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Journal Article 2012; 33(Suppl 2): 17-21 PubMed PMID: 23183504 Citation  Keywords:  Aged, Climacteric, Coronary Disease:epidemiology, Estrogen Replacement Therapy:statistics & numerical data, Estrogens:administration & dosage, Female, Humans, Middle Aged, Progestins:administration & dosage, Risk Factors, Time Factors,.   

: The aim of this work is to give summary of changes in recommendation for hormone replacement therapy (HT) and cardiovascular prevention during last decade. Conclusions from observational studies demonstrated a positive effect of HT in both the primary and secondary prevention of coronary heart disease (CHD). But large randomized trials failed to prove this positive effect; on the contrary, the cardiovascular risk was increased in the beginning of therapy. But estrogen arm of Women's Health Initiative (WHI) show neutral influence and the Estrogen in the Prevention of Atherosclerosis Trial (EPAT) indicate possible positive effects of some HT regimens. Also reanalysis of WHI in age-related groups show the window of opportunity. The prevention of CHD was excluded from possible indications of HT. Many questions regarding optimal choice in the individual treatment strategies have been raised. HT in its individualized form remains the first choice therapy for the acute climacteric syndrome, for the prevention and the therapy of urogenital atrophy and prevention of osteoporosis. Early start of HT has neutral or slightly positive effect on cardiovascular prevention....

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Journal Article 2012; 33(6): 603-607 PubMed PMID: 23160233 Citation  Keywords:  Aged, Aged, 80 and over, Biomarkers:blood, Brain Ischemia:blood, Female, Humans, Middle Aged, Prognosis, Resistin:blood, Risk Factors, Stroke:blood, Tumor Necrosis Factor-alpha:blood,.   

OBJECTIVES: Resistin may be an independent inflammatory marker of atherosclerosis. Therefore, its circulating level might be important prognostic factor of cardiovascular disease in humans. We aimed in this study to assess plasma resistin concentration in Polish women with acute ischemic stroke, who additionally suffer from chronic diseases: diabetes, hypertension and/or obesity. The changes of resistin levels after 10 days from the onset of stroke and possible associations between resistin and pro-inflammatory cytokine TNFα were also evaluated.

MATERIAL AND METHODS: Material consisted of 41 women with ischemic stroke (aged 60-85 years) and 64 controls (aged 60-85 years). Circulating resistin and TNFα concentrations were measured using ELISA. Blood was taken twice in the stroke group, in the first and tenth day from the onset of clinical symptoms, and only once in the controls. Clinical and biochemical data (blood pressure, weight, height, glucose, insulin, lipid profile) were collected.

RESULTS: Higher concentrations of resistin and TNFα were observed in ischemic stroke patients at the first day comparing to the controls. Second evaluation after 10 days in comparison with the first measurement revealed significantly higher TNFα levels and non-significant lower values of resistin. Resistin positively correlated with TNFα and stroke severity.

CONCLUSIONS: Changes in resistin and TNFα concentrations were observed in the course of stroke. Further investigations are required to assess the implication of these findings. Higher resistin concentration might be associated with worse neurological deficits....

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Case Reports 2012; 33(6): 574-578 PubMed PMID: 23160230 Citation  Keywords:  Biopsy, Brain Abscess:complications, Diagnosis, Differential, Humans, Hypopituitarism:diagnosis, Magnetic Resonance Imaging, Male, Middle Aged, Pituitary Gland:pathology, Sella Turcica:pathology,.   

: Pituitary abscess is a rare condition. Here, we present the case of a young male patient who was initially found to have a pituitary lesion following the diagnosis of panhypopituitarism. Two years later, he presented with severe headache and was subsequently diagnosed intraoperatively with pituitary abscess. At a follow-up of 6 years after surgery, the patient was continuing to do very well. We discuss the differential diagnosis and demonstrate the evolution of the pituitary lesion on magnetic resonance imaging at four different time points: at the time of the detection of the initial lesion; two years later at the time of the diagnosis of the pituitary abscess; at 7 weeks post operatively; and finally after six years from the pituitary surgery....

