The Miller-Fisher syndrome (clinical report)

The authors present a case report of two female patients, aged 16 and 33. Both patients had the same sudden onset of illness, with diplopia and nystagmus and very severe ataxia. The younger patient had absent tendon reflex, while the older one had the tendon reflex preserved. The younger patient had the triparesis present, both patients had no sphincter disorders. They did not have sensibility disturbances, except that the younger patient had hypesthesia of the soft palate (the motor function was preserved). The first patient was somnolent at the beginning. The clinical course being favourable, the younger patient recovered faster than the older one. Electoencephalogram was normal in both patients. CT of the brain was changed at one moment, locking like inflammatory changes. CSF of the younger patient, done twice, was normal. Serologic findings on viruses were normal. Electromyography in both patients showed, beside good motor velocity, the marked sensory velocity which recovered at the control check-ups. The authors present these two cases and they consider the differential-diagnostic difficulties of Fisher's syndrome compared to "brain stem encephalitis".     

Caregiver empowerment program based on the adaptation model increase stroke family caregiver outcome

Objective: Post-stroke disability and psychosocial disorders cause burdens for the families of stroke patients, including physical and financial burdens. The physical and psychological health of family caregivers determines the quality of care they provide to patients.The purpose of this study was to identify the effectiveness of the Caregiver Empowerment Program Based on the Adaptation Model (CEP-BAM) in increasing the family caregiver's coping ability against various problems and reducing their burden while caring for the stroke patient.Methods: This research was a quasi-experimental study with pre- and post-test control group design. The intervention group received CEP-BAM, while the control group received a conventional intervention in the form of a discharge planning program for family caregivers in the hospital. The samples were caregivers who care for and facilitate the recovery of stroke patients during their convalescence at home. We selected the samples from the population using the stratified random sampling method. The number of samples completed in the study was 40 in the intervention group and 40 in the control group. Measurement of outcome variables (coping and caregiver burden) was carried out 4 times including pre-test before the intervention, post-test 1 at 4 months after the intervention, post-test 2 at 5 months after the intervention, and post-test 3 at 6 months after the intervention.Results: There were significant differences in caregiver's coping (P = 0.016) and caregiver's burden (P = 0.009) in measurements between the two groups.Conclusions: The CEP-BAM interventions were effective in increasing adaptive coping strategies and reducing the burden of caregivers 4 months and continuing 6 months after the intervention.     

Consecutive flap transfer for repairing massive soft tissue defects in the opisthenar with improved donor site closure

Objective：To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor site morbidity.Methods：Six patients with massive soft tissue injuries on the opisthenar and forearm were treated with free scapular flaps.Afterwards,a pedicled flap adjacent to the donor site was transferred to cover the donor site defect by direct closure.Results：All six free scapular flaps survived without signs of infection.Three adjacent pedicled flaps presented minor signs of insufficient blood flow on the distal apex,which resolved after six weeks with only conservative therapy.All the incisions healed without other complications.At six-month follow-up,the patients regained full shoulder function.Conclusion：With the assistance of an adjacent pedicled flap,the scapular flap is a highly applicable approach in repairing massive soft tissue defects in the opisthenar.It can achieve positive outcomes in both reconstructive and aesthetic aspects.     

Development,basic characteristics and empirical norms of the DSQ-40 psychological test

Psychological defence mechanisms represent relatively stable aspect of personality, while character and frequency of defence mechanisms which a person uses, points to the character structure of personality. Measuring psychological defence mechanisms is very difficult and very unreliable, so that only several instruments have been developed for the estimation of such characteristics. The most notable instrument of this kind in the world is DSQ-40 (Defense Style Questionnaire), which has lately been more often used in our country. As DSQ-40 is still not widely known in our environment, the aim of this study was to represent the onset and the development of this test, its basic characteristics and empirical norms acquired on our population. Examination included two examined groups in military population of male sex only: soldiers of adolescent age (n = 400) and officers of the adult age (n = 165). Statistical analysis and the comparison of the results with corresponding standards obtained in foreign researches showed that defence style and structure of psychological defence mechanisms were connected with socio-demographic and cultural characteristics of examinees. It was concluded that norms of the test DSQ-40 must be adjusted to the concrete population, which hasn't diminished its practical values and employment in diagnostic and selection purposes.     

Soldier's social adaptation during the military service

Soldier's social adaptation includes his interpersonal relationships with his environment integration into the military community and the ability to fulfill his role in the military environment and to function adequately outside of it. The aim of this study was to establish the dynamics of soldier's social adaptation during the military service. The study involved soldiers of two platoons of the Armed Forces of Serbia and Montenegro, divided into three groups according to the period of the study: after the first month, after the basic training and at the end of the military service. The instruments applied for the study were sociodemografic questionnaire and Social Adaptation Self-evaluation Scale. Statistical analysis of the obtained data was done using Stident's t-test. The results of the study that soldier's contentment with his professional role and with the quality of his interpersonal relations was highest during the basic training, but the quality of leisure activities was lowest at the end of the military service.