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Tatjana Bucma

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Papers by Tatjana Bucma

Korelacija skora dobijenog upitnikom o nesposobnosti ruke, ramena i šake sa kliničkim parametrima pacijenata na rehabilitaciji poslije traume

Биомедицинска истраживања, 2018

Kratak sadržaj Uvod. Region specifični upitnik nesposobnosti ramena, lakta i šake (DASH upitnik) ... more Kratak sadržaj Uvod. Region specifični upitnik nesposobnosti ramena, lakta i šake (DASH upitnik) mjeri stepen onesposobljenja kod brojnih muskuloskeletnih stanja. Cilj rada je bio ispitati korelaciju između skora dobijenog ovim upitnikom i obima ekstremiteta, obima pokreta u zglobovima i mišićnom snagom gornjeg ekstremiteta kod pacijenata poslije traume. Metode. Istraživanje je obuhvatalo 100 pacijenata koji su od 2009. do 2015. godine bili na rehabilitaciji poslije traume prema protokolu Zavoda za fizikalnu medicinu i rehabilitaciju "Dr Miroslav Zotović" u Banjaluci. Kod svih ispitanika su na početku i po završetku terapije mjereni obim ekstremiteta, obim pokreta u zglobovima gornjeg ekstremiteta, manuelni mišićni test, i korišćenjem DASH upitnika izračunat DASH skor. Rezultati. Nakon terapije, statistički značajno je smanjen obim lakta preko olekranona (2,38 cm vs. 2,17 cm; p < 0,001), podlakta, mjereno na najdebljem mjestu (2,11 cm vs. 1,76 cm; p < 0,001), kao i šake mjereno preko metakarpalnih zglobova (1,91 cm vs. 1,74 cm; p < 0,05). Mišićna snaga se povećala nakon terapije, a ovo povećanje je bilo značajno za mišiće desnog nadlakta i mišiće podlakta i šake obostrano. Poslije terapije su povećane srednje vrijednosti svih pokreta u ramenu mada statistički neznačajno, dok je statistički značajno povećanje zabilježeno za ekstenziju i pronaciju desnog lakta i sve pokrete desne šake. Poslije terapije prosječna vrijednost DASH skora je značajno smanjena (107,38 vs. 75,98; p < 0,0005). Postoji negativna korelacija između DASH skora i snage mišića, obima ekstenzije, pronacije i supinacije lakta, fleksije i radijalne devijacije ručnog zgloba. Zaključak. DASH skor je dobar pokazatelj subjektivne procjene stanja kod bolesnika nakon traume gornjeg ekstremiteta.

Significance of Early Diagnostic of Carpal Tunnel Syndrome

Sportske Nauke i Zdravlje, Oct 3, 2022

Carpal tunnel syndrome (CTS) is the most common compressive neuropathy. The conservative treatmen... more Carpal tunnel syndrome (CTS) is the most common compressive neuropathy. The conservative treatment remains the first therapeutic choice in the treatment of mild and moderate CTS. The aim of this paper was to examine the average age of female patients with CTS diagnosed by EMNG, the frequency of bilateral CTS and its correlation with the age, and to determine the grade of electrophysiological damage of the nerve when the CTS diagnosis is confirmed for the first time. The retrospective examination included 187 female patients, aged from 27 to 79, with complains on unilateral CTS. All patients underwent EMNG for confirmation of CTS and the degree of damage to median nerve. Statistical analysis was performed by methods of descriptive statistics, Kruskal-Wallis test, and the Student t-test. The value of p < 0.05 was considered statistically significant. The average age of the female examinees was 54.53 years. The bilateral CTS was confirmed in 67.9 %, most often of a moderate degree and more often on the right hand. No statistically significant difference was found in grades of CTS between the analysed age groups of patients that had the bilateral CTS (p = 0.206), nor there was a difference in years of life between the patients with unilateral and bilateral CTS (p = 0.638). Bilaterality of CTS, as well as the degree of the damage are not connected with age. The patients report timely for the first examination and diagnostics of CTS when there is still a possibility of the conservative treatment.

Expression of vascular endothelial growth factor (VEGF) in melanocytic skin alterations

Scripta medica, 2012

Introduction. The study of growth factor expression allows further development of therapeutic mod... more Introduction. The study of growth factor expression allows further development of therapeutic modalities in the treatment of malignant diseases of the skin. This study aims to determine the relationship between the level of VEGF expression and morphological parameters (biological behavior of lesions, histological type, the defect on the surface, the density of infl ammatory infi ltrate, mitotic index, stage of growth and cell type) in melanocytic nevi and melanomas of the skin in different regions. Methods. The study included skin biopsy material of 73 patients, divided in two groups (group I-melanomas, group II-nevi). The following parameters were determined: histological type, thickness of alteration (Breslow), Clark level, pTNM stage, the width of alteration, the density of lymphocytic infi ltration of the tumor, mitotic index, stage of tumor growth, the presence of ulceration, tumor cell type, location and level of expression of VEGF. Results. Most of benign melanocytic alterations in the skin shows low expression levels of VEGF in 91.18% of cases. In the group of melanomas, a high level of expression was seen in 61.54 % of cases. Nodular and acral lentiginous type of melanoma more often showed a high level of expression of VEGF, while superfi cial spreading melanoma often showed a low level of VEGF expression. Conclusion. Benign melanocytic alterations have low, while malignant melanocytic alterations have high level of expression of VEGF.

