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Journal Article 2014; 35(8): 718-723 PubMed PMID: 25702301 Citation  Keywords:  Adult, Cesarean Section:adverse effects, Decision Making, Elective Surgical Procedures:adverse effects, Female, Humans, Obstetric Labor Complications:epidemiology, Pregnancy, Pregnancy Outcome:epidemiology, Retrospective Studies, Vaginal Birth after Cesar.   

OBJECTIVE: A retrospective analysis of the course of labour in patients after one caesarean section (CS) and of factors influencing successful attempt of vaginal birth after caesarean (VBAC).r />r /> DESIGN: A group of 296 patients after one CS was divided into: group G1 (206 patients) - elective CS, group G2 (90) - VBAC attempt, and G2 to: G2a (35) - VBAC and G2b (55) - CS after an unsuccessful VB attempt. A comparative analysis between the groups and logistic regression analysis of factors influencing a successful VBAC was made.r />r /> RESULTS: There were no differences regarding age, BMI, weight gain during pregnancy or gestational age between groups G1 and G2, as well as G2a and G2b. G2a patients had more often already given VB previously (28.6% vs 10.9%; p=0.03). The most frequent indication for a repeat elective CS was the lack of informed consent for VBAC (29.13% of all indications). The mean neonatal birthweight was highest in G1 (3 410 g), and in G2b higher than in G2a (3 275 g vs 3 098 g; p=0.009). There were no differences in newborns' general condition between the group. There were no cases of uterine rupture and 4 cases of uterine scar dehiscence in G1 and 1 in G2. Of all the analysed factors only spontaneous delivery onset (OR 7.78) and previous vaginal birth after the caesarean (OR 1.99) or before the caesarean (OR 2.03) had significant influence on successful VBAC trial.r />r /> CONCLUSION: The right classification of patients is a significant factor having effect on the success of a VB attempt after CS....

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Journal Article 2014; 35(8): 711-717 PubMed PMID: 25702300 Citation  Keywords:  Adult, Antidepressive Agents:therapeutic use, Anxiety Disorders:drug therapy, Combined Modality Therapy, Depressive Disorder:drug therapy, Female, Humans, Male, Middle Aged, Psychotherapy:methods, Self Concept, Social Stigma, Treatment Outcome,.   

OBJECTIVE: Many psychiatric patients suffer from self-stigma. One consequence of these internalized prejudices is decreased treatment efficacy. Much has been written about the effects of self-stigma in patients with severe mental disorders. However, individuals with minor psychiatric disorders also suffer from self-stigma. It is therefore necessary to explore the effect of self-stigma on treatment efficacy of neurotic patients.r />r /> METHOD: Aim of out study was to investigate relationship between self-stigma, severity of symptoms, and presence of comorbidit disorder and treatment outcome in neurotic patients. Patients were treated by combined psycho and pharmacotherapy. Level of self-stigma was measured by Internalized Stigma Of Mental Illness scale. Severity of anxiety and depressive symptoms was assed by Beck Anxiety Inventory, Beck Depressive Inventory and Clinical Global Impression Scale.r />r /> RESULTS: Level of self-stigma was significantly correlated with the levels of anxiety, depression and global evalutions of a mental state on the beginnig of the therapy. Up to our results patients with higher level of self-stigmatization had lower improvement after combined treatmet in respect to perceived anxiety symptoms.r />r /> CONCLUSION: Self-stigma seems to be an important factor influencing efficacy of combined treatment. More researches focused on self-stigmatization should be done to find an optimal therapeutic strategy for patients with higher level of self-stigmatization....

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Journal Article 2014; 35(8): 703-710 PubMed PMID: 25702299 Citation  Keywords:  Anabolic Agents:administration & dosage, Animals, Anxiety:chemically induced, Behavior, Animal:drug effects, Male, Nandrolone:administration & dosage, Rats, Rats, Wistar,.   

OBJECTIVE: Nandrolone decanoate (ND) is frequently used anabolic androgenic steroid (AAS) among the athletes. Despite the health risks, there is significant increase in prevalence of AAS abuse.r />r /> DESIGN: The aim of this study was to investigate the effects of chronic exposure to ND at supraphysiological dose (to mimic the doses for human AAS abusers) on anxiety levels in adult rats.r />r /> SETTINGS: We performed several behavioral tests (open field test, elevated plus maze test, beam-walking test, evoked beam-walking test and tail suspension test) for estimation of anxiety in rats. Adult rats received 20 mg/kg intraperitoneal injection of ND weekly for four weeks. Behavioral test were performed on the seventh day after the last dose of ND.r />r /> RESULTS: Anxiogenic-like pattern of behavior was clearly observed in several behavioral tests, such as open field test (decrease of total distance moved and cumulative duration of moving, decrease of an average velocity of the animals, decrease of frequency and total time in centre zone); elevated plus maze (decreased total time spent in open arms and the number of entries in open arms of the elevated plus maze); evoked beam-walking test (decreased time to cross the beam) and tail suspension test (increased latency to first immobility and decreased total duration of immobility).r />r /> MAIN FINDINGS: Results of this study show that four-week treatment with the supraphysiological dose of ND produced anxiogenic effects in sedentary male rats.r />r /> CONCLUSION: Our results show that rats after chronic treatment with a supraphysiological dose of ND exhibited anxiety-like behavior....

