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.

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.

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 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.

Introduction: The basic principle of non-surgical fracture treatment is to restore the original anatomical position of fractured fragments by different techniques, without direct access to the bone and without further traumatizing of tissues. Intramedullary nailing is synthesis and consolidation of fracture fragments with the main goal to gain strength and permanent placement of the implants. Two techniques of intramedullary osteosynthesis are used: with dynamic or with static intramedullary nail. Dynamization include conversion of static nail by removing screws from the longest fragment. Aim: The aim of this study is to determine whether there is a difference in the speed and quality of healing of the type A and B fractures of the femur and tibia treated by static or dynamic intramedullary nails and to compare the results. Material and methods: The study was conducted at the Clinic for Orthopaedics and Traumatology, Clinical Center University Sarajevo from January 2004 to June 2009. The study was retrospective-prospective, manipulative, controlled and it was conducted on a total of 129 patients with closed fractures of the diaphysis of the femur and tibia type A and type B, with different segments of bone, regardless of sex and age structure, with the exception of children under 14 years of age. Results: Precisely there were 47 patients with femoral fractures and 82 patients with tibial fractures. The average number of weeks of healing femoral and tibial fractures was slightly in advantage of static intramedullary osteosynthesis, it was 17.08 weeks (SD=3.382). The average number of weeks of healing in 23 patients with fractures of the femur, treated by dynamic intramedullary osteosynthesis was 17.83 (SD=2.978). We can conclude that static intramedullary nailing osteosynthesis unable movements between fragments which directly stimulates bone formation and formation of minimal callus. Conclusion: Static intramedullary osteosynthesis resolve the problem of stabilizing the fracture, limb shortening and rotation of fragments.

This paper addresses different aspects of practical interventions with regard to education and rehabilitation of children with intellectual disabilities which can take place in schools or other rehabilitation settings. The outlined approach is based on the Bruner’s concept of so-called growth sciences which include both the special education and the rehabilitation. The focus is on the theoretical, diagnostic, and rehabilitation strategy, based on the implementation of educational and treatment activities with this population of children. In the light of applied research we try to define interventions in education and rehabilitation of the children with mild intellectual disabilities. The sample was formed of 124 participants in school settings with regard to their cognitive and school achievement. With respect of these results we propose the educational and treatment strategies for these children.

Bone material is composed of an organic matrix of collagen fibers and apatite nanoparticles. Previously, vibrational spectroscopy techniques such as infrared (IR) and Raman spectroscopy have proved to be particularly useful for characterizing the two constituent organic and inorganic phases of bone. In this work, we tested the potential use of high intensity synchrotron-based far-IR radiation (50–500 cm−1) to gain new insights into structure and chemical composition of bovine fibrolamellar bone. The results from our study can be summarized in the following four points: (I) compared to far-IR spectra obtained from synthetic hydroxyapatite powder, those from fibrolamellar bone showed similar peak positions, but very different peak widths; (II) during stepwise demineralization of the bone samples, there was no significant change neither to far-IR peak width nor position, demonstrating that mineral dissolution occurred in a uniform manner; (III) application of external loading on fully demineralized bone had no significant effect on the obtained spectra, while dehydration of samples resulted in clear differences. (IV) using linear dichroism, we showed that the anisotropic structure of fibrolamellar bone is also reflected in anisotropic far-IR absorbance properties of both the organic and inorganic phases. Far-IR spectroscopy thus provides a novel way to functionally characterize bone structure and chemistry, and with further technological improvements, has the potential to become a useful clinical diagnostic tool to better assess quality of collagen-based tissues.

Introduction: Appropriate vitamin D turnover is essential for many physiological function. Knowledge of it’s function was improved in last two decades with enlargement of scientific confirmation and understanding of overall importance. In addition to classical (skeletal) roles of vitamin D, many other function (no classical), out of bone and calcium-phosphate metabolism, are well defined today. Aim: To analyze vitamin D level in the blood in dialysis and pre dialysis patients and evaluate efficacy of supplementation therapy with vitamin D supplements. Methods: Vitamin D3 level in form of 25-hydroxivitamin D3 was measured in dialysis and pre dialysis patients, using combination of enzyme immunoassay competition method with final fluorescent detection (ELFA). Parathormone was measured by ELISA method. Other parameters were measured by colorimetric methods. Statistical analysis was done by nonparametric methods, because of dispersion of results of Vitamin D and parathormone. Results: In group of dialysis patients 38 were analyzed. Among them 35 (92%) presented vitamin D deficiency, whether they took supplementation or not. In only 3 patients vitamin D deficiency was not so severe. Vitamin D form were evaluated in 42 pre dialysis patients. Out of all 19 patients (45 %) have satisfied level, more than 30 ng/ml. Moderate deficiency have 16 patients (38%), 5 of all (12%) have severe deficiency, and two patients (5%) have very severe deficiency, less than 5 ng/ml. Parathormone was within normal range (9.5-75 pg/mL) in 13 patients (34 %), below normal range (2 %) in one subject, and in above normal range in 24 (63 %). Conclusion: Vitamin D3 deficiency was registered in most hemodialysis patients; nevertheless supplemental therapy was given regularly or not. It is to be considered more appropriate supplementation of Vitamin D3 for dialyzed patients as well as for pre dialysis ones. In pre dialysis patient moderate deficiency is shown in half of patients but sever in only two.