Foreign scientists on the contribution of Serbian physician and scientist Dr. Lazar K. Lazarevic to medical science.

Dr. Lazar K. Lazarevic (1851-1890, Julian calendar/1891, Gregorian calendar) was an exceptional Serbian physician, scientist, writer and translator. During his short life and his close to 11-year-long professional career (1879-1890), Dr. Lazarevic authored 78 scientific papers and presentations in various branches of medicine. His greatest contribution to the field of neurology and to medical science in general is his description of the straight leg raising test.The article titled"Ischiac postica Cotunnii--One contribution to its differential diagnosis"was published in the Serbian language (in Cyrillic alphabet) in the Serbian Archives of Medicine in 1880.The article was translated to German and republished in Vienna in 1884 in Allgemeine Wiener medizinische Zeitung. The straight leg raising test is usually called Lasegue's test/sign, after the French clinician Charles Lasègue, although he never described it. However, there are numerous authors who admit that Lasègue never published the description of the straight leg raising test, and instead give full credits for its discovery to Dr. Lazarevic. Our objective in this article is to highlight the major literature written by foreign scientists who give credit to Dr. Lazarevic for his contribution to medical science.

Lazar K. Lazarevic, the author who first described the straight leg raising test.

OBJECTIVE: To highlight the contributions of Lazar K. Lazarevic (1851-1891), physician, scientist, writer, and translator in the field of neurology. During his brief period of professional activities, Lazar K. Lazarevic published 78 articles in various branches of medicine. His most important contribution to neurologic science was his description of the straight leg raising test. The article "Ischiac postica cotunnii: one contribution to its differential diagnosis" was published in Serbian in the Serbian Archives of Medicine in 1880, and republished in German in Vienna in 1884. In this article, based on 6 patients from his medical practice, Lazarevic correctly explained that stretching the sciatic nerve is the cause of pain during the straight leg raising test. He gave a full description of several maneuvers used to perform the test, and described the control test. Maneuvers described by Lazarevic are known by other names. CONCLUSIONS: Analysis of the historical events and documentation indicates that Lazarevic could have described the straight leg raising test in sciatica before Lasègue. He identified stretching of the sciatic nerve as the cause of pain and presented several maneuvers, which are now known by other names as labels for various diagnostic categories.

Gender and stroke lateralization: factors of functional recovery after the first-ever unilateral stroke?

PURPOSE: The goal of this prospective study was to evaluate gender differences in rehabilitation outcome in patients after the first-ever unilateral stroke. METHODS: A total of eighty right-handed patients were prospectively enrolled, 35 (44%) women, and 45 (56%) men. A degree of neurological deficit was quantified by the National Institutes of Health Stroke Scale. Functional outcome was assessed by the Motor Status Scale, Chedoke Arm and Hand Activity Inventory, Rivermead Mobility Index and Barthel Index. RESULTS: At the time of hospital admission there was no significant gender difference in clinical stroke severity. At discharge, we registered significantly better motor and functional recovery in men compared to women. Further, we found significantly better rehabilitation outcome in women with stroke in dominant left hemisphere (LH) than in women with stroke in subdominant right hemisphere (RH). Conversely, men with stroke in subdominant RH had significantly better rehabilitation outcome than men with stroke in dominant LH. Using a multivariate analysis we have found that men with stroke in RH had significantly higher probability to reach not only high response in mobility, but also more autonomy in ADL. The frequency of stroke in LH was significantly higher in both genders aged less than 51 years, as well as in women, while the frequency of stroke in RH was significantly higher in men. CONCLUSION: This paper places particular emphasis on substantial gender-based differences in functional recovery of patients with their first-ever unilateral stroke.

Gender-specific functional cerebral asymmetries and unilateral cerebral lesion sequelae.

The magnitude and direction of cerebral lateralization are thought to be sexually dimorphic. Numerous human studies indicate gender-specific differences in functional cerebral asymmetries (FCAs) for various functions. Females are thought to have a decreased magnitude of inter-hemispheric cortical lateralization compared with males, whereas males exhibit a greater degree of cortical asymmetry than females for components of cognitive and perceptual processing. Also, a large body of evidence has shown that FCAs fluctuate across the menstrual cycle, presumably as a result of cycle-related hormonal changes. Awareness of gender-based differences of the human brain may enable better understanding of differences in functional outcome between men and women after unilateral cerebral lesion.

Are female sex steroids neuroprotective in experimental stroke.

The central nervous system and the peripheral nervous system are important targets of gonadal steroids, which affect brain development and differentiation, and influence neuronal functions. Most of the studies have shown that female sex steroids progesterone and 17beta-estradiol exert protective effects in the experimental models of stroke, although deleterious effects have also been reported. Extensive studies on female sex steroids in cerebral ischemia have described their potential to act on multiple ischemic injury pathways, and pointed out the significance of numerous factors, including gender, age, brain region, duration of ischemia, and precise dose of steroids.

Estriol and progesterone: a new role for sex hormones.

The physiological states pregnancy and parturition are undoubtedly associated with clinical changes of most of the autoimmune diseases. An altered Th1/Th2 balance has been proposed as an underlying mechanism. A pregnancy has protective effect on Th1-mediated autoimmune diseases, and a deteriorative effect on Th2-mediated autoimmune diseases. Numerous studies, both experimental and clinical, imply that estriol and progesterone, at high doses (such as those achieved during pregnancy), have potent anti-inflammatory and neuroprotective roles. These studies, as well as a further investigation of pregnancy-associated immunomodulation, can be used to advance and develop a new therapy approaches.

Is pregnancy a model how we should control some autoimmune diseases?

Pregnancy and parturition are the physiological conditions that affect the course and severity of numerous autoimmune diseases. If genotype might be primarily considered as a determinant of whether or not autoimmunity develops, clinical heterogeneity of the disease might arise from the interaction of the genotype and the environment. Numerous external factors with extremely important immunoregulatory properties, including hormones, affect an in vivo open complex immune system. The further investigation of the role of neuroendocrine-immunological network, including a pregnancy-associated immunomodulation, as much as the role of "causative" or "trigger" agents, may allow the rational basis of new alternative treatment of numerous autoimmune diseases.