Cognitive Functioning and Psychological Well-being in Breast Cancer Patients on Endocrine Therapy.

BACKGROUND/AIM: Anti-cancer therapies may deteriorate cognitive functioning, affective functioning and psychological well-being. MATERIALS AND METHODS: In this prospective longitudinal pilot study, premenopausal and postmenopausal patients received adjuvant endocrine therapy (ET) (tamoxifen with or without LHRH analog or aromatase inhibitor) or were observed only (control group). At baseline testing and 6, 12 and 24 months thereafter, cognitive, depression and anxiety tests and quality of life (QOL) measurements were performed. RESULTS: Overall, 46 cases were evaluated. None of the studied cognitive parameters differed between the subgroups or changed by time. No differences were found regarding anxiety, depression or QOL measures either. Baseline cognitive test and QOL results were in association with later anxiety and depression. CONCLUSION: No cognitive impairment was found during the two years of ET. Baseline cognitive scores and QOL dimensions proved good predictors of later anxiety and depression.

Action-associated modulation of visual event-related potentials evoked by abstract and ecological stimuli.

This study investigated the influence of action-associated predictive processes on visual ERPs. In two experiments, we sought evidence for sensory attenuation (SA) indexed by ERP amplitude reductions for self-induced stimuli when compared to passive viewing of the same images. We assessed if SA is (a) present for both ecological and abstract stimuli (pictures depicting hands or checkerboards), (b) modulated by the degree of stimulus predictability (certain or uncertain action-effect contingencies), and (c) sensitive to laterality of hand movements (dominant or subdominant hand actions). We found reduced occipital responses in the early 77-90 ms time interval (C1 component), irrespective of stimulus type, predictability, or the laterality of hand movements. However, the subsequent P1 component was increased (rather than reduced) for all action-associated stimuli. In addition, this P1 effect was influenced by the degree of stimulus predictability for ecological stimuli only. Finally, the posterior N1 component was not modulated by self-initiated actions. Overall, our findings indicate that movement-related predictive processes attenuate early visual responses. Moreover, we propose that amplitude modulations in the P1 time range reflect the interaction between expectation-based SA and attention-associated amplitude enhancements. These results can have implications for assessing the influence of action-associated predictions on visual processing in psychiatric disorders characterized by aberrant sensory predictions and alterations in hemispheric asymmetry, such as schizophrenia.

TNFα Variation During the Menstrual Cycle and Thereafter: A New Explanation for Gender-Based Disparities in ICU Admission Rates, Trauma Outcomes, and General Mortality.

BACKGROUND: Multiple studies have found gender-based disparities in intensive care unit (ICU) admission rates and in complications following trauma. Female gender was associated with lower mortality when comparing patients less than 50 years of age. These data suggest an important role for cycle rather than gender itself. Our previous results indicate a crucial role for tumor necrosis factor alpha (TNFα) in inducing nososocomial infections. HYPOTHESIS: Cycle is important for TNF and other female hormone productions. METHODS: Six older than 60 years old volunteers in both genders, 40 young female volunteers (no contraceptive drug, n = 18, contraceptive drug, n = 9, lactation, n = 9, pregnant, n = 4) were collected with following exclusion criteria, malignant disease, inflammation, infection, trauma and taking non-steroid anti-inflammatory drugs and antibiotics. Females were studied on days 1 and 14 of cycle. Serum TNFα was determined by HS TNF ELISA. Female hormones were also determined. RESULTS: Serum TNFα, estradiol, and progesterone individual values in volunteers with cycle (no contraceptive drug) demonstrate marked interindividual differences on day 1 and day 14 of cycle. It can be seen beside interindividual differences the personal difference between TNFα, estradiol, and progesterone values on day 1 and day 14.Serum TNFα, estradiol, and progesterone individual values in volunteers with no cycle (contraceptive drug yes) demonstrate marked interindividual differences on day 1 and day 14 of cycle. It can be seen beside interindividual differences the personal difference between TNFα, estradiol, and progesterone values on day 1 and day 14; furthermore, seemingly lower estradiol values on day 1 and day 14 between groups can be seen. A significant decrease was demonstrated in serum progesterone values on day 14 of group with contraceptive drug compared with group with no contraceptive one.A significant negative correlation is demonstrated between serum progesterone and serum TNFα values on day 14.A marked significant difference in serum TNFα values between volunteers with cycle and with no cycle, like contraceptive, lactation pregnancy (trimesters P1, P2, P3), and climax. CONCLUSION: For homogenous group of female patients not the gender and age are important but the cycle itself.

Autoantibodies to alfa-fodrin in patients with Hashimoto thyroiditis and Sjögren's syndrome: possible markers for a common secretory disorder.

