Healing is a form of art--thesis based on daily work observation at a Gynecology-Obstetrics Hospital

In the therapeutic process the means of communication between a physician and a patient and the interactions between them constitute an important element of medical procedures. The gynecologist and obstetrician accompany women from their births till late old age. The aim of the study was to describe from the psychological point of view certain situations arising in everyday work in Gynecological-Obstetrical Hospital: motherhood, the place of a newborn and his/her parents in the Neonatal Ward, gynecological surgery, climacteric and senium.     

Serum leptin level in prepubertal children with simple obesity. Part II

The aim of the study was to determinate the serum leptin level, glucose concentration, lipids (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride) and thyroid hormones level (triiodothyronine, thyroid stimulating hormone and free thyroxine) in a group of prepubertal children with simple obesity. Fourfold higher leptin concentration in obese (23.3 +/- 11.8 ng/mL) in comparison to a group of slim children (6.8 +/- 2.7 ng/mL), (p<0.0001) was shown. There was no significant difference in serum glucose level (87.3 +/- 9.7 mg/dL) between both studied groups. In obese subjects we showed higher triglyceride, insignificantly lower HDL-C concentrations and invariable other lipid fractions. Mean values of triiodothyronine (T3) were 3.0 +/- 0.7 nmol/L in obese children and 2.8 +/- 0.8 nmol/L in slim children. On the contrary, mean values of thyroid stimulating hormone (TSH) were 2.5 +/- 1.7 mIU/L and 2.8 +/- 0.7 mIU/L in the group of obese and normal children respectively. Free thyroxine (FT4) concentrations in our obese children were lower (11.5 +/- 2.9 pmol/L) than in slim subjects (14.6 +/- 3.1 pmol/L) but were within the reference range. The results obtained indicate that in children with simple obesity there was no dyslipidemia connected with leptin and thyroid hormones levels. However, higher triglyceride and lower HDL-C concentrations suggest a necessity of monitoring the body mass index and lipid profile in these patients.     

Acute invasive fungal rhinosinusitis--case report

A case report of acute invasive fungal rhinosinusitis in 28 year old woman with acute myeloid leukemia is described in this paper. The diagnosis of the fungal disease was based on clinical presentation, endoscopic evaluation of nasal cavity, computed tomography and magnetic resonance imaging of the paranasal sinuses and histopathological findings. An aggressive treatment including antifungal therapy (amphotericin B), antibiotics and the surgery of paranasal sinuses was implemented. Unfortunately the underlying disease and the fungal invasion progressed rapidly and the patient died on the forth week post-op due to cardiorespiratory failure.     

Relationship between chronic nasal and respiratory symptoms in patients with COPD

The relationship between the upper and lower airways in chronic obstructive pulmonary disease (COPD) is unknown. We examined the prevalence of chronic nasal symptoms and the correlation with lower respiratory symptoms and parameters of severity of COPD such as exacerbation frequency and spirometry. 61 COPD patients from the East London COPD cohort were studied. [Mean (SD) age 70 (6.96) years, FEV1 0.98 (0.38) l, FVC 2.45 (0.72) l, FEV1%Pred 37.0 (12.3), and 47.6 (31.8) smoking pack years, 14 current smokers, 36 males]. COPD patients had a high prevalence of nasal symptoms (75%), more than half reporting nasal discharge (52.5%) and sneezing (45.9%). Associations were found between nasal score and daily sputum production (P = 0.005) and post-nasal drip and sputum production (P = 0.046) with a trend to increased nasal symptoms in frequent exacerbators compared to infrequent exacerbators. No significant relationship was found between nasal symptoms and FEV1 or any other lower respiratory airway symptom. Associations between nasal and respiratory symptoms were found suggesting that there is a relationship between the upper and lower airway in COPD.     

