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Journal Article 2009; 30(3): 396-399 PubMed PMID: 19855366 Citation  Keywords:  Adult, Antipsychotic Agents:administration & dosage, Cerebral Cortex:drug effects, Diagnostic and Statistical Manual of Mental Disorders, Electromyography, Evoked Potentials, Motor:drug effects, Humans, Isoxazoles:administration & dosage, Male, Neural Inh.   

: Transcranial magnetic stimulation is a neurophysiological method which enables direct quantitative in vivo assessment of cortical excitability and inhibition. The aim of the study was to assess the impact of paliperidone on the motor threshold and cortical silent period, in a drug-naive patient, with first episode schizophrenia using this technique. Paliperidone monotherapy caused a significant reduction of severity of schizophrenic symptomatology in the patient. At the same time, a significant prolongation of the cortical silent period, from 118.68 ms before to 185.13 ms after therapy, occurred. Because the cortical silent period is a function of GABA(B) receptors, we can assume that paliperidone may have the ability to enhance GABA(B) receptor-mediated neurotransmission....

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Journal Article 2009; 30(3): 382-386 PubMed PMID: 19855364 Citation  Keywords:  Acromegaly:blood, Adult, Aged, Aged, 80 and over, Biopsy, Fine-Needle, Chi-Square Distribution, Diagnosis, Differential, Female, Goiter, Nodular:blood, Human Growth Hormone:blood, Humans, Incidence, Insulin-Like Growth Factor I:metabolism, Male, Middle Ag.   

OBJECTIVE: The high prevalence of goiter in acromegalic patients is well known. Several studies revealed increased frequency of thyroid carcinoma in these patients. The aim of the study was to evaluate the incidence of thyroid lesions, including thyroid cancer in acromegalic patients and to estimate possible factors influencing their occurrence, especially high IGF-1 level.

MATERIALS AND METHODS: 86 consecutive patients with acromegaly were retrospectively analyzed. 45 patients had been previously treated for acromegaly and 41 were newly diagnosed. In all subjects hGH, IGF-1, TSH, FT4 levels were determined. Thyroid gland was evaluated in ultrasound examination. Fine needle aspiration biopsy (FNAB) was performed in every solid or mixed thyroid nodule.

RESULTS: Thyroid morphology abnormalities were found in 75 patients (87.2%). 10 patients (11.6%) had diffuse goiter and 65 patients (75.6%) had nodular goiter. There were 5 cases of thyroid carcinoma (5.8%): 3 papillary carcinomas and two follicular variants of papillary cancer. Out of five cancers three were multifocal, one infiltrated thyroid capsule and one was diagnosed at the stage of metastases to four lymph nodes.

CONCLUSIONS: Our study confirmed common co-existence of acromegaly and thyroid lesions. Furthermore, it revealed considerably high occurrence of thyroid carcinoma in these patients. In view of this correlation, the potential role of IGF-1 in pathogenesis of benign and malignant thyroid neoplasms should be considered. Due to high frequency of thyroid cancer in acromegalic patients, we suggest to perform fine needle aspiration biopsy in each case of thyroid nodule....

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Journal Article 2009; 30(3): 363-367 PubMed PMID: 19855360 Citation  Keywords:  Aged, Cardiopulmonary Resuscitation:adverse effects, Critical Care, Female, Heart Arrest:mortality, Humans, Hypothermia, Induced, Intensive Care Units, Male, Middle Aged, Quality of Life, Retrospective Studies, Survival Rate, Treatment Outcome,.   

OBJECTIVES: Sudden circulatory arrest is most often of cardiac origin. Our aim was to evaluate circulatory arrest etiology and treatment strategies in patients after cardiopulmonary resuscitation (CPR) with persistent impairment of consciousness in relation to survival and the subsequent quality of life.

DESIGN: Retrospective analysis of patients after CPR treated according to the local protocol including mild hypothermia in the intensive cardiac care unit.

RESULTS: Over 2 years, we admitted 57 mechanically ventilated patients after CPR. 47 patients (82%) were resuscitated outside the hospital. In 33 patients (58%) the initial rhythm was ventricular fibrillation; in the remaining patients (42%) asystole/pulseless electrical activity. Urgent coronary angiography was performed in 36 patients and percutaneous coronary intervention in 25 of them. The admission APACHE II score was 32,4 +/- 3,4 with predicted mortality of 77,1%. The hospital survival rate was 54% and 47% of the patients were discharged home in a good state of health (Glasgow outcome score 4-5).

