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Uvod: Mediteranska prehrana podrazumijeva svakodnevni unos cjelovitih žitarica, voća, povrća, maslinovog ulja i orašastih plodova, kao i svakodnevnu umjerenu konzumaciju crnog vina i mliječnih proizvoda, tjedni unos mahunarki, krumpira, ribe, jaja i peradi te vrlo nizak unos crvenog mesa i slatkiša. Cilj istraživanja: Cilj istraživanja bio je ispitati zastupljenost mediteranske prehrane među gimnazijalcima u Splitu. Materijali i metode: Presječno istraživanje provedeno je tijekom svibnja 2018. g. među učenicima trećih razreda gimnazija iz Splita (n=503). Učenici su ispunili upitnik o prehrambenim navikama na temelju kojeg smo izračunali indeks mediteranske prehrane. Rezultati: Ukupno se 6, 2% učenika i 5, 6% učenica hranilo po principu mediteranske prehrane. Učenici su najbolje slijedili preporuke piramide mediteranske prehrane za krumpir (87, 7%). Primjerenu konzumaciju voća imalo je 55, 6% učenika, žitarica njih 30, 5%, dok je svakodnevna konzumacija povrća u najmanje 2 obroka zabilježena u 14, 4% učenika, a maslinovog ulja u 9, 6% učenika. Logističkom regresijom zabilježena je povezanost između mediteranske prehrane i ITM-a (OR 1, 32 ; 95% CI 1, 09-1, 6 ; P=0, 004 ), sati provedenih sjedeći (OR 1, 13 ; 95% CI 1, 01-1, 25 ; P=0, 027) i percepcije sreće (OR 1, 61 ; 95% CI 1, 11-2, 33 ; P=0, 012). Zaključak: Zabilježena je izuzetno niska zastupljenost mediteranske prehrane među gimnazijalcima iz Splita. Potrebno je hitno uložiti napore u promoviranju ovog zdravog načina života.

Prikaz slučaja bolesnice s psihogenim hemifacijalnim spazmom.

Preliminary data suggest that combined treatment with nicotine, or preferably nicotinic agonists that selectively stimulate nACh receptor subtypes, could improve LID. Prospective, controlled study is needed.

Prikazani su dijagnostički i terapijski pristupi bolesnicima s Wilsonovom bolesti

Severity of autonomic dysfunction correlates with clinical stage in iPD patients. Our results also indicate that OH could be characteristic feature for α-synucleinopathies while chronotropic incompetence could be related with disorders associated with tau pathology.

A Task Force was convened by the EFNS/MDS-ES Scientist Panel on Parkinson's disease (PD) and other movement disorders to systemically review relevant publications on the diagnosis of PD.Following the EFNS instruction for the preparation of neurological diagnostic guidelines, recommendation levels have been generated for diagnostic criteria and investigations.For the clinical diagnosis, we recommend the use of the Queen Square Brain Bank criteria (Level B). Genetic testing for specific mutations is recommended on an individual basis (Level B), taking into account specific features (i.e. family history and age of onset). We recommend olfactory testing to differentiate PD from other parkinsonian disorders including recessive forms (Level A). Screening for pre-motor PD with olfactory testing requires additional tests due to limited specificity. Drug challenge tests are not recommended for the diagnosis in de novo parkinsonian patients. There is an insufficient evidence to support their role in the differential diagnosis between PD and other parkinsonian syndromes. We recommend an assessment of cognition and a screening for REM sleep behaviour disorder, psychotic manifestations and severe depression in the initial evaluation of suspected PD cases (Level A). Transcranial sonography is recommended for the differentiation of PD from atypical and secondary parkinsonian disorders (Level A), for the early diagnosis of PD and in the detection of subjects at risk for PD (Level A), although the technique is so far not universally used and requires some expertise. Because specificity of TCS for the development of PD is limited, TCS should be used in conjunction with other screening tests. Conventional magnetic resonance imaging and diffusion-weighted imaging at 1.5 T are recommended as neuroimaging tools that can support a diagnosis of multiple system atrophy (MSA) or progressive supranuclear palsy versus PD on the basis of regional atrophy and signal change as well as diffusivity patterns (Level A). DaTscan SPECT is registered in Europe and the United States for the differential diagnosis between degenerative parkinsonisms and essential tremor (Level A). More specifically, DaTscan is indicated in the presence of significant diagnostic uncertainty such as parkinsonism associated with neuroleptic exposure and atypical tremor manifestations such as isolated unilateral postural tremor. Studies of [(123) I]MIBG/SPECT cardiac uptake may be used to identify patients with PD versus controls and MSA patients (Level A). All other SPECT imaging studies do not fulfil registration standards and cannot be recommended for routine clinical use. At the moment, no conclusion can be drawn as to diagnostic efficacy of autonomic function tests, neurophysiological tests and positron emission tomography imaging in PD.The diagnosis of PD is still largely based on the correct identification of its clinical features. Selected investigations (genetic, olfactory, and neuroimaging studies) have an ancillary role in confirming the diagnosis, and some of them could be possibly used in the near future to identify subjects in a pre-symptomatic phase of the disease.

