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The evolution of homocysteine (Hcy) changes after acute myocardial infarction is still not elucidated. Serum Hcy concentration has been shown to increase between acute and convalescent period after myocardial infarction and stroke. Also a decrease in serum Hcy during acute phase was observed. It is still not clear whether the Hcy is a culprit or an innocent bystander in cardiovascular diseases. Addressing the discrepancies in Hcy changes in patients with acute myocardial infarction might give insight in Hcy role in cardiovascular diseases and offer implications both for the clinical interpretation and patients risk stratification. The aim of the study was to evaluate serum Hcy concentration changes during early post myocardial infarction. The study included 55 patients with AMI from the Clinics for Heart Diseases and Rheumatism at University of Sarajevo Clinics Centre. For Hcy analysis blood was collected on day 2 and 5 after the AMI onset. Serum Hcy concentration was determined quantitatively with fluorescent polarisation immunoassay on AxSYM system. Cluster analysis revealed two groups of AMI patients with different trends of serum Hcy changes. Increase in serum Hcy concentration was observed in 33 (60,0%) patients (AMI 1 group), while in 22 (40,0%) patients a decrease was observed (AMI 2 group). On day 2, patients in AMI 2 group had significantly higher mean Hcy concentration compared to AMI 1 group of patients (15,27+/-0,96 and 11,59+/-0,61 micromol/L p<0,05). On day 5, no significant difference in mean Hcy level between AMI 1 and AMI 2 group of patients was observed (14,86+/-1,1 vs. 12,75+/-0,74 micromol/L respectively). Significant differences between AMI 1 and AMI 2 patients were observed in VLDLC levels and CK-MB activity on day 2. Patients in AMI 1 group had significant increase in platelets count from day 2 to day 5 (230,1+/-11,6 vs. 244,2+/-11,0; p<0,05). Our study of serial Hcy changes in patients with AMI revealed two different patterns of Hcy changes in early post infarction period which might reflect two distinct populations of AMI patients. Although further research is necessary, possible explanation for the observed findings could be a different genetic background, vitamin and oxidative status of patients with AMI.

A. Džubur, Amela Džubur, M. Mekić

The polyvascular disease is the disease that includes the simultaneous existence of atherosclerotic process on coronary, carotid and lower extremities peripheral arteries. It is very difficult, if not impossible to determine the prevalence of atherosclerosis, because it is one predominant asymptomatic illness. There is no correct information related to atherosclerosis clinical readings, that is to it's most important consequences: coronary heart disease, cerebrovascular disease and peripheral blood vessels obstruction. Atherosclerosis is a complex disease with numerous predisposing factors that we call the risk factors. We divide all atherosclerotic risk factors on changeable and unchangeable (age, sex and heredity). The risk factors can further be divided on classical (conventional) and non-traditional (raised oxidative stress, endothelium disfunction and inflammation). Tobacco smoking can result by the sevenfold risk increase of peripheral arteries disease and at least the double risk increase of coronary arteries disease beginning. These two main forms of cardiovascular diseases, related with tobacco smoking, are the main atherothrombosis consequences. Obesity has overcome the global epidemical proportions with more than one million people with excessively body mass and, at least, 300 millions of clinical obese people. Obesity is considered as chronic inflammation disease that leads towards the chronic mass non-inflammation diseases as atherosclerosis, Diabetes type 2, non-alcohol stetosis of liver, cancer (of prostate, of breast) and osteoarthrosis.

Amer Ovčina DŽubur, Amela Džubur, A. Omanić, A. Džubur, Asim Bešić, Amer Ovčina

Amela Džubur, Asim Bešić, A. Omanić, A. Džubur, D. Nikšić

Due to the territorial and administrative division in the war period, information system of health protection after the war was divided in two systems, what matched organisation of health insurance in that period. Those information systems were incompatible, developed on different, both, hardware and software. Therefore, Ministry of Health, within the project "Basic hospital services", financed through the World Bank loan, applied new, common information system in health insurance. Goal of this paper is to present basic features of information system of health insurance in FB&H, as well as the way of its functioning in respect to other institutions included in the system, respective data bases, sites of entering and updating data, while using data available with Federal Bureau of Health Insurance.

Amela Džubur, A. Omanić, A. Džubur, Sanja Alispahić

Cervical and breast cancer are usually type of tumor that are found among women in fertile age in Bosnia and Herzegovina. Final goal was to establish frequency of risk factors that are responsible for development of those types of cancer as well as establish possibility of prevention, according to the existence of each risk factor. Research was conducted through out surveys among women which were selected by accident. The amount of questioned women is 200, and out of that number 70 (35%) were out of rural environment, 130 (65%) were from urban environment which led to statistic- processed information. Variables that were defining our interviews were: age, marital status, education level, stay during the war in B&H, number of given birth, consistency of gynecological examinations, changes that were found during the medical (gynecological) examination, number of sexual partners, usage of contraception, existence of sexual infections, usage of tobacco, existence of genetic factor. The most important fact is that over 50% of interviewees do not visit gynecologist, and that the gynecological infections are frequent. Usage of tobacco is in high percent founded among interviewees from urban environment (85%).

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