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A. Domić, Ivana Tomasovic, Paula Bernaciak, G. Voronov, R. Igić, R. Škrbić

Introduction. Combustible tobacco smoking accounts for nearly 30% of all cancer deaths in the United States of America and about 7 million deaths worldwide each year. Nowadays, e-cigarettes are increasingly used, especially among young people, but nicotine addiction that develops by such smoking easily converts to smoking combustible tobacco. Therefore, public health efforts must be directed to the prevention of initiation of smoking all nicotine-containing products. Role of Physicians. Medical doctors are very influential in smoking-related changes in local society, especially those who work in primary care, and they have an important role in both prevention and cessation of tobacco smoking. Tobacco smoking should be eliminated among medical doctors, yet many of them still smoke. The lowest percentage of smoking among physicians is in Oceania and North America (less than 11%) and the highest in Eurasia (25%). Smoking prevalence among medical students is higher than 35% in Georgia, Greece, Spain, and Italy, but less than 5% in the United States of America and Australia. In Serbia, 23% of physicians smoke. The age of physicians does not affect the number of smokers, but gender has a significant effect; women smoke less than men. Smoking Prevention and Cessation. Education about the effects of combustible tobacco smoking is a critical issue for successful smoking prevention and cessation; the best way is to provide educational programs on smoking at medical schools by introducing a mandatory course on combustible tobacco smoking at the beginning of the first year of study, especially in societies with a large percentage of smokers. Conclusion. In this paper, we showed how smoking can be eliminated among physicians and how they can affect the patients, public health policies, and antismoking campaigns.

Let me explain the principle of bioassay. It is an analytical method for determination of the relative strength (concentration or potency) of a substance by comparing its effect on a test organism (living animal, cells or tissues) with that of a standard preparation. Bioassays are used in pharmacology mainly to determine the concentrations of hormones or drugs, eg biologically active peptides, acetylcholine, catecholamines, prostaglandins, histamine and prostacyclin. However, there are other forms of bioassay in which one can use isolated tissues and determine actions of their nerves, such as the nerve to the diaphragm from rats. Bioassays may also be done in vivo in individual humans. The assessment of drug effects in humans is designated by clinical pharmacologists as a clinical trial. Such trials often require hundreds or sometimes thousands of patients in order to test efficacy and safety of any new drug before it can be marketed. If the human investigations produce unexpected results, quite different of those obtained in the animal experiments the trials must be redesigned, to examine why and how this occurred. There are many examples of how such discoveries resulted in new clinically useful medications (eg, discovery antihypertensive effect of beta-adrenergic blocking agents).6 Accordingly, the pharmacologists have the bioassays, as a tool, which help them in the discovery process. I wrote on the renowned pharmacologist Professor Ervin G Erdös and his scientific opus in my reminiscence article written on the occasion of his death in 2019.1 When I attended the Fourth International Congress in Pharmacology in Basel in 1969, Dr Ervin G Erdös invited me to join his laboratory. Thus, in April 1970, I arrived in Oklahoma City as a Fulbright Fellow to work with him for two years. Later on, as a visiting scientist I frequently worked in his research laboratories in Dallas and Chicago and we shared research interests through visits across the Atlantic between the former Yugoslavia and the United States.2, 3

R. Igić, Paula Bernaciak

Tobacco smoking is a mental and behavioral disease. It causes significant pathology and premature death in more than seven million individuals a year around the globe. Because smoking is such important public health issue, the general public will benefit from targeted preventive strategies. Medical doctors have a vital role in smoking cessation of their patients. Non-smokers are more successful in this role than chronic smokers. Governmental regulation on smoking, as well as strict no-smoke policy in hospitals and university campuses will help not only medical students, other health workers and the general public to quit smoking and contribute to the general good health of this population. The aim of this comment is to analyse the current smoking habits of physicians and medical students and presents policies and other help to the medical students to stop tobacco smoking.

