Introduction: Endoscopic surgery and endourological procedures imply the use of special instruments that are introduced into the urinary system through the urethra and percutaneous techniques that allow ante grade access to the urinary tract. The risk of urinary tract infection after endourological procedures and the use of antibiotic prophylaxis for these procedures is a question about which there is no unique opinion. Goal: The objective of this study was to determine the connection between endourological procedures and occurrence of urinary infections and to analyze the risk factors of urinary infection for patients who were hospitalized at the Urology Clinic of the Clinical Center University of Sarajevo (CCUS). Material and methods: The research was conducted as a prospective study on a sample of 208 patients of both genders, who were hospitalized at the Urology Clinic of the CCUS and to whom one of endourological procedures was indicated either for diagnostic or therapeutic purposes. All patients were clinically examined prior to endoscopic procedures and after the treatment attention was focused on the symptoms of urinary tract infections. Results: Analysis of the presence of postoperative bacteriuria shows that it has been more common in men or in 48 cases (28.1%) compared to women with 8 cases (21.6%) (p>0.05). Preoperative catheterization was statistically significantly more present in patients who have had a postoperative bacteriuria (16 or 28.6%) compared to those without bacteriuria (8 or 5.3%) (p<0.05). Analysis of the average duration of postoperative catheterization shows that patients with postoperative bacteriuria had longer duration of postoperative cauterization of 1.97±0.14 days (range 1-20 days) compared to those without postoperative bacteriuria with 1.4±0.4 days (range 0-5 days) and with a statistically significant difference (p<0.05). Antibiotic prophylaxis in relation to the occurrence of postoperative bacteriuria did not show a statistically significant difference (p> 0.05). Analysis of the correlation coefficient indicates that a statistically significant effect on the occurrence of postoperative bacteriuria have preoperative bacteriuria, duration of postoperative catheterization and duration of hospital stay, as well as the total duration of hospitalization before and after endourological treatment (p<0.05). Conclusion: It is important to emphasize that the endourological procedures are safe procedures in terms of urinary tract infections. This study should lay pathway to establishment of guidelines for the application of antibiotic prophylaxis in endourological procedures. This would standardize the perioperative use of antibiotics, taking into account the local prevalence of pathogens and antibiotic resistance, but keeping the individual approach to each patient, considering all risk factors for the development of urinary infection after endourological procedures..

Introduction: An abfraction lesion is a type of a non-carious cervical lesion (NCCL) that represents a sharp defect on the cervical part of tooth, caused by occlusal biomechanical forces. The largest prevalence of the NCCL is found on the mandibular first premolar. The goal of the study is, by means of a numerical method – the finite element method (FEM), in an appropriate computer program, conduct a stress analysis of the mandibular premolar under various static loads, with a special reference to the biomechanics of cervical tooth region. Material and methods: A three-dimensional model of the mandibular premolar is gained from a µCT x-ray image. By using the FEM, straining of the enamel, dentin, peridontal ligament and alveolar bone under axial and paraxial forces of 200 [N] is analyzed. The following software were used in the analysis: CT images processing–CTAn program and FEM analysis–AnsysWorkbench 14.0. Results: According to results obtained through the FEM method, the calculated stress is higher with eccentric forces within all tested tooth tissue. The occlusal load leads to a significant stress in the cervical tooth area, especially in the sub-superficial layer of the enamel (over 50 MPa). The measured stress in the peridontal ligament is approximately three times higher under paraxial load with regard to the axial load, while stress calculated in the alveolar bone under paraxial load is almost ten times higher with regard to the axial load. The highest stress values were calculated in the cervical part of the alveoli, where bone resorption is most commonly seen. Conclusion: Action of occlusal forces, especially paraxial ones, leads to significant stress in the cervical part of tooth. The stress values in the cervical sub-superficial enamel layer are almost 5 times higher in relation to the superficial enamel, which additionally confirms complexity of biomechanical processes in the creation of abfraction lesions.

Health professionals are able to make right decision in right time only if they posses prompt, accurate and up to date information about health status of patients and general population. They also need knowledge and tools, computer and information technologies, for successful management of huge amount of information. Efficient management of information is of crucial importance for health policy and decision-making process, and to produce high quality results in public health and healthcare delivery. The book presents an original effort to summarize the basic knowledge about the history of medical informatics and informatics education in Europe and broader, development stages and influence of computer sciences on development of medical informatics. In addition, history and development of medical informatics in Croatia and in Bosnia and Herzegovina is also presented, as well as some basic facts about the establishment, importance and activities of the two key international associations–IMIA and EFMI. A broad list of 36 key actors, with brief biographies and photos, is included, as the most influential scientists and doyens in development of medical informatics worldwide. The authors of the book pay special tribute to four corypheés of medical informatics–Morris F. Collen, François Grémy, Peter L. Reichertz and Jean-Claude Healy. The book is fulfilling an important gap revealing the history and emphasizing the importance of medical informatics as a new scientific discipline with very fast development and implementation in health care sector. Health informatics is contributing remarkably in everyday practice of medical and public health professionals, in efficient management of huge and increasing amount of health information and general and specific medical knowledge toward improved quality of health care, as well as to professional and scientific competitiveness in Europe and broader. The knowledge of information technology is now part of general literacy. The 264 pages are distributed in 14 chapters with references and consulted literature added to each chapter. The book is directed toward medical and other professionals in biomedicine, especially the young doctors. The book can be used by students at all levels, from undergraduate to postgraduate master and doctoral studies, and professionals in various clinical disciplines and public health. The book can also be useful as a guideline for all medical and other professionals in biomedicine in conducting everyday activities and promoting of their professional and research work. Skopje, August 2014 Prof. Doncho Donev, MD, PhD CONTRIBUTIONS TO THE HISTORY OF MEDICAL INFORMATICS