Spinal cord stimulation in chronic pain treatment - first experiences in Bosnia and Herzegovina

Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina, Feb 1, 2023

Aim To describe results of spinal cord stimulation technique when the conventional multidisciplin... more Aim To describe results of spinal cord stimulation technique when the conventional multidisciplinary treatment of neuropathic or mixed pain failed. Methods The research was conducted at the Institute for Physical Medicine and Rehabilitation "Dr. Miroslav Zotović", Banjaluka. Ten patients, who had chronic pain resistant to other therapeutic options and a failed back surgery, were sent for an evaluation. Each patient underwent a 4-week evaluation by a team of medical specialists, phychologist and social workers. Additional diagnostic methods (MRI of the lumbosacral spine, electromyoneurography of lower extermities, congnitive assessment tests) were also performed to establish a proper indication for implantation of the system for spinal cord stimulation. Leads of a system for spinal cord stimulation were implanted percutaneously or surgically at the epidural space. Functional outcome measures (visual analogue scale, Oswestry index, anxiety and depression scales) were taken before the implantation of the system and on several followups. Results Four patients did not meet critea for the inclusion in the study (two were not ready, two showed psychopathological symptoms). One patient had a percutaneous lead implant, but it was removed after six months due to paresthesia. The remaining five had surgicaly implanted epidural leads and showed significant improvement in pain control, Oswestry index had lower values, and all except one patient had improvement registered by anxiety and depression scales. Conclusion. Short-term and long-term follow up showed a long lasting pain reduction and improvement of functionality in all patients.

Stereological analysis of melanocytic skin changes

Scripta Medica, 2009

Sažetak. Nevusi su definisani kao benigne proliferacije melanocita, odnosno varijeteti hamartomsk... more Sažetak. Nevusi su definisani kao benigne proliferacije melanocita, odnosno varijeteti hamartomskih i/ili neoplastičnih lezija u koži. Za razliku od melanomskih lezija, nevusi nakon određenog perioda rasta stagniraju, a potom involuiraju. Angiogeneza je neophodna, kako za početak, tako i za završetak procesa metastaziranja. Vaskularizacijom primarnog tumora počinje ekspanzivan rast, tumor dobija metastatski potencijal. Cilj rada je da se odrede stereološki parametri (volumenska, površinska i dužinska gustina) vaskularne mreže nevusa i okoline, te melanoma i peritumorskog područja na različitim anatomskim regijama. Istraživanje je obavljeno na 10 uzoraka benignih melanocitnih promjena (nevusi) i 10 malignih melanocitnih promjena (melanomi). Materijal dobijen biopsijom je fiksiran u 10% formalinu, a od uzoraka su pravljeni serijski rezovi. Vizuelizacija krvnih sudova je vršena Mallory metodom. Pomoću mikroskopa i digitalne kamere vršeno je fotografisanje uzoraka. Dobijene fotografije su obrađivane uz pomoć programa ImageJ, verzija 1.42e (National Institutes of Health, Bethesda, USA) uz korištenje testnog sistema A 100. Statistička analiza je urađena uz korištenje programa SPSS, verzija 15.0. Statistički značajna razlika postoji u volumenskoj i dužinskoj gustini vaskularne mreže nevusa i okoline nevusa, te u dužinskoj gustini vaskularne mreže melanoma i peritumorskog područja.

Stereological analysis of neurons of extraocular motor nuclei

Scripta Medica, 2009

Sažetak. Neuroni ekstraokularnih motornih jedara (nucleus nervi oculomotorii principalis, nucleus... more Sažetak. Neuroni ekstraokularnih motornih jedara (nucleus nervi oculomotorii principalis, nucleus nervi trochlearis et nucleus nervi abducentis) su zaobljeni multipolarni, rjeđe fuziformni ili ovalni motoneuroni, blijedog jedra i nepravilno raspoređenih Nisslovih tjelašaca. Cilj rada je da se odrede stereološki parametri neurona ekstraokularnih motornih jedara (volumenska i površinska gustina, i apsolutni broj po mm² površine). Istraživanje je obavljeno na 30 moždanih stabala čovjeka, oba pola, bez dijagnostikovanih neuroloških oboljenja, stratificiranim prikupljanjem uzoraka u transverzalnoj ravni. Semiserijski parafinski rezovi (debljine 0,3 µm) su bojeni Mallory metodom. Uz korišćenje mikroskopa na histološkim presjecima su identifikovana ekstraokularna motorna jedra i pomoću digitalne kamere slikano je intermitentno svako drugo vidno polje pod uvećanjem 400x. Dobijene slike su analizirane pomoću programa ImageJ, verzija 1.42e (National Institutes of Health, Bethesda, USA) uz korišćenje testnog sistema A 100. Statistička analiza je obavljena uz upotrebu programa SPSS (verzija 16.0) uz nivo značajnosti razlike od 5%. Statistički značajna razlika (p<0,05) postojala je u volumenskoj i površinskoj gustini, i apsolutnom broju neurona po mm² površine između nc.nervi oculomotorii principalis i nc.nervi trochlearis. Između nc.nervi oculomotorii principalis i nc.nervi abducentis statistički značajna razlika postoji u volumenskoj gustini, dok se između nc.nervi trochlearis i nc.nervi abducentis razlika pronalazi u vrijednosti površinske gustine i apsolutnog broja neurona po mm² površine.

Promjene kvantitativnih parametara neurona ekstraokularnih motornih jedara sa starenjem

Scripta Medica, 2017

Promjene neurona i krvnih sudovasubstantiae nigrae kod čovjeka tokom starenja - morfometrijsko istraživanje

Scripta Medica, 2017

Changes of Neurons and Blood Vessels of Human Substantia Nigra in Aging- Morphometric Study

Scripta Medica, 2017

Introduction: With aging, populations of dopaminergic neurons in the central nervous system show ... more Introduction: With aging, populations of dopaminergic neurons in the central nervous system show prominent pathological changes compared to other brain regions. Previous studies on substantia nigra were performed in cases of Parkinson's disease and in old age. Aim of the Study: Since Parkinson's disease is a disorder associated with age, it is important to examine how the relationship between neurons and blood vessels is associated with normal aging. Patients and Methods: Ten brainstems were sliced into three strata. Each stratum was sliced in semiserial sections and stained by Mallory method. Studied phases were neurons and blood vessels of substantia nigra. The analysis was conducted by camera "Leica EC3" under the 40x magnification of light microscope "Leica" DM 1000, using ImageJ software (version 1.42 e). Determined morphometric parameters of neurons and blood vessels were: volume and surface density, and absolute numbers per visual field. Statistical analysis was performed using SPSS software, version 16.0, using Student's t-test and Pearson correlation coefficient. Results: Volume and surface density, and total number of neurons per visual field of substantia nigra significantly decreased with age, while the volume and surface density and absolute number of blood vessels per visual field significantly increased (p < 0.05). Conclusion: Decrease in size and number of neurons occurs with aging, which is compensated by the increase of vascular network. This affects the supply of nutrients from the blood to neurons, as well as the availability of blood cells or toxic substances, but also the susceptibility to neuronal diseases.

