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Case Reports 2011; 32(4): 415-420 PubMed PMID: 21876497 Citation  Keywords:  Acute Disease, Demyelinating Diseases:pathology, Female, Humans, Magnetic Resonance Imaging, Multiple Sclerosis:pathology, Severity of Illness Index, Treatment Failure, Young Adult,.   

: In this case report we describe the case of a 24 year-old female with a fulminant demyelinating disease of white matter. Disease progression was most probably consistent with the Marburg variant (malignant form) of multiple sclerosis with rapid deterioration of the patient's clinical condition, including bulbar symptoms and epileptic paroxysms and ending with persistent coma and tetraparesis, over the course of 6 months from first symptoms. Repeated Magnetic Resonance Imaging (MRI) examination showed progression of multiple demyelinating lesions culminating in a contiguous focal disorder of the white matter extending both supratentorially and infratentorially. The serial MRI changes closely mapped the deterioration in the patients clinical status. Our patient showed no response to repeated pulse corticotherapy, administration of intravenous immunoglobulins, serial plasmapheresis, and combined high-dose pulse immunosuppression (specify what was used here) and mitoxantrone....

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Journal Article 2010; 31(2): 181-186 PubMed PMID: 20424592 Citation  Keywords:  Animals, Animals, Newborn, Brain:physiopathology, Disease Models, Animal, Electroencephalography, Hypoxia:physiopathology, Hypoxia, Brain:physiopathology, Recovery of Function, Severity of Illness Index, Swine, Time Factors,.   

OBJECTIVE: To evaluate the frequency content of the electroencephalogram (EEG) during recovery after a severe hypoxic insult in newborn piglets.

METHODS: EEG was continuously monitored in nine newborn piglets exposed to a severe hypoxic period. Power spectra in five frequency bands were calculated using Fourier transformation. Spectral edge frequency 90 (SEF90) was defined as the frequency below which 90% of the power in the EEG was located. The piglets were divided into two groups; Group 1 represented piglets with some EEG recovery and Group 2 represented piglets without any EEG recovery.

RESULTS: The recovery of the EEG in Group 1 had the same time course in all frequency bands. SEF90 indicates recovery earlier than the value of total power. But SEF90 also signals activity in the EEGs that were almost completely suppressed. When SEF90 was calculated during periods of periodic EEG activity during the very early phase of recovery, the values fell within the same range as during the control period.

CONCLUSION: Spectral analysis of continuous EEG in newborn piglets exposed to very severe hypoxia showed that no specific frequency band of the EEG preceded the other ones during recovery. The results of the SEF90 measure, demonstrates the need for critical analysis of the raw EEG before any reliable estimation of cerebral function can be made....

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Journal Article 2010; 31(1): 63-66 PubMed PMID: 20150869 Citation  Keywords:  Case-Control Studies, Cystinyl Aminopeptidase:blood, Down-Regulation, Enzyme Activation, Female, Gestational Age, Humans, Pre-Eclampsia:blood, Pregnancy, Premature Birth:blood, Severity of Illness Index, Term Birth:blood,.   

OBJECTIVE: Placental Leucine Aminopeptiadse (P-LAP) also known as oxytocinase, is secreted by syncytiotrophoblast and increases gradually during pregnancy until delivery. It is a regulator of uterine contractions, of vascular resistance and of volume of the retroplacental blood pool. Recently, it was shown that it could also regulate metalloproteinase 9 activity and thus, invasiveness of trophoblastic cells. Since development of preeclampsia could be initiated by decreased cytotrophoblastic invasion of spiral arterioles and a reduced uteroplacental perfusion, we speculate that circulating P-LAP activity could be decreased during preeclampsia.

MATERIALS AND METHODS: Case-control study was evaluated in 84 women. P-LAP activity was measured in n=51 healthy pregnant women at term, and compared with n=16 normotensive women delivering preterm and n=17 women diagnosed with pre-eclampsia. P-LAP activity was determined by colorimetry in plasma samples using L-Leucine-p-nitroanilide as substrate.

RESULTS: P-LAP activity was significantly lower in sera of preeclamptic women (0.91+/-0.122 mDO/min) as compared to normotensive controls (1.41+/-0.103 mDO/min; p=0.003) irrespective of time of delivery.

CONCLUSIONS: These findings confirm the probable involvement of P-LAP in trophoblast invasion and development of preeclampsia....

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Clinical Trial 2010; 31(1): 161-167 PubMed PMID: 20150864 Citation  Keywords:  Adult, Brain Mapping:methods, Cerebral Cortex:metabolism, Cystine:analogs & derivatives, Estrogen Replacement Therapy, Female, Humans, Hypothyroidism:diagnosis, Male, Neuropsychological Tests, Prognosis, Severity of Illness Index, Technetium:chemistry, Th.   

