Introduction: Hypertension is significantly contributing to global mortality and morbidity and has been identified as the most important modifiable risk factor for early development of cardiovascular diseases (CVD). Aim: The aim of this study was to investigate the efficacy of different combinations of antihypertensive therapy on blood pressure, arterial stiffness and peripheral resistance in patients with essential hypertension using the brachial oscillometric ambulatory blood pressure monitor. Methods: This study was designed as an observational, prospective, multi centric study conducted in eight primary care centers of the Health Center of Canton Sarajevo during the period of six months. The study included 655 participants, both genders, aged between 30 and 75, who were diagnosed with hypertension according to the ESC/ESH guidelines. Participants were divided into six treatment groups based on the hypertensive drug therapy they were using; lisinopril, losartan or valsartan alone or in combination with hydrochlorothiazide (A, B and C group respectively) or combination of lisinopril, losartan or valsartan with/without hydrochlorothiazide together with amlodipine (D, E and F respectively). The participants were monitored at baseline, after 3 and 6 months (1st and 2nd follow-up). Brachial oscillometric ambulatory blood pressure monitor was used for measuring systolic (SBP), diastolic (DBP), pulse pressure (PP), pulse wave velocity (PWV) and peripheral resistance (PR). Results: SBP, DPB, PP, and PWV significantly decreased from baseline to 2nd follow-up in all treatment groups. The mean reductions in SBP were from -11.7 (95%CI; 9.3- 14.1) to -23.2 (95%CI; 18.3-28.1) mmHg and DBP reductions varied from -5.5 (95%CI; 3.9- 7.1) to -13.4 (95%CI; 7.7-19.1) mmHg. PWV decreased in all treatment groups (from -3.3% to -8.2%). Treatment regiment was not associated with significant differences in SBP, DBP, PP or PWV reductions or their values measured at 2nd follow-up. Peripheral resistance significantly decreased only in group C (p=0.011), group D (p=0.009) and group F (p=0.027). Conclusion: These data suggest that lisinopril/lisinopril + hydrochlorothiazide, losartan/losartan + hydrochlorothiazide and valsartan/valsartan + hydrochlorothiazide alone or in combination with amlodipine are equally effective and well tolerated for the reduction of both systolic and diastolic blood pressure and improve arterial stiffness in patients with essential hypertension.

Objective The association between the neck circumference (NC) and components of metabolic syndrome in different countries and ethnic groups has been insufficiently investigated. The aim of the present study was to assess the impact of gender on NC values and to determine whether NC correlates with standard anthropometric measures and blood pressure values in Bosnian young adults. Materials and Methods Study participants were recruited by the snowball method. The NC, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured by trained personnel. Differences between the means were assessed by a Student's t-test. Coefficients of correlation were determined by Pearson's test. Results In young men (n=49), the value of NC was 37.71±1.79 cm, while in young women, (n=62) the value of NC was 32.23±1.83 cm (p<0.001). A significant positive correlation in both genders between the NC and BMI (r=0.70, p<0.001 in men; r=0.53,p<0.001 in women), and between the NC and WC (r=0.48, p<0.001 in men; r=0.38, p=0.01 in women), was found. A significant correlation between the NC and SBP (r=0.08, p=0.57), and DBP (r=0.20, p=0.17), in young men was not determined. Likewise, in young women, a significant correlation between the NC and SBP (r=0.08, p=0.54), and DBP (r=0.09, p=0.49), was not observed. Conclusion Our results suggest that the NC measurement can be used as a valid method in obesity assessment in young adults. A lack of association between the NC and blood pressure requires additional investigation.

