Uvod: Zdravstveni djelatnici su rizična skupina za HIV-infekciju i imaju ključnu ulogu u prevenciji HIV-a. Cilj: Procijeniti znanje i stavove i korelaciju znanja i stavova zdravstvenih djelatnika o HIV-infekciji. Ispitanici i metode. Ispitanici su zdravstveni djelatnici zaposleni u Domovima zdravlja: Bugojno, Donji i Gornji Vakuf. Upitnik je samostalno izrađen. Stavovi su ispitivani na osnovi modificirane Likertove ljestvice. Procjena znanja i stavova napravljena je tako da više od 50% točnih odgovora ukazuje na dobro znanje i pozitivan stav. Za testiranje statističke značajnosti korišten je χ² test (p <0.05). Za određivanje korelacije varijabli znanje i stavovi korišteni su Pearsonov i Spearmanov koeficijent korelacije. Rezultati: U istraživanju je sudjelovao 81 zdravstveni djelatnik – 57 (70%) žena i 24 (30%) muškarca. Najveći broj ispitanika bile su medicinske sestre (57%), prosječne dobi 36 godina života i 13 godina radnoga staža. Većina ispitanika pokazali su relativno dobro znanje o HIV-infekciji (73%) i pozitivne stavove prema HIV-pozitivnim osobama (80%). Koeficijent korelacije za zbirne vrijednosti znanja i stavova iznosio je 0,336, sa statističkim značajem 0,002. Zaključak: Da bi se poboljšala praksa, smanjila stigma i diskriminacija HIV-pozitivnih osoba u zdravstvenim ustanovama, potrebno je provoditi kontinuiranu edukaciju svih zaposlenika.

Deskriptori ZOONOZE – epidemiologija, prijenos; SALMONELOZE – epidemiologija; BRUCELOZA – epidemiologija; LEPTOSPIROZA – epidemiologija; Q GROZNICA – epidemiologija; HEMORAGIJSKA GROZNICA S BUBREŽNIM SINDROMOM – epidemiologija; BOSNA I HERCEGOVINA – epidemiologija SAŽETAK. Cilj istraživanja. Ciljevi istraživanja bili su: ukazati na značaj zoonoza u ljudi te istražiti koje se zoonoze u ljudi najčešće javljaju u Zeničko-dobojskoj županiji (ZDŽ) i Federaciji Bosne i Hercegovine (FBiH), tijekom desetogodišnjeg razdoblja (2010. – 2019. godine). Materijal i metode. U svrhu istraživanja korišteni su podatci o osam najučestalih zoonoza (salmoneloze, bruceloza, leptospiroza, Q-groznica, hemoragijska groznica s renalnim sindromom, borelioza, ehinokokoza, listerioza), temeljem prijava Instituta za zdravlje i sigurnost hrane Zenica i Federalnog zavoda za javno zdravstvo. Dijagnoze su postavljene klinički, mikrobiološki i/ili epidemiološki. Rezultati. Tijekom desetogodišnjeg razdoblja u ZDŽ prijavljena je 871 zoonoza. Najviše (191/871; 21,9%) prijavljenih bilo je 2019. godine. Najučestalija zoonoza bila je salmoneloza (343/871; 39,4%; 95,3/100.000 stanovnika), a zatim slijedi bruceloza (323/871; 37,1%; 87,7/100.000). Najčešća zoonoza u FBiH je salmoneloza (2.764/5.219; 53%; 125,6/100.000). Na drugom mjestu je bruceloza (1.505/5.219; 28,8%; 68,4/100.000). Leptospiroza (386/5.219; 7,4%; 17,5/100.000), Q-groznica (203/5.219; 3,9%; 9,2/100.000) i hemoragijska groznica s renalnim sindromom (164/5.219; 3,1%; 7,5/100.000) javljaju se povremeno, u vidu manjih ili većih epidemija. Ostale zoonoze javljaju se sporadično. Zaključak. Zoonoze su od posebnoga javnozdravstvenog značaja i zahtijevaju blisku interdisciplinarnu suradnju različitih profila stručnjaka (iz područja medicine, veterine, šumarstva, biologije, zoologije, ekologije), poduzimanje učinkovitih mjera u nadzoru i suzbijanju te proučavanju i znanstvenom istraživanju tih bolesti.

Aim To describe a case of an eight-year-old boy with chronic Epstein-Barr virus (EBV) hepatitis with incipient cirrhosis, rarely found in practice. Methods The diagnosis was based on findings of specific IgG serum antibodies and EBV positive liver biopsy. Other etiologies of hepatitis were excluded: autoimmune hepatitis, viral hepatitis A, B, or C, cytomegalovirus (CMV), herpes simplex virus (HSV), adenovirus infection, toxoplasma infection. Results A mild form of infectious mononucleosis with acute hepatitis without icterus was found in the boy first time at the age of three. He got sick again in april 2018 with fever, minor loss of appetite and weakness, skin and sclera were anicteric, no enlarged neck lymph nodes. Ultrasonography of the spleen revealed a spleen diameter of 10.7 cm, while the liver was 11.8 cm. Laboratory findings, sedimentation, blood count, C reactive protein (CRP) were all normal. Ten days and a month later an increase of aminotransferase was noticed. The liver biopsy and PCR EBV DNA were performed six months of disease onset. The disease had lasted for about one more year with loss of strength and an increase of aminotransferase with maximum value of 3-4 times higher than normal one. The therapy was supportive. Conclusion Chronic EBV hepatitis is very rare. In differential diagnosis of hepatitis and unclear febrile conditions, EBV infection should not be forgotten.

