Peer review is at the heart of the processes of not just medical journals but of all of science. It is the method by which grants are allocated, papers published, academics promoted, and Nobel prizes won (1). Each article, which is submitted for publication in a particular journal, according to the ethical and the established standards of practice, must pass through a peer-review process (2-7). The articles go through a peer-review process, without the authors’ names, and this is essentially a blind process. Common practice is to peer-review an article by two experts, prominent enough for scholarly careers in the field from which the article comes. Through years-long experience of the editor, of several journals, I think that a search for an appropriate peer-reviewer is the most complex part in the scope of responsibilities of the editor. Theoretically, everyone wants gladly to review particular article. The higher the impact factor of the journal is, this desire grows. In practice, every fourth petition for review of a certain work is accepted (8-12). Editors are faced with many dilemmas and primarily, through the numerous e-mails, they reach a certain reviewer, after a period, which sometimes last up to a year. Sometimes this review contains only two sentences, and the editor is forced to look for new potential reviewer as a decision on the work cannot be made, on the basis of two sentences. Each reviewer receives copy of the journal, for which he/she writes its opinion on the above-mentioned work.

Introduction: Determination of the overall risk of coronary disease, enables the health professionals for planning the intensity of preventive action. Aim: The aim of this study is that by the results obtained using a modified algorithm with tables adopted by the European Society of Cardiology demonstrate the possibilities for assessment of the risk of coronary heart disease degree, for application to the targeted individual or risk factors groups. Material and methods: The study was conducted as a retrospective, prospective and controlled (included two groups of 200 respondents). Results: By comparing the presence of risk factors according to the representation of groups of diseases, or myocardial infarction, results showed that the European and SCORE table have significantly lower levels of risk factors, or those with sustained myocardial infarction are ranked in groups of low and present risk in relation to our algorithm which patients with myocardial infarction ranked as high and pronounced degree of risk. Results showed that the European and SCORE table significantly reduce the levels of risk or the persons with heart failure have been ranked in the group of low and present risks in relation to our algorithm which patients with coronary insufficiency ranked as pronounced degree of risk. Conclusion: Determination of the overall risk of coronary disease, enables the health professionals for planning the intensity of preventive action. The activities of primary prevention of risk factors, or already resulting disease, may be helpful in assessing the reduction in economic costs in healthcare, both due to lower morbidity, and reducing the total cost of treatment of patients with coronary disease.

[This retracts the articles DOI: 10.5455/medarh.2014.68.132-136, DOI: 10.5455/medarh.2014.68.79-81, DOI: 10.5455/medarh.2015.69.393-395.].

Introduction: Glaucoma is the most common optic neuropathy which is characterized by progressive loss of retinal ganglion cells, the excavation of the optic nerve head, associated with defects in the visual field. It is not a disease, but the final result of united and yet completely unidentified cellular and subcellular processes and effects of many factors responsible for changes in retinal ganglion cells leading to their accelerated apoptosis. Methods: This is a prospective-retrospective, comparative, randomized clinical trial that included 150 patients, 97 were female and 53 male. The age of patients ranged from 18 to 80 years. Results: The highest degree of myopia in category of tilted optic discs had patients with large disc (4.05 + -0.65). Values of the degree of myopia have linearly declined in relation to the size of the oblique disc. The analysis of the results revealed that the subjects who had a higher degree of myopia associated with glaucoma had frequent parapapillar atrophy of alpha and beta zones. The highest percentage of subjects with parapapillar changes were in the group of patients who had other than glaucoma and myopia (62%), then in the group of patients with glaucoma only (56%). Conclusion: Previous studies on the relationship between myopia and open-angle glaucoma are based on the results of observational studies. However, according to recent findings, based on the available studies, the systematic approach to estimate the association between myopia and glaucoma does not exist. Disc Damage Likelihood Scale (DDLS) is a new system for assessing glaucomatous damage of the optic disc which strongly correlates with the degree of visual field loss.

Objective: For last decades, there has public concern about increasing Cesarean Section (CS) rates, and it is an issue of international public health concern. According to World Health Organisation (WHO) there is no justification to have more than 10-15% CS births. WHO proposes the Robson ten-group classification, as a global standard for assessing, monitoring and comparing cesarean section rates. The aim of this study was to investigate Cesarean section rate at University Hospital Tuzla, Bosnia and Herzegovina. Methods: Cross sectional study was conducted for one-year period, 2015. Statistical analysis and graph-table presentation was performed using Excel 2010 and Microsoft Office programs. Results: Out of 3,672 births, a total of 936 births were performed by CS. Percentage of the total number of CS to the total birth number was 25,47%. According to Robson classification, the largest was group 5 with relative contribution of 29,80%. On second and third place were group 1 and 2 with relative contribution of 26,06% and 15,78% respectively. Groups 1, 2, 5 made account of realtive contribution of 71,65%. All other groups had entirely relative contribution of 28,35%. Conclusion: Robson 10-group classification provides easy way in collecting information about CS rate. It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS. Data from our study confirm this attitude.