Influence of acute and chronic 1,2,3,4-tetrahydroisoquinoline administration on the expression of proenkephalin mRNA in the rat striatum

Animal studies have shown that a depletion of dopamine or blockade of dopamine D2 receptors in the striatum produces an increase in striatal proenkephalin (PENK) mRNA expression and an increase in GABAergic transmission in the globus pallidus. Therefore, it has been suggested that an enhanced striatal PENK mRNA expression may reflect to some extent an increase in the activity of the GABAergic striatopallidal pathway whose overactivity has been suggested to take place in the course of Parkinson's disease. Therefore, the aim of the study was to investigate the role of 1,2,3,4-tetrahydroisoquinoline (TIQ), an endogenous substance suspected of producing parkinsonism in humans, in the regulation of the activity of GABAergic striatopallidal pathway in rats. TIQ administered acutely at the dose of 100 mg/kg ip increased the PENK mRNA expression in the dorsal part of the striatum at two levels I and II (rostral and central striatum, respectively). No changes were noticed in the ventral part of the striatum. Moreover, TIQ given chronically to rats for 3 weeks did not modify the level of PENK mRNA in any examined part of the striatum. The present results show that the effect of TIQ on the PENK mRNA expression is different from that described for proparkinsonian model neurotoxins (MPTP, 6-OHDA) as well as for typical neuroleptics, such as haloperidol.     

Evaluation of energy and nutritive value of meals for nursery school children

The energy value and content of nutritive components in nursery school meals have been evaluated by analytical method and calculated by Nutritionist IV computer program with Polish data base. A significant correlation between analysed and calculated values has been observed. An average nursery school meal covered recommended intake of iron, calcium, zinc, vit. B1 and % of energy from proteins, fats and carbohydrates. An average nursery school meal covered above recommended intake of total energy and % of energy from saturated fatty acids, proteins, fats, cholesterol, carbohydrates, fiber, magnesium, potassium, phosphorus, copper and vitamins A, E, C, B2 i B6. Only the average content of vit. PP and % of energy from mono- and polyunsaturated fatty acids in analysed nursery school meals has been below the recommended intake. The results indicate that there is a tendency to supply energy and some of nutritive components in nursery school meals above the recommended intake.     

Decreased activation of the anterior cingulate in bipolar patients: an fMRI study

BACKGROUND: Previous neuroimaging investigations of patients with bipolar disorder have reported abnormalities of the frontal subcortical network. The role of the anterior cingulate cortex (ACC) and the dorsolateral prefrontal cortex (DLPFC) in bipolar disorder are not clear, although both regions have been shown to be components of a neural network which plays a critical role in the completion of tasks requiring self-monitoring and inhibition, functions often noted to be altered in bipolar patients. fMRI studies have helped clarify the role of specific subdivisions of the ACC and the DLPFC during the performance of cognitive challenges, including the Stroop color word test. To date, studies that have examined ACC function in bipolar patients have not differentiated subregions within this area, nor have they examined changes in these subregions in relation with DLPFC activation. METHODS: To help clarify the specific roles of these regions in bipolar patients, we examined stable patients and control subjects during performance of the Stroop test using BOLD fMRI techniques. We hypothesized that bipolar patients would demonstrate reduced activation of two subdivisions of the ACC (AAA and VOA), as well as altered activation of the DLPFC, during the interference condition. RESULTS: Results indicate that relative to controls, bipolar patients demonstrated significantly reduced signal intensity within the right AAA subdivision (p=0.011), which accompanied an increase in the DLPFC (p=0.049) during the task. LIMITATIONS: The study sample was somewhat small (11 patients, 10 controls) which limits the generalizability of the study findings, however, the patient sample consisted of well-diagnosed, stable, chronic individuals with bipolar disorder and the sample size provided enough power to detect between-group differences. CONCLUSIONS: These findings suggest differential processing strategies of bipolar patients and support the theory of altered frontal systems in these patients during the performance of cognitive tasks.     

Review of lisdexamfetamine dimesylate in children and adolescents with attention deficit/hyperactivity disorder

Abstract

Objective

Lisdexamfetamine dimesylate is a stimulant prodrug with low abuse and diversion potential that is used in treatment of attention deficit hyperactivity disorder (ADHD) in children, adolescents and adults. This current literature review article aims to examine safety and efficacy of LDX in children and adolescents for the treatment of ADHD based on currently available data.