Introduction: Cigarette smoking among students is greatly widespread. Smoking prevalence ranges from 28% to 67% for students, respectively, from 19% to 34% for female students. Aim: The aim of this survey was to investigate the smoking habits of students, who are studying at three faculties at the University of Tuzla in academic Year 2012/2013 and to investigate whether there is a difference in smoking habits of students from different faculties and observed by gender. Patients and Methods: The study included a total of 254 students, 170 females (66.93%) and 84 male patients (33.07%). A representative sample consisted of students of three faculties of the University of Tuzla. Results: The conducted analyzes have shown that in this sample 22.8% of current smokers, and 7.8% are former smokers who now no longer smoke. Due to the adopted smoking habits, which some students began to adopt in the age of 13, in 47.5% part of students occasionally was observed some symptoms (cough, etc.) which are attributed to smoking. The analysis showed no statistically significant gender difference in smoking habits. Although the trend of smoking in the population students progression, one and the same quantity was well as male colleagues. We did not find any statistically significant difference in onset of adopting smoking habits. Conclusion: The analyzes have shown that in this sample 22.8% of current smokers, and 7.8% were former smokers who now no longer smoke. The analysis showed no statistically significant gender difference in smoking habits of all students. There were no statistically significant differences in the daily consumption of cigarettes between faculty.

Introduction: Carotid endarterectomy (CEA) is a standard treatment for the prevention of stroke and death in patients with significant stenosis of the internal carotid artery. Eversion endarterectomy is warranted in patients with symptoms of cerebral ischemia and the degree of stenosis of 70-99%. The same is suitable for treating a symptomatic carotid artery stenosis with contralateral stenosis (50-70%). Purpose: The aim of this study was to evaluate perioperative complications (ICV, TIA, MI, mortality) in patients treated with carotid eversion endarterectomy with unilateral and bilateral symptomatic stenosis (with bilateral stenosis treated with ACI stenosis ≥70%). Patients and Methods: The study included 139 patients with symptomatic carotid artery stenosis at the Department of Vascular Surgery of the University Clinical Center of Sarajevo in the period from January 2012 to December 2014 year. Given the involvement of ACI stenosis patients were divided into two groups. Group A consisted of 74 patients with bilateral stenosis (surgically treated with ACI stenosis ≥70%, while the degree of stenosis opposite ACI was from 50-70%), and group B of 65 patients with unilateral stenosis ≥70%. Results: Of the 139 patients included in the study, in the group A was 74, of which 46 male (62.2%) and 28 female (37.8%), while in group B were 42 male (64.6%) and 23 female (35.4%) (p = 0.90). The subjects in group A were slightly older 65.9 (± 7.8) compared to group B 64.2 (± 7.7) (p = 0.17). Analysis of risk factors indicating a higher number in Group A compared to group B, but the difference was not statistically significant: 34 smokers (45.9%) versus 36 (55.4%); p = 0:34), patients with hypertension (63 (85.1%) against the 52 (80.0%); p = 0.56), with statin therapy (62 (83.8%) versus 52 (80.0%); p = 0.72), diabetes (18 (24.3%) versus 18 (27.7%); p = 0.79) and with a heart disease (18 (24.3%) versus 7 (10.8%); p = 0.06). Analysis of the frequency of perioperative complications between the groups was not statistically significant: ICV (2/74 versus 3/65; p = 1.00), TIA (2/74 versus 3/65; p = 0.88), one death was recorded in group A, while myocardial infarction (MI) we had in either group. Conclusion: In this study, no statistically about significant differences in the number of perioperative complications (from 0 to 30 days) between the two groups. With this risk is acceptable to perform carotid endarterectomy in a patient in the opposite ACI stenosis of 50-70%.

