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Case Reports 2008; 29(1): 67-68 PubMed PMID: 18283251 Citation  Keywords:  Brain:blood supply, Creutzfeldt-Jakob Syndrome:diagnostic imaging, Diagnosis, Differential, Female, Fluorodeoxyglucose F18:metabolism, Humans, Middle Aged, Positron-Emission Tomography:methods, Radiopharmaceuticals:metabolism, Regional Blood Flow, Tomogra.   

: Creutzfeldt-Jakob disease (CJD) is a subacute spongiform encephalopathy. This fatal prion disease is characterized by rapidly progressive dementia with a variety of neurological disorders. Diagnostic methods provided by nuclear medicine might be helpful for evaluation of patients with probable CJD as additional diagnostic tools to MRI and cerebro-spinal fluid evaluation. The experience with FDG-PET and brain perfusion SPECT is presented....

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Journal Article 2008; 29(1): 75-79 PubMed PMID: 18283248 Citation  Keywords:  Aged, Aged, 80 and over, Alzheimer Disease:blood, Amyloid beta-Peptides:blood, Biomarkers:blood, Case-Control Studies, Female, Humans, Interleukin-10:blood, Interleukin-6:blood, Middle Aged, Tumor Necrosis Factor-alpha:blood,.   

: Alzheimer's disease (AD) belongs to a group of neurodegenerative disorders. It is characterized by irreversible and progressive memory loss accompanied with decline in other cognitive functions. At a microscopic level, the typical neuropathologic features, senile plaques and neurofibrillary lesions are found. The pathological processes lead to neuronal loss, synaptic dysfunction and inappropriate activity of neurotransmitters. The major constituent of senile plaques is abnormally aggregated beta amyloid protein. Beta amyloid (Abeta) is a short (40-42 amino acid) product of proteolysis of the transmembrane amyloid precursor protein (APP). Extracellular depositions of Abeta 1-42 may initiate a wide range of pathological processes including glia activation, neuroinflammation and neuronal apoptosis. There is convincing evidence that inflammatory response to accumulation of beta amyloid plays a pivotal role in the progression of neuropathological changes found in AD. Current research was directed at assessing beta amyloid, cytokines (IL-6, IL-10 and TNF alpha) plasma levels in women with AD. Hundred and twenty four women, aged between 59 to 86 years, were enrolled in the study. Amongst them 57 were diagnosed with AD (29 subjects in early stage and 28 subjects with moderate to severe stadium of disease) and 67 women without dementia were investigated as a control group. The lowest values of Abeta 1-42 were found in AD subjects in moderate to severe stage of disease as compared with the early stage of AD (p< 0.05) and the control group (p<0.01). Change in IL-6 values was significantly different between groups with the lowest values found in women without dementia. Both subset of AD patients demonstrated statistically enhanced IL-6 levels when compared with the control group (p<0.001, p<0.01 respectively for early and moderate/severe stage of AD). Moreover, our study revealed a trend to increase in TNF alfa and IL-10 values in AD. However, those differences were not statistically significant. In addition, we did not detect any correlations between plasma beta amyloid and investigated cytokines....

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Journal Article 2008; 29(1): 137-140 PubMed PMID: 18283245 Citation  Keywords:  Adult, Blood Glucose:metabolism, Female, Humans, Hypothyroidism:blood, Insulin:blood, Middle Aged, Severity of Illness Index, Thyroid Gland:physiopathology, Thyroidectomy, Thyrotropin:blood, Thyroxine:blood, Triiodothyronine:blood,.   

OBJECTIVES: Among the peripheral effects of thyroid hormone action, their influence on insulin is of great interest and conflicting data on this subject are available. Despite various studies already performed, of concern is whether insulin levels change in line with a deterioration of thyroid function. In this study, we investigated serum serum insulin levels and their correlations with thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) in hypothyroid women.

DESIGN AND METHODS: Study group consisted of 22 women with a history of total thyroidectomy and radioiodine ablation performed for thyroid cancer, without diabetes or glucose intolerance. After six-weeks of thyroxine withdrawal, subjects were admitted to the Department of Endocrinology of the Poznan University of Medical Sciences to perform this study.

RESULTS: Plasma glucose and insulin were respectively: 4.76+/-0.47 mmol/L and 7.19+/-4.22 microU/mL. Serum TSH, FT4 and FT3 were respectively: 91.66+/-58.59 microU/mL, 2.65+/-2.19 pmol/L, and 1.53+/-1.00 pmol/L. Correlations were: r of -0. 4381 and P of 0.0414, r of -0.2368 and P of 0.2887, and r of 0.3954 and P of 0.0686 for insulin and FT4, insulin and FT3, and insulin and TSH, respectively. The only significant correlation was an inverse correlation between insulin and FT4.

