Biomedical subjects

Rusmir Mesihović

Publications and source records attributed to Rusmir Mesihović.

15 recordsLinked to original sources

PubMed2005

Randomized trial of TEP laparoscopic hernioplasty versus Bassni inguinal hernia repair.

OBJECTIVE: To evaluate the influence of the laparoscopic tehnique in healing of hernia from the perspectives of time to full recovery, return to work and complications. TYPE OF STUDIES: Randomized, prospectiv study. All relevant factors, should be important to evaluate operative method. Laparoscopic operative treatment has several advantages over classical operative techniques. Main advantage is less tissue damage and consequently less possibility of postoperative complications. Furthermore, period of rehabilitation for patient is shorter, with less pain and shorter period for recovering. PATIENTS AND METHODS: A group of 60 qualified patients was formed with non complicated inguinal hernia. Patients of both gender, aged 19-68, were preoperatively examined. Intraoperative wounds during operation were defined as an intraoperative complications. In postoperative course complications were divided on immediate, early and late postoperative. Patients were re-examined during hospitalization, in the periods of one month, six month, one year and two years after operation. RESULTS: We had no intraoperative complications. Two immediate complications were observed scrotal swelling and hematoma. Two early postoperative complications were also noted a general disuric complication and purulent wound inflammation. As well we have noted only one late complication; pain in inguinal region. We had two relapsing hernias. Duration of hospital treatment was 1-7 days with average of 2,5 days for examined group. Overall absence was 10 day and patients were back to job under full physical activities. CONCLUSION: In non complicated inguinal hernia, laparoscopic tehnique have less complications than classic methods, shoter time to full recovery and to return to work.

Hernia, Inguinal↗

PubMed2005

Evaluation of the diagnostic accuracy of the endoscopic ultrasonography results in the patients examined in a period of three years.

INTRODUCTION: Endoscopic ultrasonography (EUS) is a well-established method of evaluating patients with gastrointestinal diseases, especially malignancies. EUS is like other similar endoscopy techniques, based on high frequency ultrasonography. This high level technology allows examination of tissue to almost microscopic level, not only in digestive system but its surrounding structures. OBJECTIVE: The aim of this study was to determine the contribution of endoscopic experience, based on the number of endosopic ultrasonography examination performed in the three years period, to obtain 80% diagnostic accuracy with staging of the disease in order to achieve a 30-60% change rate in treatment decisions which is accepted standard. RESULTS: First group with 210 patients was examined in the first year of work; 325 examined in the second year of work and 295 in the third year. DIAGNOSTIC: Accuracy in the first year of work, were 45% (p<0.001 for the choledocholithiasis; p=0.197 for the pancreatic cancer; p=0.195 for LN detection in the gastric cancer). In the second year of work diagnostic accuracy were 78%/p=0.550 for the choledocholithiasis; p=0.228 for the pancreatic cancer; p=0.503 for LN detection in the gastric cancer/. Diagnostic accuracy in the third year of work were 81%/p<0.001 for the choledocholithiasis; p=0.018 for the pancreatic carcinoma; p=0.042 LN detection in the gastric cancer/. CONCLUSION: Application of Endoscopic ultrasonography in diagnostics, based on number of EUS examination performed, after three years of work, achieved 80% diagnostic accuracy, compared to standard imaging methods and results of surgery in staging of the disease. EUS results made a change in treatment decisions in 30-60% of patients which is world standard and completely justify use of endoscopic ultrasonography in clinical practice.

Adult↗

PubMed2004

[Imaging procedures in gastroenterology].

Recent achievements in fields of physics, microelectronical devices and informatical sciences opened huge possibilities of applications in medical specialities. Spread imaging over routine high-resolution instruments continue to be in focus of scientific researches varying from simple staining techniques to most sophisticated photodynamical techniques. Magnetic resonance imaging and computed tomography are radiological specialties, however; we mentioned them for promising achievements in computed data analysis and further improvements of virtual colonoscopy. During the last few years techniques of magnifying endoscopy have been improved including trials with narrow band endoscopy, autoflourescence endoscopy, elastic scattering spectroscopy and laser confocal microscopy. In many indications capsula endoscopy have been applied successfully.

Diagnostic Imaging↗

PubMed2004

[Laparoscopy and robotics].