A. Guzijan, R. Gajanin, J. Ćulum, Z. Gojković, Ljubiša Preradović, D. Roganović

Background/Aim: Breast-conserving surgery is a type of surgery used as a treatment option for breast cancer. It was introduced at the end of the 20th century following and in accordance with relevant clinical studies. With heightened public awareness of breast cancer and the introduction of new diagnostic procedures, despite the proven oncological safety of this type of surgery, a growing number of women choose to undergo total mastectomy. The aim of this study was to confirm the oncological safety of breast-conserving surgery performed on breast cancer patients at the University Clinical Centre of the Republic of Srpska. Methods: This study analysed 305 female patients with I and II stage of breast cancer, operated on between March 2009 and December 2013. One group of patients underwent breast-conserving surgery (BCS), followed by adjuvant radiation therapy and the other total mastectomy (MX). The patients were followed up for 5 years after the surgery. Analysed herein were the local-regional recurrence, distant metastases, disease-free survival and overall survival rates. Results: After a five-year follow-up, the local-regional recurrence rate for patients in the BCS group was 4.3 %, while for the MX group it was 4.2 %. The overall survival rate of patients in the BCS group was 90.9 %, as opposed to 89.1 % for MX patients. Conclusion: After a five-year follow-up, no statistically significant difference was observed between the two groups of patients regarding the local-regional recurrence (p = 0.967) and overall survival rates (p = 0.610). Breast-conserving surgery is an oncologically safe surgical treatment for breast cancer.

J. Đeri, J. Ćulum, Zoran Aleksić, Dalibor Šaran, Romana Rajić

Background/Aim: Dehiscence of the colorectal anastomosis is one of the most serious complications in digestive surgery that is still present in a large percentage today, which significantly increases the cost of treatment and can lead to death. Due to all the above, early detection of anastomotic dehiscence is very important, as well as the decision on surgical treatment. Procalcitonin (PCT) is thought to be an important marker of inflammation and sepsis. Aim of this paper was to confirm PCT as a marker of great sensitivity in early diagnosis of anastomotic leakage. Methods: The study included patients who underwent surgery for colorectal cancer in the period from 2016 to 2020. Patients were operated according to an elective protocol and with an open surgical approach. In patients, PCT values were measured on the 2nd and 4th postoperative day (POD) to determine the association between elevated PCT values and the onset of dehiscence of the colorectal anastomosis. Results: A study was conducted in 118 patients in whom a stapler colorectal anastomosis was created. Colorectal anastomosis dehiscence occurred in 10 patients. In 4 patients with dehiscence, no re-surgical intervention was required, but they were taken care of by conservative methods. Repeated surgery was performed in 6 patients. In all patients with dehiscence, there was a multiple increase in the value of PCT above normal. Conclusion: PCT has high sensitivity and specificity (85 and 74 % respectively) as a marker in dehiscence of colorectal anastomosis. In this study it was found that PCT values were significantly correlated with the dehiscence of anastomo-sis 2nd POD and especially 4th POD.

M. Katica, Z. Obradović, M. Abdalaziz, Amela Bajrić, Amina Lučkin

Introduction/Objective Cat bites can seriously harm human health, especially if the bite comes from a stray or feral cat who is not under veterinary supervision. Cat bites are the second most common mammal bites, second only to dog bites, and responsible for ¾ of all bites that result in infection. We are presenting the case of a young woman whose hand had been bitten by a stray or feral cat. The objective of this case study is to stress the importance of timely medical treatment and wound management based on guidelines for treating bites inflicted by stray or feral cats, aiming to prevent possible complications. Case report A 32-year-old woman was admitted and examined in the University of Sarajevo Clinical Centre Emergency Department on the third day after being bitten by a stray or feral cat, by which time all signs of inflammation had already developed at the site of the injury-her right hand. Medical help was provided based on guidelines that included specific wound dressings recommended for animal bites, a prescription of antibiotics, analgesics and an anti-tetanus shot. The patient fully recovered with no complications. Conclusion The specific anatomy of the cat's canines enables them to penetrate deeply into the bitten tissue, which can cause an innoculation of a wide range of microorganisms from the cat's mouth into the patient's bloodstream. This can cause serious inflammatory processes, especially in immunocompromised patients. Adequate medical treatment of injuries resulting from cat bites is necessary as soon as possible, but no later than 48 hours after the incident.

