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Journal Article 2009; 30(3): 387-395 PubMed PMID: 19855365 Citation  Keywords:  Adiponectin:blood, Adult, Aged, Antidepressive Agents:therapeutic use, Blood Glucose:metabolism, Body Mass Index, Chi-Square Distribution, Citalopram:therapeutic use, Depression:blood, Diagnostic and Statistical Manual of Mental Disorders, Drug Therapy, C.   

BACKGROUND: Depressive disorder (DD) is associated with an increased risk of type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). It was suggested, that metabolic syndrome (MetS), cluster of metabolic and hormonal changes, such as insulin resistence (IR), abdominal obesity, dyslipidemia, arterial hypertension and elevated fasting glycaemia, could stand behind the connection. Recent findings have shown, that adipocytokines leptin and adiponectin might play a role in both depression and MetS.

AIM: The aim of this pilot study was to observe the plasma concentrations of leptin, adiponectin, leptin-to-adiponectin ratio and indices of IR in women with depressive disorder.

MATERIALS AND METHODS: The plasma leptin, adiponectin, parameters of lipid and glucose homeostasis and indices of IR were investigated in a group of 38 women with DD. The results were compared with those of 38 healthy women of the control group, matched for age.

RESULTS: Depressive women differed significantly from the controls in higher concentrations of plasma leptin (p <0.05), insulin (p <0.01), C-peptide (p <0.01), value of HOMA-IR (p <0.01), and the leptin-to-adiponectin ratio (p <0.05).The QUICKI index of insulin sensitivity was lower (p <0.01). HAM-D score of DD cases correlated negatively with adiponectin (r = - 0.3505; p < 0.05), independently of HOMA-IR. We have not found in DD group any differences between the drug free patients and those treated either with escitaloprame alone or in the combination with mirtazapine.

CONCLUSIONS: The results of the pilot study presented support the hypothesis that at least part of DD cases has increased leptin serum levels and certain features of MetS. It could be the factor connecting depression with an increased risk of either DM2 or CVD....

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Journal Article 2009; 30(3): 373-376 PubMed PMID: 19855362 Citation  Keywords:  Animals, Antioxidants:pharmacology, Electron Spin Resonance Spectroscopy, Hydroxyl Radical:metabolism, Laparotomy, Male, Oxidative Stress:drug effects, Pain:etiology, Rats, Rats, Wistar, Singlet Oxygen:metabolism, Tail:drug effects,.   

OBJECTIVES: The aim of the study was to demonstrate that direct measurement of hydroxyl radicals and singlet oxygen in the tail of living rats is possible. The basic level of hydroxyl radicals and singlet oxygen were measured and the effects of antioxidants on their levels were studied in the tail of living anaesthetized rats after acute postoperative pain. Laparotomy was performed as the source of acute abdominal pain. After closure of the abdominal cavity, the animals began to awaken within 30-60 minutes. They were left to recover for 2-3 hours; then they were reanesthetized and the effect of antioxidants was measured on the numbers of hydroxyl radicals and singlet oxygen via blood in the tail.

METHODS: The laparotomy was preformed under general anesthesia (Xylazin and Ketamin) using Wistar rats. After recovery and several hours of consciousness they were reanaesthetized and free radicals and singlet oxygen were measured. An antioxidant mixture (vitamins A, C, D and Selenium) was administered intramuscularly prior to the laparotomy. All measurements were done on the tail of anaesthetized animals. In this particular article, the effect of antioxidants is only reported for hydroxyl radicals.

RESULTS: After laparotomy, which represented both somatic and visceral pain, hydroxyl radicals and singlet oxygen were increased. Antioxidant application prior to laparotomy decreased the numbers of hydroxyl radicals.

CONCLUSION: Results are in agreement with our previous finding regarding the increase in hydroxyl free radicals and singlet oxygen following nociceptive stimulation, in this case a combination of both somatic and visceral pain. The administered antioxidants mitigated the increase. This is further confirmation that direct measurement of free radicals and singlet oxygen represents a very useful method for the biochemical evaluation of pain and nociception....

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Case Reports 2009; 30(3): 312-321 PubMed PMID: 19855352 Citation  Keywords:  Aged, Antineoplastic Agents, Alkylating:therapeutic use, Antineoplastic Combined Chemotherapy Protocols:therapeutic use, Carcinoma:drug therapy, Cyclophosphamide:therapeutic use, Disease Progression, Drug Administration Schedule, Esophageal Neoplasms:drug.   

: The synergetic use of Somatostatin, Melatonin, Retinoids, Vitamins C, D3, and E, Calcium, sulphated Aminoglucosides, and minimum doses of cyclophosphamide in a 70-year old male patient with inoperable scarcely differentiated oesophageal carcinoma, has provided, from the beginning of treatment in 1995 to the present date, an excellent quality of life, as well as a cure with functional recovery. This paper discusses the rationale and molecular action mechanisms of the treatment which has a differentiating, apoptotic anti-proliferation effect, preserving and enhancing, unlike chemo- and/or radiotherapy, both the trophic and functional capacity of organs and tissues, and immunity and antiblastic homeostasis. This result confirms the efficacy of this biological multiple treatment (MDB); it is also in line with the positive results already published on the use of MDB in low-grade NHL (66) and in stage 3 or 4 lung carcinomas (53). The MDB, with no need for hospitalisation, no toxicity and without in the least reducing working activity, gradually and slowly reduced, and then eliminated the tumour formation. According to the author, reporting this case is useful in order to call for greater interest in the possibilities offered to oncology by the MDB biological and receptor treatment....