Aim: The aim of prenatal diagnostics is to provide information of the genetic abnormalities of the fetus early enough for the termination of pregnancy to be possible. Chromosomal abnormalities can be detected in an unborn child through the use of cytogenetic, molecular- cytogenetic and molecular methods. In between them, central spot is still occupied by cytogenetic methods. In cases where use of such methods is not informative enough, one or more molecular cytogenetic methods can be used for further clarification. Combined use of the mentioned methods improves the quality of the final findings in the diagnostics of chromosomal abnormalities, with classical cytogenetic methods still occupying the central spot. Material and methods: Conducted research represent retrospective-prospective study of a four year period, from 2008 through 2011. In the period stated, 1319 karyotyping from amniotic fluid were conducted, along with 146 FISH analysis. Results: Karyotyping had detected 20 numerical and 18 structural aberrations in that period. Most common observed numerical aberration were Down syndrome (75%), Klinefelter syndrome (10%), Edwards syndrome, double Y syndrome and triploidy (5% each). Within observed structural aberrations more common were balanced chromosomal aberrations then non balanced ones. Most common balanced structural aberrations were as follows: reciprocal translocations (60%), Robertson translocations (13.3%), chromosomal inversions, duplications and balanced de novo chromosomal rearrangements (6.6% each). Conclusion: With non- balanced aberrations observed in the samples of amniotic fluid, non- balanced translocations, deletions and derived chromosomes were equally represented. Number of detected aneuploidies with FISH, prior to obtaining results with karyotyping, were 6.

Introduction: The prevalence of dyspepsia in the general population worldwide is very high (20-40%). Upper abdominal complaints are one of the most common cause of patients’ visits to primary care settings. Making an accurate etiological diagnosis of dyspepsia is difficult, but is an important challenge and goal for every doctor in primary care practice. Clinical guidelines have standards for gastroesophageal reflux disease, management of Helicobacter infection and indications for the use of endoscopy (empiric treatment, prompt endoscopy, “test and treat”). In spite of the application of those standards, many patients experience no improvement in their symptoms or often the recurrence of disease. Aim: This study presents a new approach to the diagnostic and therapeutic management of uninvestigated dyspepsia in primary care settings to provide long-term effective control of symptoms for family doctors. Material and methods: 3000 unselected consecutive dyspeptic patients underwent abdominal ultrasound, and 1000 dyspeptic patients from the same group upper endoscopy.. In this approach diagnostic evaluation of dyspepsia includes: abdominal ultrasonography as a first line obligatory routine method and the exact estimation of nutritional condition. Results: Abdominal ultrasound, physical examination and BMI control have significant value in the diagnostic evaluation of dyspepsia. The therapeutic approach includes, besides general standards (acid suppressive drugs, eradication of H. pylori, prokinetic and antidepressant agents), life style modification and nutritional interventions as first-line treatments. In this approach the use of new drugs such as ursodeoxycholic acid (UDCA), pre and probiotics, and digestive enzymes supplements is recommended. Conclusion: Throug the combination of different diagnostic procedures as first line methods, including abdominal ultrasound and nutritional condition (BMI), a family doctor can manage successfully uninvestigated dyspepsia at the primary care level.

Introduction: There are limited numbers of studies which focused on the identification of Malassezia yeasts to a species level in onychomycosis. Therefore, the aim of our study was to determine the prevalence and species composition of Malassezia yeasts in patients with clinically suspected onychomycosis and to examine if the range of species varies with patient gender, age, site of involvement and clinical pattern of onychomycosis. Methods: Specimens were taken from 785 patients presenting signs of onychomycosis and then incubated on Sabouraud dextrose agar and modified Dixon agar. The yeasts isolated were identified according to their macroscopic and microscopic features and physiological characteristics. Results: Malassezia species were diagnosed both by microscopy and culture in fourteen (1.8%) patients. M. globosa was the predominant, if not only, species identified from nail samples. Mixed cultures were observed in five cases: in 4 cases Malassezia was co-isolated with Candida albicans and in one case with dermatophyte. Fingernails were affected more frequently than toenails (85.7%) and distolateral subungual onychomycosis was the most common clinical type (78.6%). Conclusion: No significant differences were found in the distribution of Malassezia species isolated according to demographic parameters.