Age- Related Changes of Quantitative Parameters of Neurons in Extraocular Motor Nuclei

Scripta Medica, 2017

Introduction: Extraocular motor nuclei are located in the midbrain (principal oculomotor and troc... more Introduction: Extraocular motor nuclei are located in the midbrain (principal oculomotor and trochlear nucleus) and in the pons (abducens nucleus). With aging, there are significant changes in eyeball mobility. Aim of the Study: The aim was to determine whether the quantitative parameters of neurons (volume and surface density, and the absolute number per mm² of the surface) in these nuclei significantly change with aging. Patients and Methods: The study was done on 30 adult brainstems, both male and female, without diagnosed neurological disturbances. Three-millimeter-thick strata were taken in transversal plane and cut in 0.3 micrometer semi-serial sections stained with Mallory method. The images of studied nuclei were taken by "Leica" DM 1000 microscope and "Leica" EC3 digital camera under 400x magnification and analyzed by ImageJ software with A100 grid. The statistical analysis was performed by Statistical Package for the Social Sciences software using Pearson's correlation coefficient with 5% level of significance. Results: The volume density of neurons had highly statistically significantly increased with age in principal oculomotor nucleus (r = 0.571, p = 0.001) and trochlear nucleus (r = 0.581, p = 0.001), while abducens nucleus showed no change in neuron volume. Changes of values of surface density and absolute number of neurons per mm 2 with age did not reach statistical significance. Conclusion: Volume of neurons of extraocular motor nuclei located in the midbrain increase with age, while their surfaces and absolute number do not change significantly. These changes are not observed in the nucleus located in the pons.

Kvantitativna analiza magnocelularnog dijela nucleus ruber-a

Биомедицинска истраживања, 2016

Kratak sadržaj Uvod. Nucleus ruber zauzima centralni dio retikularne formacije srednjeg mozga, od... more Kratak sadržaj Uvod. Nucleus ruber zauzima centralni dio retikularne formacije srednjeg mozga, od donjeg kraja gornjih kvržica srednjeg mozga do ventralnog talamusa. Vaskularizuju ga grane P 1 i P 2 segmenta arteriae cerebri posterior, arteriae communicans posterior i arteriae choroidea anterior. Ciljevi rada su kvantitativna analiza neurona i vaskularne mreže magnocelularnog dijela nucleus ruber-a, kao i ispitivanje uticaja starenja na parametre kvantitativne analize. Metode. Deset srednjih mozgova odraslih lica oba pola je nakon fiksacije u 10% rastvoru formalina ukalupljeno u parafinu. Zbog lokalizacije magnocelularnog dijela nucleus ruber-a, uzorci srednjih mozgova su presječeni u visini sredine gornjih kvržica srednjeg mozga i idući kaudalno pravljeni su semiserijski rezovi (1,5,10...50) debljine 4 µm, koji su bojeni Mallory metodom. Pomoću digitalne kamere slikano je intermitentno svako drugo vidno polje pod uvećanjem 400x, a dobijene fotografije su analizirane pomoću programa ImageJ, uz korišćenje testnog sistema A 100. Statistička analiza je obavljena uz upotrebu programa SPSS, uz nivo značajnosti razlike od 5%. Rezultati. Prosječne vrijednosti kvantitativnih parametara neurona su iznosile: volumenska gustina 0,018 mm 0 , površinska gustina 3,56 mm-1 i apsolutni broj po vidnom polju 35,39. Prosječna volumenska gustina vaskularne mreže magnocelularnog dijela nucleus ruber-a je 0,014 mm 0 , površinska gustina 4,19 mm-1 i dužinska gustina 90,82 mm-2. Nije postojala korelacija između godina života i određivanih kvantitativnih parametara neurona i vaskularne mreže magnocelularnog dijela nucleus ruber-a. Zaključak. Ispitivani kvantitativni parametri neurona i vaskularne mreže magnocelularnog dijela nucleus ruber-a se smanjuju sa godinama života, ali smanjenje nije statistički značajno.

Quantitative analysis of vascular network of oculogyric nerve nuclei

Medical review, 2011

Introduction. Nuclei of oculogyric nerves (principal oculomotor nucleus, trochlear nucleus and ab... more Introduction. Nuclei of oculogyric nerves (principal oculomotor nucleus, trochlear nucleus and abducens nucleus) are densely vascularized brain?stem structures. The aim of this study was to determine quantitative characteristics of the vascular network of these nuclei. Material and methods. The study was done on 30 adult brainstems, both male and female, without diagnosed neurological disturbances. Three-millimetrethick stratums were taken in transversal plane and cut in 0.3 micrometer semi-serial sections stained with Mallory method. The images of studied nuclei were taken with ?Leica? DM 1000 microscope and ?Leica? EC3 digital camera under 400x magnification, and analyzed by ImageJ software with A 100 grid. The statistical analysis was performed by Statistical Package for the Social Sciences software with 5% level of significance. Results. A statistically significant difference was found in the volume and surface density between principal oculomotor nucleus and trochlear nucleus, ...

Stereological analysis of the human pons vascular network

Acta medica …, 2003

Blood vessels which supply pons are the branches of the basilar artery, anterior inferior cerebel... more

Stereological analysis of vascular network of subcortical auditory centers

Биомедицинска истраживања

Introduction. Subcortical auditory centers have several sources of blood supply. Cochlear nuclei ... more Introduction. Subcortical auditory centers have several sources of blood supply. Cochlear nuclei are vascularized by the anterior inferior cerebellar artery. Superior cerebellar and posterior cerebral arteries supply the inferior colliculus nucleus, while the medial geniculate body nucleus is supplied by several posterior cerebral artery branches. The aim of the research was to quantify the vascular network of subcortical auditory centers. Methods. Twelve adult brains, both sexes, aged 21 to 78 years, without signs of neurological diseases were analyzed in this study. Samples for histological sections, stained by the Mallory method, were obtained from strata cut at levels: the junction of the middle and rostral thirds of the oliva, the inferior colliculi, and the thalamic pulvinar. Volume, surface, and length density of the vascular network of subcortical auditory centers were analyzed stereological parameters. Results. All parameters had the highest values in the medial geniculate ...

