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Comparative Study 2009; 30(6): 769-773 PubMed PMID: 20038932 Citation  Keywords:  Adolescent, Adult, Anxiety:complications, Depression:complications, Dissociative Disorders:complications, Female, Humans, Linear Models, Male, Middle Aged, Personality Inventory, Severity of Illness Index, Young Adult,.   

OBJECTIVE: The aim of our study is to examine if the dissociation, can influence intensity of psychopathology in patients suffering with dissociative disorders compare the level of dissociation of the patients with the data of healthy subjects.

METHODS: 32 patients suffering with various types of dissociative disorder (9 males and 23 females) and 93 healthy controls (29 males and 64 females) were included into the study. The patients were psychiatrically assessed and the subjective intensity of symptoms was evaluated by Beck Anxiety Inventory and Beck Depression Inventory. All participants were assessed with the Dissociative Experiences Scale (DES).

RESULTS: The two groups didn't differ in demographic variables like age, gender and education. Level of the psychological dissociation assessed with the DES was correlated with the severity of subjective anxiety symptoms (p<0.0001), and with the severity of depression symptoms (p<0.0001). Patients had statistically significant higher mean score of DES than healthy controls (p<0.0001).

CONCLUSIONS: Our results suggest that the level of psychological dissociation in dissociative disorder patients is associated with the severity of anxiety and depressive symptoms....

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Journal Article 2009; 30(6): 723-728 PubMed PMID: 20038931 Citation  Keywords:  Adult, Antidepressive Agents:administration & dosage, Depressive Disorder, Major:diagnosis, Drug Resistance, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Retrospective Studies, Secondary Prevention, Sever.   

OBJECTIVE: The aim of this retrospective study was to compare the efficacy of combination therapy (combinations of antidepressants and various augmentations) and antidepressant monotherapy in the treatment of patients, who failed to respond at least to one previous antidepressant trial in the routine clinical practice.

METHODS: We reviewed chart documents of patients hospitalized at Prague Psychiatric Center for depressive disorder from June 2005 to June 2007 and finished at least 4 weeks of new treatment. Depressive symptoms and overall clinical status were assessed using Montgomery and Asberg Depression Rating Scale, Clinical Global Impression and Beck Depression Inventory - Short Form at the baseline and in the end of treatment.

RESULTS: We identified 49 inpatients (24-combined treatment, 25-monotherapy), who were suitable for analyses. Both groups were equal in baseline characteristics and in the duration of index episode treatment. The combined treatment was superior to the monotherapy switch in the MADRS median score reduction (16 vs. 9 points, p=0.01). The combined group achieved higher response rate compared to monotherapy group (67% vs. 36%, p=0.05). Number need to treat for response was 3.3 (95% CI, 1.85-37.3).

CONCLUSION: The findings of this study suggest that combined treatment is more efficacious than switch to monotherapy in the treatment of resistant depression....

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Biography 2009; 30(6): 675-676 PubMed PMID: 20038930 Citation  Keywords:  Chronobiology Discipline:history, History, 20th Century, History, 21st Century, Molecular Biology:history, Neuroendocrinology:history, Romania, United States,.   

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Case Reports 2009; 30(6): 700-704 PubMed PMID: 20038929 Citation  Keywords:  Dacryocystitis:drug therapy, Glucocorticoids:administration & dosage, Humans, Hypopituitarism:drug therapy, Lymphocytes:pathology, Magnetic Resonance Imaging, Male, Methylprednisolone:administration & dosage, Middle Aged, Pulse Therapy, Drug, Treatment Ou.   

OBJECTIVE: Lymphocytic hypophysitis (LH) is a rare autoimmune disorder associated with lymphocytic cell infiltration of the pituitary. It is often detected in patients with other autoimmune systemic diseases such as Hashimoto's thyroiditis, epinephritis, megaloblastic anemia, and Langerhans cell histiocytosis. Pituitary biopsy and invasive histopathological examination provide the most reliable evidence for LH diagnosis. However, because glucocorticoids are extensively used for the treatment of disease, pathological diagnosis is not always necessary. Here, we report a rare case of a male patient (50 y) with LH associated with dacryoadenitis that was successfully treated with high-dose of methylprednisolone.

RESULTS: The patient had a history of swollen lacrimal glands for two years. In addition, magnetic resonance imaging (MRI) showed a markedly thickened infundibular stem and an indiscernible signal in the posterior lobe of the pituitary. Biopsy of the lacrimal glands revealed reactive hyperplasia of the lymphoid tissue. After a high-dose of methylprednisolone pulse treatment (HDMPT), lacrimal gland swelling and infundibular stem thickness were reduced, and adenopituitary function improved within a short time period.

CONCLUSIONS: Although association of LH with dacryoadenitis is a rare, it can be effectively managed with HDMPT. In addition, response to HDMPT can avoid the more invasive diagnostic procedures, including surgical intervention and pituitary biopsies....

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Journal Article 2009; 30(6): 729-732 PubMed PMID: 20038928 Citation  Keywords:  Adiponectin:blood, Adult, Blood Glucose:metabolism, Female, Fetal Development:physiology, Humans, Insulin:blood, Insulin Resistance, Leptin:blood, Pregnancy, Pregnancy Trimester, First:metabolism, Ultrasonography, Prenatal,.   

OBJECTIVE: Fetal growth is determined by genetic factors and placental supply. There is evidence that insulin might contribute to the up-regulation of placental transporter activity. The dysregulation of adiponectin and leptin is found in insulin resistance. The objective of this study was to evaluate the relation of maternal plasma cytokine and insulin concentrations in the first trimester of pregnancy to fetal growth.

