The aim of this study was to analyze the clinical course and outcome of the disease in patients with chronic obstructive pulmonary disease (COPD) who were hospitalized at the Clinic for Infectious Diseases of the University Clinical Center of the Republic of Srpska (UCCRS), in the period from November 30, 2024 to April 1, 2025, due to confirmed influenza. The study included 125 hospitalized patients with microbiologically confirmed influenza. Among them, 20.8% had COPD, of which 48% were male and 52% female, with an average age of 68.6 years and the majority had influenza A (76%), while 24% had influenza B. The mortality rate among patients with COPD was 8%, compared to 32% in patients without COPD. Laboratory findings showed higher levels of C-reactive protein and procalcitonin in patients with COPD, indicating a more pronounced inflammatory response. Additionally, COPD patients had higher levels of D-dimer, suggesting an increased tendency toward thrombosis. Radiological analyses revealed various forms of pneumonia, with 48% of COPD patients showing negative radiological findings despite elevated CRP levels. Oxygen therapy and de-obstructive treatments were more frequently administered in COPD patients, while antibiotics were included in the treatment of all COPD patients. The results suggest the need for a specific therapeutic approach in this group of patients patient group. Also, vaccination against influenza is a key preventive measure that can prevent influenza, reduce the severity of the disease if it occurs, and improve the outcome, especially in patients with COPD, who are more susceptible to more serious complications.

Background: Seasonal flu represents a significant public health challenge and cause of morbidity and mortality, especially among vulnerable populations. The aim of our study is to describe demographic and clinical characteristics of patients hospitalized for laboratory of confirmed influenza during the 2024/2025. season.Methods: The data of patients hospitalized in the Clinic for infectious diseas of the University Clinical Center of the Republic of Srpska from December 2024 to March 2025 were restrospectively analyzed. The diagnosis of influenza was confirmed by PCR testing from a nasopharyngeal swab. Data were collected on age, sex, comorbidities, laboratory findings, therapy, the need for oxygen support and mechanical ventilation, the outcome of treatment.Results: A total of 175 patients, average age 63, were hospitalized. Influenza A was confirmed by PCR test in 78 (44.6%), and Influenza B in 20 patients (11.4%). The most common symptoms on admission were fever, cough and muscle pain. Chronic diseases were present in 155 patients (88.6%), while only 12 patients (6.9%) were vaccinated against influenza. Pneumonia was radiographically diagnosed in 102 patients (58%). Antiviral therapy was used in 160 patients (91.4%). 54 patients (30.9%) required oxygen support, while 7 patients (4%) were on mechanical ventilation. A fatal outcome was recorded in 8 patients (4.6%).Conclusion: Low vaccination rate and high proportion of chronic diseases among the hospitalized indicates to patients the need for stronger vaccination promotion and early intervention in risk groups. Timely diagnosis and adequate therapy remain key factors in prevention of severe forms of disease and reduction of mortality.

The primary objective of this study was to develop a predictive model for the supply of live livestock in the Republic of Croatia for the period 2024-2029, based on the analysis of historical data. Livestock production has long been a strategically important sector in Croatia, supported by a strong tradition and a notable presence of indigenous breeds. Nevertheless, despite these advantages, the supply of live livestock per production unit has demonstrated persistent negative trends. The study applies the Autoregressive Integrated Moving Average (ARIMA) model to analyze time series data from 2019 to 2023 in order to identify structural patterns and forecast future supply dynamics. Supplementary statistical and econometric methods are employed to examine variation, autocorrelation, and the significance of fluctuations within the series. The analysis also highlights that the cost of production, as a key non-price determinant, plays a decisive role in shaping livestock supply trends. Findings indicate a regressive trend across most livestock sectors, emphasizing the need for targeted policy measures to stabilize and enhance future production.