Hepatoprotective agents are medicines or dietary supplements that are used as an adjunct to the treatment of acute and chronic viral hepatitis, liver cirrhosis, hepatocellular carcinoma prevention, as well as other liver diseases. Experiments on animals and cell cultures have shown that natural compounds can alleviate and prevent pathological changes in the liver. In the past few years, considerable attention has been paid to medicinal herbs with hepatoprotective, antioxidant, and immune properties. The plants contain numerous phytochemicals, including polyphenols, phenolic acids, coumarins, styles, tannins, lignans, and lignins. These compounds include silymarin, curcumin, picroside, kutkoside, phyllanthin, hypophyllanthin, glycyrrhizin, glycyrrhizin, berberine, luteolin, quercetin, coumarin derivatives (4-methylumbelliferone), and others. Many studies have been aimed at collecting data on some types of edible plants and fruits (grapefruit, cranberries, grapes, beets, cacti, chamomile, spirulina, propolis) that have shown hepatoprotective effects.

Aim To establish the presence of two risk factors, smoking and alcohol use, for non-communicable diseases among students at the University of Zenica. Methods The research was conducted at eight schools of the University of Zenica in the academic year 2016/2017 during the period from 1 December 2016 to 15 February 2017. The study involved 600 students 19-29 years of age (all years of study). The research was carried out with a standardized and validated questionnaire, the STEPS non-communicable Disease Risk Factors survey, developed by the World Health Organization. Results Tobacco was used by 145 (24.2%) students, 68 (46.9%) of them being males and 77 (53.1%) females (p<0.05). Males smoked 15.62 and females 13 cigarettes per day (p<0.05). On average, male participants were 16.56 years old, and female participants 16.71 when they started consuming cigarettes (p<0.05). A total of 289 (48.1%) students consumed alcohol, of whom 135 (70.2%) were males and 154 (37.7%) females (p<0.05). Conclusion There is evidence of high prevalence of smoking and alcohol usage as the risk factors for non-communicable diseases. Two levels of the prevention measures should be applied in order to reduce the prevalence of such risk factors: strategic level with a definition of the population, actors, activities, target population and anticipated results, and tactic level which will show contingency activities at the University.

Aim To investigate epidemiological characteristics of the measles epidemic (risk factors and reasons for its emergence) in order to establish better control and prevention of future epidemics as well as to determine an influence of poor collective immunization of children against measles on appearance of epidemic disease. Methods An open retrospective epidemiological study of measles infection was conducted during the epidemic in Zenica-Doboj Canton (ZDC) in the period 2014-2015. Disease reports, Disease Reporting Forms for measles and rubella cases and the Bulletin of the Institute for Health and Food Safety Zenica were used for data collection. Results A total of 325 patients with the diagnosis of measles were registered, 262 (80.61%) in 2014 and 63 (19.39%) in 2015 resulting in overall incidence of 81.25/100.000. The majority of patients were aged 0-6 (p<0.05). Of the total number of patients, only 13 (4.73%) were orderly vaccinated (p <0.05). In the period 2009- 2015 in ZDC 25.444 (83.34%) children (p <0.05) were vaccinated with measles, mumps, rubella (MMR) vaccine. Conclusion Results of the study show that the low level of vaccination of children continues to a risk of the emergence of epidemics of measles and other infectious diseases. Therefore, in order to prevent the disease there is a need for a better vaccination campaign.

The ideal goal of antiviral therapy or cure of chronic hepatitis B is HBsAg clearance and HBsAg seroconversion. According to modern guidelines of all Associations for liver diseases pegylated interferon alfa-2a and nucleos(t)ide analogues (entecavir, tenofovir) are first choice in the treatment of chronic hepatitis B. The aim of the study was to evaluate the success of the treatment of patients with chronic hepatitis B who received pegylated interferon. At the end of ten year period, HBV DNA <50 IU/ml and HBsAg seroconversion achieved 4 (4/55, 7.00%) patients. All were HBeAg negative. Additionally, is presented the case of patients, who, after the treatment, had the shortest period of healing. Patient is a man, aged 47 years, with the newly discovered HBeAg negative chronic hepatitis B and pronounced activity of serum aminotransferases. He was treated with pegylated interferon alfa-2a, 180 µg once a week, for 48 weeks. After antiviral therapy, the patient is HBV DNA negative, HBsAg negative and neat aminotransferases, and 12 months after completion of antiviral therapy comes to HBsAg seroconversion. The degree of cure of chronic hepatitis B, unfortunately, has not been entirely satisfactory, with the exception of the few individual cases.

Aim To investigate the relationship between recovered hepatitis B infection with appearance of toxic propylthiouracil (PTU) hepatitis and point out the growing importance of the use of drugs in the development of hepatitis. Methods A case of a 45-year-old female patient with suspicion of acute viral hepatitis who had polypragmasy of drugs in the last ten years, due to the polymorphism of symptoms/illnesses (diabetes mellitus, depression, hypertension, hypothyroidism) was presented. Results A female patient had hyperthyroidism after resolved viral hepatitis B with HBsAg seroconversion (HBsAg negative, antiHBs positive). PTU had the greatest potential for hepatotoxicity of all administered drugs. After corticosteroid therapy there was a significant improvement in liver function tests. In the course of the disease there was no change of hepatitis markers and exacerbations of hepatitis B. Conclusion Clinical practice should comprehensively monitor the effects of the intricate and tight connection between drugs, liver and endocrine system in order to better resolve all manifestations, complications and worsening of one or another organic system.