Introduction: The goal of this article is to present that innovating in health care begins to become an imperative in present time. Innovating will enable the achievement of the highest quality health care results and the patients' satisfaction with the least amount of financial resources.Methods: The thorough literature review of multifaceted sources was conducted including: studies, books, monographies and peer – reviewed journals with the goal of achieving the clearer picture of today's modern challenges in the complex fi eld of health care innovation.Discussion: Theoretical and empirical studies clearly indicate that the innovation is one of the key factors in the competitiveness of the organization and its survival in the market. Developed countries of the world today are making significant efforts in order for innovation to become a national priority, with special emphasis placed on measuring innovation performance. Results of theoretical and practical studies show that in the future, treatment of the most diffi cult and complex diseases of our time, through the entirely new discoveries and results, derived from the process of innovation, will project entirely new positive forms and outcomes in the health care.Conclusion: There is no doubt that the humanity and medical science will through innovation succeed to win the battles against the majority of the most complex contemporary diseases. Malignant neoplasm of tomorrow, through the application of a new, innovative approaches to research, processes and treatments will become a chronic diseases. Among many, the particular problem in the process of innovation will represent the cost of research and development (R&D), production and the safety of prescription drugs.

As technology feature sizes shrink, aggressive voltage scaling is required to contain power density. However, this also increases the rate of transient upsets -- potentially preventing us from scaling down voltage and possibly even requiring voltage increases to maintain reliability. Duplication with checking and triple-modular redundancy are traditional approaches to combat transient errors, but spending 2-3x the energy for redundant computation can diminish or reverse the benefits of voltage scaling. As an alternative, we explore the opportunity to use checking computations that are cheaper than the base computation they are guarding. We identify and evaluate the effectiveness of lightweight checks in a broad set of common FPGA tasks in scientific computing and signal and image processing. We find that the lightweight checks cost less than 14% of the base computation. Using an exponential model for the relationship between voltage and transient upset rate, we are able to show over 80% net energy reduction by aggressive voltage scaling without compromising reliability compared to operation at the nominal voltage.

Introduction: The estrogen defi ciency after menopause leads to accelerated loss of bone mass. The aim of this study was to examine influence of physical activity on bone mineral density in postmenopausal women who hadn’t a deficit of estrogen in their menstrual history.Methods: This prospective study included 100 postmenopausal women, ages between 50 and 65, living in Sarajevo area without estrogen deficiency in menstrual history. The women in the examination group had osteoporosis. The women in the control group had osteopenia or normal mineral bone density. Mineral bone density was measured at the lumbar spine and proximal femur by Dual–Energy X–ray Absorptiometry using Hologic QDR-4000 scanner. To assess level of physical activity an International Physical Activity Questionnaire - Long Form was used.Results: In the examination group of women who had no history of menstrual estrogen deficit, level of physical activity was low in 52.00% female, and in 48.00% women level of physical activity was moderate. In the control group of women who had no history of menstrual estrogen defi cit in 10.00% female level of physical activity was low, and in 90.00% female level of physical activity was moderate. The difference in levels of physical activity between the two groups was statistically significant, X2 test = 20.6, p <0.005.Conclusion: Results of this study suggest that moderate physical activity has positive impact on bone mineral density in postmenopausal women without estrogen defi ciency in menstrual history and has the potential to reduce rapid bone loss after menopause.

Introduction: Oxidative stress represents a pathophysiological mechanism lying behind occurrence of different acute and chronic diseases. Pregnancy, mainly due to placenta rich with mitochondria, is also being associated with the state of oxidative stress. Numerous markers have been proposed in order to test oxidative stress in pregnancy state, one of them being 8-isoprostane. The aim of this study was to analyse serum concentrations of 8-isoprostane as a possible oxidative stress marker in pregnancy.Methods: Serum concentrations of 8-isoprostane were measured in overall population of 84 woman, between 20 and 30 years of age. Tested population was divided in 2 groups: 42 pregnant woman were classifi ed as being either in the fi rst or second trimester of pregnancy. In the control group healthy nonpregnant women were included. Concentration of 8-isoprostane in serum was determined by commercial 8-isoprostane EIA test kit of Cayman Chemical Company, USA.Results: The 8-isoprostane levels were signifi cantly increased in pregnant women in relation to healthy non pregnant women (p<0.05). The 8-isoprostane levels were signifi cantly increased in second and third trimester of pregnancy (p<0.05).Conclusions: According to the obtained results, 8-isoprostane might be used as a possible marker of oxidative stress in pregnancy state, but not as a biomarker for the risk of complications development in pregnancy in analysed population.

