Introduction: Mathematical modeling of coronavirus disease spread and computer simulations are currently one of the main tools in public health that can give important indicators for prevention planning Based on mathematical projections and daily updates of information, the measures are either tightened or reduced, in order to protect the health of the population Aim: The aim of this paper is to present a computer system based on an adequate mathematical model that allows frequent execution of various scenarios of spread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in any period in the future Also, the aim of this article is to point out the importance of measures for the prevention of coronavirus disease 2019 (COVID-19) in Bosnia through examples of computer simulation models Methods: Software solution based on the USLIRD model (Unpopulated - Susceptible - Latent - Infectious - Recovered - Deceased) was developed, with a number of variable parameters 'reproduction number, delay period, infectivity period, hospital capacity, characteristics of population) By setting these parameters in accordance with the existing and available data, the model is brought to an optimized state with the possibility of a realistic assessment of the course of the infection curve in any future period Data from the beginning of the pandemic are collected at the Faculty of Mechanical Engineering, University of Sarajevo and updated several times a day The set of measures is divided into two types 'Intervention 1' is a measure to close institutions that are at high risk for pandemics, working from home, wearing face mask, enhanced hygiene when entering facilities with a larger number of people 'Intervention 2' presents restrictive measures that has been introduced as mandatory in Bosnia The period 01 03 2020 to 01 09 2020 was observed Results: Without epidemiological measures, Bosnia's health system would quickly collapse Restrictive measures reduce the intensity of the spread of the infection, save human lives and keep the health system functional, but with consequences on other aspects of society - reduction of economic activities, collapse of the service industry and companies and disorders in mental health status of the population Four different scenarios of the situation were analyzed Scenario number three is current condition with measures that are currently in Bosnia The reintroduction of restrictive measures leads to a decrease in the number of infected population and suppression of the spread of the pandemic, which is shown in scenario 4 Conclusion: Self-discipline, adherence to measures, while trying to avoid restrictive measures should be the way to fight the COVID-19 pandemic Whatever the consequences, the initiation of restrictive measures to preserve the health of the population should be imperative © 2020 All Rights Reserved
Introduction: The occurrence of recurrent venous thrombosis, despite adequate therapy, is still a topic of research in the scientific world. The site of thrombosis and the involvement of anatomical segments represent a significant factor in its occurrence. Aim: To correlate fibrinogen values with anatomical location and extent of verified thrombus in patients with recurrent deep vein thrombosis. Materials and methods: In the period January 2007-January 2020, 223 patients with recurrent deep vein thrombosis were analyzed. At admission fibrinogen values were taken. Results: There was no significant difference in fibrinogen values in relation to gender (p = 0.842). The difference in mean fibronogen values between proximal (n = 171) and distal (n = 27 = veins) were not statistically significant (p = 0.326). There was no difference between the average values of fibrinogen in relation to the number of segments (1 to 3) (p = 0.298). The largest number of patients (n = 132) had 2 segments affected, and fibrinogen values was 4.7 g/L (3.6-7.1 g/L). Male gender had slightly higher fibrinogen values than females, but without significance (p = 0.091). The age of the subjects did not correlate with fibrinogen values ( p = 0.569). Fibrinogen values according to vein anatomical localization were statistically non-significant (p = 0.201). Conclusion: Fibrinogen values were not proved to be an indicator of anatomical localization and segmental involvement in patients with recurrent DVT. Keywords: fibrinogen, venous thrombosis, prognosis.
Ab s t r Ac t Introduction: Preeclampsia is the cause of increased morbidity in mothers, and mortality and morbidity of both mothers and fetuses and newborns. The pathological process is already complete when the symptoms occur, and nothing concrete can be done to stop the process. Early identification of women at risk of developing preeclampsia is a key goal of antenatal care. Alongside chemical tests, Doppler sonography of the uterine arteries plays a major role in the prediction of preeclampsia. Aims: To establish the probability of resistance to blood flow in the uterine arteries and the existence of notching in the control and test groups. Materials and methods: The study comprised 60 subjects in the second trimester of pregnancy who were going for check-ups during their pregnancy or had been hospitalized at the Maternity Clinic of Sarajevo UCC. All the subjects were divided into two groups, a control and a test group, in relation to the presence of pathological blood flow in the uterine arteries. As well as ultrasound results, the patients also provided an exhaustive history about their previous pregnancies, if any, and any relevant laboratory results. Results: A statistically significant difference was found in the average values of systolic and diastolic pressure during pregnancy between the control and the test group (p = 0.001). From an analysis of the resistance to blood flow in the uterine arteries in the control and test groups, we concluded that the flow on the side with the placenta and on the side without the placenta were physiological over five measurements in the control group of subjects. In the test group the largest number of cases of pathological flow were recorded, and there was also notching. Of the 21 subjects with a diagnosis of preeclampsia, there was notching in 10. Conclusion: Doppler sonography in the second trimester of pregnancy is a good prognostic marker for early discovery of preeclampsia.
