Fatigue and depression in multiple sclerosis: Correlation with quality of life

The aim of this work was to examine the relationship between fatigue and depression, common features of multiple sclerosis (MS), and the quality of life (QOL). The study was comprised of 120 patients with clinical manifestations of definite MS. Relapsing-remitting MS was present in 76.7% patients and secondary progressive MS was present in 23.3% patients. Mean disease duration was 8.1 ± 5.6 years and the mean Expanded Disability Status Score (EDSS) was 3.5 ± 1.8 (range 1-8). Fatigue was measured with the Fatigue Severity Scale (FSS), depression was measured by the Beck Depression Inventory (BDI) and QOL was assessed using the health-related quality of life questionnaire SF-36. We observed that the global FSS score was 4.6 ± 1.8 (range 1-7) and BDI was 10.7 ± 10.3 (range 0-39). The FSS significantly and positively correlated with the BDI scores (r = 0.572; p = 0.000). The severity of fatigue had a significant impact on the quality of life (r = -0.743; p = 0.000), in particular on mental health (r = -0.749; p = 0.000). We observed a significant correlation between the severity of depression and impaired quality of life (r = -0.684; p = 0.000). This study shows that fatigue and depression are associated with impaired QOL in MS

Fatigue and depression in multiple sclerosis: Correlation with quality of life

The aim of this work was to examine the relationship between fatigue and depression, common features of multiple sclerosis (MS), and the quality of life (QOL). The study was comprised of 120 patients with clinical manifestations of definite MS. Relapsing-remitting MS was present in 76.7% patients and secondary progressive MS was present in 23.3% patients. Mean disease duration was 8.1 ± 5.6 years and the mean Expanded Disability Status Score (EDSS) was 3.5 ± 1.8 (range 1-8). Fatigue was measured with the Fatigue Severity Scale (FSS), depression was measured by the Beck Depression Inventory (BDI) and QOL was assessed using the health-related quality of life questionnaire SF-36. We observed that the global FSS score was 4.6 ± 1.8 (range 1-7) and BDI was 10.7 ± 10.3 (range 0-39). The FSS significantly and positively correlated with the BDI scores (r = 0.572; p = 0.000). The severity of fatigue had a significant impact on the quality of life (r = -0.743; p = 0.000), in particular on mental health (r = -0.749; p = 0.000). We observed a significant correlation between the severity of depression and impaired quality of life (r = -0.684; p = 0.000). This study shows that fatigue and depression are associated with impaired QOL in MS

Lobular breast cancer in a male patient with a previous history of irradiation due to Hodgkin's disease

Background: Male breast cancer is rare and represents less than 1% of all breast cancers. Considering the fact that the male breast most often does not consist of lobules and acini, lobular carcinoma of the male breast is exceptionally rare. Case Report: In this paper we present a unique case of alveolar variant of lobular male breast cancer in a 56-year-old patient. Conclusion: According to our knowledge this is the first presentation of an alveolar variant of lobular male breast cancer that appeared 14 years after chemo- and radiotherapy for the treatment of Hodgkin's disease. Copyright © 2012 S. Karger AG, Basel

Predictive significance of myeloperoxidase for the occurrence of postoperative vascular complications

© 2016, Serbian Medical Society. All rights reserved. New findings on the activity of myeloperoxidase in the course of an inflammatory process associated with infections and vascular lesions indicate its role in the state of oxidative stress and endothelial dysfunction as well as its predictive value for cardiovascular insults. The products of actions by myeloperoxidase represent an integrative mechanism connecting the tissue lesions, infectious, inflammatory processes, oxidative stress, endothelial dysfunction and the development of vascular insult (the most common are the arterial and venous thrombosis and consecutive embolism). The most common complications of an operative surgical treatment are vascular. Seen from a conservative standpoint the most common are arterial and venous thrombosis, but more broadly suture dehiscence could be considered as a consequence of the impaired microcirculation. Operational procedures as well as the underlying pathology lead to the activation of inflammatory cascade with the activation of myeloid lineage cells whereby a release and activation of myeloperoxidase, which in addition to antimicrobial exerts multiple vascular operations. Increased concentrations of myeloperoxidase in the plasma up to three months before the clinical expression of vascular insult indicates its predictive value. Current research portrays the possibility of adjusting the successful result of the action of myeloperoxidase and prevention of vascular complications

Early cytokine profile changes in interstitial and necrotic forms of acute pancreatitis

© 2015 University of Kragujevac, Faculty of Science. All right reserved. Acute pancreatitis (AP) is a common, potentially lethal, acute inflammatory process with a highly variable clinical course. The aim of this study was to analyse early changes in the serum concentrations of pro- and anti-inflamatory cytokines in the peripheral blood of patients with the interstitial form of acute pancreatitis (IAP) and necrotic acute pancreatitis (NAP), especially in those patients who had lethal outcomes. The prospective study enrolled 52 patients who were divided into IAP (65.38% of patients) and NAP (34.62% of patients) groups. The serum levels of interleukins (IL) 6, 8 and 10, together with tumour necrosis factor (TNF)-alpha were measured on the 1st and 3rd day of hospitalisation. Significantly higher values of IL-6, IL-8 and IL-10 were found on day 1 and 3 in NAP than in IAP. IL-6 was significantly higher on both days of measurement, whereas IL-10 on the first day and IL-8 on the third day were significantly higher in the group of patients who did not survive in comparison with patients who had the interstitial form of AP. In conclusion, the data from this study showed that immune suppression and excessive immune stimulation in the first three days after admission could indicate the development of NAP and a potentially lethal outcome