Background: Observational and experimental studies consistently show that physical activity supports improvements in both physical and mental health. Various exercise modalities have been proposed as intervention protocols, ranging from aerobic training to traditional Eastern relaxation practices that incorporate elements of physical movement. Objective: The aim of this article was to analyze and synthesize evidence on the impact of different forms of physical activity on psychological stress and related symptoms of anxiety and depression among healthcare workers. Methods: A focused PubMed search was conducted for studies published in the last five years addressing physical activity interventions targeting stress, anxiety, or depression in healthcare workers. Both randomized and non-randomized intervention studies, pilot trials, and relevant systematic reviews were included to provide a descriptive synthesis because of heterogeneity in interventions and outcomes. Results: A review of PubMed-indexed studies published in the past five years identified 7,475 articles exploring the relationship between physical activity and stress levels in diverse populations. Of these, 284 studies specifically examined healthcare workers, with 72 addressing these outcomes in the context of the COVID-19 pandemic. Interventions included aerobic exercises, yoga, tai chi, qigong, and other movement-based relaxation techniques, with considerable variation in session duration, frequency, and follow-up periods. Reported outcomes varied, but most studies demonstrated reductions in perceived stress and improvements in anxiety and depression symptoms. Several studies suggested that more intensive exercise protocols may be less effective, while shorter and lower-intensity interventions often produced stronger psychological benefits. Conclusion: Various forms of physical activity can effectively reduce stress and symptoms of anxiety and depression among healthcare workers. Interventions do not necessarily need to involve high-intensity or long-duration activity to achieve meaningful improvements. Short, low-intensity protocols may represent a feasible and beneficial resource for supporting the psychological well-being of healthcare professionals.

Background: The COVID-19 pandemic is likely to have unprecedented and unforeseeable consequences, from those on a worldwide/global level to those at the local level–at the level of local communities and families, and individuals (and not just humans, but all other living beings), of which the future will testify in various ways. Objective: This work presents principles of treatment health care protection of people who has consequences of the colaps of helatcare sytem in Bosnia and Herzegovina (BiH) during Corona pandemic time and proposals how to make it better, with a focus on indications and restrictions for use different methods of education medical staff and how to improve therapeutic modalities by professional staff by education with new ICTs. Methods: System analysis of Public health sector in BiH which has felt down as consequences of great influence of rough political system generaly and at Cantonal and Community levels need to be meta analized by publich health care experts and by most influential health managers who can help to improve distroid current Health Care System at all levels, from Primary to Terciray level of ih heakth care protection. Results: The health system in BiH was unprepared for the COVID-19 pandemic. The unpreparedness of the health system varied in individual areas. The reasons for the unpreparedness of the health system in responding to the pandemic are the organization of the state of BiH by the Dayton Peace Agreement, according to which the health system is fragmented and regulated by law, without the possibility of its harmonization, coordination and interconnection. This pandemic period has clearly shown that “public health” as a medical discipline has been and remains a peripheral concern of society, that is, it has always been put on the back burner. The reason for this is the constant favoring of clinical disciplines, which is not disputed as a need, but this situation has shownhow much public health is needed and called upon when solving such pandemics, which have become a planetary problem. Proof of the previous statement is the very small number of epidemiologists and social medicine specialists in BiH. Conclusion: The response of the health system of BiH as a whole to the outbreak of the Covid-19 pandemic was inadequate, untimely, unprepared, unprofessional, chaotic, misinformed and with a lot of politicking, quasi-leadership and, in the end, it will turn out to be influenced by crime. This led to a high rate of illness and death, led to a great burden on the unprepared health system and setbacks in economic and social terms.

Background: SARS-CoV-2, though primarily a respiratory pathogen, exhibits multi-organ tropism, with the liver among the commonly affected organs. Elevations in liver enzymes are frequent in hospitalized COVID-19 patients, yet acute and pronounced hepatocellular injury in young, clinically stable individuals is uncommon. The underlying mechanisms may include direct viral cytopathic effects mediated by ACE2 receptors, immune-mediated injury, systemic inflammation, and metabolic stress. Notably, hepatic involvement can develop independently of respiratory compromise. Objective: The aim of this case report was to describe three adult patients with serologically confirmed SARS-CoV-2 infection and mild respiratory symptoms who presented with acute liver injury in the absence of other identifiable causes. Case report: During a confirmed COVID-19 wave in Bosnia and Herzegovina, a targeted outpatient study was performed in a family medicine setting. Routine liver testing was conducted for all suspected COVID-19 cases. Laboratory evaluation included liver enzymes, hepatitis serology, autoimmune markers, and inflammatory parameters, with imaging (ultrasound or MRI) to exclude structural pathology. Three previously healthy male patients (aged 25–45) developed acute liver injury during mild febrile illness, all with serologically confirmed SARS-CoV-2 infection (positive IgM and IgG). Retrospective assessment revealed unrecognized metabolic dysfunction-associated steatotic liver disease (MASLD) in all cases. Initial symptoms were fatigue and myalgia without respiratory distress. Laboratory findings demonstrated marked elevations of AST and ALT (>1000 U/L), GGT (>900 U/L), and raised ferritin and D-dimer, while bilirubin remained normal. This biochemical profile - disproportionately elevated transaminases and GGT with preserved bilirubin - was consistent across cases, suggesting SARS-CoV-2–related hepatocellular injury. All patients recovered rapidly with supportive outpatient care, without progression to liver failure. Conclusion: Clinically stable COVID-19 patients may experience acute hepatocellular injury, particularly those with underlying metabolic dysfunction such as MASLD. The recurring biochemical pattern of significantly elevated AST, ALT, GGT, and ferritin with normal bilirubin suggests a distinctive SARS-CoV-2–associated liver injury phenotype. Recognition of this presentation is essential for appropriate evaluation and management. Routine liver function monitoring should be considered in COVID-19 patients, regardless of respiratory symptom severity, especially in those with metabolic risk factors.