CONCLUSIONS: In profound hypothyroidism insulin concentrations correlate with FT4 only, but not with FT3 or TSH....

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Journal Article 2008; 29(1): 178-184 PubMed PMID: 18283239 Citation  Keywords:  Adult, Alkaline Phosphatase:blood, Bone Density:physiology, Bone Diseases, Metabolic:blood, Bone and Bones:metabolism, Case-Control Studies, Female, Humans, Hyperprolactinemia:blood, Middle Aged, Parathyroid Hormone:blood, Peptide Fragments:blood, Prognos.   

OBJECTIVES: Hyperprolactinemia could be one of possible causes of bone loss. The reason is thought to be connected with hypogonadism due to PRL excess and the role of other hormones like PTH and PTH-rP. There is no data on the influence of PTH fractions (CAP and CIP) on bone turnover and density in hyperprolactinemia. The aim of the study was to assess the influence of PTH and its fractions on bone metabolism in hyperprolactinemia of various origin.

MATERIAL AND METHODS: The study was carried out in 75 women. Group I consisted of 32 women with prolactinoma, group II consisted of 43 women with functional hyperprolactinemia. Both groups were subdivided in patients with hypogonadism and normal gonadal function. The control group consisted of 29 healthy women. In all subjects PRL, PTH and its fractions (CAP, CIP), and bone turnover markers (BAP, ICTP) were studied. BMD measurement was carried out using DXA.

RESULTS: In patients with functional hyperprolactinemia i-PTH and CAP levels were lower than in controls. CIP concentrations were lower in patients than in controls. CAP/CIP ratio was higher in patients with prolactinoma than in patients with functional hyperprolactinemia and controls. Higher values of bone turnover markers (BAP, ICTP) in patients groups and subgroups were shown as compared to controls. Some correlations between PTH and its fractions, and BMD and bone turnover were observed.

CONCLUSIONS: There is no direct benefit from the assessment of parathormone fractions and CAP/CIP ratio in the prognosis of bone metabolism changes in hyperprolactinemia of various origin....

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Comparative Study 2007; 28(6): 801-806 PubMed PMID: 18063945 Citation  Keywords:  Adult, Age Factors, Aging:physiology, Anthropometry, Biomarkers, Blood Pressure:physiology, Body Mass Index, Humans, Male, Middle Aged, Paraplegia:physiopathology, Reference Values, Vision Tests, Vision, Ocular:physiology, Vital Capacity:physiology,.   

: The actual level of the true aging of an organism is characterized by its biological age. By the means of measuring the function ability of its physiological systems, it is possible to evaluate the biological age and use it as an indicator of premature aging. Inclusion of the biological age screening among the basic health precautions should offer yet another viewpoint on how to objectively measure the changes in an organism corresponding to aging. The article presents a comparison of age dependency of selected biomarkers between groups of healthy men and paraplegics. The measurement of the battery of biomarkers was run in a group of 25 healthy male adults between 36 and 54 years of age. The second group was formed by 20 paraplegics - men between 33 and 50 years of age. In spite of small size of the groups, significant differences were found in 4 of 6 biomarkers....

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Comparative Study 2007; 28(6): 889-894 PubMed PMID: 18063943 Citation  Keywords:  Adult, Antidepressive Agents, Second-Generation:therapeutic use, Cyclohexanols:therapeutic use, Depressive Disorder:psychology, Electroconvulsive Therapy:psychology, Female, Humans, Male, Middle Aged, Patient Satisfaction, Psychiatric Status Rating Scales.   

BACKGROUND: The aim of our study was to evaluate the efficacy of electroconvulsive (ECT) and venlafaxine therapy from the patient's point of view.

METHODS: We used a retrospective chart review from 22 inpatients who underwent ECT and 22 patients treated with venlafaxine due to resistant unipolar or bipolar depression. We used bilateral ECT in a median of 8 (IQR 7-9.7) sessions and venlafaxine therapy with a median daily dosage of 225 mg (IQR 150-225 mg) for a median of 4 (IQR 4-5) weeks. The main outcome was change in a self-evaluation scale - Short Form of the Beck Depression Inventory (BDI-SF). The response was defined as the decreasing of the BDI-SF score by >or=50%, remission as decreasing of BDI-SF score
RESULTS: We did not find significant differences between sex, age and BDI-SF before therapy in both groups. The reduction of BDI-SF score was significantly higher in the ECT group than in venlafaxine group (p=0.025). Significantly more patients treated with ECT reached response than patients treated with venlafaxine (68% vs. 23%; <0.01). The remission rate after ECT was not significantly higher than venlafaxine therapy (27% vs. 5%; p=0.094). The number needed to treat (NNT) of ECT for BDI-SF response was 3 (CI95% 1.4 to 5.2) and NNT for BDI-SF remission was 5 (CI95% 2.3 to 45.8).

