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Article ; Online: Seizure or syncope: Is the history-based scale feasible to use in an emergency department setting?

Lukić, Stevo / Stojanov, Aleksandar

Australasian emergency care

2023

Abstract: Background: This study aimed to assess the efficacy of a screening questionnaire, based on historical criteria, in distinguishing between seizures and syncope in patients experiencing their first episode of transient loss of consciousness (TLOC) in a ... ...

Abstract	Background: This study aimed to assess the efficacy of a screening questionnaire, based on historical criteria, in distinguishing between seizures and syncope in patients experiencing their first episode of transient loss of consciousness (TLOC) in a neurology emergency department. Methods: A prospective cohort of 159 patients with initial TLOC episodes underwent clinical observation and answered a nine-question screening questionnaire. The questionnaire's predictive ability was compared to final diagnoses determined through detailed neurology, electrophysiology, and cardiology assessments during a minimum 12-month follow-up. Logistic regression (LR) analysis was performed with final diagnosis as the outcome variable. The calibration and discrimination of the models were assessed. Results: revealed that the screening score accurately classified 72.33% of patients. Among those with positive screening scores, 65 (67.71%) had seizures compared to 31 (32.29%) with syncope. Introducing a novel risk-scoring model incorporating age and gender, in addition to the screening score, significantly improved performance achieving an accurate classification rate of 81.48%. Among patients with a positive prediction, 63 (80.77%) had seizure, whereas 15 (19.23%) had syncope. Conclusions: Employing a structured questionnaire based on common historical criteria is a valuable tool for distinguishing between seizure and syncope in the dynamic setting of the emergency department.
Language	English
Publishing date	2023-12-05
Publishing country	Australia
Document type	Journal Article
ISSN	2588-994X
ISSN (online)	2588-994X
DOI	10.1016/j.auec.2023.11.002
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Article ; Online: Neurophysiological confirmation of phrenic nerve affection in a patient with dyspnea and herpes zoster

Martić Vesna / Stojanov Aleksandar

Vojnosanitetski Pregled, Vol 80, Iss 9, Pp 802-

2023 Volume 804

Abstract: Introduction. Herpetic lesion of the phrenic nerve is quite uncommon. These lesions are usually unilateral, and for most clinicians, the clinical manifestation of herpes zoster in the cervical or thoracic region and diaphragmatic paralysis on the same ... ...

Abstract	Introduction. Herpetic lesion of the phrenic nerve is quite uncommon. These lesions are usually unilateral, and for most clinicians, the clinical manifestation of herpes zoster in the cervical or thoracic region and diaphragmatic paralysis on the same side is sufficient for making a diagnosis of segmental herpes zoster phrenic nerve palsy. We report a patient with a classic clinical picture, in which we confirmed phrenic nerve affection on nerve conduction study. Case report. A 58-year-old female patient came for an examination due to shortness of breath. The patient had a herpetic rash on her right shoulder two and a half months earlier. The elevation of the right hemidiaphragm was seen on chest X-ray imaging. Asymmetry was evident in the nerve conduction study of the phrenic nerve: prolonged latency and reduced amplitude of her right phrenic nerve. The patient was treated with acyclovir, pregabalin, and B complex vitamins. After six months, the motor deficit was reduced completely. Conclusion. A nerve conduction study of the phrenic nerve is useful in making the definitive diagnosis. Good outcome, as in this patient, is rare in patients with this diagnosis and may be linked to timely treatment with acyclovir.
Keywords	diagnosis ; electrodiagnosis ; herpes zoster ; nerve conduction studies ; phrenic nerve ; Medicine (General) ; R5-920
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Military Health Department, Ministry of Defance, Serbia
Document type	Article ; Online
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Article ; Online: Study of monomelic amyotrophy of the lower limbs in the territory of the Western Balkans: Case series.

Djordjevic, Gordana / Milosevic, Vuk / Stojanov, Aleksandar

Medicine

2023 Volume 102, Issue 39, Page(s) e35435

Abstract: Rationale: Monomelic amyotrophy is a rare form of motor neuron disease in which the neurogenic atrophy is restricted to 1 limb, mostly the distal part of the arm. The disease most often occurs in Asia, especially in Japan and India, while in European ... ...