U radu se upoređuju tri metode za estimaciju i kompenzaciju poremećaja u diskretnim sistemima sa kliznim režimom (KR). Prva metoda koristi Luenbergerov opserver poremećaja, druga - nominalni model upravljanog objekta, a treća - integral signala klizne funkcije. Cilj rada je da pokaže ekvivalentnost navedenih metoda u primeni na diskretne sisteme upravljanja sa KR u nominalnim uslovima na jednostavnom sistemu upravljanja objektom prvog reda tipa čistog integratora. Poseban doprinos rada je modifikovani estimator poremećaja koji kombinuje Luenbergerov estimator sa estimatorom na osnovu integrala klizne funkcije. Teorijski rezultati su ilustrovani simulacionim eksperimentima.

Background: The clinical manifestations of cerebrovascular diseases (CVD) depend on the localization of the damaged region in the brain. Cognitive functions are often impaired following a stroke. Initially, CVD was referred to as atherosclerotic dementia, and was distinguished from senile dementia. Objective: The aim of this study was to examine how stroke severity and localization influence the development of vascular dementia (VD) and to identify which cognitive functions are impaired in certain types of VD. Methods: This prospective study included patients with acute stroke who were hospitalized at the Department of Neurology Tuzla, Bosnia and Herzegovina, over a one-year period. Patients were divided into the following groups: dementia of strategic infarct (DSI), cortical dementia (CD), subcortical dementia (SCD), haemorrhagic dementia (HD) and non-demented patient (NDP). Stroke localization, side and number of lesions were analyzed. Results: A total of 274 stroke patients were analyzed, of whom 190 (69%) were diagnosed with some type of VD. The odds ratio (OR) for the occurrence of dementia per point increase in NIHSS on admission was 1.131 (95% CI; 1.056 – 1.210). CD was more common in patients with right hemisphere lesions (p<0.000), whereas SCD was more frequent in those with bihemispheric lesions (p<0.0001). All assessed cognitive functions were significantly associated with CD and SCD (p<0.000). Visual perceptual (p=0.007) and visual constructive (p=0.016) functions were significantly impaired in patients with DSI. Executive functions were significantly impaired in all demented patients (p<0.0001). Conclusion: Stroke localization has a significant impact on the development of vascular dementia. All analyzed cognitive functions are significantly impaired in cortical and subcortical dementia. Visual perceptual and visual constructive functions are particularly impaired in patients with dementia of strategic infarct.

Background: Aphasia is an acquired communication disorder that affects language comprehension and production, typically occurring after brain damage. It is a frequent clinical manifestation of both benign and malignant brain tumors, particularly when lesions are localized in language-dominant areas. Objective: To assess the prevalence and characterize the types of aphasia in patients with intracranial tumors, emphasizing its clinical significance and the importance of early speech-language evaluation. Methods: This prospective study included patients with confirmed brain tumors diagnosed through neuroimaging (CT or MRI of the neurocranium), who were hospitalized at the Clinic of Neurosurgery, University Clinical Center Tuzla, over a one-year period. Patients with pre-existing aphasia of any etiology, as well as those who had not acquired reading and writing skills, were excluded. All assessments were performed prior to surgical intervention using the Boston Diagnostic Aphasia Examination. Results: Aphasia was diagnosed in 25 patients (27.5%). The most common type was anomic aphasia in 10 patients (40%), followed by Broca’s aphasia in 7 patients (28%), transcortical motor aphasia in 3 patients (12%), and transcortical sensory aphasia in 1 patient (4%). The highest number of patients with aphasia had tumors localized in the left temporal lobe, followed by the parietal and temporoparietal regions. Conclusion: Aphasia is a common clinical finding in patients with intracranial tumors, affecting more than one-quarter of the studied population. The distribution of aphasia types is consistent with the localization of lesions in language-dominant areas, particularly the left temporal lobe. Early recognition and detailed speech-language assessment are essential for timely intervention, rehabilitation planning, and optimizing functional outcomes.