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Clinical Trial 2012; 33(4): 380-384 PubMed PMID: 22936266 Citation  Keywords:  Adult, Anesthesia, Dental:methods, Clinical Protocols, Clonidine:administration & dosage, Dental Care for Disabled:methods, Disabled Persons, Dose-Response Relationship, Drug, Double-Blind Method, Drug Combinations, Drug Therapy, Combination:methods, Fema.   

BACKGROUND: Dental procedures on intellectually disabled patients represent a clinical challenge. The oral administration of sedating drugs can remediate the problems with cooperation and enable the medical procedures to take place. Standard guidelines are lacking for oral sedation of the intellectually disabled.r />r /> OBJECTIVE: To compare two oral combinations of sedating drugs in terms of time to the onset and achievement of full sedation, vital signs, behavioral measures and safety.r />r /> METHODS: In a group of 29 intellectually disabled patients we compared two oral combinations for analgosedation: ketamine (5 mg/kg) - clonidine 2 µg/kg - midazolam 0.3 mg/kg (N=17) or ketamine 5 mg/kg - midazolam 0.3 mg/kg (N= 12 patients). Drugs were dissolved in a sweet drink.r />r /> RESULTS: Full sedation was achieved within 25 min. in 27 patients and serious side effects were not detected. Clonidine in combination with ketamine and midazolam did not exert any significant effect by means of the onset of sedation, time to the achievement of full sedation, vital signs and behavioral measures of sedation (Vancouver Interaction and Calmness Scale) and agitation (Pittsburgh Agitation Scale).r />r /> CONCLUSIONS: Our study is the first to document that oral administration of ketamine and midazolam in low doses represents a safe and effective method of premedication in intellectually disabled patients indicated for dental procedures. Clonidine co-administration did not exert any substantial benefit and should be left out in this clinical setting....

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Journal Article 2012; 33(4): 393-400 PubMed PMID: 22936265 Citation  Keywords:  Animals, Cattle, Cerebellar Nuclei:cytology, Female, Glutamic Acid:metabolism, Hypothalamus:physiology, Immunity, Humoral:physiology, Male, Neuroimmunomodulation:physiology, Neurons:immunology, Rats, Rats, Sprague-Dawley, Serum Albumin, Bovine:immunology,.   

OBJECTIVES: We explored effect of glutamatergic neurons in the fastigial nucleus (FN), one of three cerebellar nuclei, on humoral immunity and revealed that this effect was mediated by the hypothalamus via FN-hypothalamic glutamatergic transmission.r />r /> METHODS: Rats were immunized with bovine serum albumin (BSA). On the third day after the immunization, 6-diazo-5-oxo-L-norleucine (DON), an inhibitor of glutaminase for glutamate synthesis, was microinjected in bilateral FN and D,L-threo-β-hydroxyaspartic acid (THA), an inhibitor of glutamate transporters on plasma membrane, was microinjected in both sides of lateral hypothalamic area (LHA). Glutamate content in the hypothalamus was examined by high-performance liquid chromatography (HPLC). Flow cytometry and enzyme-linked immunosorbent assay (ELISA) were used to measure B lymphocyte percentage in mononuclear cells of peripheral blood and levels of anti-BSA IgM and IgG antibodies in the serum, respectively.r />r /> RESULTS: DON injection in bilateral FN reduced B lymphocyte percentage and anti-BSA IgM and IgG levels, and simultaneously decreased glutamate content in the hypothalamus. Combined treatment with DON in the FN and with THA in the LHA elevated B cell number and anti-BSA IgM and IgG levels and increased hypothalamic glutamate content compared with DON treatment alone. However, combined treatment with DON in the FN and with THA in the ventrolateral thalamic nuclei (VL) did not significantly alter DON-dependent changes in B cell number and antibody levels, although the co-treatment altered DON-dependent glutamate content in the thalamus.r />r /> CONCLUSION: Cerebellar FN glutamatergic neurons participate in modulation of humoral immunity and this effect is mediated by the hypothalamus via FN-hypothalamic glutamatergic transmission....

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Journal Article 2012; 33(4): 401-405 PubMed PMID: 22936264 Citation  Keywords:  Adult, Anorexia Nervosa:blood, Case-Control Studies, Dehydroepiandrosterone:blood, Dehydroepiandrosterone Sulfate:blood, Female, Hot Temperature, Humans, Hydrocortisone:blood, Matched-Pair Analysis, Nociception:physiology, Pain Threshold:physiology, Refer.   

