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Introduction: Low sensitivity and specificity in traditional laboratory tests became insufficient for accurate diagnostics and initiation of proper treatment of patients infected with bacterial meningitis. High sensitivity Creactive protein (hsCRP) may be an appropriate supplement for rapid diagnosis of bacterial meningitis. The subject of our investigation was the determination of C- reactive protein in cerebrospinal fluid (CSF) during acute bacterial meningitis. Methods: HsCRP was analysed by a sensitive immunoturbidimetric assay using the Dimension RxL analyser (Siemens). Cerebrospinal fluid concentrations of C-reactive protein have been measured in 20 patients (age range,1 to 50 years) presenting with acute bacterial meningitis and also in a non-infected, non-inflamed control group (n=25). Results: The accuracy and precision of the method proved to be satisfactory. Repeatability of serial sampling for hsCRP described by coefficient of variation were CV=2.1-4.5%. This assay hsCRP in cerebrospinal fluid demonstrates adequate performance characteristics for routine clinical use. Elevated levels of CRP were found in 95% patients with bacterial meningitis. The mean CRP value in 25 uninfected control group was 0.25 mg/L (range 0.10-0.55). The mean CRP for patients with bacterial meningitis was 21.4 mg/L (range 0.40-100). Conclusions: A sensitive assay for CRP in CSF would be an useful adjunct to conventional investigation of acute infective meningitis.

INTRODUCTION In this study authors have analyzed the correlation between the IgG immunoglobulins in cerebrospinal fluid and the findings of oligoclonal bands on gel. Immunoglobulin IgG in cerebrospinal fluid (CSF) can be detected in neurological diseasses (infections and inflammatory neurological diseases and in demyelinating diseases, like multiple sclerosis (MS)). Quantitative IgG in CSF can be expressed by different formulae Reiber (Reiber and Felgenhauer 1987), Tourtellotte (Tourtellotte 1970), Schuller (Schuller and Sagar 1983) and IgG Index (Link and Tibbling 1977). In this study we used Reibergram. Qualitative CSF IgG can be measured by electrophoresis and isoelectric focusing (IEF). We used IEF for analysig CSF and seum because of its higher sensitivity. AIMS OF THE STUDY To determine the correlation of immunoglobulins IgG positivity in CSF with the finding of oligoclonal bands on the gel. MATERIAL AND METHODS The retrospective study based on data processed in OJ Clinical Immunology KCUS. Patients were suspicious of multiple sclerosis according to clinical findings and magnetic resonance imaging. All CSF and serum samples were processed by nephelometry, isoelectric focusing on the gel. Statistical analysis of intrathecal synthesis was also performed according to Reibergram. RESULTS Analyses were performed on 76 samples of cerebrospinal fluid and serum of patients from neurological clinic, suspected of multiple sclerosis. We received following results: 42 samples tested had type 1.25 samples tested showed type 2.3 samples had type 3.5 samples had type 4.1 sample had a fifth type. When we compare these results with values obtained by intrathecal synthesis of which is determined by Reibergram we obtained the following values: 16 samples had intrathecal synthesis of 20%-60%, 9 samples had a negative value of intrathecal synthesis of 10% or less. DISCUSSION AND CONCLUSION For most patients with established MS we found intrathecal humoral response, type two, and the number and arrangement of IgG bands generally does not change during the disease, because they reflect long-term non-specific immune stimulation rather than a specific immune response that during infectious disease changes (quantitatively and qualitatively).

