Browsing by Author "Bogićević, Dragana (8279362500)"

Background and Aim: Adverse effects are common in children treated with antiepileptic medications and may affect parental beliefs about treatment. The aim of the study was to investigate the relationship between adverse effects and parental beliefs about antiepileptic drugs used for the treatment of their children. Methods: The study was performed at the University Children’s Hospital, Belgrade, Serbia from 2013–2015. Parents of children treated with valproic acid, carbamazepine or lamotrigine, were eligible. They were asked to fill in the Beliefs about Medications Questionnaire (BMQ) and The Liverpool Adverse Events Profile (LAEP). Results: Parents of 127 children (average age 9.88 ± 4.16 years) of whom 111 had epilepsy (67 generalized, 44 focal) and 16 with febrile seizures participated in the study. Nervousness and/or agitation, weight gain, restlessness, headache, difficulty in concentrating, feeling of aggression and upset stomach were most frequent adverse effects, reported in 37% of the population. BMQ-specific necessity scores significantly correlated with parental education; parents with elementary school showed lower scores than those with higher education. The presence of difficulty in concentrating of their child was associated with higher BMQ concern scores (20.73 ± 4.25 vs. 18.99 ± 3.60, p = 0.043) as well as necessity scores (18.42 ± 3.31 vs. 16.40 ± 2.73, p = 0.017). Higher scores of BMQ-general overuse were reported in the presence of a headache (8.79 ± 2.81 vs. 7.64 ± 2.72, p = 0.027). Conclusions: The main finding of our study is that parental beliefs about antiepileptic drugs were associated with the presence of adverse effects. Understanding this relationship could allow physicians and pharmacists to structure better educational programs for parents of children treated with antiepileptic drugs. Education should be more focused towards understanding the adverse effects of antiepileptics which could alleviate parental concerns and strengthen their beliefs about the necessity of medication use in their children. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.

Aim. To identify potential risk factors for the development of subclinical hypothyroidism following long-term valproic acid monotherapy in children with epilepsy. Methods. Serumlevels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine, thyreoglobulin antibodies, and thyroid peroxidase antibodies were determined in 41 patients and in 41 sex- And age-matched healthy children. Results. Meanvalproic acid treatment durationwas 2.80?}1.96 years. The valproic acid group had higher serum thyroid-stimulating hormone (p<0.001) and free triiodothyronine (p<0.05) levels compared to the control group. Serum thyroid-stimulating hormone and free triiodothyronine were above the upper limit for healthy controls in 34% and 32% of patients, respectively, and no clinical features of thyroid dysfunction were observed. Duration of valproic acid monotherapy for less than four years was a risk factor for elevated thyroid-stimulating hormone levels. Conclusion. One third of children with normal range serum valproic acid levels may have elevated serum thyroid-stimulating hormone and free triiodothyronine levels, especially in the first four years of treatment.

Aim. To identify potential risk factors for the development of subclinical hypothyroidism following long-term valproic acid monotherapy in children with epilepsy. Methods. Serumlevels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine, thyreoglobulin antibodies, and thyroid peroxidase antibodies were determined in 41 patients and in 41 sex- And age-matched healthy children. Results. Meanvalproic acid treatment durationwas 2.80?}1.96 years. The valproic acid group had higher serum thyroid-stimulating hormone (p<0.001) and free triiodothyronine (p<0.05) levels compared to the control group. Serum thyroid-stimulating hormone and free triiodothyronine were above the upper limit for healthy controls in 34% and 32% of patients, respectively, and no clinical features of thyroid dysfunction were observed. Duration of valproic acid monotherapy for less than four years was a risk factor for elevated thyroid-stimulating hormone levels. Conclusion. One third of children with normal range serum valproic acid levels may have elevated serum thyroid-stimulating hormone and free triiodothyronine levels, especially in the first four years of treatment.

