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Evaluation Studies 2011; 32(2): 199-205 PubMed PMID: 21552187 Citation  Keywords:  Antipsychotic Agents:adverse effects, Feeding Behavior:psychology, Humans, Interpersonal Relations, Mental Disorders:drug therapy, Motor Activity:physiology, Obesity:epidemiology, Outcome Assessment (Health Care):methods, Predictive Value of Tests, Risk F.   

OBJECTIVES: Patients with mental illness are at risk for weight gain. Evidence-based risk assessment checklists have the potential to identify patients at risk early in treatment and improve patient outcomes.r />r /> METHODS: The 16-item Weight Gain Risk Factor (WGRF-16) checklist has been developed as a simple brief assessment of key weight gain risk factors during antipsychotic treatment. It consists of factors that were collected on the basis of published research on predictors to be assessed at initiation of, and early in treatment with antipsychotics.r />r /> RESULTS: The factors in the WGRF-16 checklist included age, sex, body mass index, race, appetite, energy intake, a diagnosis of undifferentiated schizophrenia, early clinical response, comorbiditites, social activity, patient insight, housing conditions, weight satisfaction, eating habits, and physical activity level. The WGRF-16 is designed to be repeated 2-3 weeks after initiation of treatment to help to predict an individual's risk of clinically significant weight gain (>7%) during long-term treatment. Further research is required to assess the predictive validity of the checklist.r />r /> CONCLUSIONS: The WGRF-16 checklist is not intended to replace other required monitoring of patients with severe mental disorders but is a facilitator of weight monitoring in conjunction with clinical guidelines....

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Journal Article 2011; 32(1): 7-24 PubMed PMID: 21407167 Citation  Keywords:  Animals, Comorbidity, Depression:epidemiology, Humans, Inflammation:epidemiology, Neuroimmunomodulation:physiology, Oxidative Stress:immunology, Reactive Nitrogen Species:metabolism, Signal Transduction:immunology, Stress, Psychological:epidemiology,.   

: There is now evidence that depression, as characterized by melancholic symptoms, anxiety, and fatigue and somatic (F&S) symptoms, is the clinical expression of peripheral cell-mediated activation, inflammation and induction of oxidative and nitrosative stress (IO&NS) pathways and of central microglial activation, decreased neurogenesis and increased apoptosis. This review gives an explanation for the multiple "co-morbidities" between depression and a large variety of a) brain disorders related to neurodegeneration, e.g. Alzheimer's, Parkinson's and Huntington's disease, multiple sclerosis and stroke; b) medical disorders, such as cardiovascular disorder, chronic fatigue syndrome, chronic obstructive pulmonary disease, rheumatoid arthritis, psoriasis, systemic lupus erythematosus, inflammatory bowel disease, irritable bowel syndrome, leaky gut, diabetes type 1 and 2, obesity and the metabolic syndrome, and HIV infection; and c) conditions, such as hemodialysis, interferon-α-based immunotherapy, the postnatal period and psychosocial stressors. The common denominator of all those disorders/conditions is the presence of microglial activation and/or activation of peripheral IO&NS pathways. There is evidence that shared peripheral and / or central IO&NS pathways underpin the pathophysiology of depression and the previously mentioned disorders and that activation of these IO&NS pathways contributes to shared risk. The IO&NS pathways function as a smoke sensor that detect threats in the peripheral and central parts of the body and signal these threats as melancholic, anxiety, and fatigue and somatic (F&S) symptoms. The presence of concomitant depression is strongly associated with a lower quality of life and increased morbidity and mortality in medical disorders. This may be explained since depression contributes to increased (neuro)inflammatory burden and may therefore drive the inflammatory and degenerative progression. It is concluded that the activation of peripheral and / or central IO&NS pathways may explain the co-occurrence of depression with the above disorders. This shows that depression belongs to the spectrum of inflammatory and degenerative disorders....

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Journal Article 2011; 32(1): 102-108 PubMed PMID: 21407166 Citation  Keywords:  Adult, Atherosclerosis:metabolism, Body Mass Index, Cholesterol, HDL:blood, Cholesterol, LDL:blood, Exercise:physiology, Female, Humans, Middle Aged, Obesity:metabolism, Oxygen Consumption:physiology, Physical Fitness:physiology, Sedentary Lifestyle, Trig.   

