Journal of Health Sciences
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    Vitamin B12 deficiency and depression in elderly: cross-sectional study in Eastern Croatia

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    Introduction: Vitamin B12 deficiency occurs frequently among elderly patients and it has recently been connected with the occurrence of depressive symptoms in this population. The aim of this study was to determine the frequency of vitamin B12 deficiency among elderly patients from Eastern Croatia and to evaluate whether there is a connection between this deficiency and the occurrence of depressive symptoms among them.Methods: This cross-sectional study was conducted from April to June 2013, among 140 elderly patients from Vukovar-Srijem County (47.9%, 67/140 males and 52.1%, 73/140 females; mean age 71.0±6.7 years). The anonymous questionnaire was used to obtain demographic data, data regarding socio-economic status and personal history of diseases of study participants as well as data pertaining to the existence of depressive symptoms among them. The competitive immunoassay vitamin B12 kit was used to determine serum levels of vitamin B12.Results: Among all study participants there were 7.1% (10/140) of them with B12 deficiency and 70.0% (98/140) of them with the symptoms of depression. Depressive symptoms occurred in 100.0% (10/10) patients with the vitamin B12 deficiency and 67.7% (88/130) of patients without it.Conclusion: The study showed positive connection between the existence of depressive symptoms and vitamin B12 deficiency among elderly patients. This finding points to the need for frequent vitamin status evaluation in this age group and its consequent correction that could improve overall health of this population subgroup

    Nurses\u27 Knowledge and Responsibility toward Nutritional Assessment for Patients in Intensive Care Units

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    Introduction: Nutritional assessment is a prerequisite for nutritional delivery. Patients in intensive care suffer from under-nutrition and nutritional failure due to poor assessment. Nursing ability to early detect nutritional failure is the key for minimizing imparities in practice and attaining nutritional goals. Aim of this article is to examine the ability of Jordanian ICU nurses to assess the nutritional status of critically ill patients, considering biophysical and biochemical measures.Methods: This cross sectional study recruited nurses from different health sectors in Jordan. ICU nurses from the governmental sector (two hospitals) and private sectors (two hospitals) were surveyed using a self-administered questionnaire. Nurses\u27 knowledge and responsibility towards nutritional assessment were examined.Results: A total of 220 nurses from both sectors have completed the questionnaire. Nurses were consistent in regard to knowledge, responsibility, and documentation of nutritional assessment. Nurses in the governmental hospitals inappropriately perceived the application of aspiration reduction measures. However, they scored higher in applying physical examination and anthropometric assessment.  Although both nurses claimed higher use of biochemical measurements, biophysical measurements were less frequently used. Older nurses with longer clinical experience exhibited better adherence to biophysical measurement than younger nurses.Conclusion: Nursing nutritional assessment is still suboptimal to attain nutritional goals. Assessment of body weight, history of nutrition intake, severity of illness, and function of gastrointestinal tract should be considered over measuring albumin and pre-albumin levels.  A well-defined evidence-based protocol as well as a multidisciplinary nutritional team for nutritional assessment is the best to minimize episodes of under-nutrition

    Modern treatment of patent ductus arteriosus – single center experience

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     Introduction: Transcatheter closure is a treatment choice for the most children with patent ductus arteriosus (PDA). The closure of the ductus is indicated in any child or adolescent with developed symptoms of significant L-R shunt. The aim of this article is to present our results in 5 years treatment of patients with PDA and their outcome. Methods: From 2009 to 2014, 30 patients underwent a transcatheter closure of PDA at Centre for Heart and Pediatric clinic of Clinical University Centre of Sarajevo. Aortic angiogram was performed to evaluate the size, position, and shape of the duct for selection of appropriate occluder device type and size. All procedures were performed by local team of cardiologists from the Department of Cardiology, Pediatric clinic, with invasive cardiologists team from Sweden and Austria. Echocardiography was repeated at intervals of 24 hours, then 1month, 3 months, and 1 year after the procedure to assess the outcome. Results: Thirty patients underwent transcatheter closure of PDA during the study period. PDA of ≤ 2.0 mm was present in 8 patients and they underwent PDA closure with coils, while 22 patients had PDA diameter  ≥ 2 mm, and they were treated by Amplatzer duct occluder (ADO). Only in 2 (6.2%) patients complications have been observed. The length of hospital stay after the treatment was two to three days. Conclusion: Transcatheter closure of PDA is a modern, safe and efficient method that ensures a faster recovery of the patients, shortens the length of hospitalization

    The effect of the infection Clostridium difficile on the rehabilitation

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    Introduction: Clostridium difficile is the cause of the post antibiotic colitis. This anaerobe, sporogenous, gram-positive bacteria is most often recognized as the cause of the nosocomial diarrhea. The aim of this work is to show the impact of the infection Clostridium difficile on the result of rehabilitation of the patients that have been treated in the rehabilitation facility.Methods: 448 patients treated at the Clinic for physical medicine and rehabilitation of the Clinical Center University of Sarajevo were included in the study. Gender, age, Barthel index, length of hospitalization, and values of the albumin in the serum were documented. Kolmogorov-Smirnov test, Mann-Whitney U test and One Sample Wilcoxon Signed Rank test were used for data analysis.Results: There were 57% female and 43% of male patients. The average age was 67.5 years for women and 52 years for men. Barthel index at admission was 4.0 and at discharge raised to 8.0 (p=0.047). The length of the hospitalization for patients without infection was shorter (28.8 days) compared to patients with infection (43 days) (p=0.015). Values of the albumin in the blood at patients with confirmed Clostridium difficile infection were significantly lower than referent values (p = 0.016).Conclusion: Patients with Clostridium difficile infection had longer period of the rehabilitation and the results were less favorable

