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Comparative Study 2003; 24(6): 425-430 PubMed PMID: 15073569 Citation  Keywords:  Adenoma:pathology, Adenoma, Oxyphilic:pathology, Adolescent, Adult, Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Pituitary Neoplasms:pathology, Prognosis, Retrospective Studies, Sex Characteristics, Treatment Out.   

OBJECTIVES: Clinically non-functioning pituitary adenomas are common tumors of the pituitary gland. No studies have yet documented gender-related differences in the growth and presentation of these tumors and nothing is known about their effects on their subsequent surgical outcome and prognosis.

SETTING AND DESIGN: Twenty-eight patients with non-functioning pituitary adenoma, that met strict inclusion criteria, and that underwent surgical treatment between January 1990 and June 1997, were retrospectively reviewed.

METHODS: The patient charts, as well as histological (incl. immunohistochemistry) and electron microscopic findings were analyzed. Tumor invasiveness was classified according to the modified Hardy criteria.

MAIN FINDINGS: Eleven patients were women and seventeen were men; the female-to-male-ratio was 1:1.5. Men were significantly older, both at diagnosis and surgery. Visual field defect and visual acuity deficit were the most common presenting symptoms with similar occurrence both in women and men, whereas blindness predominated in women. Microadenomas and invasive adenomas did not differ significantly in MIB-1 index, but patients less than 35 years old had higher MIB-1 indices (n=4, 1.72+/-1.15), than did patients over 45 years (n=11, 0.63+/-0.42) (p: n.s.). MIB-1 labeling indices were higher in adenomas of female compared to male patients (1.5 +/-1.2 vs. 0.8+/-1.8; p < 0.003). The overall outcome was significantly worse in women than in men.

CONCLUSION: The biology and the clinical course of clinically non-functioning pituitary adenoma seem to differ in women and men. In men, tumors are smaller and less invasive at surgery, and the outcome is better than in women. The present findings may justify a more aggressive therapeutic approach to clinically non-functioning pituitary adenomas in women than in men, especially to improve the availability of viable pituitary cells at the time of surgery....

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Journal Article 2003; 24(6): 412-416 PubMed PMID: 15073566 Citation  Keywords:  Adult, Birth Weight, Body Image, Depressive Disorder, Major:etiology, Humans, Infant, Newborn, Middle Aged, Prenatal Nutritional Physiological Phenomena, Retrospective Studies, Self Efficacy,.   

OBJECTIVE: Foetal origins theory has suggested that early environment can affect vulnerability to major diseases in later life. Recent research also suggests that foetal hormonal programming may influence neurotransmitter and hormone levels affecting adult psychological states (i.e. depression and general self-efficacy). However, investigations into early environment and depression have focused on hospitalised or elderly participants, using non-standard measures. This study investigates links between birthweight and depression in a non clinical adult population, as well as links with general self-efficacy and depression.

METHODS: This is a retrospective design. 100 participants mean age 25.9 self reported birthweight, current height and weight to allow computation of BMI. A General Self-Efficacy Scale and the Hospital Anxiety and Depression Scale were also completed. The official classification of low birthweight (2.5 kg) and the median weight for the group (3.26 kg) were used to identify three groups.

FINDINGS: One way ANOVA showed that variance in depression [F = 5.31, (2,97) p =.006] and lower general self-efficacy [F = 4.04, (2,96) p =.021] is explained by membership of birthweight group. There was no variance between depression and age, although general self-efficacy did increase with age [F = 6.13, (2,95) p =.003). There was no significant variance between BMI and birthweight or depression.

DISCUSSION: Findings add to the growing body of research suggesting that foetal environment influences later life, particularly that early programming may affect hormone and neurotransmitter secretions which may influence later life psychological as well as physical health....

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Journal Article 2002; 23(3): 219-225 PubMed PMID: 12080282 Citation  Keywords:  Acute Disease:psychology, Adult, Age Factors, Birth Weight, Cognition, Cross-Sectional Studies, Female, Humans, Male, Models, Psychological, Neuroimmunomodulation, Predictive Value of Tests, Retrospective Studies,.   

BACKGROUND: The Barker Hypothesis suggests that an unfavourable uterine environment can have the effect of programming the body for disease later in life. Research indicates a bidirectional relationship between thought and biochemical reactions, that may be influenced by early programming. Reports suggest that 25% of variance in birthweight is a result of foetal environment and that the health and cognitive deficits do not just affect those with an officially low birthweight.

OBJECTIVE: This study investigates the influence of birthweight on cognition and minor illness in adults.

METHODS: This is a retrospective, cross sectional design with an opportunity sample of 75 adults. Participants whose birthweight ranged from 2.5 kg to 4.88 kg, completed a symptom check list and general self-efficacy scale, reporting on the previous month.

RESULTS: Analysis of variance indicates that those with higher birthweight have fewer minor illness symptom days and higher general self-efficacy. Regression analysis indicates that birthweight is significantly predictive of levels of minor illness and general self-efficacy.

