Introduction: to evaluate the frequency and significance of immunohistochemistry-based molecular subtypes of breast cancer and investigate their association with traditional pathological features for breast cancer among Bosnian women. Materials and methods: this study included 100 female patients with primary invasive breast cancer. Immunohistochemical analyses for estrogen receptor (ER), progesterone receptor (PR), HER-2 and Ki-67 were performed to define four biological subtypes: luminal A, luminal B, HER-2-positive and triple-negative. Results: the frequency of luminal A, luminal B, HER2-positive and triple-negative subtypes of breast cancer was 44%, 39%, 11% and 6%, respectively. Molecular subtypes of breast cancer among Bosnian women showed to be independent of traditional pathological features (p>0.05). Ki-67 showed significant di erence regarding luminal B tumor type, where high (≥14%) Ki-67 score was predominantly represented in 36 (92.3%) cases (p<0.001). Conclusion: immunohistochemistry-based molecular subtypes of breast cancer in Bosnian women somehow vary in pathological features, i.e. luminal A subtype in this sample comprised mostly ductal histological type, moderate di erentiation with the involvement of lymph nodes, known as worse prognostic factors, although with no statistical significance.

Objective : There is a growing awareness of the developmental importance of distinguishing complex from simplex febrile seizures (FS) in early childhood. The aim of this study was to investigate the association between risk factors and clinical characteristics of simple and complex febrile seizures. Methods : We assessed risk factors and clinical features of febrile seizures in all children who were admitted to the Pediatric Clinic with the diagnosis of FS from January 2010 to January 2012. Two hundred and ten children having a history of FS were evaluated for age at onset of FS, age of repeated FS, total number of FS in the past, family history of FS and epilepsy. The febrile seizures were classified as simple and complex. Results : Compared with children with simple FS, complex FS were associated with more seizures in the past (OR=2.20, 95% CI: 1.31, 1.70, p=0.003). Furthermore, family history of FS increased the odds of repeated seizures within 24h (adjusted OR=2.98, 95% CI: 1.14, 7.79, p=0.026). Similarly, family history of epilepsy increased the odds of repeated FS within 24h (adjusted OR=6.20, 95% CI: 1.01, 39.4, p=0.049). Conclusion : Our study showed that higher number of FS in the past might be associated with complex FS. Our findings also show that early detection of repeated seizures within 24h in children with family history of FS and epilepsy might be a gateway to improve early diagnosis of epilepsy. However, larger prospective study with parent’s involvement in FS detection are needed. Keywords : febrile seizures, classification, prognosis, epilepsy, children

Introduction: Therapeutic ultrasound is a physical modality which is constantly expanding range of indications. Analgesic effect of ultrasound is still under discussion. Regardless the extensive application of pulsed ultrasound of low intensity, continuous ultrasound has a better analgesis effect, which is explained by its mechanism of action. Aims: The main research objective of this study was to determine the effect of continuous ultrasound to pain caused by degenerative diseases of the musculoskeletal system in the intensity and duration of ultrasound treatment. Other objectives are entailed determining the correlation between the degree of pain reduction with: location of pain, age, gender and body mass index (BMI). Material and methods: The study included 68 patients with chronic pain localized in the region of the spine or major joints of the extremities, depending on the localization of the degenerative changes. Patients are divided into two groups. The first group was treated with 10 applications of continuous ultrasound with frequency of 1 MHz, intensity 0.4 W/cm2 for 8 minutes, and the other group with 10 applications of ultrasound with frequency of 1 MHz, intensity 0.8 W/cm 2 for 4 minutes. Results and Discussion: Pain intensity was assessed before and after ultrasound therapy performed by subjective visual analogue scale (VAS) for pain, numbered from 0-10, where 0 is the rating for the state of no pain, and 10 grades for severe pain. The average VAS improvement in the first group was 3.97, and 4.74 in second one. The results of F (1.66) = 2.93, p = 0.09 analysis of variance showed no significance difference between the average improvement of two groups. Correlation between the degree of pain reduction showed significance only with BMI, or that higher BMI is associated with a lower degree of pain reduction. The results of this study showed that application of continuous ultrasound in patients with chronic pain, caused by degenerative changes in the musculoskeletal system, led to a significant reduction in pain. Different intensity and duration of ultrasound application showed no significant effect on the degree of pain reduction. Body mass index showed significant negative correlation with the degree of pain reduction, but age, gender and location of pain did not show significant correlation.

