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Case Reports 2014; 35(4): 252-256 PubMed PMID: 25038596 Citation  Keywords:  Adult, Cerebrum:metabolism, Diabetes Insipidus:blood, Diagnosis, Differential, Humans, Hyponatremia:blood, Intraoperative Complications, Postoperative Complications:blood, Postoperative Period, Sodium:blood, Syndrome, Ventriculoperitoneal Shunt:adverse ef.   

: Cerebral salt wasting syndrome (CSW-cerebral salt wasting) was first described in 1950 by Peters. This syndrome can occur in patients who have sustained damage to the central nervous system (e.g. patients with subarachnoid bleeding, bacterial meningitis or after neurosurgery). Patients present with excessive natriuresis and hyponatremic dehydration. Differentiating this syndrome with the syndrome of inappropriate antidiuretic hormone secretion (SIADH-syndrome of inappropriate antidiuretic hormone secretion), which may occur in the same group of patients, is necessary in order to administer the correct treatment which consists of fluid restriction and sodium replacement in SIADH and fluid and sodium replacement as well as occasional mineralocorticoid therapy in CSW....

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Journal Article 2014; 35(3): 218-223 PubMed PMID: 24977972 Citation  Keywords:  Adolescent, Adult, Case-Control Studies, Chemokines:blood, Female, Humans, Intercellular Signaling Peptides and Proteins, Male, Middle Aged, Multiple Sclerosis:blood, Obesity:blood, Overweight:blood, Thinness:blood, Young Adult,.   

OBJECTIVES: Chemerin, a novel adipokine produced by adipose tissue and liver, is associated with markers of metabolic syndrome, and additionally, acting as chemoattractant for cells of immune system it may regulate immune cell properties.

MATERIAL AND METHODS: In order to evaluate plasma chemerin concentration in multiple sclerosis (MS) individuals we investigated 39 MS patients (among them 23 subjects were lean and 16 were overweight or obese) and 42 controls with tension headaches (29 of them were lean and 13 were overweight or obese). All patients had a brain MRI scan with gadolinium contrast as well as an assessment of the presence of oligoclonal bands in cerebrospinal fluid (CSF) and estimation of the CSF IgG index. The neurologic status was evaluated with use of the Expanded Disability Status Scale. Chemerin levels in plasma were measured using ELISA kit. Lipid profile, glucose and insulin levels, CRP and selected cytokine concentrations were also determined.

RESULTS: Plasma chemerin concentrations in overweight/obese MS subjects were higher when comparing to lean MS individuals and the controls, both from lean and overweight/obese subgroups. Significant difference was found between the results of overweight/obese MS and lean controls.

CONCLUSIONS: An increase of chemerin levels in patients with multiple sclerosis is associated with overweight and obesity....

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Journal Article 2014; 35(3): 206-212 PubMed PMID: 24977970 Citation  Keywords:  Attitude to Health, Bipolar Disorder:epidemiology, Communication, Community Networks:organization & administration, Humans, Internet, Interpersonal Relations, Self-Help Groups:organization & administration, Social Behavior,.   

OBJECTIVE: The main therapeutic approach in the treatment of bipolar affective disorder is the administration of drugs. The effectiveness of this approach can be increased by specific psychotherapeutic interventions. There is not much knowledge about self-help initiatives in this field. Anonymous internet communication may be beneficial, regardless of the fact that it is non-professional. It offers a chance to confide and share symptoms with other patients, to open up for persons with feelings of shame, and to obtain relevant information without having a direct contact with an expert.

METHODS: Qualitative analysis of web discussions used by patients with bipolar disorder in Czech language was performed. Using key words "diskuze" (discussion), "maniodeprese" (manic depression) and "bipolární porucha" (bipolar disorder), 8 discussions were found, but only 3 of them were anonymous and non-professional. Individual discussion entries were analyzed for basic categories or subcategories, and these were subsequently assessed so that their relationships could be better understood.

RESULTS: A total of 436 entries from 3 discussion web pages were analyzed. Subsequently, six categories were identified (participant, diagnosis, relationships, communication, topic and treatment), each having 5-12 subcategories. These were analyzed in terms of relationships and patterns.

CONCLUSIONS: Czech discussion web pages for people suffering from bipolar disorder are a lively community of users supporting each other, that may be characterized as a compact body open to newcomers. They seem to fulfill patients' needs that are not fully met by health care services. It also has a "self-cleaning" ability, effectively dealing with posts that are inappropriate, provocative, criticizing, aggressive or meaningless....

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Journal Article 2014; 35(2): 149-153 PubMed PMID: 24878977 Citation  Keywords:  Aged, Aged, 80 and over, Carotid Artery Diseases:complications, Carotid Artery, Internal:pathology, Cerebral Infarction:complications, Euthyroid Sick Syndromes:complications, Female, Humans, Inpatients:statistics & numerical data, Male, Middle Aged, Nervo.   

