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Search Results: 1 - 10 of 402645 matches for " Pavlovi? Aleksandra M. "
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Dementia and diabetes mellitus
Pavlovi? Dragan M.,PavloviAleksandra M.
Srpski Arhiv za Celokupno Lekarstvo , 2008, DOI: 10.2298/sarh0804170p
Abstract: Dementia and Diabetes mellitus (DM) are major health problems nowadays. DM leads to a significant cognitive decline and increases the risk of dementia, mostly Alzheimer's Disease (AD) and vascular dementia (VaD) by 50-100% and 100-150%, respectively. Amyloid beta (Abeta), the main pathogenic factor in AD development, is eliminated by advanced glycation end products (AGEs) and degraded by insulin degrading enzyme (IDE) for which it competes with insulin. Insulin stimulates secretion of Abeta and promotes brain inflammation. DM I and II cause slowing down of mental speed, lowering of mental flexibility and DM II learning and memory disturbances. DM acts both directly by hyperglycaemia and hyperinsulinaemia and by the blood vessel changes. Hyperglycaemia changes synapse plasticity and leads to cognitive decline. AGEs disrupt the neuron function and bonding to Abeta increases its aggregability. Glycation of tau protein promotes production of neurofibrillary tangles (NFT), the main intracellular pathogenic factor in AD. AGE2 in DM causes pathological angiogenesis and apoptosis of neurons. AGE receptor (RAGE) is also the specific Abeta receptor with which it produces reactive oxygen species that has, as a result, disruption of mitochondrial function and reduction of neuronal energy resources. Insulinoresistance is linked with the dysexecutive syndrome, and hyperinsulinaemia increases the risk of AD especially by enhancing phosphorylation of tau protein and formation of NFT. Application of insulin showed improvement of memory, behaviour and affect in AD patients. Good glycoregulation emerged as an important factor in dementia prevention, and a better insight in relations of DM and brain function will lead to new potential dementia therapies. .
Antiphospholipid syndrome
Pavlovi? Dragan M.,PavloviAleksandra M.
Srpski Arhiv za Celokupno Lekarstvo , 2010, DOI: 10.2298/sarh1010651p
Abstract: Antiphospholipid syndrome (APS) is an autoimmune disease with recurrent thromboses and pregnancy complications (90% are female patients) that can be primary and secondary (with concomitant autoimmune disease). Antiphospholipid antibodies are prothrombotic but also act directly with brain tissue. One clinical and one laboratory criterion is necessary for the diagnosis of APS. Positive serological tests have to be confirmed after at least 12 weeks. Clinical picture consists of thromboses in many organs and spontaneous miscarriages, sometimes thrombocytopaenia and haemolytic anaemia, but neurological cases are the most frequent: headaches, stroke, encephalopathy, seizures, visual disturbances, Sneddon syndrome, dementia, vertigo, chorea, balism, transitory global amnesia, psychosis, transversal myelopathy and Guillain-Barre syndrome. About 50% of strokes below 50 years of age are caused by APS. The first line of therapy in stroke is anticoagulation: intravenous heparin or low-weight heparins. In chronic treatment, oral anticoagulation and antiplatelet therapy are used, warfarin and aspirin, mostly for life. In resistant cases, corticosteroids, intravenous immunoglobulins and plasmapheresis are necessary. Prognosis is good in most patients but some are treatment-resistant with recurrent thrombotic events and eventually death.
Mild cognitive impairment
Pavlovi? Dragan M.,PavloviAleksandra M.
Srpski Arhiv za Celokupno Lekarstvo , 2009, DOI: 10.2298/sarh0908434p
Abstract: Mild cognitive impairment (MCI) is a syndrome that spans the area between normal ageing and dementia. It is classified into amnestic and non-amnestic types, both with two subtypes: single domain and multiple domains. Prevalence of MCI depends on criteria and population and can vary from 0.1 to 42% persons of older age. In contrast to dementia, cognitive deterioration is less severe and activities of daily living are preserved. Most impaired higher cognitive functions in MCI are memory, executive functions, language, visuospatial functions, attention etc. Also there are depression, apathy or psychomotor agitation, and signs of psychosis. Aetiology of MCI is multiple, mostly neurodegenerative, vascular, psychiatric, internistic, neurological, traumatic and iatrogenic. Persons with amnestic MCI are at a higher risk of converting to Alzheimer's disease, while those with a single non-memory domain are at risk of developing frontotemporal dementia. Some MCI patients also progress to other dementia types, vascular among others. In contrast, some patients have a stationary course, some improve, while others even normalize. Every suspicion of MCI warrants a detailed clinical exploration to discover underlying aetiology, laboratory analyses, neuroimaging methods and some cases require a detailed neuropsychological assessment. At the present time there is no efficacious therapy for cognitive decline in MCI or the one that could postpone conversion to dementia. The treatment of curable causes, application of preventive measures and risk factor control are reasonable measures in the absence of specific therapy.
Constructional apraxia in patients with closed head injury
Pavlovi? Dragan M.,PavloviAleksandra M.
