Summary Background To evaluate the differences in the existence and size of dead space in patients with and without Gastroesophageal Reflux Disease (GERD and non-GERD) expressed through the size of intrapulmonary shunt (QS/QT). Material/Methods The study enrolled 86 subjects – 43 patients referred for endoscopy because of symptoms of GERD (heartburn, acid regurgitation, dysfagia) and 43 healthy subjects with similar anthropometric characteristics without GERD symptoms. Based on endoscopy findings, patients were classified into the erosive reflux disease (ERD) group and non-erosive reflux disease (NERD) group. Spirometry values, single-breath diffusing capacity of the lung for carbon monoxide (DLCO) and intrapulmonary shunt (venous shunt – QS/QT) determined by the oxygen method were measured in all participants. Results Statistically significant differences between GERD and non-GERD groups in FVC (p=0.034), FEV1 (p=0.002), FEV1/FVC (p=0.001), and PEF (p=0.001) were observed. There were no statistically significant differences in FEF 25% (p=0.859), FEF 50% (p=0.850), and FEF 75% (p=0.058). Values of DLCO (p=0.006) and DLCO/VA (p=0.001) were significantly lower and QS/QT was significantly higher (p=0.001) in the GERD group than in the non-GERD group. However, in both groups the average values of DLCO and DLCO/VA expressed as a percentage of predictive values were within normal range, while the value of QS/QT in the GERD group showed pathological (6.0%) mean value (normal value ≤5.0%). There were no significant differences in respiratory function test results between patients with ERD and NERD. Conclusions Our results suggest that microaspiration of stomach contents may cause surfactant damage, development of microatelectasis, and dead space expansion with consequent increase of intrapulmonary (venous) shunt.

We read with great interest the editorial article by Meshikhes AWN published in issue 25 of World J Gastroenterol 2011. The article described the advantages of emergency laparoscopic appendectomy compared with interval appendectomy as a new safe treatment modality for the appendiceal mass. The author concluded that the emergency laparoscopic appendectomy was a safe treatment modality for the appendiceal mass, and might prove to be more cost-effective than conservative treatment, with no need for interval appendectomy. However, we would like to highlight certain issues regarding the possibility of percutaneous catheter drainage to successfully treat the appendiceal mass, with no need for appendectomy, too.

O artigo discute questoes relacionadas as trajetorias e narrativas de professoras de educacao infantil do meio rural de Itaberaba (BA), ao destacar aspectos sobre formacao e praticas educativas, objetivando apreender, atraves das narrativas docentes, dificuldades existentes nesse contexto para a materializacao de uma pratica educativa articulada as proposicoes legais para essa etapa inicial da educacao basica. Busca-se, tambem, apresentar concepcoes de infância, relacionando-as a realidade da educacao infantil em espacos rurais e as questoes concernentes a profissionalizacao docente, mediante a analise de dispositivos legais que regulam o trabalho das professoras no cotidiano das classes de educacao infantil. Palavras-chave:    Narrativas autobiograficas. Educacao rural. Formacao docente. Praticas educativas. Educacao infantil.

Introduction: Cardiovascular diseases by its frequency, epidemic expenditure, socio-medical consequences and with high mortality are becoming the biggest problem of modern medicine. Mortality from cardiovascular diseases declines due to prevention measures in developed countries, in developing countries and countries in transition it increases. The aim of this study was to determine the prevalence of harmful habits and connection as a risk factor for cardiovascular disease in economically active population in the Canton of Sarajevo.Methods: The study was conducted among the active population of Sarajevo Canton. Randomly selected 443 respondents from different groups of workers aged 18-65 years, who voluntarily joined the study. Weperformed a study intersection descriptive method of research. Instrument for conducting research was a set of questionnaires, designed for research purposes.Results: The results study showed that the study group, current smokers occupy 45%, 1.8% occasional smokers who smoke and the rest of nonsmokers. It was shown that subjects who consume alcohol in biggestpercentage 73.4% consumed the same day, while the smallest percentage 2.7% comprise the same subjects who consumed annually.Conclusions: The prevalence of harmful habits as risk factors for cardiovascular disease among subjects in the Sarajevo Canton is evident represented. It is a significant development of the country, because it affects the health promotion strategy, which consequently changes the behavior based on individual needs. Health education and promotion of health can be reduced or completely prevented by a number of risk factors for cardiovascular disease.

Introduction: Depressive disorder, as a major problem of public health, takes high fourth place in its prevalence in general population, and is considered to be the second most frequent health problem of femalepopulation. Depression is the most frequent mental problem of persons in their third age of life. The aim of this study is to evaluate prevalence of depression and establish the ratio between the current number ofdiagnosed and of unrecognised depression among the residents of Gerontology Centre in Sarajevo.Methods: This is a cross-sectional, descriptive, and analytical study undertaken throughout May and June 2011 on the sample of 150 residents of “The Gerontology Centre“ in Sarajevo that were above 65 years of age. The following instruments were used for the research: the Geriatric Depression Scale (GDS), modified questionnaire consisting of two parts (general data and data related to health state), and the medical records of the residents. For statistic analysis of data was used the SPSS program for Windows.Results: According to GDS, prevalence of depression was 65.3%, out of which mild depression occurred in 46.7% cases and severe depression in 18.7%. The prevalence of verified (diagnosed) depression was 11.3per cents.Conclusions: According to the GD scale, unrecognised depressions seem to be almost six times more frequent (65.3:11%) than is the case with depressions diagnosed in medical records of the protegees of theGerontology Centre in Sarajevo. Timely recognition of depression and its treating in institutions for protection of health of persons in third age of life can substantially improve the quality of life of these patients.

