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

Melas syndrome - Case report

Syndrome that includes mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes is briefly called MELAS. It is a rare (estimated prevalence is 16/100 000), progressive, neurodegenerative and incurable disease. It is a result of mutation of mitochondrial DNA. We report herein a case of 24-year-old woman who suffers from MELAS. First simptoms occurred in the age of 13 in the manner of headache and vomiting. Later on seizures have been registered, in the beginning as atypical apsans like, and than in the way of complex partial and generalised tonic-clonic seizures. They were often refractory with the applied antiepileptic therapy. In the course of illness speech disorder, memory loss, sight and hearing disorder occured with psychiatric changes. Motor weakness appeared as a result of repeated brain ischaemia and ecephalomalacia. Previously mentioned signs of the disease had their correlation in the diagnostic procedures. Endocranial MR showed signs of continuous deterioration of the disease with necrosis in numerous parts of the brain. Elevated lactate level has been found, marked with press sequences that matches sequelaes of oxidative metabolism. EEG showed signs of epileptiform dysfunction. Genetic investigation was positive. Since there is no causal therapy, early recognition and symptomatic treatment may be of certain benefit

Prevalence of Asymptomatic Abdominal Aortic Aneurysm in Patients with Carotid Stenosis

The aim of this study was to demonstrate the prevalence of abdominal aortic aneurysm in patients with carotid disease and to analyse the influence of cardiovascular risk factors for abdominal aortic aneurysm. Methods: Ultrasound for abdominal aortic aneurysm was performed in 200 patients (112 men and 88 women, mean age 65.72±7.71 years) with known carotid disease. The primary cardiovascular risk factors (age, sex, hypertension, diabetes, dyslipidaemia and smoking) were analysed. Results: We found that 15.5% of patients with carotid stenosis also had abdominal aortic aneurysm. The prevalence of abdominal aortic aneurysm was higher in men (22.23%) than in women (6.81%). There was no correlation between the severity of carotid disease and the diameter of the abdominal aortic aneurysm (p>0.05). Advanced age and smoking were independent risk factors for abdominal aortic aneurysm. Conclusion: These results demonstrate that the prevalence of abdominal aortic aneurysm is higher in patients with carotid disease than in the general population. Patients with known carotid disease may be candidates for selective screening for abdominal aortic aneurysm detection

Temporal variations of stroke occurence

© 2017, University of Kragujevac, Faculty of Science. All rights reserved. Stroke is one of leading causes of death worldwide. Different frequency of stroke occurence is observed in days of the week and months in the year, and incidence of stroke has irregular time pattern. We analyzed 516 patients who had acute stroke and were treated in Clinic of Neurology, Clinical Center Kragujevac from January 1, 2013 to January 1, 2014, mean age 72,11 ± 11,52. Statistical analysis is conducted out using the SPSS software version 20.0. We used descriptive statistic, student T-test, chi-square or Fisher exact test. Friday is day we found the most IS and all stroke types occurences, and Wednesday is day we found the most IS in men. We found the most strokes in women younger than 65 years on Wednesday, but in women older than 65 years on Friday. Monday is day with the most admissions to hospital for patients wiThis, and we observed that there is average delay in the refering to the doctor for 1.80 ± 1.44 days. Friday is the day with the most ICH symptom beginings and the most admissions to the hospital, and Saturday is the day with the least symptom beginings and admissions to the hospital in the case of IS and ICH. The most IS occured in winter (in Decembar), and the least in summer (in August). The most ICH occured in May, and the least in July and October. We confirmed that there is a significant weekly variability in the IS symptom onset day

Suffering from cerebral small vessel disease with and without metabolic syndrome

© 2019 Tatjana Bošković Matić et al., published by De Gruyter. Cerebral small vessel disease (CSVD) and metabolic syndrome were separately associated with cognitive impairment and depression. However, whether metabolic syndrome adds to cognitive impairment and depression in patients who already have CSVD remained unanswered. The aim of our study was to investigate the association of metabolic syndrome with cognitive impairment and depression in patients with CSVD who have lacunar lesions or white matter hyperintensities. This prospective cohort study was conducted at Neurology Clinic, Clinical Center, Kragujevac, Serbia. Main outcomes of the study were cognitive assessment, and assessment of depression among hospitalized patients with or without CSVD. The study included 74 inpatients, 25 of them having lacunary infarctions, 24 with the white matter hyperintensities, and 25 control patients without CSVD. The CSVD was accompanied by impairment of cognition and depression, the patients with lacunary lesions being more cognitively impaired and more depressive than the patients with the white matter hyperintensities. The patients with CSVD who also had metabolic syndrome were more cognitively impaired and depressed than the patients with CSVD alone. In conclusion, our study showed that metabolic syndrome is associated with further worsening of already impaired cognition and existing depression in patients with CSVD

Unusual case of Marchiafava-Bignami disease presenting as axial hypotonia

© 2019 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved. Introduction: Marchiafava-Bignami disease is a rare disorder mostly associated with chronic heavy alcohol consumption that results in progressive demyelination and necrosis of the corpus callosum. Case report: We reported a 35-year-old woman with a history of alcohol consumption and malnutrition. Neurological examination revealed axial hypotonia, dysarthric speech and lack of motor coordination. The brain multislice computed tomography imaging demonstrated hypodense lesion of the corpus callosum. On the basis of her history, clinical features and imaging studies, the diagnosis of an acute form of Marchiava-Bignami disease was made. Definite diagnosis was confirmed at autopsy. Conclusion: Marchiafava-Bignami disease is of a medical emergency and early recognition and early aggressive treatment are critical for a good clinical outcome. To our knowledge, this is the first case of Marchiafava-Bignami disease presented with axial hypotonia

