Basic package of health entitlements and solidarity in the Federation of Bosnia and Herzegovina.

The aim of this report is to provide an overview of the methodology for designing a basic package of health entitlements and solidarity in the Federation of Bosnia and Herzegovina which will, respecting the principles of solidarity and equity, guarantee equal rights to all citizens of the Federation. After the analysis of the situation, we specified the reasons for the reform, listed the objectives, and described the basis of the basic package design, the establishment of federal solidarity, and the plan of realization. We discussed the background ethical theories of our policy choice, explicitly stated the normative and technical criteria for priority setting, and deliberated Federal financing solidarity policy and allocation methodology, as well as criteria for "risk equalization" among cantons.

Reform of health insurance in the Federation of Bosnia and Herzegovina.

The aim of this report is to provide an overview of the reform of health insurance in the Federation of Bosnia and Herzegovina (FBH). Health financing and resource allocation policies in the FBH are also summarized. Health financing should be ensured through three types of health insurance: compulsory, supplementary, and voluntary. The revenues for the compulsory health insurance will be ear-marked through payroll taxation. Facing the scarcity of resources, the Federation authorities have decided to raise the proportion of the payroll contribution as compared to the pre-war level and engage in various arrangements of cost-sharing and priority setting in health care. The resource allocation policy underlines two key parts of the health care reform: contracting mechanisms and payment systems. We also discuss the optimal correlation between solidarity and competition in the course of the ongoing reform of the health insurance in the Federation. The social function of a competent health system, where the well-being of the population is viewed as a sociological category of the overall society's concern, requires considerable subsidization. Incentive-based market mechanisms may be introduced into some of the segments of health care system but only under government-led control of the effects of such measures.

Priority setting and scarce resources: case of the Federation of Bosnia and Herzegovina.

The priority setting within the context of scarce resources in the Federation of Bosnia and Herzegovina (BH) can be divided into priorities within the health care services provision and priorities within the reconstruction process. Facing the resource scarcity, the Federation of BH has chosen to increase health insurance contribution rate to establish cost-sharing arrangements (co-payments) and priority setting to ration access to certain services funded by the compulsory health insurance ("basic package" of the health care services). Reconstruction process of the health care facilities is conducted on the federal level through the effective managerial infrastructure ("project implementation units"). This study reports on the consequences of the war in BH as a peculiar context of the overall reform objectives and priority setting.

[Strategic plan for reform and reconstruction of the health care system in the Federation of Bosnia-Herzegovina]. / Strateski plan za reformu i rekonstrukciju zdravstvenog sustava Federacije BiH.

The aim of this study was to represent the document of the Federal Ministry of Health entitled "Strategic Plan for Reform and Reconstruction of Health System in the Federation of Bosnia and Herzegovina". Strategic outlines of health system development in the Federation of B&H during the next three years were represented in the document, but in particular within following areas: health care financing, primary health care, specialist-consultancy hospital care, public health, pharmaceutical issues, health information system, and medical education.

[The effect of aluminum on human health]. / Efekti aluminijuma na zdravlje ljudi.

The paper aims at reviewing recent knowledge of the pathophysiological mechanisms involved in aluminium poisoning which is often manifested as anaemia, osteopathy and encephalopathy. In order to clarify the mechanisms of aluminium toxicity its metabolism and ways of human exposure are also described. The immunosuppressive effect as well as certain anticarcinogenic effects of aluminium are still insufficiently well known. It is pointed out that different chemical elements can exert a protective action during aluminium poisoning.

[The effect of suxamethonium chloride on serum potassium levels during kidney transplantation]. / Djelovanje suksametoniumklorida na koncentraciju kalija u serumu u toku transplantacije bubrega.

The aim of the investigation was to determine the effect of suxamethonium chloride on potassium concentrations in serum during anaesthesia in renal transplantation. Potassium values were measured before the operation (control values), after the administration of suxamethonium chloride, after reinstatement of the blood flow in the transplanted kidney, and after the operation. The mean potassium values after suxamethonium chloride administration (5.33 mmol/L) and after the operation (5.17 mmol/L) were significantly higher than the values before the operation (4.82 mmol/L) (P less than 0.05). The difference between potassium concentrations before the operation (4.82 mmol/L) and those measured after reinstatement of the blood flow in the transplanted kidney (5.06 mmol/L) was not statistically significant (P greater than 0.05). Increase in potassium concentration following suxamethonium chloride administration calls for caution as it may produce a toxic effect on the cardiovascular system. The potassium values in patients with terminal renal failure should not be higher than 5 mmol/L before inducing anaesthesia.

[Protective effect of zinc in chromium poisoning in rats]. / Protektivni efekt cinka prilikom trovanja hromom kod pacova.

The effect of a toxic trivalent chromium dose on histopathological changes in rat organs was investigated. To evaluate a protective effect of zinc, rats were treated with ZnCl2 two hours before chromium administration. The protective zinc action was best observed in respect to morphological changes in the organs of chromium poisoned rats, particularly in the liver. The lack of areas of focal necrosis on the liver capsule in the protected group of rats was the most evident macroscopic findings. The histopathological changes observed were in accordance with the results of own previous investigation of the changes in lactate dehydrogenase activity in rat organs induced by chromium and zinc. The mechanisms of the zinc protective effect against chromium poisoning are discussed.

[The effects of chromium on human health]. / Efekti hroma na zdravlje ljudi.

This is a review of studies dealing with the physiological role of chromium in the body and its harmful effects to human health. Trivalent chromium is discussed as a trace element essential to normal metabolism of hydrocarbons and to functioning of some enzymes. Toxic and carcinogenic effects of chromium due to occupational exposure, environmental pollution, food contamination and accidental poisoning are described.

Lactate dehydrogenase isoenzymes in human malignant tumors.

For estimation of the value of Chemetron method for LD isoenzyme separation on cellulose-acetate membranes in cancer tissues taken from corpses, malignant tumors revealed by autopsy were investigated. Overall stability of LD, as well as the maintenance of various forms of isoenzymes in the extracts with regard to post-mortem autolysis in corpse and long periods of freezing, have been demonstrated. No correlation was found between the degree of isoenzyme changes and the histologic grading of tumors. LD isoenzyme pattern in cancer metastasis has been considered with respect to vascular and metabolic role of the environmental normal tissue. In order to point out the possible role of LD isoenzyme pattern in cancer diagnosis a lot of preliminary studies has been reviewed. The clarification of the specific distribution of LD activities in different tissues has been considered.