Aim To analyse the resolution of chest X-ray findings in relation to laboratory parameters in patients infected with acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a two- month followup. Analysis of chest X-ray findings in the first few months after the disease is the main goal of our work. Methods Out of the total of 343 patients chest X-ray findings were followed in 269 patients. Patients were divided into groups according to the severity of findings. D-dimer, inflammatory markers, blood cell count, neutrophil lymphocyte ratio (NLR) were analysed. Chest X-ray was analysed during the hospitalization on the day of admission, on the third, the seventh and the fourteenth day (scoring method was used). After discharge chest X-ray was performed in a two-week follow-up, then after one and two months, and after three months if necessary. Results Incomplete chest X-ray resolution was identified in 24 (39.34%) patients with severe, 27 (22.31 %) patients with moderate and in three (3.91%) patients with mild findings. Statistical significance was established in overall score by comparison between all groups (p<0.001), and in the moderate compared to the mild group (p=0.0051). The difference of NLR in the severe compared to the moderate group was observed (p=0.0021) and in the severe group compared to the mild group (p=0.00013). Conclusion Chest X-ray findings persisted mostly in the severe group followed by the moderate and mild ones. Long-term followup is necessary for the appropriate treatment and prevention of fibrosis, and reduction of symptoms.
Aim To present the regulations governing the operation of pharmacies in Bosnia and Herzegovina over the Austro-Hungarian rule (1878-1918). Methods Qualitative secondary data analysis was used. Results The Austro-Hungarian government had found poor population's health, insufficient health facilities and qualified staff. For a long time, population was treated by old methods of medicine and pharmacy, and directed to folk doctors, healers and herbalists. As early as 1879, orders requesting mandatory possession of a university diploma to practice pharmacy and medicine, thus taking the initial steps to combat quackery. The production and dispensing of medicines became the exclusive competence of pharmacists. The Law on Pharmacies adopted in 1907 comprehensively regulated the apothecary activity. Pharmacy Gremium was founded, the first association of pharmacists with the task of protecting professional interests. All types of quackery were explicitly forbidden to pharmacy staff. Apothecary activity was regulated as a craft, not as a health activity. During this period, pharmacy became a regulated profession with educated and qualified personnel. The number of public pharmacies and qualified staff was growing. In 1878 only one graduated pharmacist was found, while in 1910 in 47 pharmacies there were 79 pharmacy staff. At the end of 1918, the masters of pharmacy were the owners of 48 pharmacies, in 38 cities. Conclusion All enacted regulations contributed to the development and improvement of the apothecary activity over the observed period, and laid the foundations for the future development of the profession.
OBJECTIVE The aim of our study was to determine the etiological factors, treatment and outcome of patients with non-variceal bleeding from upper gastrointestinal tract. MATERIALS AND METHODS This study enrolled 200 patients admitted to Sarajevo University Clinical Center with signs and symptoms of upper gastrointestinal bleeding, from January 2019 to July 2020. All patients had undergone gastroscopy, confirming the cause of gastrointestinal bleeding. Clinical and laboratory data were collected retrospectively, including previous non-steroid antiinflammatory drugs (NSAIDs) and anticoagulant therapy, comorbidities, risk factors, as well as endoscopic findings, laboratory findings, treatment and clinical follow-up. RESULTS The majority of patients were men (59%) with an average age of 53±6 years. Duodenal and gastric ulcers were the most common cause, followed by other etiologies. In our study, previous NSAIDs therapy had been registered in 29.5% of patients, anticoagulants in 8%, and proton pump inhibitors (PPI) in 2.9% of patients. Endoscopic intervention was required in 34% of patients. The need for transfusion occurred in 44.5% of cases. Rebleeding during hospitalization was observed in 7.5% of patients, mortality in 1.5% and surgery in 3% of patients. CONCLUSION The patients admitted to our hospital with symptoms of acute nonvariceal upper gastrointestinal bleeding were elderly, predominantly males, with significant comorbidities and a higher incidence of NSAID use. Gastroprotection is underutilized during NSAID treatment in patients with other coexisting risk factors, with a low rate of concomitant use of PPI during NSAIDs therapy. Endoscopic therapy, together with PPI, significantly reduces rebleeding rates, mortality and the number of emergency surgical interventions.