Introduction : One of the most important priorities in therapy is pain control. Therefore, many different groups of drugs are being used for this purpose, primarily opioid analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Opioid analgesic tramadol, by binding to specific receptors, modulates the perception and response to painful stimuli and inhibits transmitting and further processing of pain impulses. Lornoxicam, which belongs to the oxicam class of NSAIDs, is a non-selective cyclooxygenase inhibitor with strong analgesic and anti-inflammatory effects, and better tolerance profile. Preliminary research, which requires further verification, suggests that lornoxicam may be a better alternative or adjunctive therapy to opioid analgesics in the treatment of moderate to severe pain. The aim of this study was to investigate antinociceptive effects of lornoxicam, as well as the combination of lornoxicam with tramadol. Methods : Analgesic effect of combination of lornoxicam and tramadol or lornoxicam applied alone was examined on female albino mice, using a hot plate method. Measurements were made 30, 60, 90 and 120 minutes after intraperitoneal and subcutaneous administration, in dose of 10 mg/kg. Results: Combination of lornoxicam and tramadol, applied intraperitoneally, increases the threshold of sensitivity to painful stimuli, which was not the case with subcutaneous administration. Conclusions: Lornoxicam significantly increases analgesic effect when applied intraperitoneally in combination with tramadol. On the other hand, lornoxicam in combination with tramadol, did not increase the threshold of sensitivity to painful stimuli with significant difference, after subcutaneous administration

Introduction: The aim of this study is to determine prevalence of oral diseases and oral surgical procedures at Department of Oral Surgery, Faculty of Dental Medicine, University in Sarajevo.Methods: The current study is retrospective analysis of oral surgical procedures performed from January 2011 to December 2012 at Department of Oral Surgery, Faculty of Dental Medicine, University in Sarajevo. The data were statistically analyzed by T-test of independent samples and using Chi-squared test. P value lower than 0,001 was considered to be statistically significant.Results: A total of 1299 patients were included in study. The age range is from 18 to 84 years, with mean age ± SD= 35±15 years. There were 42 different clinical diagnoses, and 13 diagnoses appeared in more than 1% of all patients. Impacted and semi-impacted teeth, periapical lesions and retained roots are the most frequent diagnoses and represent 68% of all diagnoses. Embedded and impacted teeth (35%) and diseases of pulp and periapical tissues (31%) are the most frequent diagnoses with respect of ICD-10. Impacted teeth is the most common diagnosis and removal of impacted third molars is the most common oral surgical procedure.Conclusion: Study points out variety of dentoalveolar patology and complexity of dental health care that often requires interdisciplinary approach in order to achieve optimal outcome for patient.

O objetivo do trabalho foi investigar associacoes entre as atitudes em relacao a matematica e o desempenho na disciplina de alunos do 6o ano do Ensino Fundamental. Participaram 37 escolares com idades entre 10 e 14 anos. Utilizou-se a Escala de Atitudes em Relacao a Matematica (EARM) para avaliar as atitudes dos alunos em relacao a disciplina. O desempenho na disciplina de Matematica foi investigado a partir da media das notas dos tres primeiros bimestres. As meninas apresentaram medias superiores aos meninos tanto na EARM quanto no desempenho. O teste de correlacao de Spearman apontou correlacao positiva e moderada. Quando tal associacao foi analisada separadamente, observou-se que nos meninos a correlacao foi fraca ( ro=0,343 ), enquanto que as meninas encontrou-se forte ( ro=0,758 ). Os achados evidenciam uma relacao positiva entre as atitudes em relacao a Matematica e o desempenho escolar na disciplina.

Introduction: A person’s response and functioning under condition of stress and confl ict is fundamentally different from its usual behavior. Aim: To point out what type of attitude toward the management of healthcare institutions is worth developing as well as to determine which psychological dimensions of employed the best refl ect the efficacy of the management.Methods: The study included a sample of 52 subjects employed at the Clinical center at University of Sarajevo and 64 subjects employed in Healthcare clinic in Sarajevo Canton. Survey method and a method of a theoretical analysis were used in the data collection and processing.Results: The study concluded that there is no statistically significant gender difference in attitude about the value of talent development at managerial level as a factor in development of attitude toward communicationin healthcare. We find t-value of 2,213 for the Clinical center at University of Sarajevo and 2,210 for Healthcare clinic in Sarajevo Canton.Conclusion: No statistically significant results have been found for any of the factors considered in the study with respect to the gender differences.

