Intolerance of Uncertainty and Tendency to Worry as Mediators Between Trust in Institutions and Social Support and Fear of Coronavirus and Consequences of the Pandemic

The aim of this article is to formulate and test a model integrating cognitive behavioral therapy (CBT) findings regarding the importance of intolerance of uncertainty (IU) and tendency to worry with findings regarding the importance of trust in institutions, other people, and social support. We assumed that trust in institutions, other people, and social support reduce fear of the coronavirus and of the consequences of the pandemic in a direct way, but also indirectly by enhancing one’s sense of control and diminishing the tendency to worry which, further, attenuates fear of the coronavirus and fear of the consequences of the pandemic. An online survey was conducted among the Serbian general population (N = 1409, 78.1% female, M = 38.82, SD = 9.24) at the end of April 2020, which included questionnaires on fear of SARS-CoV-2, fear of consequences of the pandemic, social support, trust in other people and trust in political and health institutions. The model has been validated by data from our study suggesting that it represents one possible pattern of interrelationships between social and intrapsychic variables in the pandemic situation. Results also showed that the COVID-19 related fears are related more strongly to intrapsychic variables – IU and tendency to worry – than to variables operationalizing social context relevant for coping with pandemic at the social and individual level.

Effects of neratinib on health-related quality of life in women with HER2-positive early-stage breast cancer: longitudinal analyses from the randomized phase III ExteNET trial

BACKGROUND

We report longitudinal health-related quality-of-life (HRQoL) data from the international, randomized, double-blind, placebo-controlled phase III ExteNET study, which demonstrated an invasive disease-free survival benefit of extended adjuvant therapy with neratinib over placebo in human epidermal growth factor receptor-2-positive early-stage breast cancer.

PATIENTS AND METHODS

Women (N  = 2840) with early-stage HER2-positive breast cancer who had completed trastuzumab-based adjuvant therapy were randomly assigned to neratinib 240  mg/day or placebo for 12  months. HRQoL was an exploratory end point. Patients completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) and EuroQol 5-Dimensions (EQ-5D) questionnaires at baseline and months 1, 3, 6, 9, and 12. Changes from baseline were compared using analysis of covariance with no imputation for missing values. Sensitivity analyses used alternative methods. Changes in HRQoL scores were regarded as clinically meaningful if they exceeded previously reported important differences (IDs).

RESULTS

Of the 2840 patients (intention-to-treat population), 2407 patients were evaluable for FACT-B (neratinib, N  = 1171; placebo, N  = 1236) and 2427 patients for EQ-5D (neratinib, N  = 1186; placebo, N  = 1241). Questionnaire completion rates exceeded 85%. Neratinib was associated with a decrease in global HRQoL scores at month 1 compared with placebo (adjusted mean differences: FACT-B total, -2.9 points; EQ-5D index, -0.02), after which between-group differences diminished at later time-points. Except for the FACT-B physical well-being (PWB) subscale at month 1; all between-group differences were less than reported IDs. The FACT-B breast cancer-specific subscale showed small improvements with neratinib at months 3-9, but all were less than IDs. Sensitivity analyses exploring missing data did not change the results.

CONCLUSIONS

Extended adjuvant neratinib was associated with a transient, reversible decrease in HRQoL during the first month of treatment, possibly linked to treatment-related diarrhea. With the exception of the PWB subscale at month 1, all neratinib-related HRQoL changes did not reach clinically meaningful thresholds. ClinicalTrials.gov: NCT00878709.

The premorbid personality of patients with Parkinson's disease: evidence with the Tridimensional Personality Questionnaire

The premorbid personality traits of 102 patients with Parkinson's disease (PD) and 57 age-matched healthy controls were studied by the recently developed Tridimensional Personality Questionnaire. We found significantly fewer (p < 0.05) of a group of traits called "novelty seeking" (NS), but no changes in "harm avoidance" (HA) and "reward dependence" (RD), in PD patients, for the period approximately 5-10 years before the onset of the disease, compared to controls. Individuals who are lower than average in NS and average in HA and RD are described as reflective, rigid, loyal, stoic, slow-tempered, frugal, orderly, and persistent Since NS is thought to be directly related to central dopaminergic reactivity, the premorbid expression of these behaviors may be the reflection of neurochemical deficits (hypodopaminergic tone) accompanying the presymptomatic phase of PD.

