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Anđić belongs to that group of playwrights who are trying to preserve the tradition of literary continuity and to topicalize modern political pragma-tism (totalitarian rule and the general political character of life).Unlike previous romantic historical dramas, built on the contrast of these two historical figures (Omer-pasha Latas and Ivan Franjo Jukić), Anđić establishes a similar contrast, but his deconstruction of the hero is adapted to modern theatre, so he displays them as irrefutable evidence that the basic problem pressing them both is the totalitarian rule. The idealistic enthusiasm of young Jukić is shattered and he becomes aware that nobody is free to decide, that everything is predetermined, and that we are all merely puppets in political games. This historical drama text is at the same time the most profound comment about a man who is forced to live as a political animal, realizing that everyone is at a loss in this dirty game of existence.

M. Banovic, B. Vujisić-Tešić, V. Kujacic, S. Obradovic, Z. Crkvenac, M. Ostojić

BACKGROUND/AIM Early detection of left ventricle (LV) systolic dysfunction could be a clue for surgical treatment in patients with significant aortic stenosis (AS). Therefore, we evaluated LV peak of global longitudinal strain (PGLS) using speckle tracking imaging at rest and during low-dose dobutamine infusion in asymptomatic patients with moderate and severe AS and preserved LV ejection fraction (EF). METHODS All the patients underwent coronary angiography and had no obstructive coronary disease (defined as having no stenosis greater than 50% in diameter). The patients were divided into two groups: above and below median of 0.785 cm2 aortic valve area (AVA). PGLS was measured from acquired apical 4-chamber and 2-chamber cine loops using a EchoPac PC-workstation at rest and during 5 microg/kg/min, 10 microg/kg/min, and 20 microg/kg/min dobutamine infusion, respectively. The global strain was the average of segment strains from the apical views. RESULTS A total of 62 patients with moderate and severe AS (AVA < = 1.5 cm2), the mean age 66.12 +/- 9.91, (57.14% males), were enrolled in this prospective study. At rest, mean gradient was 43.57 +/- 0.29 mmHg and mean EF was 72.24 +/- 0.45%. When divided according to median AVA, both groups had decreased average PGLS at rest (-9.33 +/- 4.46% vs -8.95 +/- 3.08%; p = ns). During dobutamine both groups increased their average PGLS, but only the group with AVA > median reached the statistical significance (- 8.71 +/- 2.68% vs -11.93 +/- 3.74%, p = 0.002). In addition, PGLS increase was also significant in 4-chamber view in the patients with AVA above median, but only when comparing baseline to peak 20 microg/kg/min (-10.72 +/- 3.07% vs -13.14 +/- 4.79%; p = 0.034). Conversely, in both groups the increase of PGLS in 2-chamber view did not reach significance. CONCLUSION Two-dimensional strain speckle tracking analysis of myocardial deformation with measurement of peak systolic strain during dobutamine infusion is a feasible and accurate method to determine myocardial longitudinal systolic function and contractile reserve and may contribute to clinical decision making in patients with significant AS.

Muhamed Ibrahimović, Edisa Puška, A. Puška

Posao učitelja ili nastavnika kao profesionalca, odgajatelja, pedagoga i čovjeka, svakodnevno je podložan brojnim izazovima i preprekama tokom njegove karijere. Pojavom novih znanja i tehnologija, sam nastavnik je suprotstavljen sve težim izazovima u svom profesionalnom radu, jer se od njega očekuje da bude savremen, svestran i da ima povjerenje u sebe, a i prvenstveno u svoj profesionalni rad. Kako nauka i tehnologija napreduju, raste i znatiželja učenika, ne samo u oblasti iz nastavnih pred- meta, nego i iz svih područja, prvenstveno iz oblasti tehnologije i nauke, a i o životu uopšte. Ovaj napredak traži od nastavnika da i on napreduje i da bude savremen tj. da njegove nastavne metode budu na najnovijem standardu i da njegov pristup radu ne bude jednoličan i da ne zastarjeva. Da bi nastavnik bio siguran da je njegov profesionalni rad savremen, on može primjeniti brojne metode samostalnog provjeravanja i napredovanja. Jedan veoma efikasan način je putem akcionog istraživanja. Cilj ovog rada je da objasni pojam i značaj akcionog istraživanja u nastavi, faze i načine njegovog sprovođenja, te da kroz primjere demonstrira kakve prednosti nastavnik može putem njega ostvariti i kako mu ono može pomoći da napreduje i poboljša radnu praksu i pridijeliti mu ulogu učenika.