Faktori koji utiču na ishod liječenja sindroma kaude ekvine

Биомедицинска истраживања, 2016

Uvod. Grupa znakova i simptoma koji se javljaju kao rezultat oštećenja nervnihkorjenova caudae eq... more Uvod. Grupa znakova i simptoma koji se javljaju kao rezultat oštećenja nervnihkorjenova caudae equinae smještenih u kičmenom kanalu nosi naziv sindromkaude ekvine (cauda equina syndrome). Najčešće je uzrokovana lumbalnomhernijacijom intervertebralnog diska. Klinička slika se karakteriše bolom ukrsnom, glutealnom i perinealnom regionu, bolom duž zadnje strane donjegekstremiteta, utrnulošću i motornim i senzornim deficitima na donjim ekstremitetima.Može se javiti i disfunkcija mokraćne bešike i potencije.Prikaz bolesnika. Pacijent dolazi na pregled kod fizijatra zbog jakog bola uslabinskom segmentu, koji se propagirao duž oba donja ekstremiteta praćenosjećajem slabosti, više lijevo, te nemogućnosti pražnjenja mokraćne bešike.Snimak dobijen nuklearnom magnetnom rezonancom (NMR) pokazujeprotruziju intravertebralnog diska na dva nivoa. Pacijent je podvrgnut operativnomzahvatu: Hemilaminectomia L4 l. sin et foraminotomia L5-S1 l. sin,extirpatio disci. Mjesec dana nakon operativnog zahvata...

Stereologic Analysis of Vascular Net and Nerve Cells of General Somatomotor Nuclei of Cranial Nerves

Acta Medica Medianae, 2006

The analysis was done on 10 samples of general somatomotor nuclei (GSN) of cranial nerves located... more The analysis was done on 10 samples of general somatomotor nuclei (GSN) of cranial nerves located in the brain stem, which were colored by the Mallory method. The research was conducted by standard testing system A 100 with the use of the light microscope and 40 x zoom objective. We determined the volume density of vascular net and nerve cells of investigated structures. The obtained values were mutually compared. GSN located in mesencephalon were more significantly vascularized. A part of the oculomotorius nuclei, made of nerve cells, is significantly larger compared with other GSN. The oculomotorius nuclei have equal number of nerve cells and blood vessels, while the number of blood vessels in the other GSN is a significantly larger.

Morfološka i topografska analiza krvnih sudova cisternalnog segmenta vestibulokohlearnog nerva

БИОМЕДИЦИНСКА ИСТРАЖИВАЊА, 2011

Uvod. Kompresija nerava od strane krvnih sudova u pontocerebelarnom uglumože uzrokovati funkciona... more Uvod. Kompresija nerava od strane krvnih sudova u pontocerebelarnom uglumože uzrokovati funkcionalne promjene ovih nerava. Radikularni, cisternalnidio vestibulokohlearnog nerva (n.VIII) ishranjuju grančice a. cerebelli anteriorinferior (AICA).Metode. Istraživanja su vršena na 40 mozgova odraslih lica, oba pola, dobiod 21 do 78 godina. Po završetku fiksiranja vršeno je fino preparisanje strukturapontocerebelarnog ugla, a zatim evidentiranje varijacija i odnosa krvnihsudova i nerava.Rezultati. AICA je u 17% desno i 6% lijevo bila dvostruka. Hipoplastična AICAje češće viđena na lijevoj strani (30 %). Odnos sa n. abducens-om (n.VI) je ostvarivalačešće sa lijeve strane, a sa n. facialis-om (n.VII) i n.VIII češće desno.AICA je u 22% desno i u 30% lijevo pravila omču oko n.VIII. Kada je riječ oodnosu bočnih grana AICA i n.VIII, najčešće su druga desna (45 % slučajeva) idruga lijeva (35 % slučajeva) grana imale blizak odnos sa pomenutim nervomZaključak. Iako postoji čest nalaz bliskog odnos...

Problems, interventions, and their outcomes during the routine work of hospital pharmacists in Bosnia and Herzegovina

International Journal of Clinical Pharmacy

Morfološka i topografska analiza krvnih sudova cisternalnog segmenta vestibulokohlearnog nerva

БИОМЕДИЦИНСКА ИСТРАЖИВАЊА, 2011

Uvod. Kompresija nerava od strane krvnih sudova u pontocerebelarnom uglumože uzrokovati funkciona... more Uvod. Kompresija nerava od strane krvnih sudova u pontocerebelarnom uglumože uzrokovati funkcionalne promjene ovih nerava. Radikularni, cisternalnidio vestibulokohlearnog nerva (n.VIII) ishranjuju grančice a. cerebelli anteriorinferior (AICA).Metode. Istraživanja su vršena na 40 mozgova odraslih lica, oba pola, dobiod 21 do 78 godina. Po završetku fiksiranja vršeno je fino preparisanje strukturapontocerebelarnog ugla, a zatim evidentiranje varijacija i odnosa krvnihsudova i nerava.Rezultati. AICA je u 17% desno i 6% lijevo bila dvostruka. Hipoplastična AICAje češće viđena na lijevoj strani (30 %). Odnos sa n. abducens-om (n.VI) je ostvarivalačešće sa lijeve strane, a sa n. facialis-om (n.VII) i n.VIII češće desno.AICA je u 22% desno i u 30% lijevo pravila omču oko n.VIII. Kada je riječ oodnosu bočnih grana AICA i n.VIII, najčešće su druga desna (45 % slučajeva) idruga lijeva (35 % slučajeva) grana imale blizak odnos sa pomenutim nervomZaključak. Iako postoji čest nalaz bliskog odnos...

