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Journal Article 2014; 35(2): 116-122 PubMed PMID: 24878980 Citation  Keywords:  Aged, Anxiety:etiology, Humans, Lower Urinary Tract Symptoms:complications, Male, Middle Aged, Multivariate Analysis, Prognosis, Prostatic Hyperplasia:complications, Research Design, Severity of Illness Index, Somatoform Disorders:etiology, Surveys and Qu.   

OBJECTIVE: This study tried to test predictors of response to routine treatment in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH).r />r /> METHODS: Subjects were evaluated at baseline and at week 12 following routine treatment for LUTS/BPH using the Korean version of the International Prostate Symptom Score (IPSS) to measure the severity of LUTS/BPH. Demographics and various clinical variables were analyzed by regression analysis.r />r /> RESULTS: Ninety three patients received routine treatment for LUTS/BPH for 12 weeks in a naturalistic treatment setting. None of demographics and clinical variables was different between responders and non-responders. According to multivariate regression analysis, the presence of anxiety (OR=0.203), lower improvement in the GAD-7 total score (OR=0.755) and lower improvement in the PHQ-15 total score (OR=0.811) were independent predictors of treatment response after 12 weeks routine treatment.r />r /> CONCLUSIONS: We found the positive association of improvement in anxiety and somatization with treatment response, while presence of anxiety was negatively associated with treatment response, in patients with LUTS/BPH. However, additional studies with adequate power and improved designs are necessary to support the present findings....

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Journal Article 2014; 35(2): 104-109 PubMed PMID: 24878979 Citation  Keywords:  Animals, Anti-Inflammatory Agents:therapeutic use, Antidepressive Agents:therapeutic use, Depressive Disorder:complications, Encephalitis:etiology, Glutamic Acid:physiology, Humans, Inflammation Mediators:antagonists & inhibitors, Nerve Growth Factors:phy.   

: Post-stroke depression (PSD) is a prevalent complex psychiatric disorder that causes delay to functional recovery from rehabilitation and also increases cognitive impairment. The etiology of PSD remains controversial and appears to be physical and psycho-social in origin, alone or in combination. The causes of PSD as well as the mechanisms conferring beneficial antidepressant effects in the context of ischemic brain injury are still unknown. In addition, appropriate treatment strategies for therapy to prevent stroke-induced depression-like behavior remain to be developed. This paper, therefore, proposes two hypotheses for post-stroke depression: The inflammatory hypothesis, which is the increased production of proinflammatory cytokines resulting from brain ischemia in cerebral areas causing the pathogenesis of post-stroke depression and the glutamate hypothesis, where the excess glucocorticoids released from stress-induced over-activation of hypothalamus-pituitary-adrenal (HPA) lead to dysfunction of glutamatergic transmission. Neurotrophins, especially brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) both play various roles in the central nervous system (CNS), attenuate apoptosis in cultured neurons, stimulate neurogenesis and increase survival and protect neuronal tissues from cell death induced by ischemia or depression. We also touch upon recent treatment strategies including inhibition of pro-inflammatory cytokines, SSRI, neurotrophins and cell-based therapies. In the present review, we provide an overview of recent evidence concerning the mechanisms of post-stroke depression and propose four prospective treatment strategies so as to provide references for clinical evidence-based medications....

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Journal Article 2014; 35(2): 142-148 PubMed PMID: 24878978 Citation  Keywords:  Adult, Baroreflex:physiology, Cardiovascular Diseases:diagnosis, Endothelium, Vascular:physiopathology, Female, Humans, Male, Middle Aged, Polysomnography, Prognosis, Risk Factors, Severity of Illness Index, Sleep Apnea, Obstructive:complications,.   

