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Context: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic lung diseases and is an important cause of mortality and morbidity in the world. Chronic obstructive pulmonary disease is a heterogeneous and multisystemic disease. Aims of the study was to assess workability of patients with COPD in relation to the workplace. Settings and Design: Prospective study. Methods and Material: The study was conducted on 150 patients with COPD. Each patient was examined by an occupational medicine specialist and a standardized COPD Questionnaire was completed. A physical examination was performed with special emphasis on auscultatory findings on the lungs. Spirometric testing was performed. Using the statistical methods, the results of the parameters of temporary (number of lost working days) and permanent incapacity (exercised right to some kind of disability) of the examined group were analyzed. Statistical Analysis Used: Descriptive statistics. SPSS 10.0. Results of the study showed that out of 150 patients, 48.67% had preserved working capacity for jobs. There are mostly jobs without special working conditions. Out of 150 patients, 51.33% had reduced working capacity for jobs. Conclusions: These are mostly workplaces with special working conditions, where respondents are exposed to the harmfulness of the workplace. Reduced working capacity was found in 51.33% of examined simple.

Introduction: Laboratory personnel (LP) represent a high-risk group of healthcare workers for whom the primary laboratory environment and specific work activities are a major source of potential exposure to health hazards. This study aimed to evaluate the developed matrix and assess risk based on self-assessment. Methods: This multicenter, qualitative, and cross-sectional study was conducted on LP employed in biomedical laboratories. The respondents were divided into groups according to their territorial affiliation. The data collection tool used was a six-area questionnaire distributed online through a network of professional associations. For the risk assessment, a matrix was developed with scores ranging from 0 to 650, dividing the risk level into four categories. Descriptive and inferential statistical methods were used for the statistical analysis. Results: The developed model combined the classification of risk and risk factors with a certainty of p < 0.001. The regression analysis showed that working conditions had the greatest influence on overall risk, followed by physical, biological, and physical hazards. Of the 640 respondents, the medium risk category was the highest in European Union (EU) countries (81.2%). Comparing the values in the high-risk category between the Bosnians and Herzegovinians (BiH) group and the Republic of Serbia, Republic of Northern Macedonia, and Montenegro (SCM) group with the EU group, a doubling (16.6%: 36.7%) and tripling (16.6%: 52.1%) of the proportion was found, respectively (p < 0.001). Overall, 1.7% of the LPs from BiH fell into the high-risk category. Conclusions: The designed matrix provides a reliable basis for identifying risk predictors in the study population and can serve as a useful tool for conducting risk assessments in biomedical laboratories. The results of the risk assessment indicate significant differences between the studied groups and highlight the need for increased control of BiH workplaces through new regulatory requirements.

Jasmina Biščević-Tokić, Sanja Brekalo-Lazarević, N. Tokić, Sabina Bećirović, Selvedina Sarajlić Spahić

Aim To determine a degree of change in the bones of workers who spend their full time job in sitting position and to find a correlation between smoking and changes in bone structure. Methods Examinees were 213 female workers who worked full time sedentary work in front of computer. Each worker was subjected to physical examination and ultrasonic osteodensitometry of calcaneus. Results The average age of patients was 45.4 years. Changes in bone density were found in 110 (51.64%) workers. Correlation between smoker and non-smoker groups was positive, but "r" was higher in smokers than in non-smokers. It is worrying that 10 out of 22 persons in the group up to 30 years of age have osteopenia. Conclusion Recommendation for regular annual control of bone density of the working group at risk regardless of age should be followed. Prescribing exercise for the working group at risk should be a significant part of preventive work in clinics of occupational medicine and sports.