[Biological activities of bone morphological protein in bone regeneration]

Bone matrix contents various development factors which control structuring and absorption and those factors play important role in bone and cartilage development. Bone morphological proteins are members of TGF-beta super family and their activity is certain becoming from the bone. This activity leads to the serial development processes which include chemo taxis, proliferation and differentiation which results in trans resistant formation of cartilage as well as production of life cells of a bone tissue. Biological activities of re combinative human bone morphogenetic protein 7 (rhBMP-7). induction bone formation of non critical size mandible defect of New Zealand rabbits were researched in the study. Markers of osteoblastic differential in the study included ALP specific activity. Histological analysis performed 7, 14, 30, 60 postoperative days, C-T analysis with determination Bone Mineral Density value of new structured tissue within the defect was done 30 days. Results indicate that ectopic bone formation has been inducted with rhBMP-7 and histological analysis shown mature bone with collagen and ostheociti 60th day. Early 7 day granulocyte tissue with angiogenesis was detected, and after 30 days ostheoblastsis shown with a lot of vascular and mezenhimal tissue. Ostheogenetic processes were characteristic for typical inter membraneous ossification without cartilage tissue. ALP activity was significantly increased 21 days. C-T and Bone Mineral Density value shown density of new structured tissue determinate as bone (413 mg/cm3 and 519 mg/cm3). Studies showed that concentration of 100 mg rhBMP-7 in collagen as career had strong ostheo inductive capacity. Conditions which module BMP depend ostheo induction should be considered in the future. Information could lead to improvements of rhBMP as substitution for bone graft in clinical practice.

Chemotherapy in carcinomas of unknown primary site

PURPOSE

Carcinomas of unknown primary site (CUPS) are highly malignant diseases with a usually ominous prognosis. We report on the efficacy of chemotherapy in the treatment and survival of patients with CUPS.

PATIENTS AND METHODS

The study involved 63 patients with metastatic CUPS. Following routine light microscopy, the histological findings were classified into 3 groups: squamous cell carcinoma - 8 patients; adenocarcinoma - 33 patients; and undifferentiated carcinoma - 22 patients. Combination chemotherapy with doxorubicin 50 mg/m(2) (day 1), cisplatin 60 mg/m(2) (day 1), and etoposide 120 mg/m(2)/day (days 1-3) every 3 weeks was administered to 32 patients (20 females and 12 males), aged 29-70 years (median 54 years) who met the inclusion criteria. All patients with stable disease (SD), partial response (PR) or complete response (CR) received 6 cycles of chemotherapy.

RESULTS

CR was achieved in 3 (9.4%), PR in 12 (37.5%), and SD in 10 (31.2%) patients. Seven (21.9%) patients had progressive disease (PD). The overall response rate (RR) was 46.9% (15/32) and the median response duration of CR+PR was 11 months (range 4-43(+) months). The overall survival (OS) of patients treated with chemotherapy (n=32; 50.8%) was better compared with the OS of those not receiving chemotherapy (n=31; 49.2%/; p <0.01). Also the 2-year survival of patients with chemotherapy (40%) and without chemotherapy (0%) implies potential curability in a specific subset of these patients.

CONCLUSION

The usage of the aforementioned doses and chemotherapy scheme appears to improve the outcome of patients with carcinoma of unknown primary site.