INTRODUCTION In this study the authors have analyzed the costs associated with the immunosuppressive therapy in patients who underwent organ transplantation in two countries: the United States of America and Bosnia and Herzegovina (i.e. the entity Federation B&H). AIMS OF THE STUDY The goal of this paper is to compare and contrast the costs of the immunosuppressive therapy in two countries against the total costs of the organ transplantation. Further, the costs, dosages and effectiveness of the particular types of immunosuppressant were also analyzed. Problem of the Study: Immunosuppressive medications are essential in preventing kidney transplant rejection. Most available pharmaco-economic information to date is for induction and maintenance therapies, while the data on the financial impacts of the rejection are still limited. Immunosuppressive regiments are expensive in the socio-economic environment of limited resources and constraints. MATERIAL AND METHODS This academic article has utilized the publicly available sources of information from the Federation Entity of B&H, (i.e. Federal Department of Insurance and Reinsurance) in period 2006 to 2010, as well as peer-reviewed academic articles, books, private and government data from the United States of America from 2006 to 2010, including projections for 2011. RESULTS In the U.S. the cost of the immunosuppressive medications for the major types of organ transplantations typically range from US $19,300 to $34,600 per year based on commonly prescribed doses at average wholesale prices. In the Federation entity of B&H in 2009, the average cost per patient in F.B&H in 2010 was 6,009.00 KM (U.S.$4,292.00), which represents an absolute cost decrease of 740 KM or 11.00%, when compared to the higher average cost per patient in 2009, which was 6,749.00 KM (US $4,821.00). DISCUSSION The process of finding the ideal medication regiments to minimize morbidity and mortality, while maximizing quality of life and optimizing the cost is the major challenge to the transplantation community. Pharmaco-economic analysis can provide valuable insight toward achieving of these, rather difficult goals. CONCLUSION A sensitive pharmaco-economic analysis must be undertaken in order to achieve the best results in the world of limited/constrained resources and increasing demands for the expensive and quality of life improving immunosuppressive therapy in organ transplantation.

INTRODUCTION This study researched the distribution of desirable, borderline and high-risk values of certain lipid status parameters in healthy young individuals. AIM The purpose of this study was to research the statistical distribution of desirable, borderline and high-risk values of certain lipid status parameters in healthy young individuals (i.e. medical university students). MATERIAL AND METHODS In this research we tested 112 students studying at the University of Sarajevo, of both genders and 20-30 years of age. RESULTS Total serum cholesterol was minimally elevated in 7.1% of tested students, elevated with high risk in 2.7% and triglycerides were minimally elevated in 1.8%. Presence of elevated LDL cholesterol was found to be 2.7% minimally and 1.8% with high risk. HDL cholesterol was minimally decreased in 1 tested student. DISCUSSION Standard biochemical methods were used to determine the values of total cholesterol, triglycerides and HDL-cholesterol. The level of LDL cholesterol was also calculated. CONCLUSION Our results point to the need for performing gradual laboratory diagnostic procedures for routine check-ups of university students.

S. Hasić, E. Cengić, J. Ćorić, Mirsad Panjeta, R. Jadric, Emina, Kiseljaković

Objectives: The aim of study was to explore the pattern of the changes in haematological and iron status parameters of acute coronary syndrome patients through period 1-7 day of hospital admission in order to define the type of anaemia. Methods: Forty-one patients (15 female and 26 male patients, aged 36-81years) of the Clinic for Heart Disease and Rheumatism, University Clinical Centre Sarajevo have been included in the cross-sectional study. Haematological and serum iron status parameters have measured on days 1 and 7 of hospital admission. A decrease in haemoglobin levels to <13g/dl in men and <12g/dl in women was notified as anaemia. Results: A significant reduction in red blood cells count, haemoglobin, haematocrit (p<0.01), iron, total iron binding capacity (p<0.05) and significant ferritin elevation (p<0.05) within period the 1-7 day were noted. Percent of anaemic patients on day 1 was 17.07 % with increase of number on day 7 (36.36%). Serum ferritin has been elevated with reduction of red blood cells count, mean cell volume, mean corpuscular haemoglobin (p<0.05); haemoglobin, haematocrit (p<0.01) at first 24 hours of admission in anaemic versus non-anaemic patients. Conclusion: Anaemic patients had significantly lower values of percent transferrin saturation (p<0.05), red blood cells count, haemoglobin, haematocrit (p<0.01) compared to non anaemic on day 7. A statistically significant negative correlations were obtained between serum iron and C-reactive protein; cardiac troponin I and total iron binding capacity (rho=-0.389, p<0.05; rho=0.331; p<0.05, respectively). Observed changes in laboratory parameters through period 1-7 day indicate inflammatory type of anaemia in acute coronary syndrome.

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