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Case Reports 2014; 35(5): 352-354 PubMed PMID: 25275267 Citation  Keywords:  Empty Sella Syndrome:complications, Female, Heart Arrest:blood, Humans, Hypoglycemia:blood, Hypopituitarism:complications, Magnetic Resonance Imaging, Middle Aged, Potassium:blood,.   

: A 62-year-old woman was admitted to our hospital because of unconsciousness and hypoglycaemia. She had a history of weakness and fatigue after postpartum haemorrhage in 1983. Unfortunately, she was not diagnosed with Sheehan's syndrome and did not receive sufficient professional treatment due to the limited medical resources in her hometown. A laboratory examination at the local hospital revealed severe hypoglycaemia (1.8 mmol/L) with relatively low serum potassium (2.9 mmol/L). The woman appeared twice in the hospital with cardiac arrest, and her medical history, and the later laboratory investigations were consistent with Sheehan's syndrome. Empty sella was also found by magnetic resonance imaging (MRI). We conclude that Sheehan's syndrome may lead to cardiac arrest with the complication of hypokalaemia and deserves the vigilance of clinicians....

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Case Reports 2014; 35(5): 335-341 PubMed PMID: 25275265 Citation  Keywords:  Adolescent, Antithyroid Agents:administration & dosage, Autoantibodies:immunology, Child, Child, Preschool, Female, Graves Disease:drug therapy, Hashimoto Disease:drug therapy, Humans, Hypothyroidism:chemically induced, Male, Methimazole:administration & .   

BACKGROUND: The main clinical manifestations of autoimmune thyroid diseases are Graves' disease (GD) and Hashimoto's thyroiditis (HT). Graves' disease is the cause of most cases of hyperthyroidism in childhood. Indications for radical therapy (surgery or 131I treatment) in children are still a matter of discussion, as sustained (sometimes very long) remission of GD is possible, while the radical therapy almost always leads to hypothyroidism. Spontaneous evolution from GD with hyperthyroidism to HT with hypothyroidism may also be observed.

OBJECTIVE: The aim of the study was to analyze the clinical course of 6 cases of hyperthyroid girls with GD in whom a normalization of previously increased autoantibodies against thyrotropin (TSH) receptor (anti-TSHR) was observed together with a significant increase in autoantibodies against thyroid peroxidase (anti-TPO) and thyroglobulin (anti-Tg), with concomitant hypo- or euthyroidism but no recurrence of hyperthyroidism.

SUBJECTS: Patients' age at diagnosis ranged from 5.0 to 16.5 years. Two (2) patients had Turner syndrome, another one (1), diabetic, was on insulin therapy.

RESULTS: In all the girls, antithyroid drugs were administered and euthyroid state was achieved during the first 2.0-3.5 months of the treatment. Mild side effects were observed in only one case. The therapy was continued up to 1.5-4.0 years. Relapses during the therapy were observed in 2 cases. Up to now, no relapses have been observed for 0.5-7.5 years since the therapy withdrawal in 5 patients (1 patient was lost to follow-up), 2 patients are currently treated with levothyroxine due to hypothyroidism.

CONCLUSIONS: It seems that the prolonged pharmacotherapy with antithyroid drugs, followed by observation after remission of hyperthyroidism, may be an appropriate therapeutic option at least in some children with GD as they can be cured without radical therapy and the potential risks of such treatment....

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Journal Article 2014; 35(5): 393-397 PubMed PMID: 25275264 Citation  Keywords:  Adrenal Cortex Hormones:therapeutic use, Arthralgia:diagnostic imaging, Combined Modality Therapy, Denervation:methods, Female, High-Energy Shock Waves:therapeutic use, Humans, Low Back Pain:diagnostic imaging, Lumbar Vertebrae:diagnostic imaging, Male, M.   

OBJECTIVE: Lumbar facet joints (FJ) is a common source of low back pain and contributes approximmately on one third of chronic low back pain. Medial branch radiofrequency neurotomy is considered as a gold standard in the treatment of facet joint pain. Corticosteroid injections have also presented effect in FJ pain. As an interventional procedures, they carry not-negligible risk of possible complications including infection, damage to nerve root or medial branch structures. Shockwave therapy (SWT) is a non-invasive method for treatment of various musculoskeletal disorders. Its effect is based on transduction of mechanical energy, transferred to cascade of various biochemical processes in target tissue. Its efficacy was proved in the treatment of different painful conditions. The efficacy of SWT was not yet studied in FJ pain. Aim of our work was to compare the efficacy of SWT against interventional treatment procedures - radiofrequency neurotomy and corticosteroid FJ injections.

