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Dzevdet Smajlović

Publications and source records attributed to Dzevdet Smajlović.

7 recordsLinked to original sources
PubMed2006

Five-year survival-after first-ever stroke.

The aim of the study was to analyze the 5-year survival after first-ever ischemic stroke and intracerebral hemorrhage. In this study 836 patients were analyzed with a first-ever stroke admitted at the Department of Neurology Tuzla, Bosnia and Herzegovina, from January 1(st) 1997 to December 31(st) 1998. Of these 613 (73,3%) were ischemic strokes and 223 intracerebral hemorrhages (26,7%) Subarachnoid hemorrhages were excluded. After hospitalization surviving patients examined periodically, and a final examination was performed 5 years after the stroke. Overall, case-fatility at the first month was 36% (301/836) and the mortality rate was significantly higher in the patients with intracerebral hemorrhage (58,3% vs. 27,9%, p<0,0001). The first year survived 60% patients with ischemic stroke, and 38% with intracerebral hemorrhage. After 5 years, 188 (31%) patients with ischemic stroke and 53 (24%) with intracerebral hemorrhage were alive (p=0,5), and the cumulative survival rate for the entire study was 29%. Among 30-day survivors (n=535) surviving rate after 5 years was significantly higher in patients with intracerebral hemorrhage (57% vs. 42,5%, p=0,01). The survival rate was the highest for those 50 years and younger (57%), and the lowest for those aged over 70 years (9%). Predictors of 5-year mortality were older age and hypertension for both types of stroke, heart diseases for ischemic stroke and diabetes for intracerebral hemorrhage. Long-term survival after first-ever ischemic stroke and intracerebral hemorrhage is similar. However, among 30-day survivors the 5-year survival is better in patients with intracerebral hemorrhage.

Age Factors↗
PubMed2005

[Ischemic stroke as reaction to an acute stressful event].

The period following ischemic stroke can be considered as a reaction to a stressful event. Changes in cortisol secretion are one of the indicators of stress reaction. The aim of the study was to determine morning serum levels of cortisol in stroke patients within 48 hours and 15 days of ischemic stroke onset. Study group included 40 patients, 20 of them were females, mean age 65.3 +/- 10.3 years. The patients did not receive any corticosteroid agents or spironolactone, and did not suffer from Cushing's or Addison's syndrome. Ischemic stroke was verified by computed tomography of the brain. The fluorometric method with DELFIA Cortisol immunoassay was used to determine morning serum cortisol levels. Reference values of the measured hormone were 201-681 nmol/l. The mean level of serum cortisol within 48 hours of stroke was 560.9 +/- 318.9 nmol/l, and on day 15 it was 426.2 +/- 159.3 nmol/l, i.e. significantly lower (p < 0.02). On the first measurement, the level of serum cortisol was elevated in 32%, and on the second measurement in only 7.5% patients, which was also significantly lower (p < 0.001). It was concluded that the stress reaction in ischemic stroke patients was more pronounced within the first 48 hours of stroke onset. Judging from the morning cortisol levels, the reaction to stress was considerably less pronounced 15 days after stroke onset.

Adult↗
PubMed2005

EEG frequency and cognitive dysfunction in patients with Parkinson's disease.

INTRODUCTION: Numerous studies showed EEG changes in patients with Parkinson's disease, in comparison with healthy subjects of same age. The most often presented change is generalised (or localised) slowing of frequency. AIM: To show the correlation of EEG frequency and Mini Mental Status (MMS) in patients with Parkinson's disease. PATIENTS AND METHODS: 32 patients with Parkinsons disease were analysed. An average age was 64.63 +/- 10.01 years, and most of them were men (24 or 75%). On the basis of MMS score, two groups were selected: with and without signs of dementia. For both groups, EEG frequency values were determined. RESULTS: There were 11 patients without dementia (MMS score = 23-30) with average age of 64.63 +/- 9.54 years; and with dementia (MMS score < 24) 21 patients (average age was 62.71 +/- 10.04 years). In patients without dementia, diffuse slowing down of frequency was found in one patient (9.1%); localised in three (90.9%). In dementia patients, four patients (19.04%) had diffuse slowing of EEG and seven (80.96%) had localised. A positive correlation of EEG frequency and MMS score was found (r = 0.46), and Parkinson's disease patients with dementia had more frequently EEG with slowing frequency than non-dementia patients. CONCLUSION: EEG slowing frequency is more frequent in Parkinson's disease patients with than without dementia.

Dementia↗
PubMed2005

[Anxiety in acute phase of ischemic stroke and myocardial infarction].

