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Biomedical subjects

A Jusić

Publications and source records attributed to A Jusić.

At least 19 recordsLinked to original sources
PubMed1999

[Bioethics of dying].

The bioethical problems related to the dying person might be classified in four groups: 1) those of the society the person is involved in, 2) those of physicians and other health professionals, 3) those of the nursing staff in the broadest sense and 4) those connected with the dying person himself. The society must consider the death as a part and natural end of life. One of the most delicate problems related to patient-physician relationship is adequate information concerning the diagnosis and prognosis of the condition. A very complex problem is stopping or not introducing the treatment which cannot influence significantly the quality and length of life. Palliative therapy, although risky, should be introduced if suffering is great. The duty to alleviate suffering is more important than life prolongation. The nursing staff and family should honour the wishes of the dying. Active euthanasia legalization is too risky, especially for nonautonomous persons unable to express their will. In autonomous persons even the possibility of its realization could be the cause of extreme disturbances in patient/physician relationship. Active euthanasia, due to the involvement of public opinion, is already becoming a sociopolitical problem.

Ethics, Medical↗
PubMed1997

H-reflex, F-wave, transitional and missed response frequency distribution in limb muscles.

The late potential analysis was performed in 86 neurologically healthy subjects aged 0 month to 6 years. The following muscles were analyzed: soleus, flexor hallucis brevis, extensor digitorum brevis and abductor pollicis brevis muscle. Late potentials were evaluated according to H, HF, F and Ms (missing potentials) attributes. The potential population in a particular muscle in an age group was considered as 100%; the type frequency for a particular muscle in different age groups is presented as absolute value and percentage. No age specific combination was found. As no age specificity was recorded, attempts were made to differentiate the muscle specificity potential type distribution. The mean (x) of potential type percentages of all age groups in the same muscle was calculated. Thus, in soleus muscle, the following response types were found: 29% H-reflex, 15% HF potentials, 45% F-waves and 11% Ms potentials. Flexor hallucis brevis muscles had: 3% H-reflex, 6% HF potentials, 85% F-waves and 6% Ms potentials. In extensor digitorum brevis, not a single H-reflex or HF potential was found, whereas F-waves were observed in 46% and Ms in 54%. Abductor pollicis brevis produced 1% H-reflex, 2% HF, 66% F-waves and 31% Ms potentials. Therefore, the soleus could be defined as a high percentage of H, HF, F and low Ms responses muscle. Flexor hallucis brevis and abductor pollicis brevis had high F, very low H, HF and low or moderate Ms response muscles. In the latter, the percentage of Ms potentials was significantly higher than in the former. A very high percentage of Ms potentials was found to be an outstanding attribute of extensor digitorum brevis, as it never develops H or HF but only F potentials. The occurrence of H, HF, F and Ms responses in different limb muscles corresponded closely to that found in adults. There was no significant correlation with age. The potential type frequency of occurrence in individual muscles with aging remained more or less constant. There was no correlation with nerve conduction velocities (significantly slower during the first months of life) either. The results appear to favor the genetic determination of the electrophysiological phenomena observed, through motor units structure and function.

Action Potentials↗
PubMed1995

H-reflex and F-wave potentials in leg and arm muscles.

