Early brain development toward shaping of human mind: an integrative psychoneurodevelopmental model in prenatal and perinatal medicine.

The article introduces an integrative psychoneurodevelopmental model of complex human brain and mind development based on the latest findings in prenatal and perinatal medicine in terms of integrative neuroscience. The human brain development is extraordinarily complex set of events and could be influenced by a lot of factors. It is supported by new insights into the early neuro-ontogenic processes with the help of structural 3D magnetic resonance imaging or diffusion tensor imaging of fetal human brain. Various factors and targets for neural development including birth weight variability, fetal and early-life programming, fetal neurobehavioral states and fetal behavioral responses to various stimuli and others are discussed. Molecular biology reveals increasing sets of genes families as well as transcription and neurotropic factors together with critical epigenetic mechanisms to be deeply employed in the crucial neurodevelopmental events. Another field of critical importance is psychoimmuno-neuroendocrinology. Various effects of glucocorticoids as well as other hormones, prenatal stress and fetal HPA axis modulation are thought to be of special importance for brain development. The early postnatal period is characterized by the next intense shaping of complex competences, induced mainly by the very unique mother - newborn´s interactions and bonding. All these mechanisms serve to shape individual human mind with complex abilities and neurobehavioral strategies. Continuous research elucidating these special competences of human fetus and newborn/child supports integrative neuroscientific approach to involve various scientific disciplines for the next progress in human brain and mind research, and opens new scientific challenges and philosophic attitudes. New findings and approaches in this field could establish new methods in science, in primary prevention and treatment strategies, and markedly contribute to the development of modern integrative and personalized medicine.

Depression, prolactin and dissociated mind.

OBJECTIVES: Usual neuroendocrinological manifestation of traumatic stress and dissociation is dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. The aim of the present study is to perform examination of HPA axis as indexed by basal serum prolactin and test its relationship to dissociative symptoms and symptoms of traumatic stress. PATIENTS AND METHODS: 25 inpatients treated at the university hospital with diagnosis of unipolar depression mean age 41.23 (SD=11.53) were assessed using psychometric measures of dissociation (DES) and traumatic symptoms (TSC-40), and using standard biochemical analytical methods basal serum prolactin levels were investigated. RESULTS: Data show that prolactin manifests significant relationship to dissociative symptoms (r=0.52, p=0.004). Significant correlation was not found between prolactin and traumatic symptoms measured by TSC-40 (r=0.31, p=0.07). CONCLUSIONS: The present data suggest that serum prolactin levels in unipolar depressive patients are related to dissociative symptoms that is likely caused by passive coping mechanisms leading to dissociation.

Positive effect of flavonoids to cardiovascular and central nervous system.

Moderate intake of wine may be protective against various neurologic, cardiovascular and gastroenteric diseases. Low concentration of alcohol (wine diluted with water 1:2 to 1:10) exhibits strong antimicrobial activity against majority of gastrointestinal pathogens as well as against Chlamydia pneumoniae. In contrast, higher doses of even diluted alcohol (more than 5-7 glasses a day) may cause severe neuropsychic disorders with major social consequences. Wine contains variety of molecules with cardioprotective effect and antiinfectious properties.

Neuroinfections in developed versus developing countries.

In recent supplement of neuroendocrinology letters, first time the authors from West and East, North and South of EU and the "Third World" present data on neuroinfections in high technology society - on nosocomial meningitis and vice versa in low technology and income countries of sub-Saharan Africa. 14 years survey of 171 cases of nosocomial paediatric meningitis is presented by Rudinsky et al. [1] and subpopulations of Acinetobacter baumannii and Pseudomonas aeruginosa [1,2] within last 20 years are briefly analyzed by Huttova et al. [2] and Ondrusova et al. [3]. All cases were complicating high technology procedures, such as neurosurgery, very low birth weight neonates after shunt implants etc. Current problems of management of nosocomial meningitis are reviewed by Bauer et al. [4] and consequence of inappropriate therapy by Huttova et al. [5]. Another high technology associated infection is septic embolisation followed by brain abscess and meningitis in patients with endocarditis after cardiac surgery (Kovac et al.) [6]. Experience from more than 600 cases is discussed in the article by Karvaj et al. [7] who outlines extremely high mortality in patients with endocarditis embolizing to central nervous system - up to 60%. The rest of papers are in contrary to problems of neuroinfections in EU and US focused on meningitis and cerebral malaria as commonest neuroinfections in the third world: 261 cases of cerebral malaria are discussed in a brief research note by Sudanese team of tropical programme in area of famine and civil war in southern Sudan (Bartkovjak and Ianetti et al.) [8]. Fungal neuroinfections complicating AIDS are of decreasing trend as reported by Njambi et al. from Kenya [9] and data from 497 cases from Uganda, Ethiopia and Burundi are presented by Benca et al. [10]. Finally an outbreak of meningococcal meningitis is reported by Benca et al. [11] from meningitis belt in Darfur and southern Sudan. We hope that the supplement may show difference in etiology, risk factors, therapy and outcome of neuroinfections (which is a burning public health and social problem in tropics) in other third world countries versus developed high-tech medical settings of US, EU and other high income countries, as presented by Benca et al. [12].

Mental factors influencing recurrence of stress incontinence.

At a recent follow-up of 51 women operated on for stress incontinence, there was an astonishingly high discrepancy between symptoms claimed by the patients and signs found by the physician. To examine the influence of certain mental factors on the recurrence of stress incontinence, the patients in the above-mentioned follow-up were tested with the Eysenck Personality Inventory test and the Sabbatsberg Depression Self-rating Scale test. The women with symptoms but no objective signs of stress incontinence showed a higher degree of both neuroticism and depression than the women of perfect health. Thus, in this group, it may be a question of aggravation of symptoms, which cannot be helped by a reoperation. Instead, these women might need psychiatric attention to relieve their psychosomatic symptoms.

Some methodological aspects in the psychosomatic gynaecology.

Psychosomatic medicine--and thus psychosomatic gynaecology--is presented as an approach to be used by doctors when meeting the patient. At the same time it is a method, a technique, trying to elucidate the mechanisms in the most complicated interplay between the psychological, somatic and social "parts of the whole". Some diagnostic methods which can be used in this connection are discussed. The basic aim of the paper is to show the necessity and the possibility for the gynaecologist to use new technique from the psychodiagnostic field in his daily practice in order to achieve a better understanding of his patient's complaints and needs.

Psychodiagnostic follow-up of Neovletta -- a new low dose oral contraceptive.

In 45 somatically healthy women the possible occurrence of psychic effects of a new low dose combined oral contraceptive was studied using different psychodiagnostic test methods. All the participants were previous users of some of the standard combined oral contraceptives, but had discontinued either due to experienced, side-effects, due to fear of such effects or due to other reasons. Four patients dropped out before the end of the six-month-observation period. Women who discontinued previous use of oral contraceptives due to side-effects or due to fear of side-effects exhibited a more pronounced degree of neuroticism compared to those who terminated due to other reasons. Those who experienced side-effects during earlier medication had initially a higher depression score than the two remaining groups suggesting that women's basic psychic nature seems to play an important role in the development of psychic symptoms during oral contraceptive therapy. None of the three groups developed additional signs of depression during treatment. Moreover, no impairment of the sexual function, assessed by a number of parameters, was found. The findings clearly indicate that Neovletta did not cause any psychic disturbance in the patients studied.