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Journal Article 2014; 35(7): 586-593 PubMed PMID: 25617881 Citation  Keywords:  Aged, Aged, 80 and over, Aging:immunology, Biomarkers:cerebrospinal fluid, Cytokines:cerebrospinal fluid, Dementia:cerebrospinal fluid, Humans, Hydrocephalus, Normal Pressure:cerebrospinal fluid, Postural Balance, Urinary Incontinence:cerebrospinal fluid,.   

OBJECTIVES: Normal pressure hydrocephalus (NPH) is a treatable neurological syndrome developing in the elderly. It is characterized by balance impairment, urinary incontinence and dementia development caused by disorders in the cerebrospinal fluid (CSF) circulation. The diagnosis can be easily mistaken for other neurodegenerative diseases, which are often accompanied by inflammation and the production of cytokines. The aim of our study was to determine and compare selected CSF and plasma cytokines with respect to their informative value for laboratory diagnostics of NPH.r />r /> METHODS: The levels of IL-1β, IL-4, IL-6, IL-10, IL-17A, IL-17F, IL-21, IL-22, IL-23, IL-25, IL-31, IL-33, INF-γ, sCD40L and TNF-α were measured in the CSF and plasma in age-matched subjects with NPH (n=20) and controls (n=20) by multiplex assay.r />r /> RESULTS: CSF IL-1β, IL-6 and IL-10 were significantly increased on the 1st day of lumbar drainage in NPH (p<0.01). No significant changes were observed in the plasma. The CSF cytokines were one to three orders of magnitude higher compared to the plasma.r />r /> CONCLUSION: CSF can better show the neurodegenerative changes in the brain. The cytokines IL-1β, IL-6 and IL-10 may be helpful in NPH diagnostics....

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Journal Article 2014; 35(7): 577-585 PubMed PMID: 25617880 Citation  Keywords:  Adult, Antioxidants:metabolism, Autoimmune Diseases:immunology, Bacterial Translocation:immunology, Epitopes:immunology, Fatigue Syndrome, Chronic:immunology, Female, Humans, Immunoglobulin M:immunology, Male, Middle Aged, Nitroso Compounds:immunology, Ox.   

OBJECTIVES: There is evidence that inflammatory, oxidative and nitrosative stress (IO&NS) pathways participate in the pathophysiology of a subgroup of patients with Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS). Increased IgM-related autoimmune responses to oxidative specific epitopes (OSEs), including malondialdehyde (MDA), oleic acid and phosphatidyl inositol (Pi), and nitroso-(NO)-adducts, including NO-tryptophan (NOW), NO-arginine and NO-cysteinyl, are frequently observed in ME/CFS. Autoimmune responses in ME/CFS may be driven by increased bacterial translocation as measured by IgM and IgA responses to LPS of gram negative bacteria.r />r /> METHODS: The aim of this study is to examine whether IgM responses to OSEs and NO-adducts are related to a better outcome as measured by the Fibromyalgia and Fatigue Rating Scale (FF). 76 ME/CFS patients with initially abnormal autoimmune responses were treated with care-as-usual, including nutraceuticals with anti-IO&NS effects (NAIOS), such as L-carnitine, coenzyme Q10, taurine + lipoic acid, with or without curcumine + quercitine or N-acetyl-cysteine, zinc + glutamine.r />r /> RESULTS: We found that use of these NAIOS was associated with highly significant reductions in initially increased IgM-mediated autoimmune responses to OSEs and NO-adducts. A greater reduction in autoimmune responses to OSEs during intake of these NAIOS was associated with a lower FF score. Reductions in IgM responses to oleic acid, MDA and Pi, but not in any of the NO-adducts, were associated with reductions in severity of illness. These associations remained significant after adjusting for possible effects of increased bacterial translocation (leaky gut).r />r /> CONCLUSIONS: Our results show that autoimmune responses to OSEs are involved in the pathophysiology of ME/CFS and that these pathways are a new drug target in a subgroup of ME/CFS patients. Although hypernitrosylation and nitrosative stress play a role in ME/CFS, reductions in these pathways are not associated with lowered severity of illness. Randomized controlled trials with NAIOS should be carried out in the subgroup of ME/CFS patients with initially increased autoimmune responses to OSEs....

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Case Reports 2014; 35(7): 567-576 PubMed PMID: 25617879 Citation  Keywords:  Antihypertensive Agents:adverse effects, Calcium Channel Blockers:adverse effects, Female, Gingiva:drug effects, Gingival Diseases:chemically induced, Humans, Male, Middle Aged,.   