Introduction: Preeclampsia is defined as hypertension (systolic pressure ≥140 mmHg or diastolic pressure ≥90 mmHg) after week 20 of gestation with one or more of the following symptoms: proteinuria, organ dysfunction (including renal, hepatologic, hematologic or neurological complications) and in case of stagnation of fetal development. So far, there are no valid clinical tools or tests that can tell with sufficient sensitivity and specificity in early pregnancy which pregnant woman will develop preeclampsia or have unwanted outcomes. Aim: To present the properties of biochemical parameter, uric acid, in patients with signs of preclampsia, which was confirmed by Doppler sonography. Methods: The study included 60 female subjects in the second trimester of pregnancy who were examined or were hospitalized at the Clinic of Gynecology and Obstetrics, Clinical Center University of Sarajevo. Pregnant women who had normal Doppler sonography scan of the uterine arteries in the second trimester of pregnancy were included in the control group, while pregnant women with pathologic Doppler sonographic findings in the second trimester of pregnancy were included in the group of pregnant women at risk of preeclampsia, i.e. the study group. Results: There is statistically significant difference between the average value of uric acid in the control and in the study group (213.36 ± 28.96 μmol / L vs 249.73 ± 47.06 μmol / L) (F = 12.991; p = 0.001). Applying the Wilcoxon non-parametric paired test to the average uric acid values during all measurements within the control group, no statistically significant difference was found. There was a statistically significant increase in the study group between all measurements, from 18.04 μmol / L between the first and second measurement (Z = -1.955; p = 0.043), 29.10 μmol / L between the second and third measurement (Z = -2.973; p = 0.003), 37.27 μmol / L between the third and fourth measurement (Z = -4.325; p = 0.001) and 109.87 μmol / L at the end of the study in comparison to values from the start of the study (Z = -4.309; p = 0.001). Conclusion: Uric acid values should become part of a broad biochemical range in screening and optimizing the treatment of patients diagnosed with early preeclampsia.
The action of forces in the back and abdomen under conditions of loading of different external forces at different bending angles is unexplored area. This paper presents a methodology that enables calculation of the magnitudes of forces in the back and abdominal muscles using the combined techniques of the CATIA software system, appropriate mathematical model and polynomial regression analysis. The person of 180cm in height and 85 kg in weight is loaded with 5 + 5 kg of cargo in both hands, and three cases of bending angles of 150, 300 and 600 relative to the vertical axis are analysed.
Background: The aim of the article was to create an appropriate computer model based on the real status of the mortar operator's workplace and to analyze the workplace. After that, for any possible exceedances from the aspect of the organism's load and safety, the aim is to redesign the workplace and bring it within the limits of the permissible load, and therefore the required safety. The aim is also to identify the characteristic work movements performed by the soldier and to carry out an ergonomic analysis of the soldier's efforts and to propose appropriate improvements. Methods: The analysis is performed on a total of 20 soldiers, from which is determined an average model of the following characteristics: 180 cm in height and 85 kg in weight. The task is to take a mine from the shell containing the mines, then transfer it to the mortar and fill the mortar barrel. The weight of the 120 mm mortar grenade is 14.8 kg. The average soldier is 26 years old and his military exercise lasts 4 hours. The CATIA software package (Dassault Systemes, Velizy-Villacoublay, France) is used for analysis. By knowing the anthropometric and work environment data, with ergonomic design and analysis, the following analyses were made: biomechanical analysis, rapid upper limb assessment (RULA) and carry analysis (option from CATIA software). Results: The proposed modification of the position resulted in a decrease in the L4/L5 torque from 316 Nm to 154 Nm along with decreasing of the compression force on the L4/ L5 from 5779 N to 3038 N (the compression force allowed is 3400 N), and while the RULA analysis is from the red color position 1 (score 7; maximum load requiring rapid repositioning of such position), revised final score 4 made in yellow (a solution acceptable for this work place). Conclusions: By ergonomic analysis, obtained proposal will lead to less chance of injury, prevention of burn out syndrome, fewer chances of illness, decreasing the fatigue, greater safety, less energy spent and better preparedness for all necessary tasks.