Abstract	Rationale: Monomelic amyotrophy is a rare form of motor neuron disease in which the neurogenic atrophy is restricted to 1 limb, mostly the distal part of the arm. The disease most often occurs in Asia, especially in Japan and India, while in European countries, this disease is rarely recognized. Registration and publication of new cases of this disease aims to increase the awareness of clinicians about the existence of this disease in European countries, and with the aim of easier recognition and faster diagnosis of this essentially benign disorder. Patient concerns: Five patients with signs of atrophy of the muscles of 1 leg were examined at our Institution. Diagnoses: The criteria for selecting patients were as follows: clinical evidence of wasting and weakness confined to the 1 lower limb; progressive course, or initial progression followed by stationary course; absence of any definite sensory loss or central nervous system involved; no evidence of compression lesion of the spinal cord. Interventions: The clinical characteristics of our patients were similar to those previously described in the literature. The characteristic clinical features were sporadic occurrence, predominance in males with an initially progressive course for 2 to 5 years followed by a stationary state. There was no family history of neuromuscular disease. Outcomes: The electromyographic finding was consistent with a chronic neuropathic disorder. Magnetic resonance imaging of the lumbosacral spine excluded intraspinal pathologies and root compression in all cases. Lessons subsection: Monomelic amyotrophy of the lower limb is a rare disease that should be considered in cases of slow progressive unilateral amyotrophy of a single leg, especially in younger and middle-aged men, not only in Asia but also in the Western Balkans and Europe.
MeSH term(s)	Male ; Middle Aged ; Humans ; Balkan Peninsula ; Spinal Muscular Atrophies of Childhood/diagnosis ; Muscular Atrophy, Spinal ; Lower Extremity ; Atrophy ; Magnetic Resonance Imaging
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000035435
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Article ; Online: Values of Nitric Oxide and Superoxide Dismutase in Cerebrospinal Fluid of Patients with Sporadic Amyotrophic Lateral Sclerosis.

Djordjevic, Gordana / Milosevic, Vuk / Ljubisavljevic, Srdjan / Stojanovic, Ivana / Stojanov, Aleksandar

Neurology India

2023 Volume 71, Issue 4, Page(s) 742–747

Abstract: Introduction: Neurons are highly energy-dependent and highly specialized cells, showing great sensitivity to oxidative stress (OS). Nitric oxide (NO) and its oxidation products play a central role in neurodegeneration. This study aimed to contribute to ... ...

Abstract	Introduction: Neurons are highly energy-dependent and highly specialized cells, showing great sensitivity to oxidative stress (OS). Nitric oxide (NO) and its oxidation products play a central role in neurodegeneration. This study aimed to contribute to the further elucidation of the role of OS in the pathogenesis of amyotrophic lateral sclerosis (ALS). Methods: We assessed NO and superoxide dismutase (SOD) levels in cerebrospinal fluid (CSF) of 24 sporadic ALS (sALS) patients (13 of them presented with spinal form while 11 patients had bulbar form) and 20 controls (CG). Results: The obtained SOD levels in sALS patients were lower than those in CG (p < 0.001), while NO showed higher levels compared to CG (p < 0.001). Observed separately, there were no significant differences in the levels of NO and SOD in CSF between patients about their clinical presentations (p > 0.05). There were significant negative correlations between SOD and NO levels in all sALS patients (r = 0.31, P = 0.025). Significant correlation between SOD and functional rating scale as well as disease progression index was recorded in patients with sALS (r = 0.618. r = 0.425, P < 0.01), while NO levels were significantly associated with disease progression only (r = 0.348, P < 0.01). Conclusion: The data presented clearly support the role of impaired oxidant/antioxidant balance in the pathogenesis of ALS, where NO overproduction and decreased SOD defense activity seem to be particularly involved. The CSF SOD and NO level might serve as useful biomarkers for functional disorder and progression of the disease.
MeSH term(s)	Humans ; Amyotrophic Lateral Sclerosis ; Nitric Oxide/cerebrospinal fluid ; Superoxide Dismutase/cerebrospinal fluid ; Disease Progression
Chemical Substances	Nitric Oxide (31C4KY9ESH) ; Superoxide Dismutase (EC 1.15.1.1)
Language	English
Publishing date	2023-08-27
Publishing country	India
Document type	Journal Article
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/0028-3886.383853
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Article ; Online: Oxidative stress parameters in patients with Meniere disease

Stojanov Aleksandar / Stojanov J.