OBJECTIVE: In obese patients, we hypothesized physical exercise (PE) to affect lipids through its intrahepatic fat accumulation-lowering effect, associated with a decrease of total body fat (Fat%) and even weight (Mass).r />r /> DESIGN AND SETTING: Thirty seven sedentary, non-diabetic women (BMI median 34.8) from our out-patient department were tested. Elimination criteria: recent weight reduction, lipid-influencing or heart rate-modifying medication.r />r /> PARTICIPANTS: 50 entering, 37 finishing, 7 excluded for processing failure, 6 did not fulfill the protocol.r />r /> INTERVENTIONS: PE protocol: 60 min supervised trainings, intensity at 65% of VO2max, modified by the clamp heart rate test. Median of total training hours was 34 during 115 days (median).r />r /> MAIN OUTCOME MEASUREMENTS: an effect of PE on total cholesterol (CH), triglycerides (TG), HDL-cholesterol (HDL_C), LDL-cholesterol (LDL_C), index of atherogenity (IA), atherogenic index of plasma (AIP), maximum peak oxygen consumption (VO2max), Mass, body mass index (BMI), waist circumference (Waist) and Fat%.r />r /> RESULTS: Statistically significant differences at start (_s) and the end (_e) of PE (p<0.05): AIP -0.049, Mass -3.6 (kg), BMI -1.7 (kg/m2), Waist -2.5 (cm), Fat% -2.5, VO2max 2.92 (L.min-1kg-1). Correlation coefficients, Pearson's between Gaussian distributed (Gd-v) variables and Spearman´s (non Gd-v) statistically significant (p<0.05): IA and BMI, IA and Mass, IA and Waist, IA and Fat%, LDL and BMI, LDL and Mass, LDL and Fat%, LDL and Waist, IA and VO2max, LDL_C and VO2max.r />r /> CONCLUSIONS: PE improves lipid profile towards production of antiatherogenic particles more likely due to changes in anthropometric parameters than in improvement of physical fitness....

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Journal Article 2011; 32(1): 77-81 PubMed PMID: 21407165 Citation  Keywords:  Cholecalciferol:blood, Cholesterol, HDL:blood, Cholesterol, LDL:blood, Dehydroepiandrosterone Sulfate:blood, Estrogens:blood, Female, Hormone Replacement Therapy:methods, Hormones:blood, Humans, Hydrocortisone:blood, Hypercholesterolemia:blood, Hypogonadi.   

OBJECTIVE: In 2002 we proposed a new hypothesis of the etiology and pathogenesis of hypercholesterolemia. There is paucity of information in the literature regarding the association of steroidopenia and hypercholesterolemia. Our goal is to determine if the treatment of steroidopenia with hormonorestorative therapy (HT) to youthful levels will normalize total cholesterol (TC) levels.r />r /> MATERIAL AND METHODS: We retrospectively analyzed 43 hypercholesterolemic patients treated with HT. Laboratory workup included lipid profile, serum pregnenolone, dehydroepiandrosterone sulfate (DHEA-S), progesterone, total estrogen, cortisol, total testosterone, and vitamin D-3 levels at presentation with follow up ranging from 3 to 9 months. HT therapy included a combination of several agents such as pregnenolone, dehydroepiandrosterone (DHEA), triestrogen, progesterone, testosterone, hydrocortisone, and vitamin D-3.r />r /> RESULTS: HT lowered mean TC from 228.8 mg/dL to 183.7 mg/dL (19.7%) (p<0.05) in all patients. In 12 men of mean age 58, HT statistically significantly lowered TC from 227.9 mg/dL to 177.1 mg/dL (22.3%) (p<0.05). Apparently it did so mostly by lowering LDL and triglycerides (TRG) while HDL did not appreciably change. In 31women, mean age 57, TC declined from 229.2 mg/dL to 186.3 mg/dL (19%) (p<0.05). HDL, LDL, and TRG are also decreased to a statistically significant degree. These results were associated with statistically significant elevations in pregnenolone, DHEA Sulfate, testosterone, progesterone but not total estrogen, cortisol or vitamin D-3 changes in both men and women.r />r /> CONCLUSIONS: We conclude that correction of steroidopenia with the use of hormonorestorative therapy is an effective strategy for normalizing and maintaining cholesterol homeostasis....

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Journal Article 2011; 32(1): 90-95 PubMed PMID: 21407164 Citation  Keywords:  Adrenal Cortex Hormones:toxicity, Amygdala:drug effects, Animals, Avoidance Learning:drug effects, Behavior, Animal:drug effects, Brain:drug effects, Brain Stem:drug effects, Conditioning (Psychology):drug effects, Hippocampus:drug effects, Male, Prefront.   

