Aim To compare intraoperative hemodynamic and respiratory stability and postoperative emergence delirium between two anaesthesia regimens in children (caudal block with intravenous continuous analgosedation versus general endotracheal anaesthesia) and intensity of postoperative pain and quality of postoperative analgesia. Method Forty children aged 2-6 years who underwent lower abdominal surgery were randomized depending on performed anaesthesia into two groups: caudal block with analgosedation (group CB) and general endotracheal anaesthesia (group GA). Intraoperative hemodynamic and respiratory stability were evaluated measuring systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR) and arterial oxygen saturation (SaO2) in preinduction (t0), at the moment of surgical incision (t1), 10 minutes after surgical incision (t2) and at the time of skin suturing (t3). Postoperative emergence delirium was evaluated using Paediatric Anaesthesia Emergence Delirium score (PAED). Postoperative pain was evaluated by Children's and Infants' Postoperative Pain score (CHIPPS). Both scores were recorded every 5 minutes during first half hour postoperatively, additionally after 60 minutes postoperatively for CHIPPS score. Results SBP, DBP and MAP were lower at t1 (p<0.0001), t2 (p<0.05) and t3 (p<0.001) in the group CB. HR was lower at all studied time points (p<0.005) in the group CB. SaO2 was lower in the CB group but comparable with the GA group. PAED and CHIPPS scores were lower at 5, 10, 15, 20 and 25 minutes postoperatively (p<0.001) in the CB group. Conclusion Caudal block with analgosedation provides better control of intraoperative hemodynamic conditions, postoperative emergence delirium and postoperative pain than general endotracheal anaesthesia.

This study argues that the shift to open business models relies on aligning value-creation and value-capture activities through interactive processes that involve both provider and customer. Yet, l...

Today's grapevine assortment in Bosnia and Herzegovina is the result of several evolutionary, agroecological and historical factors. One of them is the proximity of Dalmatia as a wine-growing area, from which some cultivars were transferred and adapted to the breeding conditions of Bosnia and Herzegovina. Over the course of time, cultivars migrated from one area to another. As a result, some cultivars retained the same name in both production areas, while others were given another name. Within the program of collection and maintenance of autochthonous grape cultivars in Bosnia and Herzegovina, more than 35 genotypes were collected. For reliable grapevine germplasm characterization and identification, genetic analysis of nine standard microsatellite loci was performed. Based on the microsatellite profiles obtained, cluster analysis was carried out and mutual relations were represented by a UPGMA dendrogram. Several synonyms and homonyms have been identified among the analyzed genotypes. Comparison of genetic profiles from Bosnia and Herzegovina and Croatia also identified synonyms and homonyms within these two groups, and confirmed strong connections with the Dalmatian wine-growing region.

Introduction: Knowledge of the size of surfaces available for transport is important for assessing the amount of nutrients that can be transmitted to the fetus for its normal growth and development. Aim: The aim of our study, was to determine the stereological structural parameters of the parenchymal part of placenta, ratio of birth weight and placental weight, and to determine their correlation with the body length and head circumference of the newborns of adolescent pregnant women. Methods: The study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. The experimental group consisted of 30 placenta of pregnant women aged 13-19. The control group consisted of 30 placenta of pregnant women aged 20-35. Computer assisted morphological analysis of images of histological preparations using stereological methods was performed. Results: Surface density of terminal villi of adolescent placentas is significant higher than the control group (t = 14,179, df = 29, p <0,0001). The T-test (t = -5,868, df = 29, p <0,0001) showed statistically significant difference in the surface density of fibrinoid in two compared groups. T-test (t = 6.438, df = 29, p <0.0001) found that total surface of terminal villi was significantly higher in adolescent placentas. The T-test (t = -6,747, df = 29, p <0,0001) found that total surface of fibrinoid was significantly lower in adolescent group. The T-test (t = 4.203, df = 29, p <0.0001) found that the ratio of birth weight of newborn and adolescent placental weight was significantly higher in relation to the control group. Conclusion: Adolescent placentas was more efficient in increasing the weight of newborns, compared to the control group placentas.

