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Spomenka Kristić, A. Begić, S. Zubović, Amila Bašić, Haris Kurić

Background: Pulmonary Embolism (PE) represents a life-threatening medical emergency that, given the serious complications, requires urgent application of anticoagulant therapy. In addition to other factors that are taken into account when choosing a therapy for treatment of PE, the anatomical distribution of thrombi is also considered–whether it is a central, lobar, segmental or subsegmental PE. D-dimer is an intermediate product of degradation of fibrin molecules and its values in the plasma are increased in the case of PE, but also in other diseases. Objective: To determine whether there is a difference in D-dimer values in subjects with different anatomical distribution of PE. Methods: The study included 100 subjects with diagnosed PE by using MSCT and/or V/P SPECT and with measured values of D-dimer. Results: Out of 100 subjects, PE was not diagnosed in 37 subjects, while 63 subjects PE was diagnosed. All subjects with diagnosed PE were divided into 3 groups regarding the anatomical localization of thrombus: lobar, segmental or subsegmental. Average D-dimer values were calculated for all 3 groups. Statistical analysis showed that there was no significant difference in D-dimer values between subjects with different anatomical distribution of PE. Conclusion: There is no significant difference in D-dimer values between subjects with different anatomical distribution od PE–lobar, segmental and subsegmental PE.

A. Šljivo, Lejla Brigić, A. Abdulkhaliq, Ilma Dadić, Leopold Reiter, I. Sirucic, Mohammed Abdulkadir, Ahmed Mulać

Background: Increasing evidence indicates that COVID-19 may result in cardiac issues in certain individuals, such as myocarditis, arrhythmias, and heart failure. Ongoing research on echocardiographic manifestations is still limited. Objective: To investigate the incidence and patterns of left and right ventricular dysfunction in COVID-19 patients. Methods: This study retrospectively observed COVID-19 patients admitted to the Clinical Center of University of Sarajevo during the third wave, with a particular focus on cardiac evaluations. Results. Our patients, predominantely male 155 (72.4%), with a mean age of 66.2±11.4, having hypertension 86 (40.1%), diabetes mellitus 61 (28.5%), hyperlipidemia 144 (67.3%), were active smokers 87 (40.6%), had family history of cardiovascular diseases 123 (57.5%) and were COVID-19 positive 95 (44.4%), presented because of chest pain 78 (36.4%), dyspnea 103 (48.1%), palpitations 67 (31.3%), fatigue 106 (49.5%) and peripheral oedema 30 (14.0%). COVID-19 patients reported much higher symptoms of dyspnea (65 (68.4%) vs 38 (31.9%)) and fatigue (73 (76.8%) vs 33 (27.7%)) than COVID-19 negative patients. On the initial laboratory report, COVID-19 patients had a significantly (p<0.05) higher mean score of C-reactive protein (24.0±4.8 vs. 6.0±2.1), D-dimer (1.6±2.5 vs 0.8±0.6), ALT (94.8±17.2 vs 36.5±19.9) and creatinine (128.0±80.8 vs. 93.4±40.1) when compared to COVID-19 negative patients. COVID-19 patients had enlarged left atrium diametes (31.6±5.6 vs 27.5±5.3), enlarged left ventricular diameter both in systole (27.9±18.1 vs 23.3±16.3) and diastole (39.3±24.1 vs 34.9±22.7), reduced left ventricular ejection fraction (53.5±9.2 vs 59.8±4.3) and elevated right ventricular systolic pressure (37.0±16.4 vs 35.1±8.6). Conclusion. COVID-19 patients had enlarged left atrium, enlarged systolic and diastolic left ventricular diameter, reduced left ventricular ejection fraction and elevated right ventricular systolic pressure.

Andrijana Milošević-Georgiev, Dragiša Obradović, Dušanka M. Krajnović

Smoking is a global public health problem, and control measures should be implemented in the community so as to reduce the number of smoking-related diseases and healthcare costs. Community pharmacies are ideal places for providing tobacco cessation counselling as a type of public health service, because they are the most accessible health facilities with direct contact with patients. We aimed to examine attitudes towards the implementation of such services, conducting surveys on a sample of pharmacy students (N=300), community pharmacists (N=383) and the general public (N=987) in the Republic of Serbia. The introduction of smoking cessation services at pharmacies was supported by pharmacy students (59.7%), pharmacists (49.2%), and the general public (36.7%). No difference was found between pharmacistsàttitudes in terms of their gender, age, level of education and years of experience. We found evidence that pharmacists as public health practitioners were recognized mostly by students (94.3%). The majority of them (86.3%) recognized the need for additional education in order to implement new services, and every third pharmacist recognized a gap in their education. The data indicate the need for directed research in order to explore the educational needs and competences for practicing pharmacists and enable them to perform services such as smoking cessation in the future.