BACKGROUND: Long term permanent changes of eating behavior and concomitant structural changes in the CNS are matter of debade in literature. Often there is not enough distinction beween acute and chronic exposure to corticoids in evaluating its effect on behavior and/or brain structural changes. For behavioral evaluation we used well established conditioned taste aversion (CTA) paradigm and coronal Nissl-stained brain sections for evaluation of neuroanatomical changes. The CTA is part of complex adaptive behavioral processes controling food intake. It is well established methodological tool for study of biological substrates of learning and memory.r />r /> AIM: Our hypothesis was that long term changes in laboratory rat behavior induced by exogenous corticosterone are not accompanyied by neurohistological changes in the rat brain, previously described in literature.r />r /> RESULTS: Firstly, our results support CTA paradigm as promising tool for testing chronic influence of stress hormones on eating behavior and memory. The results support fact that previous long term elevated corticosterone levels disrupt normal eating behavior and it could also lead to structural changes, which could be biological substrates of behavioral changes. The fact we have not found significant morphological changes in brain strengthen the notion of possible subcellular impairment taking place instead of simple neuronal loss....

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Journal Article 2011; 32(1): 64-76 PubMed PMID: 21407163 Citation  Keywords:  Adrenalectomy, Animals, Avoidance Learning:drug effects, Corticosterone:blood, Corticotropin-Releasing Hormone:blood, Hypothalamo-Hypophyseal System:physiology, Male, Maze Learning:drug effects, Memory, Short-Term:drug effects, Pituitary-Adrenal System:ph.   

OBJECTIVES: Stress activates the hypothalamic-pituitary-adrenal (HPA) axis. This activation is executed mainly through the release of corticosteroids from adrenal that subsequently exert negative feedback on corticosterone-releasing hormone (CRH) production. The effects of corticosterone on learning and memory has been studied intensively. Less is known about the effect of CRH on cognitive phenomena.r />r /> DESIGN AND SETTING: The present study aimed at studying the separate effects of stress cascade hormones, namely CRH and corticosterone, on learning and memory in a battery of learning tasks.r />r /> RESULTS: Long-term administration of CRH led to a transient impairment of spatial performance in the active allothetic place avoidance (AAPA) task requiring cognitive coordination, whilst co-application of CRH and corticosterone resulted in permanent impairment in this task. Corticosterone alone impaired the long-term retention of passive avoidance. CRH alone exerted no effect on the working memory version of the Morris water maze (MWM) and inhibitory avoidance.r />r /> CONCLUSIONS: Our results suggest differential effects of stress cascade hormones on various types of behavior....

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Case Reports 2011; 32(1): 4-6 PubMed PMID: 21407162 Citation  Keywords:  Adjuvants, Immunologic:administration & dosage, Adult, Female, Humans, Interferon beta-1b, Interferon-beta:administration & dosage, Lupus Erythematosus, Systemic:chemically induced, Multiple Sclerosis, Relapsing-Remitting:drug therapy, Time Factors,.   

: Drug-induced systemic lupus erythematosus (SLE) is a rare complication of therapies with some drugs. Breaking out after months or years of therapy with a certain drug, its occurrence is likely to increase with the duration of the medication and the cumulative quantity of the drug. The symptoms of this syndrome include, in particular, arthralgia, myalgia, fever, serositis, skin exanthema and production of antinuclear (ANA) antibodies. In contrast to SLE, its symptoms gradually abate after discontinuation of the inducing agent. The authors describe the case of a 43-year-old patient suffering from multiple sclerosis who experienced drug-induced SLE after 8-year application of interferon (IFN) beta-1b....

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Journal Article 2011; 32(1): 96-101 PubMed PMID: 21407161 Citation  Keywords:  Adenoma:metabolism, Adult, Aged, Biopsy, Female, Gonadotropins, Pituitary:metabolism, Humans, Male, Middle Aged, Neoplasm Recurrence, Local:metabolism, Pituitary Neoplasms:metabolism, Receptors, Somatostatin:metabolism,.   

OBJECTIVE: Surgical treatment of pituitary macroadenomas often fails because of tumor recurrence after the operation. The causes of tumor recurrence are complex, but one of them may be the high growth potential of the adenoma. As somatostatin receptors mediate antiproliferative, anti-angiogenic and pro-apoptotic actions, it seemed reasonable to investigate their expression in dependence on the adenoma recurrence.r />r /> METHODS: Samples of primary and recurrent gonadotropinomas excised surgically from patients were examined. This type of pituitary adenomas was chosen because of its relatively high recurrence rate. The adenoma phenotype and expression of somatostatin receptor subtypes 1-5 (SSTR 1-5) were investigated by immunohistochemistry, and the level of SSTR expression was semiquantitatively scored.r />r /> RESULTS: It was found that the adenomas undergoing the early recurrence have lower expression of SSTR 2A and 3 in comparison to those which did not recur during 5 years lasting observation. On the other hand, the recurrent tumors show higher expression of SSTR 1, 2A, 3 and 5 subtypes than their primary counterparts.r />r /> CONCLUSIONS: It is hypothesized that SSTR may, at least in part, counteract adenoma recurrence. On the other hand, it can be also presumed that the recurrent gonadotropinomas may be more sensitive to somatostatin analog treatment than primary ones. These hypotheses need to be confirmed in further studies....

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