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Journal Article 2007; 28(5): 541-544 PubMed PMID: 17984950 Citation  Keywords:  Animals, Energy Metabolism:physiology, Humans, Hypothalamo-Hypophyseal System:secretion, Nerve Tissue Proteins:physiology, Neurotransmitter Agents:physiology, Prolactin:secretion, Rats,.   

: Cocaine and amphetamine regulated transcript (CART) is widely expressed in the central nervous system and in several endocrine organs. The physiological role of this peptide includes modulation of appetite control, energy expenditure, thermoregulation and hormone secretion. It has been suggested that CART influences prolactin (PRL) secretion both directly and indirectly. However, the mechanism underlying the regulation of PRL release by CART remains unclear....

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Journal Article 2007; 28(5): 591-595 PubMed PMID: 17984947 Citation  Keywords:  Acquired Immunodeficiency Syndrome:drug therapy, Anti-Retroviral Agents:therapeutic use, Base Sequence, Citrobacter freundii:genetics, DNA, Bacterial:analysis, Enterobacter aerogenes:genetics, Enterobacteriaceae:genetics, Genes, Bacterial:genetics, Genes,.   

OBJECTIVES: Bacterial DNA isolated from the intestinal tract of 11 American and 30 Slovak HIV/AIDS patients were analyzed by colony and dot blot hybridization assay for HIV-1 specific sequences. Secondly, PCR using primers specific for the HIV-1 gag, pol and env genes for detection of HIV-1 sequences in these DNA were performed.

RESULTS: Intestinal bacteria DNA of HIV/AIDS patients hybridized in colony and dot blot hybridization assay for HIV-1 specific sequences. PCR products synthesized on specific primers of HIV-1 gag (115 bp), env (142 bp), pol-env (1484) genes were found to be for more than 90% homologous to the corresponding sequence in HIV-1.

CONCLUSIONS: Intestinal bacteria of HIV/AIDS patients are bearing sequences for more than 90% identical with those of HIV-1....

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Case Reports 2007; 28(5): 549-553 PubMed PMID: 17984930 Citation  Keywords:  ACTH-Secreting Pituitary Adenoma:blood, Adenoma:blood, Adrenocorticotropic Hormone:blood, Aged, Antineoplastic Agents, Hormonal:therapeutic use, Empty Sella Syndrome:blood, Female, Humans, Octreotide:therapeutic use, Pituitary Neoplasms:blood, Treatment F.   

BACKGROUND: Our patient was a 65-year-old woman previously diagnosed with Addison's disease. She presented an empty sella turcica and, at the age of 47, was discovered to have autonomous hypersecretion of adrenocorticotropic hormone (ACTH), suggesting a corticotropic adenoma secondary to Addison's disease, with a lack of response to high levels of dexamethasone. She maintained high ACTH levels despite corticosteroid treatment.

METHODS: The patient underwent a CRH stimulation test using an intravenous bolus (100 microg) with samples every 30 minutes for 3 hours and, the day after, an octreotide infusion (0.1 mg/200 cc saline) for 2 hours with measurements every 30 minutes for 3 hours. The following month she received subcutaneous octreotide 0.1 mg tid., and samples were taken every week.

RESULTS: Thirty minutes after the corticotropic-releasing-hormone (CRH) stimulation test, baseline ACTH levels (1 063 pg/ml) increased to 1530, the other values lying between 1 020-862. After octreotide infusion, baseline ACTH (1 212 pg/ml) was 946-643-1 630-4 600-1 730 at 30-60-90-120-180 minutes. The following month, with octreotide treatment, serum ACTH levels were 454-768-1233-429 pg/ml each week.

DISCUSSION: Octreotide acts mainly on somatostatin type 2 receptors (SSTR2) and has no effect in Cushing's syndrome, although a suppressor effect in some ACTH ectopic hypersecretions and in Nelson's syndrome has been demonstrated. It has been observed that SSTR5 appear more frequently than SSTR2 in corticotropic adenomas and corticosteroids downregulate octreotide sensitivity.

CONCLUSIONS: Octreotide did not suppress secretion of ACTH in suspected corticotropic adenoma. Newer somatostatin analogues, acting mainly on SSTR5, may be able to control ACTH hypersecretion in cases such as this....

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Case Reports 2007; 28(4): 524-526 PubMed PMID: 17693989 Citation  Keywords:  Adult, Antidepressive Agents, Tricyclic:therapeutic use, Depression:diagnosis, Fatal Outcome, Female, Humans, Mianserin:analogs & derivatives, Prefrontal Cortex:drug effects, Retrospective Studies, Suicide, Theta Rhythm,.   

: We present a case report of a 37-year old woman diagnosed with depressive disorder, first episode, who was admitted into a psychiatric hospital after a failed suicidal attempt. She responded to antidepressant therapy, as evidenced by a >50% reduction in MADRS total score. She was discharged after 4 weeks of treatment, denying any suicidal ideations. The following day the patient committed suicide; she burned herself to death. It is very likely that the patient dissimulated her symptoms and ideations. Subsequently, her quantitative EEG records were retrospectively analyzed. An increase of prefrontal theta cordance value after the first week of mirtazapine therapy was found. Recently three small studies have revealed that decrease of prefrontal theta cordance after 1 week of antidepressant administration can predict clinical response in patients with unipolar depression. In our previous study the absence of a decreased theta prefrontal cordance was associated with lack of treatment response with NPV 1.0 (Bares et al., 2007). Thus, we hypothesize that prefrontal theta cordance could become an objective marker of change of depressive symptoms, independent of patients' compliance and symptom dissimulation, more precise than objective and self-rated depression rating scales....

