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Case Reports 2015; 36(4): 303-305 PubMed PMID: 26454483 Citation  Keywords:  Adolescent, Female, Hashimoto Disease:complications, Hormone Replacement Therapy:methods, Humans, Magnetic Resonance Imaging, Oculomotor Nerve Diseases:drug therapy, Recurrence, Steroids:therapeutic use, Thyroiditis, Autoimmune:complications,.   

: Ophthalmopathy related to thyroid disease is due mainly to diffuse periorbital or eye muscle inflammation. It is more common in Grave's hyperthyroidism and rare in Hashimoto's hypothyroidism. Here we report a case of recurrent oculomotor nerve palsy associated with autoimmune hypothyroidism. Brain MRI revealed enhancement of the oculomotor nerves. Despite thyroid hormone replacement therapy, oculomotor nerve palsy recurred at the side contralateral to the initially involved nerve and the autoimmune antibody titer remained high. The symptom was responsive to high-dose steroid therapy....

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Journal Article 2015; 36(3): 288-293 PubMed PMID: 26313397 Citation  Keywords:  Adolescent, Adult, Czech Republic, Female, Health Services Needs and Demand:standards, Humans, Inpatients:psychology, Male, Middle Aged, Quality of Life:psychology, Schizophrenia:therapy, Young Adult,.   

OBJECTIVES: The main aim of the study was to investigate the quality of life and the medicinal and social needs of patients hospitalized with schizophrenia in the Czech Republic to uncover potential issues in these areas.

METHODS: Relevant self-evaluating questionnaires (SQUALA for quality of life; CANSAS for medicinal and social needs) were used in a cohort of hospitalized schizophrenic patients undergoing rehabilitation before discharge from the mental hospital.

RESULTS: Two hundred and forty-four patients (women N=115) aged 18-58 years were involved in the study. The quality of life of hospitalized patients with schizophrenia was subjectively assessed as universally worse in comparison with the general Czech population (p<0.05 in most cases; two-sample Student's t-test), but patients were not wholly critical of their own health status and overestimated its quality (arithmetic mean 63.79 in the patients vs the range of 45.5-59.8 as the norm in the general Czech population). Intimate relations, financial matters, treatment of psychotic symptoms, and sexual life were among the most pressing medicinal and social needs in our study subjects.

CONCLUSION: The results of our study should stimulate psychiatric nurses in their effort not only to detect but also address the problems of schizophrenic patients concerning quality of life and unfulfilled needs. This can be done via education, guidance towards a healthy lifestyle, or providing patients with adequate exercise. Overall this issue is of significant importance in the Czech Republic due to the fact that legislative reform of mental health care emphasizing community care and psychiatric nursing has just been implemented....

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Journal Article 2015; 36(3): 282-287 PubMed PMID: 26313396 Citation  Keywords:  Adolescent, Adult, Case-Control Studies, Chromosomes, Human, Pair 2:genetics, Female, Fetal Growth Retardation:genetics, Humans, Hypertension, Pregnancy-Induced:genetics, Polymorphism, Single Nucleotide, Pre-Eclampsia:genetics, Pregnancy, Pregnancy Outcom.   

BACKGROUND: Hypertension during pregnancy is a heterogeneous group of disorders with elevated blood pressure with or without proteinuria. The multiple researches are held on the subject of a genetic conditioning of preeclampsia and pregnancy induced hypertension.

OBJECTIVES: The study was designed to evaluate the impact of the single nucleotide polymorphism (SNP) rs7579169 on hypertension disorders in pregnancy, especially on PE and PIH as well as on the perinatal outcome.

METHODS: It is a case-control study. The study included 104 women with uncomplicated pregnancies in the control group and 75 pregnant women with hypertension disorders in the study group, hospitalized in the Perinatology and Obstetrics Department of the University Hospital in Cracow. Genomic DNA was extracted from peripheral blood leukocytes and SNP rs7579169 was genotyped from all patients. We analyzed the genotypes distribution and allele frequencies of polymorphism rs7579169 and its association with perinatal outcome in all groups. A p-value<0.05 was considered as significant.

RESULTS: Clinical evaluation included standard anthropometric measures like weight and height for the calculation of the body mass index in the beginning and in the end of the pregnancy, blood pressure, time and a method of delivery, birth weight, Apgar score. The heterozygote CT was associated with a 4.5-fold increased risk of preeclampsia in pregnant patients. The presence of TT genotype significantly increased the risk of intrauterine growth restriction (<10 percentile).