The systematic analyses of secondary muscle potentials of H-reflex and F-wave type were done in multicentric study. The examinations were carried out in healthy volunteers with 9 muscles analysed on the legs and 9 on the lower arms and hands. The H-reflex potential was found regularly in thigh muscles (vastus medialis 100%, biceps femoris 97%, semitendinosus 93%). Less frequently but still with high incidence it appeared in posterior lower leg muscles (soleus 93%, caput mediale gastrocnemii 73%). In anterior tibial muscle and extensor digitorum brevis it did not appear at all. Only exceptionally it was found in short peroneal muscle (3%) and occasionally, only on proximal nerve stimulation, in flexor hallucis brevis. The similar distribution pattern was found in lower arm and hand muscles with analysis on both sides. In flexor digitorum superficialis (73-70%) and flexor carpi radialis (73-57%) the percentage of H-potential muscles was the highest, in flexor carpi ulnaris (47-40%) lesser but still remarkable. Brachioradialis (37-30%) and extensor digitorum communis (27-27%) percentage decreased further. The even more distal, pronator quadratus (21-20%) and abuctor digiti minimi (17-17%) presented as muscles with low incidence of H-reflex positivity. In extensor indicis proprius (3%) the lowest H-potential incidence was found and in opponens pollicis no H-potential at all. F-waves if evaluated as "F-frequency" follow the similar distribution pattern. The lowest "F-frequency" was found on the legs in anterior tibial, short peroneal and extensor digitorum brevis muscles. In the last one more than one half of stimuli failed to evoke the F-potential. Those are the muscles in which H-potentials almost never appeared. The highest "F-frequency" was recorded in thigh, posterior lower leg muscle and flexor hallucis brevis. Some of the examinees displayed in almost all examined muscles H-potential (6 of 30), the others (9 of 30) had it in neither one or in a single muscle. It looks like as if a kind of H-reflex or F-wave individuals exist. If the H- or F-potentials distribution pattern got projected on the homunculus in quadrupedal position the following idea appears. The thigh muscles, the plantar flexors of the feet and hand and finger flexors are first of all tonic muscles mostly involved in standing or holding. The extensors of the foot/toes, respectively of hand/fingers interrupt phasically the sustained action of standing by lifting the foot/hand from the ground. The muscles with mostly tonic function produce much H-reflexes, transitional forms or at least F-wave with high "F-frequency". Is that a kind of phylogenetical remnants, better developed in the motorically less differentiated legs? Have the H-reflex muscles if compared with F-wave muscles different motor units structure? Have they different motoneurons, with different liability to produce recurrent discharges?

Adolescent↗
PubMed1994

Motor unit hyperactivity states (a correlative clinico-electromyographical study).

The systematic overview of spontaneous motor unit or muscle fiber activity is presented. In Part 1 the precise clinical description of fasciculations, myokymia and cramps/spasms was made using a dynamic holistic approach. The differences are often a matter of excitation quantity. Correlations with electrophysiological findings were elaborated on the grounds of literature data and personal experience. Electrophysiological correlations with clinically visible fasciculations resulted in the finding that the same clinical phenomenon may have many entirely different electrophysiological correlates. The special forms of repetitive discharges were described additionally: positive giant potentials of quadriceps muscles appearing in healthy muscular individuals and grouped potential discharges of very chronic nerve ending involvement. The electrophysiological features and genesis of many motor unit hyperexcitability signs were discussed, while topic differentiation possibilities and symptomatic treatment were recommended for some. The spontaneous activity in different nosological entities was presented in Part 2. Again the literature data on diseases with conspicuous fasciculations, myokymia and cramps with additional personal experiences (pesticide intoxication, Isaacs syndrome, hereditary autosomal cramp disease, chronic syndrome due to parathyroid insufficiency, chronic tetanus and others) were presented. A description was also given of personal observations in strictly localized forms: single nerve or root lesions and in M. Romberg patient. Symptomatic and causal treatment was suggested for some of them. Clinically similar signs may have entirely different causes responding specifically to carbamazepine, D3, PAM, or surgical decompression. The electromyographic finding may remain clinically silent even in myotonia.

Electromyography↗
PubMed1993

On the death.

The intention of this review is to approach the problem of right to decide on its own living or dying. An insight into world wide hospice movement started by Dame Cicely Saunders should be given. Finally it will be dealt with, about how to approach somebody who is dying. Asking for killing, if appears, is in fact objection against inadequate nursing and cry for more human attention. The starting idea of the hospice movement is that the death is natural event as well as the birth. The hospice with his teams wishes to help that the death would be accepted from patients, family and friends, improving at the same time the quality of this terminal part of the life. The most important in handling terminally ill persons, is a desire to help and an understanding of what's going on. The emotions and the reaction that you and the patient may experience should be understood. The human dignity should be emphasized everywhere and especially during the most critical period of human existence during the terminal period of life.

Euthanasia, Passive↗
PubMed1992

Amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a clinical entity differentiated during the last few years into definite, probable, possible and suspected ALS. There are many hypotheses trying to explain its genesis: slow virus hypothesis, trace elements, immunologic and trophic factors, excitotoxins, metabolic influences, DNA anomalies, and so on. It is necessary to differentiate ALS like syndromes and ALS variants. Some of the ALS like syndromes can be treated. Only the disease elaborated like that may be submitted to clinical therapeutical trials or molecular-genetic research. Palliative therapy is still necessary. It does not prolong life, it makes its quality better.

