Screening general practice patients for migraine without aura: construction and validation of the Balkan Migraine Screening Questionnaire (BMSQ).

Aim To develop and validate a screening questionnaire for migraine without aura with sufficient diagnostic accuracy to be used in primary care settings. Methods The study was designed as cross-sectional, multicentric, diagnostic accuracy trial of new questionnaire for screening patients who visit general practitioners, with an aim to reveal migraine without aura. The instrument was constructed for the purpose of this study, and validated on the sample of 429 primary care outpatients. The gold standard of diagnosing migraine without aura was clinical estimate by a neurologist based on the International Classification of Headache Disorders 3rd edition (ICHD-III) criteria. Diagnostic accuracy of the instrument was tested through construction of the Receiver Operator Curve. Results The Balkan Migraine Screening Questionnaire (BMSQ) instrument showed good diagnostic accuracy (sensitivity 83.4% and specificity 79.9%) for migraine without aura, with significant screening yield among previously undiagnosed patients of 75.9%. The study also confirmed a high percentage of patients with hidden migraine without aura (MWA) (52.9%) revealed by the BMSQ and the ICHD-III criteria that would otherwise remain undiagnosed. Conclusion The BMSQ is a valid and reliable clinical instrument for revealing migraine without aura, which could be easily selfadministered by patients. It has high screening yield, discovering majority of patients with previously undiagnosed migraine without aura, whose definite diagnosis should later on be confirmed by the attending physicians using the ICHD-III criteria.

Hexagon TB for the rapid diagnosis of lung TBC in praxis.

Hexagon TB is intended for the rapid diagnostics of tuberculosis. Tuberculosis is a contagious and epidemic disease. According to the data published by WHO, 3-4 millions of patients are diagnosed with this disease annually. In 2004, 107 new cases were discovered in the area of Tuzla Municipality. Annual incidence of this disease is 62,9 per 100 000 inhabitants in Bosnia and Herzegovina; 28,9 in Slovenia; 33,2 in FYRM; 48,5 in Croatia; 41,8 in Serbia and Montenegro. Western European countries have a rather low rate of the disease--5-10 cases per 100 000 inhabitants. Efficiency of Hexagon TB examination method was tested on 100 patients. The subjects were patients with clinical symptoms of active TBC infection, persons who were in contact with TBC patients and persons earlier cured of TBC. All the subjects were tested with Hexagon TB, and the results were compared against lungs X-rays and sputum test for BK and LOW. Hexagon TB is intended for rapid, qualitative detection of IgG, IgA, IgM antibodies against M. tuberculosis and mycobacterium in human serum, plasma or whole blood as an aid in the early diagnostics of tuberculosis infections for professional use. Hexagon TB was positive in 11 of the examined patients. 10 patients had changes suggesting TBC. 1 patient was directly positive for BK and 3 patients were positive for LOW. Of all the examined patients, 3 were positive for all tests positive. According to our results, Hexagon TB has significant importance in practice of rapid TBC diagnostics compared to lungs X-ray and examination of sputum for BK and LOW.

Intensive observation of toxic side effects after several-year of cyclosporin treatment in kidney transplant patient.

In this work we are going to show results of intensive observation of adverse reactions of cyclosporine therapy during 18 months. The research was applied on 30 patients with kidney transplant. The medium time of kidney transplant survival was 9,7+/-2,3 years, with time span of 6 to 15 years. All the patients were subjects to several years' cyclosporine treatment, which was applied on a daily basis with a dosage of 2 to 5 mg/kg of body weight. The concentration of cyclosporine in blood was measured once a month. The concentration of cyclosporine in blood in 19 patients was in referent values of 122,50 nag/ml up to 280,50 nag/ml of blood. In 4 of the patients the concentration was heightened up to 370 to 538 nag/ml (X=766,37 nag/ml), and in 7 patients cyclosporine was below normal dosage down to 30,78 to 96,30 nag/ml in blood (x=77,12 nag/ml). We noticed these toxic side effects: increased values of systolic and diastolic arterial blood pressure in 5 patients, neurotoxic tremor effects in 4 patients, hyperplasia gingival and hirsute in 1 patient each.