A prospective case study was conducted in the Department of Occupational Medicine, Tuzla. The purpose of this study was to indicate negative effects from occupational exposure to mercury on behavioural and mental health, memory and psychomotor function that was tested in 46 chloral-alkali plant workers (mean age was 38. 8+/- 5. 7 years; mean age of occupational history 16. 5+/- 6. 0 years). Data on toxicological monitoring on atomic absorption spectrometer, and data on mental health were collected, psychiatric and other subjective symptoms, and behavioural, psychomotor and memory function tested. The data were compared to control group, 32 healthy non exposed workers. The study was designed to assess blood and urine mercury levels and length of occupational exposure and investigate its relationships to effects on the mental health. The mean air mercury levels were 0.23 mg/m3, the mean blood mercury concentrations was 3. 6 mg/ dl and the mean urine mercury concentrations were 151.7 +/- 180.4 mg/l. In 25 (53%) workers exposed to mercury vapour was identified Depression-Hypochondrias Syndrome (p trend < 0. 001) with higher scores for scales: Hysteria (p trend <0. 001), Schizoid and Psychoastenia (MMPI). All psychological parameters were in highly significantly correlations with mercury levels and length of occupational exposure. Pathological parameters were possible general identified if the concentration of blood mercury levels are >2. 9 mg/ dl, or urine mercury levels > 87 mg/l workers exposed to mercury vapour knew that toxic effects in body resulted in loosing some of intellectual abilities, and that people who handle chemicals had an increased health risk (ESW questionnaire). The occupational mercury exposed workers had introvert behaviour (EPQ). Aggressiveness was found in 71.7% workers. The cognitive disturbances: short-term memory loss, difficult to concentrate on tasks which require attention and thinking, were significantly differed compared to those of controls (p trend < 0. 001). In 24 (52%) exposed to mercury workers we have determined ego strength loss and regressive defensive mechanisms (LB). Handwriting disturbances-micrography we have identified in 27 (58.7%) workers.

Huntington's disease is the most prominent basal ganglion disease. Huntington's gene, IT15, in chromosome 4p16.3, has 67 axons with 10,366 bp coding space and unstable CAG sequence that codes glutamine on 5' terminal. The molecular-genetic analysis of disease determined expansion of nucleotide repeated CAG sequences. In large Bosnian family with Huntington's disease specific DNA diagnosis of IT15 gene mutation is performed, according the wishes of one female member with "high genetic risk", that voluntarily accessed to DNA test in order to make plans for her own family "without risk" of pathologic gene transmission. A mutation in IT15 gene (number of CAG tandem repeats 46, size of DNA fragment 165 bp and 245 bp) is detected in DNA of her clinically affected brother. But, results of PCR analysis of her DNA sample showed 23 CAG tandem repeats (fragment size 180 bp) that excluded presence of Huntington's disease. We accentuate importance of DNA test in persons with "genetic risk", that are not gene carriers. In that case there are able to create own future without fear of pathological gene transmission.