METHODS: A retrospective study was done on 62 selected patients with unilateral chronic lumbar facet pain. There were 32 women and 30 men, divided into SWT group, corticosteroid injections group radiofrequency group. Nociceptive and neuropathic pain intensity and severity of pain were measured.

RESULTS: Shockwave therapy had shown better longterm results compared to FJ injections group and little inferior efficacy compared to RMBN. We did not observe any adverse effects and complications in SWT group. Moreover, in SWT and RMBN groups, significant longterm improvement in daily activities limitation, was observed.

CONCLUSIONS: SWT appears to be a safe and perspective option in the treatment of FJ pain with negligible side effects....

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Journal Article 2014; 35(5): 405-410 PubMed PMID: 25275263 Citation  Keywords:  Adult, Algorithms, Circadian Rhythm:physiology, Disorders of Excessive Somnolence:diagnosis, Electroencephalography, Epilepsy:complications, Female, Humans, Male, Medical History Taking, Middle Aged, Polysomnography, Prospective Studies, Sleep Stages:phys.   

OBJECTIVES: Authors evaluated quality of sleep and daytime vigilance in patients with nocturnal epilepsy and compared it to those with daytime epilepsy.

BACKGROUND: Nocturnal seizures are an important type of epilepsy. They can result in morbidity due to disruption of sleep architecture. Daytime sleepiness, as a serious consequence of nocturnal seizures, has negative influence on quality of life in patients with epilepsy.

METHODS: Authors examined 100 patients with epilepsy. The occurrence of epileptic seizures in circadian rhythm, type of epilepsy and epileptic seizures, as well as aetiology of epilepsy were evaluated. Patients were divided in two groups, 17 patients with nocturnal epilepsy and 83 patients with epileptic seizures not related to sleep. All of them underwent overnight video-EEG-polysomnography and they filled in the Epworth Sleepiness Scale questionnaire (ESS) as well as The Pittsburgh Sleep Quality Index questionnaire (PSQI).

RESULTS: Overnight video-EEG-polysomnography detected significant changes in the sleep architecture in patients with nocturnal epilepsy. Significant decrease of N3 stage of NREM sleep (14.31%±8.07 in the group of nocturnal epilepsy vs. 20.12%±9.24 in the group of daytime epilepsy, p=0.01). Concurrently, significantly poorer sleep quality according to PSQI (18.52±7.51 in the group of nocturnal epilepsy vs. 6.21±3.62 in the group of daytime epilepsy, p=0.01) and tendency to increased daytime sleepiness according to ESS was revealed in these patients.

CONCLUSION: Remarkable changes in sleep architecture associated with poor quality of sleep and increased daytime sleepiness were detected in patients with nocturnal epilepsy. In conclusion, we emphasize the importance of sleep history taking in patients with epilepsy and their further evaluation in sleep laboratory....

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Journal Article 2014; 35(5): 367-372 PubMed PMID: 25275261 Citation  Keywords:  Adult, Apgar Score, Female, Humans, Infant, Newborn, Poland, Pregnancy, Pregnancy Outcome, Prenatal Exposure Delayed Effects:drug therapy, Vitamin D:administration & dosage, Vitamin D Deficiency:drug therapy, Vitamins:administration & dosage, Young Adult,.   

OBJECTIVE: Pregnancy increases the demand for vitamins, including vitamin D. Data on effects of vitamin D deficiency for pregnant woman and fetus available in Poland are scarce. The aim of this study was to evaluate vitamin D3 concentration in pregnant women and its influence on pregnancy course, health of pregnant women and their offspring.

PATIENTS AND METHODS: The study included 102 healthy pregnant women, aged 21 to 40 years, mean 30.5±4.9 years. Women were divided into three groups based on 25(OH)D serum concentration in the third trimester of pregnancy: Group I - with sufficient 25(OH)D serum concentration (>30 ng/ml), Group II - with vitamin D3 insufficiency (20-30 ng/ml), Group III - with serious vitamin D deficiency (<20 ng/ml).

RESULTS: Optimal vitamin D concentrations were found only in 31.2% of women, however in winter months only in 16%. Bacterial vaginosis was significantly more common in women with vitamin D deficiency and insufficiency (p<0.05). In contrast, there were no relations between vitamin D status and the incidence of gestational diabetes, preeclampsia, mode of delivery and size of newborns. A relationship between vitamin D deficiency and insufficiency during pregnancy and subsequent incidence of respiratory infections in children (p<0.05) was demonstrated.

