Search

Introduction/Objective. The aim of this follow-up study was to determine the effects of topiramate therapy on cognitive functions in patients with pharmacoresistant focal epilepsy. Methods. The study sample comprised of 40 topiramate naive patients. The topiramate starting dose was 25 mg, with a fortnightly titration schedule of 25 mg. A wide range of cognitive functions was evaluated through extensive neuropsychological testing at baseline and six months after reaching the target dose (200 mg/day). Results. The most common side effects following the introduction of topiramate were cognitive impairments, reported by 45% of the participants. The neuropsychological scores on attention, executive function, verbal content recall, improved cognitive flexibility, as well as visuospatial ability and speech, obtained at six-month follow-up were significantly lower than at baseline. However, statistically significant correlation between neuropsychological scores and the number of antiepileptic drugs taken alongside topiramate could not be established. Similarly, no statistically significant differences were noted between the percentage of reduced neuropsychological scores at follow-up pertaining to patients with lower and higher baseline cognitive performance. Moreover, regression analysis indicates that the percentage change in the majority of cognitive scores is unrelated to the age at the epilepsy onset, epilepsy duration, presence of brain pathology on magnetic resonance imaging and percentage change in the depression scale score. Conclusion. Despite slow introduction and administration of a relatively small dose, topiramate exhibits adverse effects on a wide range of cognitive functions, which appear unrelated to the number of additional antiepileptic drugs, baseline cognitive functioning, age at the onset of epilepsy and its duration, presence of brain pathology and the extent of depressive symptoms.

Introduction/Objective. Recently published studies have addressed the significant impairment of healthrelated quality of life (HRQoL) in patients suffering from gastroesophageal reflux disease (GERD) and functional dyspepsia (FD). To the best of our knowledge, none of the previously published studies have compared the impact of GERD and FD on HRQoL. The aim of the study was to determine the impact of GERD and FD on HRQoL. Methods. The current sample was extrapolated from a large cross-sectional population-based study conducted in primary health care facilities. Primary care physicians and general internists diagnosed GERD according to the Montreal definition for population-based studies. Also, primary care physicians and general internists diagnosed FD based on the Rome III criteria. The Serbian version of the generic self-administered Center for Disease Control and Prevention questionnaire was used. We used the propensity score method to match GERD and FD samples on variables such as age, gender, education, and adherence to therapy. Results. Regarding self-rated health, similar results were obtained from both groups. The Center for Disease Control and Prevention HRQoL questionnaire version 4 further revealed that functional dyspepsia led to greater disturbances of every-day functioning in regard to the criteria of physically healthy, mentally healthy, and activity limitation days. Conclusion. The results of the study have shown significant impairment of HRQoL in both groups, but, surprisingly, patients with FD experienced more limitations to their every-day functioning compared to patients with GERD.

Introduction. By the year 2020, if current trends for demographic and epidemiological transition continue, the burden of depression will have increased to 5.7% of the total burden of disease, thus becoming the second leading cause of disability-adjusted life year (DALY) lost. Early detection of people at risk of developing any mental disorder is extremely important in the prevention of all mental disorders. Objective. The objective of the study was to determine depression predictors among adult residents in four Kosovo and Metohia municipalities predominantly inhabited by Serbian population. Methods. This cross-sectional study included the representative sample of adults in Leposavić, North Kosovska Mitrovica, Gnjilane and Priština and was performed in October/November of 2009. The sample was selected from the list of citizens older than 18, received in the above mentioned municipalities. The Goldberg General Health Questionnaire (GHQ-28) was used as a research instrument. The methods of statistical analysis included descriptive statistics, simple and multiple logistic regression analysis, and analysis of variance, with a significance level of 0.05. Results. Problems with depression have been significantly associated with female sex (OR=2.24), older age (OR=1.01), lower levels of education (OR=0.50), unemployment (OR=1.09), poor financial situation (OR=0.45), abuse (OR=0.08) and assessment of the future political and security situation as a highly risky one (OR=3.01). Conclusion. To determine risk groups being in greater risk to suffer from depression is important for planning, enhancing, promoting and implementing the prevention strategies for this disease.

Introduction. Recent data from the studies conducted in the Western countries have proved that patients with gastroesophageal reflux disease have significantly impaired health-related quality of life compared to general population. Objective. The study is aimed at evaluating the burden of reflux symptoms on patients’ health-related quality of life. Methods. The study involved 1,593 patients with diagnosed gastroesophageal reflux disease. The Serbian version of a generic self-administered Centers for Disease Control and Prevention questionnaire was used. Statistical analyses included descriptive statistics, Pearson chi-square test and a multiple regression model. Results. Among all participants, 43.9% reported fair or poor health. Mean value of unhealthy days during the past 30 days was 10.4 days, physically unhealthy days 6.4 days, mentally unhealthy days 5.3 days and activity limitation days 4.3 days. Furthermore, 24.8% participants reported having ≥14 unhealthy days, 14.9% had ≥14 physically unhealthy days, 11.8% reported ≥14 mentally unhealthy days, and 9.4% had ≥14 activity limitation days. Conclusion. This study addressed complex relationships between reflux symptoms and patients’ impaired everyday lives.