Aim To examine the relationship of protective factors (self-esteem, optimism, proactive coping), and a measure of psychological resistance in women diagnosed with breast cancer, and the contribution of protective factors in explaining the criterion of posttraumatic growth. Methods The study included 100 women diagnosed with breast cancer. To examine optimism the Scale of Dispositional Optimism and Pessimism, the Scale of Self-esteem for self-esteem and the Scale of Proactive Coping for proactive coping were used. The posttraumatic growth measured five factors: relating to others, new possibilities, personal strength, spiritual changes, appreciation of life. Results Self-esteem, optimism and proactive coping were associated with posttraumatic growth and its factors: new possibilities, personal strength, appreciation of life. Optimism and proactive coping positively corelated also with relating to others. Final model of posttraumatic growth in all three steps (self-esteem, optimism, proactive coping) explained 20.4% variability of the posttraumatic growth total score. Conclusion Posttraumatic growth does not mean a decrease in trauma, but leads to a change in the perception and view of life. It refers to more favourable management and use of its own resources, relying on its own strengths and capabilities, identifying new opportunities and connecting with others.

Aim To examine the effects of therapeutic hypothermia on the outcome of patients with the diagnosis of out-of-hospital cardiac arrest (OHCA). Methods The study included 76 patients who were hospitalised at the Medical Intensive Care Unit (MICU) of the Clinical Centre University of Sarajevo, with the diagnosis of out-of-hospital cardiac arrest, following the return of spontaneous circulation. Therapeutic hypothermia was performed with an average temperature of 33oC (32.3 - 34.1o C) on the patients who had coma, according to the Glasgow Coma Scale (GCS). Results Multiple organ dysfunction syndrome (MODS) significantly affected survival (p=0.0001), as its presence reduced patients' survival by 96%. In addition, ventricular fibrillation (VF) as the presenting rhythm, also significantly affected survival (p=0.019). A degree of patient's coma, as measured by the GCS, significantly affected survival (p=0.011). For each increasing point on the GCS, the chance for survival increased twice. Moreover, other physiological factors such as the pH and the lactate serum levels significantly affected patients' survival (p=0.012 and p=0.01, respectively). Conclusion In patients with the diagnosis of OHCA who underwent to the treatment with therapeutic hypothermia, verified VF as a presenting rhythm was a positive predictive factor for their outcome. Therefore, therapeutic hypothermia represents an option of therapeutic modality for this type of patients.

Aim To explore the experiences of anaesthesia nurses in assessing postoperative pain in patients undergoing total hip and/or knee arthroplasty. Methods Data were collected through four focus group interviews (FGI) using the critical incident technique (CIT). The participants were six men and 12 women, all registered nurses with further education in anaesthesia with at least five-year experience of caring for patients on a postoperative ward. Results Maintaining communication with orthopaedic patients, different ways to assess pain, the assessment of unresponsive patients, using pain assessment scales and different work circumstances influencing their use, were stated as the main problems the nurses emphasize while assessing the pain of patients. Conclusion Skills related to observing the behaviour and experience of pain in different individuals are needed to ensure an understanding of patients' pain, as well as the patients' ability to estimate their pain, where the intensity of the pain varies in different patients. Further studies are needed to examine the way health professionals assess pain, depending on the patients' ability to transform their pain from a subjective feeling into an objective numeric grade. The way individuals assess their pain differently and the way the resulting knowledge and experience of postoperative care may help nurses and other health-care professionals.

