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Journal Article 2009; 30(1): 51-55 PubMed PMID: 19300380 Citation  Keywords:  Adult, Aged, Anti-Inflammatory Agents:administration & dosage, Diskectomy:adverse effects, Epidural Space:diagnostic imaging, Female, Fibrosis:prevention & control, Humans, Injections, Epidural, Intervertebral Disc Displacement:drug therapy, Lumbar Verteb.   

BACKGROUND: Epidural fibrosis (EF) represents a frequent and poorly manageable complication of lumbar disk surgery.r />r /> OBJECTIVES: To investigate the influence of perioperative Epidural Steroid (ES) application on the development of EF.r />r /> METHODS: One hundred and seventy eight patients underwent L4/5 or L5/S1 discectomy. The study group receiving ES comprised of eighty five patients, and a further control group comprising eighty two patients received a placebo. At a 12 month follow-up, all subjects underwent contrast magnet resonance imaging of the lumbosacral spine. One hundred and sixty seven patients filled in a predetermined questionnaire containing the Visual Analogue Scale (VAS; pain scale) during the first postoperative days and 12 months after. Intergroup differences were analysed and a correlation between the extent of EF and VAS was examined.r />r /> RESULTS: The groups did not differ regarding the extent of EF. There was a statistically significant correlation between the degree of fibrosis and VAS (P<0.05). However, there was no significant difference in subjective pain assessment between both groups 12 months postoperatively. The application of ES did not influence their return to work. Patients receiving ES experienced less pain on the first and third days after surgery. The average hospital stay after surgery was shorter in the steroid treated group (4.5 days) compared to 5.2 days in the control group (p<0.05).r />r /> CONCLUSIONS: The application of ES did not prove to be useful in the prevention of Failed Back Surgery Syndrome and epidural scar formation. Postoperative pain was decreased in the steroid treated group during the first postoperative week, but not 12 months postoperatively....

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Evaluation Studies 2009; 30(1): 17-18 PubMed PMID: 19300379 Citation  Keywords:  Depressive Disorder:drug therapy, Drugs, Chinese Herbal:therapeutic use, Humans, Medicine, Chinese Traditional:methods, Models, Theoretical, Treatment Outcome,.   

: Traditional Chinese Medicine (TCM) has a long history of more than 5,000 years and it has the earliest medicine book in the world: Yellow Emperor's Canon: Internal Medicine (Huang Ti Nei Jing), by the Yellow Emperor of China (2695-2589 BC) (Lin , 1988; Shampo and Kyle, 1989; Wang, 1999). However the combinational and systemic recipes that bring TCM high efficiency also block the promotion of TCM treatment to various diseases, including depression. In this short comment we firstly give some theoretical basis for TCM treatment to depression, then some clinical reports on efficiency; we also present some possible explanations on TCM treatments to depression....

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Journal Article 2009; 30(6): 749-752 PubMed PMID: 20038936 Citation  Keywords:  Alcohol Drinking:psychology, Behavior, Addictive:psychology, Decision Making, Female, Humans, Impulsive Behavior:psychology, Male, Neuropsychological Tests, Probability, Risk-Taking, Young Adult,.   

OBJECTIVE: Little is known about the relationship between alcohol and discounting of loss, one of procrastinative behaviors. This study examined the relationship between the frequency of alcohol use and discounting delayed and probabilistic gain and loss, which is of interest in neuroeconomics of addiction.r />r /> METHODS: Thirty-three subjects conducted tasks of delay and probability discounting of gain and loss. Their alcohol use was also assessed.r />r /> RESULTS: The frequency of alcohol use was significantly correlated with the degree to which delayed monetary losses were discounted.r />r /> CONCLUSIONS: Frequent use of alcohol may associate with an increased degree of procrastination. Further, the degrees of delay discounting of loss could be a predictor of a frequent alcohol intake....

