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Publikacije (59)

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M. Basoglu, M. Livanou, C. Crnobarić, T. Frančišković, E. Suljic, Dijana Durić, M. Vranesic

CONTEXT Although impunity for those responsible for trauma is widely thought to be associated with psychological problems in survivors of political violence, no study has yet investigated this issue. OBJECTIVE To examine the mental health and cognitive effects of war trauma and how appraisal of redress for trauma and beliefs about justice, safety, other people, war cause, and religion relate to posttraumatic stress responses in war survivors. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional survey conducted between March 2000 and July 2002 with a population-based sample of 1358 war survivors who had experienced at least 1 war-related stressor (combat, torture, internal displacement, refugee experience, siege, and/or aerial bombardment) from 4 sites in former Yugoslavia, accessed through linkage sampling. Control groups at 2 study sites were matched with survivors on sex, age, and education. MAIN OUTCOME MEASURES Semi-structured Interview for Survivors of War, Redress for Trauma Survivors Questionnaire, Emotions and Beliefs After War questionnaire, Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). RESULTS The mean (SD) age was 39 (12) years, 806 (59%) were men, and 339 (25%) had high school or higher level of education. Participants reported experiencing a mean of 12.6 war-related events, with 292 (22%) and 451 (33%) having current and lifetime posttraumatic stress disorder (PTSD), respectively, and 129 (10%) with current major depression. A total of 1074 (79%) of the survivors reported a sense of injustice in relation to perceived lack of redress for trauma. Perceived impunity for those held responsible for trauma was only one of the factors associated with sense of injustice. Relative to controls, survivors had stronger emotional responses to impunity, greater fear and loss of control over life, less belief in benevolence of people, greater loss of meaning in war cause, stronger faith in God, and higher rates of PTSD and depression. Fear and loss of control over life were associated with PTSD and depression (odds ratio [OR], 2.91; 95% CI, 2.27-3.74 and OR, 2.30; 95% CI, 1.75-3.03, respectively), and emotional responses to impunity showed a relatively weaker association with PTSD (OR, 1.53; 95% CI, 1.16-2.02) and depression (OR, 1.39; 95% CI, 1.02-1.91). Appraisal of redress for trauma was not associated with PTSD or depression. CONCLUSIONS PTSD and depression in war survivors appear to be independent of sense of injustice arising from perceived lack of redress for trauma. Fear of threat to safety and loss of control over life appeared to be the most important mediating factors in PTSD and depression. These findings may have important implications for reconciliation efforts in postwar countries and effective interventions for traumatized war survivors.

N. Loncarević, Jasminka Dzelinović, A. Alajbegović, E. Suljic, A. Kučukalić, Azijada Suljak

The acute polyradiculoneuritis represent acute inflamatory polyneuropathy with unknown cause, frequently induced by prior virus and sometimes bacteria infection. The purpose of this paper is to establish particularities of the clinical course and results of the disease during the war and the post-war time. Within the retrospective study we performed analysis of all patients suffering from the acute polyradiculoneuritis between January 1992 and December 2003 year who during the mentioned period where treated at the Department of Neurology in Sarajevo. In addition to the anamnysis and the clinical examination, diagnostic criteria where laboratory parameters, EKG, cardiological finding, cerebrospinal liquor (LP) and the EMG finding.

N. Loncarević, E. Suljic, A. Suljak-Loncarević, A. Kučukalić

Myasthenia gravis is in group of disorders transmission at the motor end-plates is abnormal. Myasthenia gravis is characterised by fluctuating weakness, consisting principally of abnormal fatiguability, with improvement after rest. Since this symptom is subjective the diagnosis is very difficult in the early stages. Lambert Eaton's myasthenic syndrome (LEMS) is characterised by weakness and fatiguability of proximal limb muscles, mainly in legs, with improvement after exercise. Considering the degree of disease, similar symptomatology with a substantially different treatment, we performed this paper to enable the earlier diagnosis and adequate care of these patients.