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Controlled Clinical Trial 2012; 33(6): 651-659 PubMed PMID: 23160228 Citation  Keywords:  Aged, Biomechanical Phenomena:drug effects, Chondroitin Sulfates:administration & dosage, Disease Progression, Female, Glucosamine:administration & dosage, Humans, Hyaluronic Acid:administration & dosage, Knee Joint:drug effects, Male, Middle Aged, Models.   

OBJECTIVES: This study seeks to demonstrate the influence of pharmacological substances from the SYSADOA group on the progression of osteoarthritis in the human knee. The quantification methods were direct measurement of the rheological properties of the knee joints in vivo and standard WOMAC index questionnaires.

MATERIALS AND METHODS: The drugs were administered orally to 34 probands with second degree gonarthrosis for 13 weeks. The untreated control group consisted of 10 probands. The rheological properties of the joints were determined by a biorheometer, and subjective assessment of the knees by patients (WOMAC) before and after medication, and for a further 13 weeks. Changes in the calculated parameters over time were compared.

RESULTS: During the audited perioda slight deterioration in all of the parameters was observed in the untreated group. The treated group, however, improved in all the parameters and some indicators showed statistically significant differences. The positive effects of the SYSADOA persisted for 3 months after the end of treatments. Partial correlation was found between the results of the WOMAC questionnaire and the rheological measurements.

CONCLUSIONS: This study shows the positive effects of the preparation on arthritic changes in the knee joint, but due to the large variance of the collected data, this conclusion is on the borderline of statistical significance. The method of measuring the rheological properties of the joints is suitable for evaluating the progression of OA....

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Case Reports 2012; 33(6): 590-596 PubMed PMID: 23160226 Citation  Keywords:  Aged, Brain Neoplasms:diagnosis, Fatal Outcome, Female, Humans, Hydrocephalus:diagnosis, Hypothalamic Diseases:diagnosis, Hypothalamus:surgery, Male, Middle Aged, Neurosurgical Procedures:adverse effects, Postoperative Complications:diagnosis, Subdural Ef.   

BACKGROUND: Opening of the lamina terminalis is often used in surgery of the optico-chiasmatic region. Consequently, alteration of cerebral-spinal fluid (CSF) dynamics can occur after this manoeuvre, thus potentially translating into clinical complications. Herein, we describe 2 cases in which clinically relevant hypothalamic dysfunctions developed after few days opening of the lamina terminalis both patients showed mild to moderate preoperative hydrocephalus which improved postoperatively.

CASES DESCRIPTION: In a patient with ruptured aneurysm of the basilar bifurcation, opening of the lamina terminalis was performed prior to acute-stage clipping. On postoperative day 7th, the patient developed significant subdural hygroma, mild disturbances of consciousness and increase of ADH concentration. These clinical features resolved only following subdural hygroma drainage and ventricular-peritoneal shunting. One previously operated patient in whom the lamina terminalis had been opened to remove a sizeable parasellar tumour showed a similar post-operative course. In this patient, sole subdural hygroma drainage was not an effective treatment, and the patient died subsequently for complications related to long-standing, though mild, hypothalamic dysfunction.

CONCLUSIONS: Our experience may suggest that hypothalamic dysfunctions should be reminded as a possible, although rare, complication following the opening of the lamina terminalis. This clinical condition, if not properly managed, may contribute to trigger severe life-threatening complications....

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Case Reports 2012; 33(6): 597-599 PubMed PMID: 23160225 Citation  Keywords:  Anti-Inflammatory Agents, Non-Steroidal:administration & dosage, Female, Headache Disorders, Primary:drug therapy, Humans, Indomethacin:administration & dosage, Middle Aged, Remission Induction, Treatment Outcome,.   

: Hypnic headache (HH) is considered as a disorder of the circadian rhythm, mostly affecting the elderly and generally considered a benign disorder, but the pathophysiology of hypnic hedache remains unclear. Various treatments have been suggested for hypnic headache, especially lithium and indomethacin. We report the case of HH fulfilling The International Classification Headache Disorders, 2nd edition criteria (ICHD-II). A 64-year-old woman, who suffered from dull headaches strictly during the night for a period of 5 months. Attacks of headache lasted from 30 to 150 minutes, with a frequency usually 4 times per week. The patient was started on indomethacin 50 mg twice a day (BID). From day 25 on she was free of hypnic headache. On day 31 we tapered the daily dose of indomethacin to 50mg at bedtime, the patient was still without headache. On day 60 the treatment was stopped. 30 months after day 60, the patient was still headache free. We reported the first Czech patient with HH with very good therapeutic response to indomethacin. The effect of therapy with indomethacin 50mg BID was very fast and stable....