Jasmina Biščević-Tokić, N. Tokić, Elma Ibrahimpasic

Introduction: Paracetamol (Acetaminophen) in addition to aspirin is the most commonly used analgesic and antipyretic medication by millions of patients worldwide. It is an example that paracetamol as medicine that in the world is provided without a doctor’s prescription, can lead to death. Today paracetamol became an integral part of a heroin mixture and is very popular at the street market. The main reason for this is that it can be obtained without a prescription, it is cheap, and by most people well tolerated without side effects. It is probably used for “cutting” the pure heroin, as it says in the jargon, and in that manner from small amount of pure drug is obtained greater amount, which is then sold on the street. The goal is to identify presence of paracetamol, by analytical method of gas chromatography mass spectrometer (GC-MS) in postmortem material together with psychoactive substances. Material and methods: For chemical-toxicological analysis is used biological material collected trough autopsy of 20 deceased people, suspected to have died due to psychoactive substance overdose. All received samples are stored at -20 ° C until analysis at our laboratory. From processed 47 samples that were analyzed in the period from 2014 to 2015, 19 are blood samples, urine 19, 3 samples of stomach contents, and 6 samples of bile content. Deceased were middle-aged, of which only 7 were female. The tested samples were processed according to two methods of extraction. Extraction by XAD-2 resin, and the extraction by the method of salting out with sodium tungstate. Extracts of the samples were then dissolved in chloroform and continued analysis at the analytical instrument. Identification of the paracetamol presence, in the test biological samples is demonstrated by the technique of gas chromatography with mass spectometry (hereinafter referred to as GC-MS). The technique of GC-MS is a selective, sensitive and reliable, and is therefore considered a “gold standard” for determining the drug, and the drug substance. Used GC-MS instrument was an Agilent 7890A with helium as the carrier gas. Results: The analysis of blood samples, urine, bile and stomach contents, obtained after the autopsy of deceased persons, by using gas chromatography with mass spectrometry, in analytical manner confirmed the fact that paracetamol is a very common component of psychoactive substances poisoning. In our assay of samples we detected psychoactive substances (heroin, codeine, morphine, sertraline, diazepam), and almost all were found in the combination with paracetamol, indicating the poor quality of illicit drugs sold on the market. Discussion: Paracetamol (Acetaminophen) is a very common component in mixtures of street drugs. Such mixtures almost anyone can afford, but the very quality of these drugs has become extremely low, because it does not sell the pure substance, but is mixed with various medications. According to research Pantazia et al. the heroin mixture proportion of the heroin is very small so a lot of that mixture has only 3% of heroin, a large number of cases can be only 1% of pure heroin. Most of the time it replaces caffeine and paracetamol. According to the Risser et al. reason why acetaminophen component is present in these mixtures is because it can be purchased without a prescription, it is cheap, well tolerated by most people and shows no side effects. Conclusion: When we talk about illegal drugs, we must emphasize the fact that there is no quality control, or the composition of the drug. The composition of the drug purchased on the black market is still unknown to potential user. While reaching the final drug users it pass through many hands, and at each step something is added to increase earnings. Most often present additives or impurities in narcotic drugs that are added are caffeine, ephedrine, acetaminophen, acetylsalicylic acid (aspirin) and additives such as powders, cement and chalk.

Jasmina Biščević-Tokić, N. Tokić, Adnan Musanović

ABSTRACT Introduction: Pneumonia is the most serious inflammatory disease of the respiratory system and also the most common infectious disease. Even now, in the 21st century, pneumonia occupies a prominent place in clinical medicine and public health. We are confronted daily with the increased number of patients, as well as the constant increase in annual mortality due to this infectious disease. Goal: The goal was to investigate the prevalence and pneumonia characteristics as the most serious lower respiratory tract infection, the incidence of typical and atypical pneumonia, hospitalization duration of the patients at the Clinic of Infectious Diseases, Clinical Center of Sarajevo University CCUS. Patients and Methods: From January 2011 until December 2012 the study involved 100 hospitalized patients with infections of the lower respiratory tract at the Clinic of Infectious Diseases CCUS. Results: Among the most common infections the pneumonia is highly represented. Lung X-Ray in two planes, by all protocols, demonstrated with the auscultatory finding has the highest value in the diagnosis of clinical pneumonieae. A statistically significant difference among our hospitalized patients, compared to typical and atypical pneumonia, is in favor of the first–typical bacterial pneumonia. Hospitalization duration ranges between 7-14 days. Conclusion: We believe that the introduction of the pneumococcal vaccine (PCV) should reduce the number of pneumonia caused by this bacterium. Recommendations for its use also come from the WHO. Until December 2012, WHO added 86 states in the PCV immunization as a part of their national immunization programs. Pneumococcal conjugate vaccine (PCV) is safe and effective for the reduction in number of patients suffering from pneumonia caused by St. pneumoniae. In particular, the vaccine is a significant protection for children, who due to age and severity of the disease must remain under medical supervision. In elderly vaccine is important and useful as preventive measure, due to their biological characteristics and life circumstances which mark this group as vulnerable population, like the youngest, and can be fatal for them.

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