Introduction: Burnout syndrome in some European countries is recognized as an occupational disease. In the past time, it has been identified predominantly in the service sectors such as healthcare, social services, mental health and education, but later it started to be predominant in other occupations with high job requirements and time pressure. The aim of this study was to assess the presence of burnout at work among the bank employees of Sarajevo Canton, Bosnia and Herzegovina.Methods: A cross-sectional study was conducted in banks (n = 6) located in Sarajevo Canton, Bosnia and Herzegovina, between January and April 2018. Employees filled out an anonymous questionnaire, after their written informed consent had been obtained. The study included employees regardless of their job positions and job seniority.Results: The total number of surveyed employees was 260. There are not statistically significant gender differences (p = 0.854¸ p < 0.05) compared to the total Maslach Burnout Inventory (MBI) score. Statistically significant differences in relation to the total MBI score were observed in the examinees who have been working in the banking sector between 15 and 20 years (p = 0.04; p < 0.05) and examinees working temporarily <2 h/week (p = 0.016; p < 0.05), that is, more than 8 h/week (p = 0.015; p < 0.05). Mid value and standard deviation of the score in the subscale of emotional exhaustion (EE) is 26.26 ± 11.15, which shows that one third of the examinees are in high risk of EE.Conclusion: We can conclude that less than one third of examinees are in high risk of burnout syndrome.

Aim To evaluate the relationship between cardiovascular remodelling and glomerular filtration rate (eGFR) in pre-dialysis chronic kidney disease (CKD) patients without cardiovascular diseases (CVD) and in renal transplant recipients (RTR). Methods The cross-sectional study included 83 patients with eGFR<60 mL/min/1.73m2 (45 with CKD 3 stage and 38 with CKD 4 stage). Thirty six RTR had eGFR 67.8 (57.3-73.7) mL/ min/1.73m2 and control group consisted of 44 patients with eGFR>60 mL/min/1.73m2 . All patients were evaluated by echocardiography and X-ray. Results Left ventricular hypertrophy (LVH) was present in 74.7% CKD patients, most frequently in CKD 4 stage and in RTR. Calcifications of abdominal aorta (CAA) were present in 87% CKD 4, 60% RTR and in 44% CKD 3 patients. Calcifications of the mitral valve were found in 34.2% CKD 4, 25.0% RTR and in 6.7% CKD 3 stage patients. Aortic valve calcifications were most frequently present in CKD 4 stage (26.3%). The LV mass index negatively correlated with eGFR (p<0.001), and positively with parathyroid hormone (p<0.001), phosphorus (p=0.043), age (p<0.001) and diabetes (p=0.043). In multivariate regression analysis the risk factor for calcifications of the mitral and aortic valve, as well as for CAA was the decline in eGFR (p<0.001). Conclusion Renal transplant recipients have a higher incidence of CV remodelling than patients with CKD 3 and less than patients with CKD 4 stage, indicating incomplete regression of CV calcifications and LVH after kidney transplantation. A decrease of renal function represents a significant risk factor for valvular and vascular calcifications occurrence in CKD patients.

The r enal damage is an emerging complication of excess weight.  Aim of this study was to determine the occurrence of chronic kidney disease (CKD) in subjects depending on their weight and the influence of body mass index (BMI) on glomerular filtration (GF) rate decline in outpatients with hypertension and/or diabetes mellitus type 2. Methods: This observational, cross sectional, pilot study included 200 adult patients suffering from hypertension and/or diabetes mellitus type 2 from March 2012. to March 2013. in the Institute for Occupational Medicine of Canton Sarajevo. Renal function was evaluated by using MDRD equation and measurement of microalbuminuria and proteinuria in 24 - hour urine, using nefelometric method at the Institute of Clinical Biochemistry of the University Clinical Center in Sarajevo K/DOQI classification  was used to define the stages of CKD. Results: Of the total 200 patients (62.5% male; mean age of 52.46 ± 8.2 years) most of them had a BMI of 25 - 30 (n=99; 49.5%). Most patients with a body mass index above 30 suffered from hypertension associated with diabetes mellitus type 2 (n=23; 34.3%,  p<0.05). The average values of BMI were statistically higher in men than in women (29.16±4.4 vs. 27.76±3.7). Early CKD was found in 118 patients (59.0%), mostly those with a BMI above 30 (63.8%). Conclusion: Early detection of CKD in primary care should definitely be a priority, especially in high - risk patients. It is also necessary to increase work on the prevention of obesity in order to prevent disease progression.

Introduction: Chronic kidney disease (CKD) is a significant public health problem. The aim of this study was to determine the presence of early stages of renal disease in hypertensive and diabetic outpatients without previously diagnosed renal damages. Methods: In this cross-sectional study we studied a random sample of outpatients with essential hypertension and/or diabetes mellitus type 2 in the general practice ambulance of city Sarajevo. Renal function was evaluated by using MDRD (Modification of Diet in Renal Disease) equation and with measurement of renal biomarkers. K/DOQI classification was used to define the stages of CKD. Results: The study included 200 patients, of whom 75 (37.5%) were females, mean age of 54.81 ± 6.1 years, and 125 (62.5%) male, mean age 52.46 ± 8.2 years. More than half of respondents (54.0%) were hypertensive during the follow up period. Early CKD was detected in 52% respondents. Higher prevalence of early CKD was verified in the group of patients who had hypertension associated with diabetes mellitus type 2 (59.6% vs. 47.2% in hypertension group vs. 54,0% in diabetic group, p<0.05). Significant negative correlation was found between estimated glomerular filtration rate and presence of albuminuria (p<0.001), duration of hypertension (p=0.003), duration of type 2 diabetes mellitus (p=0.021), stages of hypertension (p=0.012), female gender (p<0.001) and older age of subjects (p=0.040). Conclusion: Our results confirmed high prevalence of CKD and the importance of early detection of CKD in high risk groups of patients in order to prevent the progression of the same. Prevention of chronic kidney disease in our country is still not carried out satisfactorily. Required is a much greater collaboration between primary care health givers and nephrologists.