The SARS-CoV-2 (COVID-19) pandemic has emerged as one of the greatest problems of the 21st century worldwide. Efforts to fight this pandemic require a global co-operation and a multidisciplinary approach. An application of information and communication technologies (ICT) to a great degree contributes to fighting the pandemic as these technologies are one of the key services that assist patients, researchers, health institutions and other interested parties in different activities in an effort to fight the pandemic and its consequences. The present paper presents the features of certain mobile applications (apps) that are being used for different purposes such as: tracking patients, COVID-19-related warnings, keeping tracks of statistical data, organising life and business, etc. Aside from presenting the features of a certain number of applications, a review of technologies used for the development of these applications will also be presented. Furthermore, the paper addresses certain challenges that come along with the mobile technologies applications and offers suggestions for future research.
Aim To identify predictive factors related with noninvasive ventilation (NIV) failure that are not based on the patient's respiratory status or acid base gas analyses in COVID-19 critically ill patients, and to create a predictive model of NIV failure. Methods A total of 73 COVID-19 critically ill patients who developed acute respiratory failure and underwent NIV were divided into two groups: Group 1, patients who required endotracheal intubation and invasive mechanical ventilation after NIV and Group 2, patients with successful weaning from NIV. Demographic data, clinical symptoms and signs, clinical index and scores, duration indicators and laboratory data were analysed. Predictive factors of NIV failure were assessed using univariate and multivariate regression analyses followed by the receiver operating characteristic (ROC) curve. Results In the Group 1 (NIV failure) there were 54 (73.97%) patients. Predictive factors for NIV failure were: the presence of dyspnoea on the day of admission at hospital (p<0.05; sensitivity 44.40%; specificity 84.20%), higher radiographic assessment of lung oedema score (RALES) on the day of starting NIV (p<0.009; sensitivity 70.40%; specificity 73.75%), higher length of NIV (p<0.014; sensitivity 48%; specificity 84.10%) and higher urea on the day of starting NIV (p<0.004; sensitivity 70.44%; specificity 73.72%) Conclusion NIV treatment in COVID-19 critically ill patients has a high failure rate. In addition to respiratory parameters, dyspnoea, higher RALES, higher length of NIV and increased urea value could predict NIV failure. These factors should be considered in treatment decision making.
Aim To analyse demographic data, clinical symptoms and signs, laboratory data and comorbidities in patients with COVID-19 pneumonia admitted to the intensive care unit (ICU), mechanically ventilated with fatal outcome. Methods Medical records of 92 patients were retrospectively analysed. Demographic data, clinical symptoms and comorbidities were collected on the day of hospital admission. Clinical signs and laboratory data were collected on the day of hospital admission (T1), on the day of starting non-invasive ventilation (T2), and on the day of starting invasive ventilation (T3). Results Average age of the patients was 60.05 years. Patients over 50 years of age, 71 (77.1%) (p=0.000), and males, 62 (67.4%; p=0.001) were predominant. The most common patient symptoms were exhaustion, myalgia, dyspnoea and cough. Hyperthermia was recorded on the day of hospital admission. Tachycardia, hyperglycaemia, hypoxemia were recorded at all observed study times. The most common comorbidity was hypertension arterialis with a very strong correlation with fatal outcome, followed by diabetes mellitus and chronic heart disease that were moderately correlated with fatal outcome. Conclusion The treatment of COVID-19 patients in ICU with mechanical ventilation has a high failure rate. Demographic data, clinical symptoms and signs as well as accompanying comorbidities can be a significant component in making decisions about diagnostic-therapeutic procedures.