Introduction: Breast augmentation is one of the most frequently performed aesthetic surgical procedures in the world. The most important preoperative decisions which influence the final appearance of the augmented breast are the breast implant pocket choice and selection of the most appropriate implant. Described pocket locations are subglandular, subfascial, partially retropectoral, totally submuscular and dual plane. Aim: We have introduced a new method of pocket forming for implant placement, which is combination of Tebbett’s dual-plane 2 or 3 and Graf’s subfascial. We named it as dual plane subfascial. Methods: Between January 2016 and April 2018, total of 27 patients were operated using dual plane subfascial breast augmentation. The pinch test in the medial pole less than 2,0 cm and in upper pole less than 2,5 cm are indications for this technique. In our modification, in primary cases a dissected flap in front of muscle is fasciocutaneous (not cutaneous as in Tebbett’s technique). It will be finally located caudally of pectoral muscle and in front of the lower pole of implant. Fasciocutaneous flap in primary cases and two independent levels of soft tissue coverage (fascial and cutaneous) in secondary cases (subglandular to dual plane subfascial conversion) in front of the lower pole of implants provide better coverage than cutaneous flap alone. Results: Hematoma and infection did not occur in any patient in our study. A capsular contracture grade I/II without the need for reoperation occurred in two patients. In one patient with secondary augmentation minimal bottoming out was noticed (before reoperation patient had significant bottoming out deformity). Minimal palpability of implants is recorded in three patients. Conclusion: Dual plane subfascial is a good option in primary breast augmentation with a well set indication especially in the breasts with the upper pinch test less than 25 mm and medial pinch test less than 20 mm. The idea can be followed even in secondary breast augmentation (subglandular to dual plane subfascial conversion). There is additional soft tissue in front of the implant which led to a less implant palpability, especially in thin patient with smaller amount of subcutaneous fat.

This paper, on the basis of experimental research of the system in exploitation, identifies the main disadvantages of the existing troubleshooting scenarios for IPTV over xDSL. Also, this paper shows how the process of troubleshooting can be made more efficient in practice, with the already existing test solutions and other possibilities of test devices and xDSL transceivers.

Introduction: Noise represent an unwanted sound that endangers human health in multiple manners and in work setting causes reduction of productivity on one side, and increased waste on the other. Noise pollution occurs when the ear is exposed to the volume of sound that is disturbing, stressful or directly damaging hearing, but also acting on the organism as a whole. Aim: The aim of the article is to examine the vulnerability of workers working on the „press“ machine, and to carry out an analysis and examine the press operator workplace, then perform the noise spread measurement in the press operator work area and compare the current measurements with the permissible levels and analyze the time period of worker exposure, as well as presentation of the effects of noise on productivity and workers health. The aim of the article also includes the proposal for decrease of noise pollution. Methods: A noise analysis at the workplace of workers working on a „press“ machine was performed, which is exposed to a high impulse noise due to which the quality and quantity of production are reduced. For the purpose of calculating the noise level for one working day at the press operator site 1, 2 and 3, it is necessary to analyze the noise level in time. Operators spend most of their working hours at stations 1 and 3 where the measured noise level is Lm1 = 94.7 dB is taken, or at position 3, Lm3 = 97.2 dB. The measured noise level at these locations without the operation of the press is Lm1 = 80.1 dB, or at station 3 is Lm3 = 80.1 dB. Results: It was found that these operators working on the machine in question were exposed to a noise over the limit for more than three years. Their health problems that arise as a result of noise exposure are documented in their health charts. In order to achieve uninterrupted work at the press machine, during the eight hours shift, a noise correction is required to allow the equivalent sound level to fall within one day to the permissible 85 dB. In this regard, we consider the fact that we have known that the press produces a sound level of 110 dB, and that there is a reverberation (reflecting) sound. Given the technical characteristics of the plant, the reduction of the sound intensity of the source itself is not possible, so the suggestions of the technical solution will be based on reduced reflected sounds and to prevent the spread of direct sound to the operator. Conclusion: Workers are exposed to permanent noise during a working day, which produces a number of consequences for the health of the worker, but also the employer and the community. The imperative of the employer is to reduce the number of rejects, increase profitability and to have a positive impact on the health of the individual.

