se unos može bitno smanjiti, no postignuti uspjeh je ipak nedostatan, a dugoročni ishodi nepoznati. Summary Excessive salt intake is a major cardiovascular risk factor. Examined was the impact of enhanced warning on daily salt intake in Mostar (Bosnia and Herzegovina). A sample of 150 treated hypertensives was randomized in a group receiving a leaflet about the harmful effects of excessive salt, and a group receiving in addition warning stickers for household salt containers. Blood pressure (BP) and 24 h urinary sodium excretion (Na24) were measured at the start of the trial, and one and two months later.

OBJECTIVE Poor and inadequate communication affects the therapeutic relationship between doctors and patients. Guided by this idea, we organized a minor elective course entitled "communication skills". We wanted to bring closer to the students the holistic approach of the family physician to the patient, the importance of the family, its impact on the patient and vice versa, and the significance of the local community and its influence on an individual's health. The aim of this article is to explain how we organized this elective course. METHODS The course was organized in the form of 12 hours of theory (3 lectures and 9 seminars) and 24 hours of practical training. There were 26 students from all years. Through theory, and even more through the practical part the students met with different types of patients. RESULTS At the end of the course, students in lower years were evaluated by means of an interview, and graduate students through a practical test - a conversation with a patient. The initial results, including the students' grading of this course, were highly encouraging. Both teachers and students were highly satisfied on completion of the course. CONCLUSION Content on communication training is rare in teaching. Practicing communication skills will empower the doctor - patient therapeutic relationship.

OBJECTIVE The aim of this study was to assess the frequency of experience in school bullying and family violence, satisfaction with the preventive-promotional program, knowledge about methods for opposing violence and attitudes toward the role of the family physician in bullying prevention. MATERIALS AND METHODS The project was conducted by family physicians, nurses and sixth year medical students. The target group were 5th to 8th grade pupils of two primary schools randomly selected by computer. Basic information about the presence and types of bullying, the long-term consequences of violence and methods to oppose violent behavior was given as an interactive lecture to large groups of pupils. After the lecture, pupils received questionnaires about their experience of school violence, satisfaction with the program and their opinion about the role of the family physician in bullying prevention. RESULTS The results of the short term outcome evaluation of the program show that younger pupils evaluate the program better than older ones. Furthermore, we found that the frequency of experienced violence is not connected with satisfaction with the program. CONCLUSION Most students have never experienced violence in schools and families, 5th and 6th grade students showed greater satisfaction with training, better knowledge of help in case of violence and a more positive attitude towards medical help. We found no significant differences in pupil's satisfaction with the program, knowledge about methods of opposing violence and attitudes towards the role of the family physician in bullying prevention, in relation to the frequency of experience of family violence and school violence.

BACKGROUND Medication nonadherence is a frequent problem in the treatment of chronic conditions. OBJECTIVE To study the adherence to pharmacological treatment of chronic nonmalignant pain, as well as factors and patient attitudes related to nonadherence in patients aged ≥65 years. METHODS The cross-sectional study was conducted with a self-administered questionnaire among 100 patients aged ≥65 years by five family physicians at the Health Care Centre Mostar, Bosnia and Herzegovina. RESULTS According to their own statements, 57% of the patients were nonadherent, while 84% exhibited some form of nonadherence on the Morisky scale. The patients reported a mean pain intensity of 6.6 ± 2.2 on a visual analog scale. The most common deviation from the prescribed therapy was self-adjustment of the dose and medical regimen based on the severity of pain. Polymedication correlated positively with nonadherence. Nonsteroidal anti-inflammatory drugs were the most frequently prescribed medications. The majority of the participants (59%) believed that higher pain intensity indicates progression of the disease, and half of the participants believed that one can easily become addicted to pain medications. Nonadherence was associated with patient attitudes about addiction to analgesics and ability of analgesics to control pain. CONCLUSION.: High pain intensity and nonadherence found in this study suggest that physicians should monitor older patients with chronic nonmalignant pain more closely and pay more attention to patients' beliefs regarding analgesics to ensure better adherence to pharmacological therapy.

Department of Family medicine has been formed in academic year 2002/2003, few years later after the foundation of the School of Medicine University of Mostar. The formal members of department are professor and assistants who lecture and lead seminars. In addition, physicians in rural practices contribute to teaching of family medicine. Clinical teaching of family medicine at Mostar School of Medicine is organized in the summer semester of sixth year of the study. It lasts six weeks and contains lectures, seminars and practices. Every student has right and obligation to evaluate educational process at the end of the course in a form of questionnaire and essay. Family medicine continuously receives high marks by students, especially practices. Evaluation of teaching by students is good way of giving feedback about teaching. We believe that student opinion can revise and improve teaching practice. Our good experience and good marks may prompt the changing our educational curriculum to include family medicine at each study year of medical program.