Vojnosanitetski Pregled , 2005, DOI: 10.2298/vsp0505339p
Abstract: Introduction. Constructional apraxia is a disorder characterized by an inability to join the elements into a unity. It has not been studied much in patients with closed head injury (CHI). Methods. Forty-one patients with CHI were examined, of which 11 (26.83%) were with the right-sided, 12 (29.27%) with the left-sided, and 18 (43.90%) with bilateral lesion using the Wechsler Individual Intelligence Test (VITI) - Serbian version, Rey Complex Figure (RCF) test, Trail Making Test - TMT A and B, and the Wisconsin Card Sorting Test (WCST). Results. Intelligence quotient (IQ) was significantly higher in the patients with the right-sided (95.27) and bilateral cerebral lesions (87.56) than in the left-sided (84.42). RCF scores did not show any significant difference regarding the side of the lesion, but was numerically the lowest scores were in patients with bilateral brain damage. Patients with left-sided lesions had the score of 30.63, right-sided of 28.68, and bilateral of 27.39. TMT B showed a significantly lower result in patients with the left-sided (196.50 seconds) and bilateral lesions (192.07 seconds) compared to the right-sided (140.14 seconds). WCST scores were not significantly different regarding the side of the lesion, but the absolute value of the categories was less than expected. Conclusion. Constructional apraxia was more frequently present in the patients with CHI than it was previously considered. The use of sensitive tests can show the presence of the disorder mainly in bilateral, but also in unilateral lesions.
Pharmacotherapy of dementia
Pavlovi? Dragan M.,PavloviAleksandra M.,Toti? Sanja
Vojnosanitetski Pregled , 2010, DOI: 10.2298/vsp1005419p
Abstract: nema
Pathogenesis of Alzheimer disease
Pavlovi? Dragan M.,PavloviAleksandra M.,?ugi? Stana
Vojnosanitetski Pregled , 2007, DOI: 10.2298/vsp0711765p
Abstract:
The neuropsychology of hallucinations
Pavlovi? D.M.,PavloviAleksandra M.,La?kovi? Maja
Archives of Biological Sciences , 2011, DOI: 10.2298/abs1101043p
Abstract: Hallucinations are a psychopathological phenomenon with neuropsychological, neuroanatomical and pathophysiological correlates in specific brain areas. They can affect any of the senses, but auditory and visual hallucinations predominate. Verbal hallucinations reveal no gross organic lesions while visual hallucinations are connected to defined brain lesions. Functional neuroimaging shows impairments in modality specific sensory systems with the hyperactivity of the surrounding cerebral cortex. Disinhibition and expansion of the inner speech was noted with impaired internal monitoring in auditory verbal hallucinations. The subcortical areas and modal-specific associative cortex and cingulate cortex are essential for the occurrence of hallucinations.
Omega 3 fatty acids in psychiatry
Pavlovi? D.M.,PavloviAleksandra M.,La?kovi? Maja
Archives of Biological Sciences , 2013, DOI: 10.2298/abs1301043p
Abstract: Omega-3 long-chain polyunsaturated fatty acids (ω-3 LC-PUFAs) are thought to be important for normal dopaminergic, glutamatergic and serotonergic neurotransmission. Depression is less prevalent in societies with high fish consumption, and depressed patients have significantly lower red blood cell ω-3 levels. Studies with ω-3 supplementation have led to controversial results. A significantly longer remission of bipolar symptomatology has been confirmed from a high-dose DHA and EPA mixture. Greater seafood consumption per capita has been connected with a lower prevalence of bipolar spectrum disorders. Reduced levels of ω-6 and ω-3 PUFAs were found in patients with schizophrenia. [Projekat Ministarstva nauke Republike Srbije, br. 175033 i br. 175022]
The anterior cingulate cortex
Pavlovi? D.M.,PavloviAleksandra M.,La?kovi? Maja
Archives of Biological Sciences , 2009, DOI: 10.2298/abs0904659p
Abstract: The anterior cingulate cortex (ACC) has a role in attention, analysis of sensory information, error recognition, problem solving, detection of novelty, behavior, emotions, social relations, cognitive control, and regulation of visceral functions. This area is active whenever the individual feels some emotions, solves a problem, or analyzes the pros and cons of an action (if it is a right decision). Analogous areas are also found in higher mammals, especially whales, and they contain spindle neurons that enable complex social interactions. Disturbance of ACC activity is found in dementias, schizophrenia, depression, the obsessive-compulsive syndrome, and other neuropsychiatric diseases.
Hashimoto encephalopathy: Neurological and psychiatric perspective
Pavlovi? D.M.,PavloviAleksandra M.,La?kovi? Maja
Archives of Biological Sciences , 2009, DOI: 10.2298/abs0903383p
Abstract: Hashimoto encephalopathy (HE) is an autoimmune disease with neurological and neuropsychiatric manifestations and elevated titers of antithyroid antibodies in serum and cerebrospinal fluid. Patients are mostly women. Age varies from 8 to 86 years. Prevalence of HE is estimated to be 2.1/100,000. Neurological and/or psychiatric symptoms and signs constitute the clinical picture. The disease responds well to corticosteroid therapy, but sometimes other immunomodulatory therapies must be applied. Autoimmune mechanisms with antibodies against antigens in the brain cortex are suspected. The course of the disease can be acute, subacute, chronic, or relapsing/remitting. Some patients improve spontaneously, but a few died in spite of adequate therapy.
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