PURPOSE To estimate short-term and long-term influence of protracted stress caused by the NATO bombing of Serbia on self-reported cigarette smoking, we performed and analyzed smoking survey data. MATERIALS AND METHODS The survey included 320 adult citizens from Sombor, Novi Sad, and Belgrade, three cities that were bombed during the NATO campaign along with other Serbian target cities. We queried participants about their smoking habits before, during, and 8 years after the military intervention. We recorded smoking prevalence rates, intentions to stop smoking, and the age at which smoking began. We also recorded smoking history and cessation attempts. RESULTS Prior to bombing, 48% of the women and 63% of the men were smokers. During the bombing period, smoking prevalence in male smokers increased significantly. During this period, 32% of the women and 36% of the men increased their smoking by as much as two packs of cigarettes per week. A month after the bombing, the rate of consumption returned to the prewar levels. At present, 44% of the women, and 59% of the men smoke. The average age of current smokers is 43 years (standard deviation /SD/, 14.4) for women and 45 (SD, 16.3) years for men. Female smokers expressed greater interest in quitting smoking than their male counterparts, and they were slightly more successful than men at maintaining abstinence (20 vs. 18%). The participants in our study acknowledged that a compounding factor for successful abstinence was information on depleted uranium (DU) and other pollutants introduced into the environment by the war. CONCLUSION Prolonged stress imposed by war causes a short-term increase in smoking prevalence in male smokers and higher cigarette consumption both in male and female smokers. Even though these increases dissipated after the war was over, the prevalence of smoking within the population of urban Serbia remains very high. Counseling and pharmacological support for abstinence relapse in Serbia ere insufficient to sustain smoking cessation during the 8-year period after the NATO bombing. Motivation for smoking cessation stems primarily from governmental regulatory measures and awareness of the dangers to health posed by tobacco smoking.

We present a short history of the RAS, including biological actions of angiotensin peptides, and the functions of the enzymes that generate and metabolize angiotensins, including the likely effect of manipulating them. Attention is devoted to renin, (pro) renin receptors, angiotensin converting enzyme (ACE), ACE2, chymase, and neprilysin. Also, the rationale for targeting the RAS, based on numerous clinical studies of the ACE inhibitors and AT(1) receptor blockers is included. These two drug classes have protective and beneficial effects preventing functional and structural abnormalities of the cardiovascular system, and reduce the end organ‐damage. Finally, we consider the investigational agents acting on the RAS that have a potential for clinical usage, and give the perspective of pharmacological, immunological and gene targeting of the RAS for treatment of cardiovascular disease.

The news of the death of dr. Momir Macanovic deeply movedmany who had the honour to know this quiet intellectual, a dedicatedand extremely capable research physician.

Twenty five years ago, medical students of the former Yugoslavia accepted an idea that emerged from the Medical School in Tuzla to carry out a national preventive campaign "January 31st, a Day without Cigarette". This campaign was soon recognized by the World Health Organization (WHO) as one of "the most successful preventive achievement of medical students in Europe". The only contribution that the government made was printing and releasing a postal stamp on January 31st, 1990. During the war in Bosnia, the UN sanctions imposed to Serbia, and the NATO bombing campaign of the F.R. Yugoslavia (Serbia & Montenegro) weakened this antismoking campaign. At the time of the civil war in several Yugoslav republics, more citizens, including children and youth, started to smoke than in previous years. In 2002, January 31st was proclaimed as the National Antismoking Day in Serbia and the "Republic of Srpska" in Bosnia & Herzegovina; the Republic of Slovenia, and to a smaller extent the rest of the "Bosnian Federation", continued to observe this antismoking campaign. In the future, the medical professionals have to look for new ways to help smokers quit smoking and to maintain abstinence. In addition to education and professional advice, they may use smoking cessation interventions, especially to smokers that require elective surgery. Medical students should continue to participate in the national antismoking campaigns, and they could be included in the comprehensive smoking intervention programs to improve their smoking cessation counseling skills. However, the governments should plan and rigorously realize needed measures to control smoking at public places, offices, and other closed working places. Such measures are especially needed in poor and developing countries where many people die unnecessarily.

Effective blood pressure control with a large arsenal of conventional antihypertensive drugs, such as diuretics, beta-adrenergic blockers, and calcium channel blockers, significantly reduce the morbidity and mortality associated with cardiovascular disease. However, blood pressure control with these drugs does not reduce cardiovascular disease risks to the levels in normotensive persons. Only two drug classes that inhibit or antagonize portions of the renin-angiotensin system (RAS), angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor type-1 (AT(1) receptor) blockers, have protective and beneficial effects unrelated to the degree of blood pressure reduction. These drugs may prevent the blood pressure related functional and structural abnormalities of the cardiovascular system and reduce the end organ-damage. The first part of this review presents the components of the RAS, biological actions of angiotensin peptides, and the functions of the enzymes that generate and metabolize angiotensins, including the likely effect of manipulating them. Special attention is devoted to renin, ACE, ACE2, chymase, and neprilysin. The second part of this review presents the rationale for targeting the RAS, based on clinical studies of the ACE inhibitors and AT(1) receptor blockers. Finally, we present the investigational agents acting on the RAS that have a potential for clinical usage, and give the perspective of pharmacological, immunological and gene targeting of the RAS for treatment of cardiovascular disease.

Itch and pain, like other sensations, serve as physiological self-protective mechanisms. However, in many clinical conditions, unrelieved itch and pain have potentially devastating effects on body functions. Thus, these two sensations present maladaptive phenomena. In this review, we present the neurophysiologic mechanisms of pruritus and pain, including their mutual interactions, but the accent is on causes, consequences and assessment of pruritus and pain in cancer patients. Understanding the mechanisms of pain and itch may optimize pain control in cancer patients amd enhance their quality of life.

