Milorad Zikic

Publications (213) View all

• Article: Our experience with thrombolytic therapy -- preliminary report.

  Sinisa Miljković, Tamara Rabi-Zikić, Milan Arbutina, Zoran Vujković, Dusko Racić, Slobodanka Crncević, Aleksandar Jesić, Milorad Zikić
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  ABSTRACT: Stroke is a rapidly developing clinical disturbance of focal or global cerebral function, lasting for more than 1 hour. It is an acute form of symptoms of brain function disorder, with no apparent cause other than vascular origin. It is the final phase of arterial disease, the main cause of disability, and the second leading cause of death. Today, ischemic stroke can be treated successfully by acting on its cause using a very powerful weapon, thrombolytic therapy. The aim is to present a preliminary report of our experiences with thrombolytic therapy in patients with ischemic stroke. Results recorded in 20 patients who received thrombolytic therapy within three hours of stroke onset are presented. Nineteen patients survived and one patient died from therapy side effects, i.e. intracerebral hematoma. Seventeen of 19 patients were released from the hospital without any neurologic deficit, while two patients had Rankin score 2 (minimum disability) three months after stroke onset. Our experience confirms that thrombolytic therapy is the treatment of choice in patients with ischemic stroke if administered in accordance with precise protocols.
  Acta clinica Croatica 06/2011; 50(2):217-23. · 0.25 Impact Factor
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  Available from: Milorad Zikic

  Article: Functional outcome after thrombolytic therapy.

  Sinisa Miljković, Drasko Prtina, Tamara Rabi Zikić, Zoran Vujković, Dusko Racić, Vlado Dajić, Aleksandar Jesić, Milan Arbutina, Milorad Zikić
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  ABSTRACT: In this paper, we report our experience from a prospective study in 40 ischemic stroke patients admitted during the last two years at University Department of Neurology Stroke Unit, Banja Luka Clinical Center, in order to assess the safety and efficacy of thrombolytic therapy, the impact of age, sex and risk factors, and functional outcome at 6 months of intravenous tissue plasminogen activator treatment. According to the National Institutes of Health Stroke Scale, there were 5 mild, 22 moderate and 13 severe stroke cases in the study group. The outcome measures at 6 months of thrombolytic treatment were taken in 38 (100%) patients, yielding a Functional Independent Measure score > or=90 (good clinical outcome) in 21 (52.50%) and modified Rankin Score < or =2 (good clinical outcome) in 22 (55%) patients. The rate of symptomatic intracerebral hemorrhage in tissue plasminogen activator treated patients was 5%, with a mortality rate of 17.50%. The outcomes were comparable with those found in the NINDS t-PA trial. Current guidelines recommend a 'door-to-needle' time of less than 60 minutes and emphasize that 'time is brain'.
  Acta clinica Croatica 06/2010; 49(2):151-7. · 0.25 Impact Factor
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  Available from: Zeljko Zivanovic

  Article: Effects of relapsing-remitting multiple sclerosis treatment with interferon beta-1b results of a three-year follow-up study.

  Aleksandar Jesić, Dragana Stefanović, Nenad Delibasić, Marija Semnic, Lorand Sakallasz, Dragica Dobrenov, Zeljko Zivanović, Tamara Rabi-Zikić, Milorad Zikić
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  ABSTRACT: The aim of this prospective study was to evaluate therapeutic effects in a cohort of 32 patients with relapsing-remitting multiple sclerosis (RRMS) that were continuously treated with interferon beta-1b during a three-year period and to compare the results obtained with literature data available. Additionally, dropouts and side effects were assessed. The annual relapse rate at three years of treatment as the primary study end-point decreased by 60.5% compared with the relapse rate throughout the pretherapeutic course of disease (0.39 +/- 0.55 vs. 0.97 +/- 0.46; P<0.001) and by 71.3% compared with the relapse rate one year prior to treatment (0.39 +/- 0.55 vs. 1.34 +/- 0.65; P<0.001). The mean Extended Disability Status Scale (EDSS) increased significantly from 2.46 +/- 0.86 at baseline to 2.90 +/- 1.30 (P<0.01) at three years of treatment, whereas the mean progression index (EDSS/disease duration) decreased significantly from 0.76 +/- 0.50 prior to treatment to 0.43 +/- 0.24 (P<0.001), yielding a 56.6% improvement and proving the disease modifying effect of interferon beta-1b. Seventeen (53.12%) patients remained relapse-free during the course of therapy. Among patients that experienced disease relapse, the mean time to first exacerbation was 11.5 +/- 8.34 months. Our study results were consistent with similar studies performed worldwide, clearly indicating that Interferon beta-1b therapy decreased the disease activity and had a beneficial effect on the progression of RRMS, with low incidence and severity of serious side effects. This study has paved way for further long-term follow up studies at our institution.
  Acta clinica Croatica 06/2009; 48(2):183-6. · 0.25 Impact Factor
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  Available from: Milorad Zikic