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Comparative Study 2012; 33(5): 565-567 PubMed PMID: 23090277 Citation  Keywords:  Aged, Alzheimer Disease:epidemiology, Caregivers:psychology, Cohort Studies, Cross-Sectional Studies, Czech Republic:epidemiology, Fatigue Syndrome, Chronic:epidemiology, Female, Humans, Male, Middle Aged, Psychophysiologic Disorders:epidemiology, Sex Cha.   

BACKGROUND: This study was motivated by the growth in the number of elderly with dementia and consequent need to help family caregivers who face the daily stress for long periods of time. The aim was to describe the frequency of some common psychosomatic symptoms in self-assessed health status and to determine whether there are gender differences in these symptoms and the perception of one´s own health in family caregivers.

METHODS: The first results of cross-sectional survey design as the first phase of a longitudinal cohort study are presented. The participants in this investigation (n=73) were family caregivers of outpatients suffering from moderate (59 cases = 80.8%) or mild (14 cases = 19.2%) stage of Alzheimer´ s disease (AD).

RESULTS: The group of caregivers consisting of 61 (83.6%) women and 12 men (16.4%). Participants of this study were recruited from the Department of Psychiatry, Prague, Czech Republic. Data from caregivers were collected by using a self-administered questionnaire containing various items to measure self-perceived health including some common psychosomatic symptoms in relationship with their caregiving role.

CONCLUSIONS: The following symptoms appeared the most frequent among family caregivers: chronic fatigue and sleeping disturbances. Most caregivers of patients with moderate stage of AD evaluated their own health as poor and experienced more symptoms in comparison with caregivers of patients with mild stage of Alzheimer´s disease, who scored their own health as good or very good. A follow-up of the survey population seems to be necessary....

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Journal Article 2012; 33(5): 536-545 PubMed PMID: 23090273 Citation  Keywords:  Adult, Aged, Aged, 80 and over, Body Mass Index, Carcinoembryonic Antigen:blood, Female, Humans, Life Style, Lipid Peroxidation:physiology, Logistic Models, Middle Aged, Neoplasms:metabolism, Obesity:metabolism, Oxidative Stress:physiology, Risk Factors, .   

BACKGROUND: Non-communicable diseases (NCDs) constitute leading cause of morbidity, disability and premature mortality. Oxidative processes are involved in the pathogenesis of NCDs.

OBJECTIVES: To investigate the relationship between lipid peroxidation (LPO), an index of oxidative damage to membrane lipids, or carcinoembryonic antigen (CEA), a tumor marker, and potential risk factors for NCDs in women at midlife and beyond.

METHODS: Data on lifestyle, such as dietary habits, smoking, physical activity, etc. and medical history, were assessed by a questionnaire in 323 female outpatients of the Regional Centre of Menopause and Osteoporosis - Outpatient Department of Endocrinology, Lodz (Poland), at midlife and beyond. Blood serum LPO and CEA levels, as well as anthropometric measurements were evaluated.

RESULTS: Positive correlations between LPO level and body mass or body mass index or hip circumference were found. LPO level was increased in women who did not declare regular menstrual cycles. CEA level was increased in women who smoked (and positively correlated with duration of smoking), who consumed pickled food every day and over-consumed animal fats, who had not breastfed in the past, as well as in women with malignancy in anamnesis. Logistic regression analysis has revealed that LPO constitutes the independent positive determinant, whereas CEA constitutes the independent negative determinant, of obesity. Moreover, CEA was independently associated with malignancy in anamnesis, cigarette smoking and animal fat over-consumption.

CONCLUSION: Both LPO and CEA are independently associated with certain modifiable risk factors for NCDs....

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