Gender differences in incidence of cardiac arrhythmias have been documented. It is generally believed that cardiac pathology provides an arrhythmogenic substrate but that a trigger such as sympathetic nervous system activation is required to initiate arrhythmias. This study was done to determine whether there is a sex difference in susceptibility to epinephrine-induced arrhythmias in healthy rats without preexisting pathology and to determine whether gonadal hormones play a role in development of arrhythmias. Untreated, sham-operated, and gonadectomized male and female rats were anesthetized and given IV boluses of epinephrine. ECG, heart rate, and blood pressure were measured continuously for 1 minute and intermittently over a period of 30 minutes. Male rat hearts have a higher occurrence and frequency of epinephrine-induced premature ventricular contractions, missed beats, and blocks than female rat hearts. Ovariectomy increases arrhythmias, thereby abolishing the female advantage. Castration has no effect on occurrence and frequency of premature ventricular contractions but attenuates missed beats and blocks. Sex differences and effect of gonadectomy on epinephrine-induced alterations in heart rate and blood pressure implicate baroreceptor reflex in the dimorphic arrhythmogenic response. Male rat hearts are more susceptible than female hearts to epinephrine-induced arrhythmias, and gonadal hormones play a role in this disparity.

PURPOSE We tested the hypothesis that the American environment influences the immigrants from developing countries with high incidence of smokers to quit smoking. METHODS The sample included 218 immigrants who came as adults from the former Yugoslavia. A total of 275 persons were randomly selected, and the overall study response was 79.2%. The survey included questions about current smoking, smoking history, and demographic data, such as year of immigration to the USA, education, and employment status. RESULTS Upon their arrival, 34.8% of the adult Yugoslav immigrants were smokers; now 20.2% of these immigrants smoke(p<0.001). Smoking prevalence for women was 9.1% higher than for men. The number of cigarettes that men and women smoke per day was similar. CONCLUSION For an immigrant smoker, the best chance of quitting smoking was within 5 years of acculturation. The local media in their languages may provide the best health education to immigrants, including information on the effects of cigarette smoking. To reduce smoking prevalence in the former Yugoslav republics and other developing countries, rigorous antismoking measures may effectively reduce smoking prevalence and contribute to better health of their citizens.

In 1884 Anton Pavlovich Chekhov graduated from the Medical School and started working as a physician in a suburban Moscow hospital. Eight years later he set up a general practice in Melikhovo, 70 km south of Moscow, where he spent seven years as a country doctor and a writer. There, Chekhov saw hundreds of patients, made over 1,000 house calls, fought against cholera and illiteracy, wrote many stories and two plays: The Seagull and Uncle Vanya. He started his day at five in the morning at his office where he examined patients and performed minor surgical procedures. Chekhov was an idealist and hardworking doctor driven by his dedication to serve patients in rural Russia where corruption and incompetence ruled at all levels. He did not charge his patients although he ran a private practice. He frequently even bought for his patients needed medications and gave them useful non-medical advice and financial help. Thus, the peasants called him “an unusual doctor” [1]. Today, Russia and other Eastern European countries are subjected to the period of rapid transition from a socialistic to a capitalistic economy. A fraction of the population hurries to privatize some property that used to belong to the state. Greed dominates in this race, and even some physicians participate in this contest; while working in the state health system, they ask for bribes. The most aggressive of them hope to purchase, overnight, some property, open private clinics or even a hospital. Bribery and other ethical lapses among medical doctors and other professionals show us that human nature is still flawed. We need contemporary Chekhovian examples to inspire mankind. The Germans do not in vain have a saying: Nur ein guter Mensch kann ein guter Arzt sein (Only a good man can be a good medical doctor). Doctor-Writer

A novel electro-thermal decoupled approach for large time-scale electro-thermal simulation of an inverter power module (IPM) used to drive a permanent magnet synchronous motor (PMSM) is presented. The key assumption is that the inverter drive system electrical performance is not affected by the temperature of the semiconductor power devices; this allows the electrical and thermal simulations to be decoupled. Based on this strategy, the electro-thermal simulation of the inverter power module is divided into two phases: (1) the overall electrical simulation of the inverter drive system in the continuous time domain; (2) PWM switching signal based power losses calculation and the thermal simulation of the inverter power module. The feature of this method is that the PWM switching signal is reconstructed using continuous smooth time-domain motor voltages obtained from phase (1), so that accurate power loss calculation and thermal simulation can be carried out using continuous smooth electrical waveforms. In this way, the conventional approach where devices are represented by switches is avoided and the electrical-thermal simulation can be carried out using relatively large simulation time steps, which allows a significant speed-up of the simulation. Simulation of over 10 minutes of real time operation has been carried out; the total simulation is of the order of 1 hr CPU time for a 3.12 GHz CPU 1 Gbyte memory PC.

War has resulted in devastating effects on health throughout human history [1]. Like a cancer, it destroys the normal functions of the society, spreads rapidly leaving destruction in its wake, and is the most serious threat to millions of lives. The effect of war on scientific output may also be huge. It can be precisely measured by changes in the number of papers from affected areas published in the peer-reviewed scientific journals indexed in the Science Citation Index (SCI) [2]. We have recently shown that the scientific output from a country at war in its own territory was drastically reduced [3,4]. These data parallel the human tragedies as well. The purpose of this study was to assess the damage of the civil war, the United Nations (UN) sanctions, and NATO military interventions during the forceful disintegration of the former Yugoslavia on scientific output as measured by changes in the number of publications indexed in the SCI from two of the cities that were affected, Sarajevo and Novi Sad. Also, this study set out to follow a recovery of such damage in the postwar period. Methods and Results