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E. Tupković, R. Softić, Jasmina Klebić, Senada Selmanović, E. Becirovic, M. Mirković Hajdukov, Miralem Smajić

Introduction: Cognitive impairment is common finding in individuals with PTSD. Dysfunctional metacognitions in variety of anxiety disorders can represent generic vulnerability for anxiety disorders, as well as elements that contribute to maintaining the disorder. There is little empirical information about metacognition in war veterans with PTSD, and its relation to cognitive and/or social, occupational and psychological functioning. Aim: to determine the values and reciprocal correlations of different aspects of metacognition, with cognitive and global functioning in outpatient war veterans with PTSD. Methods: The study was conducted on 25 war veterans (24 male), with confirmed diagnosis of PTSD by a trained psychiatrist, average age 48,5±6,2 (38-63) years, with average duration of symptoms of 9,9±4,7 (0,5-16) years. We used the Metacognitions questionnaire, Mini Mental Status Examination, and Global Assessment of Functioning Scale to assess metacognition, cognitive impairment, and global functioning. Median values of Metacognitions questionnaire subcomponents, Global Assessment of Functioning Scale and Mini Mental Status Examination were determined, and also reciprocal correlations of all parameters expressed with Spearman Rank Correlation. Results: 12 patients (48%) had impaired cognitive function. Significant negative correlation of score on Mini Mental Status Examination, and negative beliefs about worry is observed (r=-0,4278, p=0,034), as well as non significant correlations between rest of metacognition subscales and score on Mini Mental Status Examination. Cognitive self-consciousness showed high positive correlation with Global Assessment of Functioning Scale (r =0,7436, p<0,0001). Conclusion: Follow up of metacognitions, cognitive and global functioning, and its relations, may have an important role in assessment of war veterans with posttraumatic stress disorder.

Anita Racetin, Marija Jurić, N. Filipović, Ivana Šolić, Ivona Kosović, M. G. Durdov, Nenad Kunac, S. Z. Tomaš et al.

Aim To explore the spatial and temporal expression patterns of DAB1 and Reelin in the developing and postnatal healthy human kidneys as potential determinants of kidney development. Methods Paraffin-embedded fetal kidney tissue between the 13/14th and 38th developmental weeks (dw) and postnatal tissue at 1.5 and 7 years were stained with DAB1 and Reelin antibodies by double immunofluorescence. Results During the fetal kidney development and postnatal period, DAB1 and Reelin showed specific spatial expression pattern and diverse fluorescence intensity. During the fetal period, DAB1 was strongly expressed in the distal convoluted tubules (DCT), with strong reactivity, and diversely in the proximal convoluted tubules (PCT) and glomeruli. In the postnatal period, DAB1 expression decreased. The strongest Reelin expression in early fetal stages was observed in the PCT. In the postnatal period, Reelin expression decreased dramatically in all observed structures. These two markers were colocalized during early developmental stages, mostly in PCT, DCT, and podocytes. Conclusion The appearance of DAB1 and Reelin during fetal kidney development confirms their potential significant role in the formation of kidney structure or function. High DAB1 expression in the DCT implies its regulatory role in tubular formation or function maintenance during development. Reelin was highly expressed in human kidneys at early fetal stages, mostly in the PCT, while at later fetal stages and postnatal period its expression decreased.

Ab s t r Ac t Introduction: Preeclampsia is the cause of increased morbidity in mothers, and mortality and morbidity of both mothers and fetuses and newborns. The pathological process is already complete when the symptoms occur, and nothing concrete can be done to stop the process. Early identification of women at risk of developing preeclampsia is a key goal of antenatal care. Alongside chemical tests, Doppler sonography of the uterine arteries plays a major role in the prediction of preeclampsia. Aims: To establish the probability of resistance to blood flow in the uterine arteries and the existence of notching in the control and test groups. Materials and methods: The study comprised 60 subjects in the second trimester of pregnancy who were going for check-ups during their pregnancy or had been hospitalized at the Maternity Clinic of Sarajevo UCC. All the subjects were divided into two groups, a control and a test group, in relation to the presence of pathological blood flow in the uterine arteries. As well as ultrasound results, the patients also provided an exhaustive history about their previous pregnancies, if any, and any relevant laboratory results. Results: A statistically significant difference was found in the average values of systolic and diastolic pressure during pregnancy between the control and the test group (p = 0.001). From an analysis of the resistance to blood flow in the uterine arteries in the control and test groups, we concluded that the flow on the side with the placenta and on the side without the placenta were physiological over five measurements in the control group of subjects. In the test group the largest number of cases of pathological flow were recorded, and there was also notching. Of the 21 subjects with a diagnosis of preeclampsia, there was notching in 10. Conclusion: Doppler sonography in the second trimester of pregnancy is a good prognostic marker for early discovery of preeclampsia.

