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Journal Article 2011; 32(5): 631-633 PubMed PMID: 22167153 Citation  Keywords:  Child, Child Abuse:prevention & control, Child Psychiatry:standards, Humans, Intellectual Disability, International Cooperation, Patient Advocacy:standards, Patient Rights:standards, Slovakia,.   

: In Slovakia, Legislation regulates the rights of individuals with mental disorders. Observance of these regulations is monitored by a designated Ombudsman or Public Defender of Rights which was created with the adoption of the Constitutional Act No. 90/2001. The Public Defender of Rights pays special attention toward the young generation including mentally handicapped children which since 2002 serves as the basis for collaboration with Child Ombudsmen who also act in prevention of Child Abuse and Neglect Syndrome (CAN). Problematic children receive little attention not only in Slovakia. Such children can be found in many other countries and this is where the Child Ombudsman could act with beneficial effect. Since December 2008, Slovak school children have selected from their ranks a "Child Ombudsman" who is willing to defend the rights of every classmate, including those with mental problems. The Child Ombudsmen become assistants in Pedopsychiatry. An international network of Child Ombudspersons aimed at preventing development of mental and physical damage has been developed. Functioning in 22 European countries within The European Network of Ombudspersons for Children was implemented on a greater scale in April 2010. The Child Ombudspersons should be included in all public healthcare system....

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Case Reports 2011; 32(1): 1-3 PubMed PMID: 21407153 Citation  Keywords:  Abdominal Abscess:epidemiology, Antiviral Agents:administration & dosage, Drug Therapy, Combination, Female, Hepatitis C, Chronic:drug therapy, Humans, Interferon-alpha:administration & dosage, Middle Aged, Oophoritis:epidemiology, Polyethylene Glycols:ad.   

BACKGROUND: Serious infections are rare complications of standard treatment in chronic hepatitis C with pegylated interferon alpha (Peg IFN) and ribavirin.

CASE: We report two cases of life-threatening tubo-ovarian abscess (TOA) in women older than 40 year of age. No casual risk factors of TOA could be identified in them. In one case septic shock and acute renal failure occured. TOA was caused by endogenic bacteria (Porphyromonas asaccharolytica in the first case and Streptococcus intermedius in the latter). Surgical treatment and interruption of IFN therapy was necessary in both cases.

CONCLUSIONS: Serious gynecological infections may have the significant negative influence on chronic hepatitis C therapy outcome. Because of the risk of TOA developing during IFN therapy gynecological care is needed in chronic hepatitis C management....

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Comparative Study 2010; 31(6): 731-737 PubMed PMID: 21196930 Citation  Keywords:  Adult, Depression:physiopathology, Electroencephalography, Evoked Potentials, Eye Movements, Female, Humans, Male, Neuropsychological Tests, Nystagmus, Optokinetic, Oculomotor Muscles:physiopathology, Outpatients:psychology, Panic Disorder:physiopathology.   

OBJECTIVES: Abnormalities and disturbances of saccadic and pursuit eye movements were studied in several mental disorders and diseases. Certain irregularities in the particular oculomotor behaviour have been proposed they may correspond with specific type of mental disorder. It was our aim to contribute to this question by analyzing the bioelectrical correlates of the visual-oculomotor integration in patients suffering from panic disorder and from depressive symptoms.

METHODS: The horizontal saccadic eye movements, optokinetic nystagmus, saccadic eye movement evoked potentials as well as saccadic eye movement related potentials we recorded in the groups of outpatients suffering from depressive symptoms and panic disorder respectively. Groups of healthy volunteers served as control.

RESULTS: Saccadic eye movements were found to be significantly more inaccurate as compared to healthy subjects. The gain of the optokinetic nystagmus at middle and high velocities was significantly lower in panic patients. Preparation of motor plan for a saccade as well as the time of the maximal recruitment of the oculomotor muscle units was delayed in both groups of patients and their oculomotor event-related potentials were of the overall longer duration and higher variability as well.

CONCLUSION: The changes in oculomotor behavior as well as in its EEG correlates in the groups of above mentioned patients can not be taken as specific for the given disorder. On the other hand, they may help to follow up the course of the complex therapy....

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Journal Article 2010; 31(6): 754-760 PubMed PMID: 21196922 Citation  Keywords:  Adolescent, Adult, Analysis of Variance, Antidepressive Agents:therapeutic use, Body Mass Index, Body Weight:drug effects, Combined Modality Therapy, Feeding and Eating Disorders:diagnosis, Female, Humans, Inpatients, Male, Personality Inventory, Precisio.   

