Hypertension is chronic disease with high prevalence, which can successfully be treated with antihypertensive drugs. Previous researches have shown that existing hypertension treatment guidelines are not fully implemented in practice. We have analysed antihypertensive drug utilization in Canton Sarajevo during five-year period (2004-2008). Research findings are discussed in relation to expected drug utilization according to Canton Sarajevo treatment guidelines. Objective of this research is to examine prescription patterns of antihypertensive drugs in primary health care in Canton Sarajevo during five-year period. Based on study findings we did an estimation of adherence to local treatment guidelines, which are similar to those published globally. Drug utilization data were collected from the largest pharmacy (retail) chain, representing more than 80% of pharmacies in Canton Sarajevo. Following drug groups have been analyzed: diuretics, beta-blockers, calcium-channel-blockers, ACE-Inhibitors (plain and combinations), Angiotensin-II-antagonists and alpha-blockers. Drug utilization is expressed in number of defined daily dose (DDDs), defined daily dose per thousand inhabitants per day (DDD/TID), drug utilization 90% (DU90%) and value in euros. ACE-Inhibitors are most prescribed drug class; combination of ACE-Inhibitors and diuretics account 46% of total antihypertensive budget spending. ACEIs are followed by calcium-channel-blockers. Diuretics utilization is decreasing from 2006 and being replaced with beta-blockers. Diuretics, recommended as first line therapy, are ranked as third in total antihypertensive drug utilization. It is necessary to introduce follow-up and enforce adherence to developed treatment guideline. Drug utilization studies can be used as tool for assessment of treatment guidelines adherence in primary health care.

Endothelin 1 (ET-1) is vasoactive peptide that acts via ET-A receptors coupling inducing vascular smooth muscle cell proliferation and contraction. ET-1 is involved in the development and maintenance of hypertension. Aim of this study was to determine the contribution of Ras farnesyl transferase, mitogen activated protein kinase (MAP kinase) and cytochrome P¬450 (CYP450) metabolites to ET-1 induced hypertension. ET-1 (5 pmol/kg per minute) was chronically infused into to the jugular vein by use of mini-osmotic pump for 9 days in male Sprague-Dawley rats. Mean arterial blood pressure (MABP) in ET-1-treated rats was 154±2 mm Hg (hypertensive rats) compared with 98±3 mm Hg in control (normotensive) rats. Infusion of Ras farnesyl transferase inhibitor FPTIII (138 ng/min), MAP kinase inhibitor PD-98059 (694 ng/min) and CYP450 inhibitor 17-ODYA (189 ng/min) significantly attenuated MABP to 115±2.5 mm Hg, 109±3 mm Hg and 118±1.5 mm Hg, respectively. These results suggest that CYP-450 metabolites and Ras/MAP kinase pathway contribute to the development of ET-1 induced hypertension. Further investigation has to be done to confirm whether activation of RAS/MAP kinase pathway by arachidonic acid metabolites plays an important role in the development of ET-1 induced hypertension.

Background. Transfusion therapy represents a rational model of therapy which is frequently used in neonatal period. Aim.to investigate predictive role of blood group, Rh factor and gestational age in transfusions reaction in neonates. Patients and methods. we evaluated 95 neonates gestational age between 28 and 42 weeks treated with blood components. All neonates were treated in the Unit of Neonatology at Department of Gynecology and Obstetrics at University Clinical Center Tuzla in the period of 01.01.2006.-31.12.2008. Results. During the period of investigation there were 12 526 born neonates gestational age from 28 to 42 weeks. Incidence of transfusion reaction was 0, 37%. The median of gestational age in the complete sample was 38 weeks, with interquartile range from 35 to 39 weeks, with 28 weeks minimum and 40 weeks maximum. The incidence of transfusion reaction in relation with the blood group was most evident in recipients in blood group type A, but there were no statistically significant differences in incidence of transfusion reactions between four blood groups (X2=6.352; df=3; p=0.097). There was no statistically significant difference in incidence of transfusion reaction according to the Rh factor (X2=0.755; df=1; p=0.385). Investigation of transfusion reaction according to the blood group and Rh factor showed no statistically significant difference (X2=8.063; df=7; p=0.327). The logistic regressional analyses showed that the gestational age is significant predictor of appearance of transfusion reaction (OR=0.867; %95 CI=0.756 do 0.993; p=0.04). Conclusion. Transfusion reactions in neonates are not rare. The blood group and Rh factor are not valid in prediction of transfusion reaction while the gestational age is good predictor in appearance of transfusion reaction.

BACKGROUND: Heart failure is a common disease that requires frequent and long hospitalizations, the active participation of health workers and family members in the care of such patients, and it leads to reduction of physical activity and lifestyle changes with the patient, which significantly affects the quality of life of patients with heart failure. OBJECTIVE: To determine the quality of life of patients with heart failure in relation to severity of the clinical features. RESPONDENTS AND METHODOLOGY: Analysis of life quality was performed for 120 patients suffering from heart failure, both genders, all age groups in relation to severity of the clinical features. Patients were divided into 4 groups according to NYHA classification of heart failure. The control group consisted of 10 subjects who do not suffer from heart failure. Assessment of quality of life was performed using the SF-36 questionnaire which consists of 8 segments classified in the dimension of physical and mental health. RESULTS: Study group consisted of 130 participants with heart failure had 66 (51%) of male, and other were females, divided into 4 NYHA groups, where every group had 30 subjects (23.1%), and one control group of 10 subjects (7.7%). The analysis of gender and age distribution within the groups found no statistically significant difference (X2=1.70; df=4; p=0.79), (ANOVA; F=0.74; p=0.57). The values of SF-36 score expressed as the median in the control and 4 NYHA groups were decreasing as the functional class progressed. The Spearman Correlation Coefficient showed that there is a strong negative correlation between the scores of SF 36 (total, segments and dimensions) and heart failure expressed through the NYHA classes. CONCLUSION: Quality of life in patients with heart failure was exacerbated and associated with severity of the clinical features.

The nonlocal van der Waals density functional approach is applied to calculate the binding of graphene to Ir(111). The precise agreement of the calculated mean height h = 3.41  Å of the C atoms with their mean height h = (3.38±0.04)  Å as measured by the x-ray standing wave technique provides a benchmark for the applicability of the nonlocal functional. We find bonding of graphene to Ir(111) to be due to the van der Waals interaction with an antibonding average contribution from chemical interaction. Despite its globally repulsive character, in certain areas of the large graphene moiré unit cell charge accumulation between Ir substrate and graphene C atoms is observed, signaling a weak covalent bond formation.