Background: HCV infection is characterized by a tendency towards chronicity. Acute HCV infection progresses to chronic infection in 70% of cases. Hepatitis C virus infection can cause progressive liver injury and lead to fibrosis and eventually cirrhosis. The degree of histologic fibrosis is an important marker of the stage of the disease. One of current standard treatment for CHC infection is the combination of PEG-IFN α and ribavirin. Objectives: The aim of the study was to investigate the effect of the therapy with Peginterferon alfa-2a or alfa-2b plus Ribavirin on evolution of liver fibrosis in patients with chronic hepatitis C. Also, our aim was to examine whether there was a difference between the genders in the efficacy of these antiviral therapy. Our goal also was to determine effect of the therapy with Peginterferon alfa-2a or alfa-2b plus Ribavirin on evolution of liver steatosis in patients with chronic hepatitis C. Patients and Methods: A retrospective study was made of chronic hepatitis C patients who had been treated from 2005 to April 2014 at the Clinic of Gastroenterohepatology, Clinical Center University of Sarajevo. We reviewed 40 patient medical records to collect demographic, epidemiological and clinical information, as information on liver biopsies that was performed prior to the antiviral therapy and FibroScan® test that was performed after the antiviral therapy. For the processing of data SPSS (Statistical Package for the Social Sciences Program) for Windows, ver. 21.0 statistical software was used. Comparisons between qualitative and quantitative variables were performed using the Student t-test. Mann Whitney U test was used to compare differences in variables such as fibrosis stage and steatosis grade. A value of p<0.05 was considered as statistically significant. Results: After treatment, there was a statistically significant increase in the number of patients with no fibrosis (p<0.05). There was no statistically significant reduction in the number of patients with cirrhosis (F4) (p>0.05). There was significantly higher decrease of fibrosis progression at the patients that were in an mild-to-moderate fibrosis (F1/F2/F3), patients that were in advanced stage of fibrosis (F4) at the time of the pre-treatment did not have a statistically significant fibrosis reduction. We found significant association in evolution of fibrosis after treatment with PEG-IFN α2a (40) kD and PEG-IFNα2a (12,5) kD with ribavirin (p< 0.05). We also found significant association in evolution of steatosis after treatment with PEG-IFN α2a (40) kD and PEG-IFNα2a (12,5) kD with ribavirin (p < 0.05). There was statistically significant differences (p<0.05) between genders within fibrosis qualitative evolution. Conclusions: There were significant regression of fibrosis especially at the patients that were in an mild-to-moderate fibrosis (F1/F2/F3), patients that were in advanced stage of fibrosis (F4) at the time of the pre-treatment did not have a statistically significant fibrosis reduction after treatment with PEG-IFN α2a (40) kD and PEG-IFNα2b (12,5) kD with ribavirin. Our results showed significant improvement in steatosis in patients infected with HCV after treatment with PEG-IFN α2a (40) kD and PEG-IFNα2b (12,5) kD with ribavirin. Those results provides further evidence for direct involvement of HCV and antiviral therapy in the pathogenesis of hepatic steatosis. Female gender showed a higher degree of fibrosis reduction.

Pharmacists as the most accessible health care professionals in outpatient settings can improve palliative patient care. The aim of this review was to assess utility of pharmacists (the effectiveness of pharmacists' interventions) on clinical outcomes of patients in palliative care at all levels of health care and in home care. Two electronic databases were searched: PubMed and SCOPUS (last searched August 2014). Primary studies, of any type of research design, in English, related to clinical outcomes of patients in palliative care and pharmacists' interventions were eligible. Studies that used surrogate outcome measures, such as number of pharmacists' recommendations were excluded. A total of 764 reports were found, and only three of them met our inclusion criteria. All of them assessed effects of pharmacists' interventions in outpatient settings and were case series. Symptoms improvement and stabilization of patients' conditions has been the main utility of pharmacists' interventions. Assessed quality of two studies was moderate, and one study had low quality. As number of studies and quality of the evidence were limited, and results of reviewed studies indicate that pharmacists' interventions potentially could improve clinical outcomes of patients in palliative care, more research is needed to provide evidences in this field .

Uvod. Osnovni cilj endodontske terapije je adekvatna obrada i opturacija cjelokupnog kanalnog sistema. Nekompletna instrumentacija i ciscenje kanala, neadekvatna opturacija i zaboravljeni kanali najcesci su razlozi neuspjeha endodontske terapije. Stoga je poznavanje morfologije korijenskog sistema zuba od velikog znacaja i može da smanji neuspjeh endodontske terapije uzokovane nekompletnom kanalnom preparacijom i opturacijom. Cilj rada je da se prikaže endodontska terapija maksilarnog drugog molara sa dva palatinalna korijena i pet korijenskih kanala. Prikaz bolesnika. U radu je prikazan maksilarni drugi molar sa cetiri korijena kod pacijenta starosti 27 godina. Poslije klinickog ispitivanja i analize radiograma, uoceno je postojanje dva palatinalna korijena. Sprovedena je endodontska terapija u dvije posjete. Poslije zavrsene intrakanalne medikacije u trajanju od 15 dana, kanali su opturisani gutaperka poenima i silerom. Zakljucak. Prikaz istice važnost dobrog poznavanja kanalne morfologije i ukazuje da anatomske abnormalnosti treba uvijek uzeti u obzir kada se sprovodi endodontsko lijecenje.

