Mijajlović, Milija

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Is the female sex associated with an increased risk for long-term cognitive decline after the first-ever lacunar stroke? Prospective study on small vessel disease cohort

Pavlović, Aleksandra; Pekmezović, Tatjana; Mijajlović, Milija; Tomić, Gordana; Zidverc Trajković, Jasna

(Frontiers Media, 2023)

TY  - JOUR
AU  - Pavlović, Aleksandra
AU  - Pekmezović, Tatjana
AU  - Mijajlović, Milija
AU  - Tomić, Gordana
AU  - Zidverc Trajković, Jasna
PY  - 2023
UR  - http://rfasper.fasper.bg.ac.rs/handle/123456789/5018
AB  - Background: Sex is a significant determinant of survival and functional outcome after stroke. Long-term cognitive outcome after acute lacunar stroke in the context of sex differences has been rarely reported. Methods: A cohort of small vessel disease (SVD) patients presenting with first-ever acute lacunar stroke and normal cognitive status has been evaluated 4 years after the qualifying event for the presence of cognitive impairment (CI) with a comprehensive neuropsychological battery. Differences in baseline clinical and neuroimaging characteristics were compared between sexes in relation to cognitive status. Results: A total of 124 female and 150 male patients were analyzed. No difference was detected between the groups regarding age (p = 0.932) or frequency of common vascular risk factors (p > 0.1 for all). At the baseline assessment, women had more disabilities compared to men with a mean modified Rankin scale (mRS) score of 2.5 (1.5 in men, p < 0.0001). Scores of white matter hyperintensities (WMH) of presumed vascular origin and a total number of lacunes of presumed vascular origin on brain MRI were higher in women compared to men (p < 0.0001 for all). As many as 64.6% of patients had CI of any severity on follow-up, women more frequently (77.4%) than men (54.0%; p < 0.0001). Univariate logistic regression analysis showed that female sex, higher NIHSS and mRS scores, presence of depression, and increasing WMH severity were associated with an increased risk for CI. Multivariate regression analysis indicated that only depression (OR 1.74, 95%CI 1.25–2.44; p = 0.001) and WMH severity (OR 1.10, 95%CI 1.03–1.17; p = 0.004) were independently associated with the CI. Conclusion: At the long-term follow-up, women lacunar stroke survivors, compared to men, more frequently had CI in the presence of more severe vascular brain lesions, but this association was dependent on the occurrence of depression and severity of WMH, and could not be explained by differences in common vascular risk factors. Copyright © 2023 Pavlovic, Pekmezovic, Mijajlovic, Tomic and Zidverc Trajkovic
PB  - Frontiers Media
T2  - Frontiers in Neurology
T1  - Is the female sex associated with an increased risk for long-term cognitive decline after the first-ever lacunar stroke? Prospective study on small vessel disease cohort
VL  - 13
DO  - 10.3389/fneur.2022.1052401
ER  - 
@article{
author = "Pavlović, Aleksandra and Pekmezović, Tatjana and Mijajlović, Milija and Tomić, Gordana and Zidverc Trajković, Jasna",
year = "2023",