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 consists of 6 chapters: Connections between Computer Sciences and Medical Informatics; Development of Information and Communication Technologies (ICT); Development of Internet and Social Networks; Development of Classification Systems in Biomedicine; Development of Artificial Intelligence, Expert Systems and Biocomputers; The Role of IMIA and EFMI in Development of Medical Informatics. 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 former Yugoslav countries 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 history of establishing and activities of all Working Groups of IMIA and EFMI is included, as the most influential scientists and doyens in development of medical informatics worldwide. The author of the book pay special tribute to most important events and persons who were included in the development of Medical informatics during last 50 years, especially for establishing and developing of International Association of Medical Informatics (IMIA) and European Federation for Medical Informatics (EFMI) and MIE and MEDINFO Congresses organized from 1974 in Stockholm till 2014 organized in Istanbul. 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 212 pages are distributed in 6 chapters with references and consulted references 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.

Introduction: Increased levels of C-Reactive Protein are found in 30-60% on hemodialysis patients and it is closely associated with the progression of atherosclerosis, cardiovascular morbidity and mortality. Non enzymatic antioxidants are antioxidants which primarily retain potentially dangerous ions of iron and copper in their inactive form and thereby prevent its participation in the production of free radicals. Aim: The aim of the study was to examine the relationship of CRP and non enzymatic antioxidants (albumin, ferritin, uric acid and bilirubin) i.e. examine the importance of CRP as a serum biomarker in assessing the condition of inflammation and its relationship to antioxidant protection in patients on hemodialysis. Methods: The study was cross-sectional, clinical, comparative and descriptive. The study involved 100 patients (non diabetic) on chronic hemodialysis. The control group consisted of 50 subjects without subjective and objective indicators of chronic renal disease. In all patients, the concentration of CRP as well as concentrations of non enzymatic antioxidants were determined. Results: In the group of hemodialysis patients 60% were men and 40% women. The average age of hemodialysis patients was 54.13 ± 11.8 years and the average age of the control group 41.72 ± 9.8 years. The average duration of hemodialysis treatment was 91.42 ± 76.2 months. In the group of hemodialysis patients statistically significant, negative linear correlation was determined between the concentration of CRP in and albumin concentration (rho = -0.251, p = 0.012) as well as negative, statistics insignificant, linear correlation between serum CRP and the concentration of uric acid (r = -0.077, p = 0.448). Furthermore, the positive, linear correlation was determined between serum CRP and ferritin (r = 0.159, p = 0.114) and positive linear correlation between CRP and total serum bilirubin (r = 0.121, p = 0.230). In the control group was determined a statistically significant, positive, linear correlation between serum CRP and uric acid concentration (rho = 0.438, p = 0.001) and statistically significant, positive, linear correlation between serum CRP and total serum bilirubin (rho = 0.510, p = 0.0001) A statistically significant, negative linear correlation was determined between CRP and albumin concentration (rho= -0.393, p = 0.005) as well as statistically significant, negative linear correlation between serum CRP and ferritin control group (rho = -0.391, p = 0.005). Conclusion: Elevated CRP level is a strong and independent predictor of low levels of serum albumin, which indicates that the hypoalbuminemia in hemodialysis patients could be more due to inflammation than malnutrition. There was no statistically significant correlation between CRP and other non enzymatic antioxidants (uric acid, ferritin, bilirubin), which shows that indicators of antioxidant defense in hemodialysis patients must be individually measured to determine their actual stocks and activity.

It is my great pleasure to introduce to you this special issue of the journal Materia Socio-Medica on the occasion of the 4th Congress of Nephrology of Bosnia and Herzegovina with international participation that will be held in Sarajevo from 22nd to 25th April 2015. The Association of Nephrology, Dialysis and Transplantation of Bosnia and Herzegovina has organized congress under the auspices of the European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) and the International Society of Nephrology (ISN). This scientific meeting covers the most recent discoveries in the fields of acute kidney injury, chronic kidney disease, cardiovascular diseases, hypertension, diabetes mellitus, dialysis and kidney transplantation. Gathering a large number of national and international nephrologists as well as many distinguished international speakers will certainly contribute to the knowledge transferring and quality of this meeting. There will be more than 200 participants, submitted presentations from more than 20 countries.

