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1. Teduglutide therapy in a child with short bowel syndrome

Author

Stojšić Mirjana, Redžek-Mudrinić Tatjana, and Mikov Aleksandra

Subjects
short bowel syndrome, child, teduglutide, glucagon-like peptide 2, Medicine
Abstract

Introduction. Short bowel syndrome (SBS) in children is a rare disease. One of the most common etiological factors for the development of SBS in children is atresia of the small intestine. After surgical correction of the congenital anomaly, the remaining intestine attempts to increase absorption to restore homeostasis, and the process of intestinal adaptation begins. This process of adaptation can be assisted with analogues of endogenous growth factors of the intestine, such as teduglutide. Case outline. This report presents а girl, aged two years and eight months, who had an estimated 20 cm of small intestine after surgical correction of congenital small bowel atresia and clinical signs of SBS. She was repeatedly hospitalized due to frequent need for parenteral correction of fluid, electrolyte, and nutrient imbalances. Stagnation in body weight and slow growth in body height were accompanied by weakened gross motor strength and slowed psychophysical development. After exploit conservative treatment measures, stimulation of intestinal adaptation was initiated with the drug teduglutide. After six months of drug therapy, progress was observed in body parameters, as well as an increase in intelligence quotient and motor abilities. Conclusion. SBS is a challenging entity for every clinician, and its previous therapy has mainly consisted of parenteral substitution of nutrients, fluids, and electrolytes. Surgical treatment carries the risk of loss of the remaining bowel and lifelong immunosuppression. The pharmacological possibilities of promoting intestinal adaptation using drugs such as teduglutide represent a light at the end of the tunnel for patients with SBS.

Published
2023
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2. Risk factors for cerebral palsy

Author

Demeši-Drljan Čila, Mikov Aleksandra, Krasnik Rastislava, Knežević Aleksandar, Zvekić-Svorcan Jelena, and Mikov Igor

Subjects
cerebral palsy, gestational age, infant, premature, pregnancy complications, pregnancy, twin, risk factors, Medicine (General), R5-920
Abstract

Background/Aim. Cerebral palsy (CP) etiology is multi-factorial and heterogeneous, manifesting as damage to the developing brain. The associated risk factors can arise in the prenatal, perinatal, or postnatal period. The aim of this study was to determine the risk factors for CP and examine the associations between CP type, gestational age, and perinatal risk factors. Methods. The study sample comprised 206 children with CP. Pertinent data were collected from medical records and included participants’ gestational age at birth, medical history, and CP clinical characteristics. Risk factors were divided according to the timing of brain injury into prenatal, perinatal, and neonatal. Results. Hormonally maintained pregnancy (55.3%), twin pregnancy (28.9%), vaginal bleeding after the 20th week of gestation (21.1%), threatened abortion in the first half of pregnancy (13.2%), and maternal infection (10.5%) were identified as the main prenatal risk factors for CP. Prematurity (54.5%) was the leading perinatal risk factor, followed by low birthweight (50.8%), Apgar score < 7 (41.7%), assisted delivery (41.4%), and breech presentation (13.5%). Respiratory distress syndrome (16%), need for treatment in the Neonatal Intensive Care Unit (22.3%), assisted ventilation (18.4%), hypoxic-ischemic encephalopathy (11.2%), and neonatal convulsions (5.8%) were identified as the leading neonatal risk factors for CP. A statistically significant difference was found in the total number of perinatal risk factors in relation to gestational age (p < 0.001) and CP type (p = 0.006). Perinatal risk factors were most prevalent in preterm infants and children affected by the CP of spastic bilateral type. A statistically significant difference was noted in the distribution of CP types de-pending on the gestational age (p < 0.001). In particular, spastic bilateral CP type was most prevalent in the group of preterm-born children. Conclusion. CP is characterized by heterogeneous risk factors and is a result of interaction among multiple risk factors.

Published
2023
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3. The difference between the pain self-perceptions of children with cerebral palsy and those of their caregivers

Author

Krasnik Rastislava, Zvekić-Svorcan Jelena, Demeši-Drljan Čila, Dimitrijević Lidija, Lalić Nensi, and Mikov Aleksandra

Subjects
pain, children, pain intensity, cerebral palsy, Medicine
Abstract

Introduction/Objective. Pain is often an underrecognized entity in children with cerebral palsy. The aim of this study was to determine whether there are differences in pain self-perception between children with cerebral palsy and their caregivers. Methods. This retrospective study included 70 children with cerebral palsy and 70 of their caregivers, treated at the Institute of Child and Youth Health Care of Vojvodina, Serbia. Pain intensity ratings on the Visual Analog Scale (VAS) provided by children and/or their caregivers were analyzed. Results. The research involved 70 children with cerebral palsy and the same number of their caregivers. While only 43 (61.4%) of these children were testable, all 70 caregivers participated. Pain was reported by 19 (44.2%) children and 42 (60%) caregivers, while 17 (39.5%) children suffered from musculoskeletal pain, which was noted by 39 (55.7%) caregivers. Average caregiver rating for musculoskeletal pain for children at Level V, I and III on the Gross Motor Function Classification System (GMFCS) was 6.20 ± 2.10, 2.67 ± 2.18, and 2.50 ± 2, respectively. Average self- and caregiver-reported VAS rating for headache/stomachache was 2.73 ± 1.86 and 2.35 ± 1.49, respectively (p > 0.05). Statistically significant differences were noted in the musculoskeletal pain VAS scores provided by the caregivers for children at different GMFCS levels (p < 0.01). Conclusion. Although no differences in pain perception between children with cerebral palsy and their caregivers have been established, in children with the most severe level of motor disability, caregivers report a statistically higher level of musculoskeletal pain.

Published
2021
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4. Factors Affecting Balance Performance in Adolescents.

Author

Kovačević, Milena, Krasnik, Rastislava, Mikov, Aleksandra, Mikić, Darko, Zvekić-Svorcan, Jelena, Vukliš, Dragana, Dedić Novaković, Dajana, and Đelić, Marina

Subjects
LEG physiology, STATISTICAL correlation, CROSS-sectional method, PREDICTION models, DATA analysis, FUNCTIONAL assessment, SEX distribution, STATISTICAL sampling, KRUSKAL-Wallis Test, FUNCTIONAL status, AGE distribution, DESCRIPTIVE statistics, MANN Whitney U Test, RESEARCH, STATISTICS, BODY movement, SOCIODEMOGRAPHIC factors, ANTHROPOMETRY, ENDURANCE sports training, CONFIDENCE intervals, TORSO, DATA analysis software, POSTURAL balance, REGRESSION analysis, PHYSICAL activity, ADOLESCENCE
Abstract

(1) Background: The influence of different factors on balance in adolescence is assessed by conducting functional balance tests that examine its different components. (2) Materials and methods: The study sample comprised 110 healthy adolescents of both sexes, aged 12–18 years. Single Leg Stance with Eyes Open (SLS-EO) and Eyes Closed (SLS-EC) tests were conducted to evaluate static balance, whereas the Functional Reach Test (FRT) and Lateral Reach Test (LRT) were performed to establish functional stability limits. The influence of sex, age, demographic factors, anthropometric characteristics, participation in sports activities, and trunk extensor muscle endurance (Biering–Sorensen test) on balance performance was determined through correlational and univariate linear regression analyses. (3) Results: Older age (Beta [β] = 0.247; 95% CI [0.75, 5.20]; p < 0.01) and better trunk extensor muscle endurance (β = 0.224; 95% CI [0.015, 0.13]; p < 0.05) were significant predictors of the SLS-EO results, while younger age (β = −0.219; 95% CI [−1.32, −0.11]; p < 0.05) and higher muscle percentage (β = 0.237; 95% CI [0.06, 0.48]; p < 0.05) emerged as significant predictors of LRT performance, and greater bone mass was a significant predictor of FRT results (β = 0.444; 95% CI [3.62, 8.17]; p < 0.01). However, none of the independent variables was a statistically significant predictor of the SLS-EC results. (4) Conclusions: The current study found that age, trunk extensor muscle endurance, muscle percentage, and bone mass are significant predictors of different balance components, suggesting that balance is task-specific. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Bone mineral density in comparison to anthropometric parameters and level of gross motor function in children with cerebral palsy

Author

Zvekić-Svorcan Jelena, Stojšić Mirjana, Krasnik Rastislava, Nenadov Nataša, Demeši-Drljan Čila, Mikov Aleksandra, and Radovanov Maja

Subjects
cerebral palsy, child, anthropometry, bone density, muscle tonus, Medicine (General), R5-920
Abstract