DISCUSSION: After the median of 3 failed antidepressant trials, ECT was more effective than venlafaxine in the short term therapy in some parametres according to our patients. We suggest that the fact that mental state was evaluated by patients themselves is an important pro-argument in the discussion about ECT....

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Clinical Trial 2007; 28(6): 881-888 PubMed PMID: 18063941 Citation  Keywords:  Adolescent, Adult, Aged, Aged, 80 and over, Antipsychotic Agents:adverse effects, Benzodiazepines:adverse effects, Dibenzothiazepines:adverse effects, Dibenzothiepins:adverse effects, Female, Humans, Hyperprolactinemia:blood, Middle Aged, Prolactin:blood,.   

OBJECTIVES: The main objective was to evaluate the effect of five second-generation antipsychotics (amisulpride, quetiapine, olanzapine, risperidone, and zotepine) on prolactinaemia during 6 week therapy in 433 female in-patients with mainly schizophrenic disorders. Secondary objectives included identification of dynamics of change in serum prolactin levels and correlations of changes of prolactinaemia with some demographic and clinical parameters.

METHODS: The trial was a prospective, open-label, single-center one with a flexible dosing of SGAs. The therapeutic effect of SGAs was assessed by a change of scores of CGI-S and CGI-I scales from a baseline to the endpoint. Blood samples were taken in the morning under fasting condition.

RESULTS: Amisulpride and risperidone increased prolactinaemia significantly in 100% of patients, as early as after week 1 of the therapy. Quetiapine and zotepine relatively reduced prolactinaemia significantly, as early as from week 1 of the quetiapine treatment. Olanzapine led to a transient mild prolactin elevation. The much lower prevalence of hyperprolactinaemia over 2 000 mIU/l differentiates olanzapine from amisulpride and risperidone. Prolactin elevation did not correlate with age, menopausal condition, therapeutic efficacy, antipsychotic daily dose, serum levels of lipids and glucose. There was significant correlation with first vs. subsequent psychotic episodes, weight, EPS and serum levels of thyroid hormones.

CONCLUSION: Amisulpride and risperidone had marked and early prolactin elevating effects, requiring, therefore, more frequent monitoring of prolactinaemia and associated undesirable effects and risks than olanzapine, quetiapine and zotepine....

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Journal Article 2007; 28(6): 861-867 PubMed PMID: 18063934 Citation  Keywords:  Adult, Analysis of Variance, Antibody Formation:immunology, Autoimmunity:immunology, Depression:blood, Depressive Disorder, Major:blood, Fatigue:blood, Fatigue Syndrome, Chronic:blood, Female, Humans, Immunoglobulin M:blood, Male, Middle Aged, Neuropsycho.   

: Major depression and chronic fatigue syndrome (CFS) are accompanied by signs of oxidative and nitrosative stress (O&NS) and an inflammatory response. Phosphatidyl inositol (Pi) is thought to play a role in depression. The aim of the present study is to examine whether depression and CFS are characterized by an IgM-mediated immune response directed against Pi. Toward this end, this study examines the serum IgM antibodies directed against Pi in 14 patients with major depression, 14 patients with CFS, 14 subjects with partial CFS, and in 11 normal controls. We found that the prevalence and mean value for the serum IgM levels directed against Pi were significantly greater in patients with major depression and CFS than in normal controls and patients with partial CFS. There were significant and positive correlations between serum IgM levels directed against Pi and two symptoms of the FibroFatigue Scale, i.e. fatigue and depression. The results show that an IgM-related immune response directed against Pi may occur in both depression and CFS and may play a role in the pathophysiology of the key symptom of CFS and major depression. It is suggested that the above disorders in Pi result from increased O&NS in both depression and CFS. Autoanti-Pi antibodies may have biological effects, for example, by changing inositol 1,4,5-triphosphate (IP3), phosphatidylinositol-4,5-bisphosphate (PIP2), diacylglycerol and phosphatidylinositol-3,4,5-triphosphate (PIP3) production, thus interfering with intracellular signalling processes. Future research in major depression and CFS should focus on the functional consequences of the immune responses directed against Pi....

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