Simultaneous or sequential chemotherapy for locally advanced breast cancer

Chemotherapy of breast cancer is still an area of intensive research. Based on mathematical model of tumor cell growth kinetics, a novel concept of chemotherapy in breast cancer was launched which implies dose-densification of chemotherapy through the use of sequential non crossresistant single agents or regimens. The relative infrequency of locally advanced breast cancer (LABC) has limited the speed of clinical progress in this area. The introduction of primary (neoadjuvant) systemic chemotherapy (PSCT), however, improved the outcome of patients with LABC. The first data concerning neoadjuvant sequential chemotherapy were related to primary operable breast cancer. Many studies, using the two most active classes of cytotoxic drugs, anthracyclines and taxanes, in primary breast cancer, showed that sequential PSCT was superior to simultaneous combination chemotherapy in terms of enhancing the rates of patients rendering suitable for breast-conserving (BC) treatment. There are few trials dealing with sequential PSCT in LABC. In the majority of them sequential dose-dense PSCT was administered because the rapid delivery of the most active cytotoxic drugs (anthracyclines and taxanes) is necessary to achieve reduction of the size of the primary tumor, to increase the possibility of BC treatment and to eliminate occult distant micrometastases, contributing thus to possible prolongation of survival. This article summarises recent data concerning sequential PSCT in LABC in order to evaluate its possible use in clinical practice.

Diet and breast cancer

Nutritional factors have been prominent among the environmental determinants of breast cancer hypothesized to account for the large increases in rates among offspring of migrants from countries with low incidence to countries with high incidence. The dominant hypothesis has been that high fat intake increases risk, but in addition to this possibility, several alternative hypotheses have been suggested, too.

Epidemiology of breast cancer in the city of Nis, Serbia

PURPOSE

Over the past 10 years, Serbia has been affected by a heavy economic and political crisis that in 1999 even led to war and bombardment. Numerous facts indicate that the crisis has resulted in low-level health protection, increasing mortality, as well as other deteriorating effects over the general health of the population. The aim of the study was to assess mortality trends in female breast cancer in the city of Nis prior to (1986-1993) and following (1995- 1999) the socio-economic crisis peak.

MATERIALS AND METHODS

Population and hospital cancer registry data for the 1986-1999 period were used for analysis, as well as death certificate data for all women who lived and died in the city of Nis in the given period. Survival was calculated according to the Kaplan-Meier method. The rates were calculated per 100,000 inhabitants (1991 census) and were not standardized.

RESULTS

A total of 455 women in the city of Nis died of breast cancer during 1986-1999. The polynomial trend in mortality revealed an increasing (1986-1992) and decreasing (1993-1996) tendency, although the first period showed a lower average mortality (28.7) than did the second one (30.45). Survival rates were calculated for the periods 1986- 1993 and 1995-1998. The 12-month survival rate was 84.7% in the first and 92% in the second period; the 24-month survival rate for the first period was 76.6% and 87.9% for the second; the 36-month survival was 67.7% in the first and 80.5% in the second period; the 4-year survival rate for 1986-1993 was 64.1% and 78.1% for 1995-1999.

CONCLUSION

The socio-economic and political crisis has proved to affect breast cancer patients in Serbia. Overall, the mortality rate increased. Calculated upon division of the whole period into two, mortality shows an upward trend in the first period (1986-1992) and a downward trend in the second. Although 1993-1999 was more difficult for the Serbian and Yugoslavian population (manifested in the therapy of all diseases, including breast cancer), the diagnosis of breast cancer improved and the disease was detected at earlier stages, the result of which were better survival rates in the 1986-1992 period.

Sensitivity, specificity, positive and negative predictive value of serum S-100 beta protein in patients with malignant melanoma

PURPOSE

To establish the sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of serum S-100 beta protein (sSB) in patients with malignant melanoma (MM), based on its concentration in the peripheral blood and the likelihood ratio (LR) for the whole group of patients with MM, as well as for each separate clinical stage.

PATIENTS AND METHODS

sSB was determined immunoluminometrically in 172 patients with histologically confirmed MM. Sera from 64 healthy subjects were used as controls.