OBJECTIVES: Obstructive sleep apnea syndrome (OSA) is associated with increased cardiovascular morbidity and mortality. Endothelial dysfunction (ED), accelerated atherosclerosis and autonomic dysfunction might be the key players responsible for development of vascular diseases in patients with OSA. In a population with suspected OSA and low burden of cardiovascular risk factors, we therefore aimed to investigate the association between potential cardiovascular risk factors including OSA-specific indices, ED and autonomic activity.r />r /> METHODS: ED was investigated using reperfusion hyperaemia index (RHI). OSA was assessed using standard polysomnography, autonomic activity was assessed using baroreflex sensitivity (BRS).r />r /> RESULTS: We enrolled 31 patients (42.1±11.7 years) with OSA. Significant inverse correlation was found between RHI and apnea-hypopnea index (AHI) (r=-0.550, p=0.001) and between RHI desaturation index (r=-0.533, p=0.002). Positive correlation was found between RHI and minimal nocturnal oxygen saturation (r=0.394, p=0.028). In a multiple regression model AHI was the only significant variable to predict RHI (β=-0.522, p=0.003). We found no correlation between RHI and BRS. RHI in the population with severe OSA (AHI above 30) was significantly lower than RHI in the rest of the population (p=0.012).r />r /> CONCLUSION: AHI was the only significant independent predictor of impaired endothelial function as expressed by RHI. RHI showed no association with BRS in patients with OSA....

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Journal Article 2014; 35(2): 149-153 PubMed PMID: 24878977 Citation  Keywords:  Aged, Aged, 80 and over, Carotid Artery Diseases:complications, Carotid Artery, Internal:pathology, Cerebral Infarction:complications, Euthyroid Sick Syndromes:complications, Female, Humans, Inpatients:statistics & numerical data, Male, Middle Aged, Nervo.   

OBJECTIVES: The low triiodothyronine (T3) syndrome indicates poor prognosis for patients with cerebral infarction. It is unknown, however, whether basic conditions or severities in the patients with the low T3 syndrome are different compared to those without the low T3 syndrome.r />r /> METHODS: We compared the risk factors and the severity of the disease using the National Institutes of Health stroke scale (NIHSS) score at the worst condition for cerebral infarction in patients with or without the low T3 syndrome in order to better understand the characteristics underlying the worse prognosis in patients with the low T3 syndrome.r />r /> RESULTS: We found that cerebral infarction patients with the low T3 syndrome were significantly older (p<0.001) and significantly more likely to be female (p=0.002) and had hypertension (p=0.04) or homocystinemia (p=0.001), but less likely to smoke (p=0.008), compared to patients without the low T3 syndrome. The proportion of NIHSS score ≥8 in the patients with LAA-ICA-associated cerebral infarction accompanied by the low T3 syndrome was significantly higher than in those without the low T3 syndrome (p=0.001).r />r /> CONCLUSION: We concluded that increased numbers of risk factors for cerebral infarction and more severe neurological deficits may be important causes for worse prognosis in the patients with the low T3 syndrome which may more likely occur in patients with LAA-ICA cerebral infarction. Intense secondary prevention in cerebral infarction especially in older women are needed....

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Clinical Trial 2014; 35(2): 123-128 PubMed PMID: 24878976 Citation  Keywords:  Aged, Electromyography, Fatty Acids, Monounsaturated:adverse effects, Female, Fluorobenzenes:adverse effects, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors:adverse effects, Incidence, Indoles:adverse effects, Male, Middle Aged, Muscular Diseases:.   