P. Lazic, Đurica Nikšić, D. Stojanovic, T. Gavrilović

The Lece mine is characterized by the fact that it has gold and silver besides the main valuable components in the flotation concentrates of lead and zinc. Practically since the opening of the mine and flotation, research has been carried out with the aim of obtaining better technological indicators on all four valuable metals (lead, zinc, gold and silver), especially on gold. This paper represents a contribution to that research in order to increase the recovery of gold in flotation concentrates. Gold occurs in ore in several ways (native, with lead and zinc, with pyrite and quartz), which requires a complex technological scheme of gold valorization. Most of the gold is bound to galena and is valorized through lead concentrate. A smaller part of the gold is bound to zinc and is valorized through zinc concentrate. However, about 25% of the gold remains in tailings. Researchers ie. the authors of this paper tried to valorize part of the gold that is lost in the tailings by introducing a third pyrite concentrate with an increased gold content. The paper presents the results of laboratory experiments on the possibility of obtaining pyrite concentrate from the Lece tailings and a proposal for a technological scheme of the process.

D. Hodžić, Miloš Purković, Katarina Maksimović, Ivan Soldatović, Jelena Ilić-Živojinović, Miloš Maksimović

Sedentary lifestyle and physical inactivity are some of the leading risk factors for cardiovascular diseases and total mortality. The aim of this study was to examine the effects of dosed physical exercise on the nutritional status of recreational athletes. In this study, we included 50 respondents of both sexes between the ages of 18 and 55, who engage in recreational physical exercise, were included in the study. All subjects had their body mass and height measured before the start of exercise and after three months, based on which the body mass index (BMI), waist circumference, and body fat percentage were determined. The exercise was carried out according to the plan 3 times a week for 75 minutes and combined anaerobic training (45 minutes) and aerobic training (30 minutes). The average body weight of all subjects at the beginning of the study was 81.74 kg, while at the end it was 80.16 kg. The average body weight of men at the end of the study was 1.95 kg less than the initial value, while it was 0.71 kg less for women. There is a statistically significant difference in BMI, waist circumference and fat percentage in the total number of respondents at the beginning and at the end of the study. Regular physical activity and exercise have a positive effect on BMI, waist circumference and body fat percentage, showing the importance of exercise in the prevention of obesity and chronic non-communicable diseases.

N. Hadživuković, J. Pavlović, M. Račić, N. Ivković, Olivera Kalajdžić, R. Perućica, S. Živanović, Ljubiša Kucurski

Introduction. A specific characteristic of the elderly is brittleness or fragility, and due to its prevalence, fragility needs to be understood as a public health priority. The aim of the study was to examine the association of functional and anthropometric parameters with fragility in persons over 65 years of age. Method. The study was designed as a cross-sectional study and included 446 elderly people. As research instruments, a general questionnaire was used to assess the functional status of the Tinetti test and, of anthropometric parameters, the circumference of the upper arm and the circumference of the middle part of the lower leg. We used the ch2 test and Pearson's correlation analysis as statistical tests. Results. Females had poorer functional status, walking, and balance compared to males (ch2 = 4.125; p <0.127). It was observed males subjects had higher values of upper arm circumference (26.96 ± 3.44) compared to females, while females had higher values of the middle circumference of the lower leg (32.66 ± 6.29). Analyzing the correlation of anthropometric measurements with the total score of the Tinetti test and in relation to subjects' gender, it was noticed there is a correlation analysis between the parameters. Conclusion. A high percentage of people over the age of 65 have poor functional status, as well as lower values of anthropometric markers, suggesting that they may be potential risk factors for the fragility in the elderly.

