Electroclinical characteristics of MRI negative focal epilepsy: A video-EEG study

Background/Aim. Epileptogenic lesions carry intrinsic epileptogenicity or epileptogenic potential in their close vicinity. One third of patients with focal epilepsy have no epileptogenic lesions magnetic resonance imaging [MRI(-)]. The aim of this study was to determine the epileptogenic zone investigating electrical and clinical properties of MRI-patients. Methods. In 180 patients with focal epilepsy we analyzed 1,712 seizures for interictal and ictal electroencephalography (EEG) and seizure semiology. If multiple seizures occurred we took the best seen on video as an example, with secondary generalized tonic-clonic seizures (GTCS) if it occurred. Brain MRI was focused to investigate the zone of ictal EEG onset. Electroclinical properties of the MRI-patients were compared to lesion positive patients [MRI(+)]. Results. A single epileptogenic lesion was identified in 68.89% [hippocampal sclerosis (HS) in 58, focal cortical dysplasia (FCD) in 28 and other pathologies in 38 patients]. MRI(-) patients had significantly less interictal epileptiform abnormalities, and presented more often (p lt 0.001) with secondary GTCS as the only seizure. Eye opening, hypermotor seizure, bilateral asymmetric clonic seizure, vocalization, and contralateral body turning occurred more frequently in the MRI-group compared to the MRI+ one. MRI-patients share some semiological features with FCD as opposed to HS patients. Conclusion. MRIepilepsy patients frequently present with electroclinical features seen in frontal lobe epilepsy or in epilepsy associated with FCD

Haemoglobin level in relation to vitamin D status in infants and toddlers

Introduction: Vitamin D Deficiency (VDD) is defined as the level of 25(OH)D in the serum < 30 ng/ml. According to the contemporary research, even the slight vitamin D deficiency can adversely affect our body in many ways. Numerous studies indicate that vitamin D deficiency is very common in children. The study aimed to research the frequency of vitamin D deficiency in infants and toddlers, the connection between VDD and iron deficiency anemia (IDA), as well as the correlation between 25-hydroxycholecalciferol (25(OH)D) and haemoglobin (Hb) in the examinees. Method: The study includes 150 children, 73 (49%) newborns and 77 (51%) infants. Vitamin D status was determined through the amount of 25(OH)D in blood, using the electrochemiluminescence. Results: Vitamin D Deficiency was found in 58% of infants and toddlers (severe vitamin D deficiency was found in 16% of examinees, vitamin D deficiency was found in 23% of examinees, while vitamin D insufficiency was found in 19% of examinees). Vitamin D deficiency (VDD) and anaemia were found in 80% of examined infants and toddlers. VDD was found in 49% of newborns that were not anaemic. We have observed the substantial difference between the examinees suffering from both anaemia and VDD and the examinees suffering from VDD only. Conclusion: The highest level on anaemia was found in the children with severe vitamin D deficiency, while in the examined infants and toddlers, there was a connection between the level of 25(OH)D and Hb in the serum

The Monitoring of Protein Markers of Inflammation and Serum Lipid Concentration in Obese Subjects with Metabolic Syndrome

Background: Obesity is one of the most common modern health problems worldwide. Proinflammatory cells accumulate in the adipose tissue of the obese, and the presence of a low level chronic inflammation in obesity is associated with the emergence of a range of metabolic disorders in cluding cardiovascular disease, insulin resistance, type-2 diabetes, fatty-liver disease, and others. Neutrophils are early parti - cipants in inflammatory processes. After the appropriate stimu lation, these cells release reactive oxygen and nitrogen species, which leads to degranulation and secretion of myeloperoxidase and other enzymes. Myelo per oxidase and its reactive oxidants contribute to tissue damage during inflammatory processes in the human body. Methods: The study included 175 subjects who were, in com - pliance with the International Diabetes Federation criteria, divided into 3 groups: normal weight subjects (N=106), subjects with abdominal obesity (N=37) and the third group consisted of subjects with the metabolic syndrome (N=32). Results: By analyzing the myeloperoxidase enzyme activity (kU/L), and the levels of high-sensitivity C-reactive protein in the blood of all subjects, we detected their significantly higher activity and levels in subjects with the metabolic syndrome, as compared to normal weight subjects (p<0.001). Conclusion: Based on our results, we can conclude that the MPO activity in the serum progressively increases with obesity and the metabolic syndrome, which indicates that this prooxidant enzyme may play a role in the pathophysiological mechanisms of the obesity and the metabolic syndrome related complications