Uvod. Silovanje je seksualno nasilje uz primjenu tjelesne snage za koje se izricu stroge kaznene mjere, a ponasanje nasilnika je nagonsko uz promjenljivu psihoptologiju. Cilj istraživanja je da se provjeri destruktivan uticaj porodicnih i psihopatoloskih faktora na sve vise izražen stepen nasilja u BiH u periodu od 01. 01. 2003. do 31. 12. 2012. godine. Hipoteticno je u BiH seksualno nasilje izraženo u vecem stepenu nasilnosti. Metode. Eksperimentalnu grupu cini 150 lica forenzicki obrađenih koja su na tretmanu nakon silovanja. Kontrolna grupa se sastoji od 150 lica forenzicki obrađenih nakon recidivantnih drugih delikata. Dizajn je multicentricna longitudinalna studija. Mjerni instrumenti su: lista opstih podataka, Hamiltonova skala depresivnosti (HAMD), Skala zdravlja nacije (HoNOS), profil indeks emocija (P.I.E-Plutchic R). Rezultati su analizirani metodama deskriptivne statistike i multivarijantnom regresionom analizom. Rezultati. Multivarijantna regresiona analiza je pokazala da su sljedece varijable znacajno povezane sa nasiljem uz P<0,001: nezaposlenost [OR=0,770 (95%), CI=0,830-1,150], usamljenost [OR= 0,750 (95%), CI= 0,845 – 1,250], opsti kriminalitet [OR=0,910 (95%), CI= 0,875- 1,255], ratne posljedice [OR=0,920 (95%), CI=0,875-1,215], misli o seksu [OR= 0,770 (95%), CI=0,835-1,150], retardacija [OR=0,790 (95%),CI=0,880-1,125], kognitivni poremecaji [OR=0,910 (95%), CI=0,925-1,150], zastita [OR=0,770 (95%), CI=0,865 – 1,160], i istraživanje okoline [OR= 0,910 (95%), CI= 0,870-1,175]. Kod recidivantnih lica su signifikantni prediktori: obrazovanje [OR= 0,835 (95%), CI= 0,815 – 1,125], anksioznost [OR= 0,855 (95%), CI=0,870-1,250], depresivnost [OR=0,930 (95%), CI=0,830-0,990], vegetativni poremecaji [OR=0,855 (95%), CI=0,850- 1,155], inkorporacija [OR=0,835 (95%), CI=0,870-1,115] i lisavanje [OR=0,845 (95%),CI=0,7925-1,255] na P.I.E. testu. Zakljucak. Studija prikazuje porodicne i druge mikrosocijalne razlike. Visok je skor destrukcije nasilnika na psiholoskim testovima, sto daje psihopataloski sadržaj: poremecaj licnosti, rjeđe lica sa upotrebom psihoaktivnih supstanci. Forenzicki znacaj, osim ekspertize, cine i preporuke u tretmanu nasilnika i recidivantnih.

The goal: The goal of this work was to give advantage to EUS as endoscopic method in diagnosis and following therapeutic treatment of pancreatic cancer in relation to radiological methods of CT and CTA. Material and Methods: The study included 49 patients, 20 women and 29 men hospitalized at the Clinic for gastroenterohepatology, due to suspicion on pancreatic cancer during observed 2 years period. All cancers were histologically and cytologically confirmed. The patients underwent ERCP as a mandatory part of staging and all patients underwent endoscopic ultrasound as well as CT or CT angiography. Results: Testing of differences was carried out using Fisher’s exact test in open-source software R. The following characteristics were tested: involvement of the blood vessels, lymph nodes, metastases, tumor size and duodenum infiltration. Results showed statistically significant difference at the 0.05 level for EUS, CT and CT angiography. Risk ratio showed that EUS is less effective in detecting infiltration of blood vessels within a malignant process then CTA where RR=0.52, CI 0.2–1.38, p-value=0.33. EUS and CTA are equal in the diagnosis of enlarged lymph nodes affected by malignancy where RR=1.3, CI 0.75–1.42, p-value=0.09. Comparison according to distant metastases showed that EUS is less effective compared to CT in approximately 30% of cases. In the diagnosis of duodenal infiltration EUS is in 5% of cases less accurate than the CT with the RR=0.95, CI 0.27–3.32, p-value=0.76, but the CTA method is more efficient because the comparison of EUS and CTA showed RR=12.52, CI 0.2–1.38, p-value=0.33. EUS as a diagnostic method is dominant in determining the size of malignant lesions located in the pancreas as compared to CT and CTA. Conclusion: EUS as endoscopic method compared to CT and CTA is one of the more invasive methods of examination but due to its ability to be performed immediately, to locate a changes smaller than 5 mm and the target biopsy option, to measure the change and that in many cases determine the relationship of malignant lesions with blood vessels, along with visualization of the surrounding lymph nodes and metastases in neighboring organs, we may give this method an advantage over other methods in the preoperative staging of patients with pancreatic cancer.