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Case Reports 2009; 30(3): 300-311 PubMed PMID: 19855351 Citation  Keywords:  Adult, Belgium, Cognitive Therapy, Diagnosis, Differential, Evidence-Based Medicine, Exercise Therapy, Fatigue Syndrome, Chronic:diagnosis, Female, Government, Humans, Inflammation:diagnosis, Outcome Assessment (Health Care),.   

: The World Health Organization acknowledges Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) to be a medical illness. ME/CFS is characterized by disorders in the inflammatory and oxidative and nitrosative stress (IO&NS) pathways. In 2002, the Belgian government started with the development of CFS "Reference Centers", which implement a "psychosocial" model. The medical practices of these CFS Centers are defined by the Superior Health Council, e.g. treatment should be based upon Cognitive Behavioral Therapy (CBT) and Graded Exercise Therapy (GET); and biological assessments and treatments of ME/CFS should not be employed. Recently, the Belgian government has evaluated the outcome of the treatments at the CFS Centers. They concluded that a "rehabilitation therapy" with CBT/GET yielded no significant efficacy in the treatment of ME/CFS and that CBT/GET cannot be considered to be curative therapies. In case reports, we have shown that patients who were "treated" at those CFS centers with CBT/GET in fact suffered from IO&NS disorders, including intracellular inflammation, an increased translocation of gram-negative enterobacteria (leaky gut), autoimmune reactions and damage by O&NS. Considering the fact that these findings are exemplary for ME/CFS patients and that GET may even be harmful, it means that many patients are maltreated by the Belgian CFS Centers. Notwithstanding the above, the government and the CFS Centers not only continue this unethical and immoral policy, but also reinforce their use of CBT/GET in patients with ME/CFS treated at those Centers....

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Journal Article 2009; 30(3): 284-299 PubMed PMID: 19855350 Citation  Keywords:  Cognitive Therapy, Exercise Therapy, Fatigue, Fatigue Syndrome, Chronic:therapy, Humans, Randomized Controlled Trials as Topic, Treatment Outcome,.   

: Benign Myalgic Encephalomyelitis (ME) / Chronic Fatigue Syndrome (CFS) is a debilitating disease which, despite numerous biological abnormalities has remained highly controversial. Notwithstanding the medical pathogenesis of ME/CFS, the (bio)psychosocial model is adopted by many governmental organizations and medical profes-sio-nals to legitimize the combination of Cognitive Behavioral Therapy (CBT) and Graded Exercise Therapy (GET) for ME/CFS. Justified by this model CBT and GET aim at eliminating presumed psychogenic and socially induced maintaining factors and reversing deconditioning, respectively. In this review we invalidate the (bio)psychosocial model for ME/CFS and demonstrate that the success claim for CBT/GET to treat ME/CFS is unjust. CBT/GET is not only hardly more effective than non-interventions or standard medical care, but many patients report that the therapy had affected them adversely, the majority of them even reporting substantial deterioration. Moreover, this review shows that exertion and thus GET most likely have a negative impact on many ME/CFS patients. Exertion induces post-exertional malaise with a decreased physical performan-ce/aerobic capacity, increased muscoskeletal pain, neurocognitive impairment, "fatigue", and weakness, and a long lasting "recovery" time. This can be explained by findings that exertion may amplify pre-existing pa-thophysiological abnormalities underpinning ME/CFS, such as inflammation, immune dysfunction, oxidative and nitrosative stress, channelopathy, defec-tive stress response mechanisms and a hypoactive hypothalamic-pituitary-adrenal axis. We conclude that it is unethical to treat patients with ME/CFS with ineffective, non-evidence-based and potentially harmful "rehabilitation therapies", such as CBT/GET....

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Journal Article 2009; 30(2): 209-214 PubMed PMID: 19675515 Citation  Keywords:  Aged, Aged, 80 and over, Amiodarone:adverse effects, Female, Follow-Up Studies, Goiter:radiotherapy, Humans, Hypothyroidism:chemically induced, Iodine Radioisotopes:adverse effects, Male, Middle Aged, Recurrence, Remission Induction, Thyrotoxicosis:chemic.   

INTRODUCTION: Amiodarone (AM) is frequently used in the therapy of patients with cardiac disorders. However, due to high iodine content, it has side effects on thyroid function. The use of radioiodine therapy (RIT) in amiodarone-induced thyrotoxicosis (AIT) with low radioactive iodine uptake (RAIU) is still controversial. In these patients therapeutic choices for refractory disease include surgery, antithyroid drugs, or glu ocorticosteriods.

AIM: The aim of the study was to evaluate the efficacy of RIT in patients presenting AIT and low RAIU in two-year follow-up.