Xanthohumol (XN), isoxanthohumol (IX) and 8-prenylnaringenin (8-PN) are important prenylflavonoids present in hops with potential beneficial properties. In this study, we examined differences in the content of XN, IX and 8-PN in hops and beer produced under organic and conventional production regimes. A An ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS) method for analysing XN, IX and 8-PN in hops and beer was developed and validated, with LOQ ranging from 0.5 to 10 ng/mL. Finally, we examined 15N/14N and 12C/13C isotope ratios in the hops and beer using isotope ratio mass spectrometry (IRMS). The results show no statistically significant difference in the content of the selected prenylflavonoids between organic and conventionally produced hops and beer—in the whole sample group, as well as between the matched pairs. Stable isotope analysis indicated that only δ15N values are statistically higher in organically produced hops and beer. However, the differentiation according to the type of production could not be made solely based on the δ15N signature, but it could be used to provide supporting evidence.
With stress echo (SE) 2020 study, a new standard of practice in stress imaging was developed and disseminated: the ABCDE protocol for functional testing within and beyond CAD. ABCDE protocol was the fruit of SE 2020, and is the seed of SE 2030, which is articulated in 12 projects: 1-SE in coronary artery disease (SECAD); 2-SE in diastolic heart failure (SEDIA); 3-SE in hypertrophic cardiomyopathy (SEHCA); 4-SE post-chest radiotherapy and chemotherapy (SERA); 5-Artificial intelligence SE evaluation (AI-SEE); 6-Environmental stress echocardiography and air pollution (ESTER); 7-SE in repaired Tetralogy of Fallot (SETOF); 8-SE in post-COVID-19 (SECOV); 9: Recovery by stress echo of conventionally unfit donor good hearts (RESURGE); 10-SE for mitral ischemic regurgitation (SEMIR); 11-SE in valvular heart disease (SEVA); 12-SE for coronary vasospasm (SESPASM). The study aims to recruit in the next 5 years (2021–2025) ≥10,000 patients followed for ≥5 years (up to 2030) from ≥20 quality-controlled laboratories from ≥10 countries. In this COVID-19 era of sustainable health care delivery, SE2030 will provide the evidence to finally recommend SE as the optimal and versatile imaging modality for functional testing anywhere, any time, and in any patient.
Heat shock protein 70 (Hsp70) engages Toll-like receptors (TLR) 2 and 4 when found in the extracellular compartment and contributes to inflammation in chronic obstructive pulmonary disease (COPD). Since there is growing evidence for the genetic risk factors for COPD, the gene expression of HSP70, TLR2 and TLR4 was determined, as well as the association between HSP70, TLR2 and TLR4 single nucleotide polymorphisms, (SNPs) and COPD. The gene expression was assessed in peripheral blood cells of 137 COPD patients and 95 controls by a quantitative polymerase chain reaction (qPCR), while a total of nine SNPs were genotyped by TaqMan allelic discrimination real-time PCR. HSP70 and TLR2 gene expression was increased in COPD patients compared to the controls, regardless of the disease severity and smoking status of participants. The rs6457452 SNP of HSP70 was associated with COPD, indicating the protective role of the T allele (OR = 0.46, 95% CI = 0.24–0.89, p = 0.022). Furthermore, COPD C/T heterozygotes showed a decreased HSP70 mRNA level compared to COPD C/C homozygotes. In conclusion, HSP70 and TLR2 may have a role in the pathogenesis of COPD, and the HSP70 rs6457452 variant might influence the genetic susceptibility to COPD in the Croatian population.
A study of the trichomes types and distribution and pollen morphology was carried out in nine Micromeria taxa (M. cristata ssp. cristata, M. cristata ssp. kosaninii, M. croatica, M. graeca ssp. graeca, M. graeca ssp. fruticulosa, M. juliana, M. kerneri, M. longipedunculata and M. microphylla) and five closely related Clinopodium species (C. dalmaticum, C. frivaldszkyanum, C. pulegium, C. serpyllifolium and C. thymifolium) from the Lamiaceae family of the Balkan Peninsula. By scanning electron microscope, non-glandular trichomes, peltate and capitate trichomes were observed on the calyx, leaves and stem of the studied species. Two subtypes of capitate trichomes were observed in Micromeria species: subtype 1 (consisting of a basal epidermal cell and an elliptically shaped head cell) and subtype 2 (consisting of a basal epidermal cell, two to three stalk cells and a round head cell). In Clinopodium species, three types of capitate trichomes were observed: subtype 1, subtype 3 (consisting of a basal epidermal cell, a short peduncle cell, and a single round head cell), and subtype 4 (consisting of a basal epidermal cell, a stalk cell, and an elongated head cell). These results support the recent transfer of Micromeria species from the section Pseudomelissa to the genus Clinopodium.