Ljubiša Kucurski, J. Pavlović, Ljiljana Savic, Marko Savić, N. Hadživuković

Introduction/Aim: The problems facing the health sector in the Balkans, but also in most European Union countries (especially highly developed countries) is the lack of university-educated nurses in the labor market. The aim of the paper was to examine the attitudes of health professionals about the importance and possibilities of academic education of nurses. Methods: The cross-sectional study was conducted on 233 health workers in the period from July 10, 2019 to August 31, 2019 in the Public Health Institution (PHI) Health Center Zvornik, PHI Health Center Foca, PHI General Hospital Zvornik, PHI University Hospital Foca. All respondents filled out a questionnaire, which was previously culturally adapted. ch2 was used in the statistical analysis of the data. Results: The majority of health workers (73.8%) were women. There were slightly more women under the age of 50, and men over the age of 50. There were 41.3% of doctors/specialists, 42.2% of nurses with secondary education, and 16.4% of nurses with post-secondary and higher education. The largest percentage of health workers (91.4%) state that they are familiar with the possibilities of nursing education, while 69.5% are of the opinion that thorough secondary education and specialization is enough for nurses. About half of health workers (50.2%), regardless of the level of education, states that there is no need for the education of nurses at the level of doctoral studies, and ¼ abstained on this issue. Doctors of medicine and specialist doctors and nurses with secondary education were statistically significantly more likely (ch2 = 10,151; p = 0.038) to consider that there is no need for education of nurses at the level of doctoral studies than nurses with post-secondary and higher education. The largest percentage of health workers (66.6%) have the opinion that the nurse has the same authority as other team members, 86.3% agree with the statement that the development of the nursing profession will affect the quality of health care, and 55.8% believe that nurses have the professional capacity, knowledge and experience to innovate solutions and manage the inevitable changes on the pathway to modern nursing. Conclusion: In order to raise the reputation of the nursing profession, it is necessary to define the scope of work and set clear boundaries between the competencies of nurses of different levels of education at the level of the whole of Bosnia and Herzegovina. In order to further develop the nursing profession, better promotion of new postgraduate programs is necessary.

S. Živanović, V. Kulić, Natalija Hadživukuvić, J. Pavlović, Sandra Matović, M. Vasiljević, M. Despotović

Introduction: Diabetes mellitus (DM) is a global public health problem. It is a complex illness which affects on the medical, psychological and social aspects of life. The aims of this research were to determine the subjective sense quality of life of patients with diabetes mellitus, to determine whether or not there are differences in the quality of life of patients with diabetes mellitus compared to sex, age and place of residence, as well as to determine factors the quality of life of patients with DM. Material and methods: The study was conducted as a crosssectional study of the population of persons with (DM). The sample consisted of 100 respondents, who in the observed period were treated at the Department of Internal Medicine of the University Hospital in Foča. A combined questionnaire consisting of 40 questions was used. The questions in the questionnaire were related to socio-demographic characteristics, hobbies, support of family and friends of patients, eating habits, as well as the presence of comorbidities. The HolmesRahe Stress Scale and the Subjective Assessment of Well-Being Scale (SVB Life Satisfaction Scale) were also included in the questionnaire. Results: Among the respondents there were 48 (48%) men and 52 (52%) women. Respondents rated their satisfaction with the quality of life, with an average score of 6.68 ± 1.72. Younger respondents have significantly better quality of life (7.09 ± 1.91) compared to the older group of subjects 6.35 ± 1.50. Also, respondents who living in the city are significantly satisfied with their quality of life (6.95 ± 1.80) compared to respondents who lives in the countryside (6.14 ± 1.45). Respondents with secondary education (30%) are significantly satisfied with their quality of life compared to respondents without primary school (13%), with elementary school (3%) or with higher education (12%). Conclusion: People with diabetes their own quality of life estimates with satisfactory grades.

Nina Stoičević, Tatjana Milosavljević, J. Pavlović

Emotional intelligence and health care are closely linked. Empathy is regarded as one of key dimensions of emotional intelligence. The nursing profession has numerous general, but also generic, competencies which requires not only technical knowledge, but also psychological support in everyday work. The aim of this review paper is to point out the importance of assessing the emotional intelligence of nurses on the basis of recent data from the literature. There are many challenges and various sufferings that many health workers are exposed to, especially nurses, which clearly indicates the necessary fact, ie. requires a high degree of emotional skills and competence, because the more complex the job, the more important emotional intelligence. High self-awareness, self-control, the ability to cope with feelings are just some of the competencies that nurses/ technicians should possess. All these characteristics are important factors of emotional intelligence and a basic prerequisite for providing empathy. There are numerous tests and instruments used to assess emotional intelligence.

