P300 as an auxiliary method in clinical practice: A review of literature

Cognitive functions can be assessed and followed up over a period of time with cognitive evoked potentials (CEP) P300. In this context, brainstem auditory evoked potentials (BAEP) are most commonly used, but visual evoked potentials (VEP) are utilized as well. The research in this area has demonstrated that these techniques could be used as a supplemental method in diagnostics of numerous diseases such as Alzheimer's disease, mild cognitive impairment, vascular dementia, epilepsy, craniocerebral trauma, Parkinson's disease, multiple sclerosis, and other degenerative diseases. In addition, P300 can also be used as an auxiliary method in the diagnostics of mental disorders conditions such as schizophrenia, panic disorders, narcotic drug addiction, nicotinism, alcoholism, etc. The method assists in monitoring the course of diseases leading to encephalopathy, such as liver and kidney damage and grave anaemia. The advantages of P300 testing are easy application, non-invasiveness, and an unlimited number of potential applications. Moreover, the results obtained with this method are measurable and can be compared

QUALITY OF LIFE AND MENTAL HEALTH IN MULTIPLE SCLERORSIS PATIENTS IN BOSNIA AND HERZEGOVINA MEASURED BY GENERC AND DISEASE-SPECIFIC QUESTIONAIRE

Background: Multiple sclerosis (MS) as chronic neurodegenerative disease significantly impact patients’ quality of life (QoL). QoL instruments can be generic (EQ-5D, SF-36) and disease-specific like MSQoL-54. Use of disease-specific instruments is preferred since it captures broader symptoms related to MS than generic instruments. Mental health is impacted by MS and different psychiatric conditions significantly impact QoL. We have conducted prospective non-interventional study among MS patients. Aim was to measure and compare MS patients QoL by generic and disease-specific instrument at baseline and after one year and to identify potential correlation between these two types of measurements and to assess mental health scores among MS patients in Bosnia and Herzegovina (B&H) and other countries. Subjects and methods: Study included 62 patients diagnosed with MS and treated at Neurology clinic in Sarajevo from April 2016 to May 2017. Study was approved by Ethical Committee. QoL has been measured by EQ-5D and MSQoL-54. Measurement has been performed at baseline and after 12 months. Results: Average utility score measured by EQ-5D at the baseline and end of the study were 0.688 and 0.639 respectively with no significant difference (p=0.850). EQ-5D utility and MSQoL-54 score showed high correlation at baseline; rho=0.873 p=0.0001 for physical health and rho=0.711 p=0.0001 for mental health. At the end of the study no significant correlations have been found (p>0.05). High negative correlation found between EDSS and scores measured by EQ-5D and MSQoL-54; at baseline (rho=-0.744 p=0.0001) and at the end of the study (rho=-0.832 p=0.0001). Similar MS impact and loss of QoL found in B&H and other countries. Conclusions: Both instruments can be used in measuring QoL but disease-specific are preferred since they capture broader symptoms impacting MS patient QoL. Using QoL instruments could drive clinician decision and patient-centric care as well as reimbursement and policy decision by recording treatment outcomes

Korelacija između ranih i kasnih epileptičnih napadaja tijekom i nakon moždanog udara i srčanih bolesti

