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Congresses 2012; 33(Suppl 2): 13-16 PubMed PMID: 23183500 Citation  Keywords:  Atherosclerosis:therapy, Czech Republic, Endocrinology:trends, Humans, Neurology:trends,.   

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Journal Article 2012; 33(6): 626-630 PubMed PMID: 23160232 Citation  Keywords:  Adult, Aspartic Acid:analogs & derivatives, Choline:metabolism, Cognition Disorders:etiology, Creatine:metabolism, Female, Glutamic Acid:deficiency, Gyrus Cinguli:metabolism, Humans, Hyperthyroidism:complications, Magnetic Resonance Spectroscopy, Male, Yo.   

OBJECTIVES: Patients with hyperthyroidism frequently have neuropsychiatric complaints such as lack of concentration, poor performance in memory, depression, anxiety and mania. These symptoms suggest the dysfunction of brain. However, the underlying process of this dysfunction is not well understood. At the same time, glutamatergic system has been considered important in neuropsychiatric process by recent studies. Thus, this study is to investigate the change of glutamate concentration in patients with hyperthyroidism using proton magnetic resonance spectroscopy.

METHODS: Fifteen untreated patients with hyperthyroidism and fifteen age- and gender- matched controls participated in the study. The region of the posterior cingulate cortex was examined by magnetic resonance spectroscopy with a technique referred as TE-averaged PRESS at 3T field strength. The concentrations of N-Acetylaspartate, creatine, choline and glutamate were assessed using jMRUI v4.0 software.

RESULTS: Hyperthyroid patients, compared with controls, showed a decrease of glutamate concentration (P<0.047) and glutamate/creatine ratios (P<0.009) in the posterior cingulate cortex. The decrease of choline concentration (P<0.004) and choline/creatine ratios (P<0.012) were also discovered. No significant difference was found in the concentrations of N-Acetylaspartate or creatine between patients and controls.

CONCLUSION: Concentration of glutamate decreased in the region of posterior cingulate cortex in patients with hyperthyroidism. This reduction indicated a possible involvement of glutamate in the brain dysfunction in hyperthyroidism....

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Journal Article 2012; 33(6): 619-625 PubMed PMID: 23160231 Citation  Keywords:  Antidepressive Agents:therapeutic use, Bipolar Disorder:drug therapy, Humans, Incidence, Prodromal Symptoms, Risk Factors, Secondary Prevention,.   

OBJECTIVE: The purpose of this qualitative review is to examine prodromes, precipitants, and risk factors for repeated episodes of mania and depression in bipolar disorder.

METHODS: PubMed, EMBASE, and PsychInfo were searched for "bipolar disorder" in conjunction with: "prodromes", "triggers", and "life change events".

RESULTS: Phenomenology and prevalence of prodromes, precipitants, and risk factors are described, and their therapeutic implications are outlined.

CONCLUSIONS: Most patients with bipolar disorder are able to recognize their prodromes. This ability depends largely on insight. Psychoeducation focused on improving various aspects of insight, including treatment adherence, reduces incidence of relapses in bipolar disorder....

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Case Reports 2012; 33(6): 574-578 PubMed PMID: 23160230 Citation  Keywords:  Biopsy, Brain Abscess:complications, Diagnosis, Differential, Humans, Hypopituitarism:diagnosis, Magnetic Resonance Imaging, Male, Middle Aged, Pituitary Gland:pathology, Sella Turcica:pathology,.   

: Pituitary abscess is a rare condition. Here, we present the case of a young male patient who was initially found to have a pituitary lesion following the diagnosis of panhypopituitarism. Two years later, he presented with severe headache and was subsequently diagnosed intraoperatively with pituitary abscess. At a follow-up of 6 years after surgery, the patient was continuing to do very well. We discuss the differential diagnosis and demonstrate the evolution of the pituitary lesion on magnetic resonance imaging at four different time points: at the time of the detection of the initial lesion; two years later at the time of the diagnosis of the pituitary abscess; at 7 weeks post operatively; and finally after six years from the pituitary surgery....

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Case Reports 2012; 33(6): 579-589 PubMed PMID: 23160229 Citation  Keywords:  Adult, Antibodies, Monoclonal, Humanized:therapeutic use, Brain:pathology, Drug Resistance, Female, Humans, Magnetic Resonance Imaging, Male, Multiple Sclerosis:drug therapy, Natalizumab, Secondary Prevention, Treatment Outcome, Young Adult,.   

