Cardiovascular diseases rank first on the mortality list globally or 31%. The basic measure of prevention in accordance with the recommendations of the World Health Organization is a change in risk lifestyle in terms of diet, physical activity, tobacco and alcohol consumption. Vitamin D was previously recognized as a regulator of calcium and phosphorus ratio, bone remodeling or the main controller of skeletal pathophysiology. However, vitamin D enjoys great interest in clinical and epidemiological research in terms of its possible impact on reducing the risk of cardiovascular diseases. Among other things, vitamin D deficiency is associated with an increased risk of endothelial dysfunction. Although the deficiency has been identified as a risk marker for cardiovascular diseases, the mechanism of action of vitamin D on the path from endothelial dysfunction to cardiovascular diseases has not been fully revealed. The findings in this segment of activity of vitamin D would be significant in terms of reducing morbidity and mortality from cardiovascular diseases.

Objective. The aim of this study was to compare mortality of patients after colorectal cancer surgery between hospitals in Serbia, which performed organized colorectal cancer screening and those which did not. Methods. The database included all patients who underwent surgery for colorectal cancer after the introduction of organized colorectal cancer screening Program in Serbia, in 2014-2015. The target group were patients 50-74 years old in the colorectal screening program, and the data was compared to the age-matched group from hospitals which did not perform the program logistic regression. Results. The was used to determine the significance of the differences in the observed variables, and the predictors of mortality after colorectal cancer surgery. Results. The 3631 patients were included in this study. The majority of them were operated due to the rectal cancer 2111 (58%), while 1062 (29.2%) were operated due to the colon cancer. Postoperative survival was significantly better in the target group in organized screening program (p<0.001; OR=0.46; 95%CI 0.33-0.62). There was a significant difference between patients who underwent surgery for colorectal cancer localized in the left colon, compared to the patients with localization in the right colon (p<0.001). The mortality after the surgery of colorectal cancer (4.7%) was followed by high comorbidity of cardiovascular diseases (24%). Conclusion. Patients included in the organized colorectal cancer screening have lower postoperative mortality than these not included. This indicates the necessity for further work on organized colorectal cancer screening, in order to reduce postoperative and overall mortality.

Introduction. Serological testing for SARS-CoV-2 virus infection is a valuable method of estimating the extent of COVID-19 disease prevalence. The study aims to assess the seroprevalence of SARS-CoV-2 virus infection in a specific group of respondents employed in the health insurance sector, to determine the ratio of symptomatic and asymptomatic cases, as well as to examine susceptibility to COVID-19 in relation to the ABO blood group system. Methods. This research was conducted among 150 randomly selected employees from the health insurance sector of the Republic of Srpska. All respondents completed the survey, voluntary consent to participate, and had a blood sample taken. Serum samples were tested for the presence of SARS-CoV-2 specific IgG antibodies. Results. The seroprevalence of SARS-CoV-2 virus infection was 70.7%. Out of the 100 seropositive respondents, 48% had the presence of a symptom of COVID-19, while 52% had no symptoms of the disease in the period from 1 March 1 2020 until the day of testing. Examining the association between ABO blood group system and seropositivity in our study, we found that the highest seroprevalence of SARS-CoV-2 IgG antibodies among respondents was in blood group B (83.3%), followed by blood group AB (80.0%) and blood group A (75.0%), while the lowest seroprevalence was among respondents with blood group O (54.1%). Conclusion. Among employees in the health insurance sector, SARSCoV-2 seroprevalence of 70.7% was registered. Among respondents with a positive serological result on IgG, 52% were asymptomatic. The seroprevalence of SARS-CoV-2 virus infection is the lowest among subjects with blood group O.

