Browsing by Author "Grgić, Sanja (56698137700)"

Background/Aim. Chronic low back pain syndrome (CLBPS) is the most common cause of functional disability and loss of working ability in developed countries. Some research shows that neuropathic pain (NP) is present in almost 50% of patients with CLPBS. The aim of this study was to determine the characteristics of NP and its impact on quality of life (QoL) in patients with CLBPS. Methods. Patients were tested using three questionnaires for NP: Pain Detect Questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and Douleur Neuropathique 4 questions. Thirty-two patients diagnosed with NP based on current clinical criteria and with positive results for NP on all three NP questionnaires formed an experimental group. A control group consisted of 32 patients with CLBPS who did not fulfill clinical criteria for NP and were negative for NP on all three questionnaires. Hamilton depression and anxiety rating scales (Ham-D and Ham-A, respectively) and Short Form (SF)-36 questionnaire were also applied. Results. According to magnetic resonance imaging (MRI), disc herniation was typically detected in the experimental group, while degenerative changes were commonly found in the control group. Patients from the experimental group had significantly greater intensity of pain, pain radiation in the legs, and the pain was usually presented as episodes of sudden attacks with mild pain between them. The most distinctive features of NP were allodynia, electric shock sensation, and hypoesthesia to prick. Patients from the experimental group also had significantly higher depression and anxiety scores, as well as worse QoL compared to the control group, especially in mental domains. Predictors of worse QoL in the patients with CLBPS were a higher level of anxiety and depression. Conclusion. The presence of allodynia, electric shock-like sensations, and hypoesthesia to prick in patients with CLBPS suggest NP. CLBPS patients with NP had worse scores in mental domains of QoL compared to CLPBS patients without NP. © 2022 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. Diagnosis of amyotrophic lateral sclerosis (ALS) is based on combination of clinical signs and electrophysiological correlates of pathological process which takes place in general. New electrophysiological criteria Awaji-Shima (AS) additionally qualify the complex fasciculations and neurogenically modified potentials of motor units as signs of active lesions of peripheral motor neuron, contrary to previously valid revised El Escorial criteria (rEE). The objective of this research was to determine the clinical significance and advantages of using the AS criteria in patients with ALS. Methods. Thirty patients (59.2 ± 10.9 years, 57% of them with spinal form of the disease) with clinically suspected ALS were monitored from the time of diagnosis until reaching the category of definitive diagnosis or death. The clinical evaluation and electromyographic (EMG) examinations were carried out at 3-month intervals. Results. By applying the AS criteria, the category of probable or definite diagnosis was achieved in all patients with ALS, except in one (96.6%), as contrary to the rEE (33.3%), after 6 months of the follow-up period. The subclinical affection in more than two body regions has been defined through detection of denervation potentials (80% of the patients by using the AS, or 67% by the rEE criteria). The complex fasciculations were registered particularly often in small muscles of the feet (37– 40%). Conclusion. Application of the AS criteria improve the achievment of category of probable or definite diagnosis of ALS by 2.7 months earlier compared to the rEE. This outcome is particularly affected by a higher frequency of positive EMG findings, when the AS criteria were employed. Early determination of diagnosis provides the better perspective and more frequent participation of the ALS patients in pharmacotherapy studies intended to establish new therapeutic options. © 2018, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. The prevalence of diabetes mellitus in general population is constantly increasing. On the other hand, the number of diabetic patients with neuropathic pain is large. The aim of the study was to examine influence of neuropathic pain on quality of life (QoL) in patients with diabetic sensorimotor polyneuropathy (DSPN) who did not have any other diabetic complication or any other significant comorbidity. Methods. A total of 32 patients with DSPN and definitive neuropathic pain were compared with 32 patients with DSPN without neuropathic pain. The respondents were matched according to age, gender, and duration of illness. The following scales were used: the Pain Detect Questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, Douleur Neuropathique EN 4 Questions, Hamilton depression and anxiety rating scales, Neuropathy Impairment Score of the Lower Limb (NIS-LL), and the Short Form 36 Health Survey Questionnaire (SF-36). Results. Patients with neuropathic pain had significantly more severe DSPN measured with NIS-LL (p < 0.01). They were more likely to be engaged in physical work (p < 0.05), and had more symptoms of depression (p < 0.05) than patients without neuropathic pain. Patients with neuropathic pain had significantly lower QoL in both physical and mental domains (p < 0.01). Independent predictors of worse QoL in DSPN were presence of depression (beta=-0.58, p < 0.01) and presence of neuropathic pain (beta = -0.23, p < 0.05) - R2adjusted = 0.48. Conclusion. Independent predictors of QoL in patients with DSPN were presence of depression and neuropathic pain, which signifies importance of their early recognition and early treatment. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.