Telerobotics is a wide term and include multiple directions and aspects in its development. When speaking of different aspects of its development, one should think of its functionality, construction aspects, communication aspects, implementation safety and acceptance by the environment. Robotics is a science dealing with possibilities of implementing different tasks, through mechanical instruments, controlled by humans. Telesurgery does not include only aspects of teleconference but assists in surgical procedures, i.e. enables for the part of surgical procedure to be performed through electronic commands on bigger distances. Currently, two robotic systems are employed in clinical practice. One is ZEUS system, constructed by the Computer Motion and manufactured by AESOP. Second one is Da Vinci surgical system. For laparoscopic robotic telesurgery, identical set of apparatus and instruments as the one used in a routine laparoscopic surgical procedures is needed. In all reports, authors refer to safe and successful surgical method. Recovery of the patient is identical as in classic laparoscopy. No statistically significant difference has been found in the duration of the surgery between robotic and classic laparoscopy. When counting used instruments, it was found that less instruments were used in the robotic laparoscopy. From presented studies related to the robotic laparoscopy, it can be seen that there is an intention to present this method as safe and usable. One thing is sure--this method is the first step toward new model of planning and performing surgical procedures with only one goal--to help the patient.

Humans↗

PubMed2003

[Endoscopic ultrasonography of the upper digestive tract].

Endoscopic Ultrasonography, or EUS, has joined medical techniques of endoscopy with high frequency ultrasound technique, known as ultrasound. This removable achievement allows physician for microscopic tissue examination, not only in digestive system, but also in its surroundings by highly frequent technique. Endoscopic ultrasonography detects all kinds and nature of possible abnormalities, including and information, which are necessary for proper diagnosis and optimal treatment. In experience hands, EUS can detect abnormalities, which are undetectable during any other techniques of examination. EUS is applied from inside the body, near or even touching the examined surface, so the precise, highly frequent energy of showing the images can be used. The sonography, MRI, CT techniques must show the inner organs through outside surface of body, loosing the resolution during process. The superior resolution of EUS shows 5 layers of digestive tract, almost equally good as by microscope; none of other techniques allows showing of intestinal wall equally good as this one. By EUS liquid has been proved with 90% of precision in diagnosis of operative degrees of pancreas tumours. CT in this case has shows only 50% of precision. Highly skilled surgeons are aware of application of these diagnostics techniques in preoperative cases so the surgical removement of tumours is going to be more effective. The precision of EUS findings are of critical importance for the utilisation of maximum of new treatment having in mind that abnormalities could be diagnosed and characterised without operative intervention. To be able to focus on specific anatomic surfaces, there is need of great knowledge, skillfulness and praxis during the manipulation with EUS instrument. The years of experience are needed to be able to achieve high standard of expertise. The accuracy of results varies, depending on physicians diagnostic experience, sub-optimal results are not going to be a good guide during treatment planning. Endosonographist must be in position to document at least 80% of accuracy in diagnosis and determination of disease stage in order to achieve 30-60% changes in plans treatment.

Digestive System↗

PubMed2003

[Superiority of endoscopic ultrasonography in detection of choledocholithiasis over standard ultrasound].

AIMS: The EUS is a minimally invasive method, with a most specificness and sensitivity in verification of concrements in choledochus. The aim of this study is to compare the findings of conventional ultrasound with radial EUS in diagnosis of choledocholithiasis. PTS AND METHODS: 2o pts were included in the study, 13 females. All pts were under susceptibility of concrement presence in choledoch. From 32 examinees in 13 by the none methods was confirmed that they have the obstruction of this ethiolology. The rest 19 examinees underwent endoscopy by an experienced endosonographyst, completely independent of eventual findings by conventional US. Comparative method was done by an ultrasonographer, also uninformed of earlier procedures. RESULTS: 5/20 pts (25%), were excluded from the study. 5/15 pts (33%) were females. Nine (60%) pts (2 males) examined by EUS, showed a presence of concrements in a choledoch, its size varying from 1 x 1 mm to 16 x 6 mm. US provided a very similar results, with minimal differences in the size of concrements (t = 1,706; p < 0.10). In 3 pts the EUS determined a presence of concrements in choledoch, with sizes varying from 1.5 mm to 4 mm, whilst US showed a susceptible changes with recommendation for further analysis. The EUS findings in 3 patients verified a small concrements in choledoch, while standard US did not show presence of these concrements. It is necessary to underline that last three patients underwent cholechistecthomy. CONCLUSION: The radial EUS is a preferred method with excellent performance in verification of choledocholithiasis.

Adult↗

PubMed2003

[Helicobacter pylori infection and chronic gastritis as extra-esophageal factors in gastroesophageal reflux disease].