Stroke is the leading cause of mortality and the main cause of disability in adults in Europe. According to the American Heart Association, "the profile of apoplectic personality is determined by systolic blood pressure greater than 160 mm Hg, diastolic blood pressure higher than 95 mm Hg, family history of cardiovascular diseases, hypercholesterolemia, smoking, alcohol abuse and diabetes mellitus". The aim of this retrospective study was to assess the correlation between early and late epileptic seizures during and after stroke, and some heart diseases associated with hypertension. Ten-year records (January 1, 1989 till December 31, 1998) of the University Department of Neurology, Sarajevo University Clinical Center, were examined. There were 7001 stroke patients (53.6% with cerebral thrombosis, 17.35% with embolic etiology, 21.96% with intracerebral hemorrhage, and 1.17% with subarachnoid hemorrhage), with a 3.38% incidence of symptomatic epileptic seizures. The following cardiac diseases were considered relevant for the study purpose: absolute arrhythmia, subdecompensated heart state, well treated cardiac decompensation, angina pectoris, postmyocardial infarction state, and extrasystoles. Results revealed a statistically significant difference in the correlation with cardiac diseases between patients with early and late epileptic seizures. The patients with early epileptic fits had severe heart problems compared to those with late seizures. The former suffered from angina pectoris, heart decompensation and chronic subdecompensated state, yielding a ratio of 1.1 to 0.6. There was no statistically significant difference between the groups according to absolute arrhythmia. Study results suggested the patients with cerebrovascular disease and early epileptic fits to have a significantly higher rate of heart problems compared to stroke patients with late epileptic fits, in whom the morphological changes of the brain appeared neurophysiologically to act as an epileptogenic focus.Moždani udar je vodeći uzrok smrtnosti i glavni uzrok invalidnosti u odraslih osoba u Europi. Prema Američkom udruženju za srce, "profil apoplektične osobe određen je sistoličkim krvnim tlakom višim od 160 mm Hg, dijastoličkim krvnim tlakom višim od 95 mm Hg, obiteljskom poviješću kardiovaskularnih bolesti, hiperkolesterolemijom, pušenjem, zlouporabom alkohola i šećernom bolešću. Cilj ove retrospektivne studije bio je procijeniti korelaciju između ranih i kasnih epileptičnih konvulzija tijekom i nakon moždanog udara uz neke srčane bolesti povezane s hipertenzijom. Studija je obuhvatila bolesnike liječene na Klinici za neurologiju, Klinički bolnički centar u Sarajevu, kroz razdoblje od deset godina (od 1. siječnja 1989. do 31. prosinca 1998.). Ukupno je bio 7001 bolesnik s moždanim udarom (53,6% s moždanom trombozom, 17,35% s moždanim udarom embolijske etiologije, 21,96% s moždanim krvarenjem i 1,17% sa subarahnoidnim krvarenjem). Incidencija simptomatičnih epileptičnih konvulzija bila je 3,38%. U radu su obrađene slijedeće srčane bolesti: apsolutna aritmija, subdekompenzirano srčano stanje, liječena srčana dekompenzacija, angina pektoris, stanje nakon infarkta miokarda i ekstrasistole. Rezultati su pokazali statistički značajnu razliku između bolesnika s ranim i onih s kasnim epileptičnim napadajima u odnosu na sretane bolesti. Tako su bolesnici s ranim epileptičnim napadajima imali ozbiljnije srčane probleme u usporedbi s onima s kasnim napadajima. U prvoj je skupini zabilježena angina pektoris, srčana dekompenzacija i kronično stanje subdekompenzacije, uza statistički omjer od 1,1 prema 0,6. Nije bilo statistički značajne razlike između dviju skupina glede apsolutne aritmije. Zaključano je da su bolesnici s cerebrovaskularnom bolešću i ranim epileptičnim konvulzijama imali značajno više srčanih problema negoli oni s moždanim udarom i kasnim epileptičnim napadajima, u kojih su morfološke promjene na mozgu u neurofiziološkom smislu predstavljale epileptogeno žarište

Neurosurgical Options for Glioma

Glioma surgery has been the main component of glioma treatment for decades. The surgical approach changed over time, making it more complex and more challenging. With molecular knowledge and diagnostic improvement, this challenge became maximally safe resection of tumor, which resulted in prolonged overall survival, progression-free period, and a better quality of life. Today, the standard glioma treatment includes maximally safe resection, if feasible, administration of temozolomide, radiotherapy, and chemotherapy. Surgical resection is performed as subtotal resection, gross total resection, and supratotal resection. Subtotal resection is the resection where a part of tumor is left. Gross total resection is a complete removal of the magnetic resonance imaging (MRI) visible tumor tissue. Supratotal resection is performed as gross total resection with excising the MRI visible tumor tissue borders into the unaffected brain tissue. Before we make final decision on which type of resection should be performed, many factors have to be considered. The main question has to be answered: what the actual impact of resection on the progression of glioma is and what the functional risk of resection is

TINGKAT KECUKUPAN CAIRAN PADA PASIEN GANGGUAN JIWA DI RUMAH SAKIT dr. H. MARZOEKI MAHDI BOGOR

The purpose of this study was to measure the fluids adequacy of mental disorder patients. This study was a cross-sectional study at dr. H. Marzoeki Mahdi hospital in Bogor. The number of subjects were 13 mental disorder patients at a condition of calm and willing to collaborate in data collection body weight, height and consumption for three days. Overall fluids requirement of the total subject was 2 376.39±199.80 mL/day. Mean fluid intake from food, drink and metabolic at the patients were 2 530.78±856.02 mL/day. The fluids adequacy of males were 102.83±8:24%, while the females were 116.90±17.80%. Fluids adequacy in patients were 76.92% categorized as enough and 23.08% categorized as excessive. 