Background/Aim. Children with cerebral palsy (CP) grow at a slower rate relative to their peers. Their body height, body weight and bone mineral density are significantly below those measured for healthy children of corresponding age. The aim of this work was to estimate bone mineral density in relation to the anthropometric parameters and the level of gross motor function in the children with cerebral palsy. Methods. This cross-sectional pilot study included 23 children with CP, aged 6 to 17 years, in whom the gross motor function level was estimated according to the Gross motor function classification system- expanded and revised (GMFCS-E&R), while the anthropometric parameters were established in relation to the developmental charts for healthy children as well as those pertaining to children with CP. Bone mineral density was measured by dual energy X-ray absorptiometry and the findings were interpreted in accordance with the International Society for Clinical Densitometry Official Positions of Adults & Pediatrics. Mean values with interquartile deviations, along with frequencies and percentages were the descriptive statistical measures employed in the analyses. Differences between groups were ascertained through the Kruskal-Wallis test. Results. Our sample of 23 children comprised of 56.5% boys and 43.5% girls, aged 13.00 ± 3.56 years, of whom 3/4 had a severe form of gross motor dysfunction (GMFCS-E&R levels IV and V). All subjects had lower bone density in both regions of interest [spinal Z-score -1.60 ± 1.40 standard devation (SD); hip Z-score -2.00 ± 3.00 SD], as well as lower anthropometric parameters [height Z-score -2.74 ± 4.28; body weight Z-score - 3.22 ± 6.96; body mass index (BMI) Z-score -2.64 ± 6.03]. In the observed sample, bone mineral density in the spine (p < 0.01) and the hip (p < 0.05) was reduced in all subjects, and all children had a lower body weight (p < 0.01) and the BMI (p < 0.01), but not body height, in relation to the existing developmental charts for the CP children adopted from the US. Children with the CP Level IV on the GMFCS-E&R had a significantly lower bone density (spinal Z-score -1.90 SD; hip Z-score -3.40 SD), with the reduction even more pronounced at level V (spinal Z-score -3.80 SD; hip Z-score -2.30 SD). Conclusion. A significantly lower bone mineral density as well as the decreased values of all observed anthropometric parameters, were noted in the children with CP. In the observed sample, bone mineral density in both spine and hip was reduced in all subjects, all of whom also had lower body weight and the BMI, but not body height compared to the existing developmental charts for the children with CP adopted from the US. The children with severe forms of CP (GMFCS-E&R levels IV and V) had significantly lower bone mineral density.

Published
2019
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7. Minor neurological dysfunction in children aged 5 to 7

Author

Galić Maja, Mikov Aleksandra, Sekulić Slobodan, Kopitović Aleksandar, and Peričin-Starčević Ivana

Subjects
neurological manifestations, risk, child, child, preschool, age factors, sex factors, Medicine (General), R5-920
Abstract

Background/Aim. Assessment of minor neurological dysfunction (MND) provides information about a child's neurological condition which helps to identify the vulnerability of the child to the development of motor impairment, difficulties in learning or behavioral disorders. The aim of this study was to determine differences in the prevalence of MND in children from the general population with respect to age (5 and 6 years old) and sex. Methods. The examination was carried out in a preschool institution in the city of Novi Sad, Serbia. The total sample included 120 children divided into two groups according to age: 60 children aged 5 (group A) and 60 children aged 6 years (group B). The children were recruited at three randomly selected kindergartens and approximately equal sex representation, randomly selected as well. The testing was done by the Touwen's test, modified by Hadders-Algra. The results were classified into three groups: the absence of MND, presence of simple MND (presence of one or two domains of dysfunction) and the presence of complex MND (presence of at least three domains of dysfunction). Results. Sixtyseven children out of 120 (55.8%) had a normal neurological condition, while 53 (44.2%) showed MND [49 (40.8%) simple, and 4 (3.4%) complex]. MND occurred more frequently in the youngest age group than in the older children (57% vs. 32%; p = 0.01). MND was also more frequent in boys than in girls, but this difference was not statistically significant. Conclusion. Our results show the importance of testing children at preschool age in order to detect potential neurological vulnerability and timely begin with the appropriate therapy.

Published
2018
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8. Factors that predict walking ability with a prosthesis in lower limb amputees

Author

Knežević Aleksandar, Petković Milena, Mikov Aleksandra, Jeremić-Knežević Milica, Demeši-Drljan Čila, Bošković Ksenija, Tomašević-Todorović Snežana, and Jeličić Zoran D.

Subjects
amputation, rehabilitation, recovery of function, support vector machines, Medicine
Abstract

Introduction. Identification of predictive factors for walking ability with a prosthesis, after lower limb amputation, is very important in order to define patient’s potentials and realistic rehabilitation goals, however challenging they are. Objective. The objective of this study was to investigate whether variables determined at the beginning of rehabilitation process are able to predict walking ability at the end of the treatment using support vector machines (SVMs). Methods. This research was designed as a retrospective clinical case series. The outcome was defined as three-leveled ambulation ability. SVMs were used for predicting model forming. Results. The study included 263 patients, average age 60.82 Ѓ} 9.27 years. In creating SVM models, eleven variables were included: age, gender, cause of amputation, amputation level, period from amputation to prosthetic rehabilitation, Functional Comorbidity Index (FCI), presence of diabetes, presence of a partner, restriction concerning hip or knee extension, residual limb hip extensor strength, and mobility at admission. Six SVM models were created with four, five, six, eight, 10, and 11 variables, respectively. Genetic algorithm was used as an optimization procedure in order to select the best variables for predicting the level of walking ability. The accuracy of these models ranged from 72.5% to 82.5%. Conclusion. By using SVM model with four variables (age, FCI, level of amputation, and mobility at admission) we are able to predict the level of ambulation with a prosthesis in lower limb amputees with high accuracy.

Published
2016
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9. Cerebral palsy in preterm infants

Author

Demeši-Drljan Čila, Mikov Aleksandra, Filipović Karmela, Tomašević-Todorović Snežana, Knežević Aleksandar, and Krasnik Rastislava

Subjects
cerebral palsy, risk factors, infant, premature, Medicine (General), R5-920
Abstract

Background/Aim. Cerebral palsy (CP) is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy in Europe (SCPE) and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS). Results. More than half of the children with CP were born prematurely (54.4%). Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001). In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049), children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0%) affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032). Conclusion. The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy. [Projekat Ministarstva nauke Republike Srbije, br. 41012 i br. 44008]

Published
2016
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10. Risk factors for cerebral palsy.

Author

Drljan, Čila Demeši, Mikov, Aleksandra, Krasnik, Rastislava, Knežević, Aleksandar, Zvekić-Svorcan, Jelena, and Mikov, Igor

Subjects
*CEREBRAL anoxia-ischemia, *CEREBRAL palsy, *NEONATAL intensive care units, *MULTIPLE pregnancy, *BREECH delivery, *RESPIRATORY distress syndrome
Abstract

factorial and heterogeneous, manifesting as damage to the developing brain. The associated risk factors can arise in the prenatal, perinatal, or postnatal period. The aim of this study was to determine the risk factors for CP and examine the associations between CP type, gestational age, and perinatal risk factors. Methods. The study sample comprised 206 children with CP. Pertinent data were collected from medical records and included participants’ gestational age at birth, medical history, and CP clinical characteristics. Risk factors were divided according to the timing o f brain injury into prenatal, perinatal, and neonatal. Results. Hormonally maintained pregnancy (55.3%), twin pregnancy (28.9%), vaginal bleeding after the 20th week of gestation (21.1%), threatened abortion in the first half of pregnancy (13.2%), and maternal infection (10.5%) were identified as the main prenatal risk factors for CP. Prematurity (54.5%) was the leading perinatal risk factor, followed by low birthweight (50.8%), Apgar score < 7 (41.7%), assisted delivery (41.4%), and breech presentation (13.5%). Respiratory distress syndrome (16%), need for treatment in the Neonatal Intensive Care Unit (22.3%), assisted ventilation (18.4%), hypoxic-ischemic encephalopathy (11.2%), and neonatal convulsions (5.8%) were identified as the leading neonatal risk factors for CP. A statistically significant difference was found in the total number of perinatal risk factors in relation to gestational age (p < 0.001) and CP type (p = 0.006). Perinatal risk factors were most prevalent in preterm infants and children affected by the CP of spastic bilateral type. A statistically significant difference was noted in the distribution of CP types depending on the gestational age (p < 0.001). In particular, spastic bilateral CP type was most prevalent in the group of preterm-born children. Conclusion. CP is characterized by heterogeneous risk factors and is a result of interaction among multiple risk factors. [ABSTRACT FROM AUTHOR]

Published
2023
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11. Scaphoid fractures in children

Author

Gajdobranski Đorđe, Živanović Dragoljub, Mikov Aleksandra, Slavković Anđelka, Marić Dušan, Marjanović Zoran, and Milankov Vukadin

Subjects
scaphoid, fracture, treatment, children, Medicine
Abstract

Introduction. Scaphoid fractures are rare in childhood. Diagnosis is very difficult to establish because carpal bones are not fully ossified. In suspected cases comparative or delayed radiography is used, as well as computerized tomography, magnetic resonance imaging, ultrasound and bone scintigraphy. Majority of scaphoid fractures are treated conservatively with good results. In case of delayed fracture healing various types of treatment are available. Objective. To determine the mechanism of injury, clinical healing process, types and outcome of treatment of scaphoid fractures in children. Methods. We retrospectively analyzed patients with traumatic closed fracture of the scaphoid bone over a ten-year period (2002-2011). The outcome of the treatment of “acute” scaphoid fracture was evaluated using the Mayo Wrist Score. Results. There were in total 34 patients, of mean age 13.8 years, with traumatic closed fracture of the scaphoid bone, whose bone growth was not finished yet. Most common injury mechanism was fall on outstretched arm - 76% of patients. During the examined period 31 children with “acute” fracture underwent conservative treatment, with average immobilization period of 51 days. Six patients were lost to follow-up. In the remaining 25 patients, after completed rehabilitation, functional results determined by the Mayo Wrist Score were excellent. Conclusion. Conservative therapy of “acute” scaphoid fractures is an acceptable treatment option for pediatric patients with excellent functional results.

