The aim of this prospective study was to evaluate and compare the relative increase of serum myoglobin level and total creatine kinase (CK) activity in acute myocardial infarction (AMI) patients (n=36). We measured serial changes in total CK activity and myoglobin serum level in three-time periods (6-9 hours, 24 hours and 6-7 days) from chest pains onset. Myoglobin peaked during the first 6-9 hours but total CK reached its peak activity after 24 hours from AMI symptoms onset. Results of this study showed that as non-specific cardiac marker myoglobin had better sensitivity and earlier rise in serum than total CK activity in AMI patients. Rapid kinetic of myoglobin level is important for its utility as marker for re-infarction diagnosis. Early myoglobin increase in serum is important for early triage of AMI patients and early "ruling out" of AMI diagnosis if there is no evidence of its elevation in circulation.

Over the past 13 years mitochondrial defects have been involved in wide variety of degenerative diseases - Parkinson disease, Alzheimer dementia, arteriosclerosis, ageing and cancer. Mitochondria are believed to control apoptosis or programmed cell death. Disturbance in mitochondrial metabolism has also been implicated in many common diseases such as congestive hart failure, diabetes and migraine. Scientific investigations have showed complexities in mitochondrial genetics, but at the same time, pathophysiology of mitochondrial diseases is still enigma. Mitochondria and their DNAs are opening the era of "mitochondrial medicine". What we today call "a mitochondrial medicine" is only a part of the whole panorama of diseases based on disordered mitochondrial function.

Angiotensin converting enzyme (ACE) and nitric oxide (NO) have been suggested to be involved in the regulation of fluid homeostasis. In the present investigation, ACE activity and NO levels were determined in serum of 20 patients (10 men and 10 women) with dehydration caused by gastroenterocolitis and 20 healthy individuals (10 men and 10 women). Serum and tissue ACE activity was determined by spectrophotometric method using hippuryl-l-histidyl-l-leucine (Hip-His-Leu) as a substrate. NO synthesis was determined by measuring the products of NO, nitrite and nitrate. The concentration of nitrites was determined by classic colorimetric method using Griess reagent. Nitrate concentration was determined indirectly by their reduction with elementary zinc into nitrite. Results have shown that serum ACE activity in patients with dehydration (36,46+/-2,74 U/L) is statistically higher then in healthy individuals (28,71+/-1,77 U/L, p<0,05). The average level of nitrites/nitrates in serum of patients with dehydration (30,57+/-1,05 microM; mean +/- SEM) is also statistically higher then in healthy individuals (12,44+/-0,60 microM, p<0,0001). There was no correlation between ACE activity and NO production. The results indicate that ACE and NO may participate in the regulation of the alteration in blood flow and in the regulation of the water balance in patients with dehydration.

There is no such science as medicine where half life is 7 years, what means that in 3-4 years 50% of current knowledge will be wrong. If doctors use old techniques and methods then they will cure patients wrongly. Very fast and rapid increase of biomedical sciences and medical information in certain way force medical professionals to continuity learning in order to stay update. In this project a quantitative method of examination has been used. For the purposes of the research a survey questionnaires were created consisted of 28, 35 and 18 questions for all three groups of examinees. Beside general characteristics (sex, age, faculty, and year of studies) the questionnaire included questions referring to the variables of structure, process and results in the system of education. Authors used Lickert five degree scale for the evaluation. Total of 521 students of the faculties of biomedical science in Sarajevo were surveyed; students of the Faculty of Medicine, Faculty of Dental Medicine (Stomatology), Faculty of Pharmacy, Nursing College, students of final year and postgraduate students from Faculty of Medicine, University of Sarajevo. On the basis of survey results authors concluded that the following should be done: The reform needs to be carried out in accordance with possibilities and needs, general faculty rules should include regulations that refer to insuring the quality of education, a continuous quality of studying needs to be insured - internal and external evaluation of the quality of work of respective education institution needs to be carried out, education standards need to be set, i.e. minimum knowledge and skills which a student needs to gain during studies is to be set, curriculums and programs need to be harmonized with countries in the region and Western Europe, Regular evaluation of lecturers needs to be done, Increase of size and content of the practical part of teaching needs to be encouraged as well as distance learning organized on Cathedra for Medical Informatics and Family Medicine at Faculty of Medicine in Sarajevo, increase of international and regional mobility of students needs to be encouraged, students need to be included in the faculty reform, panel discussions need to be organized where students will be informed on the reform progress, where students can talk about their problems, give suggestions and solutions to certain situations. Students are motivated to study further when their ideas are accepted, the number of books in libraries needs to increase in accordance with financial possibilities and audio/visual and electronic aids need to be purchased and in place. Concept of quality incorporates at least three dimensions and has three different meanings. Those are: - Comparative meaning in terms of the level of perfectionist, - Quantitative meaning in terms of the level accessed and - Appropriateness for certain purpose. Objective of this study is to begin process of improvement of educational process at biomedical faculties at University of Sarajevo, but ultimate goal of all involved in medical education should be large number of health professionals who will be able to work independently and cure patients in best manner in 21st century.

