Search

Introduction/Objective. The objective was to explore whether there is a difference in headache manifestation and level of its intensity in patients with functional dyspepsia and irritable bowel syndrome. Methods. We assessed a cohort of 420 participants out of which 300 satisfied the recruiting criterion of the presence of irritable bowel syndrome (148) or functional dyspepsia (152). Diagnoses of irritable bowel syndrome and functional dyspepsia were made according to Rome IV criteria. Intensity of headaches was estimated in irritable bowel syndrome and functional dyspepsia participants using visual analog scale. All the patients underwent subsequent testing by Hamilton?s Depression Inventory and anxiety scale. Results. Our results showed that males with headaches are more susceptible to functional dyspepsia, statistical significance in the group of patients with irritable bowel syndrome with high scores on the visual analog scales, in relation to Hamilton?s anxiety scores in the group of patients with irritable bowel syndrome. Gender and visual analogue scale scores were determinants to show whether the patient falls within the group of functional dyspepsia or irritable bowel syndrome. Scores of visual analogue scale where the patient felt the best was statistically borderline (p = 0.061) and its higher values pinpointed which of those patients fall into irritable bowel syndrome group. Conclusion. Gender and level of headache intensity as a extraintestinal manifestation showed to be the main variables to make a difference between patients with functional dyspepsia and irritable bowel syndrome where irritable bowel syndrome had higher scores and greater dominance in differential diagnosis if the headache was determining variable.

Background and Aims: Non-alcoholic fatty liver disease (NAFLD) is a metabolic disease with extensive multi- organ involvement, whose extra-hepatic manifestations include diabetes mellitus type 2, cardiovascular disease, obstructive sleep apnea (OSA), chronic kidney disease, and polycystic ovary syndrome. Our hypothesis was that there was a strong psychological component in NAFLD and OSA suffering patients and that psychotherapy would be helpful in the treatment of the mentioned diseases. Methods: Of 144 initially selected patients (with NAFLD, obesity and OSA), 32 patients agreed to undergo psychotherapy, and 31 therapy-naive NAFLD and OSA patients agreed to participate as controls. Results: Psychological evaluation revealed that self-esteem rose significantly after one-year psychotherapy (p=0.005). Body mass index (BMI) was significantly lower after psychotherapy, followed by the changes in laboratory results. Binomial logistic regression revealed that the reduction of BMI in high probability led to self-esteem improvement (p=0.03). Conclusions: Psychotherapy was an efficient supporting method in the treatment of patients with NAFLD, obesity and OSA. It raised self-esteem and stimulated the motivation for further treatment of obesity, as one of the important factors for NAFLD and OSA. Still, it is advisable to use psychotherapy in combination with other clinical methods of treatment.

Background: Transsexuality is explained and defined as a gender-identity disorder, characterised by very strong conviction of belonging to the opposite sex and has been associated with a distinct neuroanatomical pattern. Materials and methods: We performed a structural analysis in search of possible differences in grey matter structures based on magnetic resonance imaging scans of the brains of 26 individuals between 19 and 38 years of age. The participants were divided into two groups of 15 controls and 11 transgender individuals. The segmentation of subcortical grey matter was performed using FIRST model a model-based segmentation/registration tool, from FSL software package. Results: The results showed that the volume of the brain region called nucleus accumbens on the left side was significantly smaller in the group of transgender individuals compared to the control. It was the most important parameter which was shown to make distinction between two examined groups. Conclusions: The results also showed decreased volumes of the left thalamus, right hippocampus and right caudate nucleus.