Goal was to compare the results of surgical and non-surgical treatments of combat injuries of genitourinary system and to compare our data with data collected in the recent studies. The study was designed as a retrospective review of data collected in prospective databases. The data extracted from inpatients' medical records included demographics, mechanisms and type of injury, distribution of the lesions, clinical presentation features, applied diagnostic studies, treatment modalities, types of complication and results of treatment. Among 4.125 patients treated in the Mostar War Hospital, 111 had injury of genitourinary tract: 62 underwent a surgical and 49 non-surgical treatment. Mortality among operated patients was 16 (26%). Complications were noted in 47 patients (42%); in 33 (70%) were manifested as early complications, and 14 (30) as delayed ones (p = 0.006). Among the surgically treated patients, 40 (36%) had some complication, in comparison to 8 (7.2%) patients with complications among non-surgically treated patients; which represent a statistically significant difference (p < 0.05). In this study, there was a surprisingly high number of non-surgically treated patients, and this sub-group of UGT trauma patients had in some ways the superior treatment results in comparison with surgically treated patients. Conservatively treated patients had lower rate of complications, no mortality, and no patients with permanent disability.

INTRODUCTION There is obvious decline in quality of life after MI and stroke. The main factors that reduce quality of life in these patients were the inability of returning to normal activities, pain and the development of depression / anxiety. We wanted to know what has the biggest influence on recovery and differences in quality of life in patients after stroke and heart attack. SUBJECTS AND METHODS Cross-sectional study was conducted using HADS and WHOQOL-Bref questionnaire. Criteria for exclusion were diabetes, previous depression, cancer or other co morbidities that influenced the quality of life. It has been surveyed total of 396 patients, of whom 378 patients satisfied the criteria of inclusion in the study. Based on the personal data of patients, they were divided according to gender, age, educational level, and social support expressed by number of members with whom patient lives. RESULTS In all the observed parameters of the SU group had better results than the stroke group. The recovery after a stroke affected age, length of education and depression. Age, gender and length of education influence on a heart attack recovery. Disease duration did not affect the quality of life in either group. Significantly more patients after a stroke had depression compared to MI (p<0.001). Anxiety was not found significant in differences between groups (p=0.051). Metabolic syndrome was more frequent in the stroke group, but the difference between groups was not significant (stroke/MI) (p=0.098). In the group of stroke patients who had MS patients more often had depression (p=0.003) for different of respondents from the group with MI. CONCLUSION Quality of life was significantly worse in patients after stroke compared to those with MI. The recovery from stroke was most significantly impacted by depression and age and level of education, while the recovery from heart attack was at most affected by gender, age and level of education.

INTRODUCTION This study investigates association between psychosomatic and traumatic symptoms among adolescents. SUBJECTS AND METHODS This cross-sectional survey using self-completion questionnaires was conducted among 868 adolescent in grade 6th, 7th and 8th of primary schools in Mostar (Bosnia and Herzegovina). RESULTS Psychosomatic symptoms are strongly associated with traumatic symptoms, with exception of symptom of anger. The association is the highest between anxiety, depression and PTS symptoms on the one side and cardiovascular symptoms on the other side. CONCLUSION According to our results, psychosomatic symptoms are strongly associated with psychosomatic symptoms in early adolescence.

The aim of this work is to investigate the influence of gender on recovery after cerebral stroke.It is believed that functional outcome of cerebral stroke (CS) depends on gender. Female gender is mildly negative prognostic factor in after stroke results. Two hundred and two patients who had first ischemic cerebral stroke were questioned with help of, HADS and WHOQOL-Bref questionnaires, looking for differences in recovery depending on gender. Average patients' age was 72+/-13 (ME+/-IR) years. The youngest patient had 40 years, and the oldest 92 years, and medium range was 52 years. There were 112 males and 90 females. Quality of life was equally graded by both male and female after CS (p=0.208). Male patients had significantly better results in physical (p=0.035) and psychological (p=0.020) domain of life quality. After CS, male patients had better results only in memory dimension (p=0.003). Anxiety was statistically more frequent among female patients (p=0.009). Gender did not influence frequency of metabolic syndrome in patients with CS. Quality of life after CS was better in male patients, and statistically significant difference has been shown in physical, psychological domain and memory dimension. Female patients were more anxious then male after CS.