Diagnosis and management of patients with SLE (Systemic Lupus Eritematosus), autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), involves specific diagnostic tests, such as IFA-AMA, IFA anti-dsDNA and immunoblotting for the detection of autoantibodies for specific autoantigens (mitochondria, dsDNA, M2, LKM-1, LC-1, SLA/LP). We established specific correlation between the detected autoantibodies and corresponding clinical findings. The total of 813 serum specimens were probed with IFA-anti-dsDNA, 98 of which tested positive. We also performed dilution analysis to the end point for all the positive specimens. Numerous specimens were tested by IFA, AMA and immunoblotting.

This describes the indivisible anastomosis of the main stem of median nerve with ulnar nerve through cubital tunnel followed by the anomaly of ulnar artery that appears as superficial ulnar artery. Both anomalies are found during the anatomical dissection of a grown-up male cadaver, on his right arm. Such case is very rare as, in the literature available to us, it has not been described.

The current animal health situation in Bosnia and Herzegovina requires the prioritization of diseases for the application of control measures. One of the diseases requiring high priority is brucellosis of ruminants. Brucellosis is a zoonotic infectious disease and one of the most important zoonoses in the world. Brucellosis has been recognized during the past five decades as an important infectious disease in ruminants in Bosnia and Herzegovina. Control and eradication of brucellosis in animals is based on test and slaughter control policy. When the existing brucellosis control program was instituted, the veterinary and animal production sector was almost exclusively owned by the government, an arrangement that promoted compliance with the program and resulted in the successful control of the disease. This paper provides an overview of the current institutional and legislative framework for brucellosis control including the laboratory detection system and the epidemiological status of brucellosis in ruminants in Bosnia and Herzegovina. Relevant data were collected during the period spanning from the beginning of 2001 until the middle of 2007. Data we collected reveal an increase in the number of reported outbreaks in ruminants as well as a related increase in the number of human cases. This has brought serious consequences to public health, animal health and production and international trade.

The purpose of this work is to analyze the frequency of depression and anxiety and children behaviour in families whose heads of the family (father) suffer from post-traumatic stress disorder (PTSD). The study was conducted from September 2005 until July 2006, with patients living in Mostar. The frequency of depression and anxiety in family members older than 18 years, and changes of the behaviour in children younger than 18 years of age were measured. The data were collected from 60 men and their families who had been diagnosed with PTSD by their psychiatrist. The control group was formed using matching criteria (age of the head of the family, his education, religion, family income and number of children). In this study, three questionnaires were used: one specially designed for this study, covering general information about family members, and a personal opinion of each family member about the family situation and relations within the family; Hopkins symptoms checklist - 25 (HSCL-25) for evaluation of depression and anxiety for subjects older than 18; and General Health Questionnaire (GHQ) for children 5 to 18 years of age, which was completed by their mothers. More wives from the PTSD families had depression than wives from the controlled group (chi2=21,099; df=1; P<0,050). There was no difference between groups in frequency of depression and anxiety (chi2=0,003; df=1; P=0,959) for children older than 18 years. No difference in answers between groups of children younger than 18 years were found in the General Health Questionnaire. However, we found significant differences in separate questions. Mothers, who filled the questionnaire form, reported that children from fathers who had PTSD experienced stomach pain more often (chi2=10,474;df=2; P=0,005), eating problems (chi2=14,204;df=2; P=0,001) and breathing problems (chi2=9,748;df=2; P=0,008), than children from fathers who did not have PTSD. Children from fathers with PTSD were more easily upset (chi2=7,586; df=2; P=0,023) and worried more often (chi2=12,093; df=2; P=0,002), they were also more aggressive towards other children (chi2=6,156; df=1; P=0,013). The controlled group of children who wanted to help with the house work was larger than the tested group (chi2=10,383; df=2; P=0,006). More children from the controlled group missed school than from the other group of surveyed children (chi2=6,056; df=2; P=0,048). A significantly larger number of women, whose husbands had PTSD, were depressed, unlike women whose husbands were not ill. There was no significant difference in depression manifestation in a group of children older than 18, as well as in behaviour of a group of children younger than 18, but significant differences in some provided answers were found, that indicate the differences between controlled and tested groups.

