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

Recurrent painful ophthalmoplegic neuropathy: A report on the patient from the Romani population and 82-year-old patient

© 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved. Introduction. The current diagnostic criteria for recurrent painful ophthalmoplegic neuropathy (RPON) are at least two attacks of unilateral headache, associated with ipsilateral paresis of one, two or all three cranial nerves (III, IV or VI). There is no case report about RPON in the Romany population. The oldest patient with RPON, published in the literature, was 74 years old. Case report. The first patient was a 31-year-old man from the Romani population who was treated during three episodes of RPON, with III nerve palsy during one episode and with alternating VI nerve palsy during two episodes. All examination were normal except serum lipid levels and Cytomegalovirus immunoglobulin G (CMV IgG), Toxoplasma gondii IgG, Epstein-Barr virus (EVB) IgG and Varicella zoster IgG which were elevated. The second patient was a 82-year-old male patient with two RPON episodes with alternating VI nerve palsy. All examinations were normal, except Herpes simplex type 1 virus IgG, CMV IgG, Toxoplasma gondii IgG, EBV IgG and Varicella zoster IgG which were elevated, and his brain magnetic resonance imaging (MRI) showed lacunar ischemic lesions. Both patients were started on corticosteroid. Recovery was completed after all five episodes of RPON. Conclusion. There are no data on the frequency of RPON among the Romani population. The presentation of RPON in the oldest age is rare. RPON should be considered as a diagnostic option in these minorities. New case reports or systematic review articles about RPON are necessary to create a new insight into the nature of the disease

Fatigue in Patients with Autoimmune Thyroid Diseases

Fatigue is a common feature in a wide variety of chronic inflammatory and autoimmune diseases, but fatigue in autoimmune thyroid disease (AITD) has not been investigated so far. The aim of this study was to examine fatigue in patients with AITD and to analyse the correlation between fatigue and the serum concentrations of thyroid antibodies, thyroid function and depression. This cross-sectional clinical study included 62 patients with increased concentrations of thyroperoxidase antibodies (TPOAbs) as confirmation of AITD and 52 healthy individuals who were negative for thyroid antibodies; all controls were euthyroid. Thyroid antibodies, free thyroxine and thyroid-stimulating hormone were measured in the sera of all subjects. The Fatigue Severity Scale was used to measure the severity of fatigue; the level of depression was measured by the Beck Depression Inventory. Eight (12.9%) patients had evident fatigue, 7 (11.3%) patients had fatigue limit values, and 47 (75.8%) patients had no fatigue. The frequency of fatigue was highly significant and almost three times higher in the AITD patients compared to the control group, in which only 2 (3.8%) patients had evident fatigue. The majority of patients with fatigue had normal thyroid function, and only one (1.6%) patient had overt hypothyroidism. Seven (11.3%) patients had both fatigue and depression, whereas one (1.6%) patient had fatigue without depression. We did not find significant correlations between fatigue and the concentrations of thyroid antibodies, but we found statistically significant correlations between fatigue and depression in AITD patients

VEP Score of a Left Eye Had Predictive Values for Achieving NEDA-3 over Ten Years in Patients with Multiple Sclerosis

Background: The aim of this study was to determine the predictive value of visual evoked potentials (VEPs) in patients with relapsing–remitting multiple sclerosis (RRMS) in achieving no evidence of disease activity-3 (NEDA-3) during up to 10 years of first-line immunomodulatory therapy and to determine whether the lateralization of optic nerve damage may have prognostic significance concerning clinical disability and response to therapy.Methods: In a retrospective study, a total of 83 patients (53 female and 30 male) with RRMS participated. The average age of patients was 38.31 ± 9.01. Patients were followed for 2, 5 or 10 years. VEPs were measured at the beginning of the follow-up and after many years of monitoring. Data on optical neuritis (ON) were obtained from medical history. The degree of disability was estimated by the neurologist (independent rater), and magnetic resonance (MR) imaging of the endocranium was performed with gadolinium contrasts. Achieving NEDA-3 is considered a favorable outcome of treatments.Results: Among those treated, 19 (22.9%) reached NEDA-3, while 64 (77.1%) did not reach NEDA-3. The values of the evoked potential (EP) score for the left eye (r = 0.008, odds ratio (OR) = 0.344 (0.156–0.757)) and latency for the left eye (r = 0.042, OR = 0.966 (0.934–0.999)) at the onset of disease were predictive factors for achieving NEDA-3. Conclusions: A normal VEP at the beginning of RRMS increases the chance of reaching NEDA-3 by about six times