OBJECTIVES: The low triiodothyronine (T3) syndrome indicates poor prognosis for patients with cerebral infarction. It is unknown, however, whether basic conditions or severities in the patients with the low T3 syndrome are different compared to those without the low T3 syndrome.

METHODS: We compared the risk factors and the severity of the disease using the National Institutes of Health stroke scale (NIHSS) score at the worst condition for cerebral infarction in patients with or without the low T3 syndrome in order to better understand the characteristics underlying the worse prognosis in patients with the low T3 syndrome.

RESULTS: We found that cerebral infarction patients with the low T3 syndrome were significantly older (p<0.001) and significantly more likely to be female (p=0.002) and had hypertension (p=0.04) or homocystinemia (p=0.001), but less likely to smoke (p=0.008), compared to patients without the low T3 syndrome. The proportion of NIHSS score ≥8 in the patients with LAA-ICA-associated cerebral infarction accompanied by the low T3 syndrome was significantly higher than in those without the low T3 syndrome (p=0.001).

CONCLUSION: We concluded that increased numbers of risk factors for cerebral infarction and more severe neurological deficits may be important causes for worse prognosis in the patients with the low T3 syndrome which may more likely occur in patients with LAA-ICA cerebral infarction. Intense secondary prevention in cerebral infarction especially in older women are needed....

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Case Reports 2014; 35(2): 137-141 PubMed PMID: 24878975 Citation  Keywords:  Central Nervous System:physiopathology, Child, Glycogen Storage Disease:complications, Humans, Intellectual Disability:complications, Male, Microcephaly:complications, Mutation, Missense, Phenotype, Phosphoglucomutase:genetics,.   

OBJECTIVES: A 10-year-old boy presented with cleft palate, hepatopathy, cholecystolithiasis, myopathy, coagulopathy, hyperlipidemia, hypoglycemia, hyperuricemia, short stature, obesity, hypothyroidism, microcephaly and mild intellectual disability. The multi-systemic manifestation involving certain distinct clinical features prompted us to search for a subtype of congenital disorders of glycosylation (CDG).

METHODS: The patient was screened for CDG by examining the distribution of transferrin (TRF) and apolipoprotein C-III (ApoC-III) sialylated isoforms using isoelectric focusing of serum. This was followed by spectrophotometric measurement of phosphoglucomutase 1 (PGM1) activity in fibroblasts and molecular analysis including sequencing and PCR-RFLP of PGM1 gene. Selected bioinformatics tools were used to evaluate the data.

RESULTS: Increased relative levels of di-, mono- and asialotransferrin reflected a defect of N-glycosylation in the patient. Markedly decreased activity of PGM1 corresponding to less than 5% of control´s was found. Sequencing of PGM1 gene revealed the presence of two heterozygous missense mutations c.1010C>T (p.T337M) and c.1508G>A (p.R503Q), whose pathogenicity was confirmed by in silico analysis.

CONCLUSION: We report the first Czech patient with a glycosylation disorder due to PGM1 deficiency. Compared to the described cases, no dilated cardiomyopathy was noted in our patient. However, he suffered from a mild neurological impairment, which is an uncommon feature that extends the phenotype associated with PGM1-CDG. Lactose-rich diet, which was previously reported to have ameliorated the clinical symptoms in some PGM1-CDG patients, did not result in any improvement in our patient....

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Journal Article 2014; 35(2): 110-115 PubMed PMID: 24878974 Citation  Keywords:  AIDS-Related Opportunistic Infections:immunology, Amino Acid Sequence, Antigens, Bacterial:chemistry, Blotting, Western, Cambodia, Child, Cohort Studies, HIV Antigens:chemistry, HIV Infections:complications, HIV-1:immunology, Humans, Intestines:immunology.   

OBJECTIVES: Human immunodeficiency virus type 1 is widely accepted as the cause of AIDS (Acquires Immunodeficiency Syndrome) but it is necessary to consider other factors, not only HIV, which may be involved in AIDS process. It is apparent that a viral reservoir persists in virtually all infected individuals receiving HAART. Reservoirs were detected in macrophages and other cells of the blood system, in which even very effective HAART was not able to eliminate the virus. Over the last period of time AIDS research has been focused on the gut and other mucosal tissue as the major site of HIV infection and CD4+ T cells loss. Intestinal bacteria and cells associated with GIT are in close vicinity and so has been raised the idea that bacteria may be involved in AIDS pathogenesis. Matherial/Methods: Bacteria and yeast isolated from a cohort of 67 Cambodian and Kenyan HIV positive children and from a cohort of 62 Slovak and American AIDS patients were analyzed for detection of expression of HIV-1 antigens p17, p24, p55, gp41 and gp120 (Abcam, UK).