Introduction/Objective. This research aims to evaluate the impact of chronic stress on behavioral effects of ketamine, which are still not sufficiently clear. Methods. Wistar male rats aged five weeks were used in the experiment. The animals were divided into two equal groups: control and experimental. After being exposed to a chronic unpredictable stress paradigm for 42 days, experimental rats received a single injection of ketamine (10 mg/kg; day 45) as did the control group. The impact of ketamine was assessed using behavioral tests, spontaneous coordinate activity, and water maze tests for the evaluation of short-term memory. Results. The experimental group rats showed less spontaneous motoric activity than before ketamine application. Statistical significance was shown in gaining weight after time of ketamine application in the control group, as well as in the experimental group, where they showed weight loss during stress paradigm and then increased their weight after ketamine application. There was no statistical significance in speed measurements in either group, showing no effects on short-term memory behavior. Conclusion. These findings show that ketamine in a single subanesthetic dose has antidepressant and anxiolytic-like effects in male rats exposed to chronic unpredictable stress paradigm.

Peritonitis is one of the most important sources of abdominal sepsis. Since intra-abdominal infection leads to the activation of the inflammatory response, this suggested that some of these mediators could be used as markers of the severity of newly formed sepsis, but primarily to identify or rule out new-onset sepsis. The aim of this study was to evaluate the sensitivity and specificity of serum markers of inflammation: C-reactive protein, procalcitonin and serum amyloid A in the serum of patients with diffuse secondary peritonitis.The results of our study suggest that finding a specific marker for the diagnosis of abdominal sepsis, a marker that would differentiate between SIRS and sepsis, pre- and postoperatively, would be very useful.

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease which is characterized by extremely complex pathogenetic mechanisms and multifactorial etiology. Some of the many pathophysiological mechanisms involved in the development of NAFLD include oxidative stress, impaired mitochondrial metabolism, inflammation, gut microbiota, and interaction between the brain-liver-axis and the regulation of hepatic lipid metabolism. The new therapeutic approaches in the treatment of NAFLD are targeting some of these milestones along the pathophysiological pathway and include drugs like agonists of peroxisome proliferator-activated receptors (PPARs), glucagon-like peptide-1 (GLP-1) agonists, sodium/glucose transport protein 2 (SGLT2) inhibitors, farnesoid X receptor (FXR) agonists, probiotics, and symbiotics. Further efforts in biomedical sciences should focus on the investigation of the relationship between the microbiome, liver metabolism, and response to inflammation, systemic consequences of metabolic syndrome.

Purpose: The femoral condyle diameter may influence anterior tibial translation whose main stabilizer is the ACL. The aim of this study is to determine the influence of the size of the lateral and medial femoral condyles on ACL rupture. Methods: 41 matched pairs of subjects were included in the study who had suffered knee injury and were either professional or recreational athletes engaged in track and field or sports involving intensive rotation movements. The experimental group was composed of patients with ACL rupture, while the control group comprised patients with joint distortion without ACL. The diameter of the medial and lateral condyles were measured on sagittal MRI images of these patients’ knees. Results: Subjects with ACL rupture had a highly statistically significantly shorter diameter of the lateral condyle as compared to their matched pairs from the control group (p0.05). Patients with intact ACL demonstrated significant indirect correlation of the diameter of both femoral condyles with the valgus angle of the lower leg (p

The quantum mind or quantum consciousness group of hypotheses propose that classical mechanics cannot explain consciousness. Quantum theory is used to insert models of cognition that target to be more innovative than models based on traditional classical probability theory, which includes cognitive modeling phenomena in science. At the moment we can say that there is no clearly defined neurophysiological mechanisms of creation of the quantum-like representation of information in the brain, but we can mention the hypothesis of matching the information processing in the brain with quantum information and probability with contextuality as the key word. Using limited cognitive resources, incompatibility provides humans the means for answering an unlimited number of questions, thus promoting parsimony and cognitive economy.

