Aim To examine two methods of extracting risks for undetected type 2 diabetes (T2D): derived from electronic medical record(EMR) and family medicine (FM) assessment during pre-consultation phase. All risks were structured in three lists of patients' data using Wonca International Classification Committee(WICC). Missing data were detected in each list. Methods A prospective study included a group of 1883 patients(aged 45-70) identified with risks. Risks were assessed based on EMR for continuity variables and FM's assessment for episodes of disease and personal related information. Patients were categorized with final diagnostic test in normoglycaemia, impaired fasting glycaemia and undetected T2D. Results Total prevalence of diabetes was 10.9% (new 1.4%), of which 59.3% were females; mean age was 57.4. The EMR risks were hypertension in 1274 patients (yes 67.6%, no 27.9%, missing 4.4%), hypolipemic treatment in 690 (yes 36.6%, no 30.9%, miss 32.5%). In the episodes of disease: gestational diabetes mellitus in 31 women (yes 2.8%, missing 97.2%). Personal information: family history of diabetes in 649 (yes 34.5%, no 12.4%, missing 53.1%), overweight in 1412 (yes 75.0%, no 8.4%, missing 16.6%), giving birth to babies >4000g in 11 women (yes 0.9%, missing 99.1%). Overweight alone was the best predictor for undiagnosed type 2 diabetes, OR: 2.11 (CI: 1.41-3.15) (p<.001). Conclusion Two methods of extraction could not detect data for episodes of the disease. In the list of personal information, FMs could not assess overweight for one in six patients and family history for every other patient. The study can stimulate improving coded and structured data in EMR.
Introduction: Uveitis as extra-articular manifestation of juvenile idiopathic arthritis (JIA) is present in 20% of children with the persistent form, in 30% with the extended oligoarticular form, while it is present in psoriatic and polyarticular rheumatoid factor (RF) negative arthritis in 10% and 14%, respectively. Aim: The aim of the study was to evaluate the frequency of uveitis and its complications in children with JIA. Material and Methods: A retrospective study was conducted with an analysis of the medical records of children with JIA who were treated for the last 5 years. The analysis included the following: the child’s age and sex, age at onset of arthritis, of uveitis, complications, RF values and antinuclear antibodies (ANA). Results: The study included 97 children with JIA: in 14 (14.4%) uveitis was observed; the most common form of JIA was the oligoarticular extended form (6/14), oligoarticular persistent form was observed in 5 children, while 3 children with uveitis had polyarticular RF negative JIA. The age of arthritis onset was lower in children with uveitis (4.7 vs 8.2 years); ANA positivity was more common in children with JIA and uveitis (64% vs 41%). Uveitis was the first manifestation of the disease for 2 children; 28.6% of children had clinically asymptomatic uveitis, while 42.4% of children developed uveitis within 4 years from the JIA onset. 8/14 children developed uveitis complications: 3 cases of synechia, 2 band keratopathy, 2 cataracta, 1 glaucoma. Conclusion: Uveitis as significantly present manifestation of JIA requires to timely recognize, treat, monitor children in order to prevent complications.
Aim The aim was to show rare cases of congenital cystic adenomatoid malformation (CCAM) and the manner of its surgical treatment with video-assisted thoracoscopic surgery (VATS). Methods Two male and one female child, 7, 4 and 3 years of age were treated for symptoms of cough and high temperature in district hospitals. In all three children laboratory blood tests and chest radiography were done. Auscultatory findings showed the presence of pneumonia. Children were treated with appropriate doses of antibiotics. After the rehabilitation of inflammation, they were sent to the University Clinical Center Sarajevo, where video-assisted thoracoscopic lobectomy (VATS) was indicated after computerized tomography (CT). Results Chest CT scan pointed to the CCAM and pulmonary sequestration (PS) changes to the lungs. This has required surgery lobectomy of an affected part of the lungs. In two children with PS, the aberrant systemic artery came from the most proximal part of aorta abdominals, the third patient did not have an anomalous artery. Conclusion VATS lobectomy is an alternative to the traditional thoracotomy for the treatment of CCAM and PS, however, it should be investigated in the future for its safety and effectiveness.
1. “MEDICAL ARCHIVES” JOURNAL DURING THE YEAR 2016 Journal “Medical Archives”, the offi cial journal of Academy of Medical Sciences of Bosnia and Herzegovina, has got a new web site from January 1st, 2017 (Figure 1). “Medical Archives” was established in 1947 and it is the oldest and the most important journal for clinical practice in Bosnia and Herzegovina, which covers the area of all clinical disciplines of medical sciences. Articles published in the “Medical Archives” during 2016 came from three continents (Europe, Asia and North America) and from 15 diff erent countries. Th e largest number of articles came from the country of origin of the journal, Bosnia and Herzegovina (Figure 2). Th e total amount of 110 articles were published in “Medical Archives” during 2016. Acceptance rate in 2016 was 35.7% (Figure 3). Th e most comEDITORIAL
Introduction: Unilateral spastic cerebral palsy (US CP) is the second most common subtype of cerebral palsy. Aim: The aim of the study was to analyze neuroimaging findings in children with unilateral spastic cerebral palsy. Material and methods: The study was hospital based, which has included 106 patients with US CP (boys 72/girls 34, term 82/preterm 24). Neuroimaging findings were classified into 5 groups: Brain maldevelopment, predominant white matter injury, predominant gray matter injury, non specific findings and normal neuroimaging findings. Results: Predominant white matter lesions where the most frequent (48/106,45.28%; term 35/preterm 13), without statistically significant difference between term and preterm born children (x2=0.4357; p=0.490517). Predominant gray matter lesions had 32/106 children, 30.19%; (term 25/preterm 7, without statistically significant difference between term and preterm born children (x2=0.902; p=0.9862). Brain malformations had 10/106 children, 9.43%, and all of them were term born. Other finding had 2/106 children, 1.89%, both of them were term born. Normal neuroimaging findings were present in14/106 patients (13.21%). Conclusion: Neuroimaging may help to understand morphological background of motor impairment in children with US CP. Periventricular white matter lesions were the most frequent, then gray matter lesions.
Integrated fruit production (IFP) is an economical, high-quality fruit production which prioritizes ecologically acceptable means of production, which minimize side-effects aiming to increase environment conservation and human health. Following the market demands and increasing production standards, integrated production imposes itself, which is to enable lucrativeness, market competition and ecological acceptability of agricultural products. Introducing and implementing multi-criteria model of decision-making is based on DEXi method (multi-attribute analysis). This method makes selection of the most adequate fruit sort for initiating fruit production. This model of decision-making is based on opinions of experts from the Feld of integrated production. The main criterion in evaluating IFP according to DEXi and expert system are: economic, technological, ecological and socio-political. The result of multi-criteria expert system DEXi have shown that the plum fruit sort yields the best results according to integrated production concept and can be recommended as the first planting alternative. The second alternative recommends apple while the third one recommends pear.
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