PATIENTS AND METHODS: 40 patients (25 men and 15 women) aged from 63 to 83 years (x +/- SD: 66.2 +/- 5.0 years; median: 65 years) treated with RIT were included into the study. In these patients AM therapy was essential for the underlying heart disorder, while surgery, antithyroid drugs or glucocorticosteroids, were contraindicated. Forty seven patients with toxic multinodular goiter (TMNG) (39 women and 8 men), matched for age (67 +/- 12 yr; range 54-89 yr), were enrolled into the study as a comparative group. The diagnostic procedures included baseline thyroid function tests (thyrothropin - TSH, free triiodothyronine - fT3 and free thyroxine - fT4 levels), thyroid autoantibodies measurement (antithyroglobulin autoantibodies - TgAb, antithyroid peroxidase autoantibodies - TPOAb, anti-TSH receptor autoantibodies - TRAb), thyroid ultrasonography, thyroid scintiscan and RAIU assessment.

RESULTS: Serum values of TSH, TgAb, TPOAb and TRAb were undetectable in both groups. In patients with AIT fT4 level was 18.7 to 38.7 pmol/l (mean: 27.1 +/- 5.8) and fT3 concentration was 3.9 to 5.6 pmo/l (mean: 5.7 +/- 1.4), while in TMNG patients level of fT4 was 31.5 to 22.2 pmol/l (mean: 25,3 +/- 5,8) and fT3 concentration was 3.8 to 4,2 pmo/l (mean: 4,2 +/- 0,2). Mean RAIU values after 5h and 24h in AIT patients were 2.3 +/- 0.5 and 3.1 +/- 0.9%, while in TMNG patients were 18,0 +/- 3,8 and 35,7 +/- 9,1%, respectively. A significant difference (p<0.001) between 5h and 24h RAIU in AIT compared to TMNG was noted. In all patients with AIT, a dose of 800 MBq of 131I was administered. During two-year-observation recurrence of hyperthyroidism was observed in two patients (5%) with TMNG. These patients received a second radioiodine dose 16.2 +/- 15 months later (the mean re-treatment dose was 735.93 +/- 196.1 MBq). In comparison, none of the patients with AIT required a second 131I dose and only one patient (2.5%) 6 months after ablative 131I dose needed anti-thyroid medication. Transient hypothyroidism was observed in only two patients (5%) with AIH, though was not observed in TMNG. During follow-up time, no sudden deaths in AIT patients were observed; one patient was diagnosed with prostate cancer, and in one patient acute toxic hepatitis after AM occurred.

CONCLUSION: RIT may be a safe and useful method of AIT therapy in patients with low RAIU, in whom other treatment methods are contraindicated....

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Journal Article 2009; 30(2): 256-261 PubMed PMID: 19675512 Citation  Keywords:  Adolescent, Adolescent Development:drug effects, Age of Onset, Antipsychotic Agents:adverse effects, Body Weight:drug effects, Female, Humans, Male, Psychotic Disorders:drug therapy, Retrospective Studies, Schizophrenia:drug therapy, Time Factors, Weight .   

OBJECTIVES: The aim of the study was to assess weight changes associated with certain atypical (AAP) and typical (TAP) antipsychotic drugs in patients with early-onset schizophrenia and other related psychotic disorders.

METHODS: Our retrospective study included 109 patients (52 boys, 57 girls) with a mean age of 15.8 +/- 1.6 years. The patients were evaluated based to their medical records prior to starting therapy, and then after 1, 3, and 6 weeks of treatment.

RESULTS: During the first week of treatment, the AAP group (n = 85; risperidone, olanzapine, ziprasidone, and clozapine) gained 1.5% of baseline weight whereas the TAP group (n = 24; haloperidol, perphenazine, and sulpiride) gained only 0.2% (p = 0.049). Differences in relative changes between the two groups were not significant at weeks 3 and 6. Expressed as absolute values, patients in our sample gained an average of 3.4 kg (SD 3.2) on AAP and 2.0 kg (SD 3.9) on TAP during 6 weeks of treatment (p = 0.335). Only the risperidone, olanzapine, and clozapine groups had sufficient numbers of patients to allow a comparison at the endpoint of the study (week 6). The patients gained, on average, 3.6 kg (SD 2.6) on risperidone, 4.4 kg (SD 2.5) on olanzapine, and 2.1 kg (SD 4.0) on clozapine during the six weeks of treatment (p = 0.286).

CONCLUSIONS: In our study, we did not find a difference in weight gain between the AAP and TAP groups, as large as has been described in the literature. It also seems plausible that the unique and variable weight changes associated with individual AAPs in the pediatric population are different from those observed in the adult population....

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Journal Article 2001; 22(1): 53-73 PubMed PMID: 11393163 Citation  Keywords:  Adrenal Glands:physiology, Animals, Biological Clocks, Blood Pressure:physiology, Chronobiology Disorders:physiopathology, Chronobiology Phenomena, Chronotherapy, Circadian Rhythm:physiology, Drug Administration Schedule, Genomics, Homeostasis, Humans, Pi.   

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