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Journal Article 2009; 30(4): 429-436 PubMed PMID: 20010491 Citation  Keywords:  Animals, Autistic Disorder:pathology, Cell Adhesion Molecules, Neuronal:physiology, Cell Movement:physiology, Disease Models, Animal, Extracellular Matrix Proteins:physiology, Humans, Nerve Tissue Proteins:physiology, Neuronal Plasticity:physiology, Neuro.   

: Autism is the most genetically influenced neuropsychiatric disorder with heritability of approximately 90%. Since genetic factors seem to play a crucial role in autism etiology, enormous attention is focused on genetic analyses of the disorder. Reelin, one of the autism candidates, is necessary in regulation of neuronal migration during brain development and also in maintaining synaptic plasticity during postnatal life period. Reduced reelin levels were observed in sera and brain cortices of autistic patients. In this review, abnormalities in reelin signaling and the relationship between reelin deficiency and principal neuroendocrine pathways are discussed....

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Case Reports 2009; 30(4): 450-452 PubMed PMID: 20010490 Citation  Keywords:  Adult, Albumins:therapeutic use, Cordocentesis, Female, Fetal Therapies, Humans, Hydrops Fetalis:diagnosis, Infant, Newborn, Paracentesis, Pregnancy, Pregnancy Outcome, Premature Birth,.   

BACKGROUND: Nonimmune hydrops fetalis (NHF) is an abnormal accumulation of fluid - especially serous - in visceral cavities and soft tissues. This condition may be caused by: cardiovascular diseases, chromosomal disorders, infections, lung, stomach, intestinal, kidneys, urinary tract and blood diseases, metabolic disorders and tumors. NHF may by diagnosed by an ultrasound scan. THE AIM of the study was to present diagnostic and therapeutic difficulties as well as management with reference to NHF.

CASE STUDY: An abnormal accumulation of fluid in visceral cavities and subcutaneous tissue of two fetuses was diagnosed by an ultrasound scan. Despite a detailed and specific diagnostic proceeding which included: infections, congenital malformations, chromosomal abnormalities etc. it was impossible to establish the cause of NHF. The symptomatic therapy was performed: periodic cordocentesis with an injection of human albumin solutions. In case of the first fetus therapeutic thoracocentesis was performed. The fetuses were delivered in 32nd and 31st week of pregnancy. Both neonates survived but even after the delivery it was impossible to establish the cause of NHF.

CONCLUSIONS: Multidirectional diagnostic approach is essential for the implementation of causal treatment of NHF. In case of idiopathic NHF the only management is symptomatic therapy, fetal monitoring and preterm delivery....

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Journal Article 2009; 30(4): 535-539 PubMed PMID: 20010489 Citation  Keywords:  Age of Onset, Biomarkers:blood, Fetal Blood, Humans, Infant, Newborn, Infant, Newborn, Diseases:blood, Infection:blood, Interleukin-6:blood, Morbidity, Pneumonia:blood, Prevalence, Sensitivity and Specificity,.   

UNLABELLED: Perinatal infections exert considerably negative effects on morbidity and mortality of newborns.

HYPOTHESIS: elevations of cytokine IL levels may be used as a marker of early-onset neonatal infections.

TARGETS: to establish relationships between elevated IL 6 cytokine levels and neonatal morbidity (cranial and pulmonary).

METHODS: examinations of the umbilical blood for IL 6 values in 392 newborns weighing under 1500 g treated in Ceské Budĕjovice at the Intensive Care Unit and Unit of Intensive Care and Resuscitation.

RESULTS: a statistically significant relationship was demonstrated between elevations of cytokine IL 6 levels and pulmonary morbidity in newborns.

DISCUSSION: the authors recommend examination of cytokine IL levels in the umbilical blood with a possibility to acquire the result within 2 hours after the delivery, which makes neonatologists possible to initiate goal-directed antibiotic therapy....

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Journal Article 2009; 30(4): 482-486 PubMed PMID: 20010488 Citation  Keywords:  Adult, Brain Diseases:complications, Child, Cohort Studies, Epilepsy:epidemiology, Hospitalization:statistics & numerical data, Humans, Incidence, Retrospective Studies, Seizures, Febrile:epidemiology, Slovakia:epidemiology, Substance-Related Disorders:co.   