Aim To analyse the resolution of chest X-ray findings in relation to laboratory parameters in patients infected with acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a two- month followup. Analysis of chest X-ray findings in the first few months after the disease is the main goal of our work. Methods Out of the total of 343 patients chest X-ray findings were followed in 269 patients. Patients were divided into groups according to the severity of findings. D-dimer, inflammatory markers, blood cell count, neutrophil lymphocyte ratio (NLR) were analysed. Chest X-ray was analysed during the hospitalization on the day of admission, on the third, the seventh and the fourteenth day (scoring method was used). After discharge chest X-ray was performed in a two-week follow-up, then after one and two months, and after three months if necessary. Results Incomplete chest X-ray resolution was identified in 24 (39.34%) patients with severe, 27 (22.31 %) patients with moderate and in three (3.91%) patients with mild findings. Statistical significance was established in overall score by comparison between all groups (p<0.001), and in the moderate compared to the mild group (p=0.0051). The difference of NLR in the severe compared to the moderate group was observed (p=0.0021) and in the severe group compared to the mild group (p=0.00013). Conclusion Chest X-ray findings persisted mostly in the severe group followed by the moderate and mild ones. Long-term followup is necessary for the appropriate treatment and prevention of fibrosis, and reduction of symptoms.
Aim To present the regulations governing the operation of pharmacies in Bosnia and Herzegovina over the Austro-Hungarian rule (1878-1918). Methods Qualitative secondary data analysis was used. Results The Austro-Hungarian government had found poor population's health, insufficient health facilities and qualified staff. For a long time, population was treated by old methods of medicine and pharmacy, and directed to folk doctors, healers and herbalists. As early as 1879, orders requesting mandatory possession of a university diploma to practice pharmacy and medicine, thus taking the initial steps to combat quackery. The production and dispensing of medicines became the exclusive competence of pharmacists. The Law on Pharmacies adopted in 1907 comprehensively regulated the apothecary activity. Pharmacy Gremium was founded, the first association of pharmacists with the task of protecting professional interests. All types of quackery were explicitly forbidden to pharmacy staff. Apothecary activity was regulated as a craft, not as a health activity. During this period, pharmacy became a regulated profession with educated and qualified personnel. The number of public pharmacies and qualified staff was growing. In 1878 only one graduated pharmacist was found, while in 1910 in 47 pharmacies there were 79 pharmacy staff. At the end of 1918, the masters of pharmacy were the owners of 48 pharmacies, in 38 cities. Conclusion All enacted regulations contributed to the development and improvement of the apothecary activity over the observed period, and laid the foundations for the future development of the profession.
Aim To measure a calibre of radial and ulnar septocutaneous perforators at the anterior forearm, and to count its number in proximal, middle and distal thirds. Methods The study was conducted on 50 fresh amputated forearms (trauma, tumours) in the period between January 2012 and December 2021. Forearms were collected from several hospitals in Belgrade, and analysed at the Institute of Anatomy, Medical School, University of Belgrade, Serbia. Injection of ink-gelatin and fine dissection of autopsy material was performed on 30 forearms, and corrosion method with injecting methyl methacrylate for 3D analysis on the other 20 forearms. Results A mean calibre of septocutaneous perforators on the radial artery was 0.53±0.46 mm (0.2-0.85). Averagely, there were 8.1 radial artery septocutaneous perforators - two perforators on the proximal third, 3.7 on the middle third, and 2.7 on the distal third. The mean calibre of ulnar artery perforators was 0.65±0.35 mm (0.18-1.8). The average number of septocutaneous perforators of the ulnar artery was 5.6; 1.2 on the proximal third, two on the middle third, and 2.2 on distal third. Conclusion Determination of the origin, calibre and spreading directions of the arterial septocutaneous perforators on the anterior forearm provide quantification of data about arborisation of radial and ulnar septocutaneous perforators at the anterior forearm. Clinical relevance of those anatomical data is in defining of safe locations and dimensions of forearm fasciocutaneous flaps in plastic surgery.