Potential drug-drug interactions in acute ischemic stroke patients at the Neurological Intensive Care Unit

© 2019 Dejan Z. Aleksic et al. Background: Clinically relevant potential drug-drug interactions are considered preventable adverse drug reactions. Objective: The aim of this study was to ascertain the frequency of potential drug-drug interactions in acute ischemic stroke patients and to explore factors associated with occurrence of potentially contraindicated drug-drug interactions. Methods: This observational retrospective cohort and nested case-control study was carried out among patients treated for acute ischemic stroke at the Neurological Intensive Care Unit in the Clinical Centre Kragujevac, Serbia. The potentially drug-drug interactions for each day of hospitalization were identified using Micromedex® software. Based on the existence or absence of potentially contraindicated drug-drug interactions, the participants were divided into a group of cases (n=111) and the control group (n=444). Results: A total of 696 patients were analysed. All patients had a minimum of one potential drug-drug interaction during hospitalization. The most common drugs involved in potential drug-drug interactions were aspirin (8.02%), diclofenac (7.49%) and warfarin (7.14%). The number of medications prescribed for simultaneous use during hospitalisation and the use of antipsychotics in therapy significantly increased the likelihood of potentially contraindicated drug-drug interactions after adjustment by means of logistic regression for 1.2 and 3 times, respectively. Conclusions: This study suggests that patients with acute ischemic stroke are frequently exposed to potential drug-drug interactions. It is essential to identify potentially drug-drug interactions in these patients as early as possible in order to prevent adverse drug reactions and ensure safe recovery. Besides, full attention should be paid when adding each new medication in therapy, particularly when a neurologist decides to prescribe antipsychotics, such as risperidone

Temporal Variations of Stroke Occurence

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

Fatigue in patients with autoimmune thyroid diseases

© 2017, University of Kragujevac, Faculty of Science. All rights reserved. Fatigue is a common feature in a wide variety of chronic inflammatory and autoimmune diseases, but fatigue in autoimmune thyroid disease (AITD) has not been investigated so far. The aim of this study was to examine fatigue in patients with AITD and to analyse the correlation between fatigue and the serum concentrations of thyroid antibodies, thyroid function and depression. This cross-sectional clinical study included 62 patients with increased concentrations of thyroperoxidase antibodies (TPOAbs) as confirmation of AITD and 52 healthy individuals who were negative for thyroid antibodies; all controls were euthyroid. Thyroid antibodies, free thyroxine and thyroid-stimulating hormone were measured in the sera of all subjects. The Fatigue Severity Scale was used to measure the severity of fatigue; the level of depression was measured by the Beck Depression Inventory. Eight (12.9%) patients had evident fatigue, 7 (11.3%) patients had fatigue limit values, and 47 (75.8%) patients had no fatigue. The frequency of fatigue was highly significant and almost three times higher in the AITD patients compared to the control group, in which only 2 (3.8%) patients had evident fatigue. The majority of patients with fatigue had normal thyroid function, and only one (1.6%) patient had overt hypothyroidism. Seven (11.3%) patients had both fatigue and depression, whereas one (1.6%) patient had fatigue without depression. We did not find significant correlations between fatigue and the concentrations of thyroid antibodies, but we found statistically significant correlations between fatigue and depression in AITD patients

EEG Abnormalities as Diagnostic and Prognostic Factor for Encephalitis

The aim of the study is to examine whether EEG abnormalities in patients with encephalitis might be prognostic and diagnostic factors for final epilepsy outcome and/or be correlated with the severity of the disability

Specific Polymorphism 4G/5G Gene for PAI-1 as a Possible Cause of Cerebral Venous Thrombosis: A Case Report

Thrombosis of veins and venous sinus (CVT) is the rare cerebral vascular disorder which makes less than 1% of all strokes. Thrombosis of veins and venous sinuses is picturesquely called “мајоr neurological forger” since it is characterized by very varied clinical picture. Among the various causes of CVT, which can be of infective or non-infective nature, the congenital hyper coagulations especially stand out, diagnosis is based on highly sophisticated diagnostic tests

Potential drug-drug interactions in acute ischemic stroke patients at the Neurological Intensive Care Unit

Clinically relevant potential drug-drug interactions are considered preventable adverse drug reactions