplantation surgery (1). On the basis of research results from isolated animal perfused livers, we suggest that both a safe preservation of hepatic grafts is possible (for up to18 hours) and that conterporary used liver transplantation process have to be modify according to the following guidliness:

published by Slovak Society of Skeptics

New guidelines for modification of liver transplantation process

The Skeptik 2013;2:84-86.

Kukan M

Slovak Medical University, emeritus, Bratislava, Slovakia

At present, hepatic grafts can be preserved in UW solution by the static preservation for less than 12 hours for good outcome of liver transplantation surgery (1). On the basis of research results from isolated animal perfused livers, we suggest that both a safe preservation of hepatic grafts is possible (for up to18 hours) and that conterporary used liver transplantation process have to be modify according to the following guidliness:

publikované Slovenskou spoločnosťou skeptikov

h-index, a missleading value for evaluation of scientist research output

The Skeptik 2013;2:87-88

Kukan M, Ginter E

Slovak Medical University, emeritus, Bratislava, Slovakia

Eight years ago, Dr. Hirsch elaborated systems of mathematical equations for elucidation of individual´s scientific research output (1). This so called h-index was widely accepted in scientific databases. Actually, it appears to be appropriate number to assess research scientist´s impact in the science. However, here we give examples of three slovakian research scientists, working in the same town, under both the area of socialism and capitalism that the use of h-index is not a valid number. (From ethical point of view we cannot give his/her names).

published by Slovak Society of Skeptics

h-index, a missleading value for evaluation of scientist research output

The Skeptik 2013;2:87-88

Kukan M, Ginter E

Slovak Medical University, emeritus, Bratislava, Slovakia

Eight years ago, Dr. Hirsch elaborated systems of mathematical equations for elucidation of individual´s scientific research output (1). This so called h-index was widely accepted in scientific databases. Actually, it appears to be appropriate number to assess research scientist´s impact in the science. However, here we give examples of three slovakian research scientists, working in the same town, under both the area of socialism and capitalism that the use of h-index is not a valid number. (From ethical point of view we cannot give his/her names).

publikované Slovenskou spoločnosťou skeptikov

Use and overuse of antidepressants and neuroleptics for treatment of patient´s depression

The Skeptik 2013;2:89-90

Kukan M, Ginter E

Slovak Medical University, emeritus, Bratislava, Slovakia

The depression is an ilness, which affects world-wide a large number of psychiatric patients. There are 6 major groups and/or drugs of antidepresants. First group represents inhibitors of monoamineoxidasy. The second group are selective serotonine re-uptake inhibitors. The third drug is venlafaxine, which inhibits both serotonine and norepinephrine re-uptake. The problem with venlafaxine is that its doses must be carefully regulated and patients are highly dependent on its use. The five drug is a newly synthetised agomelatin (1). However, agomelatin increses ALT and AST hepatic enzymes (in 10% of patients), which means than it disrupts hepatocellular membrane integrity. The six group are antidepresants with nonspecific effects and they are mostly obsolents.

published by Slovak Society of Skeptics

Use and overuse of antidepressants and neuroleptics for treatment of patient´s depression

The Skeptik 2013;2:89-90

Kukan M, Ginter E

Slovak Medical University, emeritus, Bratislava, Slovakia

The depression is an ilness, which affects world-wide a large number of psychiatric patients. There are 6 major groups and/or drugs of antidepresants. First group represents inhibitors of monoamineoxidasy. The second group are selective serotonine re-uptake inhibitors. The third drug is venlafaxine, which inhibits both serotonine and norepinephrine re-uptake. The problem with venlafaxine is that its doses must be carefully regulated and patients are highly dependent on its use. The five drug is a newly synthetised agomelatin (1). However, agomelatin increses ALT and AST hepatic enzymes (in 10% of patients), which means than it disrupts hepatocellular membrane integrity. The six group are antidepresants with nonspecific effects and they are mostly obsolents.

publikované Slovenskou spoločnosťou skeptikov

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