Introduction: Information and communication technology have brought about many changes in medical education and practice, especially in the field of diagnostics. During the academic year 2013/2014, at Faculty of Medicine, University of Sarajevo, students in the final year of the study were subjected to examination which aim was to determine how medical students in Bosnia and Herzegovina subjectively assessing their skills for using computers, have gained insight into the nature of Information Technology’s (IT) education and possessive knowledge. Material and methods: The survey was conducted voluntary by anonymous questionnaire consisting of 27 questions, divided into five categories, which are collecting facts about student’s: sex, age, year of entry, computer skills, possessing the same, the use of the Internet, the method of obtaining currently knowledge and recommendations of students in order to improve their IT training. Results of the study: According to the given parameters, indicate an obvious difference in the level of knowledge, use and practical application of Information Technology’s knowledge among students of the Bologna process to the students educated under the old system in favor of the first ones. Based on a comparison of similar studies conducted in Croatia, Sri Lanka, Pakistan and Denmark, it was observed that the level of knowledge of students of the Medical Faculty in Sarajevo was of equal height or greater than in these countries.

Telemedicine itself is not the medical profession, it is not a medical specialty, but the way in which the medical profession conduct its activity. Therefore we are talking about tele otorhinolaryngology, tele cardiology or tele pathology. In the definition of a multitude of telemedicine that can be found in the literature is the following: Telemedicine is a system that supports the process of health care by providing ways and means for more efficient exchange of information that allows multitude of activities related to health care, including health care and health personnel, including education, administration and treatment. Telemedicine applications include tele diagnosis, tele consultation, tele monitoring, tele-care, tele consultations and remote access to information contained in one or more databases. It turned out that telemedicine is an important factor in technological, professional, financial and organizational uniformity of development of the health system. Telemedicine, although a new area, to a large extent already changed the ways of providing health care, and even more influence on the ways of designing the future of medicine.

Introduction: Family medicine as a part of the primary health care is devoted to provide continuous and comprehensive health care to the individuals and families regardless of age, gender, types of diseases and affected system or part of the body. Special emphasis in such holistic approach is given to the prevention of diseases and health promotion. Family Medicine is the first step/link between doctors and patients within patients care as well as regular inspections/examinations and follow-up of the health status of healthy people. Most countries aspire to join the European Union and therefore adopting new regulations that are applied in the European Union. Aim: The aim of this study is to present the role and importance of family medicine, or where family medicine is today in 21 Century from the beginning of development in these countries. The study is designed as a descriptive epidemiological study with data from 10 countries of the former Communist bloc, Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Kosovo, Albania, Bulgaria, Romania, Czech Republic, Slovakia and Hungary, just about half of them are members of the EU. We examined the following variables: socio-organizational indicators, health and educational indicators and health indicators. The data used refer to 2002 and as a source of data are used official data from reference WebPages of family medicine doctors associations, WONCA website (EURACT, EQuiP, EGPRN), WebPages of Bureau of Statistics of the countries where the research was conducted as well as the Ministries of Health. Results: Results indicates that the failures and shortcomings of health care organizations in Southeast Europe. Lack of money hinders the implementation of health care reform in all mentioned countries, the most of them that is more oriented to Bismarck financing system. Problems in the political, legal and economic levels are obstacles for efficient a problem reconstructing health care system toward family medicine and primary prevention interventions. The population is not enough educated for complicated enforcement for and prevention of diseases that have a heavy burden on the budget. Health insurance and payment of health services is often a problem, because the patients must be treated regardless of their insurance coverage and financial situation. The decrease in production and economic growth, as well as low gross national income in the countries with economic crisis, lead to the inability of treatment for a large number of the population. Such situation a system leads to additional debts and loans to healthcare system. Measures implemented for provision of acute curative care largely did not lead to improvements in the health status of the population. Educational and preventive measures, as well as higher standards for quality and accessibility of health care services for entire population in each country, especially those struggling are bound to joining the European Union and their implementation must start. The most A large number of medical institutions are is inefficient in health education and health promotion and must work to educate patients and families and increase the quality of preventive health services. Modernization of health care delivery and joining the European Union by increasing overall economic stability of countries is one of the primary goals of all countries in Southeast Europe.

AIMS Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy in ST-elevation myocardial infarction (STEMI). We conducted this study to evaluate the contemporary status on the use and type of reperfusion therapy in patients admitted with STEMI in the European Society of Cardiology (ESC) member countries. METHODS AND RESULTS A cross-sectional descriptive study based on aggregated country-level data on the use of reperfusion therapy in patients admitted with STEMI during 2010 or 2011. Thirty-seven ESC countries were able to provide data from existing national or regional registries. In countries where no such registries exist, data were based on best expert estimates. Data were collected on the use of STEMI reperfusion treatment and mortality, the numbers of cardiologists, and the availability of PPCI facilities in each country. Our survey provides a brief data summary of the degree of variation in reperfusion therapy across Europe. The number of PPCI procedures varied between countries, ranging from 23 to 884 per million inhabitants. Primary percutaneous coronary intervention and thrombolysis were the dominant reperfusion strategy in 33 and 4 countries, respectively. The mean population served by a single PPCI centre with a 24-h service 7 days a week ranged from 31 300 inhabitants per centre to 6 533 000 inhabitants per centre. Twenty-seven of the total 37 countries participated in a former survey from 2007, and major increases in PPCI utilization were observed in 13 of these countries. CONCLUSION Large variations in reperfusion treatment are still present across Europe. Countries in Eastern and Southern Europe reported that a substantial number of STEMI patients are not receiving any reperfusion therapy. Implementation of the best reperfusion therapy as recommended in the guidelines should be encouraged.