RESULTS

Increased values of sSB were detected in 65 out of 172 patients with MM, and in 5 cases among healthy subjects. Sensitivity, specificity, PPV and NPV were 38%, 92%, 93% and 35%, respectively. In stage I 1/29 patients had increased values of sSB, in stage II 3/34, in stage III 13/47 and in stage IV 48/62 patients. Sensitivity, specificity, PPV and NPV for stage I were 3%, 92%, 17% and 68%, respectively/ for stage II 9%, 92%, 37% and 65%, respectively; for stage III 28%, 92%, 72% and 63%, respectively; and for stage IV 77%, 92%, 91%, and 81%, respectively. The LR for sSB values of >13 mug/l was 5 for the whole group of patients with MM, 0.4 for stage I, 1 for stage II, 3 for stage III and 10 for stage IV.

CONCLUSION

Based on our results we conclude that sSB is a reliable serum marker for the diagnosis of stage IV MM.

Adjuvant chemotherapy of premenopausal breast cancer patients and patients under 35 years of age

Micrometastases in patients with primary breast cancer are the rationale for adjuvant systemic treatment. The Early Breast Cancer Trialists' Collaborative Group (EBCTCG) sequential studies have shown that adjuvant systemic therapy decreases recurrence and prolongs survival. According to tumour and patient-related prognostic factors, the risk for relapse could be evaluated. If the risk for relapse is over 10% for 10 years, adjuvant systemic therapy is indicated. Adjuvant chemotherapy is associated with a greater 15-year absolute reduction in death in premenopausal than in postmenopausal patients. Anthracycline- based regimens have demonstrated superiority over classic cyclophoshamide, methotrexate and 5- fluorouracil (CMF) combination chemotherapy, and the role of taxanes is questionable. Timing and duration of adjuvant chemotherapy plays an important role in its individualization. The need for tailored treatments in premenopausal patients is most pronounced in women under 35 years of age at diagnosis.

The role of endocrine therapy in early breast cancer: adjuvant treatment of preand postmenopausal patients

Two major trends are evident from ongoing conferences and panels of experts on early breast cancer adjuvant treatment. The first strongly suggests the application of wellestablished standards of adjuvant treatment in everyday clinical practice. The second encourages participation in international adjuvant clinical studies of breast cancer. Our growing knowledge of the role of endocrine adjuvant therapy in early breast cancer has emerged from the findings of large adjuvant studies. Meta-analyses of numerous randomised trials have accumulated evidence that has been analysed on many occasions by international panels of experts and has become a major source of consensus recommendations. Nevertheless, many open questions still exist, and new ones arise. This paper reviews the current standards for the adjuvant treatment of endocrine-dependent breast cancer, as well as some perspectives emerging from ongoing clinical studies.

Current value and future potential of biological markers in breast cancer

Over the last 25 years, many studies have confirmed that oestrogen receptor (ER) content is a good indicator of response to endocrine therapy in breast cancer. However, there is little information that allows such clear selection of therapy for patients with ER negative disease (ER(-)). There are at least 8 classes of biomarkers that can be described. Studies are urgently needed to determine which combinations of these classes of markers will give the best tools for optimal management of breast cancer patients.

[Clinical features of essential tremor]

Essential tremor is a dominant hereditary disorder with incomplete penetration manifested in action, postural tremor with no signs of parkinsonism, cerebellar lesions or other neurological signs [1]. The diagnosis of essential tremor is established on the basis of the clinical picture, and is greatly variable and insufficiently defined [5].

MATERIAL AND METHODS

The study concerned patients with the diagnosis of essential tremor established by the International Association for Tremor Studies in 1995 where tremor was classified into definite++, possible and probable [6]. All patients were subjected to a special questionnaire including demographic and clinical characteristics of tremor. Detailed neurological examinations focusing the presence of extrapyramidal signs were carried out. Fischer's Exact test was used for statistical analysis.

RESULTS

The study comprised 107 patients (55 males, 41 females), aged 17-84 years (57.3 +/- 15.6) and 7-77 (46.3 +/- 17.9) at onset of the disease. Postural tremor was present in 36% of patients, postural tremor with intentional deterioration in 16%, statopostural tremor in 21% and continuous tremor in 17% of subjects. Extrapyramidal signs were present in 31% of patients, and clumsiness in fine alternating movements was present in 17 patients. The patients with longer duration of illness were significantly more clumsy in fine alternating movements (Fischer's Exact test; p = 0.507 < 0.05), but not in the presence of extrapyramidal signs (Fischer's Exact test; p = 0.507 > 0.05).