OBJECTIVES: The goal of this clinical trial was to determine the incidence of undesirable side effects, and to ascertain any occurrence of genetic polymorphisms.r />r /> MATERIAL AND METHODS: Clinically, we looked for manifestations of a benign myositis and of serious rhabdomyolysis. We observed a group 198 patients treated with statins, primarially fluvastatin and rosuvastatin. There were 126 (mean age = 58.3 ± 4.1; male 91, mean age = 57.4 ± 5.9; female 35, mean age = 60.5 ± 6.5) patients in a subgroup where we administered rosuvastatin. Undesirable muscular signs and symptoms were present in 32 patients (25.39%). In 11 (8.73% of the total 126) CK level increased maximally to 4 times ULN, in 6 (4.7%) statins were excluded because of very intense subjective suffering. CK levels 2-5 times ULN were present in 9 (7.14%). CK blood levels over 10 times ULN or higher indicated statins exclusion in 2 (1.58%). Increased levels of the further muscular enzyme AST by 5 times ULN were present in 16 (12.69%), up to 10 times ULN in 2 (1.58%), and over 10 times ULN also in 2 (1.58%).r />r /> RESULTS: We observed rhabdomyolysis in 6 patients (3.03% of the total 198 patients group) using other types of statins (three of them undergo chronic hemodialysis). In this group we performed molecular-genetic analysis of the following proteins relating to statin myopathy: SLCO1B1(388AA/AG-521TT) - (discovered polymorphism in 1 patient), further cytochroms Cyp 2C9 (in 1 patient), 2C8 (in 1 patient), Cyp SA/4 (non discovered positivity) and finally UGT1A1*2B (discovered in 2 patients).r />r /> CONCLUSIONS: In the group of patients treated by rosuvastatin, we discovered not one case of rhabdomyolysis. In each patient with rhabdomyolysis (brown urine discoloration, mal-odorous urine, painful muscle cramps, muscle weakness, fatigue) at least one polymorphism of "statins´ genes" was present....

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Case Reports 2014; 35(2): 137-141 PubMed PMID: 24878975 Citation  Keywords:  Central Nervous System:physiopathology, Child, Glycogen Storage Disease:complications, Humans, Intellectual Disability:complications, Male, Microcephaly:complications, Mutation, Missense, Phenotype, Phosphoglucomutase:genetics,.   

OBJECTIVES: A 10-year-old boy presented with cleft palate, hepatopathy, cholecystolithiasis, myopathy, coagulopathy, hyperlipidemia, hypoglycemia, hyperuricemia, short stature, obesity, hypothyroidism, microcephaly and mild intellectual disability. The multi-systemic manifestation involving certain distinct clinical features prompted us to search for a subtype of congenital disorders of glycosylation (CDG).r />r /> METHODS: The patient was screened for CDG by examining the distribution of transferrin (TRF) and apolipoprotein C-III (ApoC-III) sialylated isoforms using isoelectric focusing of serum. This was followed by spectrophotometric measurement of phosphoglucomutase 1 (PGM1) activity in fibroblasts and molecular analysis including sequencing and PCR-RFLP of PGM1 gene. Selected bioinformatics tools were used to evaluate the data.r />r /> RESULTS: Increased relative levels of di-, mono- and asialotransferrin reflected a defect of N-glycosylation in the patient. Markedly decreased activity of PGM1 corresponding to less than 5% of control´s was found. Sequencing of PGM1 gene revealed the presence of two heterozygous missense mutations c.1010C>T (p.T337M) and c.1508G>A (p.R503Q), whose pathogenicity was confirmed by in silico analysis.r />r /> CONCLUSION: We report the first Czech patient with a glycosylation disorder due to PGM1 deficiency. Compared to the described cases, no dilated cardiomyopathy was noted in our patient. However, he suffered from a mild neurological impairment, which is an uncommon feature that extends the phenotype associated with PGM1-CDG. Lactose-rich diet, which was previously reported to have ameliorated the clinical symptoms in some PGM1-CDG patients, did not result in any improvement in our patient....

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Journal Article 2014; 35(2): 110-115 PubMed PMID: 24878974 Citation  Keywords:  AIDS-Related Opportunistic Infections:immunology, Amino Acid Sequence, Antigens, Bacterial:chemistry, Blotting, Western, Cambodia, Child, Cohort Studies, HIV Antigens:chemistry, HIV Infections:complications, HIV-1:immunology, Humans, Intestines:immunology.   