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Journal Article 2014; 35(8): 697-702 PubMed PMID: 25702298 Citation  Keywords:  Adult, Depressive Disorder, Major:pathology, Diffusion Tensor Imaging:methods, Female, Humans, Male, Nerve Regeneration:physiology, White Matter:anatomy & histology,.   

OBJECTIVE: While increasing evidence suggests that major depressive disorder (MDD) is coincident with the altered white matter microstructure in many brain regions including the prefrontal cortex, parietal lobe, ventral tegmental area and limbic system, it remains controversial in the nature of white matter structural changes and in its relationship with depression syndrome. We believe that the age of patients and the antidepressant treatment to them would contribute to that controversy. Here in this study we explored the microstructural changes of the entire brain white matter of the adult patients with first-episode, antidepressant drug-naïve MDD.r />r /> DESIGN: We performed the diffusion tensor imaging (DTI) among a relatively large sample size of patients and age-matched control individuals (forty-one MDD patients and forty-one control subjects) and used recently developed tract-based spatial statistics to analyze the difference of mean fractional anisotropy (FA) between patients and control individuals.r />r /> RESULTS: We surprisingly found that MDD patients exhibited a significantly greater mean FA, which is used to elucidate the structural organization of the neural fibers, than control subjects in the whiter matter of the left superior longitufinal fasciculus. However, this change in the white matter of MDD patient did not correlate with depressive clinical features (HMAD, illness duration and initial age) in the present study.r />r /> CONCLUSION: Our data suggest that a potential compensatory regeneration of nerve fibers occurs in the early course of MDD development. Advanced understanding of the potential nerve fiber regeneration in the early course of MDD and its associated mechanisms will possibly shade light on a better strategy for MDD prevention and treatment....

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Journal Article 2014; 35(8): 691-696 PubMed PMID: 25702297 Citation  Keywords:  Age of Onset, Aged, Aged, 80 and over, Alzheimer Disease:epidemiology, Apolipoprotein E4:genetics, Comorbidity, Diabetes Mellitus:epidemiology, Female, Humans, Hypertension:epidemiology, Male, Protective Factors, Risk Factors, Stroke:epidemiology,.   

rong>OBJECTIVE:rong> The aim of our current research project is to further evaluate the role of risk factors in the pathogenesis of Alzheimer's disease; these include genetic variations, environmental factors and lifestyle issues.r />r /> rong>METHODS:rong> We have been conducting an association study on 373 patients with Alzheimer's disease and 286 unrelated control individuals. The occurrence and the age of onset of diabetes and cardiovascular diseases were evaluated in both groups. Apolipoprotein E genotype was analyzed in all subjects by PCR method.r />r /> rong>RESULTS:rong> We report that, in Czech population carrying ApoE4 allele increases risk of Alzheimer's disease 2.1-fold and genotype E4E4 increases the risk 8.4-fold. We have also identified a significant association between ApoE4 allele, Alzheimer's disease and hypertension. Hypertensive subjects with the ApoE4 allele have 1.5-fold greater risk of Alzheimer's disease. Thus, hypertension together with ApoE4 allele translates into 1.5-fold higher risk of AD. The most intriguing original finding in the present study is that Alzheimer's disease patients have significantly later onset of diabetes, hypertension and stroke in comparison with control subjects. This effect was not influenced by ApoE genotype. The diabetes appeared in AD patients on average more than 10 years later than in the control subjects (p<0.0001), hypertension was diagnosed 14 years later in AD patients (p<0.00001) and stroke occurred on average 6 years later (p<0.005), compared to the control group.r />r /> rong>CONCLUSIONS:rong> Overall, in addition to the above novel findings, our study expands the data base on risk factors that could be used in near future when testing for the genetic risk of Alzheimer's disease.

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Journal Article 2014; 35(8): 684-690 PubMed PMID: 25702296 Citation  Keywords:  Animals, Apoptosis:drug effects, Dietary Supplements, Disease Models, Animal, Drug Therapy, Combination, Hippocampus:drug effects, Hormone Replacement Therapy, Hypothyroidism:drug therapy, Male, Oxidative Stress:drug effects, Random Allocation, Rats.Rats.   