Adsorption of mycotoxins by organozeolites

Adsorption of zearalenone (ZEN), ochratoxin A (OCHRA) and aflatoxin B1 (AFB1) on natural zeolite, clinoptilolite, modified with different amounts of octadecyldimethylbenzyl ammonium (ODMBA) ions was investigated. Results showed that adsorption of hydrophobic ionizable ZEN on unmodified zeolite tuff was very low and that adsorption on organozeolites increased with increasing hydrophobicity of the zeolitic surface. The adsorption was independent of the form of ZEN in solution and the solution pH, indicating that hydrophobic interactions with ODMBA are responsible for ZEN adsorption. Adsorption of low polar ionizable OCHRA on organozeolites also increased with increasing hydrophobicity of the zeolitic surface, however, OCHRA showed moderate adsorption on unmodified zeolitic tuff at pH 3. OCHRA adsorption on unmodified zeolite as well as on lower surface coverage of organozeolite was dependent on the form of OCHRA in solution; there was a decrease of adsorption at high pH, where OCHRA is in the anionic form. It indicated that at acidic pH, low surface coverage allows some combination of hydrophobic interaction with ODMBA and interactions with the surface of the zeolite. At higher surface coverage, the OCHRA adsorption was higher and practically independent of pH, indicating that the hydrophobic interactions of OCHRA with ODMBA are responsible for its adsorption. Nonionizable low polar AFB1 had a high affinity for the unmodified zeolitic tuff and the adsorption of AFB1 was greatly reduced for organozeolites, indicating that AFB1 does not have high tendency for hydrophobic interactions with ODMBA. pH dependence of AFB1 adsorption, while AFB1 has the same form at all pHs, demonstrated that the surface modification of the zeolite depends on pH and that these modifications have influence on its adsorption. The calculated dipole moments of neutral mycotoxin molecules: AFB1-9.5D, OCHRA-6.9D and ZEN-2.2D are in qualitative agreement with adsorption experimental data. (c) 2005 Elsevier B.V All rights reserved

The role of hyperhomocysteinemia in the development of postoperative vascular complications

© 2016, Serbian Medical Society. All rights reserved. Hyperhomocysteinemia is one of the unconventional risk factors of cardiovascular morbidity – it is causally associated in both directions with oxidative stress, endothelial dysfunction, mechanisms of cell signaling and apoptosis. Numerous clinical and experimental studies have explained the mechanisms and clinical expression of atherosclerotic and prothrombotic effects of homocysteine. The main pathological substrate, previous therapy, and surgical procedure-intervention itself are associated with the state of oxidative stress and endothelial dysfunction, which is one of important factors for elevated plasma homocysteine levels. Recent studies point to the possibility of a successful correction of hyperhomocysteinemia, especially secondary one

The importance of defining serum MMP-9 concentration in diabetics as an early marker of the rupture of atheromatous plaque in acute coronary syndrome

Acute coronary syndrome (ACS) is the main cause of mortality in diabetics. Acute myocardial infarction (AMI) in diabetics is much more often than in non-diabetics. MMP-9 activity could ease the formation of atherosclerosis, destabilization and plaque rupture as well as thrombocyte aggregation. The aim of this study is to examine: MMP-9 defining in serum in diabetics; the impact of diabetes mellitus on atherosclerosis and MMP-9 level; relation between serum values of MMP-9 and markers of glycoregulation and lipid status, respectively. Results: The greatest concentration of both total and active MMP-9 serum has been noted in diabetics group with ACS. Both total and active MMP-9 values, in group with diabetes and ACS showed significantly important difference regarding the values in control group. Total and active MMP-9 showed statistically important correlation between the values of glycated hemoglobine A1c (HbA1c) and inverse correlations with values of subfraction HDL3.Active MMP-9 showed statistically important inverse correlation with value of HDL cholesterol. In conclusion: According to the results, it has been thought that active MMP-9 shows a certain degree of atherosclerotic changes on blood vessels better than total MMP-9. MMP-9, active one, could present an early marker of atherosclerosis, especially on coronary blood vessels, in diabetics with type 2

Clinical and laboratory parameters associated with death in acute pancreatitis

© 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. Acute pancreatitis is an inflammatory condition having the significant mortality rate in the case of severe forms of the disease. The aim of this study was to investigate putative factors of increased mortality in patients with acute pancreatitis with contradictory prior evidence, and to reveal factors that were insufficiently explored previously. Methods. This prospective cohort study with nested case/control design included all adult patients treated for acute pancreatitis in the Clinical Center of Kragujevac, Serbia, during the 3-year period (from October 2011 to December 2014). The cases (n = 19) were patients who died, while the controls (n = 113) were patients who survived. The associations between putative risk factors and the study outcomes were tested by univariate and multivariate logistic regressions, and expressed as crude and adjusted odds ratios (OR) with corresponding 95% confidence intervals (CI). Results. Significant association with the lethal outcome in acute pancreatitis was found for advanced age (adjusted OR 1.12, 95%CI 1.02-1.23), presence of significant comorbidities (adjusted OR 10.62, 95%CI 1.01-111.39), higher interleukin-8 (IL-8) value on third day from onset of symptoms (adjusted OR 1.05, 95%CI 1.02-1.08), use of tramadol and/or mor-phine (adjusted OR 47.34, 95%CI 3.21-699.08), the Bedside index for severity in acute pancreatitis (BISAP) score ≥ 3 in the first 24 hours (adjusted OR 48.11, 95%CI 3.14-736.29), and prophylactic use of antibiotics (adjusted OR 0.07, 95%CI 0.01-0.85). Conclusion. Advanced age, significant comorbidities, use of tramadol and/or morphine and more severe disease as assessed by BISAP score can increase the risk of death in acute pancreatitis, while prophylactic use of antibiotics may have a protective role