Published
2014
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12. Humeral lengthening: Case report

Author

Gajdobranski Đorđe, Marić Dušan, and Mikov Aleksandra

Subjects
humerus, bone lengthening, external fixator, child, Medicine
Abstract

Introduction. Difference in length of upper extremities has mainly esthetic significance and is therefore not so often a subject of operative treatment, compared to lower extremities. Case Outline. We are presenting a case of a 16­year­old patient in whom a shortening of 9 cm of the right humerus was determined at the end of growth. This shortening was the result of surgical treatment of solitary bone cyst at the proximal end of the humerus done at the age of 10 years. In order to correct the length of the humerus we applied distraction osteogenesis with a compressive­distracting device according to Mitkovic (Traffix), and we achieved the lengthening of 7.5 cm. During the period of distraction we encountered the following complications: minimal suppuration at the site of the wedges that was successfully resolved with intensive local treatment, while pain and paresthesias along the N. radialis were resolved with a temporarily slowing of the distraction process. Fixation with a plate, i.e. bone grafting was not necessary, and final functional and esthetic result was excellent. Conclusion. Successful lengthening of the shortened humerus can be achieved with a unilateral compressive­distracting device according to Mitkovic as its application up to a complete bone reconstruction does not require additional plate fixation or bone grafting. The patient was capable of performing usual daily activities during application of the device.

Published
2013
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13. Risk factors for cerebral palsy

Author

Demesi-Drljan, Cila, primary, Mikov, Aleksandra, additional, Krasnik, Rastislava, additional, Knezevic, Aleksandar, additional, Zvekic-Svorcan, Jelena, additional, and Mikov, Igor, additional

Published
2022
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14. Botulinum toxin type a for the treatment of spasticity in children with cerebral palsy

Author

Dimitrijević Lidija, Stanković Ivona, Živković Vesna, Mikov Aleksandra, Čolović Hristina, and Janković Irena

Subjects
cerebral palsy, botulinum toxin type A, muscle spasticity, child, preschool, treatment outcome, Medicine (General), R5-920
Abstract

Background/Aim. Cerebral palsy (CP) is the most common physical disability in childhood. Children have problems with motor functions as a result of limbs spasticity, which leads to severe contractures and limbs deformity. There is a growing interest in the therapeutic role of botulinum toxin type A (BTA) in CP. The aim of this study was to examine the effects of BTA on spasticity, active range of motion and functional motor outcomes in children with CP. Methods. This study included 42 children of both sexes, aged 2−6 years, with spastic CP, divided into two groups: group I (21 child) treated with BTA and physical therapy, and group II (21 child) treated with physical therapy only. The following parameters were analyzed: spasticity; active range of motion of the hip, knee and ankle, and functional motor outcome. These parameters measurements were carried out four times in both groups: before the treatment, three, eight and 16 weeks after the beginning of the treatment. The obtained results were statistically processed and compared. Results. There was no evidence of any significant difference between the groups before the treatment. After eight weeks there was a remarkable difference concerning spasticity reducing on behalf of the group I (group I - 0.76±0.51 vs. II group - 2.17±0.64; p < 0.0001). There was statistically significant difference concerning active range of motion increasing on behalf of the group I (hip abduction: group I - 44.37±1.130 vs. group II - 32.61±8,070, p < 0,01; knee extension: group I - 0,77±1.820 vs. II group - 14.99±7.610, p < 0.01; dorsiflexion of the foot: group I - 11.50±6.080 vs. group II - 8.98±7.850, p < 0,01). A statistically significant difference was found after 16 weeks in functional motor outcome as well, on behalf of the group I: functional motor abilities level in the group I was 1.86 vs. 2.71 in the group II, p < 0.05. Conclusion. Botulinum toxin type A application leads to an important spasticity decreasing, active range of motion increasing, as well as to functional abilities in children with CP. .

Published
2007
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15. Kvalitet života radno sposobnih pacijenata sa lumbalnim sindromom lečenih u banjskim uslovima

Author

Demeši, Čila, Tomašević-Todorović, Snežana, Mikov, Aleksandra, Dimitrijević, Lidija, Krasnik, Rastislava, Striković, Viktor, Demeši, Čila, Tomašević-Todorović, Snežana, Mikov, Aleksandra, Dimitrijević, Lidija, Krasnik, Rastislava, and Striković, Viktor

Abstract

Lumbalni sindrom je najučestaliji u životnoj dobi kada je čovek radno sposoban. Troškovi zbog bolovanja i lečenja pacijenata sa bolom u donjem delu leđa su veoma visoki, uz narušen kvalitet života. Utvrđivanje kvaliteta života kod radno sposobnih pacijenata sa lumbalnim sindromom na početku, po završetku fizikalnog tretmana i šest meseci nakon sprovedene rehabilitacije; utvrđivanje kvaliteta života kod radno sposobnih pacijenata sa lumbalnim sindromom u odnosu na trajanje lumbalnog bola (akutni, subakutni i hronični) i na vrstu lumbalnog bola (nespecifični ili radikularni). Istraživanje je bilo prospektivno. Uzorak je obuhvatio 120 osoba oba pola, starosti 18-65 godina, sa dijagnozom lumbalnog sindroma, koji su lečeni na Odeljenju za fizikalnu medicinu i rehabilitaciju Opšte bolnice "Dr Radivoj Simonović" u Bezdanu, tokom perioda od 01.01.2014. do 01.01.2016. godine. Procenjivano je trajanje lumbalnog bola (akutni, subakutni, hronični) kao i vrsta lumbalnog bola (radikularni ili nespecifični). Ispitanici su popunjavali odgovarajuće testove i upitnike (opšti upitnik konstruisan za potrebe istraživanja,Vizuelna analogna skala-VAS, 36-Item Short Form Survey (SF-36), Oswestry Disability Index-ODI, Roland-Morris Disability Questionnaire-RDQ i Beck Depression Inventory-BDI). Prosečna starost ispitanika bila je 48,81 godina (SD 8,70). Pacijenti sa bolom u leđima imali su značajno manji stepen depresivnosti i manji stepen intenziteta bola neposredno nakon fizikalnog tretmana u odnosu na početak lečenja. U narednih šest meseci javio se suprotan trend u vidu značajnog porasta stepena depresivnosti. Nije bilo značajne razlike u jačini bola kod bolesnika sa subakutnim i hroničnim lumbalnim bolom neposredno nakon tretmana, ali se posle šest meseci beleži značajno povećanje jačine bola kod bolesnika sa hroničnim bolom. Nakon sprovedenog fizikalnog tretmana uočen je značajno manji stepen onesposobljenosti pacijenata sa bolom u leđima mereno ODI upitnikom i značajno bolji kvalitet, Lumbar syndrome is most common in the period of life when people are work-capable. Costs of sick leave and treatment of patients with lower back pain are very high, with poor quality of life. Determining the quality of life in work-capable patients with lumbar syndrome at the beginning and upon completion of rehabilitation treatment, as well as six months after the rehabilitation process; determining the quality of life in work-capable patients with lumbar syndrome in relation to the duration of lumbar pain (acute, subacute and chronic) and the type of lumbar pain (non-specific or radicular). The research was prospective. The sample included 120 persons of both sexes aged 18-65 years with a diagnosis of lumbar syndrome who were treated at the Department of Physical Medicine and Rehabilitation of the “Doctor Radivoj Simonović” General Hospital in Bezdan between 1 January 2014 and 1 January 2016. Assessment was made of the duration of lumbar pain (acute, subacute, chronic) and the type of lumbar pain (radicular or non-specific). Respondents answered appropriate tests and questionnaires (a general questionnaire designed for the purposes of this research, Visual Analog Scale – VAS, 36-Item Short Form Survey (SF-36), Oswestry Disability Index – ODI, Roland-Morris Disability Questionnaire – RDQ and Beck Depression Inventory – BDI). The average age of respondents was 48.81 years (SD 8.70). Patients with back pain had a significantly lower degree of depression and a lower degree of pain intensity immediately after physical treatment compared to the beginning of treatment. In the next six months, the opposite trend appeared in the form of a significant increase in the degree of depression. There was no significant difference in the severity of pain in patients with subacute and chronic lumbar pain immediately after the treatment, but after six months a significant increase in pain was noted in patients with chronic pain. After physical treatment, a significantly lower degree