Introduction. Inhalation of coal dust during blasting in brown coal mines has been shown to lead to a lung disease called pneumoconiosis. There is very little data in the literature on the direct impact of coal on the quality of life of people who work in coal mines as well as the body's immune response to the effects of coal dust. The aim was to examine the immune response to exposure to coal dust in miners in a brown coal mine and whether mine workers have poorer quality of life compared to those not exposed to coal dust. Methods. This is a cross-sectional study among 100 employees in the Brown Coal Mine in Ugljevik, of which 50 of them are exposed to coal dust on a daily basis. Blood samples were taken from all subjects to test for the presence of cytokines IL-2, 4, 5, 9, 10, 13, 17A, 17F, 21, 22, IFN-g and TNF-a. The quality of life of employees was measured using a questionnaire for self-assessment of physical and mental health (36-item Short-Form Health Survey, SF-36). Results. Group of miners had a significantly (p<0.05) higher concentrations of pro-inflammatory cytokines IL-6, IFN-g, IL-17A and IL-22 when compared to the control group. Subjects from the control group had significantly (p<0.05) higher concentrations of anti-inflammatory cytokines IL-4 and IL-10 when compared to the group of miners. The quality of life was significantly (p<0.05) better in the control group when compared to the group of miners. Conclusion. Physical functioning, general health, mental health and Physical component summary were significantly poorer in the group of miners. Exposition to coal dust led to a significant increase in the production of pro-inflammatory cytokines and a decrease in the production of anti-inflammatory cytokines.

Pneumoconiosis of workers in brown coal mines is an occupational disease, a global public health problem and a serious disease of the lung parenchyma. If it is not prevented, it leads to irreversible changes in the lungs with complications. The disorder occurs after prolonged exposure to coal dust containing high concentration of free crystalline silica. Data in literature regarding its health impact on people working in coal mines are relatively scarce. Recently, there has been an increase in miners’ pneumoconiosis, which requires a stricter policy to protect workers in the mines. There are two classical types of CWP: simple and complicated. The main diagnostic method of CWP is based on a specific X-ray finding, and the auxiliary method of choice is spirometry. The pathophysiological mechanism of CWP formation is not fully known, although it has been shown that damage to the lung parenchyma goes through three phases caused by effect of lung cells exposure to coal dust. Studies show that cytokines play an important role in inflammation and the immune response as mediators of toxic and pathogenic effects in CWP. A link between exposure to coal dust in brown coal mines and the development of CWP has also been demonstrated, with a consequent reduction in the physical and psychological quality of life of workers in the mines.

Seila CiloviC-lagarija1, NiNo HaSaNiCa2,3, MilaN radojiCiC4, elMa SokiC-BegoviC5 , Maida MuliC6, BiljaNa MijoviC7 , aida Pilav8, doriS BardeHle9, SaNjiN MuSa1 1Institute for Public Health of FB&H, Sarajevo, Bosnia and Herzegovina 2Institute for Health and Food Safety Zenica, Institute for Public Health, Bosnia and Herzegovina 3Department of Healthcare, Faculty of Medicine, University of Zenica, Bosnia and Herzegovina 4Institute for Public Health of Herzegovina-Neretva Canton, Bosnia and Herzegovina 5Ministry of Health of Federation of Bosnia and Hercegovina 6Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina 7Faculty of Medicine, University of East Sarajevo, Bosnia and Herzegovina 8Institute for Public Health of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina 9Foundation of Men ́s Health Berlin; Germany

