Chemotherapy-Induced Peripheral Neuropathy (CIPN) in Patients Receiving 4-6 Cycles of Platinum-Based and Taxane-Based Chemotherapy: A Prospective, Single-Center Study from Kosovo.

BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is most commonly associated with platinum-based drugs, taxanes, and vinca alkaloids. This prospective study from a single center in Kosovo aimed to evaluate CIPN in 120 patients receiving 4-6 cycles of platinum-based and taxane-based chemotherapy. MATERIAL AND METHODS One hundred twenty patients underwent neurological examination and nerve conduction studies (NCS) before chemotherapy, and after 4 to 6 cycles of treatment. Sixty patients were treated with platinum-based chemotherapy, 30 were treated with taxane-based chemotherapy, and 22 patients received a combination of platinum- and taxane-based chemotherapy. The most commonly used platinum-based compounds were oxaliplatin and carboplatin, whereas the most commonly used taxane medications were paclitaxel and docetaxel. Presence of neuropathy was confirmed with neurological examination of electrophysiological criteria applicable for polyneuropathies. Total Neuropathy Score (TNSr) was used to combine clinical and electrophysiological values. RESULTS Around 90% of patients self-reported neuropathic symptoms, and in 60% of them polyneuropathy was present in NCS. All sensory and motor nerves had significantly lower amplitudes (P<0.01). Platinum-based agents caused more pronounced decrease in ulnar nerve compound motor action potential (CMAP) (P<0.05); when used solely or in combination with taxanes, they caused significant decrease in tibial nerve CMAP (P<0.01). TNSr did not reach statistical significance between groups; only clinical muscle strength showed pronounced weakness in the combined protocol (P<0.05). CONCLUSIONS These findings support previous studies and show that CIPN, including sensory and motor symptoms, is commonly associated with chemotherapy. Platinum-based chemotherapy agents were more commonly associated with ulnar and tibial nerve damage in this study population.

Hypertension on admission is associated with a lower risk of early seizures after stroke.

PURPOSE: Despite the common occurrence of early seizures (ES) after stroke, the relationship between risk factors and this complication of stroke is not well established. In this study we have examined the relationship between clinical measures on admission and ES after stroke. METHODS: We included 1073 patients (mean age 69 ± 12, 51.6% females) with ischemic and haemorrhagic stroke. The frequency of seizure occurrence within 2 weeks of stroke was determined. We used a logistic regression model to analyse the effect of blood pressure on admission and other clinical factors (age, gender, diabetes, atrial fibrillation and dyslipidemia) on the occurrence of ES after stroke. RESULTS: ES occurred after 4.1% and 4.0% of ischemic and haemorrhagic strokes respectively. Compared to patients with high blood pressure on admission, those with low and normal blood pressure had a higher risk of ES after stroke (2.9% vs.7.5% vs. 7.6%, p=0.001). Also the mean age of patients with post-stroke ES was lower (62.5 vs. 69.3, p<0.001). In a logistic regression analysis, low/normal blood pressure remained independently associated with ES after stroke with OR of 2.46 (95% CI 1.38-4.63, p=0.006). CONCLUSION: ES after stroke was equally frequent in patients with ischemic and haemorrhagic stroke. Low/normal blood pressure on admission and younger patient age were risk factors for ES after stroke.

Prevalence of the hospitalisation of mentally ill offenders in the Forensic Unit of the Clinic of Psychiatry in Pristina over a three-year period and long-term strategy implications for the management of the Forensic Mental Health System Service.

BACKGROUND: As a new field in our country, forensic psychiatry needs strategies for management and rehabilitation programmes. AIM: The aim of this study was to evaluate the sociodemographic characteristics of psychiatrically diagnosed inpatients who were hospitalised in the three years from January 2009 to December 2011 and the prevalence of such diagnoses. The specific objectives of this study were to use our results to identify rehabilitation programmes for the treatment of patients and to identify the specific training needs of mental-health professionals. METHODS: In this retrospective study, we collected data about the sociodemographics and violent behaviour of all forensic inpatients who underwent court-ordered psychiatric forensic evaluation and assessment. We reviewed and studied the documented diagnoses based on the following criteria and sources: the ICD-10 criteria for mental disorders, the Structured Clinical Interview (SCID), recidivism rates, criminal data, court records and other hetero-anamnesis data. The data were analysed using a descriptive approach. RESULTS: The subjects were referred for forensic psychiatric evaluation, diagnosis and treatment either directly from prison (23.2%) or from the court (76.8%). The majority of the offenders (85.7%) were currently on trial, and charges of physically threatening others were more common than charges of domestic violence or murder. The prevalence of psychiatric diagnosis was 94.6%, and the most common diagnosis was psychosis (69.1%). Drug abuse and personality disorders, including high-risk behaviours, were also common. The overall relapse rate for aggressive behaviour was 48.9%. CONCLUSION: Rehabilitation programmes for treatment and management are needed that specifically focus on psychotic disorders, severe personality disorders and drug abuse.