Praxis Medica, Vol 48, Iss 1, Pp 19-

2019 Volume 23

Abstract: Introduction: The role of oxidative stres in patients with Meniere disease (MD), is still unresearched. The aim: The aim was to compare serum levels of total and direct bilirubin, albumins, uric acid and creatinine as antioxidative status parameters in ... ...

Abstract	Introduction: The role of oxidative stres in patients with Meniere disease (MD), is still unresearched. The aim: The aim was to compare serum levels of total and direct bilirubin, albumins, uric acid and creatinine as antioxidative status parameters in patients with MD with healthy controls, and patients with multiple sclerosis (MS). Methods: We divided patients in three groups - 85 MD patients, 75 healthy controls (HC) and 72 MS patients. Patients with MD were divided into groups according to sex, age at the time of the disease onset, and number of attacs per year. Severity of clinical presentation during the attack was assessed by Vertigo Symptom Scale. Results: The serum levels of all parameters were significantly lower in MD and MS group compared to the healthy control group (p<0.05). Regarding severity of clinical presentation we found strong correlation (p<0.001) which indicates lower antioxidant status in patients with severe clinical presentation. Conclusion: The results of our research showed significantly lower values of all investigated parameters in MD group related to the healthy controls, which could suggest a potential role of oxidative process in MD patophysiology.
Keywords	Meniere disease ; oxidative stress ; antioxidant serum status ; Medicine ; R
Subject code	610
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Medicinski fakultet Priština, Društvo lekara Kosova i Metohije Srpskog lekarskog društva
Document type	Article ; Online
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Article ; Online: The immediate effects of the Covid-19 pandemia on postpartum women

Stojanov Jelena / Stojanov Aleksandar / Stanković Miodrag / Žikić Olivera

Praxis Medica, Vol 49, Iss 1-2, Pp 59-

2020 Volume 61

Abstract: The new pandemic, caused by the corona viral disease 2019 (Covid-19), has brought with it a series of restrictive measures that have drastically altered people's way of life and which restrict freedom of movement, behavior and social engagement. At the ... ...

Abstract	The new pandemic, caused by the corona viral disease 2019 (Covid-19), has brought with it a series of restrictive measures that have drastically altered people's way of life and which restrict freedom of movement, behavior and social engagement. At the time of pandemia, almost all aspects of each individual lifestyle have been impaired, especially in members of vulnerable groups, particularly women in postpartum women. Acute psychological reactions to a pandemia may include insomnia, fear of infection, anxiety, frustration, panic attacks, loneliness, but also depressive episodes. Non-psychotic postpartum mood and anxiety disorders can occur as an inability to adapt to stressful life situations. A comprehensive understanding of the impact of the pandemia on the mental health of women in the postpartum period is needed, in order to devise adequate approaches to recovery from such a major disaster as the Covid-19 pandemic.
Keywords	covid-19 ; postpartum period ; mental disorders ; Medicine ; R
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Medicinski fakultet Priština, Društvo lekara Kosova i Metohije Srpskog lekarskog društva
Document type	Article ; Online
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Article ; Online: Quality of Life of Myasthenia Gravis Patients in Regard to Epidemiological and Clinical Characteristics of the Disease.

Stojanov, Aleksandar / Milošević, Vuk / Đorđević, Gordana / Stojanov, Jelena

The neurologist

2019 Volume 24, Issue 4, Page(s) 115–120

Abstract: Background: Myasthenia gravis (MG) affects overall quality of life (QoL). The aim of the research was to evaluate QoL in patients suffering from MG in regard to epidemiological and clinical factors of the disease.: Methods: The study included 70 ... ...

