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Džemal Jusuf Kevelj, Mašinski Bijedić " Univerzitet U Mostaru, Herzegovina Fakultet Sjeverni Logor Bb Bosnia, Mostar, Doç., Haznadarević Lutvo, Džemal Bijedić " Univerzitet U Mostaru, Mašinski Fakultet Sjeverni Logor Bb Bosnia et al.

INTRODUCTION In this study the authors have analyzed the costs associated with the immunosuppressive therapy in patients who underwent organ transplantation in two countries: the United States of America and Bosnia and Herzegovina (i.e. the entity Federation B&H). AIMS OF THE STUDY The goal of this paper is to compare and contrast the costs of the immunosuppressive therapy in two countries against the total costs of the organ transplantation. Further, the costs, dosages and effectiveness of the particular types of immunosuppressant were also analyzed. Problem of the Study: Immunosuppressive medications are essential in preventing kidney transplant rejection. Most available pharmaco-economic information to date is for induction and maintenance therapies, while the data on the financial impacts of the rejection are still limited. Immunosuppressive regiments are expensive in the socio-economic environment of limited resources and constraints. MATERIAL AND METHODS This academic article has utilized the publicly available sources of information from the Federation Entity of B&H, (i.e. Federal Department of Insurance and Reinsurance) in period 2006 to 2010, as well as peer-reviewed academic articles, books, private and government data from the United States of America from 2006 to 2010, including projections for 2011. RESULTS In the U.S. the cost of the immunosuppressive medications for the major types of organ transplantations typically range from US $19,300 to $34,600 per year based on commonly prescribed doses at average wholesale prices. In the Federation entity of B&H in 2009, the average cost per patient in F.B&H in 2010 was 6,009.00 KM (U.S.$4,292.00), which represents an absolute cost decrease of 740 KM or 11.00%, when compared to the higher average cost per patient in 2009, which was 6,749.00 KM (US $4,821.00). DISCUSSION The process of finding the ideal medication regiments to minimize morbidity and mortality, while maximizing quality of life and optimizing the cost is the major challenge to the transplantation community. Pharmaco-economic analysis can provide valuable insight toward achieving of these, rather difficult goals. CONCLUSION A sensitive pharmaco-economic analysis must be undertaken in order to achieve the best results in the world of limited/constrained resources and increasing demands for the expensive and quality of life improving immunosuppressive therapy in organ transplantation.

INTRODUCTION This study researched the distribution of desirable, borderline and high-risk values of certain lipid status parameters in healthy young individuals. AIM The purpose of this study was to research the statistical distribution of desirable, borderline and high-risk values of certain lipid status parameters in healthy young individuals (i.e. medical university students). MATERIAL AND METHODS In this research we tested 112 students studying at the University of Sarajevo, of both genders and 20-30 years of age. RESULTS Total serum cholesterol was minimally elevated in 7.1% of tested students, elevated with high risk in 2.7% and triglycerides were minimally elevated in 1.8%. Presence of elevated LDL cholesterol was found to be 2.7% minimally and 1.8% with high risk. HDL cholesterol was minimally decreased in 1 tested student. DISCUSSION Standard biochemical methods were used to determine the values of total cholesterol, triglycerides and HDL-cholesterol. The level of LDL cholesterol was also calculated. CONCLUSION Our results point to the need for performing gradual laboratory diagnostic procedures for routine check-ups of university students.

Introduction: Transurethral resection (TUR) of bladder tumors is surgical treatment for visible tumors of the urinary bladder and is performed to remove the tumor and take samples for histopathological examination in order to determine the stage and tumor grade. Transurethral resection of prostate tumors (TURBT) is a surgical procedure that is performed daily at the Clinic for Urology, Clinical Center University of Sarajevo (CCUS). As for all other endoscopic urology procedure, typically urine must be sterile preoperatively. Patients with preoperative asymptomatic bacteriuria have a high risk of bacteremia and sepsis. In urological guidelines, antibiotic prophylaxis in TURBT is only given in cases of high risk patients, and necrotic tumors. Methodology: The study was conducted as a retrospective study which included patients underwent surgical treatment–TURBT and who underwent preoperative urine tests and postoperatively the clinical manifestation of UTI, urine cultures were isolated, and in case of the clinical indications also the blood culture. Included are only patients with preoperative sterile urine findings. The source of data was history of the disease. Results: From the 512 patients which underwent TURBT in 159 cases (31.0%) patients did not receive antibiotic prophylaxis and 353 (68.9%) patients received antibiotic prophylaxis. The first group of patients which did not receive antibiotic prophylaxis in 22 cases (14%) patients developed symptomatic urinary tract infection confirmed by urine culture and in 5 (3.1%) patient with blood culture was proven bacteraemia. In the second group of patients who received prophylactic antibiotic therapy in 78 cases (22%) patients developed a urinary infection and in 2 cases (0.57%) patients bacteremia was detected in blood culture. Conclusion: With regard to the set goals we have prove the incidence of urinary infection after performing TUR of bladder tumors in our Clinic.