OBJECTIVE: The purpose of this study was to correlate hypothyroid-related symptomatology with regional cerebral blood flow (rCBF) during hypothyroidism.

MATERIALS AND METHODS: Nine thyroidectomized patients underwent neuropsychological testing and single photon emission computed tomography (SPECT) of their brains with technetium-99m (Tc-99m) ethyl cysteinate dimer (ECD), a lipophilic cerebral blood flow radiotracer, while hypothyroid, and again following thyroid hormone replacement. Neuropsychological test scores and TSH levels while hypothyroid were correlated with rCBF in hypothyroid-affected areas of the brain.

RESULTS: Correlations were found during hypothyroidism between the noted parameters and ECD radiotracer accumulation in the following respective regions, all of which demonstrated hypothyroid-related cerebral blood flow (CBF) aberrations: TSH and left middle occipital gyrus; psychomotor performance speed and left precentral gyrus; and depression and right middle frontal gyrus, left middle frontal gyrus, right insula, and left thalamus.

CONCLUSIONS: Severity of psychomotor impairment and depression, and TSH level during hypothyroidism appeared to correlate with CBF to brain regions associated with motor activity, mood and vision, respectively; and previously shown to manifest significantly altered rCBF during hypothyroidism....

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Journal Article 2009; 30(1): 85-90 PubMed PMID: 19300400 Citation  Keywords:  Adolescent, Adult, Female, Humans, Male, Middle Aged, Multiple Sclerosis:cerebrospinal fluid, Nerve Growth Factor:cerebrospinal fluid, Neuromyelitis Optica:cerebrospinal fluid, Research Design, Severity of Illness Index, Thyroid Hormones:cerebrospinal flu.   

OBJECTIVE: Multiple sclerosis (MS) is an inflammatory demyelinating disease of the human central nervous system (CNS) and a major cause of neurological disability among adults in North America and Europe. Neuromyelitis optica (NMO) is a very severe disease of inflammatory demyelination located in the optic chiasm, nerves and the spinal cord. The aim of this study is to assess thyroid hormone (TH) and nerve growth factor (NGF) levels in cerebrospinal fluid (CSF) of MS, NMO patients and controls, and investigate whether there is any correlation between TH and NGF levels in the CSF.

PATIENTS AND METHODS: 38 relapsing-remitting multiple sclerosis (RRMS), 10 NMO and 19 controls were investigated whether there was any correlation between TH and NGF levels in the CSF.

RESULTS: MS and NMO patients exhibited significantly higher CSF NGF (respectively P<0.05, P<0.05), TT4 levels (P<0.001) and higher TT4/ rT3 ratio (respectively P<0.01, P<0.01) compared with the controls. Significant correlation was found between CSF NGF levels and CSF rT3 levels or TT4/ rT3 ratio in controls (respectively P<0.01, P<0.05). EDSS was significantly correlated with CSF rT3 levels and TT4/ rT3 ratio in MS patients (respectively P<0.05, P<0.001).

CONCLUSIONS: These results indicate that an abnormal thyroid hormone may exist within the brain in the patients with MS. CSF rT3 levels and TT4/ rT3 ratio could be regarded as useful markers of underlying disease activity....

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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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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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Journal Article 2009; 30(5): 624-628 PubMed PMID: 20035254 Citation  Keywords:  Adolescent, Adult, Anxiety:physiopathology, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder:physiopathology, Severity of Illness Index, Young Adult,.   

OBJECTIVE: According to recent findings, clinical symptoms in patients with obsessive-compulsive disorder (OCD) seem be related with dissociation. The aim of the present study was to evaluate the relationship of psychological dissociation and clinical characteristics in OCD.

METHODS: The study sample comprised of 49 patients with OCD (55.1% females) and 45 healthy controls (66.7% females). All participants were assessed with the Yale-Brown Obsessive-Compulsive Scale, the Beck Depression Inventory-II, and the Beck Anxiety Inventory. Dissociation was quantified by the Dissociative Experiences Scale (DES).

RESULTS: Psychological dissociation assessed with the DES was associated with the severity of anxiety symptoms (beta=0.49, t=3.89, df=47, p<0.001), but not with the level of OCD symptoms. Patients had higher level of dissociation than healthy controls.

CONCLUSION: Our results suggest that the level of psychological dissociation is associated with the severity of anxiety symptoms rather than with OCD symptoms. Further investigation of association between dissociative and anxiety states is needed....

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