Abstract	Background: Myasthenia gravis (MG) affects overall quality of life (QoL). The aim of the research was to evaluate QoL in patients suffering from MG in regard to epidemiological and clinical factors of the disease. Methods: The study included 70 patients. The severity of clinical manifestation was estimated using quantitative MG score and MG composite score. Patients were classified by using Myasthenia Gravis Foundation of America Classification. The Questionnaire of Life Quality Specific for Myasthenia Gravis-15 items (MGQOL15) is developed for QoL assessment in patients suffering from MG. In addition to the MGQOL15 revised version (MGQOL15r), a 36-item health survey of the Medical Outcomes Study Short Form (SF36) questionnaire, the Hamilton scales for the assessment of anxiety (HAM-A), and depression (HAM-D) were also used. Results: MGQOL15r scores are negatively correlated with SF36 scores and positively correlated with scores on HAM-A and HAM-D scales (P<0.001). Patients with longer disease duration and severe clinical manifestation often manifest anxiety, depression, and have poorer QoL (P<0.05). In relation to the presence of the anti-nAchR antibody, statistically significant differences were found in relation to the summed scores on scales for assessing QoL, as well as on a HAM-A scale (P<0.05). Physical workers and unemployed patients had worse scores in relation to retired and administrators/intellectual workers on all scales (P<0.001). Conclusion: MGQOL15r is a life quality assessment questionnaire that could be used in routine practice in patients with MG. It is much simpler for use in these patients than SF36 and provides relevant data.
MeSH term(s)	Activities of Daily Living/psychology ; Adult ; Aged ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Myasthenia Gravis/diagnosis ; Myasthenia Gravis/psychology ; Quality of Life/psychology ; Severity of Illness Index ; Surveys and Questionnaires
Language	English
Publishing date	2019-06-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1361380-7
ISSN	2331-2637 ; 1074-7931
ISSN (online)	2331-2637
ISSN	1074-7931
DOI	10.1097/NRL.0000000000000238
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Article ; Online: The risk for nonpsychotic postpartum mood and anxiety disorders during the COVID-19 pandemic.

Stojanov, Jelena / Stankovic, Miodrag / Zikic, Olivera / Stankovic, Matija / Stojanov, Aleksandar

International journal of psychiatry in medicine

2020 Volume 56, Issue 4, Page(s) 228–239

Abstract: Objective: The coronavirus disease 2019 (COVID-19) appears to be the largest pandemic of our times. The aim was to recognize the risk factors for nonpsychotic postpartum mood and anxiety disorders (NPMADs) in women during the pandemic and state of ... ...

Abstract	Objective: The coronavirus disease 2019 (COVID-19) appears to be the largest pandemic of our times. The aim was to recognize the risk factors for nonpsychotic postpartum mood and anxiety disorders (NPMADs) in women during the pandemic and state of emergency police lockdown in Serbia. Methods: We assessed 108 postpartum women who completed the Edinburgh Postnatal Depression Scale (EPDS) and an additional survey constructed for this study. We also used the additional, previously mentioned survey, in 67 healthy age-matched women with children who were ≥2 years of age. The additional survey allowed us to gain insight into the impact of the pandemic as well as postpartum period on the risk of NPMADs. Results: In 16 (14.8%) subjects we found a score ≥10 on EPDS. Higher rates on the EPDS were noticed in elderly, single, and unemployed, women who lost their jobs due to the pandemic, or women who were dissatisfied with their household income (p < 0.05). The risk of NPMADs was linked significantly to quarantine, and social isolation, the absence of social support, as well as having emotional problems. Postpartum women, compared to non-postpartum women, were more anxious and had feelings of helplessness during social isolation. Conclusion: Understanding the factors that increase the risk of NPMADs during the pandemic could help prevent mental disorders during a possible future pandemic.
MeSH term(s)	Adult ; Animals ; Anxiety Disorders/epidemiology ; Anxiety Disorders/psychology ; COVID-19/psychology ; Cross-Sectional Studies ; Female ; Humans ; Middle Aged ; Mood Disorders/epidemiology ; Mood Disorders/psychology ; Pandemics/prevention & control ; Psychiatric Status Rating Scales ; Puerperal Disorders/epidemiology ; Puerperal Disorders/psychology ; Quarantine/psychology ; Risk Factors ; SARS-CoV-2 ; Serbia/epidemiology ; Social Support ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2020-12-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	220669-9
ISSN	1541-3527 ; 0091-2174
ISSN (online)	1541-3527
ISSN	0091-2174
DOI	10.1177/0091217420981533
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Article ; Online: Quality of sleep and fatigue in patients with the relapsing-remitting multiple sclerosis during the coronavirus disease-2019 pandemic.

