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Journal Article 2012; 33(1): 16-20 PubMed PMID: 22467106 Citation  Keywords:  Arthritis, Rheumatoid, Biomarkers:blood, Cytokines, Humans, Periodontitis:therapy,.   

: Chronic destructive periodontitis is no longer considered to be just a local inflammatory process afflicting the periodontal tissues, but a systemic infection. Bacteria, their products and various pro-inflammatory cells and substances can penetrate into the blood stream and infect distant organs and structures. Periodontitis and rheumatoid arthritis indicate several common histo-pathological correlations, as the destroyed osseous tissues and cartilages are permanently washed with inflammatory fluid full of proteolytic and osteolytic substances. Although exact causal and molecular associations between both diseases have not been explained yet, there are some common etiopathogenic correlations that can have influence on relationship between both diseases. Among these factors belong: a positive finding of common genes, genetic polymorphisms and hyper-inflammatory types of some immune competent cells and molecules, common cytokine profiles and increased concentrations of pro-inflammatory mediators in periodontal and joint structures. Periodontitis and some periodontal pathogens can influence various auto-immune reactions connected with rheumatoid arthritis (RF, anti-CCP). Possible causal associations are indicated in some studies dealing with treatment of RA, when a beneficiary effect of RA treatment led to improvement of some periodontal parameters. This relationship works both ways; the periodontal therapy had positive influence on some markers of rheumatoid arthritis. This provides sufficient theoretic evidence to perform professional and personal oral hygiene in a more active way....

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Journal Article 2012; 33(1): 1-2 PubMed PMID: 22467103 Citation  Keywords:  Adiponectin:blood, Animals, Antidepressive Agents:therapeutic use, Lithium,.   

: The effect of antidepressants and mood stabilizers on serum levels of adiponectin was investigated. Fluvoxamine (30 and 50 mg/kg/day) or lithium (40 and 60 mg/kg/day) was dissolved in distilled water and administered orally to rats every day for 4 weeks. Fluvoxamine (50 mg/kg/day) alone significantly elevated the serum level of adiponectin, but no significant difference was found between other drug-treated groups and the control group. This difference of these drugs' effectiveness on serum adiponectin might contribute to their differences of action mechanisms and therapeutic effects....

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Journal Article 2011; 32(6): 781-789 PubMed PMID: 22286801 Citation  Keywords:  Cognitive Therapy:education, Health Personnel:education, Humans, Psychotherapy:education,.   

HYPOTHESIS: For cognitive behavioural therapy, acquisition and maintenance of psychotherapeutic and supervisory competencies is crucial.

METHODS: The PubMed, Web of Science and Scopus databases were searched for articles containing the following keywords: cognitive-behavioural therapy, competencies, therapeutic relationship, intervention, technique, training, supervision, self-reflection, empirically supported, transference, countertransference, scheme of therapy, dialectical behaviour therapy. The search was performed by repeating the words in different combinations with no language or time limitations. The articles were sorted and key articles listed in reference lists were searched. In addition, original texts by A.T. Beck, J. Beck, C. Padesky, M. Linehan, R. Leahy, J. Young, W. Kuyken and others were used. The resources were confronted with our own psychotherapeutic and supervisory experiences and only most relevant information was included in the text. Thus, the article is a review with conclusions concerned with competencies in cognitive behavioural therapy.

RESULTS: For cognitive behavioural therapy, four domains of competencies in psychotherapy are crucial - relationship, case assessment and conceptualization, self-reflection and intervention. These may be divided into foundational, specific and supervisory. The foundational competencies include recognition of empirical basis for a clinical approach, good interpersonal skills, ability to establish and maintain the therapeutic relationship, self-reflection, sensitivity to a difference and ethical behaviour. The specific competencies involve the skill of case conceptualization in terms of maladaptive beliefs and patterns of behaviour, ability to think scientifically and teach this to the patient, structure therapy and sessions, assign and check homework, etc. The supervisor's competencies include multiple responsibilities in supporting the supervisee, identification and processing of the therapist's problems with the patient, continuous development, increasing the supervisee's self-reflection, serving as an example and being as effective as possible in the role of a clinical instructor.

CONCLUSION: Both the literature and our own experiences underline the importance of competencies in cognitive behavioural therapy and supervision....

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Case Reports 2011; 32(6): 748-750 PubMed PMID: 22286782 Citation  Keywords:  Adolescent, Anorexia Nervosa:epidemiology, Blindness:epidemiology, Body Image, Comorbidity, Female, Humans, Psychotherapy,.   