INTRODUCTION: Some substances, for example amoniac, that appear during an infection caused by Helicobacter Pylori (HP), can neutralise acid. It is assumed that a HP infection can attribute to the worsening of GERB disease with antral predominant gastritis and a defensive factor eith corpus-predominant gastrytis or esofagitis. AIMS: The aim of this study is to ascertain the role of HP infection in the modification of GORD through a prospective study, that is to see does a HP infection prospectively influence the disease or not, with a special focus on symptomatology with pathohistological findings of the antrum and the corpus of the gaster through a monitoring period of 12 months. MATERIALS AND METHODS: 50 patients of the main group were involved in this prospective study with symptoms of GORD, or that eventually had a black stool. A control group of 47 patients was formed that had Gerb positive symptomatology, identical to the first group. During endoscopic act eventual changes in oesophagus in view of GORD, so they have been graduated according to Sawary-Millerov graduation from 1991: via Standard Olympus byoptic tongs byoptic specimens were taken with changes in view of GORD, and corpus and antrum mucosac of gaster and they were put into 2% formalin, so analyses has been done at Institute for pathology in Sarajevo. A special attention has been made to the graduation of gastritis, so Sydney classification has been followed. A modification lasted for four weeks since dg has been made, so two groups were formed, one with eradicated HP and second with HP presence. In the second part of this study both groups were followed without treatment in the period of 12 months, meaning that the natural course of illness has been followed up. RESULTS: The results of tests of significant differences between treated and control group after 12 months gr. I Sawary-Miller: normal differences n.s. (t = 0.122); chronic differences n.s. (t = 0.724), reflux esophagitis difference n.s.t = 0.733). Tests of differences between treated and control group of pts according to topographic classification of gastritis for GORD gr. I (X2 = 1.076)-n.s.; za GORD gr. II (X2 = 0.999) non significant. Tests between groups of PTS for treated group (X2 = 1.4) n.s., for control group (X2 = 5.073) significant result for p < 0.05; GORD gr. II for treated group (X2 = 1.051) n.s. The results of tests of significant difference between pathohistological findings of corpus antrum treated and control group within gr. I Sawary-Miller: the difference is not statistically significant t = 0.816. The results of test significant differences of antrum after 12 months between treated and control group: within gr. I X2 = 1.623 difference n.s.; within gr. II t = 0.015 difference n.s. CONCLUSION: This study proved that eradication of HP infection acts to GORD course by improvement of endoscopic findings by Sawary-Miller and pathohistological findings on oesophagus, as well as with decrease of activity predominant antral atrophic gastritis in I degree of GORD 12 months after and by decreasing daily acid symptoms. The eradication of HP infection in GORD do not influence on activity of predominant corpus gastritis, as well as on heartburn symptom, weekly acid symptom nor chest pain.

Chronic Disease↗

PubMed2003

[Mucosal damage caused by nonsteroidal anti-inflammatory agents in H. pylori infection].

BACKGROUND: The pathogenic role of Helicobacter pylori (H. pylori) infection in the setting of NSAID use is still controversial. Aim of the study is to prove increased incidence of gastric mucosa damage in H. pylori positive NSAID users compared to H. pylori negative patients. METHODS: Patients with dyspeptic symptoms (n = 160, average age 62.13 +/- 6.24, ranged from 51 to 77 years) were divided in two groups: 80 patients (45 male, 35 female) with positive history of using NSAID and same group with negative history for NSAID. All patients underwent endoscopy, examined to H. pylori presence by rapid unease test. Patients with ulcer or erosions (> 5) were evaluated and grade of gastric mucosa damage were done according to Forrest classification of gastrointestinal bleeding. RESULTS: In first group 69/80 of examined patients were H. pylori positive, in second group 56/80 were H. pylori positive (X2 = 5.266; p = 0.022). In gastric mucosa bleeding, caused with NSAIDs, H. pylori was not diagnosed more often compared to other group (p > 0.05). CONCLUSION: Patients with NSAID induced gastric injury were significantly greater incidence of H. pylori infection compared to patients without history of NSAIDs abuse. H. pylori was not significantly present in complication of ulcer disease (bleeding) caused by NSAID.

Aged↗

PubMed2003

[Differences in the postoperative course and treatment in patients after laparoscopic and standard cholecystectomy].