OBJECTIVES: Human immunodeficiency virus type 1 is widely accepted as the cause of AIDS (Acquires Immunodeficiency Syndrome) but it is necessary to consider other factors, not only HIV, which may be involved in AIDS process. It is apparent that a viral reservoir persists in virtually all infected individuals receiving HAART. Reservoirs were detected in macrophages and other cells of the blood system, in which even very effective HAART was not able to eliminate the virus. Over the last period of time AIDS research has been focused on the gut and other mucosal tissue as the major site of HIV infection and CD4+ T cells loss. Intestinal bacteria and cells associated with GIT are in close vicinity and so has been raised the idea that bacteria may be involved in AIDS pathogenesis. Matherial/Methods: Bacteria and yeast isolated from a cohort of 67 Cambodian and Kenyan HIV positive children and from a cohort of 62 Slovak and American AIDS patients were analyzed for detection of expression of HIV-1 antigens p17, p24, p55, gp41 and gp120 (Abcam, UK).r />r /> RESULTS: By monoclonal antibodies against HIV-1 proteins p17 and p55 was detected protein with molecular weight of 45-55 kDa. In samples of Cambodian and Kenyan HIV positive children was found 35 kDa protein using MAb against HIV-specific protein p17. By using MAbs against p24 was found protein of 55-60 kDa in Cambodian and Kenyan samples but, suprisingly, no proteins were detected in bacterial extracts of American and Slovak AIDS patients by this MAbs. Using monoclonal antibodies against HIV-1 specific protein gp41 was positive signal identified in 30-35% of samples from both cohorts of patients from Kenya and Cambodia and in 75% of samples from American and Slovak patients. The protein of about 75-85 kDa was detected by MAbs against gp120 only in protein extracts obtained from yeasts Candida sp. of Cambodian and Kenyan HIV positive children.r />r /> CONCLUSION: The molecular weight of 55 kDa protein was detected by MAbs anti HIV p24, p17+p55. Its molecular weight is comparable to gag-encoded Pr55Gag precursor. Surprisingly, such proteins were not found in bacterial extract from samples of American and Slovak patients by using the MAbs against HIV-specific protein p24. The protein of about 75-85 kDa was detected only in Candida species protein extracts of Cambodian and Kenyan HIV positive children by the MAbs against gp120. In Slovak and American samples, protein reacting with MAbs anti gp120 was not found. These results suggest that there are specific differences between Slovak and American HIV positive patients bacterial proteins on one side and Cambodian and Kenyan on the other. These differences may suggest a diverse bacterial evolution in various geographical areas....

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Journal Article 2014; 35(2): 159-169 PubMed PMID: 24878973 Citation  Keywords:  Aged, Cytokines:blood, Diabetes Mellitus, Type 2:blood, Female, Hemoglobin A, Glycosylated:analysis, Humans, Interleukin-12:blood, Interleukin-6:blood, Male, Mental Disorders:blood, Middle Aged, Psychometrics, Surveys and Questionnaires, Tumor Necrosis Fa.   

OBJECTIVES: The aim of this study was to investigate the association of IL-6, IL-12, and TNF-α with trait and state psychological factors in type 2 diabetic patients.r />r /> DESIGN: Patients were divided in two groups. Group A consisted of 86 controlled diabetic patients (HbA1c<7) and the Group B consisted of 45 uncontrolled diabetic patients (HbA1c ≥ 7).r />r /> SETTINGS: During the initial phase of the study (T0), blood samples were taken for measuring IL-6, IL-12 and TNF-α serum levels as well as a battery of psychometric instruments. One year later (T1), the uncontrolled diabetic patients were re-evaluated with the use of the same psychometric instruments and with the identical blood analysis.r />r /> RESULTS: The average values of tnf-α were significantly different among controlled (7.73 ± 5.51) and uncontrolled patients (9.29 ± 4.52) at a significance level of 5% (p=0.009). Controlled diabetic patients show a statistically significant relationship between IL-6 and neuroticism (rp=0.303, p=0.010), and between IL-12 and psychotism, (rsp=0.382, p=0.001). Controlled diabetic patients show a statistically significant relationship between IL-12 and the act out hostility (rsp=-0.307, p=0.009). The scores of the psychometric tests differ significantly between the first and second evaluation. Acting out hostility and the direction of hostility increased when HbA1c values fell below the threshold of 7, while the total hostility index, as well as all other scales, dropped when patients controlled their metabolic profile.r />r /> CONCLUSIONS: The present results provide evidence that IL-6, IL-12 and TNF-α are closely related to the course and treatment of type 2 diabetes....

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