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30.06.2022.

Original Scientific Articles

Magnetic resonance imaging of the heart as a method of long-term monitoring of right heart function after tetralogy of Fallot surgery

By Biljana Milinković, Jelena Milić, Dejan Bokonjić, Verica Prodanović, Bojan Joksimović, Siniša Ristić

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Edited by:

Prof. Siniša Ristić MD, PhD

Vol 16, No 1 (2025):

Biomedicinska istraživanja

Published: 06.02.2025.

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Introduction. Modern approaches to auditory perception therapy are essential for the effective rehabilitation of individuals with hearing impairments. Speech and language therapists and hearing therapists are central to planning and delivering interventions that are grounded in current scientific knowledge and tailored to the individual needs of each client. Their familiarity with methods directly influences the quality of auditory training, speech perception development, and overallcommunication outcomes. This study aims to examine the extent to which speech and language therapists and hearing therapists in Bosnia and Herzegovina (BiH) are familiar with contemporary approaches to auditory perception treatment and to identify potential gaps in professional training and clinical practice.
Methods. The study included 60 speech and language therapists and hearing therapists from institutions across Bosnia and Herzegovina where auditory perception treatment was conducted. The majority of the participants were speech and language therapists (73%), while hearing therapists accounted for 15% of the sample. Participants were both males and females, aged between 25 and 44 years. A specially designed questionnaire was used for this study.
Results. The results indicated that speech and language therapists and hearing therapists in Bosnia and Herzegovina were not generally well-informed about contemporary approaches to auditory perception treatment. Many professionals reported limited opportunities to implement such treatments in their institutions. 
Conclusion. The findings indicate that the availability of materials for implementing contemporary auditory perception treatment methods is limited or problematic within Bosnia and Herzegovina. This may be due to financial constraints or insufficient awareness among professionals regarding the existing possibilities. Additionally, there is a noticeable lack of organized training programs aimed at equipping professionals with the necessary skills to apply these modern methods. Improving access to materials and professional development opportunities is essential for enhancing the implementation of advanced auditory perception treatments.

14.10.2025. Case Reports Online First
Swelling of the optic nerve head due to the coexistence of idiopathic intracranial hypertension and optic nerve drusen

By Željko Maraš, Tanja Kalezić, Bojan Joksimović, Radmila Balaban Djurević

Introduction. Optic nerve head drusen (ONHD) is one of the most common congenital disorder of the optic nerve with prevalence from 0,5-2% in general population. Idiopathic intracranial hypertension is a condition that occurs in children, unlike adults, regardless of gender or the presence of obesity. Both conditions in children present on the eye as swelling of the optic disc, which is difficult to distinguish by clinical examination. They are extremely rarely associated.

Case report. A 15-year-old girl was urgently admitted due to decreased vision in both eyes for the past 7 days. Computerized visual field (CVP) testing revealed annular scotoma in both eyes, with a residual of 10 degrees and decreased sensitivity. Fundus examination showed an edematous both ONH. Echo B scan showed highly reflective changes corresponding to drusen in ONH. Acetazolamide 250 mg orally three times a day was introduced into the therapy. Neurological examination and MRI of endocranium was normal. After 3 weeks, VA in both eyes was 0.5 corrected with -0.50 Dsph to 1.0. ONH significant regression with unclear boundaries temporally, superiorly and inferiorly. The follow-up period over the next year, visual acuity was stable, and normal CVP, only slightly unclear boundaries of the ONH.

Conclusion. The diagnosis of optic nerve drusen is possible in children with benign intracranial hypertension. For this reason, it is necessary to thoroughly diagnose the patient in order to start treatment in a timely manner and prevent the development of visual impairment.

14.10.2025. Original Scientific Articles Online First
Thyroid Dysfunction in Patients with Multiple Sclerosis: Prevalence and Associated Risk Factors

By Daliborka Tadić, Sanja Grgić, Aleksandra Dominović Kovačević, Zoran Vukojević, Gabrijela Malešević, Valentina Soldat Stankovic

Introduction: Thyroid dysfunction has been identified as one of the most common comorbidities in people with multiple sclerosis (pwMS). This study aimed to determine the prevalence of thyroid disease and vitamin D levels in patients with MS compared to the general population, and to assess the potential impact of thyroid status and vitamin D levels on the degree of physical disability and the prediction of multiple sclerosis.