Edin Medjedović, Alma Suljević, A. Iglica, A. Rama, E. Mahmutbegović, Amela Muftić, Ema Dzihic

Introduction: Preeclampsia is defined as hypertension (systolic pressure ≥140 mmHg or diastolic pressure ≥90 mmHg) after week 20 of gestation with one or more of the following symptoms: proteinuria, organ dysfunction (including renal, hepatologic, hematologic or neurological complications) and in case of stagnation of fetal development. So far, there are no valid clinical tools or tests that can tell with sufficient sensitivity and specificity in early pregnancy which pregnant woman will develop preeclampsia or have unwanted outcomes. Aim: To present the properties of biochemical parameter, uric acid, in patients with signs of preclampsia, which was confirmed by Doppler sonography. Methods: The study included 60 female subjects in the second trimester of pregnancy who were examined or were hospitalized at the Clinic of Gynecology and Obstetrics, Clinical Center University of Sarajevo. Pregnant women who had normal Doppler sonography scan of the uterine arteries in the second trimester of pregnancy were included in the control group, while pregnant women with pathologic Doppler sonographic findings in the second trimester of pregnancy were included in the group of pregnant women at risk of preeclampsia, i.e. the study group. Results: There is statistically significant difference between the average value of uric acid in the control and in the study group (213.36 ± 28.96 μmol / L vs 249.73 ± 47.06 μmol / L) (F = 12.991; p = 0.001). Applying the Wilcoxon non-parametric paired test to the average uric acid values during all measurements within the control group, no statistically significant difference was found. There was a statistically significant increase in the study group between all measurements, from 18.04 μmol / L between the first and second measurement (Z = -1.955; p = 0.043), 29.10 μmol / L between the second and third measurement (Z = -2.973; p = 0.003), 37.27 μmol / L between the third and fourth measurement (Z = -4.325; p = 0.001) and 109.87 μmol / L at the end of the study in comparison to values from the start of the study (Z = -4.309; p = 0.001). Conclusion: Uric acid values should become part of a broad biochemical range in screening and optimizing the treatment of patients diagnosed with early preeclampsia.

N. Rustempašić, Selma Semi

Introduction: Abdominal aortic aneurysm represents a local pathological dilatation of the abdominal aorta. It is caused by structural weakness of aortic wall but there are many other risk factors that may positively correlate with incidence of AAA like hypertension, smoking, male gender, older age, family history etc. Aim: The purpose of the study was to evaluate the correlation of atherosclerotic risk factors and the size of aortic aneurysm in patients that were admitted for the surgical treatment at the Clinic for cardiovascular surgery in Sarajevo during period 2016-2019. Methods: The study was designed as a retrospective study with one group of patients that was conducted at the Clinical Center of the University of Sarajevo at the Clinic for Cardiovascular Surgery. It included 150 patients, 126 males and 24 females, all of them with infrarenal localization of AAA. From medical records we have collected relevant anamnestic data (age, gender, positive family history, diabetes mellitus, hypertension, hyperlipidemia, smoking, alcohol consumption and obesity). The size of aneurysm was determined by both ultrasound and CT arteriography. The data are processed in the Statistical Package for Social Sciences Ver. 22.0. The results are tabulated or graphically showed, and level of statistical significance was set at p <0.05. Results: Total amount of 129 of patients (86%) had hypertension, 57.3% (n=86) of them were smokers, 18.7% (n = 28) were former smokers, and 24% (n = 36) were non-smokers Blood lipid level analysis have shown that 44% (n = 66) of patients were normolipemic, while elevated blood lipid levels were found in 56% (n = 84) of patients. Diabetes mellitus was present in 17.3% (n = 26) of patients, 2.7% (n = 4) of them had an insulin-dependent form, while 14.7% (n = 22) of the analyzed patients had insulin independent DM. Almost half of total number of patients (46%, n = 69) were obese. 19.3% (n = 29) of patients consumed alcohol while the 80.7% (n = 121) denied alcohol consumption. Ratio of males in comparison to females was 5:1. The average age in males was 69.79 ± 8.16 years and 72.13 ± 9.11 years in females. Significant statistical correlation of AAA size and risk of atherosclerosis factor has not been established. We have found that there is a significant positive correlation between size of aneurysm and risk of rupture (p= 0,000<0,05). Conclusion: Although risk factors of atherosclerosis were present, statistically positive correlation was not confirmed between the size of AAA and analyzed risk factors.