abstract = "Background: Sex is a significant determinant of survival and functional outcome after stroke. Long-term cognitive outcome after acute lacunar stroke in the context of sex differences has been rarely reported. Methods: A cohort of small vessel disease (SVD) patients presenting with first-ever acute lacunar stroke and normal cognitive status has been evaluated 4 years after the qualifying event for the presence of cognitive impairment (CI) with a comprehensive neuropsychological battery. Differences in baseline clinical and neuroimaging characteristics were compared between sexes in relation to cognitive status. Results: A total of 124 female and 150 male patients were analyzed. No difference was detected between the groups regarding age (p = 0.932) or frequency of common vascular risk factors (p > 0.1 for all). At the baseline assessment, women had more disabilities compared to men with a mean modified Rankin scale (mRS) score of 2.5 (1.5 in men, p < 0.0001). Scores of white matter hyperintensities (WMH) of presumed vascular origin and a total number of lacunes of presumed vascular origin on brain MRI were higher in women compared to men (p < 0.0001 for all). As many as 64.6% of patients had CI of any severity on follow-up, women more frequently (77.4%) than men (54.0%; p < 0.0001). Univariate logistic regression analysis showed that female sex, higher NIHSS and mRS scores, presence of depression, and increasing WMH severity were associated with an increased risk for CI. Multivariate regression analysis indicated that only depression (OR 1.74, 95%CI 1.25–2.44; p = 0.001) and WMH severity (OR 1.10, 95%CI 1.03–1.17; p = 0.004) were independently associated with the CI. Conclusion: At the long-term follow-up, women lacunar stroke survivors, compared to men, more frequently had CI in the presence of more severe vascular brain lesions, but this association was dependent on the occurrence of depression and severity of WMH, and could not be explained by differences in common vascular risk factors. Copyright © 2023 Pavlovic, Pekmezovic, Mijajlovic, Tomic and Zidverc Trajkovic",
publisher = "Frontiers Media",
journal = "Frontiers in Neurology",
title = "Is the female sex associated with an increased risk for long-term cognitive decline after the first-ever lacunar stroke? Prospective study on small vessel disease cohort",
volume = "13",
doi = "10.3389/fneur.2022.1052401"
}
Pavlović, A., Pekmezović, T., Mijajlović, M., Tomić, G.,& Zidverc Trajković, J.. (2023). Is the female sex associated with an increased risk for long-term cognitive decline after the first-ever lacunar stroke? Prospective study on small vessel disease cohort. in Frontiers in Neurology
Frontiers Media., 13.
https://doi.org/10.3389/fneur.2022.1052401
Pavlović A, Pekmezović T, Mijajlović M, Tomić G, Zidverc Trajković J. Is the female sex associated with an increased risk for long-term cognitive decline after the first-ever lacunar stroke? Prospective study on small vessel disease cohort. in Frontiers in Neurology. 2023;13.
doi:10.3389/fneur.2022.1052401 .
Pavlović, Aleksandra, Pekmezović, Tatjana, Mijajlović, Milija, Tomić, Gordana, Zidverc Trajković, Jasna, "Is the female sex associated with an increased risk for long-term cognitive decline after the first-ever lacunar stroke? Prospective study on small vessel disease cohort" in Frontiers in Neurology, 13 (2023),
https://doi.org/10.3389/fneur.2022.1052401 . .
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Povezanost stepena obrazovanja i bolesti malih krvnih sudova mozga