The book “Clinical Aspects of Hemodialysis” contains 19 chapters: 1. Chronic renal disease; 2. Epidemiology; 3. Uremic syndrome; 4. Cardiovascular disease in dialysis patients; 5. Hemodialysis in elderly patients; 6. Mineral-bone disease in hemodialysis patients; 7. Gastrointestinal diseases in dialysis patients; 8. Hepatitis virus infection in patients on chronic dialysis program; 9. Malnutrition in patients on chronic dialysis; 10. Amyloidosis; 11. Neurological complications in dialysis patients; 12. Skin lesions in chronic hemodialysis patients; 13. Pruritus in chronic hemodialysis patients; 14. Pregnancy and chronic renal disease; 15. Ethical problems in dialysis; 16. Psychological preparation of patients for hemodialysis; 17. Nutrition of dialysis patients; 18. Exercises for hemodialysis patients; 19. The general principles of medications dosage in patients with chronic renal disease. This book represents a comprehensive material in the field of advanced renal disease study by the most contemporary approach. The book clearly and systematically elucidated factors for occurrence kidney disease as well as their distribution and frequency of occurrence in this population. In current elaboration of this problem the authors suggest that there is no tissue and organ system that cannot be affected by changes, or the final consequences, i.e. terminal renal impairment. In a meaningful and clear manner are presented the problems of cardiovascular diseases in hemodialysis which are the leading cause of death in this group of patients. Because of the high incidence of these diseases Cardionephrology is being developed as a separate medical discipline. All other important aspects of uremic syndrome events in certain systems of human pathology are described and explained in this book. Separately are presented the directions for resolving the dilemmas in hemodialysis among elderly patients, the problems of malnutrition, inflammation, pregnancy, ethical problems and problems of patient’s rehabilitation and physical exercises. All terms in the text are aligned in the presentation of these issues with the regulations of European and global recommendations for the overall management of patients on hemodialysis. Book chapters are written systematically and transparently, their contents are clear and written in understandable manner, accompanied by the most current data from the world literature in this field. Literature is listed at the end of each chapter. Text is by its content designed and innovated with new essential material from the world’s leading recommendations for monitoring patients on hemodialysis. The authors of the book, using their rich scientific and expert experience, created the content and presented the recommended guidelines in their own way and make it appropriate and acceptable for experts in this field of medicine, as well as all other common specialty, family physicians whose task is to identify as early as possible the potential kidney disease patients and send them for treatment at higher or inpatient levels of health care. The book is both a textbook for students in all three cycles of study by the Bologna concept of education, because it was written by a multidisciplinary team of experts and content of the described chapters in the book may be of assistance to specialists and residents from all fields of internal medicine, as well as resuscitation medicine, vascular surgery and infectious diseases. By retrieval of the contents of this book in biomedical databases, in particular aspect of the approach to solving the current problem of hemodialysis patients in clinical practice, especially in Bosnia and Herzegovina, which is described in this book - textbook, I came to the conclusion that this approach is somewhat unique and therefore is attractive and instructive and it should be used in practice for more efficient treatment of hemodialysis patients. Sarajevo, March 2015

