15 research outputs found
Should MS be Treated by Escalation or Induction Therapy?
MS is a chronic, increasingly disabling disease whose long-term outcomes determine the key social, medical and economic impact of this disease. Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are prescribed to delay disease progression and to protect a patientās functional capability. The concepts of escalation and induction immunotherapy in MS represent different therapeutic strategies for the treatment of MS. Both strategies may be valuable options for patients starting on DMT, however, induction therapy mainly focuses on patients with very aggressive course of MS from the onset. Using a patient unique approach to selection of treatment, MS can be effectively control disease and may delay or even prevent the development of secondary progressive MS
Electrophysiological Correlates Activated During the Wisconsin Card Sorting Test (WCST)
In the present study we investigated changes in Event-Related Potentials (ERPs) during the Wisconsin Card Sorting
Test (WCST) in order to identify cognitive processes underlying the set-shifting aspects of the task and to determine test
sensitivity for frontal and prefrontal cortical areas. ERPās were recorded from a sample of 20 healthy adults while they
performed a computerized version of the Grant & Berg (1948) version of the WCST, using 32-channel electroencephalogram
recordings. The ERP waveforms were calculated for the set-shifting trials, or more precisely for the 2nd and the 3rd
trials in the WCST series (set change condition) and compared to those associated with the last two trials in a series before
the set change (set unchanged condition). The results indicated changes in central frontal and parietal electrodes
during attentional set-shifting. More precisely, the P300 effect was replicated in this dataset, confirming the claim that
theWCST measures function of prefrontal cortical areas of the brain. However, the obtained wave resembled P3b indicating
the working memory component of the task. The results suggest that the frontal and parietal cortical activity is especially
involved in set-shifting during WCST performance. Therefore, these electrophysiological results are not consistent
with some recent studies that question the specificity of WCST as a measure of frontal and parietal lesions
Prevalence of the Metabolic Syndrome in the Old Institutionalized People in Zagreb, Croatia
Metabolic syndrome (MeS) is defined by a cluster of abnormalities comprising obesity, hypertension, carbohydrate intolerance and dyslipidemia. MeS increases the risk of developing various diseases, including coronary heart disease, stroke, peripheral angiopathy and type 2 diabetes1,2. In our study, the subjects were 561 persons, residents of 11 homes for the elderly in Zagreb, Croatia. There were 160 men (28,5%) and 401 women (71.5%), aged from 56 to 96 years (the average being 79 years). Physical examination was conducted, which included blood pressure measurement, and body height and weight. Blood samples were taken for biochemical analysis. Along with other biochemical parameters, the levels of glucose, triglycerides and cholesterol (LDL, HDL-C) were also measured. The results have shown the prevalence of MeS in the elderly instutionalised people to be in the range of 20.8%, according to WHO criteria. The most common MeS component was hypertension, and it was significantly more frequent in women than in men; also, the elevated triglyceride levels were more often found in women; the difference between men and women was also statistically significant. MeS is a serious and growing health problem not only in Croatia but worldwide as well. Further studies are needed to verify the prevalence of MeS in Croatia, as it is a major risk for CVD and many other severe diseases
Hearing in Children with Otitis Media with Effusion ā Clinical Retrospective Study
Hearing loss accompanied with middle ear effusion was analyzed according to audiometric frequencies for different age group. Results for left and right ears were compared in/ and between study and control group. Pure tone audiometry for bone and air conduction and tympanometry was performed in study group of ninety-eight children with conductive hearing loss and otitis media with effusion Control group included fifty-seven children with hearing loss, enlarged adenoids,
dysfunction of Eustachian tube and no present middle ear effusion served. Means of hearing loss thresholds for 250 Hz ā 4 kHz were established and compared between groups of right vs. left ears of tested vs. control ears according to age subgroups: 1ā3 yr, 4ā6 yr, 7ā9 yr, 10ā12 yr, 13ā15 yr. At age 1ā3 yr otitis media with effusion children showed no ear side difference in hearing loss. Age groups of 4ā6 and 7ā9 yr otitis media with effusion children showed left ears with
higher threshold of hearing loss across all of the tested frequencies than right ears in study and control ears. Right ears showed smaller hearing loss in study and control group and no age group predicted for hearing impairment. Higher hearing loss threshold for 4 kHz in adolescence in otitis media with effusion ears is early sign of sequels after repetitive episodes of middle ear effusion. Control groups showed no ear side or age group dependent difference of hearing loss threshold. Age group of 4ā6 and 7ā9 y have faster craniofacial structural change in soft tissue than bone base so ear side differences suggest being developmentally determined
Hearing in children with otitis media with effusion--clinical retrospective study [OÅ”teÄenje sluha kod djece sa sekretornim otitisom]
