The First Hospital-Based Registry of Patients with Multiple Sclerosis in Croatia.

The first hospital-based registry of patients with multiple sclerosis (MS) was established at the University Department of Neurology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia, in 2014. The aim of the registry was to continuously provide data on the number of hospital-managed MS patients, patterns of disease progression, predictors of disability progression, changes in lifespan and long-term outcomes. Relevant medical data included age and gender of MS patients, family history of MS, data on previous immunization, disease course, Expanded Disability Status Scale (EDSS) score, cerebral magnetic resonance imaging (MRI) lesion load quantification, and cerebrospinal fluid analysis.

Mediterranean diet in healthy lifestyle and prevention of stroke.

Several studies demonstrated the beneficial and preventive role of Mediterranean diet in the occurrence of cardiovascular diseases, chronic neurodegenerative diseases and neoplasms, obesity and diabetes. In randomized intervention trials, Mediterranean diet improved endothelial function and significantly reduced waist circumference, plasma glucose, serum insulin and homeostasis model assessment score in metabolic syndrome. Several studies support favorable effects of Mediterranean diet on plasma lipid profile: reduction of total and plasma LDL cholesterol levels, plasma triglyceride levels, and apo-B and VLDL concentrations, and an increase in plasma HDL cholesterol levels.

Moyamoya disease in a patient with brain tumor: case report.

A 40-year-old male presented to emergency room with epileptic grand mal seizure. He had untreated hypertension, and prior diagnostic investigation showed duplex renal arteries of the right kidney with hyperreninemia in the left renal vein. He was nonsmoker, with moderate alcohol intake.

Low high-density lipoprotein cholesterol as the possible risk factor for stroke.

Recent evidence suggests that lower HDL-cholesterol (HDL-C) may worsen the atherosclerotic process by promoting inflammation and progression from subclinical lesion to clinical event. Carotid intima-media thickness (CIMT) is recognized as a marker of early atherosclerosis and used to predict future vascular events. Among the common lipid parameters, LDL has strongest relation with carotid plaque.

There is no healthy level of smoking.

Cigarette smoking is the leading preventable cause of death in the world. Nicotine is a highly addictive substance. Nicotine dependence is a major barrier to successful smoking cessation.

The art: neuroscientific approach.

Scientists have for centuries tried to localize and define artistic talent. Modern diagnostic techniques that enable visualization and measurement of brain morphology and function are positron emission tomography (PET), magnetic resonance imaging (MRI), functional transcranial Doppler (fTCD) and some biochemical methods. In the majority of people, the left hemisphere is dominant, but the right hemisphere is considered to be creative, visual, imaginative and intuitive.

Neuropathic pain.

Neuropathic pain refers to pain that originates from pathology of the nervous system. Common causes of neuropathic pain are diabetes mellitus, reactivation of herpes zoster, nerve compression or radiculopathy, alcohol, chemotherapy or abuse of some drugs, and trigeminal neuralgia. Specific symptoms of neuropathic pain are mechanical allodynia and cold hyperalgesia.

Pineal gland cysts--an overview.

Pineal cysts occur in all ages, predominantly in adults in the fourth decade of life. In series of magnetic resonance imaging (MRI) studies, the prevalence of pineal cysts ranged between 1.3% and 4.

Treatment of multiple sclerosis.

Multiple sclerosis is an autoimmune inflammatory demyelinating disease of the central nervous system, characterized by multifocal inflammatory destruction of myelin, axonal damage and loss of oligodendrocytes. The disease is carried through two stages: inflammatory and degenerative. The most common form of disease in approximately 85% of the cases is RRMS (relapsing-remitting form).

Differential diagnosis and diagnostic algorithm of demyelinating diseases.

Demyelinating diseases of the central nervous system include a wide spectrum of different disorders that may resemble multiple sclerosis (MS). The diagnosis of MS is based on typical clinical and paraclinical criteria. The simplified McDonald's criteria, which combine clinical picture, NMR findings, CSF analysis and visual evoked potentials, are appropriate for daily neurologic routine.

Stroke unit--where all stroke patients should be treated.

Acute stroke is one of the leading causes of morbidity and mortality worldwide, and as the most important cause of morbidity and long-term disability imposes an enormous economic burden. Stroke units (SU) are an effective option to fight stroke. According to the European Stroke Organization, SU should provide coordinated multidisciplinary care provided by medical personnel specialized in stroke care.