OBJECTIVES: Anorexia nervosa (AN) patients represent a natural model of relationship between changed hormonal level and pain perception due to lower level of sex hormones and consistently described increased pain threshold. As the adrenal stress steroid hormones (cortisol and DHEA) are known to be also changed in AN (and share a common precursor), our study was aimed to analyze the association between these hormones and pain perception in AN patients and control healthy women.r />r /> METHODS: The pain threshold latencies to radiant heat stimuli were measured in 20 DSM-IV diagnosed patients with AN and in 21 healthy women. Blood samples were collected in the morning hours and analyses of the plasma levels of dehydroepiandrosterone (DHEA), its conjugated sulfate ester (DHEA-S) and cortisol were implemented.r />r /> RESULTS: Thermal pain threshold was higher in AN than in healthy women and correlated negatively with the level of DHEA and positively with cortisol/DHEA(S) ratio. No significant correlation between thermal pain and hormones was found in healthy women. If both groups were pooled together, the rest pain threshold correlated negatively with DHEA-S (r=-0.42, p=0.008).r />r /> CONCLUSION: We showed for the first time that sensitivity to thermal pain in women is dependent on DHEA-S and on cortisol/DHEA(S) ratio in patients with AN....

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Comparative Study 2012; 33(4): 419-424 PubMed PMID: 22936263 Citation  Keywords:  Adult, Alcohol Drinking:metabolism, Alcoholism:metabolism, Cerebellum:diagnostic imaging, Female, Fluorodeoxyglucose F18:metabolism, Humans, Male, Middle Aged, Positron-Emission Tomography:methods, Radiopharmaceuticals:metabolism, Time Factors, Treatment .   

OBJECTIVES: The acute and maintenance treatment of alcohol addiction represents the clinical challenge. The aims of our study were to evaluate the influence of alcohol consumption on regional brain metabolism and the predictive value of PET by means of the duration and quality of remission which followed the sub-acute treatment.r />r /> METHODS: PET investigation with 18 fluoro-deoxyglucose (18FDG) were performed in detoxified patients with alcohol dependence at the end of short-term treatment. Abstinence was evaluated in patients during the one year follow-up period.r />r /> RESULTS: We detected the positive correlation between 18FDG uptake in the cerebellar vermis (FWE, p<0.05) and duration of abstinence within one year.r />r /> DISCUSSION: Our findings support the assumption that the cerebellum would be involved in the maintenance of abstinence in alcohol dependent subjects. Cerebellar connections with cortical areas critical for addiction such as frontal, parietal, temporal regions would mediate the influence of the cerebellum on emotional systems related to addiction.r />r /> CONCLUSIONS: Our study is the first to document that the cerebellum and particularly the vermis is involved in the clinical outcome in terms of abstinence during one year. Our findings support the role of the cerebellum in addiction and the possibility to predict therapeutic outcome....

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Journal Article 2012; 33(4): 431-441 PubMed PMID: 22936262 Citation  Keywords:  Adolescent, Adult, Analysis of Variance, Case-Control Studies, Efferent Pathways:physiology, Evoked Potentials, Motor:physiology, Female, Humans, Male, Middle Aged, Motor Cortex:physiology, Muscle, Skeletal:innervation, Neural Inhibition:physiology, Neuro.   

OBJECTIVES AND METHODS: Excitability changes in the primary motor cortex in 17 spinal-cord injured (SCI) patients and 10 controls were studied with paired-pulse transcranial magnetic stimulation. The paired pulses were applied at inter-stimulus intervals (ISI) of 2 ms and 15 ms while motor evoked potentials (MEP) were recorded in the biceps brachii (Bic), the abductor pollicis brevis (APB) and the tibialis anterior (TA) muscles.r />r /> RESULTS: The study revealed a significant decrease in cortical motor excitability in the first weeks after SCI concerning the representation of both the affected muscles innervated from spinal segments below the lesion, and the spared muscles rostral to the lesion. In the patients with motor-incomplete injury, but not in those with motor-complete injury, the initial cortical inhibition of affected muscles was temporarily reduced 2-3 months following injury. The degree of inhibition in cortical areas representing the spared muscles was observed to be smaller in patients with no voluntary TA activity compared to patients with some activity remaining in the TA. Surprisingly, motor-cortical inhibition was observed not only at ISI 2 ms but also at ISI 15 ms. The inhibition persisted in patients who returned for a follow-up measurement 2-3 years later.r />r /> CONCLUSION: The present data showed different evaluation of cortical excitability between patients with complete and incomplete spinal cord lesion. Our results provide more insight into the pathophysiology of SCI and contribute to the ongoing discussion about the recovery process and therapy of SCI patients....

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Journal Article 2012; 33(4): 385-392 PubMed PMID: 22936261 Citation  Keywords:  Aged, Apolipoproteins E:genetics, Cognition:physiology, Cognition Disorders:diagnosis, Diagnosis, Computer-Assisted, Female, Humans, Middle Aged, Polymorphism, Genetic, Postmenopause:genetics,.   