CONCLUSION: Our results suggest that comprehensive post-resuscitation care including therapeutic hypothermia and percutaneous coronary intervention in selected cases may have a positive impact on the prognosis of patients after CPR....

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Journal Article 2009; 30(3): 352-356 PubMed PMID: 19855358 Citation  Keywords:  Acetic Acid:toxicity, Analgesia, Analysis of Variance, Animals, Anti-Inflammatory Agents, Non-Steroidal:pharmacology, Celecoxib, Chromatography, High Pressure Liquid, Dose-Response Relationship, Drug, Drug Synergism, Expectorants:administration & dosage, .   

OBJECTIVES: Previously, we found that guaifenesin enhances analgesia induced by paracetamol. The aim of the present study was to determine whether guaifenesin is able to also increase analgesic activity in the non-steroid anti-inflammatory drugs ibuprofen, nimesulide and celecoxib. In addition we investigated the influence of guaifenesin on plasma levels of nimesulide.

METHODS: A model of visceral pain consisting of intraperitoneal injection of acetic acid (writhing test) was used. Levels of nimesulide in plasma were measured by HPLC. All drugs were given orally and tested in mice.

RESULTS: Guaifenesin alone did not produce any antinociceptive effect. Simultaneous administration of guaifenesin (200 mg/kg) and subanalgesic doses of ibuprofen (10 and 30 mg/kg), nimesulide (10 and 20 mg/kg) or celecoxib (1 and 5 mg/kg) resulted in a significant antinociceptive effects. The plasma levels of nimesulide were significantly higher in combination with guaifenesin at 30, 60 and 90 min after oral administration in comparison to nimesulide monotherapy.

CONCLUSION: The present results suggest that guaifenesin might enhance the analgesic activity of various non-steroidal anti-inflammatory drugs....

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Journal Article 2009; 30(3): 343-351 PubMed PMID: 19855357 Citation  Keywords:  Adult, Age of Onset, Analysis of Variance, Body Height:genetics, Body Mass Index, Chi-Square Distribution, Female, Genetic Predisposition to Disease, Genotype, Haplotypes:genetics, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide:genetics, Psych.   

OBJECTIVES: The 102T/C single nucleotide polymorphism (SNP) in the 5-hydroxytryptamine receptor 2A (HTR2A) gene has been reported to be associated with schizophrenia. However, SNPs of the HTR2A gene other than the 102T/C have attracted only limited studies in relation to schizophrenia, and also on the whole SNPs of the HTR2A gene have been little studied in relation to clinical parameters in patients. Therefore, the aim of this study was to evaluate the impact of main functionally characterized SNPs of the HTR2A gene on both the schizophrenia and clinical parameters.

METHODS: Ninety-four patients with schizophrenia and 57 control subjects were genotyped for the -1438A/G, -783A/G, 102T/C and His452Tyr SNPs of the HTR2A gene. The four SNPs were then investigated in relation to the schizophrenia and clinical parameters.

RESULTS: No differences were found in genotype-, allele- or haplotype frequencies between schizophrenia patients and control subjects. However, the 452Tyr variant of the His452Tyr polymorphism occurred more often in patients with a family history of schizophrenia compared with patients without heredity (p=0.028). The 452Tyr variant was also more common in female patients with paranoid schizophrenia than in those with non-paranoid schizophrenia (p=0.018). Moreover, the male patients carrying the A/A or T/T genotypes of the -1438A/G and 102T/C polymorphisms were shorter than those carrying the G/A or C/T genotypes (p=0.007; p=0.006).

CONCLUSION: The present findings bring further support to the view that the -1438A/G, 102T/C and His452Tyr polymorphisms of the HTR2A gene are connected with a constitutive cellular change that causes susceptibility to schizophrenia....

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Journal Article 2009; 30(3): 335-342 PubMed PMID: 19855356 Citation  Keywords:  Analysis of Variance, Animals, Behavior, Animal:drug effects, Bornanes:pharmacology, Dose-Response Relationship, Drug, Grooming:drug effects, Hormone Antagonists:pharmacology, Male, Motor Activity:drug effects, Oxytocics:administration & dosage, Oxytocin:.   