RESULTS: By monoclonal antibodies against HIV-1 proteins p17 and p55 was detected protein with molecular weight of 45-55 kDa. In samples of Cambodian and Kenyan HIV positive children was found 35 kDa protein using MAb against HIV-specific protein p17. By using MAbs against p24 was found protein of 55-60 kDa in Cambodian and Kenyan samples but, suprisingly, no proteins were detected in bacterial extracts of American and Slovak AIDS patients by this MAbs. Using monoclonal antibodies against HIV-1 specific protein gp41 was positive signal identified in 30-35% of samples from both cohorts of patients from Kenya and Cambodia and in 75% of samples from American and Slovak patients. The protein of about 75-85 kDa was detected by MAbs against gp120 only in protein extracts obtained from yeasts Candida sp. of Cambodian and Kenyan HIV positive children.

CONCLUSION: The molecular weight of 55 kDa protein was detected by MAbs anti HIV p24, p17+p55. Its molecular weight is comparable to gag-encoded Pr55Gag precursor. Surprisingly, such proteins were not found in bacterial extract from samples of American and Slovak patients by using the MAbs against HIV-specific protein p24. The protein of about 75-85 kDa was detected only in Candida species protein extracts of Cambodian and Kenyan HIV positive children by the MAbs against gp120. In Slovak and American samples, protein reacting with MAbs anti gp120 was not found. These results suggest that there are specific differences between Slovak and American HIV positive patients bacterial proteins on one side and Cambodian and Kenyan on the other. These differences may suggest a diverse bacterial evolution in various geographical areas....

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Journal Article 2014; 35(2): 159-169 PubMed PMID: 24878973 Citation  Keywords:  Aged, Cytokines:blood, Diabetes Mellitus, Type 2:blood, Female, Hemoglobin A, Glycosylated:analysis, Humans, Interleukin-12:blood, Interleukin-6:blood, Male, Mental Disorders:blood, Middle Aged, Psychometrics, Surveys and Questionnaires, Tumor Necrosis Fa.   

OBJECTIVES: The aim of this study was to investigate the association of IL-6, IL-12, and TNF-α with trait and state psychological factors in type 2 diabetic patients.

DESIGN: Patients were divided in two groups. Group A consisted of 86 controlled diabetic patients (HbA1c<7) and the Group B consisted of 45 uncontrolled diabetic patients (HbA1c ≥ 7).

SETTINGS: During the initial phase of the study (T0), blood samples were taken for measuring IL-6, IL-12 and TNF-α serum levels as well as a battery of psychometric instruments. One year later (T1), the uncontrolled diabetic patients were re-evaluated with the use of the same psychometric instruments and with the identical blood analysis.

RESULTS: The average values of tnf-α were significantly different among controlled (7.73 ± 5.51) and uncontrolled patients (9.29 ± 4.52) at a significance level of 5% (p=0.009). Controlled diabetic patients show a statistically significant relationship between IL-6 and neuroticism (rp=0.303, p=0.010), and between IL-12 and psychotism, (rsp=0.382, p=0.001). Controlled diabetic patients show a statistically significant relationship between IL-12 and the act out hostility (rsp=-0.307, p=0.009). The scores of the psychometric tests differ significantly between the first and second evaluation. Acting out hostility and the direction of hostility increased when HbA1c values fell below the threshold of 7, while the total hostility index, as well as all other scales, dropped when patients controlled their metabolic profile.

CONCLUSIONS: The present results provide evidence that IL-6, IL-12 and TNF-α are closely related to the course and treatment of type 2 diabetes....

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Journal Article 2014; 35(1): 58-63 PubMed PMID: 24625912 Citation  Keywords:  Adult, Anxiety:etiology, Biomarkers:blood, Blood-Brain Barrier:metabolism, Cell Membrane Permeability:physiology, Depression:etiology, Humans, Hydrocortisone:blood, Inflammation:etiology, Interleukin-6:blood, Male, Military Personnel, Rest:physiology, S10.   

BACKGROUND: Experimental data suggest stress-related cognitive dysfunction may be associated with increased blood-brain-barrier (BBB) permeability secondary to immune activation.

METHODS: We investigated the relationship between prolonged and intense physical and psychological combat-training stress, immune activation and blood-brain-barrier permeability in 37 healthy male army medical rapid response troops.

RESULTS: Soldiers during intense combat training showed greater self-reported stress, anxiety and depression levels than at rest, as assessed by specific questionnaires. S100B, a marker of BBB permeability, as well as serum cortisol, IL-6 and TNF-α concentrations, were significantly increased in soldiers during combat training compared to rest (all p<0.05). Serum S100B correlated negatively with morning serum cortisol in soldiers during combat training, but not during the rest period (r=-0.387, p<0.05).

CONCLUSION: We conclude that combat training inducing significant levels of stress, depression and anxiety is accompanied by evidence of increased blood-brain barrier permeability and by increases in systemic pro-inflammatory mediators....

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