Prevalence of alcohol abuse and alcoholism in general population of Mostar region, Bosnia and Herzegovina.

The aim of this study was to determine the prevalence of alcohol abuse and alcoholism in the general population of Mostar region, Bosnia and Herzegovina. This study was conducted on a stratified sample of 704 participants. The prevalence of alcohol abuse was determined using standardized questionnaire on alcohol consumption--Michigan Alcoholism Screening Test. Prevalence of alcohol abuse with high risk for alcoholism was 9.9% and prevalence of alcohol addiction was 2.1%. In student population, there were 3.9% of alcohol addicts and 11.1% of persons with high risk of alcoholism. In high school population, there were 1.7% of alcohol addicts and 14.4% of persons with high risk of alcoholism. In Mostar region there was a high prevalence of alcoholism and problematic drinking, especially in high school and student population. There is a need for extensive preventive measures that have to include education, early diagnosis and intervention.

Health status of population in Federation of Bosnia and Herzegovina in 15 years of transitional period.

War in Bosnia and Herzegovina lasted from 1991 to 1995 and resulted in profound consequences marked by the large number of victims, increase in the diseases and disorders prevalence, that were not common before it occurred. The effects it had on health status of the entire population was reflected through many negative demographic trends, increasing prevalence of chronic diseases and the spread of a number of unhealthy behavioral patterns and a lot of migrations. All this presents a problem for institutions of health system which are attempting to control these negative influences especially during the transition period, marked by the direct adverse consequences of the 1991-1995 war. The present paper presents a summation of various sources which are attempting to provide a synthetic overview and provide basic information in relation to the health status of the population, and also to provide a baseline evaluation for deployment of public health interventions.

Proliferation and differentiation of glial and neuronal progenitors in the development of human spinal ganglia.

Development and differentiation of the spinal ganglia were investigated in 10 human embryos and foetuses, ranging in age between 5th and 10th developmental weeks. The aim of the study was to estimate the spatial and temporal appearance, percentage and duration of proliferation process among neural crest cells and differentiating glial cells and neurons. The process of proliferation and differentiation of cell lineages from neural crest to neurons or glial cell was analysed using immunohistochemical and immunofluorescence methods in paraffin sections. Quantification of reacting cells was performed by counting the ratio of cells stained or double-stained to specific antibodies in the number of total cell population. Data were expressed as mean+/-SD, while the difference between dorsal and ventral parts of the spinal ganglia were analysed by the Mann-Whitney test. The Ki-67 proliferation marker had the strongest expression in the 5th and 6th developmental weeks (42% of positive cells), showing also significantly higher proliferation rate in the dorsal parts of the spinal ganglia than in the ventral parts (Mann-Whitney, p=0.003). During further development, the number of proliferating cells subsequently decreased to 32% in the foetal period. A majority of the proliferating cells expressed neural crest marker nestin (71.5%) or glial cell marker S100 protein (17%). Neurons (stained with PGP9.5 marker) showed no signs of proliferation. Some cells co-expressed both neural crest cells and glial cell markers. Our results indicate the highest proliferation activity of the progenitor neural crest cells, which slightly decreased with progression of spinal ganglia differentiation. On the contrary, glial cells displayed increasing proliferation activity at later developmental stages, thus conforming significance of gliogenesis during human spinal ganglia development. Although neurogenesis was not found during the investigated period, we could not exclude the possibility of neuronal differentiation from neural crest cells, or even immature glial cells.

Case-control study: posttraumatic stress disorder and habits of war veterans.

AIM: To correlate habits (abuse of tobacco, alcohol, psychoactive substances and drugs) of war veterans and the frequency of symptoms in persons with PTSD and those without it. METHODS: We have carried out a prospective research (case-control study) over the period between September of 2005 and June 2006. The sample consisted of two groups of examinees: 60 males, war veterans with PTSD and 60 males, war veterans without PTSD. The group of war veterans without PTSD was formed using matching criteria (same age, level of education). Both groups included married males. Research was performed using a questionnaire designed for this study. RESULTS: A higher number of war veterans without PTSD were employed compared to war veterans with PTSD (chi2=45.753; df=4; p<0.050). A higher number of war veterans with PTSD used psychoactive substances during the war period compared to war veterans without PTSD (18.3% vs. 3.3%). We have observed that 85% of examinees with PTSD have used anxiolitic drugs in the period of research, compared to only 5% of those without PTSD (chi2=77.576; df=1; P<0.050). All examinees with PTSD had some form of sleep disorders comparing to 70% of those without PTSD (chi2=50.595; df=3; P<0.050). Analysis of alcohol abuse showed a statisticaly significant difference between the examined groups (chi2=9.654; df=2; P=0.008). CONCLUSION: A higher number of war veterans without PTSD had employment in comparison to the group of war veterans with PTSD. A higher number of war veterans with PTSD had some form of sleeping disorder, used psychoactive substances and anxiolitic drugs during the war period, and had alcohol abuse in comparison to the group of war veterans without PTSD.

