THE RISK MODEL OF DEVELOPING SCHIZOPHRENIA BASED ON TEMPERAMENT AND CHARACTER

Introduction: Cloninger\u27s psychological model of temperament and character confirms that the personality development is influenced by biological and psychological processes. The aim of this study is to examine personality dimensions and to determine which variable separates the healthy from the ill in the best way and could be a possible psychological marker for the presence of the illness. Methods: This research included 152 subjects, 76 patients with schizophrenia and 76 healthy controls, selected on the basis of medical interviews, random population sampling model from a wider social community using the independent T-Tests. The Temperament and Character Inventory (TCI), which compared personality traits of the patients with schizophrenia and the healthy control group, was used. Dependence of variables in these categories was assessed using the Chi-square and Fisher\u27s tests, and the impact of variables on schizophrenia was tested using univariate and multivariate binary logistic regression. The same method was used for making the mathematical model. Results: Unlike the control group, patients with schizophrenia exhibited higher Harm avoidance (HA) and Self - transcendence (ST) scores as well as lower Self - directedness (SD) and Cooperativeness (C) scores. Multivariate binary logistic regression showed that Responsibility, Purposefulness, Resourcefulness, Cooperativeness and Compassion dimensions were significantly more present in the patients with schizophrenia. The new variable Model (area=0.896, p<0.0005) is composed of five TCI parameters. It proved to be a reliable marker for separation the healthy from the ill ones (area=0.896, p<0.0005). It has a good sensitivity (80%) and specificity (84%). Conclusions: Research has emphasized variables in the temperament and character inventory, which are the best markers for distinguishing between the healthy and the ill, thus making the mathematical model

Fractional Flow Reserve Method in Cardiac Catheterization Laboratory without Cardiosurgical Backup: Initial Experiences

Background: Coronary artery disease is the most common cause of death in a modern world. This dictates the development a network of Catheterization laboratories without cardiosurgical capabilities.Aim: We postulate that the most valuable tool in the decision process on myocardial revascularization is fractional flow reserve (FFR), especially when we deal with borderline coronary lesions.Material and Methods: A total of 72 patients with 94 intermediate coronary stenosis (30%-70% diameter reduction) were included in this study. We tested FFR and angiography based decision model on myocardial revascularization.Results:  Mean FFR value on left anterior descending coronary artery (LAD) was lower than in others two arteries (p=0.017). FFR after percutaneous coronary intervention (PCI) was significantly better (p&lt;0.0001). The decision for PCI predominates before FFR diagnostics, but after FFR the decision is quite opposite. There is a weak negative correlation between FFR and diameter of stenosis assessed by angiography (r= - 0.245 p=0.038) and positive correlation between diameter of stenosis assessed by angiography and by quantitative coronary angiography (QCA) (r=0.406 p&lt;0.0005).Conclusion:  Our results strongly suggest that FFR is necessary tool in centers without possibilities of heart team onsite consultation and that prevents numerous unnecessary PCI

Incremental value of high-sensitive troponin T in addition to the revised cardiac index for peri-operative risk stratification in non-cardiac surgery

Aims We aimed to evaluate the incremental value of high-sensitive troponin T (hsTnT) for risk prediction prior to non-cardiac surgery in comparison with the established revised cardiac index. Methods and results In this prospective, international multicentre observational study, 979 patients prior to non-cardiac surgery were enrolled. The endpoints were in-hospital mortality, the combination of death, acute myocardial infarction, cardiac arrest, cardio-pulmonary resuscitation, and acute decompensated heart failure. Twenty-five patients (2.6%) deceased and 36 (3.7%) of the patients experienced the combined endpoint. Cardiac markers were elevated in those patients who died when compared with survivors (hsTnT: 21 ng/L vs. 7 ng/L; P < 0.001; NT-proBNP: 576 pg/mL vs. 166 pg/mL; P < 0.001). Applying a cut-off for hsTnT of 14 ng/L and for NT-proBNP of 300 pg/mL, those patients with elevated hsTnT had a mortality of 6.9 vs. 1.2% (P < 0.001) and with elevated NT-proBNP 4.8 vs. 1.4% (P = 0.002). The highest AUC of the ROC curve was found for hsTnT as a predictor for mortality of 0.809. In a multivariate Cox regression analyses, hsTnT was the strongest independent predictor for the combined endpoint [HR 2.6 (95% CI: 1.3-5.3); P = 0.01]. Conclusion High-sensitive troponin T provides strong prognostic information in patients undergoing non-cardiac surgery incremental to the widely accepted revised cardiac inde

