Objective. The aim of this study was to analyse individual and combinedsensitivity and specificity of ultrasound and mammography inbreast cancer diagnosis and emphasize the importance of combiningbreast imaging modalities. Patients and methods. By means ofa cross-sectional study, ultrasound and mammographic examinationsof 148 women (mean age 51.6 ± 10.8 years) with breast symptomswere analysed. All women underwent surgery and all lesions were examinedby histopathology analysis which revealed the presence of 63breast cancers, and 85 benign lesions. In relation to age, the womenwere separated in to a group under 50 years and a group 50 years andolder. Ultrasound and mammographic findings were classified on theBI-RADS categorical scale of 1-5. Categories 1, 2 and 3 were considerednegative, while categories 4 and 5 were positive for cancer. Forstatistical data processing the McNemar chi-square test for pairedproportions was used. The differences on the level of p<0.05 were consideredstatistically significant. Results. In the group under 50 years,the ultrasound sensitivity was significantly higher than the mammographicsensitivity (p=0.045, c2=4), without a statistically significantdifference in specificity (p=0.24, c2=1.39). In the women over 50, asignificant difference between sensitivity of ultrasound and mammographywas not proved (p=0.68, c2=0.17), nor any difference in thespecificities (p=0.15, c2=2.08). In the group consisting of all patients,the sensitivity of ultrasound was statistically significantly higher incomparison with the sensitivity of mammography (p=0.04, c2=4.27)with higher specificity (p=0.04, c2=4). By combining the two methodsin all patients sensitivity of 96.8% was achieved, in patients up to 50sensitivity was 90.47% and in patients over 50, sensitivity was 100%.When the two methods were combined in all patients, a decrease inspecificity was noted. Conclusion. The combination of ultrasound andmammography in breast cancer diagnosis achieves high sensitivityand the number of undetected breast cancers is reduced to minimum.

Intellectual disability is the state of stopped or incomplete mental development which is featured by the impairment of abilities occurring at the development age and contributes to general level of intelligence, such as speech, cognitive, motor and social abilities. Disability can occur together or separately from other mental or physical disorders. 290 million people worldwide are estimated to have disabilities. Health is a core element in quality of life, but poverty, marginalization, limited access to primary health care, and lack of health promotion knowledge compromise health. Based on a research results in all nine areas of the family life quality (health, nancial status, family relations, support of other, support of services, influence of values, career, leisure and recreation, and community interaction) community could influence with the permanent preventive measures on 6 concepts of family life quality: importance, possibility, initiative, achievement, stability and satisfaction. The research could be of great help for the development of comprehensive strategies for improvement of quality of life for families that have one or more members with intellectual disability. From inclusion we expect approach to individual and his/her family by the society, to take into account all their diversities, preservation and improvement of their personal physical and mental health, for optimal possible functioning, at all personal and social levels.

Introduction: The aim of this study is to examine whether moderate hiperhomocysteinemia is an independent risk factor for cerebral infarction.Methods: We have measured homocysteine levels in 50 patients with ischemic stroke during acute phase and postacute phase, 50 patients diagnosed with vascular dementia and healthy group of 50 subjects. Homocysteine concentration in serum was measured, on the basis of fluorescent polarisation measuring.Results: The study demonstrated that homocysteine concentration was 16.93 µmol/L in the patient group with ischemic stroke, and in the group of patients with vascular dementia was 20.39 µmol/L. Homocysteine increases during the postacute phase of ischemic stroke after 7 days for 1.54 µmol/L and 14 days for 3.66 µmol/L compared to the concentration of homocysteine after the first hours of hospitalization. Using Wilcoxon signed ranks and Mann-Whitney (P < 0.05) tests we got significant difference between homocysteine concentration at acute phase and post-acute phase of ischemic stroke and it was significant difference between concentrations of homocysteine in the acute and post-acute phase of ischemic stroke and vascular dementia. The Spearman correlation test was found signifiant correlation between the number of strokes and the concentration of homocysteine in serum of patients with vascular dementia.Conclusions: The homocysteine concentration rises significantly during of acute phase of ischemic brain stroke, and it is significantly increased during post-acute phase, which is a predictor factor for further development of vascular dementia, or a new ischemic brain stroke.

Introduction: Lumbar pain syndrome is the most common cause of why patients, especially the active ones, are reported to physicians. It is manifested as nonspecific or non-radicular lumbar pain syndrome which is not associated with neurological symptoms, and specific which is associated with spinal nerve root compression. Aims of this study were to determine correlation between inadequate equipment and improper position for work with disk caused lumbar pain syndrome.Methods: The study included 913 patients who have visited the Community-based rehabilitation ambulance "Praxis" due to low back pain syndrome and verified disc hernia in the five year period. Lumbar pain syndrome was diagnosed by clinical examination (history, inspection, palpation, Lasegue sign, neurologic and motoric dysfunction tests), then radiologic diagnostic methods (CT, MRI). The data about inadequate equipment and position during work were obtained in interview with  patients.Results: Lumbar pain syndrome is most common among workers (268 or 29.35%), followed by officials (239 or 26.17%). With the conducted research we determine that all the patients had inadequate equipment and the position of labor and weak abdominal and spinal muscles.Conclusion: Based on research conducted through the before mentioned variables, we can determine not only the association, but a strong influence of inadequate equipment and improper position for work to the occurrence of disk caused lumbar pain syndrome.