: Eating disorders represent significant psychopathological spectrum, particularly in adolescent girls. One of the risk factors associated with eating disorders is a strong emphasis of western visual-oriented culture on physical appearance and slimness. However, sensory handicap leading to disability to see one's own body and bodies of others does not mean that eating disorder cannot develop in blind people. The authors believe that body image is a mental construct that is not dependent on sensory perception only. They present the case of an adolescent patient, blind from early childhood, who shows symptoms of mental anorexia, depression, suicidal behavior and self-harming....

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Evaluation Studies 2011; 32(Suppl 1): 53-56 PubMed PMID: 22167208 Citation  Keywords:  Abortion, Eugenic:statistics & numerical data, Abortion, Spontaneous:epidemiology, Antidepressive Agents:adverse effects, Case-Control Studies, Congenital Abnormalities:epidemiology, Czech Republic:epidemiology, Depression:drug therapy, Drug Information S.   

OBJECTIVES: Antidepressant drugs are used frequently during pregnancy. The risk assessment of SSRI exposure is still evaluated and re-opened due to studies indicating possible increase of inborn defects, neonatal abstinence syndrome and cognitive ability or behavioral defects.

METHODS: In our study, we prospectively followed groups of pregnancies in years 2002-2009, that were exposed to SSRI. As control group we used 1) women exposed to new atypical antidepressant and anti-psychotics - APD (risperidone, mirtazapine, venlafaxine, trazodone, aripiprazole, ziprasidone, olanzapine), 2) women exposed to nonteratogenic drugs and 3) the general population according to Institute of Health Informations and Statistics (ÚZIS.) Data were analyzed using software Statistica for Windows No.5.5.

RESULTS: The total number of queries on psychotropic drugs performs in CZTIS more than 30% of all calls, constantly. We enrolled a total of 43 women exposed to SSRI and 37 women (1x twins) exposed to new psychotropic drugs (APD) in the study. Exposure to SSRI was often associated with poly-therapy. The most frequent SSRI used were citalopram and/or escitalopram (56%), and setraline (26%). Other SSRI were used sporadically. We observed significantly higher frequency of elective terminations in group of SSRI and higher frequency of abortions a prematurity in APD group. Frequency of malformations does not varied, being in all groups in expected range.

CONCLUSIONS: We confirmed that SSRI exposure during pregnancy was not associated with the higher risk of major malformation. However, number of cases was low and did not allow the statistical treatment with higher power....

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Journal Article 2011; 32(Suppl 1): 101-116 PubMed PMID: 22167207 Citation  Keywords:  Animals, Antineoplastic Combined Chemotherapy Protocols:pharmacology, Brain Neoplasms:drug therapy, DNA Damage, Dose-Response Relationship, Drug, Drug Evaluation, Preclinical, Ellipticines:administration & dosage, Histone Deacetylase Inhibitors:administra.   

OBJECTIVES: Valproic acid (VPA) and trichostatin A (TSA) exert antitumor activity as histone deacetylase inhibitors, whereas ellipticine action is based mainly on DNA intercalation, inhibition of topoisomerase II and formation of cytochrome P450 (CYP)- and peroxidase-mediated covalent DNA adducts. This is the first report on the molecular mechanism of combined treatment of human neuroblastoma UKF-NB-3 and UKF-NB-4 cells with these compounds.

METHODS: HPLC with UV detection was employed for the separation and characterization of ellipticine metabolites formed by microsomes and peroxidases. Covalent DNA modifications by ellipticine in neuroblastoma cells and in incubations with microsomes and peroxidases were detected by 32P-postlabeling. Expression of CYP enzymes, peroxidases and cytochrome b5 was examined by Western blot.

RESULTS: The cytotoxicity of ellipticine to neuroblastomas was increased by pre-treating these cells with VPA or TSA. A higher sensitivity of cells to ellipticine correlated with an increase in formation of covalent ellipticine-derived DNA adducts in these cells. To evaluate the mechanisms of this finding, we investigated the modulation by VPA and TSA of CYP- and peroxidase-mediated ellipticine-derived DNA adduct formation in vitro. The effects of ellipticine in the presence of VPA and TSA on expression of CYPs and peroxidases relevant for ellipticine activation and levels of cytochrome b5 and P-glycoprotein in neuroblastoma cells were also investigated. Based on these studies, we attribute most of the enhancing effects of VPA and TSA on ellipticine cytotoxicity to enhanced ellipticine-DNA adduct formation caused by an increase in levels of cytochrome b5, CYP3A4 and CYP1A1 in neuroblastoma cells. A lower sensitivity of UKF-NB-4 cells to combined effects of ellipticine with VPA and TSA than of UKF-NB-3 cells is also attributable to high levels of P-glycoprotein expressed in this cell line.