OBJECTIVE: The goal of this study is to determine how a comprehensive approach comprising a combination of a particular psychotherapeutic programme and antidepressant treatment influences the signs and symptoms of eating disorders.

METHODS: Inpatients entering a particular 6-week programme were assessed using body mass index (BMI), Eating Disorder Inventory (EDI), Eating Attitudes Test (EAT-26) and psychological symptoms using Symptom Checklist (SCL-90).

RESULTS: In the whole group (n=84) the mean BMI remained stable (17.9, 17.8). There was a significant effect of TIME in the repeated measures ANOVA with most of dependent variables. The "TREATMENT" had no effect (antidepressants, no antidepressants) and there was no significant interaction between "TREATMENT" and "TIME". Post-hoc analysis revealed significant differences between baseline and end-point values of all but two EDI, all EAT items and some SCL dimensions in the antidepressant-treated group.

CONCLUSIONS: The comprehensive and individualized approach is able to achieve weight stabilization, and improvement in attitudes, pathological eating behaviour and psychopathology....

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Journal Article 2010; 31(6): 775-781 PubMed PMID: 21196911 Citation  Keywords:  Adult, Aged, Depression:psychology, Female, Health Knowledge, Attitudes, Practice, Humans, Hyperthyroidism:psychology, Informed Consent:statistics & numerical data, Iodine Radioisotopes:therapeutic use, Male, Middle Aged, Patients:psychology, Poland, Surv.   

OBJECTIVES: Many patients with a chronic disease are dissatisfied with the information they are given. A brief questionnaire completed by patients would assist health professionals to identify areas of information needed to be provided, tailored to the patient's mental condition.

AIM: The aim of our study was to assess how often thyroid patients report being adequately informed about iodine treatment in connection with their real need thereof, emotional state and acceptance of the disease.

METHODS: One hundred outpatients who had presented subclinical hyperthyroidism "[19 men (19%), 81 women (81%); mean (SD±) age 53±14,range 18-77 yr ] treated with radioiodine (RAI) responded to an Experimental Questionnaire, 54 of them answered to AIS, HADS-M and Beck Inventory measuring their acceptance of the illness and depressive symptoms, 37 of them answered the Patient Request Form (PRF).

RESULTS: The obtained results indicated that about 50% of patients treated with 131I therapy did not receive suitable information about their treatment. Neither written information prepared by the specialist, nor verbal information given by physicians were adequate for specific problems of study group. The examined patients presented with a comparable intensity of three distinct types of requests: for explanation and reassurance, for emotional support, and for investigation and treatment. The acceptance of their disease was mediocre for most of the study group.

CONCLUSION: We conclude that the reported lack of satisfaction with medical information in study group was associated with depressive symptoms influencing cognitive efficiency, patients' great need of emotional and cognitive support, influencing the acceptance of their disease, and social prejudice to radioiodine (as a method of treatment), worrying them additionally. All thyroid patients even these with subclinical symptoms of hyperthyroidism should be treated with specific attention by physicians, especially during information process....

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Journal Article 2010; 31(4): 538-548 PubMed PMID: 20802458 Citation  Keywords:  Analysis of Variance, Animals, Body Weight, Male, Maze Learning:physiology, Noise, Rats, Rats, Wistar, Reversal Learning:physiology, Spatial Behavior:physiology, Stress, Physiological:physiology, Stress, Psychological:physiopathology,.   

OBJECTIVE: This study investigated the cognitive effect of chronic exposure to environmental noise on RAWM performance of juvenile rats, and the ability of adult rats exposed to a novel acute stress to perform in the RAWM as a function of whether or not they were exposed to environmental noise as juveniles.

METHODS: We examined the consequences of exposure to noise during the juvenile-early periadolescent period on adulthood stress response by assessing cognitive performance in the RAWM. Male rats were exposed to environmental noise during the childhood-prepubescent period (21-35 PND), and their RAWM performance was tested at the end of the exposure to noise, and then again two months later when they had to cope with a new stressful event. RAWM execution included a 3-day training phase and a reversal learning phase on day 4. Escape latency, reference memory errors and working memory errors were compared between experimental and control groups. In addition, body weight gain and serum corticosterone levels were evaluated.

RESULTS: Stressed rats demonstrated spatial impairment, as evidenced by poor execution on day 4. This effect was significantly noticeable in the doubly stressed group. Noise annoyance was evidenced by reduced body weight gain and increased serum corticosterone levels.

CONCLUSIONS: Our results suggest that environmental noise may produce potent stress-like effects in developing subjects that can persist into adulthood, affecting spatial learning abilities. This cognitive impairment may restrict the subject's ability to learn under a new spatial configuration....