Rudolf Ludwig Carl Virchow (1821-1902) was a German doctor, anthropologist, pathologist, prehistorian, biologist, writer, editor, and politician, known for his advancement of public health (1-4). He is known as “the father of modern pathology” because his work helped to discredit humourism, bringing more science to medicine (1). He is also known as the founder of Social medicine and Veterinary pathology, and to his colleagues, the “Pope of medicine” (2).

Eugene Ackerman (1920-2014), PhD, FACMI, Emeritus Professor of Laboratory Medicine and Pathology at the University of Minnesota (1-4). He studied Physics at Swarthmore College and Brown University, where he met and married Dorothy Hopkirk in 1943. His studies were interrupted by serving as a Conscientious Objector during World War II. After completion of a doctoral degree in Biophysics at the University of Wisconsin-Madison, he joined the Physics faculty at Pennsylvania State University, with several sabbaticals at the University of Pennsylvania in the Biophysics laboratory of Dr. Britton Chance. In 1960 he became Associate Professor of Biophysics at Mayo Clinic, working on mathematical models of physiological systems. He was instrumental in obtaining one of the first National Institutes of Health (NIH) resource grants for Biomedical Computing Facilities, followed by many research grants modeling ultrasonic behaviors of cells, enzyme kinetics, blood glucose regulation, and patterns of infectious disease epidemics (2). As adjunct Professor of Biophysics and Computer Science at the University of Minnesota, he developed a Mayo satellite program awarding a MS degree in Biophysics. In 1967 he left Mayo Clinic for the University of Minnesota, becoming Hill Family Foundation (now Northwest Area Foundation) Professor of Biomedical Computing and Professor of Biometry. A NIH grant to establish a Biomedical Computing Facility had been awarded to the University of Minnesota in 1965, and Eugene Ackerman became its director in 1968 after the illness of its first director, Dr. Eugene Johnson. With the establishment of the Academic Health Center in 1969, the entire biomedical computing program became the Division of Health Computer Sciences in the Medical School’s Department of Laboratory Medicine. Charged with developing core and collaborative research, training, dissemination and a service unit, the growing cadre of informatics faculty, fellows and graduate students helped develop departmental computer systems in the clinical laboratories, surgery, electrocardiography, pulmonary function, and nuclear medicine (4). Eugene was a superlative scientific educator and writer. One of the first and longest funded National Library of Medicine training grants in health computing was awarded to the University of Minnesota, which eventually trained over a hundred fellows from the health sciences, including ones from medicine, nursing, pharmacy, dentistry and public health. He personally directed the graduate theses of nearly a hundred students and postdoctoral fellows. Over his long career, he published hundreds of journal articles, conference abThe Most Influential Scientists in the Development of Medical Informatics (24): Eugene Ackerman (19202014)

Jules Rene Guerin (Boussu, Belgium, 1801–Hyres, 1886) commenced his medical studies at Paris in 1821, obtaining his doctorate at that university in 1826 (1-3). He was early attracted to journalism, and two years later he founded the medical journal Gazette de sante, of which he was both editor and publisher, and for which he also wrote articles.

The purpose of this study was to perform a systematic review and meta-analysis on the effect of contrast training(CT) on vertical jump performance. Thirteen out of 83 studies were included for syst ...