Introduction: Estrogen deficiency plays a critical role in the development of osteoporosis. However, some other factors may contribute to bone loss as well. Aim: To show presence of osteoporosis risk factors and to examine its influence on bone mass loss in women with normal menstrual history.Methods: The study included 30 postmenopausal women, ages from 50 to 65 with osteoporosis who entered into menopause before the age of 45, and 30 postmenopausal women, ages from 50 to 65 with osteoporosis who had normal menstrual history. Presence of risk factors has been calculated for both groups and statistical significance of differences  between two groups presented.Results: In the group with normal menstrual history 33.33% women had low level of physical activities, 56.66% suffered from insuficient intake of calcium, 63.33% of women were active smokers. Body mass index bellow 19 had 6.66% women, insuficient exposure to the sun was registered in 60%, and 23.33% women were either taking medicaments or had  diseases that could cause osteoporosis. Statistical significance of differencies in presence of certain risk factors between two groups was registered for : insuficient daily intake of calcium (p <0.001), insuficient exposure to the sun (p<0.001), and smoking (p <0.001).Conclusion: Results of the study indicate high presence of osteoporosis risk factors in women with normal menstrual history and indicate influence of certain factors (calcium, sun exposure, smoking) on occurence ofosteoporosis in this group.

Introduction: Gastrointestinal infectious diseases are a group of frequent diseases in developing countries as a result of industrialization in food production and often consuming of the food in public places. In Bosnia and Herzegovina and in Canton Sarajevo these diseases are frequent. The aim of this work is to investigate epidemiological characteristics of the most often gastrointestinal infectious diseases in Canton Sarajevo (Enterocolitis acuta, Toxiinfectio alimentaris, Salmonellosis, Amoebiasis) compared with Viral Hepatitis A and to estimate the need for the implementation of vaccination against this disease.Methods: We used individual reports as well as monthly and annual bulletins about the movement of infectious diseases which are obligatory for reporting from the Epidemiology department of the Institute for public health in Canton Sarajevo. This work is a retrospective study, for the period 2005-2009. Descriptive- analytical method was used. In statistical processing we used mean, structure index and trend index.Results: The research showed that gastrointestinal infectious diseases are registered in a huge number in all the observed years. The most often was Enterocolitis acuta, and the rarest was Viral Hepatitis A. The diseases were mostly sporadic. Distinct seasonality and coherence with warm months in the year is expressed in Enterocolitis acuta and Intoxicatio alimentaris, while the other diseases are registered during the whole year.Conclusions: Incidence of gastrointestinal infectious diseases in Canton Sarajevo is high and we need to work intensively to improve sanitary conditions as the most eficient preventive measures. There is no justification for implementing of the vaccine against Viral hepatitis A.

Introduction: Traumatic injuries of the spinal column are among the most devastating injuries in orthopedics. The primary goals of rehabilitation of these injuries are prevention of secondary complications, maximizing physical functioning and reintegration into the community. Rehabilitation after spinal injury reqires multidisciplinary team approach. Team members include, but are not limited to, physical therapists, occupational therapists, nurses, psychologists, health care managers and social workers, with each member having role and responsibility in their area of expertise. This study aimed to determine the difference in the occurrence of spinal injuries according to gender, age, cause of injury, neurological phenomenon in injured patients, the treatment and physical procedures used in the early stages of rehabilitation. Methods: The study was conducted as a retrospective and comparative at the Department of Orthopedics and Traumatology of Clinical Center University of Sarajevo. Medical records of 100 patients, treated at from January 1 st 2007 till June 30 th 2008, were processed and data about outpatient protocols and surgery protocols analyzed. Results: The results obtained from the data showed greater proportion of women (56%) compared to men (44%). Most patients were in the age group between 41 and 60. Injuries were most often due to falls from height

Introduction: In the case of the Thoraco-lumbar Junction Syndrome the pain is located in the region of the lumbo-sacral junction. Sudden torsion movements and lifting of objects while the spine is in position of torsion is the cause in most cases. In those cases, a blockade on the  Th11-Th12-L1 vertebrae occurs. The aim of this research was to determine the number of patients with the Low Back Pain whose origin is in the thoracic vertebral dynamic segments, in relation to the total number of patients according to gender, age and profession.Methods: In this retrospective, descrtiptive study we have analyzed patients treated for Lumbosacral syndrome of thoracic origin in private specialist ambulant “Cebic” in Zavidovici during one year period. We analyzed data from patients medical records and history.Results: Total of 1882 patients were treated for the Low Back Pain, of which 67 (3.56%) had an origin of the pain in the Thoraco-lumbar Junction. In the analyzed group, there were 49 (73.1%) man and 18 (26.8%) women. The largest number of males, 21 (42.8%), were between 40-49 years old, while the largest number of woman, 9 (50%), was 20 to 29 years old. Largest number of male patients, 35 (71.8%), were physical workers, while most of the female subjects, 7 (38.8%), were of ce workers.Conclusions: Our research concludes that the number of patients with Low Back Pain of the thoracic origin (3.56%) is not disregarded, but these facts are usually overlooked. Therapy for those kinds of patients is in most cases concentrated to the lower segments of the lumbar spine, which gives unsatisfactory therapeutic results.

Ultrasound devices and methodologies have been continuously evolving and becoming more important as tools in diagnostic medicine. Recently a new ultrasound diagnostic technique has been developed. Named sonoelastography, the technique enables evaluation of tissue elasticity and is based on differences in stiffness (hardness, compressibility, elasticity) of pathological changes and normal adjacent tissue. Sonoelastography (SE) is also known as Real-time tissue elastography (RTE), Real-time sonoelastography (RTSE), Tissue type imaging (TTI) and Ultrasound Strain Imaging Technology. It has been found useful in many medicine � elds and adopted readily by clinicians of different specialties. It gives more information than conventional ultrasound in evaluation of tumors, liver disease, skeletal muscles, rheumatoid nodules and other pathological changes. This review covers the basics of elastography, its applications, instruments, techniques, the scoring system and the indications for elastography. © 2011 University of Sarajevo Faculty of Health Studies