Background: The development of medicine and pharmacy in the Bosnia and Herzegovina was marked by different historical periods–first they were settled by the Illyrians and Delmatians, and after them came the Romans, the Ottoman Empire and the Austro-Hungarian Monarchy. Objective: The aims of this article are to show, based on the available literature: a) The development of medicine and pharmacy in Bosnia and Herzegovina from the medieval period until the Second World War; b) The most significant historical events that marked the development of medicine and pharmacy in the areas of Bosnia and Herzegovina; c) Methods of treatment, medicinal forms and preparations that were used in the mentioned period. Methods: The subject of this study was the development of medicine and pharmacy in the areas of Bosnia and Herzegovina from the 14th century until the Second World War. In order to achieve the set goals, a) Retreival of professional and scientific literature and b) Search of scientific databases and web pages on the Internet that offer adequate and relevant data and historical facts related to the subject of studies were carried out. Most of the facts are covered in previously published articles by the author and deposited in the PubMed and PubMed Central databases, as well as in books and monographs by the author of this text. Results and Discussion: In the Middle Ages, folk medicine was present, in which herbalists looked for medicines in certain plant and animal species. In the 13th century, Bosnia was settled by the Franciscans, who permanently marked the development of medicine and pharmacy. They are educated at prestigious universities abroad, from where they bring their knowledge, skills and recipes and write them in books, which are called ljekaruse (medicine books). Every historical period brought some changes for medicine and pharmacy, so the Ottoman Empire brought customs of frequent cleaning, public fountains and hammams were built. During the reign of the Austro-Hungarian Monarchy, the first hospitals and pharmacies were established, and laws on pharmacy activity were introduced. Written documents on the history of the medicine and pharmacy development in Bosnia and Herzegovina are mostly found in the libraries of monasteries, and a significant number of them are also in the libraries of madrasas, and the National and University Librarie in Sarajevo and the library of former Institute of Hygiene in Sarajevo. Conclusion: In connection with the medical and pharmacy practice of the Bosnian Franciscans, the question of the various medical records that they created, which helped them in their health efforts, stands out. First of all, we are talking about numerous medicinal books, so called ”ljekaruse”. On the soil of Bosnia and Herzegovina, there were many such “ljekarusa” who mostly grew up at the sources of national experience. In those books, the recipes are mostly based on the use of medicinal herbs. Historians of medicine believe that these medicinal books represent the cultural and historical significance of our regions.

Izet Masic, Bojana Jovanović, A. Skrbo

Background: The Organized health care during Ottoman Empire was poor, and the population of Bosnia looked to the clergy of all denominations, among which the Franciscans play a significant role, for a cure for their ailments, both mental and physical. The Franciscan motto of living, not only for yourself but also for others was, also, reflected in the Bosnian Franciscans’ provision of medical services to people. Objective: The aim of this article was to show, based on the available literature, the development of medicine and pharmacy in Bosnia and Herzegovina from the medieval period until the Second World War with description methods of treatment, medicinal forms and preparations that were used in the mentioned period. Methods: The subject of this study was the development of medicine and pharmacy in the areas of Bosnia and Herzegovina from the 14th century until the Second World War. In order to achieve the set goals, a) Retreival of professional and scientific literature and b) Search of scientific databases and web pages on the Internet that offer adequate and relevant data and historical facts related to the subject of studies were carried out. Most of the facts are covered in previously published articles by the author and deposited in the PubMed and PubMed Central databases, as well as in books and monographs by the author of this text. Results and Discussion: In the Middle Ages, folk medicine was present, in which herbalists looked for medicines in certain plant and animal species. In the 13th century, Bosnia was settled by the Franciscans, who permanently marked the development of medicine and pharmacy. They are educated at prestigious universities abroad, from where they bring their knowledge, skills and recipes and write them in books, which are called ljekaruse (medicine books). Every historical period brought some changes for medicine and pharmacy, so the Ottoman Empire brought customs of frequent cleaning, public fountains and hammams were built. During the reign of the Austro-Hungarian Monarchy, the first hospitals and pharmacies were established, and laws on pharmacy activity were introduced. Written documents on the history of the medicine and pharmacy development in Bosnia and Herzegovina are mostly found in the libraries of monasteries, and a significant number of them are also in the libraries of madrasas, and the National and University Librarie in Sarajevo and the former Institute of Hygiene in Sarajevo. Conclusion: In connection with the medical and pharmacy practice of the Bosnian Franciscans, the question of the various medical records that they created, which helped them in their health efforts, stands out. First of all, we are talking about numerous medicinal books, so called ”ljekaruse”. On the soil of Bosnia and Herzegovina, there were many such “ljekarusa” who mostly grew up at the sources of national experience. In those books, the recipes are mostly based on the use of medicinal herbs. Historians of medicine believe that these medicinal books represent the cultural and historical significance of our regions