Pavlović, Aleksandra; Stevanović, Aleksandar; Vujičić, Danilo; Pavlović, Viktor; Tomić, Gordana; Mijajlović, Milija; Radojičić, Aleksandra; Zidverc Trajković, Jasna

(Univerzitet u Beogradu – Fakultet za specijalnu edukaciju i rehabilitaciju (ICF), 2022)

TY  - CONF
AU  - Pavlović, Aleksandra
AU  - Stevanović, Aleksandar
AU  - Vujičić, Danilo
AU  - Pavlović, Viktor
AU  - Tomić, Gordana
AU  - Mijajlović, Milija
AU  - Radojičić, Aleksandra
AU  - Zidverc Trajković, Jasna
PY  - 2022
UR  - http://rfasper.fasper.bg.ac.rs/handle/123456789/4964
AB  - Bolest malih krvnih sudova mozga (BMKS) je odgovorna za najveći broj možda- nih udara i vaskularno kognitivno oštećenje i obično je posledica klasičnih vaskularnih faktora rizika. Cilj našeg rada je da se u kohorti bolesnika sa BMKS ispita povezanost stepena obrazovanja i kliničke i radiološke sli- ke BMKS. U studiji je analizirano 424 ispitanika, srednje životne dobi od 62 godine, 53% muškog pola, različitog stepena obrazovanja u trajanju od 8 do 20 godina. Pokazana je statistički značajna povezanost stepena obrazovanja sa postojanjem simptoma depresije (p=0,050), ukupnom težinom lezija na MR moz- ga (p=0,029), kao i ukupnim brojem izolovanih lakunarnih ishemija (p=0,032).
Zabeležena je povezanost pola (p=0,055) i lezija u periventrikularnoj regiji (p=0,062) sa stepenom obrazovanja na nivou statističkog trenda. Mehanizmi kojima stepen obrazovanja može uticati na rizik za nastanak vaskular- nih lezija mozga nisu u potpunosti razjašnjenji. Deo ove povezanost se može objasniti nižim socijalno-ekonomskim statusom, povećanom učestalošću vaskularnih bolesti (hipertenzija, dijabetes) i nezdravim navikama (pušenje, visokokalorijska ishrana, sedentarni način života), ali postoje dokazi da je ova korelacija nezavisna od klasičnih vaskularnih faktora rizika. Otkrivanje i rano korigovanje preventibilnih faktora za nastanak vaskularnih lezija mozga od velikog je društvenog značaja, uz potencijal da rane socijalne i eduka- tivne intervencije pozitivno utiču na status cerebralne cirkulacije kasnije u životu.
AB  - Cerebral small vessel disease (CSVD), the most frequent cause of stroke and vascular cognitive impairment, is typically associated with common vascular risk factors. Our paper aims to analyze the correlation between the level of education and clinical and radiological presentation in a cohort of patients with CSVD. A total of 424 patients have been recruited, with a mean age of 62 years, 53% males, with years of education ranging from 8 to 20. We found a statistically
significant correlation between depressive symptoms (p=0.050), total severity of cerebral lesions on MR scans (p=0.029), and the total number of lacunar ischemic lesions (p=0.032). The correlation between sex (p=0.055) and periventricular lesions (p=0.062) with educational status was at the level of the statistical trend. The putative mechanisms of the association between education and the risk for vascular brain lesions were not fully elucidated. Partially, this association can be explained by lower socioeconomic status, increased incidence of vascular diseases (hypertension, diabetes), and unhealthy lifestyle (smoking, poor diet, sedentary lifestyle), however, this association might also be independent of common vascular risk factors. Identification and early management of preventable risk factors for cerebral vascular lesions are of most importance to society, with the potential of early social and educational intervention to positively affect cerebral circulation status later in life.
PB  - Univerzitet u Beogradu – Fakultet za specijalnu edukaciju i rehabilitaciju (ICF)
C3  - Zbornik radova - Nacionalni naučni skup " obrazovanje i rehabilitacija odraslih osoba sa smetnjama u razvoju i problemima u ponašanju ", Beograd, Srbija, 21. decembar 2022. godine
T1  - Povezanost stepena obrazovanja i bolesti malih krvnih sudova mozga
T1  - Level of education and cerebral small vessel disease
EP  - 192
SP  - 185
UR  - https://hdl.handle.net/21.15107/rcub_rfasper_4964
ER  - 
@conference{
author = "Pavlović, Aleksandra and Stevanović, Aleksandar and Vujičić, Danilo and Pavlović, Viktor and Tomić, Gordana and Mijajlović, Milija and Radojičić, Aleksandra and Zidverc Trajković, Jasna",
year = "2022",