Aim To measure a calibre of radial and ulnar septocutaneous perforators at the anterior forearm, and to count its number in proximal, middle and distal thirds. Methods The study was conducted on 50 fresh amputated forearms (trauma, tumours) in the period between January 2012 and December 2021. Forearms were collected from several hospitals in Belgrade, and analysed at the Institute of Anatomy, Medical School, University of Belgrade, Serbia. Injection of ink-gelatin and fine dissection of autopsy material was performed on 30 forearms, and corrosion method with injecting methyl methacrylate for 3D analysis on the other 20 forearms. Results A mean calibre of septocutaneous perforators on the radial artery was 0.53±0.46 mm (0.2-0.85). Averagely, there were 8.1 radial artery septocutaneous perforators - two perforators on the proximal third, 3.7 on the middle third, and 2.7 on the distal third. The mean calibre of ulnar artery perforators was 0.65±0.35 mm (0.18-1.8). The average number of septocutaneous perforators of the ulnar artery was 5.6; 1.2 on the proximal third, two on the middle third, and 2.2 on distal third. Conclusion Determination of the origin, calibre and spreading directions of the arterial septocutaneous perforators on the anterior forearm provide quantification of data about arborisation of radial and ulnar septocutaneous perforators at the anterior forearm. Clinical relevance of those anatomical data is in defining of safe locations and dimensions of forearm fasciocutaneous flaps in plastic surgery.
With stress echo (SE) 2020 study, a new standard of practice in stress imaging was developed and disseminated: the ABCDE protocol for functional testing within and beyond CAD. ABCDE protocol was the fruit of SE 2020, and is the seed of SE 2030, which is articulated in 12 projects: 1-SE in coronary artery disease (SECAD); 2-SE in diastolic heart failure (SEDIA); 3-SE in hypertrophic cardiomyopathy (SEHCA); 4-SE post-chest radiotherapy and chemotherapy (SERA); 5-Artificial intelligence SE evaluation (AI-SEE); 6-Environmental stress echocardiography and air pollution (ESTER); 7-SE in repaired Tetralogy of Fallot (SETOF); 8-SE in post-COVID-19 (SECOV); 9: Recovery by stress echo of conventionally unfit donor good hearts (RESURGE); 10-SE for mitral ischemic regurgitation (SEMIR); 11-SE in valvular heart disease (SEVA); 12-SE for coronary vasospasm (SESPASM). The study aims to recruit in the next 5 years (2021–2025) ≥10,000 patients followed for ≥5 years (up to 2030) from ≥20 quality-controlled laboratories from ≥10 countries. In this COVID-19 era of sustainable health care delivery, SE2030 will provide the evidence to finally recommend SE as the optimal and versatile imaging modality for functional testing anywhere, any time, and in any patient.
The proliferation of wireless sensor networks (WSNs) and their applications has attracted remarkable growth in unsolicited intrusions and security threats, which disrupt the normal operations of the WSNs. Deep learning (DL)-based network intrusion detection (NID) methods have been widely investigated and developed. However, the high computational complexity of DL seriously hinders the actual deployment of the DL-based model, particularly in the devices of WSNs that do not have powerful processing performance due to power limitation. In this letter, we propose a lightweight dynamic autoencoder network (LDAN) method for NID, which realizes efficient feature extraction through lightweight structure design. Experimental results show that our proposed model achieves high accuracy and robustness while greatly reducing computational cost and model size.
In frequency-division duplexing (FDD) massive multiple-input multiple-output (MIMO) systems, deep learning for predicting the downlink channel state information (DL-CSI) has been extensively studied. However, in some small cellular base stations (SBSs), a small amount of training data is insufficient to produce an excellent model for CSI prediction. Traditional centralized learning (CL) based method brings all the data together for training, which can lead to overwhelming communication overheads. In this work, we introduce a federated learning (FL) based framework for DL-CSI prediction, where the global model is trained at the macro base station (MBS) by collecting the local models from the edge SBSs. We propose a novel model aggregation algorithm, which updates the global model twice by considering the local model weights and the local gradients, respectively. Numerical simulations show that the proposed aggregation algorithm can make the global model converge faster and perform better than the compared schemes. The performance of the FL architecture is close to that of the CL-based method, and the transmission overheads are much fewer.
Aim To investigate a profile of patients with peripheral artery disease (PAD) in Bosnia and Herzegovina. Methods This observational study included 1022 patients hospitalized at the Clinical Centre University of Sarajevo in a 5-year period, 2015 to 2019. Results Disease prevalence rises sharply after the age of 50. Most patients, 797 (78%) had proximal PAD; 658 (64.4%) were males. The death occurred in 73 (7.1%) patients, more often in females (66- 10%), and in patients with chronic kidney disease (10- 23.8%). Amputation occurred in 153 (15%) patients, where 102 (66.7%) patients had diabetes. Other surgical procedures were more common in males and smokers. Necrosis and phlegmon on lower extremities were found in 563 (55.1%) and 43 (4.2%) patients, respectively. History of tobacco use was noted in 620 (60.2%) patients, and 414 (40.8%) patients were current smokers. More than a half of patients had hypertension and diabetes, 596 (58.3%) and 513 (50.2%), respectively. One in 10 patients had a history of myocardial infarction or stroke. Most patients had high fibrinogen and blood glucose and low high-density lipoprotein (HDL). Conclusion Patients with PAD have multiple comorbidities and risk for various complications. Primary and secondary prevention of risk factors is the mainstay of treatment.