Modern society has not forgotten yet epidemics that killed millions in the last millennium and the COVID-19 pandemic caused by the SARS CoV-2 has recently emerged With the onset of the Wuhan epidemic in the Chinese province of Hubei, the initially called new corona virus due to the similarity of 80 % to the 2002 SARS virus was renamed to SARS CoV-2 The virus was originally isolated from bronchoalveolar aspirate specimens Viral RNK was detected in 6 of 41 blood samples with clinical signs of infection A senior Chinese expert told to the media that the median incubation period was 7 days, ranging from 2 -1 2 The International Health Regulations Emergency Committee for Epidemics gives a preliminary estimate basic reproduction number R0 of 1 4 - 2 5 COVID-19 is mainly transmitted by close contact with the infected by drops due to sneezing and coughing Fever, cough, myalgia and fatigue are the predominant initial signs and symptoms The clinical picture is non-specific Exacerbation occurs suddenly, as bilateral interstitial pneumonia that requires admission to intensive care Initial lethality in hospitalised cases was 15 %, but these estimates had to be taken with reserve as the situation evolved According to recent data, the global fatality rate is 3 7 %, the lethality rate in China is 3 9 % and in Italy 6 8 % According to data from the Chinese Centre for Disease Control and Prevention, of 44,672 confirmed cases 1,023 people died, therefore lethality was 2 3 % In the absence of specific prevention and control measures, mankind is limited to general prevention measures [ABSTRACT FROM AUTHOR] Copyright of Scripta Medica is the property of Scripta Medica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Chronic non-communicable diseases are diseases that arise as a response of the human body to a number of factors, the most important of which are ecological and socio-economic factors. According to the World Health Organization, their classification is based on mortality and morbidity statistics. The top four leading causes of death are as follows: cardiovascular diseases, malignancies, chronic respiratory diseases and diabetes. Non-communicable diseases (NCDs) present a global public health problem, leading to over 40 million deaths a year, whereby the population aged 30 to 69 years account for one third of the total number of deaths. Risk factors for the development of chronic NCDs can be divided into metabolic and environmental ones. Metabolic risk factors include hypertension, hyperglycemia, hyperlipidemia and obesity. Environmental risk factors include: alcohol and tobacco consumption, followed by physical inactivity and unhealthy diet. Unhealthy diet, apart from posing a risk for the development of NCDs, is also the cause of metabolic risk factor development, namely hypertension and obesity. The world nutritional authorities are focused on making dietary recommendations to prevent the rising trend and subsequently reduce morbidity from NCDs.

Atherosclerosis is the leading cause of cardiovascular disease (CVD) worldwide. Recently, mortality and morbidity from CVD have shown a trend in its occurrence in earlier years, while these diseases have been associated with older age until recently. In developed countries, mortality from diseases caused by atherosclerosis has decreased over the last 50 years. However, such a trend is not reflected in both underdeveloped and developing countries where mortality remains high. Risk factors have been identified and their control can influence the reduction in morbidity and mortality from CVD associated with atherosclerosis. Among these, the so-called variable risk factors are the following: increased concentration of LDL cholesterol fraction (LDL) and/or decreased concentration of HDL cholesterol fraction (HDL), hypertension, cigarette consumption, diabetes mellitus/metabolic syndrome, improper diet, while genetic predisposition is still considered to be an invariable risk factor. In order to reduce the incidence of atherosclerosis, the World Health Organization recommends a two-pronged approach that includes public health interventions to reduce population risk factors and medical interventions for individuals at high risk with stricter surveillance of risk factors. Examples of multisectoral public health interventions include increasing taxes on cigarettes and alcohol, followed by a massive campaign to promote physical activities and healthy diet, that is to promote healthy lifestyles.

Aims. The aim of this study was to examine self-perceived compassion fatigue and compassion satisfaction among family physicians in Bosnia and Herzegovina and describe potential contributing factors. Methods. The cross-sectional study enrolled 120 family physicians. Professional quality of life compassion satisfaction and fatigue version 5 (ProQOL5) was used to assess compassion satisfaction and two components of compassion fatigue, secondary traumatic stress and burnout. The symptoms of chronic fatigue were evaluated using the Chalder fatigue scale. Results. The majority of family physicians had moderate levels of compassion satisfaction (70%), burnout (75%) and secondary traumatic stress (55.8%). Family physicians with higher levels of secondary traumatic stress reported chronic fatigue (p = 0.001), longer length of service (p = 0.024) and residency training (p = 0.041). Chronic fatigue (p = 0.001), living in a rural environment (p = 0.033), larger size of practice (p = 0.006) and high number of patients with chronic disease (p = 0.001) were associated with a higher risk of burnout. Conclusion. Family physicians with large practices, long years of experience, a high number of chronically ill patients and experiencing chronic fatigue are at risk of developing compassion fatigue. A systematic exploration of compassion fatigue in relation to working conditions might provide an appropriate starting point for the development of preventive interventions.