Effects of combination of AT1-antagonist candesartan cilexetil and ACE-inhibitors in patients with congestive heart failure

Introduction Combination of ACE-inhibitors with angiotensin-II type 1 receptor antagonists could provide better blockade of RAAS system compared with monotherapy. Objective The aim of this study was to evaluate hemodynamic and neurohumoral effects at rest and during exercise of Candesartan cilexetil as add-on therapy to ACE-inhibitors in patients with heart failure NYHA class III to IV. Methods This was a prospective, randomized, double-blind, placebo-controlled, parallel group study. Thirty-five patients received either Candesartan 8 mg/16 mg (1st and 2nd week/ of 3-24) or placebo as add-on therapy to their previous ACE-inhibitor during a 24-weeks treatment period. Results Peak aerobic capacity remained constant in the Candesartan group of patients (0.06±1.43 mL/min/ kg) and slightly decreased in the placebo group (-1.10±1.51 mL/min/kg), without a statistically significant difference between the groups (p=0.13). Exercise time showed a relevant increase in the Candesartan (31.9±58.5 sec) and a significant decrease in the placebo group (-25.9±85.9 sec) compared to baseline value. The difference between the studied groups was statistically significant (p<0.001). Relevant differences between the two groups were observed in the changes of right atrial pressure at rest (Candesartan: -1.9±1.7 mmHg, placebo: 1.0±2.7 mmHg, p<0.01), pulmonary capillary wedge pressure at rest (Candesartan: -3.1±3.8 mmHg, placebo: 0.2±4.6 mmHg, p<0.05) and systemic vascular resistance at maximum exercise (Candesartan: -141.9±253.3 dyne*sec/cm5, placebo: 47.3±221.0 dyne*sec/cm5, p<0.05). Conclusion The efficacy of CHF treatment of congestive heart failure was moderately improved by Candesartan as add-on therapy to ACE-inhibitors

Dystocia as a cause of untimely cesarean section

Background/Aim. One of the most frequent indications for cesarean section is dystocia. It is impossible to predict, difficult to identify and coincident with the rapid expiry of the expected time, so it is important to point out some mistakes in expecting vaginal delivery. The aim of this study was to examine the frequency and the length of dystocia-related cesarean delivery, as well as the vitality of the newborn immediately after birth. Methods. A prospective, 3-year study was conducted including a total number of 6,470 deliveries regardless of whether they were completed using cesarean section after an unsuccessful attempt of spontaneous vaginal delivery or not. The Apgar score, a proved useful tool for the assessment of the vitality of newborn children in the first minute, was used. Results. On the basis of the established indications, 653 (10.10%) of deliveries were completed using cesarean section. Dystocia was the third most common indication for cesarean section (16.38%). Deliveries in which dystocia was established as a diagnosis lasted much longer (p = 0.030) which resulted in weaker vitality of newborn children (p = 0.000) compared to the deliveries ended by spontaneous vaginal delivery. Conclusion. This study shows that deliveries caused by dystocia last much longer and newborn children are of weaker vitality compared to other deliveries caused not by dystocia. Decisions concerning cesarean section must be made in a timely fashion

Stereospecific ligands and their complexes, Part VIII: Antimicrobial activity of palladium(II) complexes with 0,0'-dialkyl esters of (S,S)-ethylenediamine-N,N'-di-2-(4-methyl)-pentanoic acid

