BACKGROUND Evidence on youth suicides from Southeastern Europe is scarce. We are not aware of previous reports from Bosnia and Herzegovina, which experienced war from 1992 to 1995. Durkheim's theory of suicide predicts decreased suicide rates in wartime and increased rates afterward. AIMS To compare child and adolescent suicides in Bosnia and Herzegovina before and after the war. METHODS Data on youth suicide for prewar (1986-90) and postwar (2002-06) periods were analyzed with respect to prevalence, sex and age differences, and suicide methods. Suicide data from 1991 through 2001 were not available. RESULTS Overall youth suicide rates were one-third lower in the postwar than in the prewar period. This effect was most pronounced for girls, whose postwar suicide rates almost halved, and for 15-19-year-old boys, whose rates decreased by about a one-fourth. Suicides increased among boys aged 14 or younger. Firearm suicides almost doubled proportionally and were the predominant postwar method, while the most common prewar method had been hanging. CONCLUSIONS The findings from this study indicate the need for public education in Bosnia and Herzegovina on the role of firearm accessibility in youth suicide and for instructions on safe storage in households. Moreover, raising societal awareness about suicide risk factors and suicide prevention is needed.

The aim of this study was to assess echocardiographic changes in female patients with untreated dysfunctional thyroid states and whether the therapy aimed to normalize the thyroid dysfunction could lead to improvement in cardiac systolic and diastolic function. The study included 90 female subjects who performed control of thyroid hormonal status at the Institute of Nuclear Medicine at the University of Sarajevo Clinics Centre and who previously were untreated for the thyroid functional disorders. The study sample was divided in three groups based on the thyroid hormones levels: a) hyperthyroid group (n= 30) b) hypothyroid group (n=30) and c) euthyroid (control). Echocardiography measurements were performed on commercially available Toshiba, SSH 140. Before the therapy no statistically significant differences in the peak early and late mitral inflow velocities (E/A) values between the study groups was observed, but the mean left ventricular ejection fraction (LVEF) in hypothyroid group was significantly lower (58.30+/-1.05) compared to control (64.96+/-0.71) and hyperthyroid group (64.69+/-1.31) (p<0.001). In hypothyroid group we found significant increase in mean LVEF (58.30+/-1.05 vs. 64.95+/-0.86, p<0.01) and E/A (1.06+/-0.07 vs. 1.17+/-0.08; p=0.01) values after the normalization of thyroid hormone status.Thyroid dysfunctional states were not associated with impaired diastolic function, probably due to the short duration of thyroid dysfunction and timely and successful conversion therapy. Systolic function however was significantly reduced in hypothyroid patients but subsequently improved after the adequate therapy. Early diagnostic approach in patients with thyroid dysfunctional states is important for avoidance of cardiac complications that accompany these disorders.

The goal of this study was to determine the association between serum inflammatory parameters and diagnosed diabetes mellitus type 2. Patients and methods: The study included 100 patients of both genders from 49 to 83 years old. Based on ATP III criteria, patients were divided into two groups: A) DM2, MS - diabetic patients with metabolic syndrome and group B) DM2, NMS - diabetic patients without metabolic syndrome. The results showed statistically significant and accelerated sedimentation in group A (41.85 ± 4.99mm) than in group B (26.4 ± 3.1mm) with statistical difference p

Aim: Nitric oxide is involved in pathological processes that lead to tissue damage partly because of its free radical nature. Oxidative stress and vascular dysfunction are recognized contributors in the pathogenesis of Alzheimer disease and vascular dementia. We investigated the serum concentration of nitric acid in 20 patients with probable Alzheimer disease, 20 patients with probable vascular dementia and in 19 control subjects. We also aimed to determine the association between this concentration and cognitive impairment tested by Mini-Mental State Examination in the disease groups.

Due to heightened risk for thromboembolic complications, nonvalvular atrial fibrillation (NVAF) presents an absolute indication for long-term oral anticoagulation therapy. This was an observational, analytical, randomised, one-year clinical study, conducted in the Blood Transfusion Institute Sarajevo, Bosnia & Herzegovina. The aim of this study was to present the oral anticoagulation treatment in terms of International normalised ratio (INR) monitoring and warfarin/acenocoumarol dose titration in 117 patients with NVAF. INR values, the doses of warfarin and acenocoumarol, as well as the tendency and adequacy of their changes were monitored. Percentages of the therapeutic INR values were 51,77% and 53,62%, subtherapeutic 42,84% and 35,86%, and supratherapeutic 5,39% and 10,53% for the warfarin and acenocoumarol treatment, respectively. The average total weekly doses (TWD) which most frequently achieved the therapeutic INR values were 27,89+/-12,34 mg and 20,44+/-9,94 mg, for warfarin and acenocoumarol, respectively. The dose changes with the INR values 1,7 or lower/3,3 or higher were omitted in 13,46% and 15,63%, and with the INR values 1,8-3,2 were noted in 8,62% and 13,48% of all the check-up visits in the warfarin and acenocoumarol group, respectively. The annual dose changes were noted in 24,65% and 31,41%, and the daily dose changes in 74,43% and 73,36% of all the check-up visits of warfarin and acenocoumarol group, respectively. We can conclude that the management of the oral anticoagulation treatment in our country is in accordance with the relevant recommendations, but with the present tendency toward underdosing and unnecessary frequent dose changing.