DISCUSSION

Essential tremor is described as a dominant inherited postural tremor. Koller et al. [9] describe dominantly kinetic tremor occurring with movements, while Martinelli et al. [10] describe continuous tremor manifested at rest, posture and with movements. Static tremor was considered as a result of the disease progression [8]. In our patients those with longer duration of the disease were frequently more clumsy in fine alternating movements, but not in manifestation of extrapyramidal signs. Continuous tremor is probably a subgroup of essential tremor; suggests a more pronounced role of cerebellum in its genesis.

[Amiodarone--pro and con]

OBJECTIVE

To compare and evaluate the data for and against the use of antiarrhythmic agent amiodarone in known cardiological indications.

DATA SOURCES

A MEDLINE search was used to identify the articles dealing with amiodarone, published in the last 15 years.

STUDY SELECTION

Articles and studies (uncontrolled retrospective and controlled prospective), as well as case reports speaking decidedly for or against amiodarone were scrutinized.

DATA EXTRACTION

Simple search, no particular conditions.

CONCLUSIONS

Despite very numerous and serious side effects amiodarone is an extraordinary drug and can be recommended for use, provided that the physician is very well acquainted with all implications of its use. Large number of studies on a significant number of patients has proven the efficacy of amiodarone in supraventricular and ventricular arrhythmias of various origin. The drug is particularly suitable for the treatment of ventricular arrhythmia in patients with serious heart failure and impaired function of the left ventricle. It was successfully used in the treatment of malignant ventricular arrhythmias. In patients after myocardial infarction, intravenously administered amiodarone improved the chances of survival as well as the condition of arrhythmia, preventing spreading of the infarction. It is very convenient against ventricular arrhythmia after the successful resuscitation. Short-lasting intravenous administration of amiodarone does not cause serious side effects.

[Delayed-onset dystonia due to asphyxia in the perinatal period]

The phenomenon of delayed-onset dystonia following presumed "static" brain injuries was described after stroke and head trauma. Burke et al. described a different category of secondary dystonia, where perinatal injury (asphyxia) caused minimal or no immediate neurological deficit, with the delay of years before dystonia emerged. This type of dystonia following perinatal injury has been termed "delayed onset dystonia due to static encephalopathy of childhood". According to the definition of dystonia, we were able to select 5 patients with the aetiologic diagnosis of perinatal asphyxia from the group of 347 out- and inpatients (1.4%) treated for various types of dystonia at the Movement Disorders Department (Institute of Neurology, CCS, Belgrade) from November 1986 to November 1994. At onset of dystonia the mean age of patients was 13.2 years (range from 10 to 17), with combined initial involvement of the arm and neck in 3 patients. The period from the onset of the disease to the maximum severity lasted 8.2 years (range from 4 to 14), resulting in segmental brachial dystonia in 3, hemidystonia and generalized dystonia in one patient each (Table 1). The adverse perinatal events are described in Table 2. Three of our patients had delayed achievements of developmental milestones. All patients were regularly schooled and had preserved intellectual capacities, except the patient 3 whose achievements were below average (IQ = 86). Different drugs were administered (Table 3), but moderate effects were achieved only with trihexyphenidyl in two patients (daily doses of 24 mg and 30 mg, respectively), and baclofen (80 mg p.d.) in one patient. In this study we describe 5 new patients who fulfilled the criteria for the diagnosis of delayed-onset dystonia due to perinatal asphyxia (Tables 1 and 2). We accepted the approach of Saint-Hilaire et al. to suggest a relationship between perinatal asphyxia and later occurrence of dystonia in our 5 patients. However, coincident occurrence of a primary dystonia with a static encephalopathy of childhood due to perinatal asphyxia cannot be excluded. This phenomenon of delayed appearance of dystonia was also described in other forms of static cerebral injury; i.e. stroke, head trauma or anoxic brain damage. Interestingly enough, age at the time of anoxia or brain insults seemed to be crucial for the development of dystonia: those who suffer acute brain insults during childhood or early life are more likely to develop dystonia than the older patients. Therefore, the "static" nature of encephalopathy induced by perinatal asphyxia is questionable. Finally, this study strengthens the suggestion that perinatal asphyxia can lead to delayed-onset dystonia, and, since "some of these patients closely resemble cases of idiopathic torsion dystonia, the prior occurrence of asphyxia should be used as a criterion of exclusion for that diagnosis".