Introduction. Endocardial endothelium, a natural biological barrier between circulating blood in heart ventricle and cells, creates a complex yet finely tuned balance of interactions with the immediate environment. Objective. We investigated the roles of theophylline, nonspecific phosphodiesterase inhibitor, and imidazole, an activator of phosphodiesterase on contractility of the right ventricle of rat heart, with intact and removed endocardial endothelium. Methods. Adult rats, of both sexes, type Wistar albino, were used in this experiment. All experiments were conducted on the preparations of the right ventricle using two experimental models. In the first experimental model, an endocardial endothelium (EE) was preserved, and in the second model, an endocardial endothelium (-EE) was removed using 1% solution Triton X-100. Results. Theophylline (1x10-2 mol/l) expressed the positive inotropic effect on the heart, regardless of the presence of the endocardial endothelium. Inotropic response as multiple process can be induced by inhibition of phosphodiesterase, accumulation of cyclic nucleotides and activation of Ca2+ channels. Imidazole (2x10-3 mol/l) increased the contractility of the right ventricle of the heart with EE. The modulator effect of endocardial endothelium on contractility of imidazole proved to be significant. As imidazole influenced the contractility of the right ventricle only in the presence of the endocardial endothelium, it is assumed that its effect is mediated via deliverance of endothelial mediators with positive inotropic effect. Conclusion. An intact endocardial endothelium is necessary for completion of contractile performance of the heart.

Introduction: Hemodialysis efficacy that significantly influences morbidity and mortality of patients can be evaluated by different widely used indices of adequacy. Objective The aim of the study was to evaluate the adequacy of hemodialysis in the group of patients on maintenance hemodialysis and to examine the influence of different dialysis membranes on the indices of adequacy and frequency of symptoms and complications developing during dialysis treatment. Method The study involved 14 patients dialyzed in three successive months with three different types of dialyzers: E3 (Hemomed) - cuprophane membrane, 1.3 m2, F6 (Hemomed) - polysulfone membrane, 1.3 m2, CM23 (Zdravlje) - cuprophane membrane, 1.25 m2. Each type of dialyzers was used during one month, meaning during 12 successive 4-hour hemodialyses. Results Mean value of Kt/V index was 1.39±0.21 for E3 dialyzer, 1.18±0.24 for F6 dialyzer and 1.44±0.25 for CM23 dialyzer. The difference between the indices was statistically significant (p

Introduction. Besides numerous studies that examined various aspects of comorbidity in patients with panic disorder and agoraphobia and numerous studies that examined efficacy of different treatment modalities in these patients, there was no study that examined relationship of overall psychiatric comorbidity and treatment of patients with panic disorder and agoraphobia. Objective. The objective of the study was to establish the effect of psychiatric comorbidity on treatment efficiency of patients with panic disorder and agoraphobia. Method. The sample of the study consisted of 119 patients with primary diagnosis of panic disorder and agoraphobia. The therapy of patients was based on the use of individual integrative model of treatment, which incorporated psycho-pharmaceuticals (benzodiazepines and antidepressants) and cognitive- behavior therapy. Symptom severity was estimated by Panic and Agoraphobia Scale before and after the completion of treatment. Patients with comorbidity and patients without any comorbidity were compared by MANOVA and ANOVA with repeated measures. Results. The results of the study showed that 91% of patients met diagnostic criteria of comorbid psychiatric disorder and these patients had more severe clinical picture than patients without any comorbid disorder before the treatment. The results also showed that, after the completion of treatment, there was a significant reduction of all analyzed symptoms, that the effects of treatment were significantly better in patients with psychiatric comorbidity and that comorbid psychiatric disorders had no negative effect on the main goals of the treatment. Conclusion. Based on these results, it may be concluded that: in patients with panic disorder and agoraphobia and comorbid psychiatric disorders, the pharmacotherapy must be based on simultaneous use of antidepressants and benzodiazepines, while standard cognitive-behavior therapy of patients with panic disorder and agoraphobia must be modified in case of the existing comorbid psychiatric disorders.

Micrometastasis is a microscopic (less than 2 mm) deposit of malignant cells separated from the primary tumor. The incidence and importance of occult perigastric lymph node involvement were analyzed in 26 pNO patients using the prospective method. The occult lymph node involvement was detected by immunohistochemical method using the anticyto-keratin 8/18 antibody. Prevalence of clinically significant occult lymph node involvement (Mi+) was statistically significant, and found in 38.5% of pNO patients. Out of tumor characteristics analyzed as possible predictors of occult lymph node involvement, the histological grade (GH) and the involvement of lymphatic vessels within gastric wall (pLl) had significant effect on the respective evaluation. The patients with histological grade 3 and 4 had occult lymph node involvement more often than those with grade 1 and 2 (p