Introduction: Degenerative aortic stenosis (AS) is the most frequent cause among aortic valve stenotic changes. Mini Sternotomy Aortic Valve Replacement is a replacement of aortic valve through upper partial sternotomy. Aim: The aim of this approach is to improve postoperative convalescence by leaving pleural spaces closed and do not compromise respiratory function, to decrease bleeding, and reduce post op ventilation time and ICU stay. All these advantages decrease cost during hospital stay by reducing ICU stay, respiration time, bleeding and using blood products, pain killers and shortening hospital stay. Esthetic effect is also considerable result of this method. Case report: This case report presents an initial experience with Reversed L-Type Upper Partial Sternotomy in Aortic Valve Replacement. The goal is to demonstrate that minimally invasive advanced cardiac surgery procedures can be performed in our country.

Introduction: Bronchopneumonia is the most common clinical manifestation of pneumonia in pediatric population and leading infectious cause of mortality in children under 5 years. Evaluation of treatment involves diagnostic procedures, assessment of disease severity and treatment for disease with an emphasis on vulnerability of the population. Aim: To determine the most commonly used antibiotics at the Pediatric Clinic in Sarajevo and concomitant therapy in the treatment of bronchopneumonia. Patients and Methods: The study was retrospective and included a total of 104 patients, hospitalized in pulmonary department of the Pediatric Clinic in the period from July to December 2014. The treatment of bronchopneumonia at the Pediatric Clinic was empirical and it conformed to the guidelines and recommendations of British Thoracic Society. Results and Discussion: First and third generation of cephalosporins and penicillin antibiotics were the most widely used antimicrobials, with parenteral route of administration and average duration of treatment of 4.3 days. Concomitant therapy included antipyretics, corticosteroids, leukotriene antagonists, agonists of β2 adrenergic receptor. In addition to pharmacotherapy, hospitalized patients were subjected to a diet with controlled intake of sodium, which included probiotic-rich foods and adequate hydration. Recommendations for further antimicrobial treatment include oral administration of first-generation cephalosporins and penicillin antibiotics. Conclusion: Results of the drug treatment of bronchopneumonia at the Pediatric Clinic of the University Clinical Center of Sarajevo are comparable to the guidelines of the British Thoracic Society. It is necessary to establish a system for rational use of antimicrobial agents in order to reduce bacterial resistance.

Introduction: Chronic kidney disease (CKD) represents a serious public health problem due to the increase in incidence and prevalence of this disease worldwide. Given the significant morbidity and mortality from cardiovascular disease (CVD) in the population of patients with CKD, and the fact that dyslipidemia itself is a risk factor for CVD, increases the importance of lipid metabolism study in patients with CKD. Goal: Evaluate the lipid status of patients with chronic kidney disease. Material and methods: A one-year prospective study included 150 adult patients who were in various stages of chronic renal failure (stage I to IV). Estimate of creatinine clearance was performed using Cockroft-Goult formula. The classification of patients according to stages of chronic renal insufficiency was performed in accordance with the criteria of Kidney Disease Outcomes Quality Initiative (K/DOQI). Results: Of the total number of patients (N=150) there was 71 males and 79 females. The mean age of patients was 55.43 years. Average values of serum cholesterol were highest in patients with stage II renal disease and the lowest in patients classified as stage IV (5.76±1.60 mmol/L vs. 5.07±1.88 mmol/L). Analysis of the average value of triglycerides in blood show a slight increase through the stages of CKD in a manner that patients classified into stage I have low serum triglyceride levels (1.73±1.17 mmol/L (range 0.61 to 5.5 mmol/L), and patients classified in stage III the highest value 2.13±1.11 mmol/L (range 0.62 to 4.66 mmol/L). Conclusion: Average cholesterol levels does not statistically significantly change with progression of chronic renal disease. There is an almost linear increase in average triglyceride levels in chronic renal disease. Triglyceride levels in serum begins to increase in the early stage of chronic renal disease and reach the peak in stage IV.