1Eurofarm Centar Medical Clinic, Sarajevo, Bosnia and Herzegovina 2Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina 3General Hospital Sarajevo, Sarajevo, Bosnia and Herzegovina KeYWORdS: heart failure, statin therapy, outcome. citAtiON: Cardiol Croat. 2019;14(9-10):222. | https://doi.org/10.15836/ccar2019.222 *AddReSS fOR cORReSpONdeNce: Amina Godinjak, Fra Anđela Zvizdovića 1, 71000 Sarajevo, Bosnia and Herzegovina. / Phone: +38761187010 / Email: aminagodinjak@gmail.com ORcid: Amina Godinjak, https://orcid.org/0000-0002-3697-8006 • Miralem Dešević, https://orcid.org/0000-0001-8760-6192 Amer Iglica, https://orcid.org/0000-0002-4677-8489 • Adis Kukuljac, https://orcid.org/0000-0002-4900-5094
Aim To examine the effects of therapeutic hypothermia on the outcome of patients with the diagnosis of out-of-hospital cardiac arrest (OHCA). Methods The study included 76 patients who were hospitalised at the Medical Intensive Care Unit (MICU) of the Clinical Centre University of Sarajevo, with the diagnosis of out-of-hospital cardiac arrest, following the return of spontaneous circulation. Therapeutic hypothermia was performed with an average temperature of 33oC (32.3 - 34.1o C) on the patients who had coma, according to the Glasgow Coma Scale (GCS). Results Multiple organ dysfunction syndrome (MODS) significantly affected survival (p=0.0001), as its presence reduced patients' survival by 96%. In addition, ventricular fibrillation (VF) as the presenting rhythm, also significantly affected survival (p=0.019). A degree of patient's coma, as measured by the GCS, significantly affected survival (p=0.011). For each increasing point on the GCS, the chance for survival increased twice. Moreover, other physiological factors such as the pH and the lactate serum levels significantly affected patients' survival (p=0.012 and p=0.01, respectively). Conclusion In patients with the diagnosis of OHCA who underwent to the treatment with therapeutic hypothermia, verified VF as a presenting rhythm was a positive predictive factor for their outcome. Therefore, therapeutic hypothermia represents an option of therapeutic modality for this type of patients.
Introduction: The effect of statins on risk of heart failure (HF) hospitalization and lethal outcome remains dubious. Aim: To investigate whether statin therapy improves clinical outcomes in patients hospitalized for ischemic heart failure (HF), to compare the efficacy of lipophilic and hydrophilic statins and to investigate which statin subtype provides better survival and other outcome benefits. Material and Methods: Total amount of 155 patients in the study were admitted to the Clinic for Cardiology, Rheumatology and Vascular diseases in Clinical Center University of Sarajevo in the period from January 2014- December 2017. Inclusion criteria was HF caused by ischemic coronary artery disease upon admission. For each patient the following data were obtained: gender, age, comorbidities and medications on discharge. New York Heart Association (NYHA) class for heart failure was determined by physician evaluation and left ventricle ejection fraction (LVEF) was determined by echocardiography. The patients were followed for a period of two years. Outcome points were: rehospitalization, in-hospital death, mortality after 6 months, 1 year and 2 years. All-cause mortality included cardiovascular events or worsening heart failure. Results: Overall, 58.9% of HF patients received statin therapy, with 33.9% patients receiving atorvastatin and 25.0% rosuvastatin therapy. The most frequent rehospitalization was in patients without statin therapy (66.7%), followed by patients on rosuvastatin (64.1%), and atorvastatin (13.2%), with statistically significant difference p = 0.001 between the groups. Mortality after 6 months, 1 year and 2 years was the most frequent in patients without statin therapy with a statistically significant difference (p = 0.001). Progression of HF accounted for 31.7% of mortality in patients without statin therapy, 12.8% in patients on rosuvastatin therapy and 3.8% in patients on atorvastatin therapy (p = 0.004). Conclusion: Lipophilic statin therapy is associated with substantially better long-term outcomes in patients with HF.
Introduction: The dominant global public health challenge are non-communicable diseases. According to World Health Organization (WHO) data. The fifth leading causes of death in FB&H are diseases of the heart and coronary arteries: stroke, acute myocardial infarction, cardiac arrest, cardiomyopathy and essential hypertension. The prevention of these diseases has great importance in improving health in B&H. Objective: The aim of this study is in estimation of one-year survival and left heart systolic function after the treatment. After the data collection and evidence of their statistical value, the results of the research point to the profile of patients with a LAD disease in one-vessel coronary artery disease that should be subjected to PCI DES LAD and PCI BMS LAD, respectively, or creating guidelines for a better and more effective LAD treatment. Material and methods: The study was performed as retrospective/ prospective, clinically controlled for a period of three years. In this study was included 60 patients, which was followed in 12 months period. With the PCI BMS method was treated 63.3% and 36.7% of subjects were treated with the PCI DES in LAD. Conclusion: The number of complications in patients with one-vessel LAD coronary heart disease, treated with PCI DES and PCI BMS was statistically significant. One possible complication (4 patients) is due to the spread of the disease to other blood vessels. Due to possible complications in the treated or LAD with repeated stenosis, the complication in terms of restenosis of the previously placed stent in 75% are with BM stents justifying the use of drug eluting stent, while the progression of disease in patients (2 patients) indicates the need for detection and prevention of risk factors.
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