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  • Author: Ivan Barbov x
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Do Silent Brain Infarctions Predict the Development of Dementia After First Ischemic Stroke?


Background: Silent brain infarctions (SBI) are common findings in advanced age, but their relationship to dementia is still uncertain.

Aim The present study was designed to evaluate whether SBI predict the development of dementia after first clinical ischemic stroke.

Methods: We blindly studied admission CT scans of 102 consecutive nondemented patients presenting with ischemic stroke that clinically was their first stroke episode. SBI were defined as CT evidence of infarcts not compatible with the acute event. The patients were subsequently followed for their mental state for 2 years. Survival analysis, wherein onset of dementia was the end point, was performed on the total sample population and conducted separately on those with and without SBI at admission.

Results: Dementia developed in 33 patients (32.3%), including 17 of the 37 (45.9%) with SBI and 16 of the 65 (24.6%) without SBI. Thus, dementia was strong related to SBI.

Conclusion: Elderly people with silent brain infarcts and stroke have an increased risk of dementia and a steeper decline in cognitive function than those without such lesions

Open access
Strategies to Enhance the Intravenous Treatment Satisfaction and Drug Safety Awareness Among Patients with Multiple Sclerosis in Macedonia


Background: Multiple sclerosis (MS) treatment aims not only to prevent the rate of relapse, but also to slow down patient’s disability progression. Monoclonal antibodies constitute a new class of therapeutic agents and are administered by intravenous (IV) infusion. Treatment satisfaction and incidence of adverse drug events influence the patient’s treatment adherence which is essential to ensure patients obtain the best treatment outcomes and also to make that treatment cost-effective. Our primary objective was to assess the current IV treatment satisfaction among MS patients.

Methods: A standard questionnaire was developed which contained 20 questions about patient’s disease, IV treatment satisfaction and drug safety awareness. Analyzed data was presented as a percent of the respondents.

Results: The cross-sectional study included 13 MS patients on IV treatment, with mean age of 35 years. 54% of them had relapse-remitting MS, while 46% had secondary progressive MS. The most common onset symptoms were tingling reported in 46% and numbness in 31% patients. 70% of patients were satisfied, while 23% were not satisfied with the conditions under which they were receiving their IV treatment that lasts in average 2 hours. Well-established pharmacovigilance practice enhanced the patient’s knowledge that was reflected through 100% reporting of adverse drug reactions in the past.

Conclusion: High level of satisfaction from the current IV treatment conditions and high drug safety awareness among MS patients was shown. Establishment of infusion centre as a proposed strategy by MS patients would substantially increase their IV treatment satisfaction and adherence.

Open access
Patients with Schizophrenia and Self-Care


INTRODUCTION: Patients with schizophrenia have severe problems with self-care which affects their quality of life.

OBJECTIVE: The aim of the paper was to monitor self-care in patients with schizophrenia and to find out the differences regarding socio-demographic characteristics and ambulatory and day hospital treatment.

METHOD: The investigation included 120 subjects each with diagnosis F20 according to ICD 10 criteria; divided in two groups of 60 patients regarding their actual treatment (the first group received ambulatory care whereas those from the second group had a day hospital treatment). Patients were of different age and gender, receiving regular antipsychotic therapy. They were included in individual and group psychosocial therapeutic procedures during the day hospital treatment. The investigation utilized the following diagnostic instruments: standardized clinical interview and Personal and social performance scale (PSP scale), non-standardized questionnaire of socio-demographic data, family support and existence of mental disorder in other family members.

RESULTS: The results have shown better personal and social functioning in patients who had family support, in those who are employed, in those with no mental disorder in other family members and in patients on day hospital treatment against patients receiving ambulatory care.

CONCLUSION: Day hospital treatment, family support and social support improve self-care of patients with schizophrenia.

Open access