Hearing loss accompanied with middle ear effusion was analyzed according to audiometric frequencies for different age group. Results for left and right ears were compared in/and between study and control group. Pure tone audiometry for bone and air conduction and tympanometry was performed in study group of ninety-eight children with conductive hearing loss and otitis media with effusion. Control group included fifty-seven children with hearing loss, enlarged adenoids, dysfunction of Eustachian tube and no present middle ear effusion served. Means of hearing loss thresholds for 250 Hz-4 kHz were established and compared between groups of right vs. left ears of tested vs. control ears according to age subgroups: 1-3 yr, 4-6 yr, 7-9 yr, 10-12 yr, 13-15 yr. At age 1-3 yr otitis media with effusion children showed no ear side difference in hearing loss. Age groups of 4-6 and 7-9 yr otitis media with effusion children showed left ears with higher threshold of hearing loss across all of the tested frequencies than right ears in study and control ears. Right ears showed smaller hearing loss in study and control group and no age group predicted for hearing impairment. Higher hearing loss threshold for 4 kHz in adolescence in otitis media with effusion ears is early sign of sequels after repetitive episodes of middle ear effusion. Control groups showed no ear side or age group dependent difference of hearing loss threshold. Age group of 4-6 and 7-9 y have faster craniofacial structural change in soft tissue than bone base so ear side differences suggest being developmentally determined
Predictors of short-term neurocognitive outcome following coronary revascularisation (CABG) depending on the use of cardiopulmonary bypass [Prediktori kratkoroÄnog neurokognitivnog ishoda nakon koronarne revaskularizacije (CABG) ovisno o upotrebi izvantjelesnog krvotoka]
The purpose of our study was to investigate the association between perioperative cerebral microembolization, expressed as high-intensity transient signals (HITS) and postoperative dynamics of the neuromarker S100P in patients operated using cardiopulmonary bypass, and to assess their impact upon the neurocognitive function in the early postoperative stage. The study involved 62 consecutive male patients aged 60 or above, alls scheduled for elective aortocoronary bypass. The patients were recruited from two groups with respect to the use of CPB: on-pump group (CPB+, N = 30) and off-pump group (CPB-, N = 32). In all patients we performed intraoperative monitoring of cerebral haemodynamics using transcranial Doppler, with the goal of quantifying perioperative cerebral microembolization. The serum levels of the neuromarker S100l were measured immediately after surgery, and then 12, 24 and 48 hours after the surgery. Neurocognitive status was assessed before and after the surgery and in three cognitive domains. Results of the study have shown that with respect to the short-term postoperative neurocognitive outcome there is no significant difference between the on-pump and off-pump surgical technique of coronary revascularization'. Perioperative cerebral microembolization was significantly more pronounced in the on-pump group yet it did not affect early postoperative neurocognitive function, while the increase in the neuromarker S100beta serum level 48 hours after surgery may have prognostic value as a predictor of postoperative neurocognitive dysfunction
Prediktori kratkoroÄnog neurokognitivnog ishoda nakon koronarne revaskularizacije (CABG) ovisno o upotrebi izvantjelesnog krvotoka
The purpose of our study was to investigate the association between perioperative cerebral microembolization, expressed as high-intensity transient signals (HITS) and postoperative dynamics of the neuromarker S100P in patients operated using cardiopulmonary bypass, and to assess their impact upon the neurocognitive function in the early postoperative stage. The study involved 62 consecutive male patients aged 60 or above, alls scheduled for elective aortocoronary bypass. The patients were recruited from two groups with respect to the use of CPB: on-pump group (CPB+, N = 30) and off-pump group (CPB-, N = 32). In all patients we performed intraoperative monitoring of cerebral haemodynamics using transcranial Doppler, with the goal of quantifying perioperative cerebral microembolization. The serum levels of the neuromarker S100l were measured immediately after surgery, and then 12, 24 and 48 hours after the surgery. Neurocognitive status was assessed before and after the surgery and in three cognitive domains. Results of the study have shown that with respect to the short-term postoperative neurocognitive outcome there is no significant difference between the on-pump and off-pump surgical technique of coronary revascularization'. Perioperative cerebral microembolization was significantly more pronounced in the on-pump group yet it did not affect early postoperative neurocognitive function, while the increase in the neuromarker S100beta serum level 48 hours after surgery may have prognostic value as a predictor of postoperative neurocognitive dysfunction.Istraživanje je provedeno sa svrhom ispitivanja povezanosti perioperacijske cerebralne mikroembolizacije (HITS) i
poslijeoperacijske dinamike neurobiljega S100b s primjenom izvantjelesnog krvotoka (CPB), te utvrÄivanjem njihovog
uÄinka na neurokognitivnu funkciju u ranom poslijeoperacijskom razdoblju. U ispitivanje su ukljuÄena 62 konsekutivna
muÅ”ka bolesnika starija od 60 godina predviÄena za elektivnu operaciju aortokoronarnog premoÅ”tenja. Bolesnici su
regrutirani iz dvije skupine s obzirom na uporabu CPB: on-pump skupina (CPB+, N=30) i off-pump skupina (CPBā,
N=32). Kod svih ispitanika provedeno je intraoperacijsko monitoriranje cerebralne hemodinamike transkranijskim
doplerom u cilju kvantificiranja perioperacijske cerebralne mikroembolizacije. Serumske razine neurobiljega S100b
mjerene su prije operacije, neposredno nakon operacije te 12, 24 i 48 sati od operacije. Neurokognitivni status se ocjenjivao
prije i poslijeoperacijski u tri kognitivne domene. Rezultati istraživanja pokazuju da nema znaÄajne razlike izmeÄu on-pump i off-pump kirurÅ”ke tehnike koronarne revaskularizacije s aspekta kratkoroÄnog poslijeoperacijskog
neurokognitivnog ishoda. Perioperacijska cerebralna mikroembolizacija znaÄajno je izraženija uz primjenu izvantjelesnog
krovotoka ali ne utjeÄe na ranu poslijeoperacijsku neurokognitivnu funkciju, dok porast serumske razine
neurobiljega S100b 48 sati nakon operacije može imati prognostiÄku vrijednost kao moguÄi prediktor poslijeoperacijske
neurokognitivne disfunkcije