Possibilities for rehabilitation after stroke.

The patient's own attitude, activity and social interaction influence functional outcome and quality of life after stroke. Rehabilitation of stroke patients should start as soon as the patient is in a medically stable condition. The concept of early rehabilitation should be provided by an interdisciplinary team, preferably in stroke units.

Post-stroke depression.

Depression following a stroke, also referred to as post-stroke depression (PSD), has long been recognized as one of the most common complications of stroke. PSD has significant adverse consequences on the recovery of motor and cognitive deficits, as well as on the risk of mortality associated with stroke. The prevalence of PSD varies over time with an apparent peak 3-6 months after stroke and subsequent decline reaching about 50% of the initial rates at one year.

Increased donor rate at Sestre milosrdnice University Hospital.

The rate of organ donation reflects the level of the respective society and country development. In Croatia, attempts have been made to increase this rate. As a consequence, the number of potential donors with confirmed brain death was observed to have steadily increased during the 2004-2008 period.

Gabapentin in the prophylaxis of cluster headache: an observational open label study.

Cluster headache is an extremely painful syndrome that occurs more frequently in men. Although periodic in most cases, cluster headache has a considerable impact on the patient quality of life. Acute therapy is usually not sufficient and most patients warrant prophylactic treatment.

Blood flow velocity in middle cerebral artery during visuo-motor tasks using a mirror: a transcranial Doppler study.

Mirror illusion means that standing in front of a mirror placed in sagittal plane, with the head tilted on one side and one arm stretched forward, one side of the body is reflected as if it were the other side by mirror visual feedback. The aim of this study was to monitor blood flow changes in middle cerebral artery (MCA) by use of transcranial Doppler (TCD) in individuals during motor tasks and tasks using mirror visual feedback. Eight young healthy volunteers (four male and four female) were included in the study.

The association of obesity and cerebrovascular disease in young adults--a pilot study.

Obesity has been recognized as an isolated risk factor for stroke. In obese patients, other risk factors for stroke such as hypertension, hyperlipidemia, ischemic heart disease and obstructive sleep apnea are more frequently present. The aim of this study was to assess the presence of obesity among other risk factors for stroke in younger adult patients with ischemic stroke.

Thrombolysis for acute ischemic stroke--our experiences as part of SITS-MOST.

Thrombolysis with intravenous recombinant tissue plasminogen activator (rtPA) is the first evidence based treatment for acute ischemic stroke, which aims to reduce the cerebrovascular lesion. At University Department of Neurology, Sestre milosrdnice University Hospital, Zagreb, thrombolytic therapy with intravenous rtPA (alteplase) (Actilyse) for acute ischemic stroke was introduced in 2004. We present our results referring to demographic, time logistics and clinical outcome data as part of SITS-MOST (Safe Implementation of Thrombolysis in Stroke - MOnitoring STudy) and compare them with the results from other centers in Croatia and all other participating centers.

Emergency EEG and diagnostic yield.

The aim of the study was to determine whether an acute loss of consciousness, mental status change or related symptoms correlated with the presence of epileptiform abnormalities on urgent EEG. We analyzed 228 consecutive patients admitted to Emergency Room during the past 12 months and referred for urgent EEG evaluation. All patients had either a brief loss of consciousness or acute brain disorder, with a clinical diagnosis of epilepsy, syncope, head trauma, headache, transient ischemic attack (TIA) or vertigo.

Prospective surveillance of Croatian pregnant women on lamotrigine monotherapy--aspects of pre-pregnancy counseling and drug monitoring.

We prospectively surveyed 23 pregnant women with epilepsy on lamotrigine monotherapy and reported outcome of their pregnancies, including one fetal intrauterine death, one spontaneous abortion and two preterm deliveries. There were no congenital malformations in their offspring. Women with pregnancy planning and folic acid intake delivered babies with higher values of birth weight and birth length.

Median nerve imaging using high-resolution ultrasound in healthy subjects.

Although electroneuro- and electromyography are still the leading diagnostic methods for investigation of peripheral nerve function, they do not provide information on their morphology. This study was conducted to evaluate the suitability of ultrasonography in visualization of median nerve in healthy volunteers. Twenty-five asymptomatic volunteers (17 women and 8 men), age range 21-47 years, participated in the study.