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Case Reports 2009; 30(6): 709-714 PubMed PMID: 20038935 Citation  Keywords:  Arthropathy, Neurogenic:diagnostic imaging, Arthroplasty, Replacement, Hip, Female, Hip Joint:diagnostic imaging, Humans, Intervertebral Disc Displacement:complications, Middle Aged, Radiculopathy:complications, Spondylosis:complications, Tomography, X-Ra.   

: Neurogenic arthropathy is a rare joint disorder, characterized by rapid progression and marked destruction of articular surfaces (known as Charcot's joint) with only mild to moderate pain. Most cases are related to diabetic neuropathy, but they may complicate the course of other neurogenic clinical conditions such as neurosyphilis (tabes dorsalis), syringomyelia, myelomeningocele, Peroneal Muscular Atrophy, spine or peripheral nerve injury, alcoholism and avitaminosis. Loss of superficial sensation and proprioception plays a pivotal role in development of arthropathy because it affects the joint's normal protective reflexes and leads to joint instability, degeneration and destruction. The authors describe an unusual case of bilateral neurogenic hip arthropathy in a 61-year old women who developed this condition in the course of multilevel lumbar spondylosis with spinal and nerve root compression. The patient underwent a successful bilateral hip replacement and remains almost asymptomatic contrary to literature reports that suggest high risk of complications after the operative treatment of Charcot's joints....

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Journal Article 2009; 30(6): 739-748 PubMed PMID: 20038934 Citation  Keywords:  Adult, Birth Rate:trends, Contraception:utilization, Czech Republic:epidemiology, Europe:epidemiology, Female, Humans, Infertility, Female:epidemiology, Maternal Age, Pregnancy, Registries, Reproductive Techniques, Assisted:utilization, Risk Factors, Trip.   

OBJECTIVE: The aim of the study was to evaluate the importance of increased use of assisted reproduction technologies (ART) for the fertility trends in the Czech Republic.r />r /> DATA AND METHODS: Comparative analysis based on demographic and ART data was used. Demographic data have been published by EUROSTAT and the Czech Statistical Office. ART data have collected by ESHRE.r />r /> FINDINGS: In the 1990s a trend towards later childbearing contributed greatly to the decline in total fertility rate (TFR) in the Czech Republic. Recently, recuperation of delayed births has resulted in the increase of TFR to 1.5 children per woman which is considered to be a critical minimum level. The highest increase in fertility rates occurred in the age group of 35-39, in which the contribution of ART treatments usually is greatest. Moreover, a substantial increase of multiple births has been registered. In 2005 the estimated share of children born after ART in the Czech Republic (3%) was close to countries with the highest share (Nordic countries, Belgium or Slovenia). However, the Czech Republic registered only half the number of ART cycles per million inhabitants than in those countries. Contrary to Nordic countries the Czech Republic faced an extremely low TFR of 1.28 children per woman. As the estimation of average number of cycles suggests, the need for fertility treatment has not been met in the Czech Republic yet. Moreover, due to the continuous postponement of childbearing to higher women s age, demand for ART treatment will be even higher in the near future and will probably result in the need of more than 2 500 cycles per million inhabitants in the Czech Republic.r />r /> CONCLUSIONS: Spreading of ART is particularly relevant in the countries caught in the low fertility trap as higher impact on fertility trends could be expected. In the Czech Republic there is a chance to get over the critical level of TFR if comprehensive population policy including the improved access to ART based on well-considered strategy with explicit aim to optimize the quality of health care was accepted. However, from the demographic perspective the risk of further delay of childbearing encouraged by ART treatment should be taken into account while making these decisions....

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Journal Article 2009; 30(6): 753-756 PubMed PMID: 20038933 Citation  Keywords:  Antisocial Personality Disorder:genetics, Catechol O-Methyltransferase:genetics, Genetic Predisposition to Disease, Genotype, Humans, Logistic Models, Male, Polymorphism, Genetic, Prisoners, Violence,.   

