Aim To investigate the influence of irregular shifts on increased emotional, physical, and cognitive exhaustion and decreased working performance expressed by the phenomenon of presenteeism. Methods The study sample of 405 healthcare workers from Family medicine centres completed questionnaires in two measurement time points, in 2014 (TP1) and repeated in 2019 (TP2), when 301 respondents remained in the study. Healthcare workers completed questionnaires assessing demographics, work schedules, job burnout, and presenteeism. Results Repeated long-term exposure to rotating day-evening shifts was a significant risk for increased presenteeism (OR=1.689, 95%CI 1.042-2.739; p=0.001) and burnout (OR=1.705, 95%CI 1.237-2.352; p=0.001). Extended working hours are a predictor of presenteeism (OR=1.989, 95%CI 1.042-2.739; p=0.008). Conclusion The adverse effects of rotating day-evening shifts on burnout and presenteeism among healthcare workers in a family medicine centre was little researched, particularly the issue of managing the risks of exposure to rotating day-evening shifts and extended working hours. This study reflects a situation of uncertainty, in which the logic of precaution is imposed on mental health, and keeps working engagements in health care workers. Appropriate management of shift work and better organization of work schedules in the primary healthcare sector protects the wellbeing of healthcare workers and patients, efficient work, and quality of health care, and invites for future research on better working schedules and introducing preventive interventions with available flexibility of working times.

Sarajevo Canton in the Federation of Bosnia and Herzegovina has recorded several waves of high SARS‐CoV‐2 transmission and has struggled to reach adequate vaccination coverage. We describe the evolution of infection‐ and vaccine‐induced SARS‐CoV‐2 antibody response and persistence.

Extended hospitalization due to coronavirus disease 2019 (COVID‐19) is associated with residual musculoskeletal and functional deficits lasting even 6 months after discharge; therefore, it is crucial that post‐hospitalized patients are promptly assessed. The aim of this study was to identify post‐COVID‐19 patients' functional status and quality of life, as well as to investigate their inter‐relatedness 2–3 weeks after hospital discharge.

Abstract In breast cancer therapy, as the leading cause of death in women, besides chemo-radiotherapy, immunotherapy has been increasingly used. PD-1/PD-L1 axis blockade primarily acts on T lymphocytes, the main effectors of acquired immune response. NK cells, which are part of the innate immune response, also play a role in the anti-tumor response through the blockade of this signaling pathway. The study was conducted to examine the effects of anti-PD-1 therapy on NK and T cells in mouse breast cancer. Female BALB/c mice were used, divided into two groups, one with induced breast cancer and one treated with anti-PD-1 antibody. Breast cancer cell line was used to induce the cancer, and the anti-PD-1 antibody was applied intraperitoneally. Cell populations in spleen and tumor microenvironment were examined using flow cytometry. Data were statistically analyzed using SPSS. The percentage of NK cells expressing FasL, NKG2D, and IFN-γ is significantly higher in spleen and tumor-infiltrating NK cells upon anti-PD-1 therapy, while the expression of inhibitory markers Foxp3 and IL-10 in regulatory NK cells is significantly lower. The percentage of T lymphocytes expressing CD107a and IL-17 is significantly higher in the spleen, while a higher number of T lymphocytes expressing CD69 is present in the tumor microenvironment. The study suggests that anti-PD-1 therapy can activate NK and T cells, and improve anti-tumor immune response in breast cancer. Further research is needed to understand the interplay between these cells during PD-1 blockage.

Abstract Metabolic syndrome (MetS) and ulcerative colitis (UC) are widespread health conditions characterized by chronic, low-grade inflammation. Galectin-1 (Gal-1), an immunomodulatory peptide mainly secreted from adipose tissue, could potentially play a crucial role in mitigating these conditions. This cross-sectional study explores the involvement of Gal-1 in MetS and UC within a cohort of 75 patients, newly diagnosed with UC. The MetS subgroup displayed increased fecal Gal-1 levels compared to those without MetS. Furthermore, Gal-1 showed predominance over pro-inflammatory cytokines, including TNF-α, IL-6, and IL-17, in these subjects. These findings emphasize the potential involvement of Gal-1 in the pathophysiology of UC and MetS, presenting it as a promising diagnostic biomarker and therapeutic target for these conditions.

Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) is associated with high morbidity and mortality. Our study aimed to gain insights into patient characteristics, outcomes and treatment strategies in CS patients. Patients with CS who underwent percutaneous coronary intervention (PCI) between 2017 and 2021 were identified in a nationwide registry. Data on medical history, laboratory values, angiographic features and outcomes were retrospectively assessed. A total of 2328 patients with a mean age of 66 years and of whom 73% were male, were included. Mortality at 30 days was 39% for the entire cohort. Non-survivors presented with a lower mean blood pressure and increased heart rate, blood lactate and blood glucose levels (p-value for all <0.001). Also, an increased prevalence of diabetes, multivessel coronary artery disease and a prior coronary event were found. Of all patients, 24% received mechanical circulatory support, of which the majority was via intra-aortic balloon pumps (IABPs). Furthermore, 79% of patients were treated with at least one vasoactive agent, and multivessel PCI was performed in 28%. In conclusion, a large set of hemodynamic, biochemical and patient-related characteristics was identified to be associated with mortality. Interestingly, multivessel PCI and IABPs were frequently applied despite a lack of evidence.

SUMMARY The aim of the study was to analyze the values of Foot and Ankle Disability Index (FADI) after kinesitherapy in subjects with bimalleolar or trimalleolar fracture of the ankle after surgery treatment and the obtained values of manual muscle test (MMT) and range of motion (ROM) after rehabilitation, compared with the obtained values of FADI index and on that basis evaluate its possibility in assessing the functionality of the respondents after surgery for bimalleolar or trimalleolar fracture of the ankle. The sample included 60 subjects over the age of 18 who underwent surgery for osteosynthesis due to bimalleolar or trimalleolar fracture of the ankle. All subjects were treated with kinesitherapy as part of the postoperative rehabilitation program. The research was conducted from 2013 to 2018 at the Department of Orthopedics of Dr. Safet MujiÊ Cantonal Hospital in Mostar and Mostar University Clinical Hospital. A statistically significant correlation was found between FADI index values per group and average percentage recovery per MMT (p<0.05), as well as a statistically significant correlation between FADI score values per group and mean percentage ROM value (p<0.05). A statistically significant association was found between mean percentage recovery per ROM and MMT (p<0.05). The conducted research confirmed the working hypothesis of the conducted study. The effects of kinesitherapy after ankle surgery can be evaluated using the FADI index, as well as by manual muscle test and ROM measurement.

Lung cancer incidence in Bosnia and Hercegovina is high. The implementation of evidence-based lung cancer screening based on low-dose computed tomography (LDCT) may detect lung cancer early and decrease mortality specific to lung cancer. However, LDCT receipt may be unsatisfactory in Europe due to a low distribution of scanners and radiologists or poor access to care. In this paper, we propose a framework for the implementation of lung cancer screening in primary healthcare of Bosnia and Herzegovina based on the United States Preventative Services Task Force recommendation from 2021 and the American College of Radiology Lung CT Screening Reporting & Data System from 2022.

Aims: The aim of this study was to conduct antimicrobial analysis on novel Schiff base-derived cobalt(II) complexes (Co(L1) 2 and Co(L2) 2 )

STUDY OBJECTIVES Little is known about the effectiveness of bridge clinics as transitional care programs for people with opioid use disorder in emergency departments (EDs). We assessed the effect of bridge clinic referral on health services use among patients with opioid use disorder identified in the ED. METHODS We used data for individuals aged 18 years and over with active opioid use disorder and no history of medication for opioid use disorder who were administered medication for opioid use disorder while in the ED between January 2013 and August 2022. Bridge clinic referrals started in January 2021. Eligible patients after this date comprised the intervention group. The usual care group included eligible patients before bridge clinic implementation, who were a 1:1 propensity score matched to intervention patients. We estimated risk differences and 95% confidence limits for linkage to long-term care, ED use, and inpatient admission within 120 days of the index ED visit. RESULTS Our study population comprised 928 observations after matching. Patients referred to the bridge clinic had a higher risk of linkage to long-term care (risk differences=25%; 95% confidence limits: 20%, 30%), higher risk of ED use (risk differences=7.5%, 95% confidence limits: 1.6%, 13%), and lower risk of inpatient admission (risk differences= -1.9%, 95% confidence limits: -5.9%, 2.1%). Inpatient admission increased among patients with serious mental illness but decreased among patients without serious mental illness. CONCLUSION Our overall results suggest that bridge clinic referral increases linkage to long-term care. Nevertheless, qualitatively different effects on inpatient admission between patients with and without serious mental illness warrant consideration of unmet needs among patients with serious mental illness.