Introduction/Objective. During the past 20 years, there have been numerous attempts to design and apply a simple, affordable blood analysis tool for diagnostic and prognostic purposes in psychiatry. In this article we demonstrate that some mathematical parameters of chromatin organization and distribution in blood neutrophil granulocytes are related to stress levels in patients diagnosed with recurrent depressive disorder (RDD). Methods. The study was performed on 50 RDD participants who were asked to complete Depression, Anxiety and Stress Scales (DASS-21). Peripheral blood samples were obtained from all the participants, smeared on glass slides and stained using a modification of Giemsa method. A total of 500 representative chromatin structures (10 per patient) of neutrophil granulocytes were evaluated using textural analysis with the application of gray level co-occurrence matrix (GLCM) method. Parameters such as angular second moment (indicator of textural uniformity), inverse difference moment (textural homogeneity), and textural sum variance were calculated. Results. The results indicate that there is a statistically highly significant correlation (p < 0.01) between certain chromatin GLCM parameters such as inverse difference moment, and DASS-21 stress score. There was also a significant difference (p < 0.05) in some chromatin GLCM parameters in patients diagnosed with RDD with psychotic features, when compared to the ones without psychosis. Conclusion. These findings suggest that in the future, chromatin GLCM features might have a certain predictive value for some clinical features of recurrent depressive disorder.

Background/Aim. The key to successful anterior cruciate ligament reconstruction lies in the proper positioning of the femoral tunnel within the anatomical footprint and in providing for an adequate length of this tunnel without perforation to the lateral cortex. The aim of this study was to determine the change in the length of the femoral tunnel drilled during anatomic anterior cruciate ligament (ACL) reconstruction, depending on: the position of the limb being operated on, the degree of knee flexion, as well as the angle between the drill and the medial aspect of the lateral condyle. Methods. This study was performed on 16 cadaveric knees (6 male and 10 female) of the average age of 83. After the subcutaneous tissue was dissected, the femoral insertion of the ACL was identified. Then, 18 tunnels were drilled through the center of the femoral insertion with the help of 2 mm thick Kirschner wires. This was performed in two stages. In the first phase the leg was positioned on an arthroscopic leg holder, while in the second phase the leg was positioned on the table. In each phase the knee was placed in three different flexion positions (110?, 120? and 130?) and for each position three tunnels were drilled (70?, 60? and 50?) in relation to the medial aspect of the lateral condyle. Results. The average length of the femoral tunnel drilled with the leg positioned on the operating table (36.6 ? 4.7 mm) was highly statistically significantly greater (p = 0.000) in comparison with the length of the femoral tunnel obtained by positioning the leg on a fixed arthroscopic leg holder (35.4?4.3 mm). The greatest lengths of the femoral tunnel were obtain with the leg flexed at 130? and the reamer positioned at 50? angle in relation to the medial aspect of the lateral condyle (43 mm on the operating table and 41 mm on a fixed leg holder), while the shortest tunnel (33 mm on the operating table and 31 mm on a fixed leg holder) was obtained with the lower leg flexed at 110? and the reamer positioned at a 70? angle. Conclusion. The optimal position of the leg on a fixed leg holder for obtaining a femoral tunnel of sufficient length requires lower leg flexion of 120? and the position of the medial portal which enables the positioning of the reamer at a 60? angle in relation to the medial aspect of the lateral condyle. With the leg positioned on the operating table, it becomes unnecessary to push the leg into flexion greater than 110?; rather a longer femoral tunnel is achieved by lateralization of the medial portal.

Aim: To further examine the neurobiological mechanisms and their outcomes responsible for the PTSD sequelae induced by laboratory animal model and to explore the effects of chronic psychosocial paradigm. We tested the hypothesis that our animal model of PTSD would display abnormalities in glucocorticoid levels that are manifest in people with PTSD and that psychosocially stressed rats exhibit a significantly greater suppression of corticosterone levels than control rats following the administration of dexamethasone.Methods: Animals were divided into two groups. The experimental group was scheduled to exposure to two types of stressors: double exposure to acute immobilization stress, and combined predator-threat stress and daily social stress. There was also administration of dexamethasone in combination with stress exposure.Results: There was a statistical difference between masses of thymus in the stress group and stress group with dexamethasone appliance (p=0.024). We found statistical significance between baseline cortisol and stress induced levels of cortisol and between stress induced group and return to baseline group.Conclusion: Significant changes in HPA activity, reductions in basal glucocorticoid levels and enhanced dexamethasone induced inhibition of glucocorticoid levels have been manifested. All of this is manifested in PTSD patients also as many other stress induces changes.