Psychiatric services in Bosnia-Herzegovina before the war disaster was fairly developed and one of the best organized services amongst the republics of the former Yugoslavia. The psychiatric care system was based on psychiatric hospitals and small neuropsychiatric wards within general hospitals, accompanied by psychiatric services in health centers. The onset of war in B&H brought devastation and destruction in all domains of life, including the demolition and closing of numerous traditional psychiatric institutions, together with massive psychological suffering of the whole civilian population. Already during the war, and even more so after the war, the reconstruction and reorganization of the mental health services was undertaken. The basis of mental health care for the future is designed as a system where majority of services is located in the community, as close as possible to the habitat of the patients. The key aspect of the system of the comprehensive health care is primary health care and the main role is assigned to family practitioners and mental health professionals working in the community. Large psychiatric institutions were either closed or devastated, or have their capacities extensively reduced. There will be no reconstructions or reopening of the old psychiatric facilities, nor the new ones will be built. The most integrated part of the psychiatric system are the Community based mental health centers. Each of these centers will serve a particular geographic area. The centers will be responsible for prevention and treatment of psychiatric disorders, as well as for the mental health well being. Chronic mental health patients without families and are not able to independently live in the community will be accommodated in designated homes and other forms of protected accommodation within their communities. The principal change in mental health policy in B&H was a decision to transfer psychiatric services from traditional facilities into community, much closer to the patients. Basic elements of the mental health policy in B&H are: Decentralization and sectorization of mental health services; Intersectorial activity; Comprehensiveness of services; Equality in access and utilization of psychiatric service resources; Nationwide accessibility of mental health services; Continuity of services and care, together with the active participation of the community. This overview discusses the primary health care as the basic component of the comprehensive mental health care in greater detail, including tasks for family medicine teams and each individual member. 1. Comprehensive psychiatric care is implemented by primary health care physicians, specialized Centers for community-based mental health care, psychiatric wards of general hospitals and clinical centers in charge of brief, "acute" inpatient care; 2. Primary mental health care is implemented by family practitioners (primary care physicians) and their teams; 3. Specialized psychiatric care in community is performed professional teams specialized mental health issues' within Mental health centers in corresponding sectors; 4. A great deal of relevance is given to development of confidence and utilization of links between primary health care teams and specialized teams in Mental health centers and psychiatric in patient institutions; 5. Psychiatric wards within general cantonal hospitals, departments of psychiatric clinics in Sarajevo, Tuzla, and Mostar, and Cantonal Psychiatric hospital in Sarajevo (Jagomir) shall admit acute patients as well as chronic (with each new relapse). Treatment in these facilities is brief an patients are discharged to return to their homes, with further treatment referral to their family practitioner or designated Mental health center; 6. Chronic mental patients with severe residual impairment in social, psychological, and somatic functioning, shall live in the community with their families or independently. Those chronic patients without families and economic and other resources to live independently shall be placed in supervised Homes in the communities where they live. The above delineated strategy of mental health care program in B&H has several fundamental and specific objectives, among which the most important are: Reduction of incidence and prevalence of some mental disorders, particularly war stress-related disorders and suicide; Reduction of level of functional disability caused by mental disorders through improvement of treatment and care of individuals with mental health problems; Improvement of psychosocial well being of people with mental health problems, through implementation of comprehensive and accessible service for community mental health care; and Respect of basic human rights of individuals with mental health disabilities. The program has been updated since 1996, after the two-year pilot program. The main goals for current two- and five-year period are: Implement the mental health care reform program by launching all 38 Mental health centers in the Federation of BiH by 2002; Complete the 10-day education and re-education of at least 50% of all professionals employed in mental health services in FB&H by 2002; and Achieve that 80 percent of all mental health problems are treated by family medicine teams (primary care practitioners) and specialized mental health services (Community mental health care centers) by 2005.

In this paper, the authors were researching on expression of posttraumatic stress disorder symptoms and on effect of psychosocial help to children. Existence, time of appearing, way of going through experience and expression of PTSD symptoms were established. There were methodical used structured interviews, Questionnaire for children (Saigh, 1991) and Estimation scale for engagement of children in group work. Refugee and domicile children of age from 7 to 11 years and from 12 to 16 years old were involved in program of psychosocial care. In this research there were more significant the girls than the boys (p < 0.005). Applied therapy methods have given significant effect in increasing of willing to take part in the dialogue (p < 0.005), in increasing of interest to work in group (p < 0.005) and bigger contribute each one within group (p < 0.005). By that, it is being confirmed that the effect of methodical procedure and therapy treatment at children is successful and applicable in future activities.

Purpose: The basic research goal of the current study was to determine the relationship between stressful life events and the appearance and course of psoriasis under the extreme conditions of war. Patients and Methods: A prospective study was made encompassing 181 patients with psoriasis. One half of the patients were soldiers in active duty under war conditions, the other half consisted of civilians who were living in an area that was frequently subject to shelling from across the nearby frontline. Diagnosis was based on clinical picture, patient history, and auxiliary diagnostic methods. The study has been carried out at the University Clinical Center of Tuzla, as a result of the cooperation between the Departments of Dermatology and Psychiatry. Although numerous measurement instruments were used, the present article concentrates on the analysis of stressful life events with standardized instruments such as ‘Five-Stage Rating Scale’, and ‘Social Readjustment Rating Scale’. Severity of the clinical picture was estimated according to the PASI score, a standardized measurement instrument. Results: Stress levels were observed to be very high: 75% of the soldiers scored above 300 points, with 34% even above 500 points. Civilians scored significant lower, but 51% still had scores above 300 points. Stress was found to be strongly correlated to severity of the disease with correlations of 0.862 and 0.773 (Kendall’s tau-b, p < 0.0001) for soldiers and civilians, respectively. Conclusions: In the past, many authors reported correlations between stress and severity of psoriasis. Our findings demonstrate that under extreme circumstances the correlation between severity of psoriasis and the experience of stress is also extremely strong.