Published
2020

17. Risk factors for hand osteoarthritis

Author

Zvekic-Svorcan, Jelena, primary, Stamenkovic, Bojana, additional, Minakovic, Ivana, additional, Krasnik, Rastislava, additional, Jankovic, Tanja, additional, and Mikov, Aleksandra, additional

Published
2020
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18. Low back pain among health workers

Author

Lacokova-Krasnikova, Jarmila, primary, Dimitrov, Dejan, additional, Krasnik, Rastislava, additional, Zvekic-Svorcan, Jelena, additional, Kolundzic, Mirjana, additional, and Mikov, Aleksandra, additional

Published
2020
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19. Vitiligo In Children

Author

PRCIC, SONJA, DJURAN, VERICA, MIKOV, ALEKSANDRA, and MIKOV, IVAN

Published
2007

20. Fizikalna terapija primenom lasera male snage u subakutnom lumbalnom bolnom sindromu

Author

Lukač, Damir, Bobić, Branislav, Mikov, Aleksandra, Tomašević-Todorović, Snežana, Grujić, Nikola, Filipov, Predrag, Lukač, Damir, Bobić, Branislav, Mikov, Aleksandra, Tomašević-Todorović, Snežana, Grujić, Nikola, and Filipov, Predrag

Abstract

Uvod: Lumbalni bolni sindrom (LBS) podrazumeva tegobe u vidu bolova, u lumbalnom ili lumbosakralnom segmentu kičmenog stuba, sa ili bez iradijacije u donje ekstremitete, uz poremećaj funkcije umbosakralnog dela kičmenog stuba, zaštitnu mišićnu reakciju na bol (spazam) uz moguće znake senzitivnog poremećaja. Laser male snage (LMS) ima široku primenu u fizikalnoj medicini i rehabilitaciji zbog analgetskog, antiinflamatornog, antiedematoznog i biostimulativnog dejstva. Cilj rada: Glavni ciljevi su bili da se utvrdi da li fizikalna terapija primenom LMS utiče na smanjenje bola, povećanje pokretljivost lumbalne kičme, smanjenje spazma pravertebralne muskulature, kao i na smanjenje funkcionalne osnesposobljenosti u subakutnom LBS. Materijal i metode: Sprovedena je prospektivna studija na 123 pacijenata (50 muškaraca i 73 žene), različitih profesija, izabranih metodom slučajnog izbora, prosečne životne dobi 32.59±5.67 godina (ispitivana grupa 31.87±5.84, kontrolna grupa 33.31±5.45, raspon od 19-45). U studiju su uključeni ispitanici koji su prvi put doživeli lumbalni bolni sindrom koji su pregledani u Odeljenju za fizikalnu medicinu i rehabilitaciju Doma zdravlja Novi Sad. Ispitivanu grupu je činio 61 ispitanik koji su uključeni u fizikalni tretman, primenom laseroterapije i kineziterapije uz medikamentoznu terapiju. Kontrolnu grupu je činilo 62 ispitanika koji koji su uključeni u fizikalni tretman primenom kineziterapije uz medikamentoznu terapiju. Svim ispitanicima je uzeta anamneza, obavljen klinički pregled, izvršena samoprocena bola i popunjavali su upitnike. Navedeno ispitivanje je sprovedeno na početku tretmana, nakon 6 nedelje i nakon sprovedenog tretmana. Korišćeni su sledeći upitnici: vizuelna analogna skala (VAS), standardizovani upitnici za merenje funkcionalnog ishoda - The Oswestry Disability Index (ODI), The Rolland&Morris Disability Questionnaire (RMDQ) i SF-36 upitnik. Rezultati: Rezultati ukazuju da se intenzitet bola meren VAS skalom u obe ispitivane gru, Introduction: Low back pain syndrome (LBP) implies pain in the lumbar or lumbosacral segment of the spine, with or without irradiation into the lower extremities, with a disorder to the function of the lumbosacral part of the spine, a protective muscular reaction to pain (spasm) and possible signs of a sensory processing disorder. Low-Level Laser Therapy (LLLT) has broad application in physical medicine and rehabilitation due to analgesic, antiinflammatory, anti-edematous and biostimulative effects. Objective: The main objective of this study was to determine whether physical therapy with a LLLT has an effect on reducing pain, increasing mobility in the lumbar spine, reducing spasms of the paravertebral muscle, as well as in reducing functional incapacity in subacute LBP. Material and methods: A prospective study was conducted on 123 patients (50 men and 73 women), of different professions, chosen through random selection, with a mean age of 32.59 ± 5.67 years (examined group 31.87 ± 5.84, control group 33.31 ± 5.45, range 19-45). The study included respondents who had experienced lumbar pain syndrome for the first time and who had been examined in the Department of Physical Medicine and Rehabilitation of the Novi Sad Health Center. The examined group consisted of 61 respondents undergoing physical treatment with the application of LLLT and kinesiotherapy with medication therapy. The control group consisted of 62 respondents undergoing physical treatment with the application of kinesiotherapy with medication therapy. All patients were subject to an anamnesis, a clinical examination, a selfassessment of pain and were required to complete questionnaires. The above study was carried out at the beginning of treatment, after 6 weeks, and after treatment was completed. The following questionnaires were used: Visual Analogue Scale (VAS), standardized questionnaires for assessing functional outcomes – The Oswestry Disability Index (ODI), The Rolland & Morris Disability Ques

Published
2019

21. Klinička efikasnost programa vežbi lumbalne stabilizacije i torakalne mobilizacije u sanaciji hroničnog lumbalnog bola

Author

Tomašević-Todorović, Snežana, Mikov, Aleksandra, Krasnik, Rastislava, Konstatinović, Ljubica, Matijević, Radmila, Kostadinović, Stefan, Tomašević-Todorović, Snežana, Mikov, Aleksandra, Krasnik, Rastislava, Konstatinović, Ljubica, Matijević, Radmila, and Kostadinović, Stefan

Abstract

Uvod: Individualno kreiran program vežbi lumbalne stabilizacije, mogao bi da doprinese boljem oporavku pacijenata sa hroničnim bolom u donjem delu leđa. Program vežbi u lečenju hroničnog lumbalnog bola je prilično raznolik, ali je dokazano da su vežbe stabilizacije najefikasnije, posebno vežbe u zatvorenom kinetičkom lancu. Cilj: je bio da se uporedi program vežbi lumbalne stabilizacije u otvorenom i zatvorenom kinetičkom lancu, u odnosu na program vežbi lumbalne stabilizacije i torakalne mobilizacije u zatvorenom kinetičkom lancu kao i da se proceni klinička efikasnost oba programa vežbi. Metode: Istraživanje je sprovedeno kao prospektivna, eksperimentalna studija na 80 ispitanika oba pola (35 muškaraca, 45 žena), prosečne životne dobi (48.45+/- 10.22 godina) sa hroničnim lumbalnim bolom. Istraživanje je sprovedeno na Klinici za rehabilitaciju „dr Miroslav Zotović“ u Beogradu u periodu od juna 2017. do marta 2018. godine. Ispitanici su podeljeni u dve grupe od 40 pacijenata. Prva grupa ispitanika je sprovodila program vežbi lumbalne stabilizacije i torakalne mobilizacije u zatvorenom kinetičkom lancu (LSTMZ), a druga program vežbi lumbalne stabilizacije u zatvorenom i otvorenom kinetičkom lancu (LSZO). Pored opštih demografskih, antropometrijskih podataka o ispitanicima, korišćeni su sledeći upitnici i testovi: za procenu intenziteta bola u leđima i donjim ekstremitetima- vizuelna analogna skala (VAS), za procenu neuropatske komponente bola- DN4 (Douleur Neuropathique en 4 Questions), za procenu funkcionalnog statusa korišćen je Osvestrijev upitnik o onesposobljenosti (ODI), procena sagitalne pokretljivosti lumbosakralne kičme Schober testom, procena mišićne snage - manuelnim mišićnom testom; Ispitivanje senzitivnosti na ključnim senzornim tačkama za dermatome je vršeno prema ASIA (American Spinal Injury Association) skali, testom istezanja ishiadičnog (Lazarevićev) i femoralnog nerva ispitivano je prisustvo kompresije nervnih korenova, za procenu stabilnosti lumbo, Introduction: An individual program of lumbar stabilization exercises could contribute to a better recovery of patients with chronic lower back pain. The exercise program in the treatment of chronic lumbar pain is quite diverse, but it has been proven that stabilization exercises are most effective, especially in a closed kinetic chain. Objective: was to compare the program of lumbar stabilization exercises in the open and closed kinetic chain, in relation to the program of lumbar stabilization exercises and thoracic mobilization in a closed kinetic chain, and to evaluate the clinical efficacy of both exercise programs. Methods: The study was conducted as a prospective, experimental study of 80 subjects of both sexes (35 men, 45 women), average life expectancy (48.45 +/- 10.22 years) with chronic lumbar pain. The research was conducted at the Rehabilitation Clinic "Dr. Miroslav Zotović" in Belgrade in the period from June 2017 to March 2018. Respondents were divided into two groups of 40 patients. The first group of respondents carried out a lumbar stabilization and thoracic mobilization program in a closed kinetic chain (LSTMZ) and the second, program of lumbar stabilization exercises in closed and open kinetic chain (LSZO). In addition to general demographic, anthropometric data on respondents, the following questionnaires and tests were used: for assessing the intensity of back pain and lower extremities - visual analogue scale (VAS), for assessing the neuropathic pain component DN4 (Douleur Neuropathique en 4 Questions), for functional status assessment was used Oswestry disability index (ODI), for assessment of sagittal mobility of the lumbosacral spine- Schober test, muscular strength assessment - manual muscle test; Sensitivity testing at key sensory points for dermatomas was performed according to the ASIA (American Spinal Injury Association) scale, stretching test of the ishiadic (Lazarević) and femoral nerves was udes for detection of nerve root irritatio