Alzheimer;s disease (AD) is a multifactorial disease but its aetiology and pathophisiology are still not fully understood. Epidemiologic studies examining the association between lipids and dementia have reported conflicting results. High total cholesterol has been associated with both an increased, and decreased, risk of AD and/or vascular dementia (VAD), whereas other studies found no association. The aim of this study was to investigate the serum lipids concentration in patients with probable AD, as well as possible correlation between serum lipids concentrations and cognitive impairment. Our cross-sectional study included 30 patients with probable AD and 30 age and sex matched control subjects. The probable AD was clinically diagnosed by NINCDS-ADRDA criteria. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels were determined at the initial assessment using standard enzymatic colorimetric techniques. Low-density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) levels were calculated. Subjects with probable AD had significantly lower serum TG (p<0,01), TC (p<0,05), LDL-C (p<0,05) and VLDL-C (p<0,01) compared to the control group. We did not observe significant difference in HDL-C level between patients with probable AD and control subjects. Negative, although not significant correlation between TG, TC and VLDL-C and MMSE in patients with AD was observed. In the control group of subjects there was a negative correlation between TC and MMSE but it was not statistically significant (r = -0,28). Further studies are required to explore the possibility for serum lipids to serve as diagnostic and therapeutic markers of AD.

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.

Metabolic syndrome is a group of factors which increase the risk for development of diabetes, cardiovascular diseases and includes insulin resistance, abdominal adiposity, hyperlipidemia, hypertension and other disorders. Changes in prothrombotic and proinflammatory markers have been observed. Aim of this study was to asses the concentration of fibrinogen and other humoral markers of metabolic syndrome in type 2 diabetic patients. 77 patients both sexes, age 46-83 years have been included. Based on ATP III criteria patients were divided in two groups. Group I - diabetic patients with metabolic syndrome and Group II - diabetic patients without metabolic syndrome. Each group was divided in two subgroups, males and females. The plasma concentration of fibrinogen and humoral markers of metabolic syndrome (triglycerides, cholesterol and glucose) have been evaluated. There were 49.4% patients out of total who met the criteria for metabolic syndrome. Patients in Group I weight in average more then the patients in Group II. Average systolic and diastolic blood pressure values were in all groups and subgroups higher than recommended. Humoral markers of metabolic syndrome were significantly higher (p<0.05) in Group I (triglycerides 2.7+/-0,2 mmol/L, total cholesterol 6.0+/-0.2 mmol/L) compared to Group II (triglycerides up to 1,7 mmol/L, total cholesterol in serum up to 5,2 mmol/L ). Concentration of glucose in both groups was significantly higher compared to referral values. Average plasma fibrinogen concentration was 4.0+/-0.1 g/Lwithout significant differences between Group I and II. Females from Group I had significantly higher fibrinogen concentration (p=0.003) then the males from the same group (females 4.4+/-0.2 g/L vs. males 3.7+/-0.1 g/L). There was no difference in fibrinogen concentration between female and male patients in Group II. Fibrinogen plasma concentration is elevated in all type 2 diabetic patients without significant differences between subjects with or without metabolic syndrome.

Metabolic syndrome is a group of factors which increase the risk for development of diabetes, cardiovascular diseases and includes insulin resistance, abdominal adiposity, hyperlipidemia, hypertension and other disorders. Changes in prothrombotic and proinflammatory markers have been observed. Aim of this study was to asses the concentration of fibrinogen and other humoral markers of metabolic syndrome in type 2 diabetic patients. 77 patients both sexes, age 46-83 years have been included. Based on ATP III criteria patients were divided in two groups. Group I - diabetic patients with metabolic syndrome and Group II - diabetic patients without metabolic syndrome. Each group was divided in two subgroups, males and females. The plasma concentration of fibrinogen and humoral markers of metabolic syndrome (triglycerides, cholesterol and glucose) have been evaluated. There were 49.4% patients out of total who met the criteria for metabolic syndrome. Patients in Group I weight in average more then the patients in Group II. Average systolic and diastolic blood pressure values were in all groups and subgroups higher than recommended. Humoral markers of metabolic syndrome were significantly higher (p<0.05) in Group I (triglycerides 2.7+/-0,2 mmol/L, total cholesterol 6.0+/-0.2 mmol/L) compared to Group II (triglycerides up to 1,7 mmol/L, total cholesterol in serum up to 5,2 mmol/L ). Concentration of glucose in both groups was significantly higher compared to referral values. Average plasma fibrinogen concentration was 4.0+/-0.1 g/Lwithout significant differences between Group I and II. Females from Group I had significantly higher fibrinogen concentration (p=0.003) then the males from the same group (females 4.4+/-0.2 g/L vs. males 3.7+/-0.1 g/L). There was no difference in fibrinogen concentration between female and male patients in Group II. Fibrinogen plasma concentration is elevated in all type 2 diabetic patients without significant differences between subjects with or without metabolic syndrome.