The main purpose of this study was to determine the incidence of left handedness in 380 stuttering children and adolescents and also to examine the differences in variables of stuttering severity between the left- and right handed subjects. The results showed that the incidence of left-handedness in stuttering children was not significantly different from normally fluent children. The difference in variables of stuttering between the right- and left-handed subjects was determined using the t-test. The results obtained revealed that the difference between the left- and right-handed subjects was not statistically significant in variables of stuttering severity.

In this work is presented most frequently traumatic experience that had children during the war, level of traumatization, and discovery most frequently post-traumatic stress reactions. The works covering are school children age until 7 since 15 year with polytraumatic stress experience.

The war in Bosnia and Herzegovina has caused severe suffering of the population, and left behind destruction and misery. Hundreds of thousands were killed, ten thousands were severely injured, and almost the whole population has endured severe psychological traumas. The consequences today are numerous stress related psychical disorders, and especially PTSD. The war has almost destroyed the system of psychiatric services, and lead to lack of professional staff. Because of this, after the war, Federal Ministry of Health of Bosnia and Herzegovina has decided to carry out a complete reconstruction of psychiatric services based on new principles. Comprehensive care for improvement of mental health; prevention of mental illness, treatment and rehabilitation of mentally ill, should be transferred from institutions into the community. Consequently Ministry of Health have designed 38 Community Mental Health Centers in the Federation of Bosnia and Herzegovina in connection with already existing Primary Health Care centers (Dom zdravljas). Each of these centers is responsible for mental health in general within a catchment area of 50,000-80,000 inhabitants. A network of Community Mental Health Centers has started to operate. An efficient and useful training of the staff going to work in these centers have been carried out. Nevertheless, there is still significant resistance towards this new approach to mental health services and treatment of people with mental illness in the community. However, many problems related to this new program of community psychiatry have been identified and are under consideration.

While researching psychological disorders in soldiers during the war in Bosnia, besides the psychiatric simptomatology in post trauma stress disorder (PTSD), we analyzed also expressed somatic symptoms. The sample consists of 164 soldiers from the first front lines, divided into three groups: Group A (N = 51), soldiers who during the war asked for psychological and/or psychiatric help, group B (N = 51) soldiers who are after the war on stationary or clinical treatment and group C (N = 62) soldiers who during and after the war, did not ask for psychiatric help even though they had psychiatric problems. With the trauma questionnaire and obvious PTSD symptoms the degree of the traumatic experience and the structure of PTSD was determined, and with the self-evaluation health condition questionnaire the subjective health condition evaluation during the prewar, war and the time after the war was determined with expressed physical disorders. Another important difference was determined (P < 0.01) between soldiers who had a high stress level and suffered from PTSD, who asked during and after the war for psychological and/or psychiatric help (groups A and B) and soldiers who suffered less from PTSD and who did not ask for professional help during nor after the war (group C). 60.8% soldiers in group C and 42.1% in group B during the war, and 41.3% in group A and 92.2% in group B after the war, points out their weak or very weak health condition compared with the soldiers from group C, where 1.6% during the war and 9.7% after the war pointed out their weak or very weak health condition. Somatic symptoms are mainly in conjunction with the cardiovascular system, 47.1% in group A and 78.4% in group B, also gastrointestinal system, 50.9% in group A and 37.3% in group B, followed by back pains, 31.4% in group A and 43.1% in group B. The first signs of somatic symptoms are in direct connection with first signs of traumatic experience and first signs of PTSD symptoms. The results confirm previous researches and that is that soldiers with traumatic experiences which they can hardly bare and who suffer for a long period of time from PTSD have also the biggest number of somatic symptoms.

The association between HMSN and other diseases is not so frequent, but it is not unknown. Reports about the association between HMSN and cardiac disturbances are controversial, although a growing number of such cases is now being reported. We describe two cases of HMSN type 2 with stroke (one ischemic and one haemoragic type), which, to our knowledge, has never previously been reported.

Blocking activities of bunazosin and ketanserin on norepinephrine (NE)-induced vasoconstrictions were investigated in isolated, perfused canine and simian skeletal muscle arteries. NE caused an increase in perfusion pressure in a dose-related manner to almost the same extent in both canine and simian arterial preparations. Bunazosin and ketanserin inhibited NE-induced vasoconstrictions much more readily in simian arteries than in canine arteries. The mechanisms for the different adrenolytic activities of alpha 1-antagonists between these two arteries were discussed.