G. Pezzulo, M. Candidi, H. Dindo, Laura Barca

ABSTRACT At the Clinic of Gynecology and Obstetrics, Clinical Center University of Sarajevo there is a trend of increasing number of cesarean deliveries in the last 15 years. Material and methods: During the 2012 percentage of Caesarean sections was 35 %, which represents a true pandemic in obstetrics profession and all scientific postulates are threatened by these practices. Of the total number of vaginal births only 48 deliveries were after previous cesarean section. Of the total number of subjects in which the delivery is completed vaginally after a previous cesarean delivery in 5 (10.42 %) was used vacuum extraction, forceps was not used, while manual exploration of the uterus in order to check the condition of the scar of a previous cesarean section was performed in 32 (66.67%) cases. Results and discussion: The largest number of respondents who were surveyed were at age from 31 – 35 years (n=25), followed by group between 26-30 years (39.58%). The analysis of complications of vaginal birth after Caesarean delivery revealed that 93.75 % of the patients did not have any complications, at 4.17 % occured postpartum hemorrhage and in one patient febrile condition. Birth after cesarean delivery can be successfully completed vaginally, with a careful application of prostaglandins, with a good estimate of an experienced obstetrician, and adequate conditions to complete delivery by caesarean section if a vaginal birth is not going in the right direction and as planned.

ABSTRACT Introduction: Postmenopausal uterine bleeding is a „cancer until proven otherwise”. Endometrial cancer is a typical disease among postmenopause woman, because every bleeding in this age etiology associated with endometrial cancer (10-30%). The lifespan of women today has been extended and post menopause today last one third of a woman’s life. Early diagnosis of endometrial cancer has a very high cure rate. Screening for this cancer has limits in practice and is necessary given the definition of high-risk groups would be subject to primary and secondary prevention. Goal: Primary to evaluate the leading causes of postmenopausal uterine bleeding among patients at risk for endometrial cancer (diabetes, obesity, nulliparity, late menopause (after 55 years) and compared them with the causes of postmenopausal uterine bleeding patients without this risk. Material and methods: A retrospective, descriptive study with a targeted sample of 50 consecutive patients who had registered postmenopausal uterine bleeding in high-risk groups (cohorts) and the same number of patients with postmenopausal uterine bleeding that does not belong to the risk group (control group). Each patient underwent clinical examination, then fractionated curettements and its histopathological verification and assessment of treated clinical stage of disease with PH analysis of the resected specimens. Results: The patients of the studied risk group were significantly affected by endometrial cancer compared with the control group (RR=2.45, 95% CI 1.2 4.6, p=0.005). Endocervical pathology did not differ between groups. Clinical forms of bleeding: for those that are profuse bleeding cancer was present in 54.6% of cases. With intermittent bleeding cancer is verified in the 33.3% of patients. Risk patient groups with cancer frequently suffer from clinically more advanced stages of histologically aggressive endometrial cancer (serous adenocarcinoma–type II, low differentiated cancer).

Introduction: The aim of prenatal diagnosis is to detect fetal structural and genetic abnormalities. Used are different medical methods, procedures, processes and techniques. For this reason we can speak about the prevention and detection of hereditary diseases and congenital anomalies in the unborn fetus. Material and methods: The authors analyzed the results of early amniocentesis tests performed during 2009 in Institute for Gynecology, Infertility and Perinatology “Mehmedbasic” in Sarajevo. Performed is 299 analysis of amniotic fluid after amnion puncture done in the Institute or at the Clinic of Gynecology and Obstetrics (GAK) Sarajevo. Results and Discussion: Indications for the performance of early amniocentesis were: age greater over 35 (84.9%), positive ultrasound markers (1.6%), positive biochemical markers (5.6%) and positive family history for hereditary diseases (7.9%). Detected was 19 pathological cariograms or very high 7% of the total annual number of amniocentesis. An analysis of the distribution of pregnant women in relation to the indication of the result of cytogenetic analysis for each table made positive predictive value (PPV). For indicator age PPV was 0.11, 0.66 for ultrasound markers, for biochemical markers 0.13, for other indications–0.04. The logistic regression model (odds -ratio 11.234 ) indicate a positive ultrasound findings in relation to the year indicates that the risk to gain abnormal fetal karyotype 13 times higher when using only age as an indication for early amniocentesis. Of the 19 pathological cariogram largest number refers to M.Down (10), Sy. Edwards was detected in 2 patients, Sy. Klinefelter in 3, mosaicism in 3 and translocation gene in two of the fetus. Conclusion: The authors would like to acknowledge a very high percentage of pathological cariogram risk groups, the extension of indications for RAC indicate the value of ultrasound markers as a good screening methods and the need for social incentives to perform screening tests and early amniocentesis in B&H in order to prevent genetic abnormalities.