Prolactin and cortisol responses to fenfluramine in Parkinson's disease

Dysfunction of the central serotonergic system has been associated with depression in Parkinson's disease. To evaluate central serotonergic function in Parkinson's disease in relation to depression, we examined prolactin and cortisol responses to a single-dose challenge with fenfluramine (60 mg orally), a serotonin releasing/uptake-inhibiting agent, in the course of 5 hours in 11 patients with Parkinson's disease associated with major depression (SADS-RDC), 22 nondepressed parkinsonians, and 20 age- and gender-matched healthy controls. No difference in cortisol responses were observed between the groups; however, prolactin responses to fenfluramine were significantly impaired in patients with Parkinson's disease compared to controls, and the response was significantly more blunted in parkinsonian patients with major depression in comparison with the nondepressed ones. These findings indicate that there is a diminished serotonergic responsivity in depression associated with Parkinson's disease.

[The significance of physical activity and anthropometric parameters for the development of breast cancer]

The significance of physical activity and some anthropometric parameters (body mass, body height, body mass index) in breast cancer genesis was examined in the study. Anamnestic study included 106 women with breast cancer and 106 hospital controls, age-matched (+/-3 years). The data about risk factors for breast cancer genesis were collected by the targeted epidemiological questionnaire. The basic statistic parameters (mean, standard error) and t-test were calculated. The results indicated that physical activity and body height higher values appeared to be protective, while body mass and body mass index higher values could be considered as risk factors for breast cancer.

[Application of LNNB in patients with closed brain injury]

Closed brain injury (CBI) has become epidemiological problem with important neuropsychological consequences that, although often not obvious without formal testing, are of great influence on cognitive and social functioning of these patients. We applied Luria Nebrasca Neuropsychological Battery (LNNB) to 24 victims of moderate and severe CVI after they regained proper orientation for time and place, and 75 to 180 days later. There were 18 male and 6 female patients, age from 16 to 55 years. The most impaired functions on first testing were rhythm perception, which can be taken as a measure of attention, memory, Intellectual processes, visual function and arithmetics (in the descending order of scores). On retesting we noted significant recovery in rhythm perception, visual functions, intellectual processes, motor functions, receptive speech and arithmetics. Disorders of attention and concentration showed widespread influence on other neuropsychological functions as a nonspecific factor, especially in spontaneous recovery that stresses the importance of specific rehabilitation measures for attention and concentration. LNNB showed great opportunities for assessment of wide spectrum of neuropsychological functions both in initial and later phases, and also in planning of cognitive and social rehabilitation.

[Neuropsychological impairments in non-demented patients with multiple sclerosis]

Neuropsychological investigation of 25 patients with multiple sclerosis was carried out. The aim of the study was the detection of vulnerability of certain neuropsychological functions caused by demyelinating process and estimation of impact of the clinical characteristics of the disease on cognitive functioning. Neuropsychological evaluation was performed by Luria-Nebraska Neuropsychological Battery. The analysis of the Clinical and Factor Scales results revealed that attention, memory and intellectual functions were the most disturbed. In comparison with the achievements of the control group, the group of non-demented patients with multiple sclerosis scored lower on all Clinical Scales. The results of the present neuropsychological examination pointed out that the impairment of neuropsychological functions in patients with multiple sclerosis comprised the two levels of functioning. The first, that was more dependent on neurological deficit and the second, that included mental plan of functioning. The statistical analysis did not reveal significant correlation between neuropsychological achievements and the form and duration of illness.