BACKGROUND: Approximately 5% of the general population experiences at least one unprovoked epileptic seizure in the lifetime. This is in contrast to the cumulative incidence of epilepsy (approx. 3-4%) and incidence of acute symptomatic seizures (approx. 4%). Nearly 2% of the population experiences a febrile seizure before the 5 years of age. The aim of this article was evaluation of the distribution of acute symptomatic and unprovoked seizures in our patient cohort after the solitary epileptic seizures, as well as determination of particular etiological factors responsible for the occurrence of solitary epileptic seizure.

MATERIAL AND METHODS: Our patient cohort comprised 116 patients experiencing the solitary epileptic seizure, who were hospitalised at the 1st Department of Neurology, Faculty of Medicine of Comenius University and Faculty Hospital in Bratislava, Slovakia over a period of 10 years (January 1, 1997 - January 1, 2007). It is a retrospective analysis of data from case records and health records; eventually we contacted the patients by phone or by sending a questionnaire.

RESULTS: Of the 116 patients there were 32 cases (37.12%) of an acute symptomatic seizure and 84 cases (62.88%) of an unprovoked seizure. In the group of unprovoked solitary epileptic seizures the etiological conclusions were idiopathic and cryptogenic in 35 cases (41.7%) and late symptomatic in 49 cases (58.3%). The most frequent etiological factor in the group of acute symptomatic seizures was alcohol (40.6%). In the subgroup of late symptomatic seizures the etiology was mostly vascular (17.85%).

CONCLUSION: Data management of etiological factors responsible for the solitary epileptic seizure confirmed a need for a thorough evaluation of the first epileptic seizure....

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Comparative Study 2009; 30(4): 487-490 PubMed PMID: 20010487 Citation  Keywords:  Adult, Binomial Distribution, Child, Electroencephalography:standards, Epilepsy:diagnosis, Humans, Magnetic Resonance Imaging:standards, Reproducibility of Results, Retrospective Studies, Risk Factors, Tomography, X-Ray Computed:standards,.   

BACKGROUND: The occurrence of the first unprovoked epileptic seizure always requires thorough examination. The risk of incorrect diagnosis is high, non-epileptic seizures represent 20-33% of newly diagnosed cases. The aim of the study is to evaluate findings of various modifications of EEG examination in the group of patients who experienced solitary unprovoked epileptic seizure and compare benefits of CT and MRI examination of the brain of these patients.

MATERIAL AND METHODS: The group involved 84 patients hospitalized at the 1st Department of Neurology , Faculty of Medicine, Comenius University in Bratislava between January 1997 and January 2007 after experiencing unprovoked epileptic seizure. It is a retrospective analysis of information from medical records and clinical documentation. For statistic comparing of benefits of various modifications of EEG examination and between CT and MRI examination of the brain binomic test of proportion was used.

RESULTS: Interictal epileptiform EEG graphoelements in native EEG was recorded only in 14.29% of patients. Statistically significantly more epileptiform graphoelements comparing EEG and EEG after sleep deprivation of the patient (SD) with one- hour recording was recorded with 24-hour 8 channels EEG monitoring after SD, EEG after SD with one- hour recording was of no significance comparing to native EEG. MRI examination of the brain was statistically more significant comparing to CT examination.

CONCLUSION: Low catchment of epileptiform EEG graphoelements in patients with solitary unprovoked seizure shows the importance of precise history in diagnostics of these patients. Though EEG is a very important examination it is an auxiliary one. We confirmed that MRI examination in patients who experienced solitary unprovoked epileptic seizure is undoubtedly the first choice method....

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Journal Article 2009; 30(3): 414-420 PubMed PMID: 19855370 Citation  Keywords:  Adult, Antibodies, Viral:blood, Blood Donors, Borna Disease:complications, Borna disease virus:metabolism, Czech Republic, Enzyme-Linked Immunosorbent Assay, Female, Humans, Male, Middle Aged, Mood Disorders:complications, Psychiatric Status Rating Scales.   