Introduction: MALT lymphoma accounts for 7-8% of all B-cell lymphomas and at least 50% of primary gastric lymphoma, with the highest incidence at between 50 and 60 years of age. Aggressive forms are rare, as are indications for multi-visceral resection. Case study: A patient, 33 years old, was admitted to the tertiary hospital due to a biopsy at a small community hospital confirming adenocarcinoma of the stomach. She was Helicobacter pylori positive. CT showed thickening of the fundus and corpus wall, up to 2.7. cm., with numerous lymph nodes, along the small curvature and in the peripancreatic region, up to 1.5 cm in size. There was close contact between the changed and tumorous posterior wall of the stomach and the anterior surface of the pancreas. Neoplasm of the stomach was found that had infiltrated the body and tail of the pancreas and spleen hilum. Infiltration of the left crura of the diaphragm was also found, ex tempore biopsy showed inflammatory infiltration without elements of neoplasm. Total gastrectomy with omentectomy, and subtotal pancreatectomy and splenectomy were performed. Definitive patho-histological diagnosis confirmed MALT lymphoma of the stomach with pancreas infiltration, but no tumor cells were found on the spleen. Additional staining and immunohistological examination of the specimen from the community hospital showed that this was a misdiagnosis of carcinoma, and the specimen also contained MALT lymphoma. Discussion: MALT lymphoma frequently occurs in the stomach. For patients with MALT, systematic staging is indicated. If MALT is considered in the differential diagnosis, multiple random systematic biopsies within the stomach wall are needed to optimize diagnostic accuracy. Samples should be subject to immune phenotype analysis6. The main tumor cells of MALT are: CD 20+, CD 5-, CD 10-, CD 23-, CD 43+-. It is obvious that this kind of analysis cannot be accomplished in a small community hospital in a poor country such as Bosnia and Herzegovina, and suspicion of MALT indicates referral to a tertiary center. Although the long term risk of transformation of MALT lymphoma into the aggressive form is low9, this case of the aggressive form of MALT indicates the importance of systematic staging.

Photography, as the most powerful means of tourist propaganda and one of the strongest stimulants for travelling, has been developing almost parallel with tourist movements, continually interlacing over the time. The rapid development of photographic and marketing technology has led to the fact that today an image of every tourist destination is easily accessible for everyone. Therefore, in modern means of communication there are a number of different visual depictions of each single photographed space. Majority of those images represent ?photogenic? and groomed spaces, while undesirable sights are missing, for the sake of commercial tourist market demand.In a form of an experimental research, photos containing slum images and other realistic representations of popular tourist destinations were selected and displayed to respondents, followed by questions related to their subjective opinions, emotions and intentions to visit or know more about. The aim of this paper is to contribute to tourism and anthropological research by pointing out that representing a destination as a commodity may harm the overall tourist impressions, unless we consider a non-commercial photography as a potential medium to promote a tourist destination in a more realistic way, and thus inspire the desire for traveling in order to meet local culture and experience a real ?spirit? of a destination.

Vulnerabilidades podem comprometer as propriedades de segurança de um sistema quando adequadamente exploradas por um atacante. Uma alternativa para mitigar este risco é a implementação de sistemas tolerantes a intrusões. Uma abordagem muito utilizada para estas implementações é a replicação Máquina de Estados (RME). Porém, as soluções existentes não suportam diversidade na implementação das réplicas, de forma que um mesmo ataque pode comprometer todo o sistema. Neste sentido, este trabalho propõe uma arquitetura para fornecer suporte à diversidade de implementação em RMEs e mostra como a mesma foi integrada no BFT-SMART. Um conjunto de experimentos mostra o comportamento prático das soluções propostas.

Common reference values of arterial stiffness indices could be effective screening tool in detecting vascular phenotypes at risk. However, populations of the same ethnicity may differ in vascular phenotype due to different environmental pressure. We examined applicability of normative equations for central augmentation index (cAIx) derived from Danish population with low cardiovascular risk on the corresponding Croatian population from the Mediterranean area. Disagreement between measured and predicted cAIx was assessed by Bland-Altman analysis. Both, cAIx-age distribution and normative equation fitted on Croatian data were highly comparable to Danish low-risk sample. Contrarily, Bland-Altman analysis of cAIx disagreement revealed a curvilinear deviation from the line of full agreement indicating that the equations were not equally applicable across age ranges. Stratification of individual data into age decades eliminated curvilinearity in all but the 30–39 (men) and 40–49 (women) decades. In other decades, linear disagreement independent of age persisted indicating that cAIx determinants other than age were not envisaged/compensated for by proposed equations. Therefore, established normative equations are equally applicable to both Nordic and Mediterranean populations but are of limited use. If designed for narrower age ranges, the equations’ sensitivity in detecting vascular phenotypes at risk and applicability to different populations could be improved.

Laboratory-acquired infections due to a variety of bacteria, viruses, parasites, and fungi have been described over the last century, and laboratory workers are at risk of exposure to these infectious agents. However, reporting laboratory-associated infections has been largely voluntary, and there is no way to determine the real number of people involved or to know the precise risks for workers. In this study, an international survey based on volunteering was conducted in biosafety level 3 and 4 laboratories to determine the number of laboratory-acquired infections and the possible underlying causes of these contaminations. The analysis of the survey reveals that laboratory-acquired infections have been infrequent and even rare in recent years, and human errors represent a very high percentage of the cases. Today, most risks from biological hazards can be reduced through the use of appropriate procedures and techniques, containment devices and facilities, and the training of personnel.