[Changes in surface markers on peripheral blood lymphocytes, caused by thymic extract in breast cancer patients]

A quantification of peripheral blood CD2, CD3, CD4, CD8 i CDDR positive cells was performed to evaluate effectiveness of a bovine thymic extract, TFX-thymomodulin in expresing those surface markers, modulated by postoperative radiotherapy in breast cancer patients. Twenty patients with histologically proven breast cancer, assigned to clinical stage II using the criteria of TNM (Tumour Node Metastasis) classification were divided into two compatative groups: the first one was treated with radiotherapy only, whereas the second one was additionally treated with TFX-thymomodulin. The quantification of CD2, CD3, CD4, CD8 and CDDR positive peripheral blood cells was performed before and after treatment in both comparative groups, using the indirect immunofluorescent technique. We found significantly lower reduction in CD4 and CDDR positive cells in the breast cancer patient group, treated with radioimmunotherapy, compared to the group, treated with radiotherapy only. TFX-thumomodulin could be effective in reducing the changes of examined surface markers, caused by radiotherapy in breast cancer patients.

[The opioid peptide, beta-endorphin, in spontaneous vaginal delivery and cesarean section]

The opioid peptide, beta-endorphin, originates from proopiomelanocortin (POMC) under the influence of corticotropin releasing hormone (CHR). It increases the threshold of pain and has a certain influence on the formation of hypophyseal hormones, especially in stress. It is found that beta-endorphin stimulates the secretion of prolactin, a growth hormone, and vasopressin; it inhibates formation of follicle-stimulating and luteinizating hormones, oxytocin and dopamine, and gonadotropin, a releasing hormone. The process of acetylization decreases its activity. The results of experimental trials revealed that acetylisation in the foetal period was absent. The aim of the study was to define beta-endorphin concentration during normal vaginal labor and Cesarean section. Samples of peripheral blood of patients with spontaneous vaginal labor (n = 15) and of those in whom labor was operatively terminated (Cesarean section) (n = 10), were analysed. Values of this opiate were determined in the umbilical cord of newborn infants, in the amniotic fluid and placental compartment. The obtained results were statistically analysed. In intrapartum beta-endorphins were significantly increased reaching the highest level during expulsion (326 pg/ml); in the placental compartment these values were higher (in retroplacental blood 514 pg/ml) reaching the highest value of 917 pg/ml, p less than 0.01 in the placenta. In Cesarean section beta-endorphin values in the peripheral blood showed no significant differences during spontaneous vaginal labor. However, increased values of this natural opiate were observed six hours after surgery. Beta-endorphin concentrations in the placental compartment and the placenta during normal vaginal labor were significantly higher in comparison with labor by Cesarean section (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Serum and CSF immunological findings in ALS

Serum and CSF immunological findings were analysed in 37 patients with amyotrophic lateral sclerosis (ALS). ALS patients had significantly higher mean values of serum IgG and complement component C4 and significantly lower mean value of total haemolytic titre of complement (THC) compared with normal controls. Incidence of immune complexes (ICs) was significantly higher in sera of ALS patients than in normal controls. There was no significant difference regarding mean serum levels of IgM, IgA, and complement components C3 and Factor B between patients and controls. The blood-brain barrier (BBB) damage was found in 46% of patients. Intrathecal IgG synthesis was detected in six patients (16%). These results support the hypothesis of immune system involvement in ALS.

Auditory event-related potentials in different types of dementia

Auditory event-related potentials were recorded in demented, drug-free patients with Huntington's disease and Alzheimer's disease, as well as in demented and nondemented patients with Parkinson's disease, who were matched for age, duration and stage of the disease. The normal P3 latency at a given age was predicted by using an age regression equation that had been calculated on the basis of the findings in 42 normal adults. Using this procedure, a prolonged P3 latency was found in about two thirds of demented patients, irrespectively of the underlying disease. Although the prolonged P3 latency proved to be useful electrophysiological correlate of dementing illness, no differences were found between the observed groups in respect to other components of the auditory event-related potentials (N1 and P2).