The aim of this study was to analyze: frequency of balance disorder (vertigo and disequilibrium), frequency of abnormalities in auditory evoked potentials (AEP) and magnetic resonance imaging (MRI) changes of the brain in multiple sclerosis (MS) patients with balance disorder, relation of patient's disability status to balance disorder and relation of the changes in MRI of the brainstem to AEP abnormalities. It was analyzed 60 patients with relapsing-remitting form of MS. Two groups of patients were made consecutively under Expanded Disability Status Scale score (EDSS): A (EDSS < or =4,5) and B (EDSS > or =5,0). The study was retrospective-prospective. After the neurological exam AEP and MRI of the brain have been done. Balance disorder has been verified as initial symptom in 29 (48,4%) and out of them disequilibrium experienced 24 (83,4%) patients. During the relapses balance disorder experienced 48 (80%) patients and in 37 (77,1%) it was disequilibrium. Among them 33 (68,7%) were with lower EDSS (< or =4,5) and 15 (31,3%) with higher EDSS score (> or =5). There is no correlation between disability status and vertigo which means that vertigo is not more frequent in more disabled patients and vice-versa. The AEP were pathological in 57 (95%) patients. Of all 29 patients with vertigo AEP were pathological in 28 (96,5%) while in 31 patients without vertigo pathological AEP were in 29 (93,5%) but it is not statistical significant. The most frequent characteristic of AEP changes were prolonged inter-peak latency III-V waves (48 patients or 80%). The plaque in brainstem visualized by MRI was found in 41 (71,8%) of patients (38 or 92,6% of them had pathological AEP and in three patients AEP were normal). In group of patients with pathological AEP, 38 (66,6%) of them had plaque in brainstem. In other three patients with normal AEP it was visualized plaque in brainstem. In the group of 29 patients with balance disorder, 20 (68,9%) had plaque in brainstem as well as 21 (67,7%) out of 31 patients without balance disorder had plaque in the brainstem. This difference is not statistical significant. It is concluded that the vertigo (including disequilibrium) is relatively often (48,4%) initial symptom of MS. Vertigo is not more frequent in patients with higher EDSS score and vice-versa. Pathological AEP are frequent neurophysiologic finding in both (95%) patients with (96,5%) and without (93,5%) vertigo. The most often pathological characteristic of AEP are prolonged interpeak latency of III-V waves (78,5%), as well as abnormalities of V and than IV wave. MS plaques in brainstem visualized by MRI technique are frequent in both groups of patients with and without pathological finding of the AEP.

Since its foundation in 1992, the Croatian Medical Journal (CMJ) has followed the strict standards of quality in the scientific publishing. However, the Journal has been aware that its specific position demands more than just following the already established rules. From the very beginning, the Journal declared an “author-helpful policy,” stating that “journal editors should have a major role in training authors in science communication, especially in smaller and developing scientific communities. Journal authors usually send scientifically acceptable but poorly prepared articles and it is a pity to lose valid data because of their poor presentation.” (1,2). In brief, the editors and editorial staff of the CMJ have been well aware that the skills of scientific reporting and publishing in our academic community are not developed and that valuable research results and valid data are being lost because of poor presentation. To be perfectly honest, ten years ago this statement looked like a nice promise, one of the many we in academic medicine learnt not to take too seriously.

OBJECTIVE To determine the prevalence of anticardiolipin antibodies (aCL), anti-beta(2)-glycoprotein I (anti-beta(2)GPI) antibodies, and lupus anticoagulant (LAC) in a large cohort of children with systemic lupus erythematosus (SLE), and to evaluate the associations with neuropsychiatric manifestations. METHODS A single-center retrospective cohort study with longitudinal followup of antiphospholipid antibodies (aPL) in 137 children with SLE (25 boys and 112 girls, mean age at diagnosis 13.0 years) was performed. Patients were followed up for a mean of 31 months. RESULTS At the time of diagnosis, 65% of the children were aCL positive, 41% had anti-beta(2)GPI antibodies, and 26% were LAC positive. Analysis of the association between presence of aPL and individual neuropsychiatric manifestations at diagnosis showed a statistically significant association of positive LAC with cerebrovascular disease (5 patients; P = 0.015). A persistently positive aCL was observed in 50%, anti-beta(2)GPI antibodies in 29%, and LAC in 16% of children over time. The prevalence of anti-beta(2)GPI antibodies, but not aCL and LAC, was found to be statistically significantly higher in children with neuropsychiatric disease compared with those without (P = 0.02). Comparison for specific neuropsychiatric manifestations showed a statistically significant association between a persistently positive LAC and chorea (2 patients; P = 0.02). CONCLUSION The prevalence of anti-beta(2)GPI antibodies was found to be higher in the group of SLE patients with neuropsychiatric disease compared with those without. Our data suggest an association between LAC and cerebrovascular disease at the time of SLE diagnosis and chorea over the disease course, but not between aPL and other neuropsychiatric manifestations.