The Effects of Continued Rehabilitation After Primary Knee Replacement

Medical Archives, 2016

Korelacija skora dobijenog upitnikom o nesposobnosti ruke, ramena i šake sa kliničkim parametrima pacijenata na rehabilitaciji poslije traume

Биомедицинска истраживања, 2018

Kratak sadržaj Uvod. Region specifični upitnik nesposobnosti ramena, lakta i šake (DASH upitnik) ... more Kratak sadržaj Uvod. Region specifični upitnik nesposobnosti ramena, lakta i šake (DASH upitnik) mjeri stepen onesposobljenja kod brojnih muskuloskeletnih stanja. Cilj rada je bio ispitati korelaciju između skora dobijenog ovim upitnikom i obima ekstremiteta, obima pokreta u zglobovima i mišićnom snagom gornjeg ekstremiteta kod pacijenata poslije traume. Metode. Istraživanje je obuhvatalo 100 pacijenata koji su od 2009. do 2015. godine bili na rehabilitaciji poslije traume prema protokolu Zavoda za fizikalnu medicinu i rehabilitaciju "Dr Miroslav Zotović" u Banjaluci. Kod svih ispitanika su na početku i po završetku terapije mjereni obim ekstremiteta, obim pokreta u zglobovima gornjeg ekstremiteta, manuelni mišićni test, i korišćenjem DASH upitnika izračunat DASH skor. Rezultati. Nakon terapije, statistički značajno je smanjen obim lakta preko olekranona (2,38 cm vs. 2,17 cm; p < 0,001), podlakta, mjereno na najdebljem mjestu (2,11 cm vs. 1,76 cm; p < 0,001), kao i šake mjereno preko metakarpalnih zglobova (1,91 cm vs. 1,74 cm; p < 0,05). Mišićna snaga se povećala nakon terapije, a ovo povećanje je bilo značajno za mišiće desnog nadlakta i mišiće podlakta i šake obostrano. Poslije terapije su povećane srednje vrijednosti svih pokreta u ramenu mada statistički neznačajno, dok je statistički značajno povećanje zabilježeno za ekstenziju i pronaciju desnog lakta i sve pokrete desne šake. Poslije terapije prosječna vrijednost DASH skora je značajno smanjena (107,38 vs. 75,98; p < 0,0005). Postoji negativna korelacija između DASH skora i snage mišića, obima ekstenzije, pronacije i supinacije lakta, fleksije i radijalne devijacije ručnog zgloba. Zaključak. DASH skor je dobar pokazatelj subjektivne procjene stanja kod bolesnika nakon traume gornjeg ekstremiteta.

Significance of Early Diagnostic of Carpal Tunnel Syndrome

Sportske Nauke i Zdravlje, Oct 3, 2022

Carpal tunnel syndrome (CTS) is the most common compressive neuropathy. The conservative treatmen... more Carpal tunnel syndrome (CTS) is the most common compressive neuropathy. The conservative treatment remains the first therapeutic choice in the treatment of mild and moderate CTS. The aim of this paper was to examine the average age of female patients with CTS diagnosed by EMNG, the frequency of bilateral CTS and its correlation with the age, and to determine the grade of electrophysiological damage of the nerve when the CTS diagnosis is confirmed for the first time. The retrospective examination included 187 female patients, aged from 27 to 79, with complains on unilateral CTS. All patients underwent EMNG for confirmation of CTS and the degree of damage to median nerve. Statistical analysis was performed by methods of descriptive statistics, Kruskal-Wallis test, and the Student t-test. The value of p < 0.05 was considered statistically significant. The average age of the female examinees was 54.53 years. The bilateral CTS was confirmed in 67.9 %, most often of a moderate degree and more often on the right hand. No statistically significant difference was found in grades of CTS between the analysed age groups of patients that had the bilateral CTS (p = 0.206), nor there was a difference in years of life between the patients with unilateral and bilateral CTS (p = 0.638). Bilaterality of CTS, as well as the degree of the damage are not connected with age. The patients report timely for the first examination and diagnostics of CTS when there is still a possibility of the conservative treatment.

Expression of vascular endothelial growth factor (VEGF) in melanocytic skin alterations

Scripta medica, 2012

Introduction. The study of growth factor expression allows further development of therapeutic mod... more Introduction. The study of growth factor expression allows further development of therapeutic modalities in the treatment of malignant diseases of the skin. This study aims to determine the relationship between the level of VEGF expression and morphological parameters (biological behavior of lesions, histological type, the defect on the surface, the density of infl ammatory infi ltrate, mitotic index, stage of growth and cell type) in melanocytic nevi and melanomas of the skin in different regions. Methods. The study included skin biopsy material of 73 patients, divided in two groups (group I-melanomas, group II-nevi). The following parameters were determined: histological type, thickness of alteration (Breslow), Clark level, pTNM stage, the width of alteration, the density of lymphocytic infi ltration of the tumor, mitotic index, stage of tumor growth, the presence of ulceration, tumor cell type, location and level of expression of VEGF. Results. Most of benign melanocytic alterations in the skin shows low expression levels of VEGF in 91.18% of cases. In the group of melanomas, a high level of expression was seen in 61.54 % of cases. Nodular and acral lentiginous type of melanoma more often showed a high level of expression of VEGF, while superfi cial spreading melanoma often showed a low level of VEGF expression. Conclusion. Benign melanocytic alterations have low, while malignant melanocytic alterations have high level of expression of VEGF.

