Introduction: The goal of this article is to present that innovating in health care begins to become an imperative in present time. Innovating will enable the achievement of the highest quality health care results and the patients' satisfaction with the least amount of financial resources.Methods: The thorough literature review of multifaceted sources was conducted including: studies, books, monographies and peer – reviewed journals with the goal of achieving the clearer picture of today's modern challenges in the complex fi eld of health care innovation.Discussion: Theoretical and empirical studies clearly indicate that the innovation is one of the key factors in the competitiveness of the organization and its survival in the market. Developed countries of the world today are making significant efforts in order for innovation to become a national priority, with special emphasis placed on measuring innovation performance. Results of theoretical and practical studies show that in the future, treatment of the most diffi cult and complex diseases of our time, through the entirely new discoveries and results, derived from the process of innovation, will project entirely new positive forms and outcomes in the health care.Conclusion: There is no doubt that the humanity and medical science will through innovation succeed to win the battles against the majority of the most complex contemporary diseases. Malignant neoplasm of tomorrow, through the application of a new, innovative approaches to research, processes and treatments will become a chronic diseases. Among many, the particular problem in the process of innovation will represent the cost of research and development (R&D), production and the safety of prescription drugs.

Introduction: Motivation is one of the most complex elements of human behavior, it is the subject of debates by which we answer to the question of why someone behaves in a certain way. The aim of this study wasto examine the factors of motivation for health workers and staff in working with diffi cult patients in intensive care units and to evaluate implementation of motivation factors by managers in their daily work with a team of health professionals.Methods: The study was designed as prospective. It was conducted on 27 employees who work in intensive care units in Clinical Center of Sarajevo University. The survey questionnaire was used with a clear andconcise questions , aimed at testing the factors of motivation for daily work with diffi cult patients, as well as implementation of motivational factors by managers in the organizational unit (OU).Results: Respondents indicated that motivates them, good organization of work - 10 of them (37%), while 26% of respondents indicated that they are motivated by fi nancial gain. In our study 21 (77%) of respondentssaid that their managers infuenced the motivation for a better job. Mobbing at the workplace did not had 80% of respondents, while 8% of respondents stated that they had some form of mobbing, and 12% of respondents give partial response.Conclusions: The survey showed that most respondents have a good motivation factors for the performance of daily activities to work with diffi cult patients. As the main motivating factors respondents reportedgood organization of work, as well as positive examples of their managers.

Autoimmune diseases occur in 3−5% of the population. Study included 30 patients with clinically diagnosed SLE and 30 healthy controls (American college of Rheumatology, 1997). SLE was diagnosed according to criteria issued in 1997 by the American College of Rheumatology (ACR). The aim of this study was to evaluate concentration values of each antigen of ENA-6 profile in SLE, to investigate possible correlation between the concentration of Sm antibodies and CIC, and to test their use as possible immunobiological markers in SLE. Furthermore, the aim of our study was to determine whether there is a correlation between Sm antibodies and CIC and SLE activity. The results revealed that all of these ENA-6 and Sm antibodies as biomarkers complement diagnoses of active SLE but their use as solo markers does not allow classifying patients with SLE. Our study has shown that based on calculations from ROC curves, Sm/RNP was clearly a very important marker for diagnosis of SLE (cut off ≥ 9.56 EU, AUC 0,942). The high incidence of Scl-70 (10%) reactivity suggests that ELISA monitoring of this antibody produces more false positive results than other multiplex assay. An important conclusion that can be drawn from the results of our study is that laboratory tests are no more effective than clinical examination for detecting disease relapse, but are helpful in the confirmation of SLE activity.

Introduction: Information systems today are an inevitable link in the health care system. Health care institutions and health workers in modern society, depend on information systems in everyday tasks of organizing institutions.The goals of the study were to determine the existence and application of information technology in the health care system and of the Clinical Center of Sarajevo University and, Primary Health Care Center of Sarajevo Canton, as well as to assess knowledge and practice of managers in nursing of the Organizational units of the University Clinical Center in Sarajevo and Primary Health Care Center of Sarajevo Canton.Method: The study is of a prospective type. It will use a questionnaire based on which we will be able to determine the knowledge and application in practice of managers in nursing of knowledge about information technology in the health care system. The study was conducted from June 1st – August 1st 2010.Results: It is expected that most health institutions in the Canton Sarajevo has no organized information network system. Most managers’ nurses use e-mail in order to quickly contact other colleagues and exchange experiences. A large number of nurse’s managers in health institutions use computer technology in their daily work in order to make medical reports.Conclusions: Health system and information technology are in close relationship, although still insufficiently applied in everyday work. Management of organizational units in health care in the future will not be able to successfully function without the use of information technology in their daily work.

Introduction: epidemiological data suggests worldwide burden of clinical manifestations of atherosclerosis, (i.e. coronary heart disease, cerebrovascular disease and peripheral vascular diseases). Combined coronary and carotid disease is the most presented type of the polyvascular atherosclerotic disease. The goal is to evaluate the influence and correlation of multiple risk factors in combined coronary and carotid atherosclerotic disease and to compare them to isolated coronary atherosclerotic disease. Material and methods: we included total of 124 consecutive patients with established coronary and carotid atherosclerotic disease. Patients were divided in two groups; group with isolated coronary atherosclerotic disease (ICAD) (n=60) with clinicaly established atherosclerosis on coronary vascular bed. Group with combined carotid and coronary atherosclerotic disease (CCAD) (n=64), had clinicaly established combined atherosclerosis of two vascular beds, coronary and carotid. We performed clinical assessment, laboratory tests, and specific cardiac investigations, (i.e. invasive and non-invasive diagnostic procedures). Results: in ICAD group we found high significance in multiple risk factors; total cholesterol 92,6%, obesity 80%, and elevated fibrinogen 77,5%. In CCAD group we found high significance of multiple risk factors; total cholesterol (82,5%), elevated fibrinogen (82,5%) and tobacco smoking of 77,5%. In CCAD group in males most assessed risk factor was smoking 88,4%, and in females total cholesterol 92,8%. Comparing ICAD and CCAD group we found significantly more diabetes mellitus type 2 in CCAD group. Conclusion: in both groups of patients we found markedly increase risk factors especially arterial hypertension, smoking and total cholesterol level. Multiple regression analysis showed significant correlation of patients age as a predictor of arterial hypertension. In other risk factors; total cholesterol, obesity, diabetes mellitus and fibrinogen, we found no statistical significance related to patients’ age.

We present a case of catheter induced pseudoaneurysm of femoral artery and postprocedural course. This type of complications occurs in 2% to 8% patients after interventional procedures via trans femoral access and and has overall trend of increase due to significant number of this procedures in diagnostic and interventional cardiology. A 74-year-old female was admitted to Vascular department complaining of severe pain in her left groin. On physical examination, there was a femoral mass palpable but non-pulsatile in her left groin. Color Doppler documented the presence of femoral pseudoaneurysm as well as "to-and-fro" flow pattern on the pseudoaneurysm neck. CT arteriogram showed pseudoaneurysm with mostly thrombosed cavity, diameter of 85 x 27 mm. We concluded for further surgical repair.