Published
2019

25. Botulinum toxin: Poison and medicine

Author

Goločorbin-Kon, Svetlana, primary, Mikov, Aleksandra, additional, Vasović, Velibor, additional, Pavlović, Nebojša, additional, Lalić-Popović, Mladena, additional, Vasović, Lucija, additional, Vukmirović, Saša, additional, Kecman, Sanja, additional, and Mikov, Momir, additional

Published
2019
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27. Uticaj medicinske rehabilitacije na kvalitet života operativno i neoperativno lečenih pacijenata sa lumbalnom radikulopatijom

Author

Bošković, Ksenija, Doder, Radoslava, Mikov, Aleksandra, Bajin, Zoran, Tomašević-Todorović, Snežana, Mahmutović, Elvis, Bošković, Ksenija, Doder, Radoslava, Mikov, Aleksandra, Bajin, Zoran, Tomašević-Todorović, Snežana, and Mahmutović, Elvis

Abstract

Uvod: Sindrom lumbalne radikulopatije obuhvata disfunkciju nervnog korena lumbalne kičme, prouzrokovano kompresijom, nastalom usled hernijacije (protruzije, prolapsa) intervertebralnog diska ili zbog inflamatornih i degenerativnih promena (najčešće osteofita) u foraminalnom otvoru. Kvalitet života predstavlja savremeni koncept posmatranja ishoda oboljenja i uspešnosti terapijske procedure kako u svim oblastima medicine, tako i u problematici lumbalne radikulopatije. Cilj: Proceniti kvalitet života operativno i neoperativno lečenih pacijenata sa lumbalnom radikulopatijom na početku lečenja i 3 meseca, odnosno 6 meseci nakon sprovedene medicinske rehabilitacije. Metode: Istraživanje predstavlja prospektivnu kliničku studiju kojom je analiziran kvalitet života bolesnika sa lumbalnom radikulopatijom. Obuhvaćen je randomiziran i stratifikovan uzorak pacijenata sa lumbalnom radikulopatijom diskalne geneze starosti 20 do 65 godina, oba pola (n=100), lečenih u Specijalnoj bolnici za progresivne mišićne i neuromišićne bolesti Novi Pazar. Jedna grupa ispitanika (n=50) lečena je isključivo neoperativnim metodama, dok je druga grupa bolesnika (n=50) lečena hirurškim i neoperativnim metodama. Kod svih pacijenata sproveden je konzervativni tretman primenom fizikalnih procedura, kineziterapijskih procedura, ergonomske edukacije. Medikamentna terapija je kod svih bila identična. Za procenu stanja pacijenata, kvaliteta života i efekta rehabilitacionog tretmana korišćena su dva standardizovana upitnika: opšti zdravstveni upitnik Medical Outcomes Study Short Form 36 (SF 36) i upitnik specifičan za oboljenje The Oswestry Disability Index (ODI). Rezultati: Vrednosti SF-36 upitnika prikazanih sumarnim fizičkim (SFS) i mentalnim (SMS) skorom, i kod neoperativno lečenih ispitanika (FSFS=450,221 i p<0,001; FSMS=106,543 i p<0,001), ali i kod operativno lečenih (FSFS=490,721 i p<0,001; FSMS=72,055 i p<0,001) značajno su se menjale u toku ispitivanja. Vrednosti SFS kod neoperativno lečenih pac, Introduction: The syndrome of lumbar radiculopathy involves dysfunction of nerve roots of the lumbar spine, caused by compression, resulting due to herniation (protrusion, prolapse) intervertebral disc, or due to inflammatory and degenerative changes (usually osteophytes) in foraminal opening. Quality of life is the modern concept of observing the outcome of disease and therapeutic procedures in performance in all areas of medicine, as well as the problems of lumbar radiculopathy. Aim: Assess the quality of life for surgically and conservatively treated patients with lumbar radiculopathy at initiation of treatment and 3 months, and 6 months after conducting medical rehabilitation. Methods: The study is a prospective clinical study, which analyzed the quality of life of patients with lumbar radiculopathy. Also included is randomized and stratified sample of patients with lumbar radiculopathy of discal genesis aged 20 to 65 years, of both sexes (n=100) treated at the Special Hospital for progressive muscular and neuromuscular diseases Novi Pazar. One group of patients (n=50) were treated exclusively non-surgical methods, while the second group of patients (n=50) treated with surgical and non-surgical methods. In all patients was conducted by applying the conservative treatment of physical procedures, kinesitherapy procedures, ergonomic education. Medication treatment is at all were identical. To assess the condition of patients, quality of life and the effect of rehabilitation treatment used two standardized questionnaires: a general health questionnaire Medical Outcomes Study Short Form 36 (SF 36) and disease-specific questionnaire The Oswestry Disability Index (ODI). Results: Values SF-36 questionnaire presented summary physical (SFS) and mental (SMS) scores, with non-surgical treated subjects (FSFS=450.221, p<0.001; FSMS=106.543, p<0.001), but also at surgical treated (FSFS=490.721, p<0.001; FSMS=72.055, p<0.001) were significantly changed during the study. Values

Published
2018

28. Procena spontane motoričke aktivnosti novorođenčeta i odojčeta

Author

Dimitrijević, Lidija, Stanković, Ivona, Mikov, Aleksandra, Čolović, Hristina, Bjelaković, Bojko, Zlatanović, Dragan, Dimitrijević, Lidija, Stanković, Ivona, Mikov, Aleksandra, Čolović, Hristina, Bjelaković, Bojko, and Zlatanović, Dragan

Abstract

Introduction: Conventional methods of neurological assessment of newborns and infants include neurological examination, neurokinesiological examination, quantitative assessment using scales and tests, and the use of supplementary diagnostic neuroimaging procedures. All the above methods are of great importance for the common clinical practice. They enable rapid detection of central (and peripheral) nervous system damage, but also have common defect which is the inability to adequately predict neurological deficits. In this study Prechtl’s method of the qualitative assessments of spontaneous motor activity was used. In former studies this method had demonstrated high level of reliability in very early prediction of neurological abnormalities in new-borns and infants. Aim: To evaluate the quality of the spontaneous motor activity during neonatal period, to evaluate the quality of spontaneous motor activity during infancy, to determine neurological outcome and motor functional status during the period of 24 months of corrected calendar age, to determine predictive value of the spontaneous motor activity for neurological and functional outcome at 24 moths corrected calendar age. Research methods: The study was conducted as prospective clinical study which included children born in the maternity ward in Clinical Center Nis in 2012, ≤ 37 weeks gestational age. Whole research included 80 respondents. The observation of spontaneous motor activity was conducted according to the basic principles of the Prechtl Method. The evaluation of spontaneous activity was conducted by the educated person with valid license for evaluation of spontaneous motor activities. The evaluation was based on video analysis. Spontaneous motor activity was observed in three time periods: within 5 days of birth, period of 44.- 46. gestation weeks, and period of 50. – 54. gestation weeks postmenstrual age. Definitive neurological outcome was evaluated on the basis of a detailed neurological examination

Published
2018

29. Минимална неуролошка дисфункција и лоше држање тела у деце предшколског узраста