OBJECTIVES: Side effect of medicamentous treatment in hypertension therapy and angina pectoris with calcium channel blockers related to fibrotic gingival enlargement were examined.r />r /> METHODS: In our study we deal with clinico-histopathological and microbiological knowledge from this field underpinned by two case reports treated with antihypertensive therapy using calcium channel blockers. In the first case report we were largely concerned with microbiological findings from the area of periodontal pseudopockets diagnosed through a DNA analysis and appropriate antibiotic therapy. In a patient treated with a preparation from amlodipine group we proceeded to a complex treatment involving the change of hypertension therapy, introduction of professional and home oral hygiene and also following surgical and prosthetico-aesthetic rehabilitation.r />r /> RESULTS: Case Report 1 who was for a long term medicated with a preparation from the nifedipine group of antihypertensives we detected the presence of periodontal pseudopockets with probing depth of 4 to 7 mm with positive BOP and with marked rigid fibrotic gingival enlargement accompanied with considerable foetor ex ore. In a patient from the Case Report 2 who was for a long term medicated with a preparation from the amlodipine group of antihypertensives with large gingival overgrowth angiogenesis was characterized by cuboidal endothelial cell lining. In the samples under a layer of stratified epithelium there was present dense fibrous connective tissue comprising largely of collagen fiber bundles.r />r /> CONCLUSION: Bacterial composition in the patient with a high degree of gingival enlargement and periodontal pseudopockets 4 to 7 mm deep represented a typical spectrum of bacteria occuring in chronic forms of periodontitis. However, we cannot determine, if such distribution of bacteria was primary before the application of nifedipine antihypertensives, or it originated later after the formation of typical anaerobic setting of false periodontal pockets....

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Journal Article 2014; 35(7): 560-566 PubMed PMID: 25617878 Citation  Keywords:  Female, Humans, Sleep Apnea, Obstructive:epidemiology, Sleep Wake Disorders:epidemiology, Stress Disorders, Post-Traumatic:epidemiology, Stress, Psychological:epidemiology,.   

: Sleep disturbances are found in a majority of individuals diagnosed with posttraumatic stress disorder (PTSD). The purpose of this literature review is to provide information about PTSD, in addition to assessing sleep quality. Current research observes that the lifetime prevalence of PTSD diagnosis in women is increasing. Although there are several studies that have been conducted to assess PTSD and sleep, there is a gap in the research that pertains to women, PTSD, and sleep quality. The current study will compile information on the subject to aid in decreasing the gender disparity in PTSD research, which is important for treating the entire PTSD population. Using the PubMed and PsycINFO databases, a comprehensive search was conducted to find relevant research about sleep difficulties and PTSD. Sleep disturbances such as insomnia, re-current nightmares, REM sleep dysfunction, and obstructive sleep apnea (OSA) affect sleep quality in PTSD patients. The implications of this study suggest that more research should be conducted pertaining to women and PTSD with sleep difficulties. This research is needed to decrease both PTSD symptoms and sleep-related disorders....

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Journal Article 2014; 35(7): 553-559 PubMed PMID: 25617877 Citation  Keywords:  Aggression:physiology, Child Development Disorders, Pervasive:physiopathology, Disruptive, Impulse Control, and Conduct Disorders:physiopathology, Humans, Testosterone:physiology,.   

: Autism spectrum disorders (ASD) are a set of heterogeneous neurodevelopmental conditions, characterized by early-onset difficulties in social communication and unusually restricted, repetitive behavior and interests. Children with ASD have a high rate of irritability and aggressive symptoms which have significant impact on their lives, families and society. The etiology of aggression in humans is likely complex and includes both biological and behavioral causes. Biological approaches have focused on hormones and neurotransmitters that are hypothesized to contribute to the etiology and clinical manifestation of aggressive behavior in humans. Testosterone is a male sex hormone and some studies suggest that it can play a role in the complex etiology of aggressive behavior. Two specific subtypes of aggression have been identified: explosive and non-explosive. Explosive aggression is accompanied by a raged affect and is usually more dangerous and not immediately responsive to behavioral treatment. In our review we would like to provide current findings and discuss potential limitation of research in this area. We propose to determine bio-behavioral model of explosive aggression in children with ASD which will predict which children will be most responsive to potential antiandrogen therapy and behavioral therapy....

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Journal Article 2014; 35(7): 537-552 PubMed PMID: 25617876 Citation  Keywords:  Anxiety:etiology, Chronic Disease, Dental Amalgam:adverse effects, Depression:etiology, Evidence-Based Practice, Fatigue:etiology, Fibromyalgia:etiology, Humans, Mercury Compounds:adverse effects, Suicide,.   