Methods: A total of 127 participants were prospectively enrolled in the study: 59 (46.5%) were healthy controls, and 68 (53.5%) were patients diagnosed with MS. Both groups were assessed for serum levels of TSH, FT4, anti-TPO antibodies, and vitamin D. In the MS group, the physical disability was additionally evaluated using the Expanded Disability Status Scale (EDSS).

Results: Overt hypothyroidism (p = 0.011) and vitamin D deficiency (p = 0.013) were significantly more frequent among MS patients. Mean FT4 levels (p = 0.025) and vitamin D levels (p = 0.018) were significantly lower in the MS group, whereas anti-TPO antibody levels were markedly higher in MS patients (p < 0.001). EDSS scores showed a negative correlation with vitamin D concentrations (p < 0.050). Multivariate analysis identified independent risk factors for MS, including the presence of severe hypovitaminosis D (p = 0.035), lower vitamin D concentrations (p = 0.003), and elevated anti-TPO levels (p = 0.042).

Conclusion:  Evaluation of thyroid status, as well as vitamin D concentrations, should be considered a standard part of healthcare for pwMS.

Keywords: Multiple sclerosis, thyroid gland, vitamin D

 

 

 

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By Mirjana Ćuk, Radoslav Gajanin, Svjetlana Kulić, Milena Vasić Milanović

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Impact of elapsed time between first symptoms and diagnosis of celiac disease on psycho-physical functioning and social life of children and adolescents

By Biljana Stojanović-Jovanović, Stevan Jovanović, Biljana Vuletić

Introduction. Celiac disease is an autoimmune disease resulting from an inadequate immune response to gluten in genetically predisposed individuals as a result of consuming gluten and other related proteins present in wheat, rye, barley and oats. The only cure for this specific disease is a strict, carefully controlled and lifelong gluten-free diet. The aim of the study was to evaluate whether the elapsed time between the onset of the first symptoms and the diagnosis of celiac disease affected the psycho-physical functioning and social life of children and adolescents.

Methods. The study involved 116 respondents (39 of them were males), aged 8-18 years, who were diagnosed with celiac disease. The Documentation Sheet and the Celiac-Specific Pediatric Health-Related Instrument (CDPQOL), measuring the psycho-physical functioning and social life, were used in the study.

Results. 50% of subjects, aged ≤ 2 years, were diagnosed with celiac disease. 48.28% of them were diagnosed with the disease within three months after the symptom onset. In respondents with celiac disease, aged 8-12 years, there was no statistically significant difference between the psycho-physical functioning and social life and the elapsed time between the first symptoms and the established diagnosis. In subjects aged 13-18 years, using CDPQOL, a statistically significant difference was found in the following domains: school functioning, going out and social events, self-confidence. Furthermore, there was a statistically significant difference between total CDPQOL score and the elapsed time between the first symptoms and the established diagnosis.

Conclusion. The elapsed time between the first symptoms and the established diagnosis significantly affects the psycho-physical functioning and social life of subjects aged 13-18 years, but it does not affect the psycho-physical functioning and social life of the younger respondents. This is to confirm the importance of early diagnosis and treatment initiation.

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01.12.2011. Original Scientific Articles
Dijagnostika fokalnih promjena u jetri

By Zoran Terzić, Branko Brmbolić, Miloš Korać, Boban Đorđević, Dragica Terzić, Bogdanka Andrić, Siniša Ristić

Uvod. Patološki procesi u jetri mogu biti difuznog karaktera (zapaljenski,metaboličke bolesti, hematološke bolesti, toksične bolesti) i fokalne (zapaljenske,parazitarne i tumorske). Cilj rada je prikaz fokalnih promjena u jetrinomparenhimu nakon ultrazvučne, laparaskopske i patohistološke dijagnostike.Metode. Retrospektivno-prospektivnim ispitivanjem je obuhvaćeno 147punoljetnih pacijenata oba pola. Fokalne promjene jetrinog tkiva su sagledaneultrazvučnom, laparoskopskom i patohistološkom dijagnostikom.Rezultati. Osnovne karakteristike ispitanika: muškaraca 71 i žena 76 sanajvećim brojem pacijenata (102 - 70%) životne dobi između 40 i 70 godina,sa ravnomjernom distribucijom za svakih deset godina starosti. Međutim,neobično je veliki broj pacijenata ženskog pola registrovan u četvrtoj decenijiživota, čak 14 (9,5%) od ukupnog broja ispitanika, odnosno 18% odispitanika ženskog pola. Metastaze čine 104 (71%) svih fokalnih lezija jetre.U većini slučajeva radilo se o metastazama karcinoma dojke. Iako najčešćeimaju tipičnu ultrazvučnu prezentaciju, metastaze u jetri mogu da daju širokspektar različitih ultrazvučnih slikaZaključak. Najčešće fokalne promjene u jetri su metastaze adenokarcinoma.Samo 3 (2%) fokalne promjene dijagnostikovane ultrazvukom nisu potvrđenekao fokalne laparoskopskom tehnikom i patohistološkom analizom tkiva jetre.