The laparoscopic surgical technique differs significantly from the classical operative technique especially concerning the post-operative treatment of the patient. Introducing a new operative technique called for an adjustment of the patients' treatment on the ward. The laparoscopic operative technique has a number of advantages in comparison with the classical operative technique. The main advantage is less damage done to the tissue, which reduces the possibility of post-operative complications. Furthermore, the rehabilitation of the patient is faster. Patients experience far less pain and the recovery period is shorter. Consecutively, this means fewer days in hospital, fewer days on sick leave, a faster recovery and returning to work sooner. Patients operated on using the laparoscopic operative technique are mobilised sooner, they start their nutrition sooner, the set of laboratory tests that are conducted is different, the time of post-operative stay at the clinic is shorter. In this paper we have analysed only operations of the holecyst over a period of one year, comparing two different operative methods. Our objective was to compare the time of post-operative mobilisation of the patient as well as the time when they start taking in liquids and food. Especially emphasised in the paper are operations with complications that call for a different treatment. In the period under analysis we did 728 holecystectomies, of which 114 were done laparoscopically. We paid special attention to the analysis of data concerning the post-operative mobilisation of the patient and the start of nutrition. The results we obtained testify in favour of the significantly shorter post-operative period without peroral nutrition following a laparoscopic holecystectomy. The period when the patient is mobilised is also different and should be given special attention. Based on this, we can conclude that at the Abdominal Surgery Clinic in Sarajevo, over the course of one year, the period of post-operative mobilisation of the patient after laparoscopic holecyctectomy has been shorter in comparison with the classical operative method.

Cholecystectomy↗

PubMed2003

[Incidence of malignancies of the colon treated at the Clinic for Abdominal Surgery at the University Clinical Center in Sarajevo in the prewar (1987-1991) and postwar (1996-2000) period].

Malignant tumours are important health problems today. In most countries they are second cause of death in general population. In this work it was presented epidemiology of rectal cancer which are treated in Abdominal Surgery Department at University Clinical Center in Sarajevo of Bosnia and Herzegovina. This is only part of complete investigation of incidence malignants in Bosnia and Herzegovina. Our study is a retrospective and observation two five years periods. First is between 1987.g. and 1991.g., and second is between 1996 and 2001.g. During first period in Abdominal Surgery Department, we had 668 cases of abdominal malignant and 225 of these cases were carcinoma colorecti. In the second period we had 831 cases of abdominal malignant and 311 of these cases were carcinoma colorecti. When we compared our data with other referents from East Europe, we can say that the results mostly the same, and when we compared first five years period (1987-1991), with second five years period (1996-2001), there are also no statistically significant increase.

Bosnia and Herzegovina↗

PubMed2003

[Endoscopy of the lower part of the digestive system].

Examination of lower part of digestive system by colonoscopy is necessity in occult fecal hemorrhage occurrence, hematochesis, unresolved loss of blood iron and suspicious finding of large bowel X-ray barium study. By therapeutical colonoscopy, haemorrhage from neoplasms and angiodysplastic changes are controlled, foreign bodies are removed as well as routine polipectomics. Balloon dilation of large bowel stenosis, and palliative treatment of unoperable stenoses lead to improvement in quality of life with significant cost-benefit effects. Follow-up of patients on high-risk for colorectal neoplasms increased early diagnosis of neoplasms.

Colonic Diseases↗

PubMed2003

[Endoscopic ultrasonography--indications, diagnostic and therapeutic procedures].

Endoscopic Ultrasonography, or EUS, has joined medical techniques of endoscopy with high frequency ultrasound technique, known as ultrasound. This removable achievement allows physician for microscopic tissue examination, not only in digestive system, but also in its surroundings by highly frequent technique. Endoscopic ultrasonography detects all kinds and nature of possible abnormalities, including and information, which are necessary for proper diagnosis and optimal treatment. In experience hands, EUS can detect abnormalities, which are undetectable during any other techniques of examination. EUS is applied from inside the body, near or even touching the examined surface, so the precise, highly frequent energy of showing the images can be used. The sonography, MRI, CT techniques must show the inner organs through outside surface of body, loosing the resolution during process. The superior resolution of EUS shows 5 layers of digestive tract, almost equally good as by microscope; none of other techniques allows showing of intestinal wall equally good as this one. By EUS liquid has been proved with 90% of precision in diagnosis of operative degrees of pancreas tumours. CT in this case has shows only 50% of precision. Highly skilled surgeons are aware of application of these diagnostics techniques in preoperative cases so the surgical removement of tumours is going to be more effective. The precision of EUS findings are of critical importance for the utilisation of maximum of new treatment having in mind that abnormalities could be diagnosed and characterised without operative intervention. To be able to focus on specific anatomic surfaces, there is need of great knowledge, skillfulness and practice during the manipulation with EUS instrument. The years of experience are needed to be able to achieve high standard of expertise. The accuracy of results varies, depending on physician's diagnostic experience, sub-optimal results are not going to be a good guide during treatment planning. Endosonographist must be in position to document at least 80% of accuracy in diagnosis and determination of disease stage in order to achieve 30-60% changes in plans treatment.