OBJECTIVE The aim of our study was to determine the etiological factors, treatment and outcome of patients with non-variceal bleeding from upper gastrointestinal tract. MATERIALS AND METHODS This study enrolled 200 patients admitted to Sarajevo University Clinical Center with signs and symptoms of upper gastrointestinal bleeding, from January 2019 to July 2020. All patients had undergone gastroscopy, confirming the cause of gastrointestinal bleeding. Clinical and laboratory data were collected retrospectively, including previous non-steroid antiinflammatory drugs (NSAIDs) and anticoagulant therapy, comorbidities, risk factors, as well as endoscopic findings, laboratory findings, treatment and clinical follow-up. RESULTS The majority of patients were men (59%) with an average age of 53±6 years. Duodenal and gastric ulcers were the most common cause, followed by other etiologies. In our study, previous NSAIDs therapy had been registered in 29.5% of patients, anticoagulants in 8%, and proton pump inhibitors (PPI) in 2.9% of patients. Endoscopic intervention was required in 34% of patients. The need for transfusion occurred in 44.5% of cases. Rebleeding during hospitalization was observed in 7.5% of patients, mortality in 1.5% and surgery in 3% of patients. CONCLUSION The patients admitted to our hospital with symptoms of acute nonvariceal upper gastrointestinal bleeding were elderly, predominantly males, with significant comorbidities and a higher incidence of NSAID use. Gastroprotection is underutilized during NSAID treatment in patients with other coexisting risk factors, with a low rate of concomitant use of PPI during NSAIDs therapy. Endoscopic therapy, together with PPI, significantly reduces rebleeding rates, mortality and the number of emergency surgical interventions.
Background: Haematochesia (Lower Gastrointestinal Bleeding (LGIB) is the most common reason for endoscopic examination. Generaly it is caused by hemorrhoids and diverticular disease, but other anorectal conditions can also lead to LGIB. Recurrent bleeding may result in secondary iron deficiency anemia. Colonoscopy is the primary diagnostic option for establishing a diagnosis of colonic bleeding. Objective: This study aimed to analyze symptoms and endoscopic finding (specialy hemorrhoids) who may be sources of LGIB.Second goal of this study is to estimate time from onset of symptoms to performance of a colonoscopy. Methods: A retrospective study included 603 adult patients who underwent colonoscopy in General Hospital “Sv. Apostol Luka“, Doboj, Bosnia and Herzegovina, between 1.1.2020 and 31.12.2020. Results: Average age of the examined population was 62±13,3years. According to the gender they were mostly men. To be exact,by percentage it was 53.7% of men and 46,3% of women, or by number: 324 men and 279 women. The most common indications for colonoscopy were LGIB (48,8%), abdominal pain and irregular stool. Most frequent endoscopic findings were hemorrhoids 42%. Normal findings had almost one third of all examinated patients. Combined findings-presence of more clinical entities in one patient were presented in 95 cases. In the group with hemorrhoids were almost two thirds of males, but there was no gender difference noted in between group with LGIB and without LGIB. More than half patients were older than 61 years. Anemia was presented in almost 20% of cases. Significantly it is higher frequency of abdominal pain, irregular stool and weight loss observed on the group without LGIB. Also, significantly more frequently patients with LGIB underwent colonoscopy in 0-30 days when compared with patients without LGIB (p=0,016). Conclusion: In patients with haematochezia, taking a careful medical history is mandatory. Hemorrhoids, diverticular disease and colorectal cancers are the most common causes of bleeding. Patients with LGIB and abdominal pain were previously examined with colonoscopy. Completely colonoscopy is advocated to detect probable proximal lesions.
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