Higher serum uric acid levels in multiple sclerosis patients after long-term interferon beta treatment

© 2017, University of Kragujevac, Faculty of Science. All rights reserved. Interferon beta is a safe and efficacious treatment for relapsing multiple sclerosis (MS). However, there is some evidence that uric acid, a scavenger of peroxynitrite, is involved in MS pathology and that increasing serum uric acid levels might have beneficial therapeutic effects. The aim of this study is to investigate serum uric acid levels in MS patients before and after long-term interferon beta treatment. Blood samples from 101 MS patients (53 receiving interferon beta 1a treatment and 48 receiving interferon beta 1b treatment; 28 male and 73 female; mean age at treatment onset 32,4±7,3 years; mean duration of disease at treatment onset 5,1±3,2 years; mean EDSS 2±1,3) before and after interferon beta treatment (mean treatment duration 3±2 years) were analysed. Serum uric acid levels were measured using a quantitative enzymatic assay (Elitech Diagnostic, Sees, France). MS patients had significantly increased serum uric acid levels after treatment compared with those at the beginning of treatment (272,31±78,21 μmol/l vs. 210,17±53,65 μmol/l; p=0,019, Wilcoxon Mann-Whitney U-test). We did not find significant differences in serum uric acid levels between the interferon beta 1a and interferon beta 1b groups (p=0.98). These results indicate that one of the beneficial effects of interferon beta in MS might be based on the elevation of serum uric acid levels as a natural scavenger of peroxynitrite

Erratum to suffering from Cerebral Small Vessel Disease with and without Metabolic Syndrome (Open Med (Wars) (2019) 14 (479–484) DOI: 10.1515/med-2019-0051)

© 2020 De Gruyter. All rights reserved. In the published article “Matić TB, Toncev G, Gavrilović A, Aleksić D. Suffering from Cerebral Small Vessel Disease with and without Metabolic Syndrome. Open Med (Wars). 2019 Jun 11;14:479–84. doi: 10.1515/med-2019-0051. PMID: 31231684; PMCID: PMC6572407” the affiliation of the first and corresponding author – Dr. Tatjana Bošković Matić is incorrect. Dr Tatjana Bošković Matić is affiliated to University of Kragujevac, Faculty of Medical Science, which was missed by mistake in the publication itself. The correct affiliation of Dr Tatjana Bošković Matić is as follows: Tatjana Bošković Matić, University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Neurology and Clinical Center, Kragujevac, Serbia, tel: +381 64 112 96 21, e-mail: [email protected]

Higher Serum Uric Acid Levels in Multiple Sclerosis Patients After Longterm Interferon Beta Treatment

Interferon beta is a safe and efficacious treatment for relapsing multiple sclerosis (MS). However, there is some evidence that uric acid, a scavenger of peroxynitrite, is involved in MS pathology and that increasing serum uric acid levels might have beneficial therapeutic effects. The aim of this study is to investigate serum uric acid levels in MS patients before and after long-term interferon beta treatment. Blood samples from 101 MS patients (53 receiving interferon beta 1a treatment and 48 receiving interferon beta 1b treatment; 28 male and 73 female; mean age at treatment onset 32,4±7,3 years; mean duration of disease at treatment onset 5,1±3,2 years; mean EDSS 2±1,3) before and after interferon beta treatment (mean treatment duration 3±2 years) were analysed. Serum uric acid levels were measured using a quantitative enzymatic assay (Elitech Diagnostic, Sees, France). MS patients had significantly increased serum uric acid levels after treatment compared with those at the beginning of treatment (272,31±78,21 μmol/l vs. 210,17±53,65 μmol/l; p=0,019, Wilcoxon Mann-Whitney U-test). We did not find significant differences in serum uric acid levels between the interferon beta 1a and interferon beta 1b groups (p=0.98). These results indicate that one of the beneficial effects of interferon beta in MS might be based on the elevation of serum uric acid levels as a natural scavenger of peroxynitrite

Abo blood group and risk of glioma: A case control study from serbia

© 2019, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved. Backgraund/Aim. Gliomas are the most common primary brain tumors and the etiology is unknown. The aim of this study was to investigate possible association between incidence in relation to glioma and certain blood groups. Methods. The case-control study included 100 pathologically confirmed cases of glioma at the Clinical centar of Kragujevac, Serbia, between 2014 and 2015, and 200 age- and sex-matched controls without malignant diseases in personal and family history at the same institution. After signing the informed consent, all patients filled out an epidemiological questionnaire. Results. In the analysis comparing the glioma patients with the control group, a significant association (p < 0.0005) was observed in relation to the blood group AB. Furthermore, it was not observed a significant association in relation to the blood group A (p = 0.070), blood group B (p = 0.256), blood group O (p = 0.768) among the compared groups. Also, in the analysis comparing glioma patients with the control group, a significant association was observed in relation to the years spent