Introduction: Despite recent advances in anesthesia, cardiopulmonary bypass and surgical techniques, children undergoing congenital heart surgery require postoperativemechanical ventilation. Early extubation was definedas ventilation shorter than 12 hours. Aim of this study is to identify factors associated with successful early extubation after pediatric cardiac surgery.Methods: The study was performed during period from January 2006 to January 2011 at Pediatric Clinic and Heart Center University Clinical center Sarajevo. One hundred children up to 5 years of age, who have had congenital heart disease, with left–right shunt and obstructive heart disease were included in the study. Patients were divided into two groups: Group I - patients extubated within 12 hours after surgery and Group II - patients extubated 12 or more hours after surgery. Results: The most frequently encountered preoperative variables were age with odds ratio 4% 95%CI (1-7%), Down's syndrome 8.5 95%CI (1.6-43.15), failure to thrive 4.3 95%CI( 1-18). Statistically significant postoperative data included lung disease (reactive airways, pneumonia, atelectasis, pneumothorax) and with odds ratio 35.1 95 %CI (4-286) and blood transfusion with odds ratio 4.6 95%CI (2-12). Blood transfusion (p=0.002) (Wald=9.2) 95%CI (2-12), during as well as after operation procedure has statistically significant influence on prediction time of extubation. Proven markers were age with cut of 21.5 months (sensitivity 74% and specificity 70%) and extracorporeal circulation (ECC) with cut-of 45.5 minutes (sensitivity 71% and specificity 65%).Conclusion: Early extubation is possible in many children undergoing congenital heart surgery. Younger age and prolonged ECC time are markers associated with prolonged mechanical ventilation.

Introduction: Transcatheter closure is a treatment choice for the most children with patent ductus arteriosus (PDA). The closure of the ductus is indicated in any child or adolescent with developed symptoms of significant L-R shunt. The aim of this article is to present our results in 5 years treatment of patients with PDA and their outcome. Methods: From 2009 to 2014, 30 patients underwent a transcatheter closure of PDA at Centre for Heart and Pediatric clinic of Clinical University Centre of Sarajevo. Aortic angiogram was performed to evaluate the size, position, and shape of the duct for selection of appropriate occluder device type and size. All procedures were performed by local team of cardiologists from the Department of Cardiology, Pediatric clinic, with invasive cardiologists team from Sweden and Austria. Echocardiography was repeated at intervals of 24 hours, then 1month, 3 months, and 1 year after the procedure to assess the outcome. Results: Thirty patients underwent transcatheter closure of PDA during the study period. PDA of ≤ 2.0 mm was present in 8 patients and they underwent PDA closure with coils, while 22 patients had PDA diameter  ≥ 2 mm, and they were treated by Amplatzer duct occluder (ADO). Only in 2 (6.2%) patients complications have been observed. The length of hospital stay after the treatment was two to three days. Conclusion: Transcatheter closure of PDA is a modern, safe and efficient method that ensures a faster recovery of the patients, shortens the length of hospitalization.

Introduction: There are wide variations in diet patterns among population subgroups. Macronutrients content analyses have become necessary in dietary assessment. The purpose of this study is to analyze dietary saturated fatty acids intake in students, detect differences between men and women, and compare with nourish status and nutrition recommendations.Methods: A cross-sectional survey of 60 graduate students was performed during the spring 2013, at the Sarajevo University. Food-frequency questionnaire was conducted during seven days. Body mass index was used to assess students' nourish status. Statistical analyses were performed using the Statistical Package for Social Sciences software (version 13.0).Results: Mean age of males was 26.00±2.72, and of females was 27.01±3.93 years. The prevalence of overweight was more common among males compared to females (55.56% vs. 6.06%). Median of total fat average intake for men and women was 76.32(70.15;114.41) and 69.41(63.23;86.94) g/d, respectively. Median of saturated fatty acids average intake for men and women was 28.86(22.41;36.42) and 24.29(20.53;31.60) g/d, respectively. There was significant difference in average intake of total fat between genders (Mann-Whitney U test: p=0.04). Macronutrient data were related to requirement of reference person. Total fat intake was beyond recommended limits in 37.04% of males and 54.55% of females. Saturated fatty acids intake was beyond the upper limit in 55.56% of males and 51.52% of females.Conclusion: Diet pattern of the average student is not in accordance with the recommendations of saturated fatty acids contribution as a percentage of energy.