Author

Mikov, Aleksandra, Sekulić, Slobodan, Demeši-Drljan, Čila, Velisavljev-Filipović, Gordana, Dimitrijević, Lidija, Галић, Маја, Mikov, Aleksandra, Sekulić, Slobodan, Demeši-Drljan, Čila, Velisavljev-Filipović, Gordana, Dimitrijević, Lidija, and Галић, Маја

Abstract

Увод: Процена минималних неуролошких дисфункција (МНД) пружа информације о неуролошком стању детета, помаже у идентификовању вулнерабилности детета ка развоју моторних слабости, тешкоћа у учењу или поремећаја понашања. Деформитети кичменог стуба код деце предшколског узраста су у сталном порасту. Циљ истраживања: Утврђивање преваленце МНД-а у узорку предшколске деце тестирањем по Touwen-у, евалуација постуралног статуса код деце предшколског узраста, као и утврђивање повезаности јављања минималних неуролошких дисфункција и постуралних поремећаја код деце предшколског узраста. Материјал и методе: Истраживање је урађено у предшколској установи „Радосно детињство“ из Новог Сада. Укупан узорак је обухватио 120-оро деце која су подељена у две групе у односу на узраст, 60-оро деце старости од 6 до 7 година (група А) и 60-оро деце старости од 5 до 6 година (група Б). Методом случајног избора су изабрана три вртића из различитих делова града, а деца су насумично одабрана са приближно једнаком заступљеношћу пола. Тестирање је урађено са Touwen-овим тестом модификованим од стране Hadders-Algre. Резултати су груписани у три групе: одсуство, присуство једноставних (присуство једне или две области дисфункције) и присуство комплексних МНД (присуство најмање три области дисфункције). Код све деце урађена је евалуација постуралног статуса, као и антропометријска мерења. Резултати: Постоји статистички значајна разлика у учесталости јављања МНД-а у односу на узраст, одступања су чешће присутна у млађем узрасту. МНД се чешће јављају код дечака у односу на девојчице, али није показана статистички значајна разлика. Код 68,3% деце уочени су елементи лошег држања тела. Најчешћа одступања од нормалног постуралног положаја била су у виду спуштених стопала (45,8%), асиметрије висине рамена (35%), искривљења ахилових тетива ван (30%), повећања слабинске кривине (29,2%) и асиметрије троуглова стаса (20%). Утврђена је статистички значајна позитивна повезаност између јављања минималних неуролошк, Uvod: Procena minimalnih neuroloških disfunkcija (MND) pruža informacije o neurološkom stanju deteta, pomaže u identifikovanju vulnerabilnosti deteta ka razvoju motornih slabosti, teškoća u učenju ili poremećaja ponašanja. Deformiteti kičmenog stuba kod dece predškolskog uzrasta su u stalnom porastu. Cilj istraživanja: Utvrđivanje prevalence MND-a u uzorku predškolske dece testiranjem po Touwen-u, evaluacija posturalnog statusa kod dece predškolskog uzrasta, kao i utvrđivanje povezanosti javljanja minimalnih neuroloških disfunkcija i posturalnih poremećaja kod dece predškolskog uzrasta. Materijal i metode: Istraživanje je urađeno u predškolskoj ustanovi „Radosno detinjstvo“ iz Novog Sada. Ukupan uzorak je obuhvatio 120-oro dece koja su podeljena u dve grupe u odnosu na uzrast, 60-oro dece starosti od 6 do 7 godina (grupa A) i 60-oro dece starosti od 5 do 6 godina (grupa B). Metodom slučajnog izbora su izabrana tri vrtića iz različitih delova grada, a deca su nasumično odabrana sa približno jednakom zastupljenošću pola. Testiranje je urađeno sa Touwen-ovim testom modifikovanim od strane Hadders-Algre. Rezultati su grupisani u tri grupe: odsustvo, prisustvo jednostavnih (prisustvo jedne ili dve oblasti disfunkcije) i prisustvo kompleksnih MND (prisustvo najmanje tri oblasti disfunkcije). Kod sve dece urađena je evaluacija posturalnog statusa, kao i antropometrijska merenja. Rezultati: Postoji statistički značajna razlika u učestalosti javljanja MND-a u odnosu na uzrast, odstupanja su češće prisutna u mlađem uzrastu. MND se češće javljaju kod dečaka u odnosu na devojčice, ali nije pokazana statistički značajna razlika. Kod 68,3% dece uočeni su elementi lošeg držanja tela. Najčešća odstupanja od normalnog posturalnog položaja bila su u vidu spuštenih stopala (45,8%), asimetrije visine ramena (35%), iskrivljenja ahilovih tetiva van (30%), povećanja slabinske krivine (29,2%) i asimetrije trouglova stasa (20%). Utvrđena je statistički značajna pozitivna povezanost između j, Introduction: Assessment of minor neurological dysfunction (MND) provides information about a child's neurological condition, which helps to identify the vulnerability of the child to the development of motor impairment, difficulties in learning or behavioral disorders. Spinal deformities in preschool children are constantly increasing. Aim: Determining the prevalence of MND in a sample of preschool children using Touwen’s test, the evaluation of postural status in preschool children, as well as determining the relation between the occurrence of minor neurological dysfunction and postural disorders in preschool children. Material and methods: The examination was carried out in the preschool institution “Radosno detinjstvo” in the city of Novi Sad. The total sample included 120 children who were divided into two groups according to their age, 60 children aged 6 to 7 years (group A) and 60 children aged 5 to 6 years (group B). The children were recruited at three randomly selected kindergartens, and the children were randomly selected with approximately equal gender representation. The testing was done with Touwen's test modified by Hadders-Algra. The results were classified into three groups: the absence of MND, the presence of simple MND (presence of one or two domains of dysfunction) and the presence of complex MND (presence of at least three domains of dysfunction). Evaluation of postural status and anthropometric measurements were carried out for all the children. Results: There is a statistically significant difference in the prevalence of MND in relation to age, variations were more likely at a younger age. MND is more frequent in boys than in girls, but this difference is not statistically significant. In 68.3% of the children there are elements of bad posture. The most common deviations from the normal postural position are flat feet (45.8%), shoulder height asymmetry (35%), distortion of Achilles tendons to the outside (30%), excessive curvature of lower bac

Published
2017

32. Kvalitet života kod dece i omladine sa cerebralnom paralizom

Author

Mikov, Aleksandra, Bobić, Branislav, Švraka, Emira, Demeši-Drljan, Čila, Tomašević-Todorović, Snežana, Dimitrijević, Lidija, Krasnik, Rastislava, Mikov, Aleksandra, Bobić, Branislav, Švraka, Emira, Demeši-Drljan, Čila, Tomašević-Todorović, Snežana, Dimitrijević, Lidija, and Krasnik, Rastislava

Abstract

Istraživanje je obuhvatilo primenu generičkog upitnika (Kiddy-KINDL, Kid-KINDL, Kiddo-KINDL i verzije za roditelje Kiddy-KINDL i KINDL), bolest-specifičnog upitnika (CPQOL-Child i CPQOL-verzija za roditelje), kao i upitnika za procenu porodičnog kvaliteta života dece sa cerebralnom paralizom (Family quality of life survey. Main caregivers of people with intellectual or developmental disabilities). Analizom je obuhvaćeno 70. dece i omladine sa cerebralnom paralizom i njihovih roditelja. Kvalitet života dece sa CP uzrasta 4-17 godina, ispitan generičkim upitnikom ne pokazuje statistički značajne razlike u svim ispitivanim domenima bez obzira na nivo motoričkog onesposobljenja prema GMFCS. Kvalitet života sa aspekta roditelja ispitan generičkim upitnikom pokazuje da deca uzrasta 3-6 godina sa CP nivoa I-II prema GMFCS, imaju statistički značajno bolji kvalitet života u domenu zdravstvenog i emocionalnog stanja, samopoštovanja i socijalnog života, dok deca uzrasta 7-17 godina imaju statistički značajno bolji kvalitet života samo u domenu emocionalnog stanja. Ova razlika se može objasniti činjenicom da su roditelji starije dece sa CP prošli kroz proces prihvatanja bolesti tokom vremena. Kvalitet života dece sa CP uzrasta 8-12 godina, ispitan bolest-specifičnim upitnikom ne pokazuje statistički značajne razlike u svim ispitivanim domenima bez obzira na nivo motoričkog onesposobljenja prema GMFCS. Kvalitet života sa aspekta roditelja ispitan bolest-specifičnim upitnikom pokazuje da deca uzrasta 4-12 godina sa CP nivoa I-II prema GMFCS, imaju statistički značajno bolji kvalitet života u domenima: socijalno blagostanje i prihvatanje, osećanje o funkcionisanju, učešće i fizičko zdravlje, kao i bol i uticaj invalidnosti. Nema razlike u stavu deteta i roditelja u domenima kvaliteta života mereno generičkim upitnikom. Međutim, upotrebom bolest-specifičnog upitnika dobija se podatak da roditelji ocenjuju kvalitet života deteta značajno lošije u domenima: osećaj o funkcionisanju, The study included the use of generic questionnaire (Kiddy-KINDL, Kid-KINDL, Kiddo-KINDL versions for parents Kiddy-KINDL and KINDL), a disease-specific questionnaire (CPQOL-Child and CPQOL-version for parents), as well as the questionnaire for evaluation of family quality of life of children with cerebral palsy (FQOL-DD). The analysis included 70 children and youth with cerebral palsy and their parents. The quality of life of children with CP aged 4-17 years, examined by a generic questionnaire, shows no statistically significant differences in any investigated domains regardless of the level of motor disability according to GMFCS. The quality of life from the parent aspect obtained by the generic questionnaire shows that children aged 3-6 years with CP levels I-II GMFCS, had a significantly better quality of life related to health and emotional status, self-esteem and social life, while children aged 7-17 years had a significantly better quality of life only in the domain of emotional state. This difference can be explained by the fact that parents of older children with CP had the time to pass through the process of accepting the disease. The quality of life of children with CP aged 8-12 years, examined by the disease-specific questionnaire, shows no statistically significant differences in any investigated domains regardless of the level of motor disability according to GMFCS. The quality of life from the parent aspect according to the disease-specific questionnaire shows that children aged 4 -12 years with CP levels I-II GMFCS had a significantly better quality of life in following domains: social well-being and acceptance, feeling of functioning, participation and physical health, as well as the pain impact and disability. There is no difference in the attitude of the child and parents in the domains of quality of life as measured by the generic questionnaire. However, by using disease-specific questionnaires it is clear that parents assess the quality of life

