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Journal Article 2014; 35(1): 1-6 PubMed PMID: 24625909 Citation  Keywords:  Attention Deficit Disorder with Hyperactivity:complications, Central Nervous System Stimulants:adverse effects, Child, Child Development:drug effects, Growth:drug effects, Humans,.   

: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed childhood psychiatric disorders. It is manifested in every part of an affected child's behavior, with multiple symptomatology and heterogenous etiology. Published studies report that ADHD children may show changes in growth and development. Most of the studies on ADHD have been focused on connections between medication and growth changes and describe growth delays associated with medication. However, recent research results point to the low significance of the changes accompanying pharmacological treatment. Changes in growth may not only be a secondary effect of the treatment, but may also be specific characteristics of ADHD....

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Case Reports 2013; 34(8): 763-766 PubMed PMID: 24522023 Citation  Keywords:  Adult, Central Nervous System Depressants:administration & dosage, Female, Fertility:drug effects, Humans, Male, Melatonin:administration & dosage, Pineal Gland:surgery, Pregnancy, Semen:drug effects, Sleep Disorders, Circadian Rhythm:drug therapy,.   

OBJECTIVES: Little is known about the effect of chronic melatonin treatment on human reproductive function. We report here on the effect of 10 months treatment with a controlled-release melatonin preparation (Circadin®, 2 mg) on spermatogenesis and gonadotropic hormone status in a pinealectomised patient whose melatonin secretion was abolished.

METHODS: Semen analysis, hormone (Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), inhibin B, prolactin, testosterone and estradiol) and Sex Hormone-Binding Globulin (SHB G) concentrations were determined before and at the end of 4 and 10 months of, treatment.

RESULTS: At the end of treatment, testosterone, sex hormone-binding globulin, prolactin and inhibin B levels did not display significant variation with time, whereas FSH and LH levels showed a tendency to a decrease, but remained in the normal range. Sperm concentration and total spermatozoa count dropped below the lower limit of the reference range during melatonin treatment, whereas motility and normal form percentages remained in the normal range. Fertility was preserved, since the patient's wife became pregnant during month 10 of melatonin treatment and gave birth to a healthy female baby.

CONCLUSIONS: this isolated clinical observation shows that more investigations in large patient series are needed to document possible side-effects of melatonin administration on male reproductive function. One should therefore be cautious about melatonin prescription for circadian rhythm sleep disorders in young males....

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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(Suppl 2): 25-30 PubMed PMID: 24362089 Citation  Keywords:  Adolescent, Adult, Central Nervous System Agents:poisoning, Czech Republic:epidemiology, Databases, Factual, Drug Overdose:epidemiology, Drug-Related Side Effects and Adverse Reactions:diagnosis, Female, Humans, Information Centers:statistics & numerical .   

OBJECTIVES: To analyze the number and trends in calls to the Toxicological Information Center (TIC) concerning pharmaceutical poisoning retrospectively during the past 15 years and to compare selected characteristics of the poisonings.

DESIGN: Inquiries arising from drug poisonings in the years 1997-2012 were extracted and evaluated from the Czech database recording the consultations of TIC specialists. In addition, their cause, severity and dose evaluation (data electronically collected after 2005) were compared in the years 2005-2012 using standard statistical methods.

RESULTS: During 15 years total 152,649 calls due to all types of potentially toxic agents were recorded in the TIC database. Central nervous system (CNS) affecting drugs represented 39.8% of calls due to all pharmaceutical poisonings. The proportion of adults was 72.2% and women comprised 64.4% of all patients. Whereas the number of calls caused by poisoning with tricyclic antidepressants (TCAs) and barbiturates decreased (by 366.7% and 340%, respectively), the calls due to selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines overdose increased (by 1347.4% and 359.8%). The dose of CNS affecting drugs in 2005-2012 was considered lethal in 14.6% of the inquiries due to barbiturates and 8.6% due to TCAs, but only in 1.6% calls due to SSRIs and 0.5% of benzodiazepines. The highest percentage of medications errors was found during the treatment with barbiturates (16.4%).

CONCLUSIONS: The current drugs prescription with improved safety profiles brings the beneficial effect of lowering the severity of poisonings and better prognosis of intoxications as observed in the TIC statistics....

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Journal Article 2013; 34(5): 383-387 PubMed PMID: 23922048 Citation  Keywords:  Animals, Autonomic Nervous System:drug effects, Cholinesterase Inhibitors:pharmacology, Heart Rate:drug effects, Indans:pharmacology, Male, Piperidines:pharmacology, Rats, Rats, Wistar,.   

OBJECTIVE: Donepezil, a cholinesterase inhibitor (ChEI) that is widely used to treat Alzheimer's disease, is thought to act by increasing extracellular acethylcholine (ACh) in the central nervous system. The effects of the administration of ChEIs on the autonomic nervous system, however, are complex and controversial.

METHODS: In this study we observed the effects of donepezil at a dose of 3 mg/kg intraperitoneally (i.p.) on the autonomic nervous system for two weeks using heart rate variability (HRV). In HRV, the high frequency (HF) band is influenced by cardiac parasympathetic tone, and the low frequency (LF) band is influenced by both sympathetic and parasympathetic activity. The ratio of LF and HF (LF/HF) is used for the assessment of the sympathetic nervous system.

RESULTS: In the current study the LF/HF was found to be significantly increased by day 1, but the magnitude of the response gradually decreased. The absolute power of HF increased after an i.p of donepezil of 3 mg daily in groups treated for 1 week and for 2 weeks compared to the single-dose groups.