Reduced glutathione level and gsh-dependent enzyme activities in corticonuclear blocks of lenses in patients with senile cataract

Introduction. Reduced compound glutathione (GSH) in the lens has the function to protect the thiol group of lens proteins, and as a substrate of glutathione peroxidase (GPx) and glutathione S-transferase (GST). Protein containing thiol groups is significant for the normal function of lens epithelium, i.e. enzymes Na-K-ATP-ase, thus influencing cell permeability. The relationship GSH/GSSG (oxidized glutathione) is normally high in the lens and other ocular tissue owing to the glutathioneredox cycle, which is localized in the lens epithelium and cortex surface. Objective. The aim of the study was to investigate non-enzymic factors of the antioxidant protection of non-protein and protein tiol, as well as to determine glutathione-dependent enzyme activity in the corticonuclear blocks of lenses in patients with senile cataract. Methods. Biochemical studies of lens were carried on 101 patients with senile cataract. According to cataract maturity degree, the patients were classified into two groups: senile incipient cataract (N=41) and mature senile cataract (N=60). GSH concentration was determined by Ellman’s reagent. GPx activity was assayed with cumene hydroperoxide, and that of glutathione S-transferase by follow-up of glutathione conjugation and 1-chloro-2.4-dinitrobenzene rates. Results. A significantly higher GSH concentration was found in the corticonuclear blocks of lenses with initial as related to mature cataract (p&lt;0.001). The activity of enzyme GPx and GST was considerably higher in the corticonuclear blocks of lenses with initial cataract (p&lt;0.001). With cataract progression, the quantity of available GSH, necessary for GPx and GST functioning, declined, so that the activity of these enzymes was also significantly decreased in mature cataract. Conclusion. The determined lower GSH concentration and antioxidant enzyme activity in corticonuclear blocks of lenses, particularly in cataract with a nuclear component, indicate the weakened antioxidant response of lens tissue during the development of senile cataract

Examination of myeloperoxidase activity, as an indicator of inflammation in obese participants with metabolic syndrome

Introduction. Obesity is a complex metabolic disorder and one of the most common modern health problems. Numerous studies indicate association between chronic low-grade inflammatory state and obesity. Myeloperoxidase (MPO) and its reactive oxidants participate in tissue damage in the course of inflammatory processes. The aim of this study was to examine MPO activity in the serum of obese participants with metabolic syndrome and its relationship with other indicators of inflammation. Material and Methods: Participants were divided into three groups according to the anthropometric parameters and biochemical indicators: normally fed ones (n=30), participants with abdominal obesity (n = 30) and participants with metabolic syndrome (n = 30). In the serum of patients was being determined chlorination activity of MPO by spectrophotometry. Results: Significant differences were found in MPO activity in all three groups of participants such as: the maximum activity was measured in patients with metabolic syndrome (p <0.001). There was a positive correlation between MPO activity and atherogenic index, as well as between the MPO and the concentration of LDL-cholesterol, while the negative correlation was found between MPO and the concentration of HDL-cholesterol. Conclusion: The examination has shown that the activity of MPO progressively increases with obesity and metabolic syndrome. The obtained results suggest that MPO can be of great importance for the pathophysiological mechanisms leading to the development of complications of obesity and metabolic syndrome

Tacrolimus-induced optic neuropathy: A case report

Intrduction. Tacrolimus (fujimycin or FK506) is a potent immunosuppressive drug with growing usage. It is usually used in prevention of transplanted organ rejection. Its use is highly valuable, but like other immunosupressants, it has adverse effects. One of them is optic neuropathy. Case report. A 47-year-old white male patients who had received tacrolimus therapy for nine years, after kidney transplantation, developed a subacute, painless vision loss on both eyes. He was thoroughly examined on different possible optic neuropathies and other causes of vision loss. After exclusion of other possible causes, the diagnosis of toxic optic neuropathy was established. His therapy was converted to cyclosporine, by his nephrologist, but his vision had improved only slightly. Conclusion. Toxic optic neuropathies are presented in everyday ophthalmological practice, but they are underestimated. Diagnosis can be demanding, especially when it comes to drugs and substances whose possible toxic effect on the optic nerve is not widely known. Unlike other adverse effects of tacrolimus therapy on nervous system, optic neuropathy can causes great and permanent functional impairment