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30.06.2022. Original Scientific Articles
Magnetic resonance imaging of the heart as a method of long-term monitoring of right heart function after tetralogy of Fallot surgery

By Biljana Milinković, Jelena Milić, Dejan Bokonjić, Verica Prodanović, Bojan Joksimović, Siniša Ristić

Introduction. Cardiac magnetic resonance imaging (CMR) is considered the reference diagnostic method for quantifying right ventricular size and function, and pulmonary regurgitation in patients with tetralogy of Fallot surgery. The aim of this paper is to confirm the importance of magnetic resonance continuous postoperative monitoring of right and left heart function parameters as a diagnostic method that provides the most precise and accurate assessment.

Methods. The prospective observational study included subjects with TOF surgery who were diagnosed with residual morphological and/or functional disorders on control postoperative echocardiographic examinations. All subjects underwent magnetic resonance imaging of the heart on a 1.5 T scanner with dedicated coils for the heart surface according to the standard protocol for a period of one year from the beginning of the study. Criteria for exclusion from the study were: significant residual pulmonary stenosis, condition after pulmonary valve replacement, existence of residual shunt lesions, contraindications for cardiac magnetic resonance imaging (pacemaker, ICD, claustrophobia). Depending on the time elapsed since the tetralogy of Fallot surgery, the subjects were divided into groups: more than 15 years, 11−15 years, 6−10 years, less than 5 years.

Results. The study included 131 subjects with an average age of 24.18 ± 11.57 years with complete correction of TOF. Intergroup differences in values of right ventricular enddiastolic volume, right ventricular ejection fraction, and left ventricular ejection fraction were demonstrated, but there was no statistically significant intergroup difference in values of pulmonary regurgitation fraction. The negative interaction of the right and left ventricles intensifies during the years of follow-up of patients after TOF surgery, which is especially true fifteen years after surgery.

Conclusion. CMR has the most significant role in research efforts aimed at improving the outcomes of operated patients with tetralogy of Fallot.

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Impact of elapsed time between first symptoms and diagnosis of celiac disease on psycho-physical functioning and social life of children and adolescents

By Biljana Stojanović-Jovanović, Stevan Jovanović, Biljana Vuletić

Introduction. Celiac disease is an autoimmune disease resulting from an inadequate immune response to gluten in genetically predisposed individuals as a result of consuming gluten and other related proteins present in wheat, rye, barley and oats. The only cure for this specific disease is a strict, carefully controlled and lifelong gluten-free diet. The aim of the study was to evaluate whether the elapsed time between the onset of the first symptoms and the diagnosis of celiac disease affected the psycho-physical functioning and social life of children and adolescents.

Methods. The study involved 116 respondents (39 of them were males), aged 8-18 years, who were diagnosed with celiac disease. The Documentation Sheet and the Celiac-Specific Pediatric Health-Related Instrument (CDPQOL), measuring the psycho-physical functioning and social life, were used in the study.

Results. 50% of subjects, aged ≤ 2 years, were diagnosed with celiac disease. 48.28% of them were diagnosed with the disease within three months after the symptom onset. In respondents with celiac disease, aged 8-12 years, there was no statistically significant difference between the psycho-physical functioning and social life and the elapsed time between the first symptoms and the established diagnosis. In subjects aged 13-18 years, using CDPQOL, a statistically significant difference was found in the following domains: school functioning, going out and social events, self-confidence. Furthermore, there was a statistically significant difference between total CDPQOL score and the elapsed time between the first symptoms and the established diagnosis.

Conclusion. The elapsed time between the first symptoms and the established diagnosis significantly affects the psycho-physical functioning and social life of subjects aged 13-18 years, but it does not affect the psycho-physical functioning and social life of the younger respondents. This is to confirm the importance of early diagnosis and treatment initiation.

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