Relation between thyroid hormonal status, neutrophillymphocyte ratio and left ventricular systolic function in patients with acute coronary syndrome.

Aim To examine a relation of thyroid function, neutrophil-lymphocyte ratio (NLR) with left ventricular function measured through the left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction treated with percutaneous coronary intervention (PCI). Methods This prospective research involved 160 consecutive patients with acute myocardial infarction. Patients were divided into those with normal thyroid hormone status (n=80) and those with hypothyroidism (newly diagnosed) (n=80). Inflammatory parameters and parameters of hormonal status were taken for analysis: thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3). All patients underwent transthoracic echocardiographic examination (TTE) five days upon admission, and left ventricular ejection fraction (LVEF) was analysed. Results Significant difference between the two groups was verified in values of T3, T4, erythrocytes, haemoglobin, haematocrit, neutrophil, lymphocytes, NLR, C-reactive protein (CRP) and sedimentation rate. Patients with euthyroidism had a higher frequency of coronary single-vessel disease (p=0.035) and a significantly lower frequency of triple vessel disease (p=0.046), as well as a higher median value of LVEF (p=0.003). There was a significant correlation between LVEF with haemoglobin values (p=0.002), NLR (p=0.001), and CRP (p=001). Conclusion The altered status of the thyroid gland in acute myocardial infarction is associated with the severity of the coronary blood vessel lesion, LVEF and correlates with inflammatory response.

Working memory impairment in relation to the severity of anxiety symptoms.

A working memory (WM) deficit is a reliable observation in people experiencing anxiety. Whether the level of anxiety is related to the severity of WM difficulties is still an open question. In the present experiment, we investigated this aspect by testing the WM performance of people with different levels of anxiety symptoms. Participants were grouped according to self-report anxiety into a control group with low anxiety scores and an experimental group with clinically relevant anxiety. The experimental group was then divided into a high anxiety group and a severe anxiety group. Participants performed a battery of WM tasks tagging different WM processes. The results showed that, compared to participants with low anxiety, participants with clinically relevant anxiety scores had reduced accuracy in all the WM tasks. Interestingly, participants with high and severe anxiety did not present any significant difference. Anxious participants showed difficulties also in cognitive domains other than WM. Hence, these results supply reliable evidence that people with clinically relevant anxiety scores present WM difficulties, irrespective of symptoms severity. The observation that anxiety compromises performance also in cognitive domains other than WM suggests that the deficit might affect fluid cognition.

Cardiac biomarkers and left ventricular systolic function in acute myocardial infarction with ST- segment elevation in diabetes mellitus type 2 patients.

Aim To determine a status of systolic function in patients with diabetes mellitus (DM) type 2 with ST-segment elevation acute myocardial infarction (STEMI), to determine values of cardiac biomarkers in patients with DM type 2 with STEMI and correlate the parameters with ejection fraction of left ventricle (EFLV). Methods A total of 80 patients were divided into two groups, the study group (group I) consisting of 40 patients admitted with the diagnosis of DM type 2 and STEMI, and a control group (group II) with 40 patients with STEMI without diagnosed DM type 2. Cardiac biomarkers - creatine kinase MB fraction (CKMB), and troponin I were monitored. The EFLV was evaluated echocardiographically (using Simpson method) five days after primary percutaneous coronary intervention (pPCI). Results In the group I the EFLV five days after pPCI was significantly correlated with troponin values (with a minimum r = -0.47; p=0.002, a maximum r = -0.339; p = 0.032, as well as with an average value of r = -0.389; p=0.013), and with an average CK value (r = -0.319; p=0.045). In the group II there was a significant negative correlation of EFLV with the maximum value of troponin (r = -0.309; p=0.05). Conclusion Troponin values have an effect on the EFLV after STEMI, and thus on the left ventricular status, as well as on the pharmacological modality itself.

Impact of social and psychological factors on academic achievement of university students.

