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Journal Article 2013; 34(7): 615-617 PubMed PMID: 24463997 Citation  Keywords:  Decision Making, Entropy, Humans, Models, Psychological, Psychophysics, Uncertainty,.   

: Connections between information theory and decision under uncertainty have been attracting attention in econophysics, neuroeconomics and quantum decision theory. This paper proposes a psychophysical theory of Shannon entropy based on a mathematical equivalence of delay and uncertainty in decision-making, and psychophysics of the perception of waiting time in probabilistic choices. Furthermore, it is shown that the well-known Shannon entropy is a special case of the general psychophysical entropy. Future directions in the application of the present theory to studies in econophysics and neuroeconomics are discussed....

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Case Reports 2013; 34(7): 601-605 PubMed PMID: 24463996 Citation  Keywords:  Autoantibodies:immunology, Brain Stem:immunology, Encephalitis:complications, Gangliosides:immunology, Guillain-Barre Syndrome:complications, Humans, Magnetic Resonance Imaging, Male, Tomography, X-Ray Computed, Young Adult,.   

: We report a case of a 23-year-old man diagnosed with overlapping Bickerstaff brainstem encephalitis (BBE) and Guillain-Barre syndrome (GBS). The patient initially presented with fever and headache and gradually developed ataxia, disturbance of consciousness, respiratory muscle paralysis, bilateral facial paralysis and quadriplegia accompanied by significant atrophy of limb, temporalis and masseter muscles. Brain MRI revealed abnormality in the left basal ganglia, thalamus, and rightside posterior limb of the internal capsule. Electromyogram indicated neurogenic damage (mainly axonal damage) in the upper and lower limbs and bilateral facial nerve damage. Cerebrospinal fluid (CSF) collected via lumbar puncture was colorless and transparent with a pressure of 330 mm H2O. The white blood cell count in CSF was 200×106/L, the protein concentration was 1.25 g/L, and Pandy's reaction was positive. Both the blood and CSF were negative for GQ1b antibody. The patient was clinically diagnosed with overlapping BBE and GBS. After treatment with ventilator assisted breathing, hormone therapy, neurotrophic and anti-infection therapies, and symptomatic and supportive care for more than three months, spontaneous breathing was restored. By the 5-month follow-up examination, the patient had completely recovered and returned to work. Like GBS and Fisher syndrome, BBE might be an anti-GQlb IgG antibody syndrome. Although the serum GQlb IgG antibody-positive rate for BBE is only 66%, a normal brainstem MRI or GQlb lgG antibody-negative finding cannot completely rule out BBE. Therefore, identifying critical illness polyneuropathy for patients with respiratory muscle paralysis and tracheal extubation difficulties at early stages is clinically important....

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Clinical Trial 2013; 34(7): 687-692 PubMed PMID: 24463995 Citation  Keywords:  Adult, Dose-Response Relationship, Drug, Female, Fetus:blood supply, Hemodynamics:drug effects, Humans, Middle Cerebral Artery:drug effects, Nifedipine:administration & dosage, Obstetric Labor, Premature:diagnostic imaging, Placenta:blood supply, Pregnanc.   

OBJECTIVES: The aims were to assess the placental and fetal circulation during nifedipine tocolysis within the first 48 hours of therapy.

METHODS: Placental and fetal circulation was assessed in Doppler ultrasound examination prior to nifedipine administration and then after 24 and 48 hours. Maternal heart rate and PI in uterine arteries were evaluated as well as FHR, RI and PI of UA and MCA. E/A-wave ratio for A-V valves, MPI and SF were calculated for both ventricles independently. To determine changes over time in all study variable analysis of variance (ANOVA) for repeated measurements followed by Tukey-Kramer's multiple comparison test was used. The effects of additional clinical covariates were checked.

RESULTS: Uterine and umbilical blood flow patterns were not altered significantly during administration of nifedypine tocolysis. While MCA Doppler indicies such as RI and PI were unchanged, the evaluation of MCA PSV revealed a transient significant decrease after 24 hours. A resolution of this distraction was observed within the following 24 hours. No significant changes were observed in direct fetal cardiac function parameters calculated separately for both ventricles.

CONCLUSIONS: The decrease of MCA PSV after 24 hours of treatment was isolated and transient hemodynamic distraction observed during treatment. Neither fetal cardiac parameters nor other Doppler indices were changed. Therefore oral administration of nifedipine seems not to alter uterine nor fetal arterial blood flow pattern seriously. As significant changes were observed by different authors, further studies should be performed to verify the optimal total dose of nifedipine and its influence on hemodynamic conditions....