A control algorithm for Parallel Connected Offshore Wind Turbines with permanent magnet synchronous Generators (PCOWTG) is presented in this paper. The algorithm estimates the optimal collective speed of turbines based on the estimated mechanical power of wind turbines without direct measurement of wind speed. In the proposed topology of the wind farm, direct-drive Wind Turbine Generators (WTG) is connected to variable low-frequency AC Collection Grids (ACCG) without the use of individual power converters. The ACCG is connected to a variable low-frequency offshore AC transmission grid using a step-up transformer. In order to achieve optimum wind power extraction, the collective speed of the WTGs is controlled by a single onshore Back to Back converter (B2B). The voltage control system of the B2B converter adjusts voltage by keeping a constant Volt/Hz ratio, ensuring constant magnetic flux of electromagnetic devices regardless of changing system frequency. With the use of PI pitch compensators, wind power extraction for each wind turbine is limited within rated WTG power limits. Lack of load damping in offshore wind parks can result in oscillatory instability of PCOWTG. In this paper, damping torque is increased using P pitch controllers at each WTG that work in parallel with PI pitch compensators.
Amaç: İnterlökin-6’nın (IL-6) periodontal hastalık patogenezi ve periodontal doku yıkımındaki rolü geniş çapta ele alınmıştır. Çalışmanın amacı, evre IV periodontitis hastalarının tükürüklerindeki IL-6 seviyelerini değerlendirmektir. Gereç ve Yöntemler: Araştırmaya evre IV periodontitis teşhisi konulan 28 hasta ile 22 hastadan oluşan kontrol grubu dahil edildi. Hastaların tümü sistemik olarak sağlıklıydı. Tükürük örnekleri toplandı ve sondalama derinliği (SD), klinik ataşman seviyesi (KAS), papil kanama indeksi (PKİ), sondalamada kanama yüzdesi (SK %), plak indeksi (Pİ) ve diştaşı indeksini (Dİ) içeren klinik periodontal ölçümler kaydedildi. Her bir hastanın uyarılmamış tükürükleri, tükürük toplayıcı ile toplandı ve örneklerdeki IL-6 seviyesi enzim bağlı immünosorbent testi ile analiz edildi. Bulgular: Evre IV periodontitis hastalarının ortalama IL-6 değeri 22,18±5,96 pg/mL idi. Kontrol grubunun ortalama IL-6 değeri ise 2,23±2,17 pg/mL idi. Periodontitis Objective: The role of interleukin-6 (IL-6) in the pathogenesis of periodontal disease and tissue destruction at the periodontal site has been widely reported. This study aimed to evaluate the salivary IL-6 levels in patients with stage IV periodontitis. Materials and Methods: The study included 28 patients who were diagnosed with periodontitis stage IV and the control group of 22 periodontally healthy patients. All the patients were systemically healthy. Saliva samples were collected, and clinical periodontal measurements, including probing depth (PD), clinical attachment level (CAL), papilla bleeding index (PBI), the percentage of sites with bleeding on probing (BOP) %, plaque index (PI) and calculus index (CI), were recorded. The unstimulated saliva of each patient was collected by a saliva collector, and all samples were analysed using the enzyme-linked immunosorbent assay method for the detection of IL-6. Results: The mean value of salivary IL-6 in patients with periodontitis stage IV was 22.18±5.96 pg/mL. In the control group, the average measured value of IL-6 was 2.23±2.17 pg/mL. The periodontitis group had a significantly higher salivary IL-6 levels than the control group. A strong positive correlation was observed between the salivary IL-6 and clinical periodontal parameters (PD, CAL, PBI, BOP %, PI and CI) in patients with periodontitis stage IV (p<0.0001). Conclusion: We demonstrated a statistically significant relationship between periodontal parameters and salivary IL-6 in patients with periodontitis stage IV. New studies are needed to accurately establish salivary IL-6 potential as a biomarker for periodontal disease monitoring, including all stages and grades of periodontitis.
