Browsing by Author "Dimitrijević, Aleksandar (57202358971)"

Introduction Vitamin D intoxication represents a rare and potentially serious pathological condition caused by the excess of calcium and phosphorus. We are presenting an infant with vitamin D intoxication due to excessive daily administration, as well as therapeutic procedures that prevented its adverse effects. Case Outline A 1.5-month-old female infant, born at term, exclusively breastfed and without any complaints and abnormalities of physical findings, was observed due to the data that during the preceding month, by her mother's mistake, she had received about 200,000 IU of vitamin D3. Laboratory analyses showed a high serum level of 25(OH)D (>400 nmol/L) and calcium (2.72 mmol/L), lowered PTH (6.6 pg/ml) and high urinary calcium/creatinine ratio (1.6), while other findings, including urotract ultrasonography image, were within normal limits. Treatment based on the discontinuation of vitamin D administration, infant's forced water intake, as well as the application of 2-month prednisolone and 4-month pheno-barbitone and furosemide, resulted in complete normalization of the laboratory indicators of vitamin D overdose, as well as the prevention of its adverse effects.Conclusion By timely recognition and adequate treatment, including triple therapy with prednisolone, phenobarbitone and furosemide, adverse effects of acute vitamin D intoxication can be prevented © 2014, Serbia Medical Society. All rights reserved.

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.

Aim To determine changes in the quality of life associated with epilepsy in school-age children with newly diagnosed uncomplicated epilepsy over the first six months after diagnosis to find points relevant for the early prevention of deterioration in quality of life. Methods This prospective follow-up study, performed in University Children’s Hospital in Belgrade, enrolled 60 school-aged children with recently diagnosed epilepsy, along with their parents. The respondents completed the Children with Epilepsy Quality of Life immediately following the diagnosis of epilepsy and six months later. Results Significant decline was observed in the domains related to intrapersonal/emotional relationships by both children (P < 0.001) and their parents (P = 0.03), and in the need to keep epilepsy a secret as observed by parents (P = 0.04). Significant improvement was found in the Interpersonal/Social domain as rated by parents (P = 0.001). Total quality-of-life scores, as assessed by children and parents, did not change significantly. Conclusion Bearing in mind that stigma and intrapersonal struggles are the major factors affecting the quality of life in children with epilepsy, psychological and social support is highly recommended in the first six months following an epilepsy diagnosis. Since intrapersonal relationships improved over six months, compensating for other deteriorations in the quality of life, children with epilepsy should be encouraged to socialize with their peers and to join organizations and actions that encourage social contact. © 2024, Medicinska Naklada Zagreb. All rights reserved.

Introduction/Objective Previously, we have shown that six months after initiating monotherapy in school-age children with new-onset uncomplicated epilepsy, minimal changes in cognition and significant symptoms of anxiety, depression, and behavioral changes were observed. In the same group of children, we aimed to show and compare the effects of the most commonly used anti-seizure medications (ASMs) on cognition, psychopathological symptoms, and behavior, to provide guidance in selecting appropriate ASMs. Methods Children with newly diagnosed epilepsy completed the Revised Wechsler Intelligence Scale for Children in Serbian (REVISK), the Revised Child Anxiety and Depression Scale (RCADS), and the Nisonger Child Behavior Rating Form (NCBRF), immediately after initiating therapy and six months later, at the University Children’s Clinic in Belgrade. Results Scores on the social phobia subscale increased significantly in children on lamotrigine monotherapy compared to other ASMs, as well as on the separation anxiety disorder subscale and total internalizing symptoms in patients on ethosuximide (p < 0.05). The scores on the depressive disorder subscale increased significantly in those on ethosuximide, followed by levetiracetam (p < 0.05). There is no statistically significant difference in the change of other RCADS scores and REVISK and NCBRF scores between different types of ASMs during the six months (p < 0.05). Conclusion The subtle influence of the tested ASMs was already present during the first six months of treatment. Valproate led to a trend of improved cognition, while ethosuximide and levetiracetam contributed to worsening internalizing symptoms during the first six months. © 2025, Serbia Medical Society. All rights reserved.