Studies indicate that inflammatory mechanisms may play an important role in the pathogenesis of Alzheimer's disease (AD). C-reactive protein (CRP), marker and mediator of inflammation, has been detected in lesions typical for the affected areas of AD brain. There have been conflicting reports on serum CRP concentration in AD. Scarce data exist on association of CRP and measures of adiposity in AD patients. Thus, we investigated serum CRP concentration in fifteen overweight institutionalized patients with probable AD and fifteen age-matched control subjects. Body mass index (BMI) and waist/hip ratio (WHR) were calculated for each subject included in the study. Age, systolic and diastolic blood pressure, BMI and WHR did not differ significantly between the two groups. Serum CRP concentration was significantly higher in patients with AD compared to controls (p<0.0001). Although not significant, positive correlations between serum levels of CRP and BMI and WHR were found. Obtained results support the notion that low-grade inflammation is present in patients with AD. Absence of significant association between CRP and measures of total and central adiposity in overweight AD patients needs further investigation and explanation.

Objec ti ves: The purpose of the present study was to assess neck ­ to ­ height ra ti o (NtHR) and its possible associa ti on with other anthropometric measures of obesity and blood pressure (BP) values in Bosnian university students stra ti fi ed by new 2017 American College of Cardiology/American Heart Associa ti on Task Force hypertension (HT) guidelines. Methods: The present study included 417 subjects with median age 20 (19 ­ 21) years that were divided into normal BP, el ­ evated BP, stage 1 HT, and stage 2 HT groups based on BP measurements using auscultatory methods. Standard anthropo ­ metric indices including neck circumference (NC) were measured. NtHR (cm/m) was calculated in each par ti cipant based on the NC and height. Di ff erences between groups were assessed by Kruskal ­ Wallis followed by Man ­ Whitney test and correla ti ons were determined by Spearman test. Results : The prevalence of elevated BP was 19.2%, stage 1 HT 21.6%, and stage 2 HT 11.0 %. NtHR was highest in the stage 2 HT group. NtHR correlated signi fi cantly with all anthropometric measures in all groups. No correla ti on between NtHR, systolic BP, and diastolic BP was found, except in the stage 1 HT group, where a signi fi cant correla ti on between NtHR and systolic BP was uncovered. Conclusions: Based on the observed correla ti ons between NtHR and standard measures of obesity, NtHR could be included in clinical prac ti ce, since it is simple and does not induce discomfort. The high prevalence of elevated BP found in the present study suggests HT preven ti on requires the implementa ti on of programs aimed at promo ti ng healthy dietary habits, physical ac ti vity, as well as e ff ec ti ve stress management and coping mechanisms.

phenolic content was determined by the Folin-Ciocalteu method expressed as mg GAE/L. Antioxidant activity was determined by FRAP (mmol/L Fe2+) and Briggs-Rauscher (expressed as inhibitory time) methods, while antiradical activity was determined by the DPPH method (expressed as IC50). Results: Sweet cherry wine analysis conducted by UPLC TQ-MS/MS showed the presence of phenolic acids and flavonoids. The most dominant compound was chlorogenic acid, with a content of 232.77 to 317.34 µg/ml. Among other phenolic acids were detected: vanillic (7.62-11.58 µg/ml) and protocatehuic (12.81-22.37 µg/ml). Flavonoids detected in sweet cherry wines were catechin (11.23-21.83 µg/ml), epicatechin (75.81-110.43 µg/ml), quercetin (22.31-47.72 µg/ml) and kaempferol (2.87-7.53 µg/ml). Total phenolic content was in interval 1281.43-1721.52 mg GAE/L. Antioxidant activity detected by the FRAP method indicates that results were from 53.21-61.53 mmol/L Fe2+. Briggs-Rauscher and DPPH methods indicated significant inhibitory activity in sweet cherry wine. It is important to highlight that wines produced with the addition of sugar and enzymatic preparation showed higher contents of selected phenolic compounds and higher antioxidant and antiradical activity.