Stojanov, Aleksandar / Vojinovic, Slobodan / Stojanov, Jelena / Malobabic, Marina / Stevic, Milos / Milosevic, Vuk / Stanojevic, Goran

Clinical neurology and neurosurgery

2021 Volume 205, Page(s) 106640

Abstract: ОBJECTIVE: Sleep disturbances and fatigue are frequent symptoms in multiple sclerosis patients. The aim was to assess the quality of sleep (QoS) and fatigue in patients with the relapsing-remitting multiple sclerosis (RRMS), during the coronavirus ... ...

Abstract	ОBJECTIVE: Sleep disturbances and fatigue are frequent symptoms in multiple sclerosis patients. The aim was to assess the quality of sleep (QoS) and fatigue in patients with the relapsing-remitting multiple sclerosis (RRMS), during the coronavirus disease-2019 (COVID-19) pandemic. Methods: The study included 67 patients with RRMS and 85 healthy control subjects. RRMS patients, who were tested in first half of 2019, were retested in April and May 2020, during the COVID-19 pandemic. We collected sociodemographic and clinical data, and also used the following questionnaires: Pittsburgh sleep quality index (PSQI), Fatigue Severity Scale (FSS), and Multiple Sclerosis Quality of Life-54 Instrument (MSQOL-54). Results: The FSS score and PSQI global score were significantly higher in patients with RRMS than in the control group (p < 0.01). We noticed a statistically significant difference between the results obtained a year ago and the results during the COVID-19 pandemic in PSQI global score (p < 0.01) and all subscores. Higher disability status was an independent predictor of the worse PSQI scores. Conclusion: During the COVID-19 outbreak worse QoS were noticed in RRMS patients than in healthy individuals. Also, QoS of RRMS patients is more affected during the COVID-19 pandemic than in regular circumstances. High levels of sleep disturbance and fatigue in RRMS patients correlates with worse life quality, female gender, lower educational level and partner status. The results of the present study provide evidence in support of regular screening and monitoring of fatigue and QoS in this patient population, especially during the pandemic states.
Language	English
Publishing date	2021-04-14
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2021.106640
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Article ; Online: Cytokine Gene Polymorphisms in Patients with Chronic Inflammatory Demyelinating Polyneuropathy.

Bozovic, Ivo / Perovic, Vladimir / Basta, Ivana / Peric, Stojan / Stevic, Zorica / Popadic, Dusan / Vukovic, Irena / Stojanov, Aleksandar / Milosevic, Emina

Cells

2023 Volume 12, Issue 16

Abstract: Innate and adaptive immune responses exert their role in CIDP pathogenesis through cytokine production. Single-nucleotide polymorphisms (SNPs) may alter cytokine gene expression, with a potential influence on the pathogenesis of autoimmune diseases. ... ...

Abstract	Innate and adaptive immune responses exert their role in CIDP pathogenesis through cytokine production. Single-nucleotide polymorphisms (SNPs) may alter cytokine gene expression, with a potential influence on the pathogenesis of autoimmune diseases. However, cytokine gene SNPs have not been assessed in CIDP patients yet. We assessed functional SNPs in the genes encoding IL-10 (rs1800896, rs1800871, rs1800872 and rs3024505), IL-6 (rs1800795), TNF (rs1800629 and rs361525), IL-12B (rs3212227), IFN-γ (rs2430561), GM-CSF (rs25882) and IL-17F (rs11465553) in a cohort of 88 CIDP patients and 486 healthy controls (HCs) via qPCR. We found an association of SNP in the
MeSH term(s)	Humans ; Cytokines/genetics ; Interleukin-10/genetics ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/genetics ; Diabetes Mellitus, Type 2 ; Interleukin-6/genetics ; Polymorphism, Single Nucleotide/genetics
Chemical Substances	Cytokines ; Interleukin-10 (130068-27-8) ; Interleukin-6
Language	English
Publishing date	2023-08-10
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells12162033
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