OBJECTIVE This study aimed to demonstrate incidence, symptoms and therapy management of testicular cancer patients. Also we had evaluated significance of testicular tumor markers. PATIENTS AND METHODS The study was retrospective, clinical and manipulative, analytical and descriptive and covers the period from 01.01.2000 to 31.12. 2008 with 58 male patients from 16 years upwards. For each patient, the data were analyzed from ambulance and hospital protocol on the Urology Clinic Sarajevo. RESULTS Incidence of testicular cancer among patients at the Urology Clinic clinical center Sarajevo is on the rise for the last three years (about 20%). Of the 58 patients with testicular cancer, 70% of patients were in age 20-39 years. 47% were patients with right side testicular cancer and 53% were left sided. Walter Reed Hospital tumor classification showed I 50%, IIa 10%, IIb 19% and III 21% of patients. The highest incidence of pathohistological reports showed mixed tumors 46%, seminoma 26%, yolk sack 2%, teratoma 2%, carcinoma embrionale 16%, dysgerminoma 5% and Laydig cell carcinoma 3%. Mixed, seminoma and carcinoma embirionale represents 90% of testicular tumors. betaHCG marker was positive in 53% of patients with seminoma and non seminoma 80%. CEA marker was positive only in 9% of all testicular cancer, LDH showed higher incidence with metastatic seminoma tumor. 27,5% of patients undergone retroperitoneal lymphadenectomy treatment, all patients had radical orchiectomy. CONCLUSION The common therapeutic procedure in the treatment of testicular tumors are surgical methods radical inguinal orchiectomy, chemotherapy (advanced stages of seminoma and all stages of non seminoma tumor and radiotherapy (early stage seminoma). AFP and betaHCG are excellent markers in the evaluation of surgical and oncology treatment of testicular tumor.

Introduction: Treatment of localized prostate cancer refers to two basic modes which are the radical retro pubic prostatectomy and external radiotherapy. However, according to most authors, radical prostatectomy is the gold standard for long-term survival. Objective: To determine the occurrence of erectile dysfunction after radical operative treatment and irradiation therapy. Material and methods: In this paper we have examined the occurrence of erectile dysfunction after conducted treatment for localized prostate cancer. In this paper we have examined 84 of 138 patients who underwent radical retro pubic prostatectomy at the Urology Clinic in the period from January 2009 to December 2010 and 26 patients who underwent radical external radiotherapy in the same period, because of localized prostate cancer. Results: The average age of surgical patients was 65 years, the youngest patient was 49 years and the oldest 81 years. From the 84 patients which underwent surgery, neurovascular preservation of nerve bundles was done in 36 (42.8%) patients from which bilateral in 28 patients (77.7%) and unilateral in 8 patients (22.2%). Average age of patients who underwent irradiation therapy was 68 years. Conclusion: Erectile dysfunction occurs in greater proportion after radical retro pubic prostatectomy compared to radiation treatment, and the preservation of both neurovascular bundles reduces this difference.

INTRODUCTION Radical retropubic prostatectomy is a therapeutic option for treatment of localized prostate cancer. The goal of radical prostatectomy is to completely remove the tumor while preserving erectile function and urinary continence as well as factors that determine the postoperative quality of life. There are many factors influencing sexual function after radical prostatectomy of localized prostate cancer. All factors can be divided into the preoperative, postoperative and intraoperative. In this paper we examine the significance of individual factors affecting erectile dysfunction following surgical treatment. MATERIAL AND METHODS The study included 36 patients who underwent nerve sparing radical prostatectomy at the Urology Clinic, Clinical Center of Sarajevo University in period from January 2009 until December 2010. RESULTS Out of 84 patients tested, radical retropubic prostatectomy with the reservation of neurovascular bundles was performed in 36 patients (42.8%). Of this number, both of the neurovascular bundles were preserved in 28 patients (77.7%) and one in 8 patients (22.2%). CONCLUSION The positive predictive factor for erectile function after radical retropubic prostatectomy is the preoperative sexual function, younger age, preservation of both neurovascular bundles and early rehabilitation therapy.

M. Grbovic, N. Pranjić, Senada Selmanović, Sanja Brekalo-Lazarević, Z. Jatic

Networks protocols are implemented in combinations of software, firmware, and hardware on each end of a connection. Introduction of multiservice networks demands more intelligent control over network usage and more efficient application development practices that enable achieving Quality–of-Service (QoS) goals. As applications over the network increase, so does the need to diagnose performance at the application level, knowing how traffic patterns are affected in terms of guaranteed bandwidth, delay and reliability. In this chapter, the concept for testing multiservice networks in real-life situations during stationary time intervals, by using expert-system-based protocol analysis, is described. The architecture of hardware and software needed for data acquisition and testing, that, as a working example, was conducted on a major network with live traffic, is proposed, as well as the appropriate algorithm for estimating standard QoS parameters from the measured data that mainly included decoding with precise time-stamps and expert-system comments, resulting from the appropriate processing of the network data.

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