L. Jaha, V. Ismaili-Jaha, Bekim Ademi, F. Veselaj, D. Kryeziu, B. Gjikolli, A. Gecaj-Gashi, A. Koshi et al.

Gross hematuria caused by rupture of an artery in the urinary tract is a rare but potentially fatal condition. Iliac artery aneurysms, pelvic surgery with radiation, vascular reconstructive surgery, surgery for stenosis of the ureteropelvic junction, and transplantation are reported to be associated with this condition. In the vascular reconstructive surgery group, the most common etiology is rupture of the degenerated artery or synthetic graft in the ureter. We present a case of rupture of the small anastomotic pseudoaneurysm at the proximal anastomosis of a right iliofemoral autogenous vein extra-anatomic graft in the urinary bladder. To our knowledge, this is the first report of a rupture of an autogenous vein graft in the urinary bladder. Our patient, a 24-year-old Albanian farmer, was admitted to the emergency department in severe hemorrhagic shock induced by exsanguinating hematuria. He underwent immediate surgery, during which direct sutures to the bladder were placed and the saphenous graft was replaced with a synthetic one. The patient recovered completely, was free of hematuria, and showed no signs of pathological communication between the urinary and arterial tracts on postoperative cystoscopy and computed tomographic angiography during 2 years of follow-up. The incidence of artery-to-urinary tract fistulas is growing due to the increasing use of urologic and vascular surgery, pelvic oncologic surgery, and radiation therapy. In addition to fistulas involving a degenerated artery and ureter or synthetic grafts and ureter, they can also involve an autogenous vein graft and the urinary bladder. In our patient, the fistula was a result of erosion of the bladder from a pseudoaneurysm at the proximal anastomosis of an autogenous vein iliofemoral bypass in an extra-anatomic position. Open surgery remains the best treatment option, although there is increasing evidence of successful endovascular treatment.

Amra Ahmić Vuković, Selma Jakupović, Selma Zukić, Anita Bajsman, Alma Gavranović Glamoč, S. Šečić

OBJECTIVE The aim of this paper was to analyze the distribution of stress and deformation on the mandibular first premolar under two types of loading (axial and para-axial load of 200 N) using the FEM computer method. MATERIALS AND METHOD For this research a µCT scan of the first mandibular premolar was used, and the method used in this research was FEM analysis under two types of loading. RESULTS The values of the von Mises stress measured in the cervical part of an intact tooth under axial load were up to 12 MPa, and under paraaxial load over 50 MPa. The values of the stress measured on the bottom of the noncarious lesion are very high ≈ 240 Mpa. Stress values in the cervical part of the intact tooth are higher in the zone of the sub-surface enamel. The deformation values of the tooth under para-axial loading were ≈ 10 times higher than the value of the deformation under axial load. The greatest deformations were seen in the area of the tooth crown. CONCLUSIONS Occlusal loading leads to significant stress in the cervical part of teeth. The values of the measured stress are greater under the action of paraxial load. The values of stress in abfraction lesions measured under a paraxial load are extremely high. Exposing the lesion to further stress will lead to its deepening. The total deformation of the entire tooth under paraxial load was ≈ 10 times higher compared to the deformation value of the tooth under axial load.

Karin Zachrisson, F. Krupić, M. Svensson, Ann Wigelius, Andreas Jonsson, Angeliki Dimopoulou, Anna Stenborg, G. Jensen et al.

Bojana Olgić Draženović, S. Hodžić, Dario Maradin

Abstract The aim of this paper is to examine performance of pension funds in Croatia, or more precisely, to measure the technical efficiency of mandatory pension funds. The main role of the pension funds is to collect and invest the money contributed by the employer or the employee during working years until retirement. Therefore, development of pension funds as institutional investors is especially important for capital markets as well as for the whole economy. By applying the methodology of data envelopment analysis on a sample of 12 DMUs, i.e. four mandatory pension funds divided into three categories (A, B or C) for 2015-2018 period, we provide further evidence on their efficiency level. The results have shown very small differences among relative inefficient pension funds.

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