Background: Bloodstream infections (BSI) encountered in hospitals are one of the most complex infections that pose a great challenge. Methicillin-sensitive and Methicillin-resistant Staphylococcus aureus are common causes of severe bloodstreaminfectionsthatareassociatedwithorganfailureandsepticshock.Hence,betterknowledgeoftheincidence ofBSIcausedbyMRSAandMSSAandadequateantibiotictreatmentareimportanttoreducelengthofhospitalstayand improve treatment outcomes.Subjectsandmethods:TheaimofthisstudywastoanalyzethefrequencyofBSIwithMSSAandMRSAinadultpatients whowerehospitalizedatthesametimeandsamedepartmentsoftheUniversityHospitalCentreMostarinthecourseof six years.Results: The incidence of BSI with MSSA and MRSA was shown to be 33,21% and 17,99%, respectively. Averageage of patients infected with MRSA was 61.5 years and with MSSA was 67.5 years. MSSA and MRSA BSI were more commoninmenwithaverageof69,79%and80,77%,respectively.Inbothgroupsofpatients,onethirdhadnoassociated diseases. Patients that had associated chronic disease with mild or moderately severe activity limitations constructed 41,67%withMSSAand46,15%withMRSA.Cardiovasculardiseasesweremostcommonchronicdiseaseinbothgroups, 33.33% for MSSA and 40.38% for MRSA.Treatment of the of subjects with MSSA BSI averaged 15 days and lasted significantlyshorterwhencomparedtoMRSABSItreatmentthataveraged36days.PatientswithMRSABSIweremore treated in middle and/or high-risk departments and with inadequate antibiotic therapy. MRSA BSI patients were more oftenmechanicallyventilated(69,23%),whichcontributestoahighercostoftreatment(averageof8032.5€intotal)and higher drug consumption when compared to the MSSA BSI patients. The death rate was higher in patients treated for MRSA BSI and averaged 67.31%.Conclusions:Theresultsofthisstudyarepromisingsincetheycanbeusedinpracticebycliniciansasaguidelinefor choosing adequate antibiotics, and improve course of treatment, length, outcome and cost.Keywords:Bloodstreaminfections,MSSA,MRSA,antimicrobialtreatment

SUMMARY The aim of the study was to determine attitudes towards and habits in oral health of adolescents in Herzegovina, as well as to evaluate the possible differences in habits among individuals of different adolescent categories. The study included 120 participants (35 male and 85 female) divided into three adolescent categories, as follows: early (11-14 years of age), middle (15-18 years) and late (19-21 years) adolescence, from the Herzegovina-Neretva Canton, who presented for dental examination. All participants completed the socio-demographic questionnaire and standardized Hiroshima University Dental Behavioral Inventory (HU-DBI). The answers provided by study adolescents in the HU-DBI showed statistically significant differences among particular age groups, i.e. between early and middle adolescence in items 7 (p=0.046) and 15 (p=0.007); between middle and late adolescence in items 8 (p=0.021), 11 (p=0.04) and 12 (p=0.027); and between middle and late adolescence in item 11 (p=0.032). Respondents in middle adolescence had poorer oral hygiene attitudes than those in early and late adolescence. In order to improve the oral hygiene habits of adolescents in Herzegovina, it is necessary to put emphasis on continuous education about oral hygiene habits during their secondary education.