Incidencija epileptičnih napadaja tijekom i nakon moždanog udara u desetgodišnjem razdoblju na Neurološkoj klinici Kliničkoga centra Univerziteta u Sarajevu

Association between epilepsy and stroke has been known since 1864. The pathophysiological basis of epileptic seizures during and after stroke is molecular changes that occur in ischemia as primary events and in hemorrhage as secondary events. The aim of the study was to determine the incidence of epileptic seizures during and after stroke, recorded over a 10-year period at the Department of Neurology, Sarajevo University Clinical Center. The study covered the period from January 1, 1989 till December 31, 1998. During the period, 7001 patients were treated at the Department. Cerebral thrombosis predominated (53.6%), whereas there were only 17.25% of patients with cerebral embolism, 21.96% with intracerebral hemorrhage, and 7.17% with subarachnoid hemorrhage. The incidence of symptomatic epileptic seizures for total patient sample according to years ranged from 0.75% to 6.67%. According to type of insult, the incidence of symptomatic epileptic seizures was 1.0%-3.37% for cerebral thrombosis, 1.22%-6.67% for cerebral embolism, 0.65%4.05% for intracerebral hemorrhage, and 1.34%-4.34% for subarachnoid hemorrhage. Associated epileptic seizures, i.e. the seizures accompanying the onset of stroke, were not included in the study. Results of the study showed that there were 75 patients with symptomtic epileptic seizures (47 with late seizures and 28 with early seizures, or 1.998% of total patient sample) during the 10-year period of observation. There were 36 cases of cerebral embolism (23 and 13 in the group of late and early seizures, respectively; 2.980%), 30 cases of intracerebral hemorrhage (23 and seven with late and early seizures, respectively; 1.951%), and seven cases of subarachnoid hemorrhage (four with late and three with early seizures; 1.394%). According to stroke types and subtypes, hemorrhagic stroke was found to be a more common etiologic factor for the occurrence of early and late symptomatic epileptic seizures, whereas cerebral embolism in ischemic stroke was a more common cause of symptomatic epileptic seizures than cerebral thrombosis. During the study period, the years 1993, 1994 and 1995 were characterized by a small number of patients with symptomatic early and late epileptic seizures (9 in total). The incidence of early and late epileptic seizures in the sample of stroke patients during the study period ranged from 1.394% to 2.980%.Veza između epilepsije i moždanog udara poznata je još od 1864. godine. Patofiziološka osnova epileptičnih napadaja tijekom i nakon moždanog udara su molekularne promjene koje u ishemiji nastaju primarno, a u hemoragiji sekundarno. Cilj ovoga rada bio je utvrditi incidenciju epileptičnih napadaja tijekom i nakon moždanog udara u desetgodišnjem razdoblju na Neurološkoj klinici Kliničkoga centra Univerziteta u Sarajevu. Obuhvaćeno je razdoblje od 1. siječnja 1989. do 31. prosinca 1998. godine, tijekom kojega je na Klinici liječen 7001 bolesnik. Najviše je bilo cerebralnih tromboza (53,65), potom cerebralnih embolija(17,25%), intracerebralnih hemoragija (21,96%) i subarahnoidnih hemoragija (7,17%). Incidencija simptomatskih epileptičnih napadaja u pojedinim godinama kretala se za ukupan uzorak od 0,75% do 6,67%. Prema tipovima inzulta incidencija je bila kako slijedi: za cerebralnu trombozu 1,0%-3,375%; za cerebralnu emboliju 1,22%-6,67%; za intracerebralnu hemoragiju 0,65%-4,05%; i za subarahnoidnu hemoragiju 1,34%-4,34%. U studiju nisu bili uključeni asocirani epileptični napadaji (napadaji kojima je započinjao moždani udar). Na temelju ispitivanja zaključeno je da je u desetgodišnjem razdoblju na Klinici bilo 75 bolesnika sa simptomatskim epileptičnim napadajima (47 bolesnika s kasnim napadajima i 28 bolesnika s ranim napadajima ili 1,998% od ukupnog uzorka naših bolesnika tijekom promatranog razdoblja). Bio je 36 bolesnika s cerebralnom embolijom (23 u skupini s kasnim napadajima i 13 u skupini s ranim napadajima; 2,980%), 30 bolesnika s intracerebralnom hemoragijom (23 u skupini s kasnim napadajima i 7 u skupini s ranim napadajima; 1,951%) i sedmoro bolesnika sa subarahnoidnim krvarenjem (4 u skupini s kasnim napadajima i 3 u skupini s ranim napadajima; 1,394%). Prema tipovima i podtipovima moždanog udara utvrđeno je daje hemoragijski moždani udar u našem kliničkom materijalu bio češći etiološki čimbenik za nastanak simptomatskih ranih i kasnih epileptičnih napadaja, dok se cerebralna embolija u ishemijskim inzultima i na našem materijalu pokazala kao češći razlog pojave simptomatskih epileptičnih napadaja u odnosu na cerebralnu trombozu. Tijekom promatranoga razdoblja mali je broj bolesnika sa simptomatskim ranim i kasnim epileptičnim napadajima (ukupno 9) zabilježen u godinama 1993., 1994. i 1995. Na temelju rezultata ovoga ispitivanja zaključeno je da se je incidencija epileptičnih napadaja u ukupnom uzorku bolesnika s moždanim udarom u desetgodišnjem razdoblju kretala od 1,394% do 2,980%