L. Mićić, Homayoun Khamooshi, Lazar Raković, P. Matković

There have been a significant number of publications about digital workplace transformation. This is due to technological developments in the last decades as well as the COVID-19 pandemic. However, there is no adequate overall definition of the term. This leads to misunderstandings and confused interpretation of the digital workplace, sometimes even narrowing it down to a set of tools or a platform. Given the complexity of digital workplace transformation, there is a need to have an integrated prospective and analyze it not just from a technological perspective, but from an organizational and processes point of view as well. Therefore, this paper is an attempt to review the concept and offer a comprehensive definition of the digital workplace. This includes all the important aspects of the transformation including tools and platforms as well as personal issues, organization, processes and management. The paper provides a systematic literature review of the publications in leading bibliographic and citation bases, starting from Web of Science and Scopus to SpringerLink, IEEE Xplore and Association for Information Systems eLibrary. The review includes not only journal papers, but also leading proceedings, books and other referent publications. It addresses the authors' approaches, perspectives, terminologies, focusses and understanding of workplace transformation over the last decade by a comprehensive review of the state of art of the literature in the field of digital workplace. Finally, a set of recommendations are made to further research in increasingly important subject of digital workplace transformation.

N. Djordjevic, M. Vlahović, Slavica Mihajlović, S. Martinović, Nenad M. Vušović, Jasmina Lozanović-Šajić

During mechanical activation, qualitative changes that can produce various phenomena occur in the material. In this study, anhydrous sodium carbonate was mechanically activated for 2, 7, 14, and 28 minutes in a vibro mill at a frequency of 3000 oscillations per minute. After activation, four series of activated samples were stored in the air at room conditions for 31 days (relaxation period). To monitor the kinetics of the transformation process of activated sodium carbonate samples, i.e. the mechanism of sodium bicarbonate formation during relaxation, Fourier-transform infrared (FTIR) spectroscopy analysis was used. FTIR testing was performed as a function of relaxation time for all four series of samples, with characteristic groups observed: CO32-, HCO3- and OH-. The obtained results provided kinetics parameters for the transformation of sodium carbonate into sodium bicarbonate due to the chemisorption of moisture and carbon dioxide from the atmosphere.

A. Baraković, Mahira Jahić, A. Cerovac, A. Hadžimehmedović

Background: Vaginal microflora plays an important role in cervical carcinogenesis. An increase in vaginal pH is associated with the severity of squamous intraepithelial lesion (SIL) and a decrease in the number of lactobacilli. Microbial dysbiosis contributes to the damage of the epithelial barrier, as well as the reprogramming of immune and metabolic signaling. Dysbiotic bacteria cause damage to the epithelial barrier, immune dysregulation and genotoxicity and create a tumor-permissive microenvironment. Objective: The aim of this study was to determine the presence of risk factors (abnormal colposcopic and microbiological status, elevated pH of the vaginal environment) in regular Pap tests and LSIL. Methods: Retrospective prospective study 2021-2022. 90 women with pap smears were analyzed: 40 with LSIL at the Gynecological Center “Dr. Mahira Jahić” Tuzla and 50 with normal findings at the Tesanj Health Center. General data such as: age of the subjects, reproductive status, contraception, smoking and data on colposcopic examination, microbiological findings and vaginal pH value were analyzed. Statistical data processing was done in the SPSS program. Results: The average age of the test subjects is 39.94, in normal Pap 41.20 years, and in LSIL 38.38 years. The vital characteristics of the subjects did not differ significantly, except for smoking, where in LSIL findings, they consumed cigarettes significantly more often. Abnormal colposcopic examination were found in 85% (N-34) of women with LSIL. In subjects with LSIL, a positive microbiological test for enterobacteria was found in 47.5% (N-19) and a normal pap test in 12% (N-6). Statistically significant difference p=0.00523 p<0.05, E faecalis and E coli had the highest prevalence in LSIL. The mean pH value of the vaginal environment in LSIL is 5.38, and 4.96 in a regular pap test. Subjects with LSIL in 10% (N-4) had a normal pH test, and 48% (N-24) had a normal Pap test. P=0.00129 p < (0.05). A normal pH value was significantly more common in subjects with a normal Pap test. Microbiological flora, especially enterogenic bacteria, are more common in LSIL than in women with a regular pap test. Conclusion: when monitoring women with LSIL, special attention should be paid to the elimination of present enterobacteria (E.faecalis and E.coli) as a possible risk factor in the development of precancerous lesions (SIL) and cervical cancer.

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