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Case Reports 2012; 33(8): 757-760 PubMed PMID: 23391976 Citation  Keywords:  Adult, Anorexia Nervosa:complications, Avitaminosis:complications, Chronic Disease, Female, Humans, Hyperthyroidism:complications, Microscopy, Electron, Motor Neurons:physiology, Polyneuropathies:etiology, Sensory Receptor Cells:physiology, Severity of Il.   

OBJECTIVES: Hyperthyroidism is often associated with various neuromuscular disorders, most commonly proximal myopathy. Peripheral nerve involvement in hyperthyroidism is very uncommon and has rarely been reported. We describe a 29-year-old woman with untreated hyperthyroidism who presented with chronic severe axonal sensory-motor polyneuropathy. Peripheral nerve involvement developed together with other symptoms of hyperthyroidism 2 years before presentation. She also had anorexia nervosa for the past 6 months, resulting in multivitamin deficiency.r />r /> RESULTS: Electrophysiological and pathological findings as well as clinical manifestations confirmed the diagnosis of severe axonal polyneuropathy. Anorexia nervosa has been considered a manifestation of untreated hyperthyroidism. We considered hyperthyroidism to be an important causal factor in the polyneuropathy in our patient, although peripheral nerve involvement in hyperthyroidism is rare. To our knowledge, this is the first documented case of chronic severe axonal polyneuropathy ascribed to both hyperthyroidism and multivitamin deficiency.r />r /> CONCLUSION: Our findings strongly suggest that not only multivitamin deficiency, but also hyperthyroidism can cause axonal polyneuropathy, thus expanding the clinical spectrum of hyperthyroidism....

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Journal Article 2012; 33(8): 736-748 PubMed PMID: 23391975 Citation  Keywords:  Animals, Brain:immunology, Fatty Acids, Omega-3:metabolism, Humans, Mental Disorders:immunology, Neuroimmunomodulation:physiology, Oxidative Stress:physiology,.   

: The lipids constitute majority of dry weight of mature human brain. From lipids, 35% is comprised of PUFA with long chain (LC-PUFA), especially docosahexaenoic acid (DHA) of n-3 family and arachidonic acid (AA) of n-6 family. Humans are dependent on dietary intake of both AA and DHA. Interestingly, the dietary n-6/n-3 ratio increased considerably during last century. LC-PUFAs play numerous roles in the brain, including structural (forming the physico-chemical properties in the lipid bilayer of cellular membranes) and signaling ones. Moreover, they influence neurogenesis and neurotransmission within the nervous tissue. The metabolites of PUFA modulate immune and inflammatory processes in the brain, oxidative stress as well as its consequences. Of high importance is also their connection with several metabolic factors involved in the proper function of the brain and/or were discovered to play a role in the pathogenesis of neuropsychiatric diseases - melatonin, homocysteine, leptin, and adiponectin. This review gives short view of the metabolism and possible mechanisms of PUFA n-3 action in the brain, and their role in the pathogenesis of psychiatric diseases....

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Case Reports 2012; 33(8): 765-768 PubMed PMID: 23391974 Citation  Keywords:  Adenoma:surgery, Adult, Angiography, Digital Subtraction, Female, Humans, Male, Middle Aged, Neuronavigation:methods, Neurosurgical Procedures:methods, Oculomotor Nerve Diseases:surgery, Pituitary Neoplasms:surgery, Sella Turcica:diagnostic imaging, Sphen.   

: A concha non-pneumatized sphenoid is considered to be a contraindication for the transsphenoidal resection of a pituitary adenoma. Specifically, this anatomical variation makes it difficult to approach the sella turcica. However, in this report, an intra-operative navigational system was used as a guide to access the sella through the sphenoid sinus. This procedure was found to be both reasonable and safe....

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Journal Article 2012; 33(8): 773-781 PubMed PMID: 23391973 Citation  Keywords:  Adolescent, Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Hormonal:administration & dosage, Antineoplastic Combined Chemotherapy Protocols:administration & dosage, Antioxidants:administration & dosage, Female, Hormones:administration & dosage, Hu.   

OBJECTIVES: Lymphomas are the main form of haematological neoplasms, representing 55.6% of all tumours of the blood. Overall, they account for 5.3% of all malignant tumours (excluding basal and squamous cell skin cancer) in Italy with a prevalence constantly increasing at a rate of 3% per year. From a histological point of view, they represent a vast heterogeneous group of haematological diseases, their staging being based on defined cyto-morphological and anatomo-pathological criteria. Although the combined use of standard approaches can provide good response rates, recurrence is particularly frequent in patients undergoing traditional treatment, with critical and often irreversible side effects such as myelosuppression and a high frequency of opportunistic infections and sterility. Numerous epidemiological studies and preclinical data have for some time now reported the anticancer effects of molecules such as Melatonin, Retinoids, Vitamins E, D3, and C, Somatostatin and prolactin inhibitors in neoplastic diseases. There are, however, very few publications on the combined effects of these substances in vivo.r />r /> METHODS: We report an observational study carried out on 55 patients affected by various forms of lymphoma, treated with the biological therapy known as the Di Bella Method (DBM). The 1, 3 and 5-year survival rates are reported, together with any signs of toxicity.r />r /> RESULTS: The DBM treatment achieved partial or complete objective responses in a shorter time and in greater percentages if administered as first-line therapy. The adjuvant treatment increased survival time and improved quality of life with respect to the data reported in the literature for the same types and stages of lymphoma.r />r /> CONCLUSION: Overall, the treatment was well tolerated, with minor and transient side effects. The patients were able to continue the treatment at home, carrying out their normal activities without problems....

