Introduction:Recent research reported that prolonged use of AET is associated with changes in bone metabolism, with consequent reduction in bone mineral density (BMD) and increased risk of fractures.Objectives:Therefore, the aim of our study was to investigate the effects of carbamazepine on serum levels of 25 -hydroxyvitamin D and on biomarker of bone formation and resorption (serum levels of osteocalcin).Material and methods:We measured serum levels of 25-OHD and osteocalcin (OCLN) in normal controls (n=30) and in epilepsy patients taking carbamazepine (CBZ) (n=50) in monotherapy for a period of at least twelve months. For each participant, mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry method.Results:The average value of vitamin D in serum was significantly lower in CBZ group than in control group (Vit D 17.03+12.86 vs. 32.03+6.99, p=0.0001). The average value of osteocalcin in serum was significantly higher in CBZ group than in control group (26.06+10.78 vs. 19.64+6, 54, p=0.004).BMD value in CBZ group was significantly lower than in control group (T. score CBZ: 0.08+1.38 vs. T. score control: 0.73+ 1.13, p=0.031; Z score CBZ:-0.05+1.17 vs. Z. score control: 0.55+0.79, p=0.015).Conclusion:AEDs are associated with bone disease, as evidenced by biochemical abnormalities and decreased BMD. Patients on long-term antiepileptic therapy, especially with enzyme-inducing agents, could benefit of routine measurement of biochemical markers of bone turnover, and BMD measurement as part of osteoporosis investigation.
Conflict of interest: none declared.GoalsThe goals of this research are: a) to determine the number, gender and age representation of patients with a working diagnosis of acute stroke referred by the Institute for Emergency Medical Care (IEMC) in the Clinical Center of Sarajevo University (CCSU); b) determine the incidence of patients that have been or have not been hospitalized and why; c) determine the time and procedure for emergency medical care; d) to determine the characteristics and outcomes of patients hospitalized with ischemic stroke at the Neurology Clinic CCUS.Material and methodsThe study was retrospective and included time period from 1st June 2010 to 30th November 2010. The study included patients of both sexes, older than 18 years of age.ResultsThe study included a total of 233 patients. Of these, 65% are female, while 35% of patients were male. Of 82 patients who were admitted to hospital treatment at the Neurology Clinic, 55% of the patients were male and 45% female. The largest number of patients is older than 70 years (71%). Minimum time for emergency medical team arrival was 6 minutes and maximum 70 minutes (mean 35, SD 11.989). Motor weakness was noted in 31% of patients – left sided motor weakness was significantly more represented. In 73% of patients the diagnosis was confirmed. In 5% of patients thrombolytic therapy was administered, while 95% of patients were treated conservatively. Lethal outcome occurred in 30% of hospitalized patients, 37% were discharged as recovered, 30% were discharged as unaltered state, while 3% were discharged with worsening symptoms. Among risk factors, hypertension is the leading one, followed by an earlier stroke, diabetes mellitus, and cardiac arrhythmias.ConclusionsIn 91% of patients consciousness was preserved. In 73% of transported patients has been confirmed the diagnosis of ischemic stroke. Of the patients with confirmed diagnosis 59% were hospitalized. A significant number of strokes occur for the first time in relation to relapse. 5% of patients were treated with thrombolysis, while others were treated with conservative therapy. Recurrent stroke and patient confusion have significant impact on the outcome.
Background Translations of instruments for measuring quality of life developed in certain, mostly more developed, parts of the world usually do not cover regionally specific aspects of health-related quality of life, even after transcultural validation. The aim of this study was to develop and validate a reliable questionnaire in Serbian, Croatian, Bosnian, and Montenegrin languages suitable for measuring health-related quality of life in adults. Methods The study was of a cross-sectional type, assessing the reliability and validity of a newly developed questionnaire for measuring health-related quality of life (HRQoL) in adults residing in western Balkan states (WB-HRQoL). It was conducted on a sample of 489 adults from Serbia, Croatia, Bosnia & Herzegovina, and Montenegro, with a mean age of 52.2±14.4 years and a male/female ratio of 195/294 (39.9%/60.1%). Result The definitive version of the WB-HRQoL scale with 19 items showed very good reliability, with Cronbach’s alpha 0.905. The scale was temporally stable, and satisfactory results were obtained for divergent and convergent validity tests. Exploratory factorial analysis brought to the surface four domains of health-related quality of life, namely the physical, psychical, social, and environmental. Conclusion The WB-HRQoL scale is a reliable and valid generic instrument for measuring HRQoL that takes into account the cultural specifics of the western Balkan region.
<p><strong>Objective. </strong>The objective of our study was to investigate the effects of carbamazepine (CBZ) and lamotrigine (LTG) treatment on bone metabolism in epileptic patients.</p><p><strong>Patients and Methods. </strong>A cross-sectional study was performed on normal controls (N=30) and 100 patients with symptomatic epilepsy caused by a primary brain tumor, divided into two groups according to the treatment: LTG monotherapy group (N=50) and CBZ monotherapy group (N=50). For each participant serum levels of 25-OHD and osteocalcin (OCLN) were measured, and bone mineral density (BMD) was evaluated by the dual-energy X-ray absorptiometry method.</p><p><strong>Results</strong>. There was no statistically significant difference in the average values of vitamin D in serum between the CBZ and LTG groups (Vitamin D CBZ 17.03±}12.86 vs. Vitamin D LTG 17.97±}9.15; F=0.171, P=0.680). There was no statistically significant difference in the average values of OCLN between the CBZ and LTG groups (OCLN CBZ 26.06±}10.87 vs. OCLN LTG 27.87±}28.45; F=0.171, P=0.674). The BMD value was lower in both groups using antiepileptic agents compared to the controls, but when comparing the CBZ group to the LTG group, a statistically significant difference was only observed for the Z score (T-score CBZ: 0.08±} 1.38 vs. T-score LTG: 0.37±} 1.02; F=1.495, P=0.224; Z score CBZ: -0.05±}1.17 vs. Z. Score CBZ: 0.38±}0.96; F=4.069, P=0.046) (Table 3).</p><strong>Conclusion</strong>. The choice of antiepileptic agents for treating seizures in patients with brain tumors should be carefully evaluated in relation to their impact on bone health. These patients could benefit from supplementation and regular measurement of biochemical markers of bone turnover and BMD.
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