Psychometric Properties of the Serbian Version of the Maslach Burnout Inventory-Human Services Survey: A Validation Study among Anesthesiologists from Belgrade Teaching Hospitals

We report findings from a validation study of the translated and culturally adapted Serbian version of Maslach Burnout Inventory-Human Services Survey (MBI-HSS), for a sample of anesthesiologists working in the tertiary healthcare. The results showed the sufficient overall reliability (Cronbach’s α = 0.72) of the scores (items 1–22). The results of Bartlett’s test of sphericity (χ2 = 1983.75, df = 231, p<0.001) and Kaiser-Meyer-Olkin measure of sampling adequacy (0.866) provided solid justification for factor analysis. In order to increase sensitivity of this questionnaire, we performed unfitted factor analysis model (eigenvalue greater than 1) which enabled us to extract the most suitable factor structure for our study instrument. The exploratory factor analysis model revealed five factors with eigenvalues greater than 1.0, explaining 62.0% of cumulative variance. Velicer’s MAP test has supported five-factor model with the smallest average squared correlation of 0,184. This study indicated that Serbian version of the MBI-HSS is a reliable and valid instrument to measure burnout among a population of anesthesiologists. Results confirmed strong psychometric characteristics of the study instrument, with recommendations for interpretation of two new factors that may be unique to the Serbian version of the MBI-HSS

Krimska Kongo hemoragijska groznica: prikaz porodičnih epidemija

Uvod. Krimska Kongo hemoragijska groznica (KKHG) je akutna, virusna,prirodno-žarišna zoonoza, koja se u prirodnim uslovima prenosi na čovekaubodom nekih vrsta iksoidnih krpelja i interhumano. Klinički se ispoljavafebrilnim toksično-infektivnim sindromom sa izraženim hemoragijamarazličitih lokalizacija i intenziteta.U radu su prikazani bolesnici lečeni odKrimske-Kongo hemoragijske groznice u Klinici za infektivne bolesti Kliničkobolničkog centra u Prištini.Prikazi porodičnih epidemija. U toku lečenja bolesnika obolelih od KKHGzabeleženo je 6 porodičnih epidemija. U četiri su obolela po dva člana porodice,u jednoj četiri i u jednoj šest članova. Bolest se manifestovala visokomtemperaturom i hemoragijama različitih lokalizacija. U porodičnoj epidemijiu kojoj je obolelo šest članova, kao i u epidemiji u kojoj su obolela četiri člana,letalni ishodi su zabeleženi kod indeksnih bolesnika. Dijagnoza je postavljenana osnovu epidemioloških parametara, kliničke slike i seroloških analiza.Zaključak. Krimsku Kongo hemoragijsku groznicu karakteriše pojava febrilnostii hemoragija, a javlja se sporadično ili u manjim, najčešće porodičnimepidemijama. Od velikog je epidemiološkog značaja mogućnost interhumanetransmisije

The Role of Oxidative Stress in the Onset and Development of Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is a complex, degenerative and progressive chronic disease that leads to severe visual loss. The prevalence of early AMD accounts for 18% in the population between 65 and 74 years of age and even 30% in subjects older than 74 years. The articles published in the last decade point out to a significant role of oxidative stress in the onset and development of age-related macular degeneration. Generally, reactive oxygen species (ROS) are produced in the eye during light absorption and physiological metabolic processes. The level of oxidative stress is kept under control by the action of antioxidants and reparative enzymes. Excessive synthesis of ROS leads to increased oxidative modification of lipids, proteins and DNA, causing oxidative damage of cytoplasmic and nuclear cell elements and changes of the extracellular matrix. The accumulation of oxidatively modified compounds in drusen deposits will initiate the onset and development of AMD. The objective of this review was to highlight the mechanisms of oxidative stress in order to elucidate their significance and association with the pathogenesis of AMD