Spinal cord stimulation in chronic pain treatment - first experiences in Bosnia and Herzegovina

Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina, Feb 1, 2023

Aim To describe results of spinal cord stimulation technique when the conventional multidisciplin... more Aim To describe results of spinal cord stimulation technique when the conventional multidisciplinary treatment of neuropathic or mixed pain failed. Methods The research was conducted at the Institute for Physical Medicine and Rehabilitation "Dr. Miroslav Zotović", Banjaluka. Ten patients, who had chronic pain resistant to other therapeutic options and a failed back surgery, were sent for an evaluation. Each patient underwent a 4-week evaluation by a team of medical specialists, phychologist and social workers. Additional diagnostic methods (MRI of the lumbosacral spine, electromyoneurography of lower extermities, congnitive assessment tests) were also performed to establish a proper indication for implantation of the system for spinal cord stimulation. Leads of a system for spinal cord stimulation were implanted percutaneously or surgically at the epidural space. Functional outcome measures (visual analogue scale, Oswestry index, anxiety and depression scales) were taken before the implantation of the system and on several followups. Results Four patients did not meet critea for the inclusion in the study (two were not ready, two showed psychopathological symptoms). One patient had a percutaneous lead implant, but it was removed after six months due to paresthesia. The remaining five had surgicaly implanted epidural leads and showed significant improvement in pain control, Oswestry index had lower values, and all except one patient had improvement registered by anxiety and depression scales. Conclusion. Short-term and long-term follow up showed a long lasting pain reduction and improvement of functionality in all patients.

Stereological analysis of melanocytic skin changes

Scripta Medica, 2009

Sažetak. Nevusi su definisani kao benigne proliferacije melanocita, odnosno varijeteti hamartomsk... more Sažetak. Nevusi su definisani kao benigne proliferacije melanocita, odnosno varijeteti hamartomskih i/ili neoplastičnih lezija u koži. Za razliku od melanomskih lezija, nevusi nakon određenog perioda rasta stagniraju, a potom involuiraju. Angiogeneza je neophodna, kako za početak, tako i za završetak procesa metastaziranja. Vaskularizacijom primarnog tumora počinje ekspanzivan rast, tumor dobija metastatski potencijal. Cilj rada je da se odrede stereološki parametri (volumenska, površinska i dužinska gustina) vaskularne mreže nevusa i okoline, te melanoma i peritumorskog područja na različitim anatomskim regijama. Istraživanje je obavljeno na 10 uzoraka benignih melanocitnih promjena (nevusi) i 10 malignih melanocitnih promjena (melanomi). Materijal dobijen biopsijom je fiksiran u 10% formalinu, a od uzoraka su pravljeni serijski rezovi. Vizuelizacija krvnih sudova je vršena Mallory metodom. Pomoću mikroskopa i digitalne kamere vršeno je fotografisanje uzoraka. Dobijene fotografije su obrađivane uz pomoć programa ImageJ, verzija 1.42e (National Institutes of Health, Bethesda, USA) uz korištenje testnog sistema A 100. Statistička analiza je urađena uz korištenje programa SPSS, verzija 15.0. Statistički značajna razlika postoji u volumenskoj i dužinskoj gustini vaskularne mreže nevusa i okoline nevusa, te u dužinskoj gustini vaskularne mreže melanoma i peritumorskog područja.

Stereological analysis of neurons of extraocular motor nuclei

Scripta Medica, 2009

Sažetak. Neuroni ekstraokularnih motornih jedara (nucleus nervi oculomotorii principalis, nucleus... more Sažetak. Neuroni ekstraokularnih motornih jedara (nucleus nervi oculomotorii principalis, nucleus nervi trochlearis et nucleus nervi abducentis) su zaobljeni multipolarni, rjeđe fuziformni ili ovalni motoneuroni, blijedog jedra i nepravilno raspoređenih Nisslovih tjelašaca. Cilj rada je da se odrede stereološki parametri neurona ekstraokularnih motornih jedara (volumenska i površinska gustina, i apsolutni broj po mm² površine). Istraživanje je obavljeno na 30 moždanih stabala čovjeka, oba pola, bez dijagnostikovanih neuroloških oboljenja, stratificiranim prikupljanjem uzoraka u transverzalnoj ravni. Semiserijski parafinski rezovi (debljine 0,3 µm) su bojeni Mallory metodom. Uz korišćenje mikroskopa na histološkim presjecima su identifikovana ekstraokularna motorna jedra i pomoću digitalne kamere slikano je intermitentno svako drugo vidno polje pod uvećanjem 400x. Dobijene slike su analizirane pomoću programa ImageJ, verzija 1.42e (National Institutes of Health, Bethesda, USA) uz korišćenje testnog sistema A 100. Statistička analiza je obavljena uz upotrebu programa SPSS (verzija 16.0) uz nivo značajnosti razlike od 5%. Statistički značajna razlika (p<0,05) postojala je u volumenskoj i površinskoj gustini, i apsolutnom broju neurona po mm² površine između nc.nervi oculomotorii principalis i nc.nervi trochlearis. Između nc.nervi oculomotorii principalis i nc.nervi abducentis statistički značajna razlika postoji u volumenskoj gustini, dok se između nc.nervi trochlearis i nc.nervi abducentis razlika pronalazi u vrijednosti površinske gustine i apsolutnog broja neurona po mm² površine.

Promjene kvantitativnih parametara neurona ekstraokularnih motornih jedara sa starenjem

Scripta Medica, 2017

Promjene neurona i krvnih sudovasubstantiae nigrae kod čovjeka tokom starenja - morfometrijsko istraživanje

Scripta Medica, 2017

Changes of Neurons and Blood Vessels of Human Substantia Nigra in Aging- Morphometric Study

Scripta Medica, 2017

Introduction: With aging, populations of dopaminergic neurons in the central nervous system show ... more Introduction: With aging, populations of dopaminergic neurons in the central nervous system show prominent pathological changes compared to other brain regions. Previous studies on substantia nigra were performed in cases of Parkinson's disease and in old age. Aim of the Study: Since Parkinson's disease is a disorder associated with age, it is important to examine how the relationship between neurons and blood vessels is associated with normal aging. Patients and Methods: Ten brainstems were sliced into three strata. Each stratum was sliced in semiserial sections and stained by Mallory method. Studied phases were neurons and blood vessels of substantia nigra. The analysis was conducted by camera "Leica EC3" under the 40x magnification of light microscope "Leica" DM 1000, using ImageJ software (version 1.42 e). Determined morphometric parameters of neurons and blood vessels were: volume and surface density, and absolute numbers per visual field. Statistical analysis was performed using SPSS software, version 16.0, using Student's t-test and Pearson correlation coefficient. Results: Volume and surface density, and total number of neurons per visual field of substantia nigra significantly decreased with age, while the volume and surface density and absolute number of blood vessels per visual field significantly increased (p < 0.05). Conclusion: Decrease in size and number of neurons occurs with aging, which is compensated by the increase of vascular network. This affects the supply of nutrients from the blood to neurons, as well as the availability of blood cells or toxic substances, but also the susceptibility to neuronal diseases.