Contemporary business environment generates hyper changes and hyper competition, which is why enterprises are challenged to search for new sources to

This paper proposes two novel master-slave configurations that provide improvements in both control and communication aspects of teleoperation systems to achieve an overall improved performance in position control. The proposed novel master-slave configurations integrate modular control and communication approaches, consisting of a delay regulator to address problems related to variable network delay common to such systems, and a model tracking control that runs on the slave side for the compensation of uncertainties and model mismatch on the slave side. One of the configurations uses a sliding mode observer and the other one uses a modified Smith predictor scheme on the master side to ensure position transparency between the master and slave, while reference tracking of the slave is ensured by a proportional-differentiator type controller in both configurations. Experiments conducted for the networked position control of a single-link arm under system uncertainties and randomly varying network delays demonstrate significant performance improvements with both configurations over the past literature.

Purpose The aim of the study was to establish whether the duration of anticoagulant (AC) therapy can be tailored, on an objective basis, by using ventilation/perfusion single-photon emission computed tomography (V/P SPECT) and to assess the extent of residual perfusion defects over time. In particular, we addressed the following: (a) is the extent of perfusion recovery at 3 months of initial pulmonary embolism (PE) diagnosis a satisfactory criterion for deciding the duration of oral AC? (b) Is it safe to withdraw AC at 3 months if perfusion recovery is complete? Patients and methods Of 269 consecutive patients with suspected PE, 100 patients were diagnosed with PE using V/P SPECT. Sixty-seven patients with acute PE were followed up clinically and with V/P SPECT at 3 months. Sixty-four patients were subject to review and examination using V/P SPECT for a period of 6 months and 33 were followed up only clinically. Therapy was terminated after 3 months if perfusion was normalized, and patients were free of symptoms and the risk of hypercoagulability. Initial extension of PE did not have an impact on decision making. Results PE extension varied from 10 to 70% in the acute stage. After 3 months, complete resolution of PE was found in 48 patients. The treating pulmonologist decided to terminate therapy in 35 (73%) patients and to continue AC in 13 patients because of persistent risk factors. Six months later, at the second control stage, 53 patients had complete recovery of pulmonary perfusion. Eleven patients still had perfusion defects at 6 months. No recurrence was identified at 6 months in the 35 patients whose therapy was terminated after 3 months. No bleeding effects were observed in any of the patients during the 6-month follow-up. Conclusion This study shows that AC therapy can be tailored, on an objective basis, by using V/P SPECT. Normalization of perfusion at 3 months of initial PE diagnosis was a reliable indicator that AC could be safely withdrawn in patients who were without hypercoagulability risk.

Studies are supporting neuroprotective benefi t of therapeutic hypothermia in term newborns with hypoxic-ischemic encephalopathy.We assessed survival and neurodevelopmental outcome of neonates subjected to the procedure and factors that may haveinfl uenced it. Newborns with gestational age of more than 36 weeks and less than 6 hours of age with moderate to severe asphyxialencephalopathy underwent cooling protocol at a temperature of 33.5 °C for 72 hours and rewarming period of 6 hours. The outcomemeasures assessed were death and neurodevelopmental characteristics. Twenty-fi ve children were assessed during the period fromOctober 2010 to October 2013. Median gestational age was 40 weeks, birth weight 3470 g, Apgar score 2/4 and pH on admission tothe hospital 7.02. Four (16%) children died and two were lost for follow up. At the age of fi nal assessment, developmental categoriesof communication were normal in 68.4%, problem solving in 73.7%, personal-social in 68.4%, gross motor in 57.9%, and fi ne motorin 36.8% but with a high need of retesting in this area. Seven of 19 patients (36.8%) had completely normal results for all fi ve categories,while three (15.8%) had abnormal results for all categories. None of the 18 parameters that were correlated with neurodevelopmentaloutcome showed statistical signifi cance. Amplitude integrated electroencephalography was done in ten patients and themost prominent fi nding was discontinuous activity in eight patients. In conclusion, a relatively small number of patients and limitationsof this study design precluded any far-reaching conclusions, but we think that this method can provide better survival and lessneurologic sequels in hypoxic-ischemic encephalopathy patients.

We prove that the meromorphic continuations of the Ruelle and Selberg zeta functions considered by Bunke and Olbrich are of finite order not larger than the dimension of the underlaying compact, odd-dimensional, locally symmetric space.