Assessment and Application of the Hear Score in Remote Emergency Medicine Outposts in Bosnia and Herzegovina.

Background and Objectives. In emergency departments, chest pain is a common concern, highlighting the critical importance of distinguishing between acute coronary syndrome and other potential causes. Our research aimed to introduce and implement the HEAR score, specifically, in remote emergency outposts in Bosnia and Herzegovina. Materials and Methods. This follow-up study conducted a retrospective analysis of a prospective cohort consisting of patients who were admitted to the remote emergency medicine outposts in Canton Sarajevo and Zenica from 1 November to 31 December 2023. Results. This study comprised 103 (12.9%) patients with low-risk HEAR scores and 338 (83.8%) with high-risk HEAR scores, primarily female (221, 56.9%), with a mean age of 63.5 ± 11.2). Patients with low-risk HEAR scores were significantly younger (50.5 ± 15.6 vs. 65.9 ± 12.1), had fewer smokers (p < 0.05), and exhibited a lower incidence of cardiovascular risk factors compared to those with high-risk HEAR scores. Low-risk HEAR score for prediction of AMI had a sensitivity of 97.1% (95% CI 89.9-99.6%); specificity of 27.3% (95% CI 22.8-32.1%); PPV of 19.82% (95% CI 18.67-21.03%), and NPV of 98.08% (95% CI 92.80-99.51%). Within 30 days of the admission to the emergency department outpost, out of all 441 patients, 100 (22.7%) were diagnosed with MACE, with AMI 69 (15.6%), 3 deaths (0.7%), 6 (1.4%) had a CABG, and 22 (4.9%) underwent PCI. A low-risk HEAR score had a sensitivity of 97.0% (95% CI 91.7-99.4%) and specificity of 27.3% (95% CI 22.8-32.1%); PPV of 25.5% (95% CI 25.59-28.37%); NPV of 97.14% (95% CI 91.68-99.06%) for 30-day MACE. Conclusions. In conclusion, the outcomes of this study align with existing research, underscoring the effectiveness of the HEAR score in risk stratification for patients with chest pain. In practical terms, the implementation of the HEAR score in clinical decision-making processes holds significant promise.

Epidemiological Aspects of Age and Genotypical Occurrence of HPV Infection Among Females of Canton Sarajevo Over a 10-year Period.

Background: Human papillomaviruses (HPV) are one of the most prevalent causes of cervical, anal, and oral cancer, and it is believed that nearly all sexually active males and females have been infected with HPV at some point in their lives. Objective: The purpose of this study is to highlight epidemiological characteristics of the age and genotypical incidence of HPV infection among females in Canton Sarajevo during a 10-year period. Methods: This cross-sectional study was conducted in the period between January 2012 and December 2021 at the medical institutions "Zavod za Ginekologiju, Perinatologiju i Neplodnost "Mehmedbasic" among females who were admitted for a routine gynaecological exam in Canton Sarajevo in Bosnia and Herzegovina. Results: In total, 1517 patients who reported typical sexarche at 18.35±1.92, having one 721 (47.5%) sexual partner, regular use of contraceptive methods 820 (54.5%) with male condom 513 (62.6%) being the dominant choice of contraception and having gynacological hereditary oncological positive history 141 (9.3%), were included in the study from which 653 (43.05%) patients had positive HPV test and 864 (56.95%) had negative HPV results. HPV positive patients, 386 (59.1%) were infected either with one type of virus only, while 267 (40.9%) patients were infected with multiple virus strains where we have identified 166 virus strain combinations. Analysis showed that the patients infected by only one virus strain were one of next specific HPV viruses: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68. HPV-16 was the predominately strain 16 (22.5%) identified among all the patients. Mean age of HPV positive patients was 33.38±7.85, ranging from 18 to 61 years. Conclusion: This study highlights the significance of the most frequent HPV high-risk strains (HPV-16, -18, -31.-33,-45,-52, and -58) among the Bosnia and Herzegovina population as one of the most common cancer-causing strains worldwide.

Ultrasound measurement of cervical length as predictor of threatened preterm birth: a predictive model.

INTRODUCTION: The incidence of preterm delivery has been increasing even in developed countries and remains a serious problem for fetuses and neonates. Although many predictors for preterm delivery have been proposed, complete prediction and prevention have not yet been established. AIMS: To examine the potential association between sonographic measurement of cervical length and threatened preterm birth (TPTB) in pregnant woman at 24-36 weeks of gestation. MATERIALS AND METHODS: A cross-sectional study included a total of 360 pregnant woman at 24-36 weeks of gestation categorized in two groups: TPTB group (n=160) and non TPTB group (n=200). The study was carried out at the Department of Obstetrics and Gynecology of the Clinical Center University of Sarajevo (KCUS). Sociodemographic and clinical characteristics of patients were obtained from medical records and physical examination by gynecologist. Transvaginal sonography was carried out by GE Voluson 730. RESULTS: There was a significant association between TPTB and sonographic measurement of cervical length <25 mm (P<0.001). The logistic regression model was statistically significant, x(2)(7) = 281.530, P<0. 001. The model explained 72.6% of the variance in TPTB and correctly classified 88.1% of cases. Sensitivity was 83.8%, specificity was 91.5%, positive predictive value was 88.7% and negative predictive value was 87.6%. Out of the 7 predictor variables only 5 were statistically significant: cervical length, cervical consistency, rupture of membranes, uterine contractions and amine odor test. CONCLUSION: The findings of this study suggest association between sonographic measurement of cervical length and TPTB.