Presence of autoantibodies to alfa-fodrin was investigated in patients with Sjögren's syndrome (n = 61), Hashimoto thyroiditis (n = 27), Sjögren's syndrome associated with Hashimoto thyroiditis (n = 31) and in healthy persons (n = 77). In each group, level of alfa-fodrin antibodies was higher than in the controls. There was no significant difference in their presence either between patients with Hashimoto thyroiditis with or without Sjögren's syndrome, or-in IgA isotype-between Sjögren's and Hashimoto thyroiditis patients. Correlation was found between the level of IgG alfa-fodrin and anti-thyroglobulin antibodies. Based on these findings, fodrin can be associated with both endocrine and exocrine glandular secretion. Antibodies to alfa-fodrin might have a role in the pathogenesis of Hashimoto thyroiditis concerning the "final common effectory pathway", secretion. Alfa-fodrin antibodies can be good markers of secretory disorders. Assessment of these autoantibodies might help the diagnosis and follow-up of patients with impaired secretory capability of not only autoimmune origin.

Association of systemic and thyroid autoimmune diseases.

OBJECTIVE: There are few large cohort studies available on the association of systemic and thyroid autoimmune diseases. In this study, we wished to determine the association of Hashimoto's thyroiditis (HT) and Graves' disease (GD) with systemic autoimmune diseases. METHODS: One thousand five hundred and seventeen patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), mixed connective tissue disease (MCTD), Sjögren's syndrome (SS) and polymyositis/dermatomyositis (PM/DM) were included in the study. The HT and GD were diagnosed based on thorough clinical evaluation, imaging and fine-needle aspiration cytology (FNAC). The frequency of HT and GD in these diseases was assessed. In addition, 426 patients with HT or GD were assessed and the incidence of SLE, RA, SSc, MCTD, SS and PM/DM among these patients was determined. Prevalence ratios indicating the prevalences of GD or HT among our autoimmune patients in comparison to prevalences of GD or HT in the general population were calculated. RESULTS: Altogether 8.2% of systemic autoimmune patients had either HT or GD. MCTD and SS most frequently overlapped with autoimmune thyroid diseases (24 and 10%, respectively). HT was more common among MCTD, SS and RA patients (21, 7 and 6%, respectively) than GD (2.5, 3 and 1.6%, respectively). The prevalences of HT in SLE, RA, SSc, MCTD, SS and PM/DM were 90-, 160-, 220-, 556-, 176- and 69-fold higher than in the general population, respectively. The prevalences of GD in the same systemic diseases were 68-, 50-, 102-, 76-, 74- and 37-fold higher than in the general population, respectively. Among all thyroid patients, 30% had associated systemic disease. In particular, 51% of HT and only 16% of GD subjects had any of the systemic disorders. MCTD, SS, SLE, RA, SSc and PM/DM were all more common among HT patients (20, 17, 7, 4, 2 and 2%, respectively) than in GD individuals (2, 5, 5, 1, 2 and 1%, respectively). CONCLUSION: Systemic and thyroid autoimmune diseases often overlap with each other. HT and GD may be most common among MCTD, SSc and SS patients. On the other hand, these systemic diseases are often present in HT subjects. Therefore it is clinically important to screen patients with systemic autoimmune diseases for the co-existence of thyroid disorders.

Hypothyroidism and thyroiditis after therapy for Hodgkin's disease.

During the follow-up of thyroid function of 151 patients with Hodgkin's disease in complete remission for at least 1 year, 26 cases of subclinical, 12 cases of manifest clinical hypothyroidism and 2 cases of hyperthyroidism (Graves-Basedow disease) were confirmed. Thyroid dysfunction was more frequent in patients who had undergone mantle or neck radiotherapy. Hypothyroidism was most often revealed from the 6th year on following radiotherapy. Thyroid autoantibody positivity was found to be more frequent in patients with thyroid dysfunction, and conversely, thyroid dysfunction was more frequent among the 28 patients with autoantibody positivity. Ultrasound examination and fine needle aspiration cytology of the thyroid confirmed thyroiditis in 96% of the patients with antibody positivity. No relationship was found between thyroiditis and the form of treatment for Hodgkin's disease. We have found that both neck irradiation and thyroiditis may play a role in the increased number of thyroid dysfunction in patients treated for Hodgkin's disease. Thyroiditis is not caused by neck radiotherapy but may be the result of immune regulation disorders in Hodgkin's disease. For substitution or isohormone therapy, levothyroxine is suggested for use. We suggest that examination of the thyroid should be performed at least once a year during the follow-up of Hodgkin's disease patients.