OBJECTIVE: To examine the effect of levothyroxine (L-T4), vitamin E or both on oxidative stress status and hippocampal apoptosis in a propylthiouracil (PTU)-induced hypothyroid rat model.r />r /> METHODS: Sprague-Dawley rats were randomly divided into five groups: Control, PTU+PTU+L-T4+PTU+Vit E, PTU+Vit E+L-T4. In each group we assessed levels of serum triiodothyronine (T3), tetraiodothyronine (T4), thyroid stimulating hormone (TSH), hippocampus cellular apoptosis index (AI), hippocampus nicotinamide adenine denucleotide hydrogen (NADPH)oxidase and superoxide dismutase (SOD).r />r /> RESULTS: 1) Compared with the control group, NADPH oxidase levels were significantly increased, and SOD levels were significantly reduced in the PTU groups (p<0.05). 2) Compared to the PTU group, SOD levels were significantly increased in the PTU+Vit E and PTU+L-T4+Vit E group (p<0.05). NADPH oxidase levels were significantly decreased in the PTU+L-T4, PTU+Vit E and PTU+ L-T4+Vit E group (p<0.05). 3) Compared with the control group, hippocampus AI increased significantly in the PTU group (p<0.05). Compared with the PTU group, hippocampus AI was significantly reduced in the PTU+L-T4 group and PTU+L-T4+Vit E group (p<0.05). 4) Hippocampus AI was positively correlated with NADPH oxidase expression levels in hippocampus tissue (r=0.644, p<0.01).r />r /> CONCLUSION: Levothyroxine replacement therapy combined with vitamin E reduces hippocampus AI by improving oxidative stress. This study suggested that the mechanisms of hippocampus tissue injury in a hypothyroid rat model is related to hippocampus apoptosis from increased oxidative stress....

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Journal Article 2014; 35(8): 676-683 PubMed PMID: 25702295 Citation  Keywords:  Adolescent, Adult, Age of Onset, Dwarfism, Pituitary:psychology, Female, Human Growth Hormone:administration & dosage, Humans, Male, Quality of Life:psychology, Severity of Illness Index, Young Adult,.   

BACKGROUND: Transition is a term used to describe the period of adolescence after which the final adult height during growth hormone (GH) treatment is achieved. According to re-evaluation results in insulin tolerance test (ITT) patients with severe and partial growth hormone deficiency (GHD) may be distinguished.r />r /> OBJECTIVES: The aim of the study was to assess QoL in patients with different degrees of GHD in transition phase.r />r /> METHODS: QoL was evaluated in 76 subjects aged 16-25 years with severe (SGHD, n=26), partial GHD (PGHD, n=22) and normal GH secretion (NGH, n=28) using SF-36 v.2™ Health Survey and the Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA) questionnaires.r />r /> RESULTS: Physical Component Score (PCS), Physical Functioning (PF) and General Health (GH) results were significantly lower in patients with SGHD than in NGH group. SF-36 v.2™ Health Survey scores in PGHD were similar as in NGH patients. There were no statistically significant differences in QoL-AGHDA scores between the examined groups. We found positive correlations between peak GH in ITT and PF (r=0.29; p=0.02) or Role Emotional (r=0.37; p=0.002) scores.r />r /> CONCLUSIONS: We demonstrated that the QoL in adolescents and young adults with severe GHD in transition period is disturbed mainly in terms of physical health and emotions. These changes were detected only by generic SF-36, but not by disease-specific QoL-AGHDA questionnaire. Therefore AGHDA-QoL assessment may not be applicable in GHD patients in transition period. QoL in the patients with partial GHD is unchanged in comparison to growth hormone sufficient subjects....

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Case Reports 2014; 35(8): 673-675 PubMed PMID: 25702294 Citation  Keywords:  Adenocarcinoma:diagnostic imaging, Colonic Polyps:diagnostic imaging, Colonoscopy:instrumentation, Female, Humans, Middle Aged, Sigmoid Neoplasms:diagnostic imaging, Ultrasonography:instrumentation, Vagina:diagnostic imaging,.   

: Adenocarcinoma of the colon represents the third most frequent cause of death from cancer, being surpassed only by lung and stomach cancer. Early screening and diagnosis of polyps are important for a good prognosis. Based on a clinical case, a novel approach is presented for screening of sigmoidal polyps and neoplasia using transvaginal 2D, 3D mode in women. This novel and simple technique can be used to visualize the sigmoid diverticula during routine gynecological examination via 3D transvaginal ultrasound probe....

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