CONCLUSION: Our results suggested that ChEI administration induced sympathetic nervous activation acutely, but chronic administration induced parasympathetic activation....

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Case Reports 2012; 33(8): 757-760 PubMed PMID: 23391976 Citation  Keywords:  Adult, Anorexia Nervosa:complications, Avitaminosis:complications, Chronic Disease, Female, Humans, Hyperthyroidism:complications, Microscopy, Electron, Motor Neurons:physiology, Polyneuropathies:etiology, Sensory Receptor Cells:physiology, Severity of Il.   

OBJECTIVES: Hyperthyroidism is often associated with various neuromuscular disorders, most commonly proximal myopathy. Peripheral nerve involvement in hyperthyroidism is very uncommon and has rarely been reported. We describe a 29-year-old woman with untreated hyperthyroidism who presented with chronic severe axonal sensory-motor polyneuropathy. Peripheral nerve involvement developed together with other symptoms of hyperthyroidism 2 years before presentation. She also had anorexia nervosa for the past 6 months, resulting in multivitamin deficiency.

RESULTS: Electrophysiological and pathological findings as well as clinical manifestations confirmed the diagnosis of severe axonal polyneuropathy. Anorexia nervosa has been considered a manifestation of untreated hyperthyroidism. We considered hyperthyroidism to be an important causal factor in the polyneuropathy in our patient, although peripheral nerve involvement in hyperthyroidism is rare. To our knowledge, this is the first documented case of chronic severe axonal polyneuropathy ascribed to both hyperthyroidism and multivitamin deficiency.

CONCLUSION: Our findings strongly suggest that not only multivitamin deficiency, but also hyperthyroidism can cause axonal polyneuropathy, thus expanding the clinical spectrum of hyperthyroidism....

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Case Reports 2012; 33(5): 477-482 PubMed PMID: 23090263 Citation  Keywords:  Adult, Anorexia Nervosa:diagnosis, Anthropometry, Body Mass Index, Body Weight, Case-Control Studies, Female, Humans, Obsessive-Compulsive Disorder:diagnosis, Outpatients:psychology, Pilot Projects, Thinness:diagnosis, Young Adult,.   

OBJECTIVE: Weight preoccupations have been frequently reported in normal-weight subjects. Subthreshold anorexia nervosa (s-AN, all DSM IV TR criteria except amenorrhea or underweight) is a form of eating disorder not otherwise specified that has received scarce scientific attention. Under a case-control design we compared the general characteristics, body composition, and psychopathological features of normal-weight patients with s-AN with those of BMI- and sex-matched controls.

DESIGN: Participants in this pilot study included 9 normal-weight women who met the DSM IV TR criteria for s-AN and 18 BMI-matched normal-weight controls. The general characteristics of the study participants were collected by questionnaire. Body composition was measured by bioelectrical impedance. Behavioral and psychological measures included the standardized symptom checklist (SCL-90-R) and the eating disorder inventory (EDI-2).

RESULTS: There were no differences in age, education, employment status, marital status, and history of previous slimming treatment in the two study groups. In addition, anthropometric measures and body composition of s-AN patients and BMI-matched normal weight controls were not significantly different. In the s-AN subgroup, we found a significant relationship between waist circumference and the SCL-90-R obsessivity-compulsivity scale (n=9, r=-0.69, p<0.05). After multiple regression analysis, the SCL-90-R obsessivity-compulsivity scale (beta = 0.61, t=2.7, p=0.017) was the only independent predictor of the presence s-AN in our study cohort.

CONCLUSIONS: These pilot results suggest that psychopathological criteria (particularly related to the obsessivity-compulsivity dimension) may be more useful than anthropometric measures for screening of s-AN in normal-weight women....

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Journal Article 2012; 33(4): 401-405 PubMed PMID: 22936264 Citation  Keywords:  Adult, Anorexia Nervosa:blood, Case-Control Studies, Dehydroepiandrosterone:blood, Dehydroepiandrosterone Sulfate:blood, Female, Hot Temperature, Humans, Hydrocortisone:blood, Matched-Pair Analysis, Nociception:physiology, Pain Threshold:physiology, Refer.   

OBJECTIVES: Anorexia nervosa (AN) patients represent a natural model of relationship between changed hormonal level and pain perception due to lower level of sex hormones and consistently described increased pain threshold. As the adrenal stress steroid hormones (cortisol and DHEA) are known to be also changed in AN (and share a common precursor), our study was aimed to analyze the association between these hormones and pain perception in AN patients and control healthy women.

METHODS: The pain threshold latencies to radiant heat stimuli were measured in 20 DSM-IV diagnosed patients with AN and in 21 healthy women. Blood samples were collected in the morning hours and analyses of the plasma levels of dehydroepiandrosterone (DHEA), its conjugated sulfate ester (DHEA-S) and cortisol were implemented.

RESULTS: Thermal pain threshold was higher in AN than in healthy women and correlated negatively with the level of DHEA and positively with cortisol/DHEA(S) ratio. No significant correlation between thermal pain and hormones was found in healthy women. If both groups were pooled together, the rest pain threshold correlated negatively with DHEA-S (r=-0.42, p=0.008).

CONCLUSION: We showed for the first time that sensitivity to thermal pain in women is dependent on DHEA-S and on cortisol/DHEA(S) ratio in patients with AN....

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