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Comparative Study 2012; 33(8): 787-791 PubMed PMID: 23391972 Citation  Keywords:  17-alpha-Hydroxyprogesterone:blood, Adolescent, Adrenal Hyperplasia, Congenital:drug therapy, Androgens:blood, Androstenedione:blood, Anti-Inflammatory Agents:therapeutic use, Child, Child, Preschool, Dehydroepiandrosterone:blood, Female, Fingers:anatomy .   

OBJECTIVES: Excessive hyperandrogenism, though proper hydrocortisone supplementation is a frequent clinical problem in girls with congenital adrenal hyperplasia (CAH). This may result from autonomic regulation of androgen production established in prenatal life. It has been suggested that the length of the second finger relative to the length of the fourth finger (2D;4D ratio) is negatively related to prenatal testosterone concentration.r />r /> DESIGN AND SETTING: The retrospective study aimed to establish the relationship between the level of androgenization in utero determined using 2D:4D ratio and serum androgen concentrations in treated girls with CAH (21-OH deficiency) has been performed on 19 girls with CAH (21-OH deficiency) at the age of 3.7-19 years (mean 13.8 ± 4.07 years). All subjects were adequately treated with hydrocortisone (10-19 mg/m2; mean 13.81 ± 4.07 mg/m2). Anthropometric measurements of digits length were performed in all girls on X-rays obtained for bone age estimation. Apart from it, serum androgens concentrations (testosterone, androstenedione, s-DHEA) and 17-OH-progesterone (17-OHP) were assayed.r />r /> RESULTS: Mean androgens serum concentrations in examined group were: testosterone 150.21 ± 155.44 ng/ml; androstenedione 4.15 ± 5.32 ng/ml, s-DHEA 70.39 ± 85.52 µg/dl. Mean 2D:4D ratio was 0.96 ± 0.04. Analysis of correlation showed positive linear correlations between testosterone, s-DHEA and 2D:4D ratio (r=0.53, p=0.023 and r=0.53; p=0.019, respectively).r />r /> CONCLUSIONS: 2D:4D ratio parameter may be a simple test in indentification of female CAH patients prone to excessive androgen secretion despite proper treatment. The autonomization of adrenal androgens production in foetal life may cause its elevated levels in female patients with CAH although treated adequately....

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Journal Article 2012; 33(8): 792-795 PubMed PMID: 23391971 Citation  Keywords:  Acidosis, Lactic:mortality, Acute Kidney Injury:mortality, Aged, Critical Care:statistics & numerical data, Diabetes Mellitus, Type 2:drug therapy, Female, Hospital Mortality, Humans, Hypoglycemic Agents:therapeutic use, Incidence, Male, Metformin:therape.   

OBJECTIVES: To evaluate the significance of diabetes mellitus and metformin in patients admitted to medical ICU with lactic acidosis.r />r /> METHODS: All the patients admitted to medical ICU with serum lactic acid exceeding 5 mmol/L and pH<7.35 were enrolled into analysis. The impact of diabetes mellitus and metformin treatment on ICU presence of lactic acidosis and its mortality was evaluated. The metabolic parameters were compared with respect to the presence of diabetes mellitus and metformin application.r />r /> RESULTS: Lactic acidosis was detected in 69 (4%) out of 1,755 admitted patients, 44 were nondiabetic and 25 had diabetes mellitus, 11 of them treated with metformin. No significant impact of diabetes mellitus or metformin application on presence of lactic acidosis and its mortality was detected. In nondiabetic subjects mortality was associated with eGFR and the presence of acute renal failure while in diabetic patients with sepsis. Acute renal failure was detected in 9 out of 11 patients on metformin. Three patients died due to sepsis, however only 1 out of 6 due to another cause if renal replacement therapy was started soon after admission. The acidosis was more expressed in diabetic subjects mainly in patients taking metformin. It might be attributed to the more pronounced acute renal failure in diabetic patients.r />r /> CONCLUSION: The presence of diabetes mellitus and metformin application is not associated with the presence of lactic acidosis in medical ICU and its mortality. The prognosis of acute renal failure of patients on metformin is good if the subjects with sepsis are excluded....

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Biography 2012; 33(8): 729-731 PubMed PMID: 23391970 Citation  Keywords:  Apgar Score, Germany, History, 19th Century, History, 20th Century, Humans, Infant, Newborn, Infant, Newborn, Diseases:diagnosis, Neonatal Screening:history, Reflex, United States,.   

: It is well known that the names of discoverers are commonly used in medical terminology, especially in everyday use. The advantage of an eponym is that a complex description of a certain syndrome, surgical procedure, manifestations of a particular disease, or its details, can be expressed in a single word (Holomáňová & Brucknerová 2003). Current official anatomical nomenclatures do not use eponyms. Some exceptions do however exist. In pediatrics, we frequently use the names of two famous persons: Virginia Apgar and Ernst Moro....

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Journal Article 2012; 33(7): 674-679 PubMed PMID: 23391886 Citation  Keywords:  Endometriosis:physiopathology, Female, Humans, Infertility, Female:physiopathology, Pregnancy, Prognosis, Reproductive Medicine:methods,.   

: Although there is confirmed an association between endometriosis and infertility, precise standards of managements have not yet been established. Ablation of endometriotic lesions plus adhesiolysis in minimal to mild endometriosis is more effective than diagnostic laparoscopy alone in improving fertility. Suppression of ovarian function and hormonal treatment alone are not effective in improving fertility. In women with stage I/II endometriosis associated infertility, expectant management or IUI after laparoscopy can be considered for younger patients. Women 35 years of age or older should be treated with IUI or IVF-ET. IVF pregnancy rate are lower in women with endometriosis than in those with tubal infertility. For women with stage III/IV endometriosis who fail to conceive following conservative surgery IVF-ET is should be offered....

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