abstract = "Bolest malih krvnih sudova mozga (BMKS) je odgovorna za najveći broj možda- nih udara i vaskularno kognitivno oštećenje i obično je posledica klasičnih vaskularnih faktora rizika. Cilj našeg rada je da se u kohorti bolesnika sa BMKS ispita povezanost stepena obrazovanja i kliničke i radiološke sli- ke BMKS. U studiji je analizirano 424 ispitanika, srednje životne dobi od 62 godine, 53% muškog pola, različitog stepena obrazovanja u trajanju od 8 do 20 godina. Pokazana je statistički značajna povezanost stepena obrazovanja sa postojanjem simptoma depresije (p=0,050), ukupnom težinom lezija na MR moz- ga (p=0,029), kao i ukupnim brojem izolovanih lakunarnih ishemija (p=0,032).
Zabeležena je povezanost pola (p=0,055) i lezija u periventrikularnoj regiji (p=0,062) sa stepenom obrazovanja na nivou statističkog trenda. Mehanizmi kojima stepen obrazovanja može uticati na rizik za nastanak vaskular- nih lezija mozga nisu u potpunosti razjašnjenji. Deo ove povezanost se može objasniti nižim socijalno-ekonomskim statusom, povećanom učestalošću vaskularnih bolesti (hipertenzija, dijabetes) i nezdravim navikama (pušenje, visokokalorijska ishrana, sedentarni način života), ali postoje dokazi da je ova korelacija nezavisna od klasičnih vaskularnih faktora rizika. Otkrivanje i rano korigovanje preventibilnih faktora za nastanak vaskularnih lezija mozga od velikog je društvenog značaja, uz potencijal da rane socijalne i eduka- tivne intervencije pozitivno utiču na status cerebralne cirkulacije kasnije u životu., Cerebral small vessel disease (CSVD), the most frequent cause of stroke and vascular cognitive impairment, is typically associated with common vascular risk factors. Our paper aims to analyze the correlation between the level of education and clinical and radiological presentation in a cohort of patients with CSVD. A total of 424 patients have been recruited, with a mean age of 62 years, 53% males, with years of education ranging from 8 to 20. We found a statistically
significant correlation between depressive symptoms (p=0.050), total severity of cerebral lesions on MR scans (p=0.029), and the total number of lacunar ischemic lesions (p=0.032). The correlation between sex (p=0.055) and periventricular lesions (p=0.062) with educational status was at the level of the statistical trend. The putative mechanisms of the association between education and the risk for vascular brain lesions were not fully elucidated. Partially, this association can be explained by lower socioeconomic status, increased incidence of vascular diseases (hypertension, diabetes), and unhealthy lifestyle (smoking, poor diet, sedentary lifestyle), however, this association might also be independent of common vascular risk factors. Identification and early management of preventable risk factors for cerebral vascular lesions are of most importance to society, with the potential of early social and educational intervention to positively affect cerebral circulation status later in life.",
publisher = "Univerzitet u Beogradu – Fakultet za specijalnu edukaciju i rehabilitaciju (ICF)",
journal = "Zbornik radova - Nacionalni naučni skup " obrazovanje i rehabilitacija odraslih osoba sa smetnjama u razvoju i problemima u ponašanju ", Beograd, Srbija, 21. decembar 2022. godine",
title = "Povezanost stepena obrazovanja i bolesti malih krvnih sudova mozga, Level of education and cerebral small vessel disease",
pages = "192-185",
url = "https://hdl.handle.net/21.15107/rcub_rfasper_4964"
}
Pavlović, A., Stevanović, A., Vujičić, D., Pavlović, V., Tomić, G., Mijajlović, M., Radojičić, A.,& Zidverc Trajković, J.. (2022). Povezanost stepena obrazovanja i bolesti malih krvnih sudova mozga. in Zbornik radova - Nacionalni naučni skup " obrazovanje i rehabilitacija odraslih osoba sa smetnjama u razvoju i problemima u ponašanju ", Beograd, Srbija, 21. decembar 2022. godine
Univerzitet u Beogradu – Fakultet za specijalnu edukaciju i rehabilitaciju (ICF)., 185-192.
https://hdl.handle.net/21.15107/rcub_rfasper_4964
Pavlović A, Stevanović A, Vujičić D, Pavlović V, Tomić G, Mijajlović M, Radojičić A, Zidverc Trajković J. Povezanost stepena obrazovanja i bolesti malih krvnih sudova mozga. in Zbornik radova - Nacionalni naučni skup " obrazovanje i rehabilitacija odraslih osoba sa smetnjama u razvoju i problemima u ponašanju ", Beograd, Srbija, 21. decembar 2022. godine. 2022;:185-192.
https://hdl.handle.net/21.15107/rcub_rfasper_4964 .
Pavlović, Aleksandra, Stevanović, Aleksandar, Vujičić, Danilo, Pavlović, Viktor, Tomić, Gordana, Mijajlović, Milija, Radojičić, Aleksandra, Zidverc Trajković, Jasna, "Povezanost stepena obrazovanja i bolesti malih krvnih sudova mozga" in Zbornik radova - Nacionalni naučni skup " obrazovanje i rehabilitacija odraslih osoba sa smetnjama u razvoju i problemima u ponašanju ", Beograd, Srbija, 21. decembar 2022. godine (2022):185-192,
https://hdl.handle.net/21.15107/rcub_rfasper_4964 .