Aim To examine the correlation between personality traits, learning styles, and academic achievement and a difference between students' gender, residency status and academic achievement. Methods The study included 95 students of first year of the School of Medicine, University of Sarajevo. The survey used the sociodemographic questionnaire, Index of Learning Style and Big Five Inventory. Academic achievement was represented by a cumulative grade point of each student. Results There was significant difference between the students' gender, information processing style, i.e. active/reflective learning style and academic achievement. Academic achievement was correlated with extraversion (negatively), conscientiousness and active/reflexive learning style. Conclusion With this study we wanted to improve awareness of teachers about the importance and use of different styles during lecture, to show the importance of students knowing their own preferences and learning styles, and how personality traits can affect students' academic achievement. Academic performance is an important outcome for students. It can increase motivation, student participation in class and wish to volunteer in different activities.

The relationship between protective factors and a measure of psychological resistance in women diagnosed with breast cancer.

Aim To examine the relationship of protective factors (self-esteem, optimism, proactive coping), and a measure of psychological resistance in women diagnosed with breast cancer, and the contribution of protective factors in explaining the criterion of posttraumatic growth. Methods The study included 100 women diagnosed with breast cancer. To examine optimism the Scale of Dispositional Optimism and Pessimism, the Scale of Self-esteem for self-esteem and the Scale of Proactive Coping for proactive coping were used. The posttraumatic growth measured five factors: relating to others, new possibilities, personal strength, spiritual changes, appreciation of life. Results Self-esteem, optimism and proactive coping were associated with posttraumatic growth and its factors: new possibilities, personal strength, appreciation of life. Optimism and proactive coping positively corelated also with relating to others. Final model of posttraumatic growth in all three steps (self-esteem, optimism, proactive coping) explained 20.4% variability of the posttraumatic growth total score. Conclusion Posttraumatic growth does not mean a decrease in trauma, but leads to a change in the perception and view of life. It refers to more favourable management and use of its own resources, relying on its own strengths and capabilities, identifying new opportunities and connecting with others.

The serum triglyceride to high-density lipoprotein (HDL) ratio in patients with acute coronary syndrome with and without renal dysfunction.

Aim To assess triglyceride - to high-density lipoprotein cholesterol (TG/HDL)-C ratio in patients with acute coronary syndrome (ACS) and to verify its association with renal dysfunction. Methods A cross sectional study included 85 ACS patients divided in two groups with (ACS - RD) and without (ACS-nRD) presence of renal dysfunction, and 35 healthy subjects. Blood pressure, blood glucose, C-reactive protein, urea, creatinine, eGFR and serum lipids levels (total cholesterol, triglycerides, LDL-C, HDL-C) was measured in all participants. Based on the values of the measured lipid fractions TG/HDLc ratio was calculated. Results Patients in ACS group had significantly lower HDL-C level (p<0.0005) but significantly higher TG level (p=0.046) and TG/HDL-C ratio (p<0.0005) than controls. There was a significant increase (p<0.0005) in TG/HDL-C ratio in ACS-RD group compared to ACS-nRD group. The ACS-RD group had significantly higher level of TG (p=0.001), serum urea (p=0.02) and creatinine (p<0.0005) compared to the ACS-nRD group. With a cut-off level of 1.135 TG/HDL-C ratio had a sensitivity of 77.6% and a specificity of 62.9% in distinguishing between ACS patients and healthy subjects. With cut-off value of 1.905 TG/HDL-C ratio had a sensitivity of 75.9% and a specificity of 78.6% in distinguishing between ACS patients with and without renal dysfunction. Conclusion This study confirms the reliability of the TG/HDLC ratio as a simple, low cost and useful marker in distinguishing between patients with ACS and healthy subjects and ACS patients with and without renal dysfunction.

Depressive Symptoms Among Sarajevo University Students: Prevalence and Socio-Demographic Correlations.