Published
2016

33. Efikasnost dekongestivne i presoterapije kod pacijentkinja sa limfedemom ruke nakon operacije karcinoma dojke

Author

Popović-Petrović, Svetlana, Tomašević-Todorović, Snežana, Bobić, Branislav, Jandrić, Slavica, Mikov, Aleksandra, Bošković, Ksenija, Bojinović-Rodić, Dragana, Popović-Petrović, Svetlana, Tomašević-Todorović, Snežana, Bobić, Branislav, Jandrić, Slavica, Mikov, Aleksandra, Bošković, Ksenija, and Bojinović-Rodić, Dragana

Abstract

UVOD. Sekundarni limfedem ruke je relativno česta komplikacija nakon lečenja raka dojke. Iako se kompleksna dekongestivna terapija smatra “zlatnim standardom“ ", još uvek postoji kontroverza o tome da li dodavanje presoterapije daje bolji terapijski efekat. Stoga je cilj ovog istraživanja bio uporediti efikasnost kompleksne dekongestivne fizikalne terapije (KDFT) u odnosu na kompleksnu dekongestivnu fizikalnu terapiju sa presoterapijom na funkcionalni status, nivo bola i kvalitet života kod pacijentkinja sa sekundarnim limfedemom ruke nakon lečenja raka dojke. MATERIJAL I METODE. Prospektivna, randomizovana, paralelna, nemaskirana studija je obuhvatila 108 pacijentkinja sa sekundarnim limfedemom ruke, prosečne starosti 56,8 ± 8,5 godina, koje su završile operativno lečenje raka dojke pre 57,4 ± 46,2 meseca. One su randomizovane u 2 grupe: KDFT grupa (kontrolna) ili KDFT+presoterapija grupa (eksperimentalna). Protokol KDFT se sastojao od nege kože, manuelne limfne drenaže, kratkoelastične višeslojne bandaže i vežbi. Osim toga, eksperimentalna grupa je primala presoterapiju (intermitentnu pneumatsku kompresiju), 30 minuta dnevno pri pritisku od 40 mm Hg. Oba protokola su se provodila jednom dnevno, pet dana sedmično tokom 3 sedmice. Ispitanice su podučavane za nastavak samostalnog sprovođenja nege kože, manuelne limfne drenaže i vežbi, kao i za nošenje kompresivnog rukava, 3 meseca nakon završetka lečenja. Mere ishoda. Obim ruke, obim pokreta u zglobu ramena, snaga stiska šake, vizuelna analogna skala za bol, upitnik Nesposobnost ruke, ramena i šake (DASH) za funkciju ruke i upitnik Funkcionalna analiza lečenja raka dojke dojke sa subskalom 4+ za ruku (FACT-B4+) za kvalitet života su ocenjeni pre, neposredno nakon i 3 meseca nakon završetka lečenja. Za statističku obradu dobijenih podataka korišćene su deskriptivne metode, analiza varijanse (ANOVA) za ponovljena merenja, analiza kovarijanse, Man-Vitni test, hi-kvadrat test i Fišerov egzaktni test, prema potrebi. REZUL, BACKGROUND. Secondary lymphedema of the arm is a relatively common complication after breast cancer surgery. Although complex decongestive therapy is considered the “golden standard”, there is still a controversy as to whether adding pressotherapy is of any value. Thus, the aim of this study was to compare the efficacy of complex decongestive therapy (CDT) against complex decongestive therapy combined with a pressotherapy on functional status, pain, and quality of life in patients with secondary lymphedema of the arm after breast cancer treatment. METHODS. In this prospective, randomized, parallel, non-blind study, we recruited 108 women, mean age 56.8±8.5 years, with secondary arm lymphedema who completed breast cancer surgery 57.4±46.2 months earlier. They were randomly assigned to a CDT group (control) or CDT+pressotherapy group (experimental). The CDT protocol consisted of skin care, manual lymphatic drainage, short stretch multi-layer compression bandages, and exercises provided by therapists. In addition to that, the experimental group received pressotherapy (intermittent pneumatic compression) for 30 minutes per day at a pressure of 40 mmHg. The treatments were administered once a day, five days a week, for 3 weeks. The subjects were instructed to continue administering the skin care, manual lymphatic drainage, compression sleeve and exercises on their own for 3 months after the end of treatment. Outcome measures. Arm circumference, shoulder range of motion, grip strength, visual analog scale for pain, Disability of the Arm, Shoulder and Hand questionnaire (DASH) for the overall arm function, and Functional Analysis of Cancer Treatment- Breast 4+ (FACT-B4+) for quality of life were assessed before, immediately after, and at 3 months after the end of treatment. The statistical analyses included descriptive methods, analysis of variance (ANOVA) for repeated measures, analysis of covariance, Mann-Whitney U- test, chi-square test, and Fisher’s exact test, as appr

Published
2016

35. Rak kao profesionalna bolest u medicinskih sestara

Author

Mikov, Aleksandra

Subjects
medicinske sestre, karcinom, profesionalne bolesti
Abstract

Ovim radu pokušao se približno, napraviti pregled potencijalnih opasnosti koje sestrinska profesija ima u odnosu na mogućnost razvoja karcinoma kao profesionalne bolesti. Zanimanje medicinske sestre najbrojnije je zanimanje u zdravstvenim sustavima svih zemalja. Njezino područje djelovanja i kompetencije, na mnogim radilištima se isprepliću sa poslovima ostalih zdravstvenih radnika. Multidisciplinarno obrazovanje, sa sve većom diferencijacijom i podizanjem kompetencija rezultira i sa većom izloženošću potencijalno štetnim izvorima . Poslovi medicinske sestre na mnogim radilištima vezani su za kontakt sa tjelesnimtekućinama bolesnika, izvorima zračenja, citostatskim lijekovima, radom sa kemikalijama i mnogim drugim opasnostima u radnom okuženju. Ciklus rada odvija se u rotirajućim smjenama te redovno i noćnim radom. Često je riječ je dugogodišnjem izlaganju uvjetima i načinu rada, te radnom okruženju, a kumulacija štetnog djelovanja za posljedicu može imati maligno djelovanje na zdravlje medicinskih sestara. Najčešće ni sama sestrinska profesija nije svjesna opasnosti koje donosi izloženost radnim uvjetima, te tako i rad poboljšanju tih uvjeta nije postavljeno kao prioritet. Uvrštavanje medicine rad u sustav obrazovanje zdravstvenih kadrova u Republici Hrvatskoj je neodgodiv. Rezultat toga bi formiranje svijesti o potrebi podizanja sigurnosti radnih uvjeta na zdravstvenim radilištima, te u konačnici bi utjecao i na poslodavce da osiguraju radnom mjesto bez štetnosti po zdravlje zaposlenika.