Palladium(II) complexes (1-4) of general formula [PdCl2(R2-S,S-eddp)] with bidentate N,N'- -ligands, O,O'-dialkyl esters (R = ethyl, n-propyl, n-butyl and n-pentyl), of (S,S)-ethylenediamine- N,N'-di-2-(4-methyl)pentanoic acid (S,S-eddp) were prepared and characterized by microanalysis, infrared and UV/Vis spectroscopy. The ligands and its complexes were tested for their in vitro antimicrobial activity against 15 species of bacteria and fungi. Testing is performed by the microdilution method, with the minimum inhibitory concentration (MIC) and the minimum microbicidal concentration (MMC) being determined. The MIC values were in range from 4.9 μg cm-3 to > 5000 μg cm-3 while MMC values ranged from 78 μg cm-3 to > 5000 μg cm-3. Palladium(II) complexes [PdCl2(Ln)] (n, 1-4) have statistically significant higher activity than the corresponding ligands. Complex 4 displayed the strongest activity among all tested compounds

Correction: Chronic Hepatitis C: Conspectus of immunological events in the course of fibrosis evolution.

[This corrects the article DOI: 10.1371/journal.pone.0219508.]

Chronic Hepatitis C: Conspectus of immunological events in the course of fibrosis evolution.

In chronically infected HCV patients emergence and evolution of fibrosis, as a consequence of virus persistence, can be considered as an indicator of disease advancement. Therefore the aim of this study was to correlate alterations of immune response in chronic HCV patients with liver histopathology. Sera cytokine levels and frequency of circulating and liver infiltrating cells were evaluated using 13plex Kit Flow Cytomix, flow cytometry and immunohistochemistry. We found that the number of circulating T lymphocytes (including CD4+, CD8+ and Treg) and B lymphocytes, as well as DCs, was higher in patients with no fibrosis than in healthy subjects. In patients with fibrosis frequency of these cells decreased, and contrarily, in the liver, number of T and B lymphocytes gradually increased with fibrosis. Importantly, in patients with advanced fibrosis, liver infiltrating regulatory T cells and DC-SIGN+ mononuclear cells with immunosuppressive and wound-healing effector functions were abundantly present. Cytokine profiling showed predominance of proinflammatory cytokines in patients with no fibrosis and a tendency of decline in level of all cytokines with severity of liver injury. Lower but sustained IL-4 production refers to Th2 predominance in higher stages of fibrosis. Altogether, our results reveal graduall alterations of immunological parameters during fibrosis evolution and illustrate the course of immunological events through disease progression

Znaczenie stężenia NT-proBNP w określaniu rokowania i ocenie diagnostycznej u chorych z ostrymi zespołami wieńcowymi