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Evaluation Studies 2009; 30(1): 32-38 PubMed PMID: 19300405 Citation  Keywords:  Adolescent, Adult, Anorexia Nervosa:diagnosis, Attitude to Health, Data Interpretation, Statistical, Diagnostic Techniques, Endocrine, Diagnostic Tests, Routine:statistics & numerical data, Female, Humans, Patient Admission, Patient Discharge:statistics &.   

OBJECTIVES: So far, no unequivocal answer has been provided to the question of how to treat girls with anorexia nervosa (AN). The goal of the study was evaluation of treatment results and search for prognostic factors, regarding the outcome of administered therapy in girls with AN.

PATIENTS AND METHODS: The analysis comprised eighty-seven (87) patients with diagnosis of AN. In the course of treatment, the patients received only a balanced and highly energetic diet. The effects of dietetic procedure were evaluated, comparing clinical data and routine laboratory test results (full blood cell count, serum concentrations of sodium, potassium, glucose, cholesterol, triglycerides, total calcium, phosphates, total protein and the urea) at the onset and on the last day of hospitalisation and also an analysis of clinical data in patients with regained menstrual cycles was performed. Also, on admission to hospital, serum concentrations of TSH, FT4, FT3, E2, T and cortisol were measured (the last hormone - three times - at 8:00, 17:00 and 24:00). Moreover, a stimulation test with GnRH was performed to assess LH and FSH release. A comparison was made between the clinical data, the results of routine laboratory tests and hormone concentrations, obtained at the beginning of the therapy in the group of cured girls (the girls with regained menses) and the group, in which the therapy did not bring complete elimination of the disease.

RESULTS: After hospitalisation, 75.9% of the patients with AN continued outpatient treatment. In all the patients, who adhered to proposed therapy, menstruation cycles returned within 1 to 12 months. It was found that in the group with positive treatment outcome, the patients were older, demonstrated higher BMI values at the beginning of the therapy, as well as shorter disease duration than those in the group of patients who refused further treatment. In the group of cured patients, estradiol concentrations were significantly higher and cortisol concentrations (at 17:00 and 24:00) were significantly lower, in comparison to the uncured group.

CONCLUSIONS: The findings suggest that body weight increase by proper diet application is the most important element of therapy in AN. Patient's age, disease duration, the degree of body weight loss and serum concentrations of estradiol and cortisol at 17:00 and 24:00 are the prognostic factors for the outcome of therapy in anorexia nervosa....

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Journal Article 2009; 30(1): 91-98 PubMed PMID: 19300397 Citation  Keywords:  Adult, Case-Control Studies, Endometriosis:blood, Estradiol:blood, Female, HLA Antigens:blood, HLA-G Antigens, Histocompatibility Antigens Class I:blood, Humans, Leiomyoma:blood, Menopause:blood, Menstrual Cycle:blood, Middle Aged, Ovarian Diseases:blood,.   

BACKGROUND: HLA-G is an antigen whose participation in the regulation of the immune system is well documented. The aim of the present study has therefore been to evaluate the sHLA-G blood serum concentrations levels in both women with ovarian endometriosis and women with uterine leiomyomas.

METHODS: In our study, the soluble HLA-G concentration level was evaluated in the blood serum samples obtained from 98 women who underwent laparotomies or laparoscopies due to either ovarian endometriosis or leiomyomatous uterus. The control group consisted of 42 women, including women on whom a diagnostic laparoscopy identified no lesions, and volunteers-healthy women who returned their blood serum samples during menstrual bleeding.

RESULTS: Patients who underwent surgical treatment because of ovarian endometriosis or uterine leiomyoma, as well as patients from the control group, exhibited no sHLA-G blood serum concentration level fluctuations between the proliferative and secretory menstrual cycle phases. The sHLA-G levels were significantly lower in the patients with ovarian endometriosis and in the patients from the control group during the menstrual cycle phase than in those patients with leiomyoma. A similar relation between the sHLA-G levels of the postmenopausal patients suffering from leiomyoma and the control patients was found. In contrast, the postmenopausal women suffering from endometriosis were typified by levels of sHLA-G blood serum concentration comparable to those of the patients with leiomyoma, and the levels were significantly higher than those observed in the blood sera of the postmenopausal patients from the control group.

CONCLUSION: The soluble HLA-G blood serum level would seem to be a useful marker for evaluating the status of the microenvironment, where the tumor-immune cell and ectopic and eutopic endometrial interactions take place....

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