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Journal Article 2013; 34(7): 643-647 PubMed PMID: 24463994 Citation  Keywords:  Action Potentials:physiology, Adult, Electrophysiology, Female, Humans, Hyperlipidemias:complications, Male, Median Nerve:physiology, Middle Aged, Neural Conduction:physiology, Peripheral Nervous System Diseases:complications, Peroneal Nerve:physiology, S.   

OBJECTIVES: Metabolic disease affect all systems in the body, including the peripheral nervous system, but there is a controversy as whether to consider hyperlipidemia is a cause of peripheral neuropathy. The aim of the present study was to evaluate whether hyperlipidemic subjects with no clinical symptom or sign of peripheral neuropathy showed nerve conduction abnormalities or subclinical peripheral neuropathy according to the universally accepted electrophysiological criteria.

METHODS: The study group consisted from 29 female and 16 male patients (mean age: 47±7) while the control group consisted from 22 female and 10 male healthy volunteer subjects with a mean age of (43±9). All participants underwent an electrographic study in the classical manner described in the literature. Median and ulnar nerves in one upper, peroneal posterior tibial and sural nerves were studied in both lower extremities.

RESULTS: Median nerve 2nd digit-wrist segment sensory nerve conduction velocity were slow and sensory nerve action potential amplitude (SNAP) were low relative to controls. Sural nerve sensory nerve conduction velocity in the lower extremities were low relative to controls.

DISCUSSION: In this study the hyperlipemic group consisted from subjects with a relatively young age and with not very high serum lipid levels. Finding abnormal nerve conduction in distal sensory nerves in both upper and lower extremities in these hyperlipidemic patients made us think that; aging or uncontrolled hyperlipidemia may make these subjects susceptible to generalized peripheral neuropathy in the future.

CONCLUSION: Hyperlipidemia may affect nerve conduction in peripheral nerves and precede peripheral neuropathy....

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Journal Article 2013; 34(6): 523-528 PubMed PMID: 24378460 Citation  Keywords:  Adult, Aged, Antineoplastic Combined Chemotherapy Protocols:administration & dosage, Cholecalciferol:administration & dosage, Cyclophosphamide:administration & dosage, Dopamine Agonists:administration & dosage, Humans, Male, Melatonin:administration & dos.   

OBJECTIVE: To evaluate the objective clinical response and the safety of the combined administration of somatostatin, melatonin, retinoids, vitamin D3, dopamine subtype 2 receptor (D2R) agonists and low doses of cyclophosphamide, associated with androgen ablation, in patients with a histological diagnosis of prostate adenocarcinoma (Pac).

MATERIALS AND METHODS: The clinical data of 30 patients with non-invasive and metastatic prostate cancer, who attended our institution over a period of more than 5 years, were retrospectively reviewed.

RESULTS: 16 patients satisfied the evaluation criteria. Median age: 64 years. Disease stages: 8 patients (50%) were in Stage II. For advanced stages (Stage IV), secondary lesions were located in the bones and lymph nodes. Taken together, an overall objective response (OR) [Complete response (CR) + Partial Response (PR)] was achieved in 69% of the patients, with 88% of objective clinical benefit [CR+PR+SD]. For local Prostate Cancer group, an OR was achieved in 87.5% of patients (7 cases; 53-98; 95% CI), with CR in 62.5% (5 cases, 31-86; 95% CI). In metastatic disease, the OR was 50% (4 cases; 21-78; 95% CI), with a 20% of CR (2 cases; 7-59; 95% CI) and 75% of clinical benefit.

CONCLUSIONS: This preliminary study shows that patients with early and advanced forms of prostate cancer, not previously treated by surgery and/or chemo-radiotherapy, can achieve a more than positive clinical benefit with the protocol foreseen by the Di Bella Method. Further clinical investigations are strongly recommended....

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Journal Article 2013; 34(6): 518-522 PubMed PMID: 24378459 Citation  Keywords:  Adolescent, Blood Pressure:drug effects, Dose-Response Relationship, Drug, Female, Humans, Hypertension:chemically induced, Infant, Male, Vitamin D:administration & dosage, Vitamin D Deficiency:drug therapy, Vitamins:administration & dosage,.   

OBJECTIVE: The broad spectrum of extraosseal functions of vitamin D has recently been investigated. Although majority of recent studies have documented its hypotensive effect, some older studies warrant the risk of development the juvenile hypertension namely after pulse-fortified D vitamin supplementation during infancy. The aim of this study was to compare of the blood pressure in 13 year old groups of adolescents to the mode of D vitamin supplementation during their infancy.