CONCLUSION: From the findings of this and previous studies, it is possible to infer vertical coactions between foetal environment and immuno competence. It is suggested that birthweight is an early predictor of levels of a cognitive mediator and minor illness. Data were applied to an equilibrium model to represent the relationship in terms of Gottlieb's concept of horizontal and vertical coactions....

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Journal Article 2001; 22(1): 39-44 PubMed PMID: 11335878 Citation  Keywords:  Adult, Aged, Antiviral Agents:adverse effects, Comorbidity, Female, Follow-Up Studies, Hepatitis C, Chronic:drug therapy, Humans, Incidence, Interferon-alpha:adverse effects, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Factors, Sex Distribu.   

OBJECTIVES: To clarify the relationship between interferon-alpha (IFN-alpha) therapy and autoimmune thyroiditis in chronic hepatitis C virus (HCV) infection, we investigated a selected number of patients without basal thyroid dysfunctions.

MATERIALS AND METHODS: 130 patients (average age: 20-70), with chronic HCV infection and without basal clinical and laboratory signs of autoimmune thyroiditis were divided into two groups: IFN-alpha treated (A) and untreated (B) patients. Group A received IFN-alpha (three million U.I./3 times a week) for six months; group B was followed for the same period. Thyroid peroxidase and thyroglobulin autoantibodies were measured by radioimmunoassay; thyroid function was measured by radioimmunoassay (free thyroxine and triiodothyronine) and immunoradiometric assay (thyroid stimulating hormone).

RESULTS: After a 6-month period, thyroid autoantibodies positivity was documented in 21.1% of group A and in 10.3% of group B patients, both statistically relevant (p<0.001 and p<0.011, respectively). The comparison between the two groups was not statistically relevant (p=0.142).

CONCLUSIONS: Our study showed a prevalence of de novo thyroid autoimmunity in chronic HCV patients treated with IFN-alpha, confirming previous data in literature. The lack of a significant difference between treated and untreated patients strongly suggests that the anti-thyroid autoimmune response is linked to the HCV infection itself. Moreover, IFN-alpha therapy probably does not represent a risk factor in renewing the autoimmune processes of the thyroid gland. Thyroid function and autoantibodies must be systematically monitored in patients with HCV infection, especially in female and IFN-alpha treated population, not only to verify the possible thyroid abnormalities but also to rule out concomitant autoimmune diseases....

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Journal Article 2018; 39(3): 189-195 PubMed PMID: 30431744 Citation  Keywords:  Adult, Cervical Vertebrae, Female, Humans, Male, Maximal Respiratory Pressures, Middle Aged, Muscle Strength:physiology, Posture, Respiratory Function Tests, Respiratory Muscles:physiopathology, Retrospective Studies, Severity of Illness Index, Sitting Po.   

OBJECTIVES: In the subjects with high cervical spinal cord injury (SCI), The difference of respiratory muscle strength and pulmonary function according to supine and sitting position were investigated whether there are changes in the tendency. METHODS: Twenty-three subjects with high cervical SCI and 23 subjects with low cervical and thoracic SCI were evaluated. The reference neurological level of injury for dividing the groups was fifth cervical vertebrae (C5). SCI severity was classified as motor-complete SCI. The supine and sitting forced vital capacity (FVC), percent of the predicted FVC (FVC%), maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), MEP / MIP ratio, and peak cough flow (PCF) were compared. RESULTS: The significantly higher FVC, FVC% in the low cervical and thoracic SCI group was identified in the supine position than the sitting position. The same tendency was observed in the high cervical SCI group. In the comparison of respiratory muscle strength, higher values of supine MEP and MIP were found only in the high cervical SCI group. PCF is more positively correlated with MIP than with MEP in all groups. CONCLUSION: We found that the supine position is more advantageous for the strong breathing and larger lung capacity in patients with high cervical SCI. The positive correlation between PCF and MIP in the patients with high cervical SCI was also confirmed. These results may be used to establish a pulmonary rehabilitation strategy for patients with high cervical SCI....

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Journal Article 2018; 39(3): 205-208 PubMed PMID: 30431739 Citation  Keywords:  Adult, Aged, Bipolar Disorder:complications, Female, Humans, Injections, Intramuscular, Injections, Intravenous, Logistic Models, Male, Middle Aged, Multivariate Analysis, Psychomotor Agitation:drug therapy, Retrospective Studies, Serotonin Uptake Inhibit.   