Introduction: Polymicrogyria, the appearance of irregular small and over numbered gyri on the surface of the brain, has been reported as the most frequent finding, when exists, on the temporal lobe. Case Presentation: A patient, male, age of 35, came to the regular head and brain MRI scan due to psychiatric and hormonal treatment within transsexualism. There were no data of epilepsy in a patient’s history. MRI scans were acquired with a 1.5 T Siemens Magnetom system with a standard head coil. Three-dimensional 3D RAGE, contiguous 1.0 mm slice, and 1 acquisition sequence underwent final 3D rendering and subsequent volumetry. On the definitive 3D image, we have revealed an unusual gyrisation on the left temporal lobe which had a picture of partial polymicrogyria. Conclusion: This is a unique finding, to our knowledge, of the unilateral temporal polymicrogyria in a person with transsexualism. Although polymicrogyria is mostly related to epileptifom attacks, its impact on the transsexualism appearance is opened to be examined.

Chronic stress induces structural and hormonal changes in the various brain structures: caudate nucleus, putamen, hippocampus, amygdala, prefrontal cortex in participants with post‐traumatic stress disorder. Based on the results of recent neuroimaging studies on post‐traumatic stress disorder, hippocampus, amygdala, and prefrontal cortex play a key role in triggering the typical symptoms of PTSD. Cortisol, as the primary stress hormone, together with dehydroepiandrosterone, tries to return the body to its original state of homeostasis, but its disturbed concentration levels can modify brain structures volumes. The scanning was performed using a 3.0 T whole‐body scanner (Philips Medical Systems, Best, The Netherlands). Saliva was taken from all examined participants, for the determination of cortisol concentration and its effect on volume changes of the examined brain structures. The strongest headache that might occur during the day was marked on the pain rating scale (0–10). Hamilton depression rating scale was used for rating the depression level. Studies are moving toward the recogni‐ tion of different biomarkers that would indicate the presence of clinically significant symptoms and a predisposition or increased risk of developing post‐traumatic stress disorder, which can be made by increasing the number of studies, number of partici‐ pants, and number of different methodologies.

Background: Studies imposing rigorous control over lifetime alcohol intake usually have not found smaller hippocampal volumes in persons with posttraumatic stress disorder (PTSD). Since the majority of negative studies have used adolescent samples, it has been suggested that chronicity is a necessary condition for such findings. We have hypothesized that the volumes of hippocampus, amygdale, prefrontal cortex and the intracranial volume are reduced in the patients with PTSD and excessive alcohol intake. Subjects and methods: Study has been carried out on 54 therapy naive PTSD suffering subjects and healthy controls, divided in two groups: 29 with PTSD and consequent alcoholism, 25 with PTSD but without problems of excessive alcohol intake, and 25 healthy volunteers. All of the patients underwent same magnetic resonance imaging (MRI) protocol and volumetric evaluation of the region of interest. Results: Only hippocampal volume appeared to be significantly reduced in patients with PTSD and alcoholism. Other differences in the volumes obtained remained to be insignificant. Conclusion: Alcohol intake definitely worsens the deterioration of the hippocampal formation in PTSD suffering patients. Nevertheless, other structures of interest for this study did not manifest any kind of statistical differences in volumetric analysis.