AIM To correlate habits (abuse of tobacco, alcohol, psychoactive substances and drugs) of war veterans and the frequency of symptoms in persons with PTSD and those without it. METHODS We have carried out a prospective research (case-control study) over the period between September of 2005 and June 2006. The sample consisted of two groups of examinees: 60 males, war veterans with PTSD and 60 males, war veterans without PTSD. The group of war veterans without PTSD was formed using matching criteria (same age, level of education). Both groups included married males. Research was performed using a questionnaire designed for this study. RESULTS A higher number of war veterans without PTSD were employed compared to war veterans with PTSD (chi2=45.753; df=4; p<0.050). A higher number of war veterans with PTSD used psychoactive substances during the war period compared to war veterans without PTSD (18.3% vs. 3.3%). We have observed that 85% of examinees with PTSD have used anxiolitic drugs in the period of research, compared to only 5% of those without PTSD (chi2=77.576; df=1; P<0.050). All examinees with PTSD had some form of sleep disorders comparing to 70% of those without PTSD (chi2=50.595; df=3; P<0.050). Analysis of alcohol abuse showed a statisticaly significant difference between the examined groups (chi2=9.654; df=2; P=0.008). CONCLUSION A higher number of war veterans without PTSD had employment in comparison to the group of war veterans with PTSD. A higher number of war veterans with PTSD had some form of sleeping disorder, used psychoactive substances and anxiolitic drugs during the war period, and had alcohol abuse in comparison to the group of war veterans without PTSD.

The purpose of this work is to analyze the frequency of depression and anxiety and children behaviour in families whose heads of the family (father) suffer from post-traumatic stress disorder (PTSD). The study was conducted from September 2005 until July 2006, with patients living in Mostar. The frequency of depression and anxiety in family members older than 18 years, and changes of the behaviour in children younger than 18 years of age were measured. The data were collected from 60 men and their families who had been diagnosed with PTSD by their psychiatrist. The control group was formed using matching criteria (age of the head of the family, his education, religion, family income and number of children). In this study, three questionnaires were used: one specially designed for this study, covering general information about family members, and a personal opinion of each family member about the family situation and relations within the family; Hopkins symptoms checklist - 25 (HSCL-25) for evaluation of depression and anxiety for subjects older than 18; and General Health Questionnaire (GHQ) for children 5 to 18 years of age, which was completed by their mothers. More wives from the PTSD families had depression than wives from the controlled group (chi2=21,099; df=1; P<0,050). There was no difference between groups in frequency of depression and anxiety (chi2=0,003; df=1; P=0,959) for children older than 18 years. No difference in answers between groups of children younger than 18 years were found in the General Health Questionnaire. However, we found significant differences in separate questions. Mothers, who filled the questionnaire form, reported that children from fathers who had PTSD experienced stomach pain more often (chi2=10,474;df=2; P=0,005), eating problems (chi2=14,204;df=2; P=0,001) and breathing problems (chi2=9,748;df=2; P=0,008), than children from fathers who did not have PTSD. Children from fathers with PTSD were more easily upset (chi2=7,586; df=2; P=0,023) and worried more often (chi2=12,093; df=2; P=0,002), they were also more aggressive towards other children (chi2=6,156; df=1; P=0,013). The controlled group of children who wanted to help with the house work was larger than the tested group (chi2=10,383; df=2; P=0,006). More children from the controlled group missed school than from the other group of surveyed children (chi2=6,056; df=2; P=0,048). A significantly larger number of women, whose husbands had PTSD, were depressed, unlike women whose husbands were not ill. There was no significant difference in depression manifestation in a group of children older than 18, as well as in behaviour of a group of children younger than 18, but significant differences in some provided answers were found, that indicate the differences between controlled and tested groups.

Since its foundation in 1992, the Croatian Medical Journal (CMJ) has followed the strict standards of quality in the scientific publishing. However, the Journal has been aware that its specific position demands more than just following the already established rules. From the very beginning, the Journal declared an “author-helpful policy,” stating that “journal editors should have a major role in training authors in science communication, especially in smaller and developing scientific communities. Journal authors usually send scientifically acceptable but poorly prepared articles and it is a pity to lose valid data because of their poor presentation.” (1,2). In brief, the editors and editorial staff of the CMJ have been well aware that the skills of scientific reporting and publishing in our academic community are not developed and that valuable research results and valid data are being lost because of poor presentation. To be perfectly honest, ten years ago this statement looked like a nice promise, one of the many we in academic medicine learnt not to take too seriously.