OBJECTIVES: Trazodone is a multifunctional triazolopyridine drug with antidepressant, anxiolytic, sedative, and hypnotic properties. The current retrospective study was designed to investigate the effectiveness of trazodone for reducing acute psychomotor activation (PA) in patients with bipolar disorder (BD). We specifically reasoned that a parenteral route of administration could offer potential advantages in this clinical setting. METHODS: We assessed the effectiveness and safety of parenteral trazodone in a retrospective study conducted in 64 inpatients with BD and acute PA. The effectiveness assessment was the Clinical Global Impression Scale - Severity Of Illness (CGI-S) rated before the administration of parenteral trazodone (baseline) and at the end of treatment. A post-treatment reduction in CGI-S score ≥ 20% compared with baseline was considered as the primary outcome measure. RESULTS: Administration of parenteral trazodone was associated with significant improvements in CGI-S scores from baseline (5.4 ± 0.9) to the end of the study (4.2 ± 1.0; p < 0.001, Wilcoxon matched-pairs signed-ranks test). A total of 34 patients (53.1%) showed a post-treatment reduction in CGI-S score ≥ 20% compared to baseline. Multivariable binary logistic regression analysis using a forward selection procedure identified treatment duration (in days) as the only independent predictor of post-treatment reduction in CGI-S score ≥ 20% (odds ratio: 1.28; 95% confidence interval: 1.02-1.60, p <0.05). Adverse effects occurred in 13 (20.3%) patients. CONCLUSIONS: Parenteral trazodone is well-tolerated and effective in 53.1% of patients with BP and acute PA. Treatment duration was identified as an independent predictor of response in our sample....

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Journal Article 2018; 39(4): 281-287 PubMed PMID: 30531701 Citation  Keywords:  Adolescent, Adult, Aged, Aged, 80 and over, Brain Neoplasms:radiotherapy, Female, Glioblastoma:radiotherapy, Humans, Male, Middle Aged, Neoplasm Recurrence, Local:radiotherapy, Palliative Care, Radiosurgery, Retrospective Studies, Survival Rate, Treatment.   

OBJECTIVE: Local recurrence of glioblastoma is observed in most patients after standard oncologic treatment (surgery, chemotherapy and radiotherapy). Stereotactic radiosurgery with the Leksell Gamma Knife (SRS with LGK) was used to treat recurrent tumors in selected cases, and retrospective analysis of treatment outcome was performed. METHODS: Altogether 126 patients were treated for glioblastoma at our center from 1992-2014. Sixty-nine patients (55%) were male and 57 (45%) female, with a median age of 56 years (range 17-80 years). Prior to LGK radiosurgery, 123 (98%) underwent surgery, 126 (100%) radiotherapy and 116 (92%) chemotherapy. The median Karnofsky score before LGK radiosurgery was 90% (range 50-100), and the median time from GBM diagnosis to LGK radiosurgery was 12 months (range 1-96 months). The median tumor volume was 3.75 cm3 (range 0.04-37.10 cm3). LGK radiosurgery was performed in a single fraction with a median minimal tumor dose of 12 Gy (range 10-25 Gy) on a median 50% (range 40-86%) isodose line. Two and more LGK radiosurgeries were performed in 19 (15%) cases, a median interval of 9.6 months (range 2-45 months) from the initial LGK radiosurgery. The median prescribed dose in these patients was 12.6 Gy (range 10-15 Gy), and the median volume 5.8 cm3 (range 0.1-13.7 cm3). RESULTS: The median survival from GBM diagnosis was 20 months (range 6-237 months). The median survival after LGK radiosurgery was 7 months (range 1-223 months). The one year survival after LGK radiosurgery was 27%, 2 years 8%, and more than 3 years 4%. Tumor regression on MR images was observed in 17% of patients at a median interval of 7 months. The median interval to tumor progression on MR images after LGK treatment was 8.5 months. No treatment-related radionecrosis with expansive behaviour was detected after radiosurgery. CONCLUSION: We show that LGK radiosurgery is a safe palliative treatment modality in patients with recurrent GBM....

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Journal Article 2019; 39(7): 489-495 PubMed PMID: 30860680 Citation  Keywords:  Adult, Aged, Antibodies:immunology, Comorbidity:trends, Female, Fever:epidemiology, Hematuria:epidemiology, Humans, Iodide Peroxidase:immunology, Male, Middle Aged, Pain:epidemiology, Poland:epidemiology, Receptors, Thyrotropin:immunology, Retrospective S.   

INTRODUCTION: The clinical characteristics of subacute thyroiditis (SAT) has been changing in recent years. There are more and more patients with painless SAT, and more cases of SAT with elevated levels of anti-thyroid antibodies were reported. The aim of the study was to evaluate the clinical characteristics of SAT patients with special regard to the differences between the previously described and currently observed features of the disease. MATERIAL AND METHODS: Clinical and laboratory data were retrospectively reviewed for 64 patients with confirmed SAT. RESULTS: Mean age of the patients was 42.67 years. The male to female ratio was 1:7. Neck or ear pain was reported by 93.75% of patients, while fever occurred in 65.63% of patients. The aTPO and aTg levels were increased in 15.5% and 33.3% of patients, respectively. TRAb level was increased in 6% of patients. Transient microhaematuria was present in 63% of analyzed cases. No statistically significant differences in clinical characteristics or laboratory results were found between the groups with- and without neck/ear pain, with- and without elevated TRAb, and with- and without elevated aTPO and/or aTg. CONCLUSION: In our study, several new features of current SAT course, different from what we used to know about the disease, were reported. Higher frequency of painless SAT than it was ever described, was observed. Moreover, in as much as one third of the patients aTPO and/or aTg were present, and in 6% of SAT cases the coexistence of TRAb was demonstrated. Transient microhaematuria was typical for the acute SAT phase....

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