: Pediatric cerebrospinal multiple sclerosis (MS) constitutes about 2-5% of all MS cases. The International Pediatric MS Study Group (IPMSSG) applies diagnostic criteria for adults to MS in childhood and adolescence. Recent publications highlight an increasing number of MS in children resistant to the first-line treatment, i.e. disease modifying therapy (DMT). Furthermore, the number of published case studies on children with highly active MS treated with natalizumab also rises, whereas long-term risks as well as therapeutic potential of this therapy in pediatric population have been at the centre of attention. This paper presents a group of 5 children in whom natalizumab was selected to manage highly active disease or resistance to conventional MS treatment and provided very good clinical as well as MRI results....

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Controlled Clinical Trial 2012; 33(6): 651-659 PubMed PMID: 23160228 Citation  Keywords:  Aged, Biomechanical Phenomena:drug effects, Chondroitin Sulfates:administration & dosage, Disease Progression, Female, Glucosamine:administration & dosage, Humans, Hyaluronic Acid:administration & dosage, Knee Joint:drug effects, Male, Middle Aged, Models.   

OBJECTIVES: This study seeks to demonstrate the influence of pharmacological substances from the SYSADOA group on the progression of osteoarthritis in the human knee. The quantification methods were direct measurement of the rheological properties of the knee joints in vivo and standard WOMAC index questionnaires.

MATERIALS AND METHODS: The drugs were administered orally to 34 probands with second degree gonarthrosis for 13 weeks. The untreated control group consisted of 10 probands. The rheological properties of the joints were determined by a biorheometer, and subjective assessment of the knees by patients (WOMAC) before and after medication, and for a further 13 weeks. Changes in the calculated parameters over time were compared.

RESULTS: During the audited perioda slight deterioration in all of the parameters was observed in the untreated group. The treated group, however, improved in all the parameters and some indicators showed statistically significant differences. The positive effects of the SYSADOA persisted for 3 months after the end of treatments. Partial correlation was found between the results of the WOMAC questionnaire and the rheological measurements.

CONCLUSIONS: This study shows the positive effects of the preparation on arthritic changes in the knee joint, but due to the large variance of the collected data, this conclusion is on the borderline of statistical significance. The method of measuring the rheological properties of the joints is suitable for evaluating the progression of OA....

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Journal Article 2012; 33(6): 569-573 PubMed PMID: 23160227 Citation  Keywords:  Adrenal Glands:physiology, Brain:physiology, Humans, Neurosecretory Systems:physiopathology, Pseudotumor Cerebri:physiopathology,.   

: The clinical syndrome idiopathic intracranial hypertension (IIH), also termed pseudotumor cerebri, consists of symptoms of headache, nausea, vomiting and visual field defects in combination with findings of papilledema. IIH is more commonly seen in overweight women where the rise in intracranial pressure is putatively a consequence of an endocrine-based disturbance of electrolytes. Less frequently, it can also occur in men and in the pediatric age group. Associated risk factors include primary and secondary aldosteronism, pregnancy, recombinant growth hormone (r-GH) therapy, oral contraceptives, obesity, vitamin A intoxication or deficiency, Addison disease, corticosteroid therapy or acute withdrawal of steroid therapy and Cushing disease. Herein, we review the association between these conditions and IIH working toward its having a unifying neuroendocrine hypothesis....

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Case Reports 2012; 33(6): 590-596 PubMed PMID: 23160226 Citation  Keywords:  Aged, Brain Neoplasms:diagnosis, Fatal Outcome, Female, Humans, Hydrocephalus:diagnosis, Hypothalamic Diseases:diagnosis, Hypothalamus:surgery, Male, Middle Aged, Neurosurgical Procedures:adverse effects, Postoperative Complications:diagnosis, Subdural Ef.   

BACKGROUND: Opening of the lamina terminalis is often used in surgery of the optico-chiasmatic region. Consequently, alteration of cerebral-spinal fluid (CSF) dynamics can occur after this manoeuvre, thus potentially translating into clinical complications. Herein, we describe 2 cases in which clinically relevant hypothalamic dysfunctions developed after few days opening of the lamina terminalis both patients showed mild to moderate preoperative hydrocephalus which improved postoperatively.

CASES DESCRIPTION: In a patient with ruptured aneurysm of the basilar bifurcation, opening of the lamina terminalis was performed prior to acute-stage clipping. On postoperative day 7th, the patient developed significant subdural hygroma, mild disturbances of consciousness and increase of ADH concentration. These clinical features resolved only following subdural hygroma drainage and ventricular-peritoneal shunting. One previously operated patient in whom the lamina terminalis had been opened to remove a sizeable parasellar tumour showed a similar post-operative course. In this patient, sole subdural hygroma drainage was not an effective treatment, and the patient died subsequently for complications related to long-standing, though mild, hypothalamic dysfunction.

CONCLUSIONS: Our experience may suggest that hypothalamic dysfunctions should be reminded as a possible, although rare, complication following the opening of the lamina terminalis. This clinical condition, if not properly managed, may contribute to trigger severe life-threatening complications....

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