Objective. In our study we have hypothesized that volume changes of amygdala, hippocampus, and prefrontal cortex are more pronounced in male posttraumatic stress disorder participants.Material and Methods. We have conducted a study of 79 male participants who underwent MRI brain scanning. PTSD diagnosis was confirmed in 49 participants. After MRI was taken all scans were software based volume computed and statistically processed.Results. We found that left amygdala is the most significant parameter for distinction between PTSD participants and participants without PTSD. There were no significant differences in volumes of hippocampi and prefrontal cortices. Roc curve method outlined left amygdala AUC = 0.898 (95% CI = 0.830–0.967) and right amygdala AUC = 0.882 (95% CI = 0.810–0.954) in the group of PTSD participants which makes both variables highly statistically significant.Conclusion. The present investigation revealed significant volume decrease of left amygdala in PTSD patients. Concerning important functions of the amygdala and her neuroanatomical connections with other brain structures, we need to increase number of participants to clarify the correlation between impared amygdala and possible other different brain structures in participants with PTSD.

Cavum Septi pellucid (CSP), a cavity between the laminae of the septum pellucidum, for a longer period has been reported as an anomaly of the brain midline, associated with neuropsychiatric diseases, mostly schizophrenia, but also posttraumatic stress disorder, De la Tourette disease, and persons who survived a repeated a serious head trauma, boxers on the first place. Our investigation has been performed on 479 unfixed frozen brains, of the autopsied individuals of both genders, and MRI scans of 250 examinees, out of which 110 had neuropsychiatric illness. In our sample, the prevalence of CSP was 22.96% among the autopsied individuals and 9.2% in examinees who underwent MRI scan. The cause of the death among schizophrenia suffering persons was suicide (18 out of 25 patients). Obviously, CSP is more frequently associated with neuropsychiatric diseases, but a dilemma still exists, did we make a bias in brain suitability for the examination or we did the same mistake in observing clinical cases. A large CSP, though, is an almost certain sign for an underlying neuropsychiatric impairment, especially schizophrenia. The CSP among alcoholics and persons with the priory sustained head blows is probably of the same cause and represents an aftermath of the diffuse axonal injuries, i.e. brain trauma.

Raman spectroscopy enables non-invasive investigation of chemical composition of biological tissues. Due to similar chemical composition, the analysis of Raman spectra of brain structures and assignment of their spectral features to chemical constituents presents a particular challenge. In this study we demonstrate that standard and independent component analysis of Raman spectra is capable of assessment of differences in chemical composition between functionally related gray and white matter structures. Our results show the ability of Raman spectroscopy to successfully depict variation in chemical composition between structurally similar and/or functionally connected brain structures. The observed differences were attributed to variations in content of proteins and lipids in these structures. Independent component analysis enabled separation of contributions of major constituents in spectra and revealed spectral signatures of low-concentration metabolites. This provided finding of discrepancies between structures of striatum as well as between white matter structures. Raman spectroscopy can provide information about variations in contents of major chemical constituents in brain structures, while the application of independent component analysis performed on obtained spectra can help in revealing minute differences between closely related brain structures.

Introduction Transsexualism is a gender identity disorder soon to be removed from the DSM criteria for mental disorders. The actual developmental/congenital origin of the disorder has yet to be established. One of the theories involves morphological and neuro-hormonal modification in the corpus callosum as a possible substrate. Objectives Diagnostic assessment of a 22 year old female - male transsexual patient with a history of agoraphobia and migraine, reporting intermittent symptoms of numbness of left side of body and cheek and headaches. Method Data on personal/family history was obtained and neurological examination was performed. MRI scan was acquired with a 1.5 T Siemens Magnetom system with a standard head coil. Sagittal three-dimensional 3D RAGE, contiguous 1.0 mm slices, 1 acquisition sequences were obtained. Results and discussion: Family history of anxiety disorder was confirmed. Symptoms appeared following reduction of anxiolytic medication and emotional crisis. Neurological status showed signs of left pyramid deficit. NMR scan findings showed bilateral arachnoid cysts in genu corpus callosum probably of congenital origin. Co-morbidity versus concomitant disorders of psychiatric, neurological and congenital origin were discussed.