BACKGROUND As a contribution to the dimensional classification of mental disorders, which in the next edition of the American Psychiatric Association (APA) could dominate over the categorical, and in general, due to the impact of anger on the behavior of individuals in our society, it seems important to examine and analyze dimensions that represent risk factors for occurrence and development of anger disorders. Aim, to examine gender differences in the expression of the adaptive and maladaptive dimensions of perfectionism and anger (state and trait, as well as the anger expression and control) and to examine whether the dimensions of perfectionism are statistically significant predictors of anger. SUBJECTS AND METHODS This study included a total of 600 primary and secondary school students (305 girls and 295 boys), 12 to 18 years old. Data were collected using a Socio-demographic Features Questionnaire for general information onto the Adaptive/ Maladaptive Perfectionism Scale (AMPS), Child-Adolescent Perfectionism Scale (CAPS), and State-Trait Anger Expression Inventory-2 Child and Adolescent (STAXI-2 C/A). RESULTS Statistically significant gender differences were found in the expression of the adaptive and maladaptive dimensions of perfectionism and anger. For aspects of anger, girls have been found to control their anger more often than boys. Multiple regression analysis indicates the important contribution of the dimensions of perfectionism in the explanation of anger in adolescents. CONCLUSION Given the results obtained, our research represents a contribution to the definition of a dimensional diagnostic system to prevent comorbidity of mental disorders and provide more clinically relevant information about each individual. The instrument which is used to measure anger in this study (STAXI-2 C/A; Brunner & Spielberger 2009) was for the first time applied in Bosnia and Herzegovina. The results of this research are a contribution to its validation.

Background: A few studies described surgical personality, inquiring all its dimensions, as well as surgeons’ psychomotor abilities and propensity for teamwork. Even fewer papers examined their spirituality and its impact on the effectiveness of daily surgical labor. The aim of this paper is to evaluate personality traits, psychomotor abilities and spirituality in surgeons and surgical residents, as well as propensity for teamwork in relation to their work experience.Methods: The study involved 15 male surgeons aged 40-49 and 15 male surgical residents aged 30-39, who were divided into the case and control group according to their age. The Eysenck Personality Questionnaire, visual stimulus response rate, oculomotor, and manual ability assessments, movement stability testing, intrinsic/extrinsic religious orientation, and teamwork efficiency questionnaires were used. Results: No statistically significant differences in personality traits, psychomotor abilities, religious orientation, and propensity for teamwork were recorded between surgeons and residents. These may support the specialty choice, and selection of surgical teams helping them to make important professional decisions, which well-affect the patients’ outcome.

SUMMARY Pandemic influenza A virus (H1N1) 2009 causes a disease that is epidemiologically and clinically not significantly different from seasonal influenza, but there are differences. The aim of the study was to display and compare epidemiological and clinical characteristics of pandemic influenza in children. At Dr. Fran Mihaljević University Hospital for Infectious Diseases in Zagreb, in the first two seasons, the incidence of pandemic influenza virus A (H1N1) in particular was exhaustively analyzed only in patients with laboratory-confirmed pandemic influenza A virus (H1N1) 2009. In hospitalized children with documented influenza pandemic, moderate form of the disease predominated, which ultimately meant shorter hospital stay and fewer complications. Otitis media was the rarest complication in children in both seasons. In conclusion, children younger than 5 years, especially boys, were vulnerable groups for pandemic influenza, presenting as a mild disease with low mortality and few complications. Most of the affected children with influenza did not have important risk factors such as asthma and obesity, highlighted by other authors as significant risk factors.

BACKGROUND Suggested treatment of patients with COPD and astma requires promotion and psychological dimensions of patients. AIM Primary objective of this study was to determine frequency of developing anxiety and depression in patients with asthma and chronic obstructive pulmonary disease (COPD) in relation to gender, age and socioeconomic status and to evaluate possible differences between patients with and without high level of anxiety and depression and to find correlation between psychological aspects and disease itself. SUBJECTS AND METHODS This study included a total of 120 subjects: 60 patients with asthma and 60 patients with COPD. Data were collected using a socio-demographic questionnaire for general information on subjects, standardized Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). RESULTS Significant difference was found in the anxiety level in these two groups. Average value for the patients with COPD was 43 (15) and for the patients with asthma 37.5 (15.7). Statistically significant difference was also reported for the depression level among females. In female patients with COPD that level was 13.5 (14.7) and in female patients with asthma 7.5 (11). There is a correlation between anxiety and depression in patients with COPD and asthma, especially among women. CONCLUSION This study suggests that asthma and COPD are a significant stressor with a risk of developing anxiety and depression.