CONCLUSION: The results found here warrant further studies and may help in the design of new protocols geared to the treatment of high risk neuroblastomas....

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Clinical Trial 2011; 32(5): 688-690 PubMed PMID: 22167150 Citation  Keywords:  Adult, Electromyography, Female, Follow-Up Studies, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors:administration & dosage, Hyperlipidemias:drug therapy, Incidence, Male, Middle Aged, Peripheral Nervous System Diseases:chemically induced, Peroneal.   

OBJECTIVES: To confirm the changes in the results of EMG assessment of lower-limb peripheral nerves in patients treated with statins in the longer follow-up period of 3 years.

BACKGROUND: Long-term treatment with statins may have adverse effects: affection of muscles or peripheral nervous system. The frequency of affection of the peripheral nervous system has not been thoroughly investigated; our previous study showed the signs of peripheral nerve damage in the results of EMG assessment.

DESIGN/METHODS: Forty-two patients (23 males, 19 females, mean age 51.9 and 52.3 years) with a definitive diagnosis of combined hyperlipidemia were studied. Other metabolic disorders or chronic ethanol abuse were excluded. Initial examinations included laboratory and neurophysiological measures (peroneal and tibial nerves: MNCV, CMAP, F-wave mean latency; superficial peroneal and sural nerve: SNCV, SNAP). Subsequently, treatment with simvastatin 20 mg daily was initiated. Patients were followed for 36 months with repeated neurophysiological examinations on 24 and 36 months after statin treatment initiation.

RESULTS: None of the patients reported subjective symptoms typical for peripheral neuropathy. Neurophysiological examination of lower-limb peripheral nerves demonstrated statistically significant prolongation of F-wave mean latency on peroneal and tibial nerves (p<0.0001, paired t-test).

CONCLUSIONS: The study confirmed that long-term treatment with statins caused a clinically silent but still definite damage to peripheral nerves when the treatment lasts longer than 2 years....

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Case Reports 2011; 32(6): 751-762 PubMed PMID: 22167148 Citation  Keywords:  Antineoplastic Agents:therapeutic use, Breast Neoplasms:pathology, Chemotherapy, Adjuvant:methods, Combined Modality Therapy, Disease-Free Survival, Female, Humans, Neoplasm Metastasis, Remission Induction, Retrospective Studies, Treatment Outcome,.   

OBJECTIVES: To increase the efficacy and reduce the toxicity of cancer therapy.

METHOD: The DBM with MLT (melatonin), Retinoids, vitamins E, D3, and C has a differentiating, cytostatic, antiangiogenic, immunomodulating, factorially synergic effect, at the same time reinforcing those functions that Physiology considers essential for life. With Somatostatin and/or its analogues, the DBM has an antiproliferative effect, negatively regulating the most powerful mitogenic molecule (GH), receptorially co-expressed and interactive with Prolactin, inhibited by Cabergoline and/or Bromocriptin. The negative regulation of GH extends directly to the GH-dependent growth factors. In breast cancer, the DBM entails the use of estrogen inhibitors and minimal apoptotic, non-cytotoxic and non-mutagenic doses of Cyclophosphamide or Oncocarbide, the tolerability of which is enhanced by MLT and the vitamins in the DBM.

RESULTS: Complete and stable cure of 4 cases, and rapid regression of the tumour in another 5 cases with just the DBM (first-line therapy), without surgical intervention. No disease recurrence with the use of the DBM as adjuvant therapy. Five-year survival of 50%, of stage IV cases, considerably higher than the data reported in the literature. A more or less generalised improvement in the quality of life, without any significant and/or prolonged toxicity.

CONCLUSIONS: The acknowledgement of the still underestimated scientific evidence, such as the multiple antitumoral mechanisms of action of MLT, the negative regulation of the interactive mitogens GH-GF (GH-dependent growth factors), Prolactin and estrogens, together with the differentiating and homeostatic action of retinoids and Vitamins E, D3, and C and MLT, made it possible to achieve these results. An essential aspect of the mechanism of action on the clinical response is the factorial synergy of the DBM components....

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