Background: A laboratory professional concerned with the quality of work in medical-biochemical laboratories ensures the accuracy and precision of laboratory analyses through the implementation of international and European guidelines for working with hazardous substances, through the availability and implementation of Standard Operating Procedures (SOPs). Laboratory hazards that affect the concentration and safety of workers arise from laboratory deficiencies such as: lack of preventive measures, knowledge and skills implemented through SOPs and good laboratory practice. Biophysical hazards in medical laboratories are manifested by needles and sharp objects, infectious materials, noise, vibration, radiation, poor air quality, temperature inversions. Objective: The aim of the research was to raise awareness of the quality of work in medical-biochemical laboratories in order to ensure the safety of workers. Methods: A cross-sectional questionnaire-based study was conducted among 100 laboratory professionals from Bosnia and Herzegovina (BiH) and Croatia. The research was conducted over a period of three months. Results: A higher percentage of exposure to infectious agents and needles and sharp objects was found among respondents from BiH compared to CRO (p=0.018 and p=0.001, respectively). We found that respondents employed in accredited laboratories are aware of exposure to hazards in a high percentage related to infectious agents, toxins (p=0.0012 and p=0.0046, respectively). A significant statistical difference was found between respondents with BiH and respondents with CRO in terms of knowledge of accreditation standards of medical-biochemical laboratories (p=0.0155). Respondents who have standard operating procedures available are aware of the hazards of infectious agents (p=0.0001), toxins (p=0.0466), needles and sharp objects (p=0.0052), noise (p=0.0030), vibration (p=0.0007) and extreme temperatures (p=0.0014). Conclusion: Efficient implementation and continuous compliance with the ISO 15189: 2018 standard requires constant commitment and active participation of laboratory staff. Laboratories must have standard operating procedures in place and actively monitor their use.

Berina Hasanefendić, Armina Dedić, Sanela Hajro, Emir Šeherčehajić, Almedina Hajrović, R. Alimanović-Alagić, V. Smajlbegović, L. Ibričević-Balić

Introduction: COVID-19 is an infectious disease caused by the severe acute respiratory syndrom coronavirus 2 and causes a series of respiratory symptoms. Considering the appearance and development of symptoms, the course of COVID-19 can go from mild to severe. Depending on the course of COVID-19, the laboratory parameters change a lot, trying to defend the organism against the foreign pathogen and all the changes it causes. Therefore, the aim of this study is to observe the differences between biochemical, hematological and coagulation parameters depending on the disease stage of COVID-19 patients. Material and methods: We conducted cross-sectional study which included 160 COVID-19 patients from Sarajevo, Bosnia and Herzegovina. Biochemical, hematological and coagulation analyzes were performed. Results: COVID-19 patients with a severe clinical course have higher average values of fibrinogen (6.53±4.47,p<0.001), D-dimer (6.89±7.81, p<0.001), APTT (32.05±5.96, p=0.002), eosinophil (0.66±0.09, p=0.002) and CRP (93.42±75.86, p= 0.023), and lower values of lymphocytes (1.04±0.98, p<0.001), monocytes (0.45±0.3, p<0.001), compared to COVID-19 patients with a mild clinical course. COVID-19 patients with a severe clinical course had higher average values of neutrophils (10.12±5.80, p=0.002) and lower values of reactive lymphocytes (0.02±0.03, p<0.001) compared to COVID-19 patients with a mild clinical course. Conclusion: Biochemical, hematological and coagulation parameters can be a sensitive and specific biomarker for distinction of mild and severe COVID-19.

Almedina Numanović, Šuajb Solaković, Ž. Mladenović

The most significant characteristic of the investment interventions that are the subject of this paper is that their activation periods are one year and that their cash inflows are one-time. If there are several independent operations of this type, all those with a positive net present value, and therefore an internal rate of return that is higher than the actualization rate, will be accepted. In the case of competing operations (at certain rates of actualization), especially those whose exploitation periods are different, we may have the case that one of them is better from the aspect of net present value, and the other from the aspect of internal rate of return. The decision on their proper ranking must be based on determining the net present value for exploitation periods that are mutually equal. In the paper, we analyzed two ways of equalizing exploitation periods, the method of reciprocal interventions and the method of replacement, and obtained relevant information for their ranking, which was also confirmed by the annuity method.

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