  Article: Transitory Ischemic Attack - Clinical Diagnosis

  Fabri Izabela, Zarkov Marija, Zikic Milorad, Jovicevic Mirjana
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  ABSTRACT: Early diagnosis of transitory ischemic attack is the most important factor in preventing an ischemic stroke. Th e new clinical ABCD2 score determines the risk of early stroke following transitory ischemic attack. Our goal was to determine the risk factors for transitory ischemic attack, the frequency of clinical parameters of the ABCD2 score, the risk of subsequent stroke based on the ABCD2 score, and the correlation between the score and timing of ischemic stroke following transitory ischemic attack. Among the eight observed clinical parameters of the ABCD2 score, unilateral extremity weakness, arterial blood pressure ≥140/90 mmHg and duration of symptoms >60 minutes were the most frequent. As regards time between last transitory ischemic attack and stroke onset, we found that 50% of patients had a transitory ischemic attack on the same day as stroke and 20% on the previous day, which confi rmed our hypothesis that the ABCD2 score (moderate and high stroke risk) is a good predictor of early risk of stroke following a transitory ischemic attack.
  Aktuelnosti iz Neurologije, Psihijatrije i Graničnih Područja. 01/2010;
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  Available from: Milorad Zikic

  Article: [Neurology today].

  Petar Slankamenac, Dragana Stefanović, Milorad Zikić
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  ABSTRACT: INTRODUCTION: Neurological disorders are common worldwide, regardless of race, nationality, age, sex, education or social status. They are a major cause of human suffering and mortality. The burden of neurological disorders in the community usually correlates with the proportion of the population aged 65 years and over. According to the latest reports of the World Health Organization (WHO), one billion of the world's population (one in six people) suffer from, and about 6.8 million (one in a thousand people) die annually from neurological disorders. In Europe, the economic cost of neurological diseases was estimated at about 139 billion euros in 2004. STROKE: Stroke is the most frequent neurological disorder, and the most common cause of severe disability compared to other diseases. Research into the genetics of stroke has shown advances in prevention, treatment and neuroprotection of the brain parenchyma. The rapid advances in the field of diagnostics are especially useful, particularly MRI, CT angiography and ultrasonography, providing early detection of changes in the blood vessels and the brain. MULTIPLE SCLEROSIS: The diagnosis of multiple sclerosis (MS) is usually based on clearly defined McDonald criteria. In the management of MS, early diagnosis of clinically definite MA as well as of clinically isolated syndrome, allow early initiation of immunomodulatory therapy. DEMENTIA: The prevalence of dementia is age-dependent, and it is higher in subjects aged 60 and over, but it doubles with every five years of age. The population over 65 years and the incidence of age-dependent diseases, are ever increasing. According to reports published in December 2005, the annual incidence of dementia ranges from 5.4-9.4%. PARKINSON'S DISEASE: As the population is growing older, more and more people are vulnerable to Parkinson's disease (PD). It is a neurodegenerative disease which occurs in 10-13 per 100,000 people annually, while its prevalence in Europe ranges from 60-187 per 100,000 people. The diagnosis is primarily based on clinical findings, while neuroimaging techniques, such as brain CT and MRI, are used in the differential diagnosis.
  Medicinski pregled 12/2007; 60(11-12):629-35.