OBJECTIVES: Apolipoprotein E (APOE) gene belongs to the group of genes increasing the risk of the Alzheimer's disease (AD) development. The purpose of the study was the analysis of cognitive functions in postmenopausal women having different polymorphisms of APOE gene; battery of computer tests - Central Nervous System Vital Signs (CNS-VS) were employed.r />r /> METHODS: The women were qualified into the examined group on the grounds of clinical symptoms (minimum 2 years after the last menstruation), as well as on the basis of FSH concentration. At the qualification stage, a short test - Montreal Scale of Cognitive Function Assessment (MoCA) was conducted. The assessment of cognitive functions was made with the use of diagnostic CNS-Vital Signs equipment. Genomic DNA isolation was extracted from human whole blood. Multiplex PCR reactions have been performed in a single reaction tube with six (6) primers, consisting of 2 common primers and 4 specific primers [2 - for each of 2 single nucleotide polymorphism (SNP) sites].r />r /> RESULTS AND CONCLUSIONS: About half of the examined postmenopausal women were placed below average in the majority of the examined cognitive functions. The biggest impairments occurred in the field of processing speed, and the smallest - in the field of verbal and visual memory. Polymorphisms of APOE gene were considerably linked with the level of results of the majority of cognitive functions among postmenopausal women, as measured by battery of computer tests - CNS-VS. The presence of ε2/ε3 polymorphism of APOE gene impacted positively the obtained results of cognitive functions, whereas the presence of ε3/ε4, or ε4/ε4 polymorphisms worsened the obtained results....

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Case Reports 2012; 33(4): 375-379 PubMed PMID: 22936260 Citation  Keywords:  Female, Hemangioma:complications, Humans, Placenta:blood supply, Pregnancy, Pregnancy Complications, Neoplastic:pathology, Pregnancy Outcome, Uterine Neoplasms:complications,.   

: The aim of the study was to investigate potential influence of placental tumors on fetal outcome. The study comprised 10 cases of placental tumors. The analysis included the sonographic assessment of the tumor, signs of fetal anemia, as well as signs of hemodynamic disturbances or heart failure, and intrauterine treatment. The fetal hemodynamic was examined on the basis of Doppler blood flow in the umbilical artery and vein, middle cerebral artery, and ductus venous. The evaluation of fetal heart included the measurement of heart size, blood flow through cardiac valves and the assessment of fetal heart function based on cardiovascular score. The fetal outcome was also assessed according to birthweight, gestational age at delivery, pH, Ap score at 5th minute, abnormal neurological development and the need of intrauterine therapy. Ten cases of placental tumors were prenatally detected from 1999 to 2011. Among them 7 cases of hypoechogenic, non-vascularized cysts were identified and these neither effected the hemodynamics nor complicated fetal outcome. The vascularized tumors (chorioangioma) were the cause of severe anemia and hemodynamic disturbances and these led to fetal cardiac heart failure. In all cases of vascularized tumors from 2-3 intrauterine transfusion were performed. Rich vascularized tumors (chorioangioma) may cause hemodynamic disturbances and fetal heart failure. This may require intrauterine treatment and may result in abnormal fetal outcome and neurological development....

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Journal Article 2012; 33(4): 361-371 PubMed PMID: 22936259 Citation  Keywords:  Clone Cells:pathology, Humans, Neoplasms:etiology, Thermodynamics,.   

: The essence of life is best manifested in cell, which, when brought to the edge of its existence in the actual environment may and sometimes must self-organise into an entirely different cell (neoplasm), but it must enhance dissipation of matter and energy in its closest environment. This phenomenon has been described before as self-organisation of dissipative structures in physics, chemistry and even sociology. Each neoplastic cell is such a dissipative system - with its clonal growth, the cell causes increasing disorganisation of the body, in consequence leading to neoplastic disease. The only adequate cause of formation of neoplasms is an internal dissipathogenic cellular state, which is clinically identify as preneoplastic ones at the level of morphology or molecular biology but also biophysics. Two general directions for therapy of neoplastic diseases arise from the thermodynamic essence of neogenesis: the direct one - targeting neoplasms, and the indirect one - leading to normalisation or sufficient alteration of their environment. The greatest disappointment in the fight against neoplasm was the discovery of its thermodynamic cause in a natural self-organisation of biological dissipative structures. It is this dissipation that causes the signs and symptoms of neoplastic diseases ending with destruction of the body if the treatment comes too late and/or is insufficient, limited only to removal of neoplastic lesions without the always necessary elimination and/or prevention of preneoplastic (dissipathogenic) states....

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