Aim To assess the prognostic value of lactate level for mortality in patients with pulmonary embolism (PE) and Pulmonary Embolism Severity Index (PESI) I-III and its independence of gas-analysis parameters and acid-base status. Methods This prospective observational study was conducted at the University Clinical Hospital Mostar from 2013 to 2017. On the first day after PE diagnosis, 1.5 mL of arterial blood was collected from 103 patients with PE. Partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide in arterial blood, blood pH value, concentration of bicarbonates in arterial blood (HCO3-), base deficit, and oxygen saturation were analyzed. Lactate levels were assessed using blood samples taken from the cubital vein. Logistic regression analysis was used to assess the predictive value of gas-analysis variables, lactate level, PESI score, age, and sex for in-hospital death due to PE. Results The mortality in the group of PE patients was 19.1% (18 of 103 patients). Lactate level was an independent predictor of mortality (P = 0.002, odds ratio 0.06). HCO3- was also found to be a significant predictor (P = 0.022, odds ratio 2.4). Lactates were independent of other variables. Other gas-analysis parameters were not significant predictors of mortality. Conclusion In PE patients at low-intermediate risk of mortality (PESI I-III), lactate level was associated with a short-term mortality, independently of other gas-analytic parameters. Oxford Centre for Evidence-based Medicine level of evidence: 2.

Parental socioeconomic status is a multidimensional concept of special importance for the growth, development, health outcomes and education of children. Its definition generally refers to the amount of parents' income, their employment status and level of education. Hence, lack of economic resources and poverty of parents affect all aspects of the child's life, health outcomes and education, as well as his/her social inclusion. Accordingly, the consequences of a reduced parental socioeconomic status leave long-term effects on their children. Therefore, in order to create interventional programs for children of parents with low income and lower socioeconomic status, as well as with lower level of education, it is important to address the direct aspects of poverty. This review contributes to the evidence indicating that the parental socioeconomic status is highly influential in determining the child's physical and mental health and future outcomes including his/her academic achievements and education, as well as the parameters of his/her physical abilities, cognitive function and fundamental neurobiology affecting brain development.

BACKGROUND Spastic cerebral palsy may be interconnected with other neurodevelopmental disorders such as intellectual disabilities, and epilepsy. Brain synaptic plasticity and successful restorative rehabilitation may also contribute to diminish neurological deficit of patients having cerebral palsy. The aim of this study was to investigate the prevalence of intellectual disabilities and epilepsy in adult patients with different forms of spastic cerebral palsy and to find out correlation between the severity level of intellectual disabilities and epilepsy. SUBJECTS AND METHODS Adults diagnosed with different forms of spastic cerebral palsy were analyzed during a three-month period. The investigated features were: gender and age; form of cerebral palsy; the prevalence of intellectual disabilities and epilepsy. Intellectual disabilities were divided into 4 severity levels. The correlation between the severity level of intellectual disabilities and epilepsy was statistically analyzed. RESULTS Intellectual disability was present in 55% of patients diagnosed with spastic cerebral palsy. Epilepsy was present in 36% of such patients. It was recorded in 51.1% of quadriplegic, 21.9% of diplegic, and 19.2% of hemiplegic patients. Intellectual disability was present in 73.8% of quadriplegic, 31.3% of diplegic, and 53.8% of hemiplegic patients. The statistically significant correlation existed between the severe intellectual disability and epilepsy. CONCLUSIONS Intellectual disabilities and epilepsy most frequently occurred in patients with most severe forms of spastic cerebral palsy. Epilepsy is strongly correlated to the severity level of intellectual disability. Such patients require additional special modes of treatment and restorative rehabilitation to improve the functional outcome.