Age- Related Changes of Quantitative Parameters of Neurons in Extraocular Motor Nuclei

Scripta Medica, 2017

Introduction: Extraocular motor nuclei are located in the midbrain (principal oculomotor and troc... more Introduction: Extraocular motor nuclei are located in the midbrain (principal oculomotor and trochlear nucleus) and in the pons (abducens nucleus). With aging, there are significant changes in eyeball mobility. Aim of the Study: The aim was to determine whether the quantitative parameters of neurons (volume and surface density, and the absolute number per mm² of the surface) in these nuclei significantly change with aging. Patients and Methods: The study was done on 30 adult brainstems, both male and female, without diagnosed neurological disturbances. Three-millimeter-thick strata were taken in transversal plane and cut in 0.3 micrometer semi-serial sections stained with Mallory method. The images of studied nuclei were taken by "Leica" DM 1000 microscope and "Leica" EC3 digital camera under 400x magnification and analyzed by ImageJ software with A100 grid. The statistical analysis was performed by Statistical Package for the Social Sciences software using Pearson's correlation coefficient with 5% level of significance. Results: The volume density of neurons had highly statistically significantly increased with age in principal oculomotor nucleus (r = 0.571, p = 0.001) and trochlear nucleus (r = 0.581, p = 0.001), while abducens nucleus showed no change in neuron volume. Changes of values of surface density and absolute number of neurons per mm 2 with age did not reach statistical significance. Conclusion: Volume of neurons of extraocular motor nuclei located in the midbrain increase with age, while their surfaces and absolute number do not change significantly. These changes are not observed in the nucleus located in the pons.

Kvantitativna analiza magnocelularnog dijela nucleus ruber-a

Биомедицинска истраживања, 2016

Kratak sadržaj Uvod. Nucleus ruber zauzima centralni dio retikularne formacije srednjeg mozga, od... more Kratak sadržaj Uvod. Nucleus ruber zauzima centralni dio retikularne formacije srednjeg mozga, od donjeg kraja gornjih kvržica srednjeg mozga do ventralnog talamusa. Vaskularizuju ga grane P 1 i P 2 segmenta arteriae cerebri posterior, arteriae communicans posterior i arteriae choroidea anterior. Ciljevi rada su kvantitativna analiza neurona i vaskularne mreže magnocelularnog dijela nucleus ruber-a, kao i ispitivanje uticaja starenja na parametre kvantitativne analize. Metode. Deset srednjih mozgova odraslih lica oba pola je nakon fiksacije u 10% rastvoru formalina ukalupljeno u parafinu. Zbog lokalizacije magnocelularnog dijela nucleus ruber-a, uzorci srednjih mozgova su presječeni u visini sredine gornjih kvržica srednjeg mozga i idući kaudalno pravljeni su semiserijski rezovi (1,5,10...50) debljine 4 µm, koji su bojeni Mallory metodom. Pomoću digitalne kamere slikano je intermitentno svako drugo vidno polje pod uvećanjem 400x, a dobijene fotografije su analizirane pomoću programa ImageJ, uz korišćenje testnog sistema A 100. Statistička analiza je obavljena uz upotrebu programa SPSS, uz nivo značajnosti razlike od 5%. Rezultati. Prosječne vrijednosti kvantitativnih parametara neurona su iznosile: volumenska gustina 0,018 mm 0 , površinska gustina 3,56 mm-1 i apsolutni broj po vidnom polju 35,39. Prosječna volumenska gustina vaskularne mreže magnocelularnog dijela nucleus ruber-a je 0,014 mm 0 , površinska gustina 4,19 mm-1 i dužinska gustina 90,82 mm-2. Nije postojala korelacija između godina života i određivanih kvantitativnih parametara neurona i vaskularne mreže magnocelularnog dijela nucleus ruber-a. Zaključak. Ispitivani kvantitativni parametri neurona i vaskularne mreže magnocelularnog dijela nucleus ruber-a se smanjuju sa godinama života, ali smanjenje nije statistički značajno.

Quantitative analysis of vascular network of oculogyric nerve nuclei

Medical review, 2011

Introduction. Nuclei of oculogyric nerves (principal oculomotor nucleus, trochlear nucleus and ab... more Introduction. Nuclei of oculogyric nerves (principal oculomotor nucleus, trochlear nucleus and abducens nucleus) are densely vascularized brain?stem structures. The aim of this study was to determine quantitative characteristics of the vascular network of these nuclei. Material and methods. The study was done on 30 adult brainstems, both male and female, without diagnosed neurological disturbances. Three-millimetrethick stratums were taken in transversal plane and cut in 0.3 micrometer semi-serial sections stained with Mallory method. The images of studied nuclei were taken with ?Leica? DM 1000 microscope and ?Leica? EC3 digital camera under 400x magnification, and analyzed by ImageJ software with A 100 grid. The statistical analysis was performed by Statistical Package for the Social Sciences software with 5% level of significance. Results. A statistically significant difference was found in the volume and surface density between principal oculomotor nucleus and trochlear nucleus, ...

Stereological analysis of the human pons vascular network

Acta medica …, 2003

Blood vessels which supply pons are the branches of the basilar artery, anterior inferior cerebel... more

Stereological analysis of vascular network of subcortical auditory centers

Биомедицинска истраживања

Introduction. Subcortical auditory centers have several sources of blood supply. Cochlear nuclei ... more Introduction. Subcortical auditory centers have several sources of blood supply. Cochlear nuclei are vascularized by the anterior inferior cerebellar artery. Superior cerebellar and posterior cerebral arteries supply the inferior colliculus nucleus, while the medial geniculate body nucleus is supplied by several posterior cerebral artery branches. The aim of the research was to quantify the vascular network of subcortical auditory centers. Methods. Twelve adult brains, both sexes, aged 21 to 78 years, without signs of neurological diseases were analyzed in this study. Samples for histological sections, stained by the Mallory method, were obtained from strata cut at levels: the junction of the middle and rostral thirds of the oliva, the inferior colliculi, and the thalamic pulvinar. Volume, surface, and length density of the vascular network of subcortical auditory centers were analyzed stereological parameters. Results. All parameters had the highest values in the medial geniculate ...