OBJECTIVES: Oxytocin (OXY) in addition to peripheral actions has many central regulatory functions which can be studied on animal models. In the present study we examined in rats, which behavioral actions of OXY and long-acting carba-analog of OXY carbetocin (CBT) in the open-field can be inhibited by OXY-receptor antagonists. Our interest focused on the behavioral patterns considered indicative of anxiety-related behavior. To determine what is the participation of OXY receptor on OXY and CBT induced behavioral changes, we used two peptide and one nonpeptide OXY antagonists differing in selectivity for OXY receptor.

METHODS: OXY, CBT as well as OXY antagonists were injected intraperitoneally, and spontaneous behavior (horizontal and vertical activity, grooming) of Wistar rats was observed in the circular open-field arena 60 min after application of drugs; in some experiments testing was performed without treatment few days after drug administration.

RESULTS: OXY at the dose 0.05 mg/kg increased locomotion indicating anxiety attenuation, but 1.0 mg/kg reduced both locomotion and rearing. CBT in the dose range 0.1-3.0 mg/kg either did not change or increased horizontal activity. The increase in exploration after both peptides persisted for several days. A marked difference in the behavioral effects of the two peptides was grooming enhancement induced by OXY compared with the absence of this effect after CBT. The increase of the activity induced by OXY and CBT indicating anxiolytic-like action was blocked by OXY antagonists. However, the reduction of exploration induced by 1.0 mg dose of OXY was only partially reversed. The OXY induced enhanced grooming was completely antagonized by all used antagonists.

CONCLUSIONS: Behavioral effects of OXY and its antagonists after their i.p. application indicate that they penetrate blood brain barrier. The diversity in potency of OXY antagonists to inhibit grooming and other behaviors induced by OXY suggests that receptors participating in these behaviors may differ in brain localization, receptor conformation and/or in the utilized signaling pathways....

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Clinical Trial 2009; 30(3): 331-334 PubMed PMID: 19855355 Citation  Keywords:  Adult, Choline:immunology, Humans, Immunologic Factors:immunology, Lymphocyte Activation, Middle Aged, Multiple Sclerosis:diagnosis, Myelin Basic Protein:immunology, Peptide Fragments:immunology, Severity of Illness Index, Treatment Outcome,.   

: The efficacy of intravenous choline citrate infusions was investigated in 34 patients with multiple sclerosis (MS) by clinical evaluation and by monitoring of lymphocyte proliferation in vitro against fragments of myelin basic protein (MOG-35-55, MBP15-31, PLP 39-15) over a period of 12 weeks. Patients have been diagnosed with MS at least one year before entering the study and suffered from mild relapsing/remitting course to long-term chronic progressive disease. Twenty one patients exhibited positive lymphocyte proliferation to myelin fragments prior to treatment and were therefore selected for further studies. Choline citrate was administered with a dosage of 1200mg/ 2x week for a period of 3 months. This treatment resulted in a significant decrease of lymphocyte proliferation to neural fragments (MOG- 35-55, MBP15-31) in lymphocyte transformation test (LTT). There was no significant SI change of PLP Peptide (PLP 39-15) LTT found after treatment with choline citrate. During the 3 mo observation period, patients remained stable and no side-effects of the treatment were observed. In addition, some patients reported long-lasting improvement (less paresthesia and increase of muscle strength in lower extremities) which was demonstrated up to 3 years later. In one spectacular case a commercial pilot was able to return to duty again after treatment. This pilot was allowed back in to his position as a commercial flying cockpit member and is on duty for more than 4 yrs now....

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Case Reports 2009; 30(3): 322-326 PubMed PMID: 19855353 Citation  Keywords:  Acromegaly:diagnosis, Congenital Hypothyroidism:diagnosis, Diagnosis, Differential, Humans, Male, Middle Aged, Thyroid Dysgenesis:diagnosis,.   

: Since introduction of population-based neonatal screening for congenital hypothyroidism (CH), cases of long-term untreated inborn hypothyreosis have become very rare whereas its clinical symptoms are currently not well known. We report a patient with CH due to an ectopic thyroid. The presented case is exceptional due to both advanced age of diagnosis and unusual clinical presentation, as the anomaly was detected during evaluation of suspected acromegaly at the age of 62. This report indicates that there is still necessity of considering, in spite of its rarity, congenital form in differential diagnosis of hypothyroidism....

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