Background and aim: N terminal-proB-type natriuretic peptide (NT-proBNP) is synthesised and secreted from the ventricularmyocardium. This marker is known to be elevated in patients with acute coronary syndromes (ACS). We evaluated NT-proBNP asa significant diagnostic marker and an important independent predictor of short-term mortality (one month) in patients with ACS.Methods: NT-proBNP and cardiac troponin I (cTI) were assessed in 134 consecutive patients (median age 66 years, 73% male)hospitalised for ACS in a cardiological university department. The patients were classified into ST-elevation ACS (STE-ACS, n = 74) and non-ST-elevation ACS (NSTE-ACS, n = 60) groups based on the ECG findings on admission. Patients with Killipclass ≥ II were excluded.Results: The serum level of NT-proBNP on admission was significantly higher (p &lt; 0.0005), while there was no differencein cTI serum level in the NSTE-ACS patients compared to STE-ACS patients. There was a significant positive correlation betweenNT-proBNP and cTI in the NSTE-ACS (r = 0.338, p = 0.008) and STE-ACS (r = 0.441, p &lt; 0.0005) patients. Therewas a significant difference in NT-proBNP (p &lt; 0.0005) and cTI (p &lt; 0.0005) serum level between ACS patients who diedwithin 30 days or who survived after one month. The increased NT-proBNP level is the strongest predictor of mortality in ACSpatients, also NT-proBNP cut-point level of 1,490 pg/mL is a significant independent predictor of mortality.Conclusions: We demonstrated the differences and the correlation in the secretion of NT-proBNP and cTI in patients withSTE-ACS vs. NSTE-ACS. Our results provide evidence that NT-proBNP is a significant diagnostic marker and an importantindependent predictor of short-term mortality in patients with ACS.Wstęp i cel: N-końcowy fragment propeptydu natriuretycznego typu B (NT-proBNP) jest syntetyzowany i wydzielany przezmiokardium komór serca. Wiadomo, że stężenie tego wskaźnika jest podwyższone u chorych z ostrymi zespołami wieńcowymi (ACS). Autorzy ocenili znaczenie stężenia NT-proBNP jako istotnego wskaźnika diagnostycznego i ważnego niezależnegoczynnika prognostycznego śmiertelności krótkoterminowej (w ciągu 1 miesiąca) u chorych z ACS.Metody: Oznaczono stężenia NT-proBNP i sercowej troponiny I (cTI) u 134 kolejnych chorych (mediana wieku 66 lat, 73%mężczyzn) hospitalizowanych z powodu ACS na oddziale kardiologicznym szpitala uniwersyteckiego. Pacjentów przydzielanodo grupy ACS z uniesieniem odcinka ST (STE-ACS, n = 74) lub do grupy ACS bez uniesienia odcinka ST (NSTE-ACS, n = 60)na podstawie EKG wykonanego przy przyjęciu. Chorych w klasie Killipa ≥ II wykluczono z badania.Wyniki: Stężenie NT-proBNP w surowicy przy przyjęciu do szpitala było istotnie wyższe (p &lt; 0,0005) u pacjentów z NSTE--ACS niż u osób z STE-ACS, natomiast surowicze stężenia cTI były podobne w obu grupach. Stwierdzono istotną dodatniąkorelację między stężeniami NT-proBNP i cTI u chorych z NSTE-ACS (r = 0,338; p = 0,008) i u osób z STE-ACS (r = 0,441;p &lt; 0,0005). Stężenia NT-proBNP (p &lt; 0,0005) i cTI (p &lt; 0,0005) w surowicy różniły się istotnie między chorymi z ACS,którzy zmarli w ciągu 30 dni, a pacjentami, którzy żyli dłużej niż miesiąc. Zwiększone stężenie NT-proBNP jest najsilniejszymczynnikiem prognostycznym zgonu u chorych z ACS. Ponadto stężenie NT-proBNP powyżej progowej wartości 1490 pg/mL jest istotnym niezależnym czynnikiem prognostycznym zgonu.Wnioski: Autorzy wykazali różnice w wydzielaniu NT-proBNP i cTI między chorymi ze STE-ACS i chorymi z NSTE-ACS orazkorelacje między tymi wskaźnikami. Uzyskane przez nich wyniki dowodzą, że NT-proBNP jest istotnym niezależnym wskaźnikiemdiagnostycznym i ważnym niezależnym czynnikiem prognostycznym śmiertelności krótkoterminowej u chorych z ACS

Analysis of risk factors for perifocal oedema after endovascular embolization of unruptured intracranial arterial aneurysms

BACKGROUND: Endovascular embolization is a treatment of choice for the management of unruptured intracranial aneurysms, but sometimes is complicated with perianeurysmal oedema. The aim of our study was to establish incidence and outcomes of perianeurysmal oedema after endovascular coiling of unruptured intracranial aneurysms, and to reveal possible risk factors for development of this potentially serious complication. METHODS: In total 119 adult patients with endovascular embolization of unruptured intracranial aneurysm (performed at Department for Interventional Neuroradiology, Clinical Center, Kragujevac, Serbia) were included in our study. The embolizations were made by electrolite-detachable platinum coils: pure platinum, hydrophilic and combination of platinum and hydrophilic coils. Primary outcome variable was perianeurysmal oedema visualized by magnetic resonance imaging (MRI) 7, 30 and 90 days after the embolization. RESULTS: The perianurysmal oedema appeared in 47.6% of patients treated with hydrophilic coils, in 21.6% of patients treated with platinum coils, and in 53.8% of those treated with mixed type of the coils. The multivariate logistic regression showed that variables associated with occurrence of perianeurysmal oedema are volume of the aneurysm, hypertension, diabetes and smoking habit. Hypertension is the most important independent predictor of the perianeurysmal oedema, followed by smoking and diabetes. CONCLUSIONS: The results of our study suggest that older patients with larger unruptured intracranial aneurysms, who suffer from diabetes mellitus and hypertension, and have the smoking habit, are under much higher risk of having perianeurysmal oedema after endovascular coiling