Faktori koji utiču na ishod liječenja sindroma kaude ekvine

Биомедицинска истраживања, 2016

Uvod. Grupa znakova i simptoma koji se javljaju kao rezultat oštećenja nervnihkorjenova caudae eq... more Uvod. Grupa znakova i simptoma koji se javljaju kao rezultat oštećenja nervnihkorjenova caudae equinae smještenih u kičmenom kanalu nosi naziv sindromkaude ekvine (cauda equina syndrome). Najčešće je uzrokovana lumbalnomhernijacijom intervertebralnog diska. Klinička slika se karakteriše bolom ukrsnom, glutealnom i perinealnom regionu, bolom duž zadnje strane donjegekstremiteta, utrnulošću i motornim i senzornim deficitima na donjim ekstremitetima.Može se javiti i disfunkcija mokraćne bešike i potencije.Prikaz bolesnika. Pacijent dolazi na pregled kod fizijatra zbog jakog bola uslabinskom segmentu, koji se propagirao duž oba donja ekstremiteta praćenosjećajem slabosti, više lijevo, te nemogućnosti pražnjenja mokraćne bešike.Snimak dobijen nuklearnom magnetnom rezonancom (NMR) pokazujeprotruziju intravertebralnog diska na dva nivoa. Pacijent je podvrgnut operativnomzahvatu: Hemilaminectomia L4 l. sin et foraminotomia L5-S1 l. sin,extirpatio disci. Mjesec dana nakon operativnog zahvata...

Stereologic Analysis of Vascular Net and Nerve Cells of General Somatomotor Nuclei of Cranial Nerves

Acta Medica Medianae, 2006

The analysis was done on 10 samples of general somatomotor nuclei (GSN) of cranial nerves located... more The analysis was done on 10 samples of general somatomotor nuclei (GSN) of cranial nerves located in the brain stem, which were colored by the Mallory method. The research was conducted by standard testing system A 100 with the use of the light microscope and 40 x zoom objective. We determined the volume density of vascular net and nerve cells of investigated structures. The obtained values were mutually compared. GSN located in mesencephalon were more significantly vascularized. A part of the oculomotorius nuclei, made of nerve cells, is significantly larger compared with other GSN. The oculomotorius nuclei have equal number of nerve cells and blood vessels, while the number of blood vessels in the other GSN is a significantly larger.

Morfološka i topografska analiza krvnih sudova cisternalnog segmenta vestibulokohlearnog nerva

БИОМЕДИЦИНСКА ИСТРАЖИВАЊА, 2011

Uvod. Kompresija nerava od strane krvnih sudova u pontocerebelarnom uglumože uzrokovati funkciona... more Uvod. Kompresija nerava od strane krvnih sudova u pontocerebelarnom uglumože uzrokovati funkcionalne promjene ovih nerava. Radikularni, cisternalnidio vestibulokohlearnog nerva (n.VIII) ishranjuju grančice a. cerebelli anteriorinferior (AICA).Metode. Istraživanja su vršena na 40 mozgova odraslih lica, oba pola, dobiod 21 do 78 godina. Po završetku fiksiranja vršeno je fino preparisanje strukturapontocerebelarnog ugla, a zatim evidentiranje varijacija i odnosa krvnihsudova i nerava.Rezultati. AICA je u 17% desno i 6% lijevo bila dvostruka. Hipoplastična AICAje češće viđena na lijevoj strani (30 %). Odnos sa n. abducens-om (n.VI) je ostvarivalačešće sa lijeve strane, a sa n. facialis-om (n.VII) i n.VIII češće desno.AICA je u 22% desno i u 30% lijevo pravila omču oko n.VIII. Kada je riječ oodnosu bočnih grana AICA i n.VIII, najčešće su druga desna (45 % slučajeva) idruga lijeva (35 % slučajeva) grana imale blizak odnos sa pomenutim nervomZaključak. Iako postoji čest nalaz bliskog odnos...

Problems, interventions, and their outcomes during the routine work of hospital pharmacists in Bosnia and Herzegovina

International Journal of Clinical Pharmacy

Morfološka i topografska analiza krvnih sudova cisternalnog segmenta vestibulokohlearnog nerva

БИОМЕДИЦИНСКА ИСТРАЖИВАЊА, 2011

Uvod. Kompresija nerava od strane krvnih sudova u pontocerebelarnom uglumože uzrokovati funkciona... more Uvod. Kompresija nerava od strane krvnih sudova u pontocerebelarnom uglumože uzrokovati funkcionalne promjene ovih nerava. Radikularni, cisternalnidio vestibulokohlearnog nerva (n.VIII) ishranjuju grančice a. cerebelli anteriorinferior (AICA).Metode. Istraživanja su vršena na 40 mozgova odraslih lica, oba pola, dobiod 21 do 78 godina. Po završetku fiksiranja vršeno je fino preparisanje strukturapontocerebelarnog ugla, a zatim evidentiranje varijacija i odnosa krvnihsudova i nerava.Rezultati. AICA je u 17% desno i 6% lijevo bila dvostruka. Hipoplastična AICAje češće viđena na lijevoj strani (30 %). Odnos sa n. abducens-om (n.VI) je ostvarivalačešće sa lijeve strane, a sa n. facialis-om (n.VII) i n.VIII češće desno.AICA je u 22% desno i u 30% lijevo pravila omču oko n.VIII. Kada je riječ oodnosu bočnih grana AICA i n.VIII, najčešće su druga desna (45 % slučajeva) idruga lijeva (35 % slučajeva) grana imale blizak odnos sa pomenutim nervomZaključak. Iako postoji čest nalaz bliskog odnos...

The Effects of Continued Rehabilitation After Primary Knee Replacement

Medical Archives, 2016