Background: Previous pandemic and catastrophic events significantly changed the life of every human being, bringing him/her into a state of stress and the need to quickly adapt to new ways of daily activity. COVID-19 has a negative impact on all elements of health: social, physical and mental. Pharmacotherapy, as well as protective measures (isolation, wearing masks and maintaining physical distance) did not give the expected results. Vaccination has not yet led to herd immunity, so it is still jeopardizing every aspect of human health (1, 2). Non-pharmacological methods, such as stress and sleep control, physical activity and contact with nature are of great importance since they can significantly contribute to staying healthy during a pandemic. Objectives: The aim of this paper is to evaluate the impact of non-pharmacological measures such as stress and sleep control (with different measures against the negative effects of anxiety and depression on mental state) and the possible positive impact of “forest bathing” on improving the immune response to the virus and its consequences. Methods: Available evidence-based studies on ways to com- bat stress and the effect of the proposed measures on human mental health and the im- mune system were analyzed. From the mentioned studies, recommended measures have been registered, which refer to stress and sleep control, diet and eating habits, contact with nature (“forest bathing”, gardening), virtual communication and meditation (mindfulness practice). Results and Discussion: The combined results of these studies indicate that COVID-19 has a chronic course and complications that significantly affect the physical, mental and emotional state of the patient. Proven positive effects of non-pharmacological measures can be applied in the daily practice of primary health care in the comprehensive fight against the COVID-19 pandemic. Conclusion: Non-pharmacological measures such as stress and sleep control, spending time in nature, healthy diet, and physical activity may improve the immune response to COVID-19. These measures, with their positive effects on all aspects of health, can make a major contribution to controlling and improving the quality of life during the COVID-19 pandemic.
Background: Although scientometry gradually became prevalent way of measuring one’s research output, there are many inherent drawbacks in main indices that are used: impact factor, number of citations, number of published papers and Hirsch’s index. Objective: The aim of this study was to analyze effects of inflated co-authorship on values of scientometric indices among authors in biomedicine who participated in published papers with more than 30 co-authors. Methods: The study was of cross-sectional type, based on 100 publications randomly extracted from the MEDLINE database. The inclusion criterion was publication with more than 30 authors. The studies with topics not related to humans were excluded from further analysis. Results: On average about 10% of papers published by the surveyed authors had more than 30 co-authors, but these papers brought more than 40% of all citations and more than 40% of Hirsch’s index attributed to these authors. The duration of scientific activity was well correlated to number of citations, Hirsch’s index and the number of publications themselves with 30 or less co-authors, while the correlation did not exist with number of citations, Hirsch’s index and the number of publications with more than 30 authors. In summary, publications with > 30 authors carry more scientometric points than publications with less co-authors, and the researchers with shorter scientific activity had larger scientometric benefit from publications with more than 30 authors than senior researchers. Conclusion: Unjustified and prolific co-authorship is one of methods for inflation of scientometric indices that are not further reflecting true quality of research output of an individual. Further improvement of scientometric indicators may prevent unjustified co-authorship if it reflects the work invested in a research result.
Aim To investigate the benefit of high-dose lipophilic statin therapy on cardiac remodelling, function and progression of heart failure (HF) in patients with ischemic heart disease. Methods A total of 80 patients with ischemic HF diagnosis were followed during 6 months, and they were divided in two groups. First group (n=40) was treated by high-dose lipophilic statin therapy (atorvastatin 40 mg) and conventional therapy for HF, while the second group (n=40) had no atorvastatin in the therapy. Results In the beginning of study, from all of the observed parameters, only the ratio of flow rates in early and late diastole (E/A ratio) differed between the test groups (p=0.007). After six months, a statistically significant increase in left ventricular end-diastolic diameter (LVIDD) in patients who had not been treated with atorvastatin was found. In the patients treated with atorvastatin, there was a significant reduction in basal right ventricle diameter in diastole and systole (p<0.001 and p<0.001, respectively), and in tricuspid annular plane systolic excursion (TAPSE) (p<0.001); there was a reduction in LVIDD (p<0.001), and an increase of ejection fraction of the left ventricle according to Teicholtz and Simpson (p<0.001 and p<0.001, respectively). Also, there was an increase of deceleration time of early diastolic velocity (DTE) (p<0.05) and a decrease of isovolumic relaxation time (IVRT) (p<0.001). Conclusion The reduction in the right and left ventricle diameters was noted after the six-month atorvastatin therapy. Atorvastatin in the therapy resulted in increased EFLV and better systolic function and should be a part of a therapeutic modality of HF.
No abstract available.
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