CONCLUSIONS: 1. The current model of vitamin D supplementation in pregnant women in Poland is insufficient, particularly in winter. 2. Vitamin D deficiency in pregnant women fosters development of bacterial vaginosis during pregnancy and recurrent respiratory infections in children, suggestive of the role of vitamin D in prevention of infections....

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Journal Article 2014; 35(5): 385-392 PubMed PMID: 25275260 Citation  Keywords:  Animals, Basolateral Nuclear Complex:cytology, Dopamine:metabolism, Dopamine Agents:metabolism, Dopamine Antagonists:pharmacology, Dopaminergic Neurons:physiology, Excitatory Postsynaptic Potentials:drug effects, Male, Organ Culture Techniques, Presynapti.   

OBJECTIVES: Dopaminergic signaling in the basolateral amygdala (BLA) is important for emotion-related activity. However, little is known about the influence of dopamine (DA) on excitatory synaptic transmission of pyramidal neurons in BLA at early developmental stage. Here in this study, we observed the effect of DA on excitatory neurotransmission in the pyramidal cells of BLA in acute slices.

METHODS: Acute slices from amygdala of rats at the age of 14-16 days were prepared and maintained in vitro using standard method. Whole-cell patch clamp recordings were performed to examine the evoked excitatory postsynaptic current (eEPSC), spontaneous excitatory postsynaptic current (sEPSC) and miniature excitatory postsynaptic current (mEPSC). Drugs including DA and synaptic blockers were added in recording solution due to different experimental designs.

RESULTS: We found that bath application of DA at a concentration of 100 μM significantly inhibited the amplitude of evoked EPSC. However, the amplitude and frequency of mEPSC were not affected. We also found increased pair pulse facilitation after DA application, indicating DA inhibited excitatory neurotransmission through suppression of release probability at the pre-synaptic terminals. Importantly, DA was also effective in decreasing activity induced upregulation in sEPSCs. Moreover, the DA effects were not affected by either antagonist of dopamine 1 or dopamine 2-like receptors.

CONCLUSION: We studied the effects of DA on excitatory neurotransmission and found that DA inhibited glutamatergic synaptic transmission via modulation of pre-synaptic release probability....

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Case Reports 2014; 35(5): 347-351 PubMed PMID: 25275257 Citation  Keywords:  Amelogenesis Imperfecta:diagnostic imaging, Child, Czech Republic, Dental Enamel:abnormalities, Family Health, Female, Humans, Male, Microscopy, Electron, Scanning, Pedigree, Radiography, Siblings,.   

: Amelogenesis imperfecta (AI) is an overarching term for a group of rare inherited disorders of hard tooth tissues. It is characterized by various defects in proper enamel formation. AI is a severe disorder that affects both the aesthetics and function of the dentition, with affected teeth increasingly suffering from dental caries. Therefore, early diagnosis and lifelong stomatological interventions are important. Due to the complex nature of AI family history, stomatological, radiographic, and molecular genetic examinations should be part of the diagnostic portfolio. Additionally, we utilized new visualization methods for the assessment of teeth demineralization. We present a case report of two affected Czech sisters (6 and 8 years old) with clinically defined AI. These are the first Czech cases in which comprehensive clinical and genetic analysis had been carried out and reflect the complex clinical nature, positive treatment options, and limitations of candidate-gene molecular genetic testing....

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Journal Article 2014; 35(5): 380-384 PubMed PMID: 25275256 Citation  Keywords:  Adolescent, Adult, Brain-Derived Neurotrophic Factor:blood, Child, Child Development Disorders, Pervasive:blood, Child, Preschool, Female, Glial Cell Line-Derived Neurotrophic Factor:blood, Humans, Male, Maternal Age, Middle Aged, Nerve Growth Factor:bloo.   

OBJECTIVES: Evaluate the levels of a neurotrophic factor and some neurotrophins in the plasma of patients with Autism Spectrum Disorders (ASD).

DESIGN: This study enrolled 30 children with ASD and 19 healthy children. Plasma levels of the neurotrophins BDNF, NGF, NT3, NT4 and of the neurotrophic factor GDNF were measured by Enzyme-Linked Immunosorbent Assay.

SETTING: The etiopathogenesis of ASD is largely unknown, but it seems to involve dysfunction in several biological systems. One of these systems comprises the neurotrophic factors, which are molecules involved in many processes in the central nervous system, including neuronal survival, synaptogenesis and synaptic plasticity. Recent studies have shown association between neurotrophic factors and ASD.

RESULTS: No differences in plasma BDNF, NGF, NT3, NT4 and GDNF were found between ASD and control. Neurotrophic factors are not altered in ASD.

CONCLUSIONS: These molecules may play a minor role in ASD....

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