Neuromyelitis optica is a rare and severe autoimmune demyelinating disease of the central nervous system, clinicaly presented as optic neuritis and transverse myelitis that affects more than 3 spinal cord segments. Its initial course usually doesn't affect the brain. This feature differentiates it from the multiple sclerosis. It has a usual course of form with frequent relapses and rarely has a monophasic form. Frequent relapses often lead to a severe neurological deterioration (blindness, para/tetraplegia). The onset ranges from early childhood to late adulthood with the mean age in the forthies. Discovery of the autoantibodies directed toward aquaporine-4 receptor has significantnly revealed its pathogenesis. These antibodies are highly specific (99%) and sensitive (48- 72%) for the diagnosis of optic neuromyelitis. Current therapy strategy is directed toward intensive treatment of the acute relapse with i.v. methylprednisolone and plasmapheresis and remision prevention with imunosupressive drugs like azathioprine, mycophenolate mofetil and rituximab.

Introduction The prevalence of microalbuminuria (MA), the most important early marker of incipient nephropathy in patients with type 1 diabetes mellitus (T1DM), increases during puberty, the period of exaggerated physiological insulin resistance. Objective To assess the prevalence of MA and the relationship between MA and metabolic risk factors and pubertal hormones in adolescents with T1DM. Methods In a cross-section study involving a group of 100 adolescents of both sexes of mean age 14.90±2.18 years and with mean duration of T1DM 5.99±3.64 years, we assessed the presence of MA. In all patients, we determined albumin-to-creatinine ratio (ACR) in two or three morning first-void urine samples in the period up to 6 months. Persistent MA was confirmed in the patients with the finding of ACR rating 2.5-25 mg/mmol in males and 3.5-25 mg/mmol in females in two out of three first morning urine samples. Results MA developed in 16 (16.0%) patients. Predictors of MA determined by using multiple logistic regression were high HbA1c (OR 4.6; 95% CI 2.1-10.0), higher night-time SBP (OR 1.9; 95% CI 0.8-1.3) and higher insulin dose (OR 62.6; 95% CI 2.3-1678.5). Markers of insulin resistance such as higher body mass index (BMI) which was statistically significantly related to MA (ρ= 0.241, p<0.05) and higher dehydroepiandrosterone sulfate (DHEA-S) which was significantly higher in patients with MA (7.82 μmol/L vs. 5.02 μmol/L, p<0.01), were also identified as predictors but did not remain significant by multivariate analysis, possibly because of a small sample of subjects with persistent MA. Conclusion In addition to poor glycemic control and higher night-time systolic blood pressure, markers of insulin resistance (higher insulin dose, higher BMI and higher DHEA-S) contribute to the increased risk of MA.

Background/Aim. The umbilical cord blood (UCB) volume and hematopoietic stem cells count are used as indicators for hematopoietic potential of UBC units. These indicators are affected by a collection method and obstetric factors. It was established that birth weight and placental weight affect the volume and hematopoietic stem cells count in UCB units. The influence of other obstetric factors is less clear. The aim of this study was to investigate the impact of obstetric factors on hematopoietic potential of UCB units. Methods. The study involved 103 consecutive UCB units collected during 2013. Relationship of UCB volume, total nucleated cells, CD34+ cells and Colony Forming Unit-Granulocyte Monocyte count with maternal and neonatal characteristics was retrospectively analyzed. Results. It was shown that birth weight, placental weight and umbilical cord length ≥ 31 cm significantly increased the volume of collected samples, total nucleated cells, CD34+ cells and Colony Forming Unit-Granulocyte Monocyte count. Gestational age between 38−40 weeks increased significantly all umbilical factors (volume, total nucleated cells, CD34+ cells, and Colony Forming Unit-Granulocyte Monocyte count). Gender did not have an influence on quality of UCB units except on total nucleated cells and CD34+ cells count. Other obstetric factors did not affect significantly the quality of UCB units. Conclusion. Our study confirmed that birth weight, placenta weight, length of the umbilical cord and gestational age independently influenced the UCB unit volume, and absolute count of nuclear cells and hematopoietic stem cells. Due to a positive correlation between birth weight and placental weight, only birth weight, umbilical cord length and gestational age should be standard parameters in procedure of donor selection. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.