U istraživanju je sudjelovalo 60 osoba starijih od 60 godina, pri čemu je 15 (25%) bilo muškog i 45 (60%) ženskog spola. Prosječna dob ispitanika iznosila je 77,73 godina (SD=7,94). Najveći postotak ispitanika predstavljale su osobe s osnovnim stupnjem obrazovanja (N=47), a najniži osobe s višom ili visokom školom (N=2). Zdravstveni status procjenjivan je upitnikom za samoprocjenu zdravlja SF-36 (hrvatska inačica) te skalom za samoprocjenu anksioznosti i depresivnosti – ZUNG.

Goal: To analyze the appearance of neurodevelopmental disorders in children delivered post-term and to find out whether prolonged pregnancy may be a cause of such disorders in a selected group participants. Patients and methods: This study included a cohort of 34 children born post-term suffering from neurodevelopmental disorders who were treated at the Service for psycho-physiological and speaking disorders in Mostar, Bosnia and Herzegovina during an 18-year period. Results: There were 59.4% of male and 40.6% female patients (P=0.002). The most common neurodevelopmental disorder in the sample was intellectual disability (38.2%), followed by epilepsy (26.4%), delayed psychomotor development (14.7%), and cerebral palsy (11.7%) (P<0.001). The correlation between mothers’ parity and post-term delivery was found (P=0.016). Conclusion: Post-term delivery may be the cause of neurodevelopmental disorders. The most common disorder among them were intellectual difficulties.

CILJ: Prema popisu stanovnistva iz 2011., 17, 7 % od ukupne populacije u Republici Hrvatskoj cine osobe starije od 65 god. Starenje djeluje na razlicite bioloske, psiholoske i socioloske procese. U ovom istraživanju željela se utvrditi percepcija zdravlja i prisutnost nekih psihickih simptoma kod starijih osoba. METODE: U istraživanju je sudjelovalo 60 osoba starijih od 60 godina, pri cemu je 15 (25%) bilo muskog i 45 (60%) ženskog spola. Prosjecna dob ispitanika iznosila je 77, 73 godina (SD=7, 94). Najveci postotak ispitanika predstavljale su osobe s osnovnim stupnjem obrazovanja (N=47), a najniži osobe s visom ili visokom skolom (N=2). Zdravstveni status procjenjivan je upitnikom SF-36 (hrvatska inacica) te skalom za procjenu anksioznosti i depresivnosti – ZUNGA. REZULTATI: Rezultati na upitniku SF-36 pokazali su da je kod starijih osoba tjelesno funkcioniranje najlosije (M=30, 17 ; SD=29, 54), dok je socijalno funkcioniranje najbolje (M=55, 42 ; SD=30, 04). Nisu dobivene statisticki znacajne razlike između muskaraca i žena u procjeni zdravstvenog stanja. Pokretne osobe imaju znacajno bolju percepciju tjelesnog funkcioniranja (t=3, 23 ; p<0, 000), manje ogranicenja u ostvarenju životnih uloga zbog tjelesnog zdravlja (t=3, 25 ; p<0, 00), manje tjelesnih bolova (t=2, 26 ; p<0, 03) te su boljeg opceg zdravlja (t=3, 88 ; p<0, 000) u odnosu na polupokretne. Procjena utjecaja demografskih varijabli i razlicitih aspekata zdravlja na pojavnost depresivnosti pokazala je da su statisticki znacajni prediktori depresivnosti pokretljivost (objasnjava 11% varijance depresivnosti) i tjelesno funkcioniranje (objasnjava 68% varijance depresivnosti). Kod polupokretnih osoba i osoba s losim tjelesnim funkcioniranjem razina depresije je visa. Za razliku od depresivnosti, za varijablu anksioznosti, znacajnim prediktorom pokazala se varijabla socijalnog funkcioniranja koja objasnjava oko 55% varijance. Kod osoba koje losije socijalno funkcioniraju razina anksioznosti je visa. ZAKLJUCAK: Pokretljivost, tjelesno i socijalno funkcioniranje imaju znacajan utjecaj na kvalitetu života starijih osoba.