Charles Edwin Molnar (1935–1996) was a codeveloper of one of the first minicomputers and a pioneer in cochlear modeling research (1, 2). As a young researcher at the Lincoln Laboratory of the Massachusetts Institute of Technology in 1962, Molnar with another engineer, Wesley A. Clark — led a team of designers in developing the Laboratory Instrument Computer, or LINC. The machine, which was one of the few unclassified projects a the laboratory in the early 60s, was intended for doctors and medical researchers. Although it would be considered of insignificant power compared to modern personal computers, it was a self-contained machine that had a simple operating system and a small display and stored its programs on a magnetic tape. The LINC originated decades before the advent of the personal computer. Its development was the result of a National Institutes of Health (NIH) program that placed 20 copies of an early LINC prototype in selected biomedical research laboratories nationwide. Later, the LINC was produced in greater numbers by Digital Equipment Corp. and other computer manufacturers Molnar received a bachelor’s degree (1956) and a master’s degree (1957) in electrical engineering from Rutgers University, and received a doctoral degree (1966) from MIT in electrical engineering. His dissertation topic was the mechanics of the inner ear and how it translates auditory signals into neural responses. After leaving MIT, he established the Institute for Biomedical Computing at Washington University in St. Louis, where he worked from 1965 until 1995, when he became a senior research fellow at Sun Microsystems in California. Molnar earned a worldwide reputation for his work in selftimed computer system theory, a design approach for ultrafast computers. While the operations of commercial computers are controlled by a single clock, most researchers in the field believe that significant speed breakthroughs await the advent of systems whose components can operate independently. At Sun, Molnar was continuing his work in this area. Molnar was known as an intensely curious researcher whose talents and interests ranged from physiology and bioengineering to electrical engineering and computers, music and furniture building, and hiking and canoeing. He started practice of sending computer programs by cable technology with his colleague Clark. In the 1960s, Molnar and Clark obtained a patent for sending computer programs over cable television lines to communicate data from central computers, which were expensive at the time, to less expensive bed side terminals in intensive-care units. The patent, which is now expired, turned out to be ahead of its time. Some companies are now starting to employ the cable technology, which allows users to send data much faster than by the more common telephone lines. Charlie Molnar was also well known as a pioneer in the modeling of the auditory system, especially numerical models of the function of the cochlea (the inner ear). Before death in 1996, he was working at Sun Microsystems on asynchronous circuits with Ivan Sutherland. He died December 13, 1996 at home, at the age of 61 from the complications of diabetes. After his death, his body was donated to the University of California, San Francisco Medical Center. He will be the most remembered by his pioneer work in making numerical models of cochlea function.

Introduction: Information Technologies, taking slow steps, have found its application in the teaching process of Faculty of Medicine, University of Sarajevo. Online availability of the teaching content is mainly intended for users of the Bologna process. Aim: The aim was to present the level of use of information technologies at the Faculty of Medicine, University of Sarajevo, comparing two systems, old system and the Bologna process, and to present new ways of improving the teaching process, using information technology. Material and methods: The study included the period from 2012 to 2014, and included 365 students from the old system and the Bologna Process. Study had prospective character. Results: Students of the old system are older than students of the Bologna process. In both systems higher number of female students is significantly present. All students have their own computers, usually using the Office software package and web browsers. Visits of social networks were the most common reason for which they used computers. On question if they know to work with databases, 14.6% of students of the old system responded positively and 26.2% of students of the Bologna process answered the same. Students feel that working with databases is necessary to work in primary health care. On the question of the degree of computerization at the university, there were significant differences between the two systems (p <0.05). When asked about the possibility of using computers at school, there were no significant differences between the two systems. There has been progress of that opportunity from year to year. Students of Bologna process were more interested in the introduction of information technology, than students of old system. 68.7% of students of the Bologna process of generation 2013-2014, and 71.3% of generation 2014-2015, believed that the subject of Medical Informatics, the same or similar name, should be included in the new reform teaching process of the Faculty of Medicine, University of Sarajevo. Conclusion: Information technologies can help the development of the teaching process, and represent attractive and accessible tool in the process of modernization and progress.

The aim of the research was to determine the impact of education and spiritual message on self-evaluation and consciousness development of mothers of children with cerebral palsy. Research included the sample of 30 respondents. After evaluation of the initial status, 7 mothers gave up, so in the end, total sample was consisted of 23 respondents. Research was conducted by specially conceived protocols. Educations, and one modification of psychophysical relaxation based on Jacobson concept, were used. Multidimensional approach in inducing personal states of consciousness of the respondents, with specifically harmonically background of learning and listening to spiritual messages was used during the psychophysical relaxation. In order to review the research objective that was set, two modified scales of self-evaluation of mother herself and of the child. In order to check the hypothesis of the research, t-test for dependent sample of the respondents, was used. Based on the analysis of the obtained results, we could conclude that it has come to significant changes in applied sample of the respondents, during the séances, and that changes manifested in the levels of self-evaluation for controlled variables, of how mothers perceived themselves and their children, stimulated by spiritual messages during the séances.