CONCLUSIONS: The study show probable impact of SNP rs7579169 on pregnancy, but further studies on larger groups are needed....

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Journal Article 2015; 36(3): 269-281 PubMed PMID: 26313395 Citation  Keywords:  Adult, Amygdala:physiopathology, Cognitive Therapy:methods, Female, Frontal Lobe:physiopathology, Humans, Magnetic Resonance Imaging, Male, Outcome Assessment (Health Care), Panic Disorder:diagnosis, Parietal Lobe:physiopathology, Prognosis,.   

OBJECTIVE: Previous functional brain imaging studies have described various and contradictory activation findings in patients with panic disorder (PD). Our study focused on patients with a chronic PD, who were investigated and treated in a conventional manner, which represents the real PD patients in clinical practice.

METHODS: Continuing their medication, patients were included in a six-week cognitive-behavioral therapy (CBT) program in the psychiatry department. At the onset of the study, participants underwent clinical evaluation using standard scales and were examined using fMRI while listening to verbal threat-related stimuli contrasted to neutral words. According to the therapeutic outcome, they were subsequently divided into two groups, responders, and nonresponders and the two groups were mutually compared.

RESULTS: In non-responders compared to responders, we found increased pre-treatment activation in dorsolateral prefrontal cortex bilaterally, left orbitofrontal cortex, left frontal eye field, right parietal lobule and left amygdala. In addition, both groups showed negative fMRI BOLD correlation with BAI improvement and positive correlation with CGI improvement across the ROIs. We suggest that DLPFC over-activation may reveal a lack of cognitive control over emotional processing, which makes subsequent CBT less effective.

CONCLUSION: Despite several limitations, we found neuroimaging predictors of poor CBT response, under the conditions of standard clinical practice, in real PD patients....

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Journal Article 2015; 36(3): 262-268 PubMed PMID: 26313394 Citation  Keywords:  China:epidemiology, Humans, Ischemic Attack, Transient:epidemiology, Severity of Illness Index, Stroke:diagnosis,.   

OBJECTIVES: The ABCD2 score has been commonly used to triage patients with transient ischemic attack (TIA) who are at high risk for imminent stroke. However, its accuracy in predicting short-term stroke risk among TIA patients in China remains unclear.

METHODS: All eligible studies published up to May 2014 were identified by searching Medline, PubMed, Embase, the China Knowledge Resource Integrated Database (CNKI) and the China Biological Medicine Database (CBM-disc), as well as unpublished articles manually scanned. The strength of the associations between treatments and outcomes was estimated by incorporated risk ratios (RRs) and 95% confidence intervals (CIs) using the Mantel-Haenszel statistical method.

RESULTS: Eight and 32 studies, which validated the value for predicting the risk of stroke 2 and 7 days after TIA respectively, were included. We calculated the RRs and CIs for 2- and 7-day prediction for stroke (low: RR=0.43, 95% CI=0.17-1.10, I2=0%; moderate: RR=0.42, 95% CI=0.26-0.67, I2=0%; high: RR=0.32, 95% CI=0.21-0.48, I2=0%; and low: RR=0.29, 95% CI=0.20-0.44, I2=0%; moderate: RR=0.27, 95% CI=0.23-0.33, I2=0%; high: RR=0.22, 95% CI=0.18-0.27, I2=1%).

CONCLUSIONS: This meta-analysis indicated that the ABCD2 score may highly under-predict the short-term occurrence of stroke after TIA for the Chinese population compared with the original model derived from Caucasian populations, which may lead to neglect of the short-term risk for stroke in the clinical practice....

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Journal Article 2015; 36(3): 257-261 PubMed PMID: 26313393 Citation  Keywords:  Adult, Cervical Ripening:drug effects, Delivery, Obstetric:methods, Dinoprostone:administration & dosage, Female, Humans, Outcome Assessment (Health Care), Oxytocics:administration & dosage, Pregnancy, Urinary Catheterization:instrumentation,.   

OBJECTIVE: The aim was to evaluate which of the two analyzed methods of preinduction: intracervical Foley catether and intracervical dinoprostone is related to higher rate of successful vaginal delivery in shorter time and to shorter hospitalization after the delivery.