OBJECTIVES: The aim of this research was to detect the presence of depressive symptoms among the student population at a Faculty of Medicine, as well to determine the correlation between the socio-demographic characteristics and students' lifestyle and depressive symptoms. SUBJECTS AND METHODS: Of 800 students enrolled and asked to participate, 412 responded to the survey. The study included students from all 6 years of studies. The degree of depressive symptoms was measured by a 21-item revised form of the Beck Depression Inventory (BDI). We built bivariate logistic regression models to study whether age, gender, housing accommodation, year of medical training, and school success status (Grade Point Average - GPA) were associated with depressive symptoms. The results are reported as odds ratios (OR) with 95% confidence intervals (CI). RESULTS: The study revealed that almost one third of students reported BDI >16 (30.1%). The present study did not find any association between BDI scores and study year or age difference, but we found that there was an association between housing accommodation and depressive symptoms. Students who lived with their parents had lower BDI scores than those who lived in a dormitory. The results of this study showed there is a negative correlation between physical activity and depressive symptoms in students, as well as that there is a positive correlation between depressive symptoms and substance abuse. CONCLUSION: Overall, our study confirms that the factors associated with an increase in medical students' depressive symptoms are housing accommodation, a lack of physical activity and substance abuse. Regarding failing a year of study at the medical school, as well as gender and age differences, we did not find any significant difference between students with higher compared to those with lower depressive symptoms.

Quality of life for tobacco smokers in relation to their socioeconomic status.

AIM: To analyze differences in quality of life between smokers and non-smokers in relation to socioeconomic factors. METHODS: This study was conducted on a sample of 600 respondents equally divided in two groups, smokers (300) and non-smokers (300). Former smokers were excluded. The study included both sexes equally further distributed into age groups: 19-34, 35- 49, 50-64 and 65-70 years. A questionnaire SF-36 to test the quality of life (36 questions measuring eight dimensions of quality of life) and questionnaire EuroQoL to examine the socioeconomic status was used. For the assessment of a given factor impact multivariant and univariant analyses of variance were used. RESULTS: A significant difference in the quality of life between smokers and non-smokers according to the gender was found, but only at the subscales of physical functioning and bodily pain (p=0.000). An analysis of individual dimensions of quality of life in relation to marital status of smokers and non-smokers showed significant differences on the subscales of physical functioning (p=0.032), vitality (p=0.0430) and mental health (p=0.016). An analysis of life quality in relation to smoking status of respondents and the average monthly income showed that the average scores on all subscales were higher in non-smokers compared to smokers (p=0.000) and they were increased with the average monthly income. CONCLUSION: The results of this study prove that there are significant differences in quality of life according to the smoking status. Also the socioeconomic factors which include age, gender, the surrounding, marital status, employment, total monthly income and level of education are of great influence on the quality of life with significant differences in relation to smoking status.

[Tobacco smoking and obesity as risk factors of polyvascular atherosclerosis]. / Pusenje duhana i gojaznost kao faktori rizika za polivaskularnu aterosklerotsku bolest.

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.

[Healthcare usage by elderly people]. / Koristenje zdravstvene zastite od strane lica trece dobi.

The newest demographic changes in the world and in our country show slow population increase and accelerated growth of elderly population. Apart from this growth of elderly population today we are experiencing increase in life expectancy. Our goal is to present socioeconomic status, usage of health services and patients satisfaction with those services. Our research includes 120 persons older than 65 years living in rural areas of Vares municipality. The data was collected in the period of 01/04/2007 to 01/05/2007. Municipality register provided us with data for elderly population using random sampling method. Examination was carried out using questionnaire papers especially formulated for our research. Statistical analysis includes elements of descriptive statistics X2 and the test of correlation; results with p<05 will be used in our research. Research variables are: sex, age, education level, salary, profession before retirement, number of visits to MD as well to a specialist, days spent in hospital and overall satisfaction with health care services.

Frequency of risk factors for cervical cancer among women in fertile age.

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%).

Basic charasteristics of information system of health insurance in FB&H.

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.