Amyotrophic Lateral Sclerosis↗
PubMed1990

Steroid responsive familial neuropathy with liability to pressure palsies.

Autosomal dominant motor and sensory neuropathy with liability to pressure palsies was studied in three members of the same family. Only one of two monozygotic twin sisters was clinically affected. She developed unilateral peroneal palsy twenty minutes following local pressure. Electromyography revealed a weak intermediate innervation pattern with very rapid action potentials in the right anterior lower leg muscle. A 25-70 per cent reduction of motor and sensory conduction velocity was recorded in the clinically unaffected twin sister and in the father. The electrophysiological findings in the mother were normal. The sural nerve biopsy revealed "sausage-like" formations. The palsy persisted for two months and disappeared after eight weeks of fluocortolon treatment. It is possible that the myelin sheaths acted as antigen.

Biopsy↗
PubMed1989

Hereditary increased muscle mechanical irritability and progressive contracture with stretch-induced electromyographic activity.

A son and mother are reported with autosomal dominantly transmitted painless, increased mechanical irritability in the limb and trunk muscles and progressive finger contracture. Immediately after a tap, muscle swelling appeared. With light tapping, wavelike muscle surface movements appeared. Progressive contractures developed first in the proximal interphalangeal finger joints and subsequently involving the lower arm muscles. The contractures disappeared in the local curare test. No spontaneous activity was recorded on concentric needle recording. Serial repetitive activity was recorded with fine wire electrode recording, induced by muscle stretch, performed by percussion hammer blows or by prolonged finger grasp. A slight, irritative peripheral nervous lesion could be the cause. The chronic sensorimotor polyneuropathy may be also a part of the syndrome.

Adult↗
PubMed1989

[The terminal latency quotient in patients with compressive syndromes].

In our investigation 119 patients suffering from carpal tunnel syndrome, and 45 suffering from cubital tunnel syndrome have been analyzed. The above mentioned syndromes belong to compressive mononeuropathies and are the result of the narrowing of the anatomical channel, through which the nerve passes, causing direct or indirect pressure on the nerve and difficulties in the flow of particles and nerve impulses towards the periphery. The aim of our work was to study the influence of the compressive lesion, primarily on the distal motor and sensory latencies. To achieve a better precision, the distal motor latency is expressed as a quotient of terminal latency. It is obtained by dividing the distance between the stimulation and the recording point in centimeters with the latency of response expressed in miliseconds. Sensory latencies are obtained by orthodromic stimulation of the finger and the detection of the neural potential at the wrist. According to our results, the proximal pathological process, besides causing the localized slowing down of conduction velocity, affects the conduction velocity of the distal sensory fibers in a higher degree than of the distal motor fibers. In any case the distal motor latencies are in a higher percentage prolonged by the distal lesion, such as carpal channel syndrome, in comparison with the proximal lesion (cubital tunnel syndrome). The less pronounced prolongation of the distal latencies, especially of sensory ones, must not be proclaimed as a consequence of a local compression without additional plurisegmental analysis.

Action Potentials↗
PubMed1987

Selective ACTH insensitivity associated with autonomic nervous system disorders and sensory polyneuropathy.

A 10-year-old boy is described with a syndrome of adrenal insufficiency due to selective ACTH insensitivity associated with autonomic nervous system disorders. In addition to insufficient production of glucocorticoids and adrenal androgens, achalasia, defective lacrimation, anisocoria and hyperkeratosis of palms and soles we also found defective sweating, permanent cutis anserina and sensory polyneuropathy, which have not been reported previously in this rare syndrome.

Adrenal Cortex Diseases↗
PubMed1985

Rigid spine syndrome associated with tent-like configuration of the thoracic cage, cerebral lesion and delayed sexual maturation in three patients.

Three male patients with rigid spine syndrome and predominantly proximal myopathy which developed slowly from childhood are described; two cases were sporadic, one possibly hereditary. All three had the same associated signs and symptoms, differing only in degree. They had tent-like thoracic cages with very steeply sloping ribs, reduced anteroposterior diameter and reduced vital capacity. The EGGs were slightly abnormal. All the patients had some cerebral abnormality, in one case of diffuse demyelinating type. All had the signs and symptoms of slightly delayed puberty.

Adult↗