A. Alajbegović, D. Kantardžić, E. Suljic, S. Alajbegović

It is a general rule today, after a relevant diagnostics of an epilepsy, to start a monotherapy treatment, depending on a kind of a seizure, a life age and a general health condition. First line of monotherapy epilepsy drugs remain carbamazapine and sodium valproat. New drugs that are being introduced are: felbamat, gabapentin, lamotrigin, oxcarbazepin, tiagabin, topiramat, vigabatin and zanisamid. These are commonly used as add-on therapy, or as an addition for previously used antiepileptic. Their indicated areas are complex resistant partial seizures with or without generalization. Attention should be paid on proper dosage, interactions and toxicity. Regardless on the new epileptic era, according to reports of International League against epilepsy, most of the patients do not receive the drug that is the most appropriate for them concerning the price (cost-benefit). Neurosurgical methods in epilepsy treatment are: selective amygdalo-hyppocampotomy, temporal lobotomy, subpial resection, hemispherectomy, corpus callosotomy, removal of lesions like tumors or cysts provide encouraging results in reduction of epileptic seizures that can be followed by reduction of drug therapy. N. vagus stimulation is being wider introduced in resident epileptics. Treatment of epilepsy in women requires an approach to sexuality, conception, pregnancy, introduction of medicaments, antiepileptic terratogenity, contraception, motherhood and menopause. A special significance of modern approach to epilepsy is in treatment of elderly who have cerebrovascular and neurodegenerative disease as a cause of seizures. A complex treatment of epilepsy using pharmacological and neurosurgical approach requires supportive psychotherapy, socio-therapy, the work with a family, education about epilepsy and living a life with more quality having one.

UNLABELLED The state of mental confusion is described as an dependent risk factor in development of early and late epileptic-onset seizures following CVI. The aim of this paper is to determine the influence of confused state as possible predictor of symptomatic seizures in the course and following CVI. MATERIAL AND METHODS The patients who were treated in The Department of Neurology for early and late-onset seizures in the course and following CVI in the period between 1.1.1989 and 31.12.1998. RESULTS We had total number of 106 patients with symptomatic seizures, 56 in the group of late-onset and 50 in the group of early seizures. 52.8% of the patients have a registered state of mental confusion at the admission to hospital (in the stage of acute CVI), 19.2% of patients had a clear sensorium. Disorder of consciousness of the type of coma was registered in 27.4% of the patients. There was statistically significant increase of the occurrence of mental confusion in the group of patients with late-onset seizures, 62.5% while there was a statistically significant increase of coma in conditions related to type, frequency and outcome of seizures. We can conclude that mental confusion has significant influence of the occurrence of late-onset seizures while it does not influence the type and frequency of seizures.

E. Suljic, A. Alajbegović, A. Kučukalić, N. Loncarević

A seizure is a disturbance of movement, feeling or consciousness occasioned by sudden, inappropriate and excessive electrical discharges in the grey matter of the brain. The most common psychiatric disorder in epilepsy is interictal depression, with lifetime prevalence of 40 to 60%. Particular attention should be paid to suicidal ideations, due to the fact that most of the patients have easy access to potentially lethal when overdosed, antiepileptic drugs. The aim of our paper is to determine the presence of depressive symptoms in epileptic patients according to their treatment protocols (monotherapy or polytherapy), gender, age, social status, age when diagnosed, type and frequency of seizures. Prospective evaluation of monotherapy and polytherapy in 60 subjects, (30 subjects in each group), who were diagnosed with epilepsy. Assessment of depressive symptoms was performed with the use of BDI scale. In both groups there was a similar structure according to gender, mean age was 34 (with an s.d. of 11.06). More than 96 percent of the subjects had low or average socioeconomic status. Average age of first attack was 20.43 (with an s.d. of 11.9). In the group treated with monotherapy there was the biggest number of generalized convulsive seizures, and in the group treated with polyantiepileptic therapy there was the biggest number of partial complex seizures. Symptoms of moderate and severe depression were registered in 33% patients treated with monotherapy and 60% of patients treated with polytherapy (t = 2.198, for p less than 0.05). 16.7 percent of the patients had suicidal ideation. On the basis of our research we can conclude that significantly more frequent and severe depressive symptoms were found in the group of epileptic patients who were treated with polytherapy. In those patients the occurrence of partial complex seizures was the biggest, and their frequency was weekly or even daily.

2002.
0
A. Alajbegović, N. Hadziahmetovic, Amila Alikadić, E. Suljic

The facial nerve has predominantly the motoric, and less sensitive function and gets nerved the muscle musculature of the face and its damages, significantly disturbs the function of the series of the muscles of the face. Regarding to this that the parases of the nervus facialis are often in the physician practice, we have written this article with aim to facilitate to the physicians in the practice the early establishing of the diagnosis, and also to give the instructions into the basic physical and rehabilitation procedures which is with success to carry out in patients with the damages of this nerve.

2002.
0
A. Alajbegović, N. Hadziahmetovic, Amila Alikadić, E. Suljic

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