I-123 Ioflupane brain SPECT and I-131 MIBG myocardial scintigraphy serve as a useful complementary diagnostic tools in patients with parkinsonism

TCD is useful support method for diagnosing iPD

Case report of patient with Wilson's disease presenting with dystonia

Izlaganje je posvećeno klasifikaciji, kliničkoj prezentaciji i molekularnoj patogenezi najučestalijih ataksija uz uvid u terapijske pristupe.

Case report of patient with Wilson's disease presenting with dystonia

The age of HC onset, clinical and genetic characteristics of the patients and the course of the disease did not differ significantly in our patients when comparing with other West European Studies.

Huntington's disease and/or chorea (HD) is autosomal dominant neurodegenerative disease that never skips generations. The first description was provided by George Huntington in the year 1872. Its prevalence in the world is 8-10 per 100000 inhabitants and in Croatia 4.46 per 100 000 inhabitants. It starts between 30 and 50 years of age and ends after 15-20 years with death. It is a disease of CAG triplet repeats and is characterized by poliglutamine repeats. The number of CAG trinucleotid repeats correlates with the age of the onset of the first symptoms, as well as with the clinical picture. The selective therapy for Huntington's chorea still does not exists and for symptomatic treatment the blockers of dopamine have turned out to be the most useful.

Being of the most frequent causes of insomnia, which in the end leads to chronic fatigue, inadequate performance of daily activities, and serious disruption of quality of living, restless legs syndrome (RLS) is nowadays not only a serious medical problem but a socio-economical one as well. Prevalence of the disorder in general population is estimated at 5 to 15%. Family history is positive in over 50% of idiopathic RLS patients which points to genetic basis of the disorder. The characteristics of the secondary or acquired form of RLS are symptoms that start later in life as well as a rapid progression of the disease. On the other hand, idiopathic RLS more often starts at a younger age and the prognoses are better. Over twenty disorders and conditions are brought in connection with secondary RLS. Although the cause of primary RLS is still unknown, there is a strong connection between central metabolism of iron as well as dopamine levels and RLS manifestation. A differential diagnosis of RLS includes a wide specter of motor and sensory disorders. Diagnosis is based on clinical features and the history of disease. To correctly diagnose idiopathic RLS one must first eliminate secondary causes of RLS and then also exclude any disorders with clinical features that mimic those of RLS. It has been estimated that some 20 to 25% of patients need pharmacological therapy. Best initial therapy is the application of nonergot dopamine agonists. Anticonvulsants, benzodiazepines and opioides can be given to patients who are refractory to dopaminergic therapy, those suffering from RLS with emphasized painful sensory component and those with RLS connected with insomnia.

This is the first prevalence study of RLS in Croatia showing the 9.5% prevalence of idiopathic RLS. Results found in this study are similar to the findings of other European countries and are in compliance with present knowledge.

According to our preliminary results TCS of BRN could not distinguish CD patients with and without depression, but further research is needed.