ABSTRACT Aim of the work: Examine clinical characteristics of aerobic vaginitis and mixed infection for the purpose of better diagnostic accuracy and treatment efficiency. Materials and methods: Prospective research has been conducted at Clinic for Gynecology and Obstetrics, Department for Microbiology and Pathology at Polyclinic for laboratory diagnostic and Gynecology and Obstetrics Department at Health Center Sapna. Examination included 100 examinees with the signs of vaginitis. Examination consisted of: anamnesis, clinical, gynecological and microbiological examination of vaginal smear. Results: The average age of the examinees was 32,62±2,6. Examining vaginal smears of the examinees with signs of vaginitis in 96% (N-96) different microorganisms have been isolated, while in 4% (N-4) findings were normal. AV has been found in 51% (N-51) of the examinees, Candida albicans in 17% (N-17), BV in 15% (N-15), Trichomonas vaginalis in 13% (N-13). In 21% (N-21) AV was diagnosed alone while associated with other agents in 30% (N-30). Most common causes of AV are E. coli (N-55) and E. faecalis (N-52). AV and Candida albicanis have been found in (13/30, 43%), Trichomonas vaginalis in (9/30, 30%) and BV (8/30, 26%). Vaginal secretion is in 70,05% (N-36) yellow coloured, red vagina wall is recorded in 31,13% (N-16) and pruritus in 72,54% (N-37). Increased pH value of vagina found in 94,10% (N-48). The average pH value of vaginal environment was 5,15±0,54 and in associated presence of AV and VVC, TV and BV was 5,29±0,56 which is higher value considering presence of AV alone but that is not statistically significant difference (p>0,05). Amino-odor test was positive in 29,94% (N-15) of associated infections. Lactobacilli are absent, while leukocytes are increased in 100% (N-51) of the examinees with AV. Conclusion: AV is vaginal infection similar to other vaginal infections. It is important to be careful while diagnosing because the treatment of AV differentiates from treatment of other vaginitis.

Introduction: Periodontal disease belongs to a group of diseases with more than one cause, it is a disease of a multifactorial etiology. Although bacteria are the main cause of the disease, immunoinflammatory reaction of the host is responsible for the majority of destructive changes in periodontal tissue. The main issue in the evaluation of the success of periodontal therapy is the pluralism of the bacteria and their dynamic changes during the duration, on the one hand, and the possible inaccuracy of classical microbiological analysis in determination of the dominant role of a microorganism, or the success of its reduction or elimination, on the other. Thanks to advances of microbiology and technological development, it is possible to make an assessment of specific microorganisms in a large number of samples of sub-gingival plaque with extreme precision, using checkerboard DNA-DNA hybridization and method of polymerase chain reaction (PCR). The development of laser technology and the discovery of its significant antimicrobial effects have introduced and presented this treatment modality as a possible auxiliary method of periodontitis treatment. Materials and Methods: The sample for the study estimating the efficiency of application of diode lasers in the reduction of periodontal pockets consisted of 1164 periodontal pockets in 24 subjects of both sexes. For laser irradiation of periodontal pockets a diode laser was used, a low-power laser (SmilePro 980, Biolitec, Germany), working in a mode precisely tuned for treatment of periodontal pockets. All subjects underwent: general anamnesis, periodontal status, and orthopantogram radiograph analysis. Following a standard periodontal preparation, a sample of subgingival plaque was collected for molecular-biological analysis (real-time PCR method) prior to laser irradiation of periodontal pockets, immediately following the irradiation, and during the control examination 3 months after irradiation. Results: The results of the molecular-biological analysis of target periodontal pathogens Actinobacillus (Aggregatibacter) actinomycetemcomitans (AA) and Porphyromonas gingivalis (PG) isolated from periodontal pockets prior to laser irradiation, immediately after laser irradiation, and at the control examination after 3 months were processed statistically (using real-time PCR method). The results showed that there was a statistically significant decrease in CT values for the tested bacteria immediately after treatment and the control examination, compared with the level of CT values for the same bacteria before treatment. Conclusions: Based on the obtained results, we concluded that diode laser irradiation reduces the number of active periodontal pathogens. We believe that the use of diode lasers, as a supplementary method in the treatment of periodontal disease, is extremely useful and efficient, and can be recommended as part of standard clinical practice.

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