DESIGN: A retrospective analysis of 198 patients with unfavorable cervix for labor induction (Bishop score ≤ 6), hospitalized at 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, was carried out. In 105 patients labor preinduction was conducted with Foley catheter (study group) and in 93 with intracervical dinoprostone (control group).

RESULTS: There were no significant differences regarding patients' age, body mass index (BMI), weight gain during the pregnancy, duration of pregnancy and parity between the groups. 68.6% of patients in the study group and 65.6% in the control group delivered vaginally (p=0.65). In the study group significantly less women developed spontaneous onset of labor (36.2% vs 66.7%; p<0.001). The time from preinduction to delivery onset and from preinduction to vaginal delivery were longer in the study group (780 min vs 489 min; 1682 min vs 920 min; p<0.001). The time of hospitalization after the delivery was significantly shorter in the study group (4.1 days vs 6.8; (p<0.001).

CONCLUSION: Both Foley catheter and dinoprostone seem to be equally effective in achieving vaginal delivery. In terms of time effectiveness Foley catheter preinduction is related to longer time from preinduction to delivery, nevertheless shorter time of hospitalization....

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Journal Article 2015; 36(3): 246-256 PubMed PMID: 26313392 Citation  Keywords:  Animals, Cerebellar Ataxia:chemically induced, Disease Models, Animal, Immunity, Cellular:immunology, Immunity, Humoral:immunology, Male, Rats, Rats, Sprague-Dawley,.   

OBJECTIVE: We previously showed that the cerebellum modulates the immune system. Here we determined whether cerebellar ataxia alters immunological function to further demonstrate an involvement of the cerebellum in immune modulation.

METHODS: Neurotoxin 3-acetylpyridine (3-AP) was intraperitoneally injected in rats to induce cerebellar ataxia. Behavior and motor coordination were tested on day 7 following 3-AP injection. Nissl staining and high-performance liquid chromatography (HPLC) were used to determine neuronal loss and neurotransmitter contents, respectively, in all the three cerebellar nuclei, fastigial nucleus (FN), interposed nucleus (IN) and dentate nucleus (DN). T and B lymphocyte differentiation and function were measured by flow cytometry, Western blot and ELISA.

RESULTS: 3-AP induced motor discoordination and locomotor reduction. In all the three cerebellar nuclei, FN, IN and DN, there was a neuronal loss and a decrease in contents of glutamate and GABA (but not glycine) after 3-AP injection. Importantly, CD4+ T cells, but not CD8+ T cells, were increased by the 3-AP treatment. Moreover, interferon (IFN)-γ-producing cells and interleukin (IL)-17-producing cells were decreased in cerebellar ataxia rats, but IL-4-producing cells and CD25-expressing cells were increased. Expression of the T helper (Th)1- and Th17-related cytokines, IFN-γ, IL-2, IL-17 and IL-22, was downregulated in CD4+ cells in cerebellar ataxia rats, while expression of the Th2 and regulatory T (Treg)-related cytokines, IL-4, IL-5, IL-10 and transforming growth factor (TGF)-β, was upregulated. Furthermore, B lymphocyte number and anti-bovine serum albumin (BSA) IgM and IgG antibody levels were elevated in cerebellar ataxia.

CONCLUSION: Cerebellar ataxia alters cellular and humoral immunity....

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Case Reports 2015; 36(3): 241-242 PubMed PMID: 26313390 Citation  Keywords:  Cesarean Section:methods, Female, Humans, Pregnancy, Pregnancy Complications:pathology, Torsion Abnormality:pathology, Uterine Diseases:pathology,.   

: This paper describes a case of uterine torsion not only around the long, but also the horizontal axis, diagnosed post-operatively. The patient was 28-years-old, II/I in the 34th week of her gravidity. She was admitted due to amniotic fluid leak. Due to unsuccessful delivery induction using prostaglandins, a caesarean section was indicated to end the gravidity. Uterine torsion 180° around the longitudinal axis and 90° around the transversal axis was diagnosed during the surgery. The uterine wound was treated in accordance with guidelines and the patient was dismissed in a good condition. Control hysteroscopy and laparoscopy done after a time interval showed problem-free healing of the wound in the posterior uterine wall....

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