OBJECTIVES: Borna disease virus (BDV) is an RNA virus belonging to the family Bornaviridae. BDV is a neurotropic virus that causes changes in mood, behaviour and cognition. Patients with psychiatric disorders have a higher incidence of BDV positivity than healthy individuals.

METHODS: We examined the seropositivity of BDV circulating immunocomplexes (CIC) in psychiatric patients and healthy individuals (blood donors). We examined 39 psychiatric inpatients for the presence of BDV CIC in the serum by ELISA on day 0, 28 and 56. During the same period psychopathology was measured using psychiatric scales (CGI, CGI-I, MADRS, SDS, PANSS). This is the first such study performed in the Czech Republic.

RESULTS: BDV CIC positivity was detected in 66.7% of psychiatric patients (26/39) on day 0, in 53.9% (14/26) on day 28 and in 52.9% on day 56 (9/17). The control group was 22.2% (28/126) positive. The incidence of BDV CIC was significantly higher in psychiatric patients than in healthy individuals (p=0.001). The significantly higher level of BDV CIC was associated with the higher severity of psychopathology in comparison with patients with mild or moderate psychopathology (p=0.03). We did not find any association between BDV CIC positivity and other characteristics (age, diagnosis, family, personal history, the history of infectious diseases, contact with animals).

CONCLUSION: In our study psychiatric patients had significantly higher levels of BDV CIC than the control group. The highest levels of BDV CIC were detected in patients with more severe psychopathology....

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Journal Article 2009; 30(3): 409-413 PubMed PMID: 19855369 Citation  Keywords:  Activities of Daily Living, Aged, Dementia:drug therapy, Geriatric Assessment, Humans, Neuropsychological Tests, Psychiatric Status Rating Scales, Severity of Illness Index, Treatment Outcome,.   

BACKGROUND: An effort to share our many years of clinical experience.

OBJECTIVE: To predict the effectiveness of medication in advanced phases of dementia in the light of pharmaceutical economics and to find the most suitable alternative treatments.

METHODS: Use of 3 commonly available geriatric tests Mini-Mental State Examination (MMSE), Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL). Threshold values of these tests, after mathematical transformation to comparable values, enables calculation of the hypothetical Point of Reversibility Pr found on the range here called MEKO.

RESULTS: Estimated values of SD can be used to choose the most effective medical treatment.

CONCLUSION: Beyond the upper threshold of S(D), on the basis of the above mentioned method, continued medication is of dubious value....

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Journal Article 2009; 30(3): 403-408 PubMed PMID: 19855368 Citation  Keywords:  Analysis of Variance, Apgar Score, Birth Weight:physiology, Blood Flow Velocity:physiology, Female, Humans, Hypertension:diagnostic imaging, Infant, Newborn, Laser-Doppler Flowmetry, Placental Circulation:physiology, Pregnancy, Pregnancy Complications, Ca.   

BACKGROUND: Hypertension is one of the most frequent complications of pregnancy. Due to high risk of morbidity and mortality in both mothers and children, it is necessary to continuously monitor the pregnancy, principally with biophysical methods. Particularly, doppler velocimetry of the materno-fetal circulation proves useful. THE AIM of the study was to assess the usefulness of doppler test in monitoring the condition of the foetus in preterm delivered pregnancy complicated with hypertension.

MATERIAL AND METHODS: The retrospective analysis comprised the data of 116 women who delivered prematurely at the Clinics of the Department of Gynaecology and Obstetrics at the Collegium Medicum of the Jagiellonian University in the years 2006-2007, resulting in creation of Group I involving 38 pregnant women with preeclampsia, and Group II of 36 women whose pregnancy was complicated with gestational hypertension. Control group was formed of 42 women with correct arterial blood pressure. When describing the groups, the differences in the birth weight and Apgar score were indicated.

RESULTS: A significant statistical difference was found in the area of pulsation rate in the umbilical artery and cerebro-placental ratio (CPR). In the case of preterm delivery complicated with arterial pressure disorders, the foetus is characterised with worse organic perfusion and slower somatic growth than if no concomitant hypertension is present. Hypertension forms an additional risk factor in the course of preterm delivery, and doppler velocimetry is a good method for monitoring the condition of the foetus, as it allows for detection of irregularities and for implementation of relevant treatment to improve the newborn's condition at birth....

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