Published
2013

36. Upotreba asistivnih tehnologija kod osoba sa invaliditetom

Author

Golubović, Špela, Mikov, Aleksandra, Milankov, Vesela, Komazec, Zoran, and Krasnik, Rastislava

Subjects
assistive technologies, invaliditet, ICF, disabilities, MKF, pomoćne tehnologije
Abstract

Kao rezultat sve većih očekivanja i zahteva korisnika asistivnih tehnologija u cilju povećanja njihovih sposobnosti i postizanja većeg ste- pena samostalnosti i nezavisnosti u funkcionisanju, dolazi do sve inten- zivnijer razvoja i primene asistivnih tehnologija. Na obaveznost i neop- hodnost primene i ovog vida podrške i pomoći osobama sa različitim vi- dovima invaliditeta posebno su ukazala različita zakonska akta i kla- sifikacije. Ukazano je i na neka pitanja koja se u radu diskutuju kao što su: faktori koji utiču na izbor pomoćnih tehnologija, korisnost primene i barijere za njihovu primenu. Na rezultate korišćenja uticaće kako sre- dinski, tako i lični faktori, odlike samog proizvoda i pravilna procenu potreba korisnika. Koristi primene ovih tehnologija su brojne, ali je neo- phodan i stručan, profesionalan pristup prilikom njihovog odabira i rada sa korisnicima i njihovim porodicama Due to growing expectations and demands from users of assistive technologies, and with the aim of improving their abilities and ensuring a higher degree of independance and self-reliance in their functioning, there have been major advances in the development and application of assistive technologies. The requirement and need for providing this type of support and help to people with different types of disabilities have been highlighted in a series of legislative acts and classifications. They raise some questions addressed in this paper such as: factors that influence assistive technology selection, benefits from and obstacles to their application. The outcomes of using these technologies will be influenced by environmental as well as personal factors, features of the product itself, and proper assessment of user needs. There are numerous benefits of applying these technologies; however, a professional approach during the entire selection process and while working with users and their families is required.

Published
2012

40. Functional status of patients after stroke

Author

Tomasevic-Todorovic, Snezana, primary, Kopcanski, Sanja, additional, Mikov, Aleksandra, additional, Boskovic, Ksenija, additional, Popovic-Petrovic, Svetlana, additional, and Savic, Mirjana, additional

Published
2015
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41. Faktori koji utiču na nivo osposobljenosti za hod uz pomoć proteze nakon amputacije donjih ekstremiteta

Author

Mikov, Aleksandra, Savić, Dragan, Bobić, Branislav, Jeličić, Zoran, Tomašević-Todorović, Snežana, Knežević, Aleksandar, Mikov, Aleksandra, Savić, Dragan, Bobić, Branislav, Jeličić, Zoran, Tomašević-Todorović, Snežana, and Knežević, Aleksandar

Abstract

Lower limb amputation represents one of the classical rehabilitation problems amenable to intervention by a physiatrist. Because of the aging of the population and the increased incidence of diabetes the number of amputation is expected to increase in the future. Identification of predictive factors of ability to walk with prosthesis is very important in order to define patient's potentials and realistic goals. Goals: To determine a number of comorbidities in persons with lower limb amputation and their influence on the level of ability to walk with prosthesis. To determine the influence of the different factors such as: functional status of the residual limb and time period from amputation to beginning of prosthetic rehabilitation process, on the level of ability to walk with prosthesis. Patients and methods: The study was etrospective-prospective and encompassed patients with major lower limb amputation who underwent prosthetic rehabilitation at Clinic for medical rehabilitation in Clinic center of Vojvodina for the period 2000-2013. Beside classical statistics, we formed regression models using algorithms based on Support Vector Machines (SVM). Results: Vascular disease accounted for the vast majority of amputations: in retrospective study 88,5 percents, and in prospective study for 90 percents of all cases. Majority of amputations were transfemoral: 65 percents in retrospective and 62 percents in prospective study. Average Functional Co morbidity Index (FCI) score was 2,19 in retrospective, and 2,91in prospective study. Average time period from amputation to prosthetic fitting was 186,22 days in retrospective, and 172 days in prospective study. Multivariate analysis in retrospective study identified age, level of amputation, and functional status at the beginning of the rehabilitation treatment as significant predictors for level of ability to walk with prosthesis. Our model identified level correctly in 58,1 percents of all cases. Multivariate analysis in prosp

Published
2014

42. Propriocepcija zgloba kolena posle kidanja prednjeg ukrštenog ligamenta kod profesionalnih sportista

Author

Savić, Dragan, Milankov, Miroslav, Ninković, Srđan, Harhaji, Vladimir, Tanackov, Ilija, Mikov, Aleksandra, Matijević, Radmila, Savić, Dragan, Milankov, Miroslav, Ninković, Srđan, Harhaji, Vladimir, Tanackov, Ilija, Mikov, Aleksandra, and Matijević, Radmila

Abstract

Ova studija je bila prospektivnog karaktera. Uz dopuštenje etičkog komiteta Kliničkog centra Vojvodine istraživanje je sprovedeno na Klinici za ortopedsku hirurgiju i traumatologiju i obuhvatilo je 60 pacijenata muškog pola, koji su metodom slučajnog izbora na randomizirani način uključeni u ispitivanje, a koji se aktivno i profesionalno bave fudbalom, košarkom ili odbojkom, primljenih na Kliniku za ortopedsku hirurgiju radi artroskopske rekonstrukcije pokidanog prednjeg ukrštenog ligamenta. U ispitivanje su uključeni samo oni pacijenti koji su dali potpisani informisani pristanak da učestvuju u ispitivanju, koji su zadovoljii sve kriterijume za uključivanje i koji nisu imali niti jedan kriterijum za isključivanje iz studije. Kriterijumi za uključivanje u studiju podrazumevali su sledeće: da je pacijent primljen na Kliniku za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine u Novom Sadu radi operativnog lečenja prekida prednjeg ukrštenog ligamenta kolena, da je potpisao informisani pristanak za uključivanje, da je starosne dobi od 18 do 45 godina, da se aktivno i profesionalno bave fizičkom aktivnošću regulisanom pravilima (fudbal, odbojka, košarka). Kriterijumi za isključivanje pacijenata iz istraživanja bili su sledeći: prisustvo udružene povrede i spoljašnjeg pobočnog ligamenta koja zahteva operativno lečenje, pojava težih opšte – hirurških komplikacija, želja pacijenta da bude isključen iz daljeg ispitivanja, bez obaveze da tu svoju odluku obrazloži. U prvoj fazi konstruisan je aparat, digitalni goniometar, uz pomoć kojeg je urađen eksperimentalni deo ovog ispitivanja i napravljena je baza podataka sa poljima za upis deskriptivnih i antropometrijskih parametara. Potom je uz pomoć aparata svim ispitanicima testirana sposobnost propriocepcije (JPS). Testiranje je obavljeno preoperativno na povređenom i nepovređenom ekstremitetu, u dva maha: odmah po zadavanju ciljnog ugla od 35° i nakon 5 minuta. Druga faza je obavljena minimum 6 meseci nakon o, In this prospective study examined group consisted of 60 male patients with an anterior cruciate ligament tear and all participants were at the time before injury actively playing afootball, basketball or volleyball. The study was conducted at the Clinic for Orthopaedic Surgery and Traumatology Clinical Center of Vojvodina in Novi Sad where participants were admitted for arthroscopic ligament reconstruction. All participants were informed of the study by their clinicians and gave written consent. Thee exclusion criteria were the following: occurrence of combined cruciate ligament with lateral collateral ligament injury that required surgical treatment; occurrence of more serious general surgical complications; the patient’s wish to be excluded from further research without an obligation to give any further explanation to his decision. In the first stage of the study, an apparatus called digital goniometer was constructed, which was used to conduct the experimental part of the study, and a database with fields for inserting descriptive and anthropometric parameters was made. Next, by using the apparatus, all subjects were tested for proprioception ability (JPS). The tests were performed preoperatively on the injured and the uninjured limb in two instances: straight after determining the target angle of 35° and 5 minutes afterwards. The second stage was performed postoperatively in the same maner, following a minimal 6-month period after a surgical arthroscopic reconstruction of the torn anterior cruciate ligament by bone-tendon-bone (BTB) technique. The clinical evaluation of each patient involved Lachman test (positive / negative), Lysholm and IKDC scales, first pre-operatively and then during post-opera

Published
2014

44. Cerebral palsy in preterm infants.

Author

Drljan, Čila Demeši, Mikov, Aleksandra, Filipović, Karmela, Todorović, Snežana Tomašević, Knežević, Aleksandar, and Krasnik, Rastislava

Subjects
*PEOPLE with cerebral palsy, *PREMATURE infants, *HEALTH outcome assessment, *MOTOR ability, *MEDICAL records, *HEALTH
Abstract

Background/Aim. Cerebral palsy (CP) is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy in Europe (SCPE) and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS). Results. More than half of the children with CP were born prematurely (54.4%). Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001). In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049), children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0%) affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032). Conclusion. The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy. [ABSTRACT FROM AUTHOR]

Published
2016
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