Introduction: Selection of optimal nutrition for physical activity of sportsmen depends on several factors, and includes the type and duration of exercises, total energy consumption, time needed for recovery, andnutritional preferences. Proper nutrition of sportsmen relies on adequate combination and participation of all the macronutrients. The aim of this research was to analyse and determine the nutritional awareness andhabits of sportsmen depending on their age and type of sports they indulge.Methods: This is a cross-sectional, descriptive, and analytical study undertaken from May to July 2011 on the sample of 100 examinees/sportsmen of the Football Club “Željeznicar“ and Basketball Club “Bosna“.Results: General awareness of sportsmen on basic principles of proper nutrition is unsatisfactory. Statisticalsignificance per type of sport and age of sportsmen is proved through representation of macronutrients in their nutrition. For 49.1% footballers and 52% sportsmen over 19 years of age the most important combinationof macronutrients resembles the model of carbohydrates-proteins-fats, while 48.9% of basketballers and sportsmen under 18 prefer proteins-carbohydrates-fats. The study had shown a statistically significantdifference (p=0.01) between the footballers and basketballers with regard to the type of meal they consume before the trainings.Conclusion: Insufficient knowledge on the subject reflects in bad nutritional habits, especially those related to the number and arrangement of daily meals in comparison to respective sports activities.

Introduction: Osgood–Schlatter disease is an irritation of the patellar tendon at the tibial tubercle. Sports with jumps, running, and repeated contractions of knee extension apparatus are considered to be importantexternal risk-factors which could cause Osgood–Schlatter disease.Objectives of the study are to draw attention to the importance of clinical examination in diagnostics of Osgood–Schlatter disease in boys playing soccer or basketball.Methods: The research included data obtained from 120 boys, average age of 14 years. Examinees were split into two groups, one with young athletes which regularly have soccer or basketball trainings and thesecond one with boys who do not participating in sports. We performed anthropological measurements and clinical examinations of both knees and hips for both groups. For the statistical analysis we used pointbiserialcorrelation coefficient.Results: Based on clinical examination, Osgood–Schlatter disease was diagnosed in 51 examinees (42.5%). In “athletic group” Osgood–Schlatter disease had 31 boys or 52%, comparing with “non-athletic group” wherewe found 20 adolescents with disease (33%). Number of boys with Osgood–Schlatter disease was higher for 19% in “athletic group” comparing with “non-athletic group”. Comparing incidence rate for boys in both groups with diagnosed II and III level of Osgood–Schlatter disease we found that rate is higher in “athletic group” 2.25 times comparing with “non-athletic group”.Conclusions: Clinical examination is critical method in the process of diagnosing Osgood–Schlatter disease especially for identifying II and III level of this disease.

Introduction: Low sensitivity and specificity in traditional laboratory tests became insufficient for accurate diagnostics and initiation of proper treatment of patients infected with bacterial meningitis. High sensitivity Creactive protein (hsCRP) may be an appropriate supplement for rapid diagnosis of bacterial meningitis. The subject of our investigation was the determination of C- reactive protein in cerebrospinal fluid (CSF) during acute bacterial meningitis. Methods: HsCRP was analysed by a sensitive immunoturbidimetric assay using the Dimension RxL analyser (Siemens). Cerebrospinal fluid concentrations of C-reactive protein have been measured in 20 patients (age range,1 to 50 years) presenting with acute bacterial meningitis and also in a non-infected, non-inflamed control group (n=25). Results: The accuracy and precision of the method proved to be satisfactory. Repeatability of serial sampling for hsCRP described by coefficient of variation were CV=2.1-4.5%. This assay hsCRP in cerebrospinal fluid demonstrates adequate performance characteristics for routine clinical use. Elevated levels of CRP were found in 95% patients with bacterial meningitis. The mean CRP value in 25 uninfected control group was 0.25 mg/L (range 0.10-0.55). The mean CRP for patients with bacterial meningitis was 21.4 mg/L (range 0.40-100). Conclusions: A sensitive assay for CRP in CSF would be an useful adjunct to conventional investigation of acute infective meningitis.

Introduction: Community Based Rehabilitation (CBR) is a strategy within community development for rehabilitation, equalizes opportunities and social integration of incapacitated people. This is a comprehensivestrategy of involving people with disabilities in their communities through the development program. CBR system provides for the people with disabilities equal access to treatment and rehabilitation, education, promotes health and healthy living, and also indicates the existence of other features that make these people become full members of society and the community in which they live and is currently used in over 90 countries around the world.Methods: Research was conducted in two CBRs (CBR-Kumrovec and CBR-Saraj Polje) in the department of physical medicine and rehabilitation in the Sarajevo Canton. The study included and statistically treated 97patients during the period from 01.01.2008 to 31.12.2008 year.Results: In a study from the total number of respondents 65% were women, 35% male respondents, and the most represented were respondents of age group from 71-80 years - 40%. Of all diseases, the most represented were respondents with ICV, 43%.Conclusion: This type of treatment in the home conditions is providing necessary medical rehabilitation services by qualified physical therapists through a sufficiently long period for successful medical rehabilitation inthe natural environment of patients (home conditions), and the presence of family members who we can also educate for the enforcement of basic physical procedures and instruct them on the condition of the patientand his perspective.