Aim: The aim of this paper was to evaluate the incidence of thyroid gland diseases in relation to age, sex, existing associated symptoms and thyroxine and thyroid-stimulating hormone levels, in correlation with morphological characteristics and corresponding clinical diagnosis for thyroid gland. Methods: Retrospective research was conducted in the period 1-Dec-2017 to 31-Dec-2017 and included a total of 500 subjects of both sexes aged 1 to 80 years. All subjects had clinical examination, which included anamnestic data, palpatory examination of thyroid gland, as well as functional status of thyroid gland. Results: The results of the research have shown that majority of subjects were females (78.6% vs. 21.4%). The largest number of subjects was in the age group 41 to 60 years. The average age of females was 43.22 years and 42.86 for males. The most common associated symptom for both sexes was related to cardiovascular system disorder (61.2%). Subclinical hypothyroidism was the most prevalent thyroid gland disease (12.8%), while diffuse enlargement of thyroid gland (4.60 %) was the most common in morphological classification. The mean value for free thyroxine for the overall sample was 14.39 pmol/L and 3,4 mlU/L for thyroid-stimulating hormone. Thyroid-stimulating hormone levels were highest in the age group 41-60 years (p=0.043). Conclusion: The overall incidence of thyroid gland diseases was 18.57% for females and 13.08% for males. Free thyroxine levels were highest in thyroid gland with nodular changes and subclinical hypothyroidism (p=0.0001). Thyroid-stimulating hormone levels had the highest value in a thyroid gland with diffuse changes and subclinical hypothyroidism (p=0.0001).

Introduction: Pathology of thyroid nodules is present in all ages and it is frequently encountered in clinical practice. Thyroid nodules do not represent a single disease, but they are the clinical manifestation of a wide range of different thyroid diseases. Aim: The objective of this study is to evaluate the frequency and localization of malignancy in solitary scintigraphic cold nodules, as well as the sensitivity, specificity and diagnostic accuracy of FNAB in comparison with histopathological findings. Methods: The study was included 49 patients with palpatory findings of the solitary nodule located in the both lobes or isthmus of thyroid gland. All subjects underwent the scintigraphy and FNAB, followed by a cytologic results that was compared to the final histopathological diagnosis, after surgery. Results: The study results show that the highest number of solitary nodules (81,6%) is localized in the lower pole of the both lobes of the thyroid gland. The cytologic results were benign 8 cases, malignant in 23 and indeterminate (follicular neoplasm) in 18 cases. The highest number of thyroid cancer is histopathologically confirmed in the patients with cytological diagnosis of follicular neoplasms, i.e. follicular cancer is found in 66.7% and papillary cancer is found in 33.3% of subjects. The most common cancer is papillary cancer found in 61,2%. Since the pathohistological diagnosis of all our patients responded to cancer, it was done indirect statistical evaluation of the diagnostic sensitivity of cytological method in the estimation of malignant thyroid lesion, which was 83,7%. Conclusion: FNAB is a highly sensitive method in the diagnostics of malignant thyroid lesions with the sensitivity Se=83,7%. The highest number of thyroid cancer is histopathologically confirmed in the patients with cytological diagnosis of follicular neoplasm (66.7%). The highest number of patients had a cytological diagnosis of papillary cancer.

Introduction: After family medicine’s famous beginnings in the early 60’s through introduction of the world’s first family medicine specialization, with transitional changes and war also come changes in former Yugoslavia’s healthcare systems. Aim: The primary aim of this article is to analyze frequency and causes of sanctioning of family physicians by Health insurance funds in the countries of former Yugoslavia. The secondary aim is to evaluate frequency and types of workplace violence family physicians experienced due to insurance boundaries for patients. Methods: The comparative, cross-sectional survey was carried out from October 2017 to February 2018. Study participants were general practitioners’ (GPs), family physicians (FPs) and those without a specialty designation but providing family medicine services in one of the five Western Balkans countries: Croatia, Slovenia, Serbia, Macedonia and Bosnia and Herzegovina (B&H). The questionnaire was designed for the purpose of the study. Results: Forty-nine percent of participating physicians have been sanctioned by Health Insurance Fund and 77. 5% has been exposed to workplace violence. The most common type of violence was verbal (76.6%). Financial penalties according to the scale had the highest rates in Macedonia (73.9%) and Slovenia (43.9%). Conclusion: It is necessary to educate creators of healthcare policies, doctors and patients for the purpose of establishing partner relations which would lead to strengthening of primary healthcare, but also to a more efficient healthcare system.