INTRODUCTION: Period after ischemic stroke and myocardial infarction is followed by different psychological reactions. Anxiety represents one possible psychological problem. AIM: To investigate presence of anxiety in patients within period from 48 hours till 15 days after ischemic stroke and myocardial infarction. SUBJECTS AND METHODS: Fourty patients formed analyzed group. Their average age was 65.3 +/- 10.3 years (33-83). Twenty of them were females. Thirty patients formed controled group. Their average age was 57.46 +/- 10.6 years (42-78). Eleven of them were females. Twenty questions self-assessment Zung scales were used for anxiety levels determination, Responses were scored by points, which were summarized as final result. Final score of 50 and more points suggested that anxiety was present. RESULTS: Average self-assessment anxiety score within 48 hours since ischemic stroke was 44.4 +/- 8.8 points, and 15-th day 42.2 +/- 7.7 (p=0.237). In twelve patients (30%) anxiety was found during the first surveying, and in 10 patients (25 %) during the second the surveying. Average self-assessment anxiety score within 48 hours since myocardial infarction was 43.1 +/- 8.3 points, and 15-th day 43.2 +/- 6.7 (p=0.959). In seven patients (23.3%) anxiety was found during first surveying, and in 5 patients (16.7%) during second surveying (p=0.52). CONCLUSION: Anxiety represents important psychological problem for patients after ischemic stroke and myocardial infarction. Aldo number of anxiety patients is larger within 48 hours after ischemic stroke and myocardial infarction, average value in anxiety scale stays unreduced even 15 days after the beginning of the disease.

Adult↗
PubMed2004

Sensitivity of the neuroimaging techniques in ischemic stroke.

The aim of this study was to investigate and compare the sensitivity and effectiveness of neuroimaging techniques in 190 patients with acute ischemic stroke. The first computed tomography (CT) scan for all patients was performed within the first 12 hours of the stroke symptoms onset. For each patient, between the third and fifth day of the hospitalization, at least one more neuroimaging procedure (CT and/or magnetic resonance imaging--MRI, and/or diffusion weighted imaging--DWI) was done. The CT scan in the first 12 hours of the stroke onset was positive in 32% of the patients; the highest number of the positive findings was in the patients with total anterior circulation infarct (52%). After 48 hours of the stroke onset second CT was positive in 85% (75/89), MRI in 93.5% (115/123), and DWI in 98.8% (79/80) patients. MRI was significantly more sensitive than CT in detection of ischemic lesion (88% vs. 72%, P=0.01), particularly in the patients with lacunar infarcts (75% vs. 50%, P=0.005). In detection of ischemic stroke 48 hours of the stroke onset the slightly higher number of strokes were detected on DWI in comparison with MRI (98.6% vs. 88.7%). According to our results, within the first 12 hours after the stroke onset, CT is reliable only for detection of considerable number of cortical ischemic strokes of the anterior cerebral circulation. After 48 hours from the stroke onset CT, MRI and DWI show high sensitivity in the detection of ischemic lesion of all clinical stroke subtypes. MRI is more sensitive in comparison with CT in detection of ischemic lesion, while DWI does not show dominance in comparison with MRI in identification of ischemic stroke after 48 hours of the symptoms onset.

Aged↗
PubMed2003

[Ischemic insult in the anterior and posterior cerebral circulation].

In the everyday practice among clinical and etiological classifications for ischemic stroke, the terms strokes in the anterior and posterior cerebral circulation are also in use. The aim of this study was to analyze the frequency of ischemic strokes in the anterior and posterior circulation, their age and sex distribution, risk factors and hospital mortality. In the study it was analyzed 1772 patients with acute ischemic stroke hospitalized at the Department of Neurology Tuzla, Bosnia and Herzegovina, between January 1st 1996 and December 31st 2000. The mean age was 65.5 years (+9.9), 942 (55%) were females. Ischemic strokes for all patients were confirmed with computed tomography, while other data were collected from the standard patients' history charts. Anterior circulation stroke (ACS) had 1408 patients (81.8%), the rest of 314 (18.2%) had posterior circulation stroke (PCS). In the both types females were slightly overrepresented: 784 (56%) in ACS, and 158 (50.5%) in PCS. Moreover, females were significantly older than males: 67 (+9.8) versus 64 (+10) years in ACS (p < 0.001), 67.5 (+10.3) versus 63.5 (+9.2) in PCS (p < 0.001). Hypertension was the major risk factor occurring in 67% patients with ACS and 71 with PCS; heart diseases 54% in the both types, and diabetes in 23% patients with ACS and 20% with PCS. The cortical ischemic lesion was verified in 46% patients with ACS, 41% with PCS; subcortical in 12.5% and 14.5%; and lacunar in 41.5% and 44.5%, respectively. Hospital mortality was 30% (430 patients) for ACS, and 32% (101 patients) for PCS. Hospital mortality was considerably higher among females: 33% versus 28% for ACS (p = 0.03), 38% versus 27% for PCS (p = 0.03). On the basis of our study we can conclude that ischemic strokes in the anterior cerebral circulation are 4/5 of all ischemic strokes at the Department of Neurology Tuzla. Both, anterior and posterior circulation strokes are more frequent in females, witches were in average older than males. The cortical lesion dominated in ACS, and lacunar in PCS. The distribution of risk factors (hypertension, heart diseases, and diabetes) is similar for ACS and PCS, and hospital mortality also; however, mortality rate is higher in females.

Aged↗