: The purpose of this review is to examine the evidence for a relationship between mercury (Hg) exposure from dental amalgams and certain idiopathic chronic illnesses--chronic fatigue syndrome (CFS), fibromyalgia (FM), depression, anxiety, and suicide. Dental amalgam is a commonly used dental restorative material that contains approximately 50% elemental mercury (Hg0) by weight and releases Hg0 vapor. Studies have shown that chronic Hg exposure from various sources including dental amalgams is associated with numerous health complaints, including fatigue, anxiety, and depression--and these are among the main symptoms that are associated with CFS and FM. In addition, several studies have shown that the removal of amalgams is associated with improvement in these symptoms. Although the issue of amalgam safety is still under debate, the preponderance of evidence suggests that Hg exposure from dental amalgams may cause or contribute to many chronic conditions. Thus, consideration of Hg toxicity may be central to the effective clinical investigation of many chronic illnesses, particularly those involving fatigue and depression....

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Journal Article 2014; 35(6): 463-469 PubMed PMID: 25433852 Citation  Keywords:  Adult, Anxiety Disorders:epidemiology, Asian Continental Ancestry Group:statistics & numerical data, Chronic Pain:epidemiology, Depressive Disorder, Major:epidemiology, Female, Health Status, Humans, Pain Measurement, Psychophysiologic Disorders:epidemiol.   

OBJECTIVE: We investigated the influence of somatic symptoms on the severity and clinical outcomes in female Korean patients with major depressive disorder (MDD) in routine practice.r />r /> METHODS: Two hundred and seven female patients with MDD were prospectively recruited. Patients with somatic symptoms (PSS) was defined as a total score ≥ 10 on the Patient Health Questionnaire-15 (PHQ-15), others were classified as non PSS (NPSS). The PHQ-9 for de-pression, the Generalized Anxiety Disorder Scale (GAD-7) for anxiety, the Clinical Global Impression-Severity (CGI-S) for clinical status, and the Visual Analogue Scale (VAS) for health status were utilised.r />r /> RESULTS: Of 207 participants, 126 (60.9%) were PSS and 81 (39.1%) were classified as NPSS. The proportion of patients showing severe symptoms (65.1% vs. 24.7%) and recurrence of depression (74.6% vs. 49.4%), the CGI-S (4.6 vs. 4.1), the PHQ-9 (16.8 vs. 11.1), and the GAD-7 (8.3 vs 6.7) scores were significantly higher in PSS than in NPSS, while the VAS (39.4 vs. 51.2) was significantly lower in PSS than in NPSS. The improvement of depressive symptoms (-1.3 vs. -2.0) measured by the changes in CGI-S was also significantly less in PSS than in NPSS after 6 months treatment.r />r /> CONCLUSION: Our findings have shown the significant impact of somatic symptoms on the symptomatology as well as treatment outcomes in Korean female patients with MDD, indicating that clinicians should carefully evaluate somatic symptoms in patients with MDD in routine clinical practice. Due to the methodological shortcomings of the present study, further adequately powered and well-designed investigations are necessary....

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Journal Article 2014; 35(6): 440-444 PubMed PMID: 25433851 Citation  Keywords:  Biomarkers:metabolism, Female, Humans, Placenta:metabolism, Pregnancy, Pregnancy Complications:metabolism, Pregnancy Proteins:metabolism, Pregnancy Trimester, First:metabolism, Prenatal Exposure Delayed Effects:metabolism,.   

: Normal trophoblast growth is one of the more important stages of early pregnancy that has a deciding factor on its later development and normal outcome. Identifying pregnant women who have a high risk of complications connected to hypertension during pregnancy is currently one of the most important tasks of perinatal medicine. Abnormal placentation is related not only to the appearance of preeclampsia, but also to many other complications, such as premature placental abruption, intrauterine fetal demise, and intrauterine growth restriction. Preeclampsia and eclampsia are one of the major causes of maternal morbidity and mortality and appear in about 5% of all pregnancies. Clinical symptoms are a far-removed consequence of abnormal placentation. When they become visible, it is definitely too late for preventive action, and there is essentially no effective treatment. New research data suggests that a chance of prophylactic intervention might exist as early as in the first trimester of the pregnancy. One of the clinically documented possibilities is to apply low doses of acetylsalicylic acid before the 16th week of gestation. Despite the great importance of the placenta in the physiology of pregnancy, not much attention has been paid to the way it functions. This paper reviews selected biochemical and biophysical markers which are, or could be, used in clinical practice in the future....

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