METHODS: Study group represent 1138 thirteen year old adolescents in complex health care of 21 primary care pediatricians (PCPs). This group was divided into three subgroups according their mode of D vitamin supplementation in infancy. 100 children were given the continuous daily supplementation of AD vitamin 200-400 IU /day - " regular subgroup 0", 933 children were given by bolus doses of D vitamin forte 450 000 IU every three months during first year of life - "fortified subgroup 2", and 105 children given by bolus doses of D vitamin during winter, and continuous daily AD drops during summer - " mixed subgroup 1". D vitamin supplementation was done approximately 13 years before blood pressure study.

RESULTS: The mean systolic blood pressure was 110 mmHg, and mean diastolic one was 70 mmHg in all subgroups, regardless the mode of vitamin D supplementation. There were no statistic differences among subgroups, between girls/ boys, blood pressure levels were in normal limit. Although calculated daily doses of D2 vitamin during infancy exceeded RDA (200-400 IU) four to ten time, no difference in morbidity was found, concerning various chronic diseases (allergy, cardiovascular, renal, etc.). These results are in full accordance to recent knowledge of higher requirement and safety limit during vitamin D application.

CONCLUSION: The mode of D vitamin prophylaxis during infancy (pulse or daily application) has no influence to blood pressure level in early adolescence. No adverse effects have been found despite that the calculated daily dose was exceeded from three to ten times the recommended daily allowance....

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Journal Article 2013; 34(6): 482-497 PubMed PMID: 24378458 Citation  Keywords:  Disease Progression, Erectile Dysfunction:drug therapy, Estrogen Antagonists:therapeutic use, Humans, Male, Phytoestrogens:antagonists & inhibitors, Phytotherapy:methods, Prevalence, Regeneration:drug effects,.   

: Article presents the latest knowledge on the pathophysiology of erectile dysfunction (ED), the influence of xenoestrogens on ED and fertility in men and the possibilities of the blocking xenoestrogen actions with natural ingredients as well as treatment options for ED with medicinal plants. With the rising phenomenon of ED in the world there is rising a market with ED treatment products. Especially in menu of internet online shops come increasingly to light new natural over the counter products for ED treatment. Sale and use of medicinal plants and their extracts in the treatment of ED is based according to the declaration of the producers first of all on a number of the thousand-year-old traditions in some nations, based on the efficacy and safety of these plants, verified in the healing practice. Aim of this article was to make an extensive review of the scientific and professional literature and to find out which medical plants, sold in the herbal products for ED, was evaluated for efficacy and safety in relevant clinical trials. The review of the literature shows, that by some marketed medicinal plants lack clinical studies, the results of some clinical studies related to the same medicinal plant are controversial and some bring significantly positive effects, but their number is minimal. The future is therefore open to starting the number of new clinical trials testing the medicinal plants in the treatment of ED with possible inclusion of some of these plants in evidence based medicine, if confirming their efficacy and safety....

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Journal Article 2013; 34(6): 539-542 PubMed PMID: 24378457 Citation  Keywords:  Adult, Aged, Aged, 80 and over, Choroid Neoplasms:diagnosis, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Male, Melanoma:diagnosis, Middle Aged, Nevus, Pigmented:diagnosis, Optic Disk:pathology, Retinal Pigment Epithelium:pathology, Tomogra.   

OBJECTIVE: To assess the utility of the optical coherence tomography (OCT) in diagnosing, differentiating and monitoring of choroidal nevi situated in the posterior pole and optic disc area.

MATERIAL AND METHOD: 116 consecutive patients (65 women, 51 men) aged 27-95 years, with choroidal nevus were included to the research. Routine ophthalmoscopic evaluation and OCT using the Zeiss Stratus OCT as well as fundus photography were performed in each patient. The OCT was used to assess the structure of the retina overlying the choroidal nevus, the retinal pigment epithelium (RPE) - choriocapillaris complex, as well as the anterior portion of the choroidal lesion. In 31 patients due to suspected malignant melanoma fluorescein angiography and ultrasound were additionally performed. Follow-up OCT was done after 12 months in 51 out of 85 patients with characteristics of choroidal nevi, and after 6 and 12 months in 27 patients with "suspicious" lesion.

RESULTS: The basal dimension of the lesion ranged from 0.5 mm to 12 mm (mean 2.75mm), mean thickness was 1.25 mm. The pigmented lesion did not affect visual acuity. In 85 patients the lesion was flat or slightly elevated, without secondary changes in the retina. In 31 patients additional changes in the retina were observed - most frequently subretinal fluid. Two patients were eventually diagnosed with malignant melanoma. The follow-up OCT did not show progression in neither patients without secondary changes nor those with risk factors of malignancy.

CONCLUSION: Optical coherence tomography enables detailed evaluation of the retina overlying the pigmented lesion. Secondary changes in the retina need additional exams and strict observation. OCT could be an additional tool in the evaluation of treatment of malignant melanoma....

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