Digestive System Diseases↗

PubMed2003

[Helicobacter pylori infection, history, diagnosis and therapy].

Since 1874, possibility of gastric mucosa infection was discussed as a cause of ulcer forming. In 1893 spirochette in gastric mucosa of animals were described. In 1940 bacteria in gastric mucosa of patients with ulcers and cancers were found. In 1983, a new era in gastroenterology begun with synchronic discoveries of bacterial etiology of chronic gastritis and ulcer disease. Australian scientists Barry Marshall and Robin Warren were the first who publisher results about relations between gastric mucosa spiral microorganisms and chronic gastritis. Previously named Campilobacter--like organisms evolved to Helicobacter pylori. In 1994, International Agency for Research on Cancer (IARC) sorted H. pylori in first class of carcinogenics for etiological role in B-cell lymphoma and gastric cancer.

Helicobacter Infections↗

PubMed2003

[Clinical effectiveness of omeprazole, azithromycin and amoxicillin in ulcer healing and eradication of Helicobacter pylori infection].

AIM: Prospective clinical investigation efficacy of omeprazole was proved in combination with two antibiotics (azithromicine and amoxycillin) in H. pylori eradication. Efficacy of omeprazole was also followed in gastric and duodenal ulcer healing. PATIENTS AND METHODS: Patients with dyspepsia and peptic ulcer of stomach and duodenum were examined. Positive H. pylori status was proved by rapid urease test (Pronto dry). During first 7 days patients were treated with omeprazole (Ulzol caps. 2 x 20 mg), amoxycillin 7 days (Amoxil 2 x 1000 mg), and Azithromicin 3 days (Sumamed 1 x 1000 mg). After that period patients received omeprazole (Ulzol caps. 1 x 20 mg) in single morning dose next 21 or 28 days in continuation of antisecretory treatment. Control endoscopy revealed rate of ulcer healing and rate of H. pylori infection with same test at least 28 days after initiation of treatment. RESULTS: Complete eradication of H. pylori was in 46/50 (92%) patients (p < 0.001), complete ulcer healing in 48/50 (96%) patients. No patients had complication after omeprazole treatment. Two patients (4%) had worsening of dyspepsia, but without treatment discontinuation. CONCLUSION: Triple treatment with omeprazole, azithromicin and amoxycillin achieved high rate of H. pylori eradication, gastric and duodenal ulcer healing. Treatment was well tolerated, with rapid pain and dyspepsia symptoms relief.

Adult↗

PubMed2002

[Effect of eradication of Helicobacter pylori infection on endoscopic findings and symptoms of gastroesophageal reflux].

Gastroesophageal reflux disease (GORD) represents an illness which reflects a syndrome caused by returning of acid gastric, alkaline pancreatic and bowels content into the oesophagus, which is in the stomach, because of the protective mechanisms of oesophageal loss. The aim of this study was that this prospective study should explain the role of Helicobacter pylori infection in modification of GORD, respectively whether the Helicobacter pylori infection acts protectively or by deterioration of the disease. According to the settled rules, the inquiry was performed as well as the selection of 97 candidates to undergo research in this study. Helicobacter pylori infection has been proved by immunoassay in all pts in the beginning of this study. Endoscopy has been performed in all pts, the degree of gastroesophageal reflux disease by Sawary-Miller was done. The main group consisted of 50 candidates in whom the eradication of Helicobacter pylori infection was done with triple therapy, pantoprazol + amoxycilin + klaritromicin, which was proven by an immunoassay test. Two groups of pts were formed: the main one with eradicated Helicobacter infection, and a controlled one with a Helicobacter positive infection, which was subject to modification of life style. During 12 months, this study consisted of endoscopic evaluations and monthly evaluation of pts daily difficulties. The eradication of Helicobacter pylori infection acts on the improvement of gastroesophageal disease course by improvement of endoscopic findings by Sawary-Miller, and by decreasing daily acid symptoms. The eradication of Helicobacter pylori infection in gastroesophageal reflux disease does it act at the symptoms such as heartburn, weekly acid symptoms and chest pain.

Gastroesophageal Reflux↗