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Comparative Study 2007; 28(4): 386-394 PubMed PMID: 17693975 Citation  Keywords:  Adult, Aged, Aldosterone:blood, Altitude, Atrial Natriuretic Factor:blood, Cross-Sectional Studies, Health Surveys, Humans, Hypertension:blood, Jordan, Male, Middle Aged, Prevalence, Renin:blood,.   

: A cross-sectional study was designed to investigate the association of the levels of plasma renin activity (PRA) and aldosterone (ALDO) and atrial natriuretic hormone (ANH) with the rates of hypertension prevalence in people living at 340 meters below sea level, the Jordan Valley (JV) and those residing at 620 meters above sea level, Irbid City. 1072 natives from the JV and 1402 natives from Irbid City were covered by a questionnaire to estimate hypertension prevalence in the JV and Irbid city (population age: 35-65 years). Male subjects were selected from the JV (24 hypertensives, 46+/-15 years old, and 93 normotensives, 33+/-13 years old) and from Irbid City (31 hypertensives, 47+/-12 years old, and 89 normotensives, 40+/-13 years old) to evaluate the levels of PRA, ALDO and ANH. Hypertension was less common in the JV than in Irbid City (9.9% vs. 13.6%). The levels of PRA in the hypertensive subjects compared to the normotensive subjects were lower in the JV (1.7+/-1.0 vs. 2.6+/-1.4 ng/ml/hr) but were similar in Irbid City (2.9+/-2.7 vs. 3.2+/-2.7). The levels of ALDO in the hypertensive subjects compared to the normotensive subjects were similar in the JV (119+/-58 vs. 139+/-66 pg/ml) but were higher in Irbid City (199+/-112 vs. 146+/-84). The levels of ANH in the hypertensive subjects compared to the normotensive subjects were lower in the JV (13.9+/-9.3 vs. 28.0+/-12.7 ng/ml) and were also lower in Irbid City (21.0+/-12.2 vs. 26.7+/-11.6)....

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Journal Article 2007; 28(4): 438-444 PubMed PMID: 17693972 Citation  Keywords:  ACTH-Secreting Pituitary Adenoma:pathology, Adenoma:pathology, Adolescent, Adult, Aged, Child, Endoscopy:adverse effects, Female, Growth Hormone-Secreting Pituitary Adenoma:pathology, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Minimally Invasi.   

AIM OF THE STUDY: The paper presents endoscopic surgical technique used in the treatment of hormonally active pituitary adenomas and assessment of the method in terms of its effectiveness and safety.

MATERIAL AND METHODS: In 217 cases the surgery was performed due to pituitary adenomas applying the technique developed by Jho and Carrau, with our own modifications. 70 patients were treated for hormonally active adenomas. The group consisted of 36 somatotrophic adenomas, 21 prolactinomas and 13 corticotrophic adenomas. There were 51 females and 19 males with mean age of 42.6 years (range 11-77 years). The follow-up period was between 7 and 56 months (mean - 34 months). The effectiveness and occurrence of complications were confirmed on the basis of neurosurgical, laryngological, endocrinological, ophthalmological examinations and neuroimaging.

RESULTS: Biochemical and neurosurgical criteria for complete resection were obtained in 21 (58.3%) of 36 patients with all somatotrophic adenomas. In the group of prolactinomas complete resection was achieved in 17 (80.9%) of 21 patients. Of the 13 patients with Cushing's disease 11 (84.6%) were cured. In the studied group there were no deaths. In the postoperative course only 2 (2.8%) patients suffered liquorrhoeas and new anterior lobe pituitary insufficiency was noted in 8 (11.4%) cases. Meningitis was noted in 1 (1.4%) case and another 1 (1.4%) patient had epistaxis which required repeated endoscopic surgery.

CONCLUSIONS: Endoscopic technique is an effective method of treatment of hormonally active pituitary adenomas. It is characterised as being minimal invasive and has a low severe complication rate....

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Journal Article 2007; 28(Suppl 2): 34-35 PubMed PMID: 17558376 Citation  Keywords:  Anti-Bacterial Agents:therapeutic use, Child, Child, Preschool, Cross Infection:drug therapy, Humans, Infant, Infant, Newborn, Meningitis, Bacterial:drug therapy, Neurosurgical Procedures:adverse effects, Postoperative Complications:drug therapy, Retrospe.   

: Analysing 101 cases of nosocomial meningitis due to staphylococci other than S. aureus within last 15 years, coagulase negative staphylococci represented the commonest pathogen. Major risk factor for staphylococcal meningitis was prior neurosurgery, mainly ventriculoperitoneal shunt insertion. Ten of 101 cases were caused by glycopeptide intermediate resistant strains in patients pretreated with multiple combination of antibiotics including vancomycin and shunt exchanges: 76% of strains were also oxacillin resistant....

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Journal Article 2007; 28(Suppl 2): 30-31 PubMed PMID: 17558374 Citation  Keywords:  Anti-Bacterial Agents:therapeutic use, Cross Infection:drug therapy, Humans, Hydrocephalus:etiology, Infant, Newborn, Language Development Disorders:etiology, Meningitis, Bacterial:drug therapy, Rare Diseases, Retrospective Studies, Streptococcal Infectio.   

: Streptococcus agalactiae is a rare cause of neonatal meningitis in the era of peripartum prophylaxis with prophylaxis with ampicillin in colonized/infected mothers. However 5 cases of meningitis among 171 cases of pediatric nosocomial meningitis database within last 15 years occurred. All 5 children were neonates (one VLBW and early gestation newborn), 2 after neurosurgery. All 5 cases were successfully cured with a combination of cefotaxim (or ceftazidim) plus aminoglycosides, in one case also with addition of vancomycin or ampicillin. However 3 of 5 cured patients had neurologic sequellae, two of them reversible hydrocephalus and in speech retardation....

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