Simulación-validación del efecto bioeconómico de estrategias de mejora de la base forrajera en función de la producción estacional de leche en vaquerías

Possible variations of bioeconomic indicators for milk production were simulated and validated taking into account seasonal calvings and also strategies to improve forage availability. To this end, ten dairy farms from Jimaguayú municipality, Camagüey province, Cuba, showing higher calving percentages from April through August were assessed, since April 2001 up to march 2006. A number of strategies to improve cattle feeding were simulated according to variables mean values for the ten dairy farms. Variables measured were simple rehabilitation, conventional rehabilitation, natural protein source (30 %), biomass source (CT-115), and Lecaena leucocephala (CT115 + 30 %). The effect of highest calving percentages was validated by grouping the ten dairy farms into three patterns: P-I (48 %-57% calvings on farms 1, 2 and 5), P-II (58 %-68 % calvings on farms 4, 6, 7 and 9), and P-III (69 %-79 % calvings on farms 3, 8 and 10). Botanical composition, dry matter yield per hectare, and forage balance were estimated. Efficiency analyses included physical and financial indicators. Simulation increased forage availability and utilization, feedstuff consumption efficiency, and bioeconomic efficiency for every variable. Concerning validation, dairy farm 8 showed that the highest calving percentage registered at grass maximal growth period improved milk production (216 766 kg) and productive efficiency (2 274 kg milk/ha), and reduced costs ($0,53/kg milk).Con el objetivo de simular-validar posibles variaciones de los indicadores bioeconómicos en la producción de leche, en función de partos estacionales y según estrategias de mejora de la base forrajera, se estudiaron las diez vaquerías de Jimagüayú, Camagüey, Cuba, con mayores porcientos de partos en abril-agosto. El estudio se realizó de abril de 2001 a marzo de 2006. Se simularon estrategias tecnológicas para mejorar la alimentación, tomando como base valores promedio de las variables de las 10 vaquerías. Las variantes utilizadas fueron: rehabilitación simple (RS) y convencional (RC), banco de proteína 30$ 0,53 /kg leche). Palabras clave: simulación, pariciones, producción de leche, base alimentari

The SARS-CoV-2 Delta (B.1.617.2) variant with spike N501Y mutation in the shadow of Omicron emergence

Circulation of the Omicron variant with the reemergence of the N501Y mutation along with many others in the spike protein has once again stirred the academic community. Interestingly, tracing the genetic diversity of SARSCoV- 2 shed light on a less frequent N501Y þ Delta variant which has been in the global circulation for some time before the Omicron appearance. This paper aims to present the molecular characteristics of the SARS-CoV-2 Spike_N501Y þ Delta variant detected in Bosnia and Herzegovina. The study was conducted during November and December 2021. All patients were tested using real-time RT-PCR for detection of SARS-CoV-2. A representative number of SARS-CoV-2 positive samples was pre-screened using VirSNiP SARS-CoV-2 Spike N501Y kit. The characterization of the viruses was carried out with Illumina RNA Prep with enrichment and the Respiratory Virus Oligo Panel kit. Among the analyzed sequences, we found two isolates of the Delta variant that differ from their most related clade- GK AY.4.3 in additional mutations N501Y and L54F. In this study, we described the presence of a rare form of Delta variant with Spike_N501Y mutation in the shadow of the Omicron emergence. Despite the set of mutations in the Spike protein, this form of Delta variant does not indicate the large-scale consequences for the general population. Further functional studies of this form could provide more information about its antigenicity and infectivity