Introduction: Injury during peripheral nerve blocks is relatively uncommon, but potentially devastating complication. Recent studies emphasized that location of needle insertion in relationship to the fascicles may be the predominant factor that determines the risk for neurologic complications. However, it is wellestablished that concentration of local anesthetic is also associated with the risk for injury. In this study, we examined the effect of location of injection and concentration of Ropivacaine on risk for neurologic complications. Our hypothesis is that location of the injection is more prognostic for occurrence of nerve injury than the concentration of Ropivacaine.Methods: In experimental design of the study fi fty Wistar rats were used and sciatic nerves were randomized to receive: Ropivacaine or 0.9% NaCl, either intraneurally or perineurally. Pressure data during application was acquired by using a manometer and was analyzed using software package BioBench. Neurologic examination was performed thought the following seven days, there after the rats were sacrificed while sciatic nerves were extracted for histological examination.Results: Independently of tested solution intraneural injections in most of cases resulted with high injection pressure, followed by obvious neurologic defi cit and microscopic destruction of peripheral nerves. Also, low injection pressure, applied either in perineural or intraneural extrafascicular area, resulted with transitory neurologic defi cit and without destruction of the nerve normal histological structure.Conclusions: The main mechanism which leads to neurologic injury combined with peripheral nerve blockade is intrafascicular injection. Higher concentrations of Ropivacaine during intrafascicular applications magnify nerve injury.

Introduction: Postponed recuperation from anesthesia can lead to different complications such as apnoea, aspiration of gastric content whit consequent development of aspiration pneumonia, laryngospasm, bradycardia, and hypoxia. Aim of this research was to determine infl uence of propofol, sevoflurane and isoflurane anesthesia on post anesthesia recovery rate.Methods: This was a prospective study; it included 90 patients hospitalized in period form October 2011 to may 2012 year, all patients included in the study underwent lumbar microdiscectomy surgery. Patients were randomly allocated to one of three groups: group 1: propofol maintained anesthesia, group 2: sevoflurane and group 3: isofl urane maintained anesthesia. Assessments of recovery rate were done 1, 5 and 10 minutes post extubation using White fast tracking scoring system.Results: Significant difference was observed only 1 minute after extubation (p=0,025) finding recovery rate to be superior in propofol group. Propofol group compared to inhaled anesthesia with sevoflurane group, shows significantly faster recovery from anesthesia only one minute after extubation (p=0,046). In comparison of propofol group and isofl urane anesthesia group, statistical significance was noticed one minute following extubation (p=0,008). Comparison of propofol group and inhaled anesthesia groups recovery rates were not significantly different at all times measured. When we were comparing sevoflurane and isoflurane anesthesia, recovery rates shoved no signifi cant statistical difference.Conclusions: Recovery rate evaluated by using White fast tracking scoring system was superior and with fewer complications in propofol maintained in comparison to sevoflurane and isoflurane maintained anesthesia only one minute post extubation, while after fifth and tenth minute difference was lost.

Introduction: The aim of the study was determining the type of weapon and shooting distance depending on chemical analysis of inorganic gunshot residue from the skin gunshot wounds in experimental animals (pigs).Methods: Experimental study was conducted in order to determine components and their percentage in gunshot residue (GSR). In 60 samples, pig skin was shot by fi ring projectiles from four different weapons and from three different distances (contact wound and near contact wound from 5 cm and 10 cm). The methodology included determining the presence of inorganic material: antimony, barium, lead, nickel, zinc and copper in the skin and subcutaneous tissue using atomic absorption spectrophotometry (AAS).Results: Formula for determining weapon type was provided cutt-off points for different weapons, with 78.6% of original grouped cases being correctly classifi ed. Formula for determining weapon type was provided cutt-off points for different distances, with 58.9% of original grouped cases being correctly classified, which was slightly less reliable compared to weapon type discrimination analysis.Conclusion: The presented study showed that chemical analysis of GSR in entrance wound with AAS could be useful in determining the type of weapon, as well as the shooting distance, i.e. in our study, determiningwhether the wound is contact or near contact. This could be particularly useful in postmortally putrefi ed or charred bodies with gunshot wounds.

Introduction: Air pollution occurs when the concentration of certain substances (pollutants) reaches a size which causes its toxicity, or in other words, begins to cause harm to human health, fl ora and wildlife.Methods: Measurements were performed in the period from 2005 to 2010, at the measuring point Bjelave-Sarajevo by the method of Griess-Saltzmann. It encompasses the following parameters: NO, NO2, NOx, measured concentrations of pollutants in the atmosphere reduced to normal atmospheric conditions of 293 K (Kelvin) and pressure of 101.3 kPa (kilopascal).Results: NO concentration in the period from 2005 to 2008 was above the permitted value, but the results of research in the period between 2009 and 2010, have shown that there was a decrease in NO concentration in the atmosphere. Measurements show that the concentration of this pollutant is currently declining, which is a positive result compared to the pollution of the atmosphere by nitrogen monoxide. Furthermore, the results of the research showed that the concentration of NO2 for the period of 2005 to 2010, is in the limited values, and that has a decreasing trend, which is also a positive result compared to the pollution of the atmosphere by nitrogen dioxide. Related to the total concentration of NOx in the atmosphere, the results of the research show that their representation corresponds to the limit values existing in the Rulebook on limit values for air quality.Conclusion: The results of the research for the pollution of the atmosphere by nitrogen oxides in the investigated area show that the amount of nitrogen oxides in the atmosphere is in constant decline.