Recommendations for neuropathic pain treatment.

Damage to the somatosensory nervous system poses a risk for the development of neuropathic pain. Such an injury to the nervous system results in a series of neurobiological events resulting in sensitization of both the peripheral and central nervous system. The symptoms include continuous background pain (often burning or crushing in nature) and spasmodic pain (shooting, stabbing or "electrical"). The diagnosis of neuropathic pain is based primarily on the history and physical examination finding. Although monotherapy is the ideal approach, rational polypharmacy is often pragmatically used. Several classes of drugs are moderately effective, but complete or near-complete relief is unlikely. Antidepressants and anticonvulsants are most commonly used. Opioid analgesics can provide some relief but are less effective than for nociceptive pain; adverse effects may prevent adequate analgesia. Topical drugs and a lidocaine-containing patch may be effective for peripheral syndromes. Sympathetic blockade is usually ineffective except for some patients with complex regional pain syndrome.

[Depression among students of the Medical Faculty and doctors in Mostar]. / Depresija medu studentima Medicinskog fakulteta i lijecnicima u Mostaru.

UNLABELLED: To assess out how many students and doctors have a mild, a moderate and a gravely depressive episode. SUBJECTS: The research was carried out among the students and doctors of the Medical Faculty in Mostar, Bosnia and Herzegovina, in March 2003. Out of the total number of 255 medical students and 115 doctors of, 200 (78.4%) medical students and 90 (78.3%) doctors participated in the research. The were analysis in accordance with DSM-IV criteria. RESULTS: One hundred and twenty (41.4%) participants experienced mildly depressive episode, and 52 (17.9%) participants experienced moderately depressive episode. Medical students were more depressive (66.5%) than the doctors (43.3%, p=0.001). A majority of the mildly depressive, and in particular the moderately depressive respondents, reported about a mild and moderate, respectively, intensity of disorder of mood loss of interest for the usual activities, fatigue, and the loss of energy. CONCLUSION: Medical students and doctors constitute a vulnerable professional group, having a high percentage of depressive disorders.

Suicidal ideation and medical profession: from medical students to hospital physicians.

OBJECTIVE: With regard to an increased risk of suicide among physicians, the prevalence and predictors of suicidal ideation among medical students have attracted increased attention in recent years. The aim of this study was to investigate the level and characteristics of suicidal ideation in medical students and hospital physicians of School of Medicine, University of Mostar. SUBJECTS AND METHOD: Suicidal ideation was assessed in 200 students: 45 students of the first year, 36 students of the second year, 44 students of the third year, 28 students of the fourth year, 25 students of the fifth year and 22 students of the sixth year and 90 hospital physicians. RESULTS: Some form of the actual suicidality was found in 9.16% of medical students: 4.4% of students of the first year, 8.4% of students of the second year, 9.1% of students of third year, 3.6% of students of the fourth year, 13.6% of the sixth year as well as in 2.2% of the hospital physicians. CONCLUSIONS: The level of suicidal ideation among medical students is warning and should initiate preventive interventions.

Sensation and spinal tumors.

Sensory disorders were investigated in a retrospective study of 131 patients operated on for tumors of the spine. The most common sign of sensory disorder was pain, followed by hypoesthesia and anesthesia. In case of intramedullary tumors, the most frequent signs were anesthesia and pain. There were no significant sex differences in the incidence of spinal tumors or sensory disorders. Moreover, sensory disorders did not significantly differentiate benign from malignant tumors. The study suggested the importance of sensory disorders in the possible development of spinal tumors, particularly if sensory disorders are frequent, long-term, and react poorly to therapy. Scanning of the axial skeleton and spinal cord is the technique of choice in the diagnosis and differential diagnosis of spinal cord tumors.