Climate change is definitely one of the greatest challenges of human development in the 21st century. Climate change is expected to increase the risk of communicable diseases in Europe. This impact will depend not only on local climatic conditions, but on other factors, such as current infrastructure, public health services, biodiversity specificity, etc. The population in Bosnia and Herzegovina, Croatia and Serbia has been severely affected by the floods caused by cyclone Tamara in 2014. The basic mode of transmission of the disease caused by the West Nile virus is the bite of the infected mosquito. The West Nile virus is not transmitted among humans through contact, nor can it be transmitted from infected birds to humans without mosquito bite. The aim of the study was to analyze and present the trend of this disease in the period 2014-2018 and to show the connection between the spatial occurrence of cases and location of the flooded area in 2014 in the Republic of Srpska. Using the descriptive method, the demographic data of the patients were analysed, the most common clinical form of the disease and the incidence of the disease in the period 2014-2018 was analysed. The cases were mapped and we analysed the connection of the case and location that was flooded. The incidence ranged from 0.79 in 2014 to 0.43 in 2018. Patients were of all age groups and both sexes, most commonly cases from rural areas (78%). The most common clinical form of the disease is shown, which were symptoms of the central nervous system infection. Out of the total number of patients, 94% were from flooded areas. All reported cases have been diagnosed at the Institute of Microbiology at the University Clinical Center of Republika Srpska and were reported as probable cases in accordance with the international case definition of communicable diseases. However, it is crucial to implement internationally endorsed procedures as a clinical alghoritm for the confirmation of the case in accordance with the laboratory criteria for the case definition. The occurrence, frequency and spatial distribution of cases indicates a possible connection with the floods in 2014.

Objectives: Increased C. difficile infection rates were observed during the last decade, as well as the onset of complicated forms of the disease. The primary objective of this study was to report the first outbreak of C. difficile in a Serbian hospital, aiming to determine clinical and environmental factors associated with the outbreak. The secondary objective was to describe outbreak control measures taken.Design: The retrospective cohort study conducted from 18 April to 22 May 2013 in Serbian healthcare. Ninety-five patients hospitalized at the Department for orthopedic surgery during the CDI outbreak.Results: Prophylactic antibiotic therapy was identified among 93.3% patients with and 87.9% without C. difficile infection. The multivariate logistic regression analysis has shown that the independent risk factors for C. difficile infection incidence are the age beyond 70 (OR = 4.5; 95%CI = 1.1-18.2; p = .031) and the length of antibiotic therapy (OR = 1.5; 95%CI = 1.1-2.1; p = .017).Conclusion: The length of antibiotic prophylaxis is linked with the incidence. Orthopedic departments have a risk of C. difficileinfection. Infection control measure, antimicrobial stewardship programs and compliance to guidelines for the prescribing of antibiotics play important role in the prevention of C. difficile infection burden.

Objective: The primary aim of this study was to examine whether the perception of the patient’s disease and adherence to treatment process influence treatment outcomes of heart failure. The secondary aim was to analyze whether there were differences in perception and adherence in patients with heart failure in relation to anemia. Method. A cross-sectional study was carried out in 2015. One group consisted of 100 patients with heart failure and sideropenic anemia. The other group consisted of 100 patients without anemia. The standardized questionnaire was used to collect demographic data, the Brief Illness Perception Questionnaire to measure the patients’ perception of the disease and modified Clinician rating scale to assess patient’ s adherence. Results: The majority of respondents in the first group were women 63%, while in the second group there were 58% male and 42% female respondents. Respondents from the first group had statistically significantly lower adherence compared to respondents from the second group (χ2 = 23.28; p=0.05). A significant difference was found between the groups of subjects in comparison to the perception of disease control (χ2=18.03; p=0.05). Conclusion: The illness perception and treatment adherence have a significant impact on treatment outcomes of heart failure. Comorbidities, such as anemia, contribute to the patients’ perception of their disease and influence their adherence. Кey words: heart failure, sideropenic anemia, illness perception, adherence doi:10.5937/opmed1902029D