METHODS: 55 women with singleton pregnancy, between 12th and 14th weeks of gestation, were included to the study. Plasma concentrations of adiponectin, leptin, insulin and glucose were analyzed together with fetal ultrasound measurements and neonatal birth weight. The HOMA-IR were calculated (fasting insulin (microU/ml) x fasting glucose (mmol/l/22.5) to assess the insulin sensitivity.

RESULTS: Mean concentrations of adiponectin, leptin and insulin were 15.29 +/- 13.83 microg/ml, 6.93+/-5.39 ng/ml and 43.59+/-26.28, respectively. The average insulin resistance defined by HOMA-IR was 1.35+/-0.8. The ratios of adiponectin to leptin, adiponectin to insulin and HOMA-IR were calculated. The percentiles of fetal crown-rump length (CRL) were negatively correlated with adiponectin plasma concentration (r=-0.32; p<0.05), with no relation to leptin and insulin plasma concentration. Correlations between fetus CRL percentile and the ratio of adiponectin to leptin concentration (r=-0.37; p<0.02) and adiponectin to HOMA-IR (r=0.35; p<0.05) were also observed. No association between adiponectin, leptin, fasting insulin, HOMA-IR and neonatal birth weight or birth weight percentile was found. The percentile of fetal CRL in the 1st trimester was positively correlated with neonatal birth weight percentile (r=0.3; p<0.05).

CONCLUSIONS: The results of this study imply that maternal adiponectin concentration may play a role in early determination of fetal growth....

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Comparative Study 2009; 30(6): 774-778 PubMed PMID: 20038926 Citation  Keywords:  Adolescent, Adult, Aged, Agoraphobia:complications, Anxiety:complications, Depression:complications, Dissociative Disorders:complications, Female, Humans, Male, Middle Aged, Panic Disorder:complications, Personality Inventory, Severity of Illness Index, Y.   

OBJECTIVE: According to recent findings, clinical symptoms of the patients suffering from panic disorder are related to dissociation. The aim of our study is to examine if the dissociation, can influence the intensity of psychopathology in patients suffering from panic disorder with or without agoraphobia and compare the levels of dissociation in the patients and healthy subjects.

METHODS: 41 patients suffering from panic disorder (70.1% females) and 66 healthy controls (77.3% females) were included in the study. The patients were psychiatrically assessed and the subjective intensity of symptoms was evaluated using Beck Anxiety Inventory and Beck Depression Inventory. All participants were assessed with the Dissociative Experiences Scale (DES).

RESULTS: The two groups didn't differ in demographic variables like age, gender and education. Level of the psychological dissociation assessed with the DES was correlated with the severity of subjective anxiety symptoms (p<0.0001), but not with the severity of depression symptoms. Patients did not have significantly higher mean score on the DES than healthy controls.

CONCLUSIONS: Our results suggest that the level of psychological dissociation in panic disorder patients is associated with the severity of anxiety but not depressive symptoms....

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Case Reports 2009; 30(6): 705-708 PubMed PMID: 20038924 Citation  Keywords:  Adolescent, Deglutition, Family Conflict:psychology, Female, Foreign Bodies:diagnosis, Humans, Needles, Self-Injurious Behavior:diagnosis, Suicide, Attempted:psychology,.   

: Self-harm represents a serious and pathological behavior that occurs most notably during adolescent years and currently seems to be a problem that is on the increase. Self-harm is a self destructive behavior which most frequently takes the form of cutting and burning. Relative to suicidal behavior, self-harm, in and of itself, is not intended to be lethal and tends to be repeated and addictive. However, in cases of self-harm the risk of suicidal behavior cannot be ignored. This presentation is a case study of a girl who engaged in an unusual form of self-harm, by swallowing needles....

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Journal Article 2009; 30(6): 733-738 PubMed PMID: 20038922 Citation  Keywords:  Adult, Amniotic Fluid:metabolism, Biomarkers:metabolism, Chorioamnionitis:diagnosis, Female, Fetal Membranes, Premature Rupture:diagnosis, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Interleukin-8:metabolism, Predictive Value of Tests, Pr.   

OBJECTIVE: To determine whether amniotic fluid levels of interleukin-8 (IL-8) are of value in the antenatal diagnosis of acute histological chorioamnionitis (HCA) in preterm premature rupture of membranes (PPROM).

SETTING: Department of Obstetrics and Gynaecology, Charles University, Medical School and University Hradec Kralove, Czech Republic.

METHODS: We compared amniotic fluid IL-8 levels in twenty-nine pregnant women with preterm premature rupture of membranes between 24th and 36th gestational weeks with presence and absence acute histological chorioamnionitis or/and microbial invasion in the amniotic cavity using nonparametric tests (Mann-Whitney test), given the non-normal distribution of analyte. Comparisons of proportions were performed with Shapiro-Wilk normality test.

RESULTS: Patients with HCA had a significantly higher median amniotic fluid IL-8 concentration than patients without the histological signs of chorioamnionitis (1867 pg/mL, 826-5577 versus 1045 pg/mL, 60-4133, p=0.013). Patients with MIAC had a significantly higher median amniotic fluid level than patients without invasion (1888 pg/mL, 519-5577 versus 1225 pg/mL, 60-2766, p= 0.017). Women with HCA and MIAC had a significantly higher median amniotic fluid IL-8 level than women without histological signs of chorioamnionitis and microbial invasion (3117 pg/mL, 826-5577 versus 1468 pg/mL, 394-2766, p=0.034).

CONCLUSIONS: HCA or/and MIAC are associated with a significant increase of amniotic fluid interleukin-8 levels. Amniotic fluid IL-8 seems to be a marker of intraamniotic inflammation....

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