OBJECTIVE: The relationship between catechol-O-methyltransferase (COMT) polymorphisms and violent behaviour was tested in highly selected group of non-psychotic violent offenders.r />r /> METHODS: We conducted an association study comparing 47 male repeatedly sentenced for impulsive violent attacks diagnosed with Antisocial Personality Disorder (APD) with 43 healthy male controls matched on education. Three COMT polymorphisms were analysed: COMT Val158Met and COMT Ala146Val on exon 4, and untranslated polymorphism on the 6th exon, at the regulatory region of the COMT gene with deletion-insertion character del/C.r />r /> RESULTS: Logistic regression analysis revealed that while Val158Met is not associated with violence in APD, another COMT polymorphism - COMT Ala146Val is more frequent among violent offenders with APD (p=0.017).r />r /> CONCLUSIONS: To conclude, our findings provide further support that COMT is a modifying gene that plays a role in determining interindividual variability in the proclivity for violent behaviour in subjects without major mental disorder....

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Comparative Study 2009; 30(6): 769-773 PubMed PMID: 20038932 Citation  Keywords:  Adolescent, Adult, Anxiety:complications, Depression:complications, Dissociative Disorders:complications, Female, Humans, Linear Models, Male, Middle Aged, Personality Inventory, Severity of Illness Index, Young Adult,.   

OBJECTIVE: The aim of our study is to examine if the dissociation, can influence intensity of psychopathology in patients suffering with dissociative disorders compare the level of dissociation of the patients with the data of healthy subjects.r />r /> METHODS: 32 patients suffering with various types of dissociative disorder (9 males and 23 females) and 93 healthy controls (29 males and 64 females) were included into the study. The patients were psychiatrically assessed and the subjective intensity of symptoms was evaluated by Beck Anxiety Inventory and Beck Depression Inventory. All participants were assessed with the Dissociative Experiences Scale (DES).r />r /> RESULTS: The two groups didn't differ in demographic variables like age, gender and education. Level of the psychological dissociation assessed with the DES was correlated with the severity of subjective anxiety symptoms (p<0.0001), and with the severity of depression symptoms (p<0.0001). Patients had statistically significant higher mean score of DES than healthy controls (p<0.0001).r />r /> CONCLUSIONS: Our results suggest that the level of psychological dissociation in dissociative disorder patients is associated with the severity of anxiety and depressive symptoms....

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Journal Article 2009; 30(6): 723-728 PubMed PMID: 20038931 Citation  Keywords:  Adult, Antidepressive Agents:administration & dosage, Depressive Disorder, Major:diagnosis, Drug Resistance, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Retrospective Studies, Secondary Prevention, Sever.   

OBJECTIVE: The aim of this retrospective study was to compare the efficacy of combination therapy (combinations of antidepressants and various augmentations) and antidepressant monotherapy in the treatment of patients, who failed to respond at least to one previous antidepressant trial in the routine clinical practice.r />r /> METHODS: We reviewed chart documents of patients hospitalized at Prague Psychiatric Center for depressive disorder from June 2005 to June 2007 and finished at least 4 weeks of new treatment. Depressive symptoms and overall clinical status were assessed using Montgomery and Asberg Depression Rating Scale, Clinical Global Impression and Beck Depression Inventory - Short Form at the baseline and in the end of treatment.r />r /> RESULTS: We identified 49 inpatients (24-combined treatment, 25-monotherapy), who were suitable for analyses. Both groups were equal in baseline characteristics and in the duration of index episode treatment. The combined treatment was superior to the monotherapy switch in the MADRS median score reduction (16 vs. 9 points, p=0.01). The combined group achieved higher response rate compared to monotherapy group (67% vs. 36%, p=0.05). Number need to treat for response was 3.3 (95% CI, 1.85-37.3).r />r /> CONCLUSION: The findings of this study suggest that combined treatment is more efficacious than switch to monotherapy in the treatment of resistant depression....

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