Biomedical subjects

F Catibusić

Publications and source records attributed to F Catibusić.

5 recordsLinked to original sources

PubMed2000

[Obstetrical injuries of the brachial plexus].

Although birth-related brachial plexus injury (BPI) was first described more than two centuries ago, it still represents therapeutic dillemma. Incidence is 0.37-2.0 per 1000 live births. The most frequent etiologic cause is extreme lateral traction and excessive fundal pressure in a case of shoulder dystocia. However, in last decade there are reports that cite of BPIs occurring prior to delivery in up to 46% cases--intrauterine maladaptation. In 1998. and 1999. at the Rehabilitation Department of Pediatric Hospital, Clinical University Center in Sarajevo 32 children with BPI were treated. The incidence is 2.67 per 1000 live births. There were 21 cases of Erb's palsy (65.63%), 2 cases of Klumpke's palsy (6.25%). Total plexus palsy was present in 9 children (28.63%), and Horner's Syndrome in 1 case. In 25.77% of cases (8 children) there was-no evidence of shoulder dystocia at delivery. Treatment of the brachial plexus injuries in newborn is still controversial. Proper immobilization in first 7-15 days is of great importance. In this study 25 children (78.13%), in average age of 4.6 days, were brought for examination with improper immobilization. The role of widely applied electrotherapy is controversial. Complete recovery is expected in about one half, and in this study it was achieved in 75% of cases (24 children). Consensus about timing od surgical approach does not exist still. However, there is strong agreement that decision about eventual surgical treatment should be based on clinical motor testing and that MRI should precede the surgery. Although the electrodiagnostic studies have proven to be of limited prognostic value in the evaluation of children with acute obstetrical brachial plexus injuries, electromyography should be performed prior the surgery in the aim of later comparison of the results. According to our data, at this particular moment in BiH surgical treatment in this age is not available, as well as use of MRI in diagnostics of BPIs.

Birth Injuries↗

PubMed2000

[Hypoparathyroidism].

Hypoparathyreoidism of different etiology is the most common disorder of parathyreoidea. Symptoms caused by hypocalcemia are dominant and they are sign of disturbed neuromuscular balance. Alopecia is frequent disorder which occurs in the course of the illness. We report a case of five year old girl sent from Mostar because seizures incurable by phenobarbitone. Total alopecia was obvious. At admission total serum calcium level was 1.23 mmol/l. The level of parathormon was measured two times, and both results were under lowest value of normal range (< 10 pg/ml). After introducing calcitriol (Rocaltrol) in therapy, serum calcium level was almost normal and child was without symptoms.

Alopecia↗

PubMed1999

[Vigabatrin in childhood epilepsy--personal experience].

Vigabatrin has been in clinical use for 18 years. It has not been used widely in our country because of unavailability and costs of therapy. After the end of war in Bosnia and Herzegovina we started to use it in treatment of childhood epilepsies. We studied 19 patients that received vigabatrin as add on therapy and monotherapy. Follow up period was 6 months to 2 years. Nine of those patients were diagnosed as West syndrome, three had tuberous sclerosis, seven had intractable partial epilepsies. In the group with West syndrome 7 patients (5 as add on therapy and 2 as monotherapy) responded with complete control of seizures and disappearing of hypsarrhythmia in electroencephalographic recordings. One patient responded with reduction of seizures for 50%, one did not respond. In the group with tuberous sclerosis 1 was completely seizure free, one had reduction of seizures for 75%, one did not respond. Out of 7 patients with intractable partial epilepsies 3 responded with reduction of seizures between 75%-100%, 1 with reduction of seizures of 25%-50%, and 3 did not respond. Vigabatrin was well tolerated, we did not experience any serous adverse reactions. This antiepileptic drug can be a major improvement in treatment of some of the epileptic syndromes and needs further investigation.

Adolescent↗

PubMed1999

[Clinical algorithms in the treatment of status epilepticus in children].

The clinical algorithm is a text format that is specially suited for presenting a sequence of clinical decisions, for teaching clinical decision making, and for guiding patient care. Clinical algorithms are compared as to their clinical usefulness with decision analysis. We have tried to make clinical algorithm for managing status epilepticus in children that can be applicable to our conditions. Most of the algorithms that are made on this subject include drugs and procedures that are not available at our hospital. We identified performance requirement, defined the set of problems to be solved as well as who would solve them, developed drafts in several versions and put them in the discussion with experts in this field. Algorithm was tested and revised and graphical acceptability was achieved. In the algorithm we tried to clearly define how the clinician should make the decision and to be provided with appropriate feedback. In one year period of experience in working we found this algorithm very useful in managing status epilepticus in children, as well as in teaching young doctors the specifities of algorithms and this specific issue. Their feedback is that they find that it provides the framework for facilitating thinking about clinical problems. Sometimes we hear objection that algorithms may not apply to a specific patient. This objection is based on misunderstanding how algorithms are used and should be corrected by a proper explanation of their use. We conclude that methods should be sought for writing clinical algorithms that represent expert consensus. A clinical algorithm can then be written for many areas of medical decision making that can be standardized. Medical practice would then be presented to students more effectively, accurately and understood better.

Algorithms↗

PubMed1994

[Difficulties in maintaining metabolic control in children with insulin-dependent diabetes mellitus during war].

In this study we analyzed the quality of metabolic control in 42 diabetic children aging 5-20 years (x 14 + 5.1) during the war 92/93 year. We estimated metabolic control in these patients by traditional methods: 24 hours glycaemia (every 3 months), 24 hours glycosuria and home monitoring of glycosuria (self-control 4 times daily) Glicolizated HbA1C and the other up to date laboratory findings we were not able to do in any of diabetics. Metabolic control in all analysed patients was unsatisfactory metabolic control only in 19.1% of diabetics. High level of blood glucose were influenced by in coordinated doses of human insulin and bad correlated food intake during the war. Long duration of hyperglycaemia would have high influence onto early development of microvascular complications.

Adolescent↗