INTRODUCTION Osteoporosis is bone disease characterized by reduced bone mass and reduction of bone tissue. Main complications of osteoporosis and major cause of morbidity and mortality in elderly population are fractures. Early diagnosis and detection of osteoporosis can prevent complications of osteoporosis in terms of fractures. OBJECTIVES Diagnostic assessment of osteoporosis is mostly being done threw two commonly used methods: ultrasound of calcaneus and osteodensitometry (DXA). The results were compared through a prospective study involving two groups of patients with osteoporosis. PATIENTS AND METHODS The study included 100 female patients with average age 54. In I phase every patient had some protocol. That protocol included: age, body, mass index (BMI), employment, marrital status, risk factors (smoking, coffee, physical activity), endocrine causes of osteoporosis and osteoporotic fractures. ln II phase for every patient we were using two methods in diagnostics of osteoporosis: ultrasound of calcaneus and DXA. In both methods, we analyzed T score and Z score. RESULTS 21% patients had 21,12 BMI (low BMI), 58% patients were in menopauses, triad of risk factors (smoking, consumption of coffee, low physical activity) had 32%, 28% of patients had osteoporotic fractures. Quality of life patients with osteoporosis was weak. T score is main score for diagnostics. Results of T score with UZ and DXA had statisticly significant differents. CONCLUSION T score (UZ) and maximum T score (DXA) (lumbal spine and hip) has statisticly similar value with potential possibility to predict osteoporosis fractures.

UNLABELLED Prevalence of chronic pain which develops after spinal cord injury (SCI) varies, but in average is 65%. There are many questionnaires and scales for characterisation and classification of chronic SCI pain. One of them is LANSS (Leeds Assesment of Neuropathic Symptoms and Signs) scale for differentiation of neuropathic pain. Aims of this study were: (1) To assess prevalence of chronic pain in the sample of patients with SCl; (2) To classify the pain; (3) To analyse its correlations with demographic and neurological features as well as with activities of daily life (ADL); (4) To evaluate pain treatment. PATIENTS AND METHODS Retrospective, randomized, observational study based on personal interview, Visual Analog Scale (VAS) for pain intensity evaluation, graded from 0 to 10, and on LANSS scale included 100 patients. RESULTS 50% of patients reported existence of chronic pain. In 80% of them pain was below the level of SCI and in 20% of them pain was at the level of SCI. 92% of patients with chronic pain fulfilled LANNS score for neuropathic pain. VAS showed higher intensity of pain among men (average 7.4) than in women (average 6.6). There were positive correlations: between VAS and LANSS scale (p = 0.002), between VAS and age (p = 0.040) and between VAS and level of injury (Pearson rho = 0.329; p = 0.020). 60% of patients declared pain interference with ADL. 24% of patients did not treat pain at all, 16% treated pain with physical procedures and 60% treated pain pharmacologically. CONCLUSIONS RESULTS of this study confirmed high prevalence of chronic pain among patients with SCI, and its features indicated neuropathic type of pain. Pain intensity had positive correlation with gender, age, level of SCI and ADL. RESULTS showed that pharmacological treatment of this pain is much more in use than non-pharmacological one.

One of the complications caused by spinal lesion is osteoporosis which development is induced by lesion itself, and its mechanism is not explained enough. Risk factor of this kind of osteoporosis is fracture which management is difficult and is cause of further complications which aggravate already damaged quality of life of patients with spinal cord injury, and demand additional health insurance expenses. Importance of prevention and treatment of spinal cord injury induced osteoporosis is enlightened by case report.

Kinesitherapy (KT) is field of rehabilitation that uses the movement in order to cure patient. Knowledge about movement, condition and method of act of movement determine the final effect of this kind of treatment. Nevertheless, the role of patient is active and the positive effect can be achieved only if patient understand his role in process of therapy. The role of patient is frequently forgotten and the results of this research are valuable in assessment of patients' role in treatment.

Periarticular ossifications in paraplegics most frequently occur around the hip. Typically, the newly formed bone limits foremost flexion. The ossification takes place in the connective tissues of the muscle; its etiology and pathogenesis remain to be elucidated. In general, neither the joint nor its capsule are involved in the process of ossification. The incidence of HO in paraplegics is said to 18% of clinically relevant ossifications. There is a general consensus that surgery should only be performed after maturation of the ossification. The determination of alkaline phosphatase and a bone scan are used for assessment of osteogenic activity.

Low back pain, with or without propagation to lower extremities, still remains challenge not only for therapy but as diagnostic entity as well. This is the reason why literature is regularly refreshed with new epidemiological studies of low back pain. Six years retrospective study included 55.725 patients rehabilitated in Rehabilitation centre "Reumal" in Fojnica, from January 1997 to December 2002. From this sample it has been isolated 12.296 patients with diagnosis referred to low back pain, in order to get certain epidemiological parameters of low back pain, as: intrahospital prevalence, gender and age overview, overview of diagnostic entities referred to low back pain and their relationship to gender. Total prevalence of low back pain was 22,6 %, ranging from 17,8 % to 28,6 % by years. This epidemiological parameter of low back pain, as well as others, correlate with data of other studies.

The authors presented this case because of the determined characteristics in the clinical picture and electrophysiologic finding which refer to spinocerebral degeneration and neuropathia of the hereditary type, and give the possibility of the classification into two nosologic entities. One is Roussey Levy's syndrome, what is the advisable diagnosis of our patient, and another Freidreich's ataxia. Regardless to the impossibility of the establishing of diagnosis by means the specific enzimatic and genetic tests, the authors on the basis of the clinical picture, electromioncurographic findings and data from the literature of the diagnostic ally decided for Freidreich's ataxya. The neuropathy have classified into the hereditary motor sensor neuropathy--HMSN type II and presented its characteristics.