Aim To compare intraoperative hemodynamic and respiratory stability and postoperative emergence delirium between two anaesthesia regimens in children (caudal block with intravenous continuous analgosedation versus general endotracheal anaesthesia) and intensity of postoperative pain and quality of postoperative analgesia. Method Forty children aged 2-6 years who underwent lower abdominal surgery were randomized depending on performed anaesthesia into two groups: caudal block with analgosedation (group CB) and general endotracheal anaesthesia (group GA). Intraoperative hemodynamic and respiratory stability were evaluated measuring systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR) and arterial oxygen saturation (SaO2) in preinduction (t0), at the moment of surgical incision (t1), 10 minutes after surgical incision (t2) and at the time of skin suturing (t3). Postoperative emergence delirium was evaluated using Paediatric Anaesthesia Emergence Delirium score (PAED). Postoperative pain was evaluated by Children's and Infants' Postoperative Pain score (CHIPPS). Both scores were recorded every 5 minutes during first half hour postoperatively, additionally after 60 minutes postoperatively for CHIPPS score. Results SBP, DBP and MAP were lower at t1 (p<0.0001), t2 (p<0.05) and t3 (p<0.001) in the group CB. HR was lower at all studied time points (p<0.005) in the group CB. SaO2 was lower in the CB group but comparable with the GA group. PAED and CHIPPS scores were lower at 5, 10, 15, 20 and 25 minutes postoperatively (p<0.001) in the CB group. Conclusion Caudal block with analgosedation provides better control of intraoperative hemodynamic conditions, postoperative emergence delirium and postoperative pain than general endotracheal anaesthesia.

Temperature distribution at depth is of key importance for characterizing the crust, defining its mechanical behavior and deformation. Temperature can be retrieved by heat flow measurements in boreholes that are sparse, shallow, and have limited reliability, especially in active and recently active areas. Laboratory data and thermodynamic modeling demonstrate that temperature exerts a strong control on the seismic properties of rocks, supporting the hypothesis that seismic data can be used to constrain the crustal thermal structure. We use Rayleigh wave dispersion curves and receiver functions, jointly inverted with a transdimensional Monte Carlo Markov Chain algorithm, to retrieve the VS and VP/VS within the crust in the Italian peninsula. The high values (>1.9) of VP/VS suggest the presence of filled‐fluid cracks in the middle and lower crust. Intracrustal discontinuities associated with large values of VP/VS are interpreted as the α−β quartz transition and used to estimate geothermal gradients. These are in agreement with the temperatures inferred from shear wave velocities and exhibit a behavior consistent with the known tectonic and geodynamic setting of the Italian peninsula. We argue that such methods, based on seismological observables, provide a viable alternative to heat flow measurements for inferring crustal thermal structure.

Aim To determine the prevalence of depressive episodes and recurrent depressive disorders despite of the length of therapy and type of antidepressants. Methods The study was conducted among 508 patients aged 19-65 years who were treated for depression for at least 3 months (mild and moderate episodes were controlled and the effects of treatment monitored by family physicians, while severe episodes were controlled by a psychiatrist) during 2013- 2015 in Zenica-Doboj Canton using the Hamilton Depression Rating Scale (HDRS). Results The average age of the patients was 48.98±11.585 years. Depressive disorder was most commonly represented in patients with high-level education, 22%, more frequently in non-productive workers (non-productive vs. manufacturing 58%:35%). A significant number of patients who were treated for depression were unemployed (57%). All respondents were suffering from the most serious episode of depression with an average depression rate at the Hamilton scale 18.49±8.603, with a very serious depression level of 32%, severe 17%, moderate 21%, and mild 20%. Most patients were treated with paroxetine, 27%, fluoxetine 22% and sertraline 17%. Efficacy of depression treatment with different types of selective serotonin reuptake inhibitors antidepressants (SSRIs) was not significantly different (p=0.502). Conclusion Success of the treatment with the absence of symptoms of depression was achieved in 10% and the maintenance of depressive episodes occurred in 90% of cases. Adverse reactions with the most commonly prescribed SSRI in our country should be important in creating procedures and strategies for the future treatment of depression in family medicine.