    Use of colposcopy for detection of squamous intraepithelial lesions

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    Introduction   Pap smear, the main tool of cervical cancer screening is not always available, but some patients are in urgent need for proper diagnostic. Aim of this article was to investigate accuracy of colposcopy for detection of squamous intraepithelial lesions of low or high grade (LGSIL, HGSIL) and to promote colposcopy as useful tool for detection of patients in need for immediate further diagnostics. Methods Prospective multicentric study performed in B&H in 2012 -2013 included 87 patients with colposcopic images related to squamous intraepithelial lesion (SIL) who formed experimental group: 56 patients with colposcopic images related to LGSIL and 31 patients related to HGSIL. Control group included 50 patients without colposcopic abnormalities. To test accuracy of colposcopy, PAP smear and histology were used. For statistical analysis χ2 was used.Results 94.5% patients in experimental group had abnormal PAP test:  64.3% correlated to LGSIL (χ2= 60.48 P < 0.0001), while 64.5% correlated to HGSIL (χ2 = 54.23 P<0.0001) Odds Ratio = 490; 95% CI = 42.024 to 5713.304).  HGSIL was confirmed in 27 (87%) cases by histology (CIN II /CIN III). There were no statistically significant differences between colposcopic finding and histology results (Yates-corrected χ2 = 0.33 P = .5637)Conclusions This study showed high level of correlation between colposcopy and PAP results    (63-64%) and to histology for HGSIL (87%). In absence of PAP test colposcopy could be used to select patients in need for biopsy

    Influence of cigarette smoking on bone mineral density in postmenopausal women with estrogen deficiency in menstrual history

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    Introduction: Estrogen deficiency leads to bone mass loss and increased risk for osteoporosis. The aim of this study was to examine influence of cigarette smoking on bone mineral density in postmenopausal women with estrogen deficiency in menstrual history.Methods: The total of 100 postmenopausal women living in Sarajevo area, aged 50-65 years, with estrogen deficiency in menstrual history participated in this prospective study. The subjects were divided in two groups, examination and control group, based on bone mineral density values. The women in the examination group had osteoporosis while in the control group were women with osteopenia or normal bone mineral density. Bone mineral density was measured at the lumbar spine and proximal femur by Dual–Energy X–ray Absorptiometry using Hologic QDR-4000 scanner. Smoking habits were assessed for each subject.Results: The average number of cigarettes smoked per day in women with estrogen deficiency in menstrual history was 14.86 in the examination group and 4.67 in the control group. The difference in the average number of cigarettes smoked per day between the two groups was statistically significant (p <0.01). The coefficient of linear correlation between T score and the number of cigarettes smoked per day among women with estrogen deficiency in menstrual history in the examination group was statistically significant (p<0.01). The coefficient of linear correlation between T score and the number of cigarettes smoked per day among women with estrogen deficiency in menstrual history in the control group was statistically significant ( p<0.05).Conclusion: Results of this study suggest that cigarette smoking has negative impact on bone mineral density and that healthy lifestyle (no smoking) has the potential to reduce bone loss in postmenopausal women with estrogen deficiency in menstrual history

    The incidence of vascular complications after coronary angiography: evaluation of results and risk factors

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    Introduction: The aim of this study was to present the incidence of the vascular complications that had to be surgically treated during the two-year period of transfemoral cardiac catheterization procedure and to identify the risk factors associated with the complications.Methods: A retrospective two-year study of post-catheterization complications with the six-month postoperative follow-up and analysis of risk factors was done. Patients with cardiovascular diseases who underwent therapeutic or diagnostic coronary angiography in the period of 2012-2013 were included in the study. A total of 1320 patients were subjected to catheterization for coronary angiography, of which 24 had vascular complications that had to be surgically treated. Indications for operative treatment included rapid growth of pseudoaneurysm, hemorrhage, large hematoma, hemodynamic instability, failure of the targeted compression therapy.Results: Twenty-four patients experienced some kind of post-operative complication. Infection and dehiscence of surgical wound were the two most common complications. There were no fatalities. The average length of a hospitalization was 4 days. The important risk factors are gender (women more than man), obesity, concomitant use of anticoagulation therapy and antiplatelet therapy after catheterization.Conclusion: Insufficient length of the compression of the punctured place and increased risks of a pseudoaneurysm formation, such as female gender, obesity, and use of a combined anticoagulant therapy are the main causes of these complications. Late vascular complications are not uncommon

    Cardiac aspects of DiGeorge syndrome: a report of two cases with molecular analysis

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    DiGeorge syndrome (DGS) which is also known as velocardiofacial syndrome is caused by a submicroscopic chromosome deletion of band 22q11. It is associated with a disturbed development of the pharyngeal arches. In this report we describe two unrelated male children with clinical features consistent with 22q11.2 microdeletion syndrome characterized by cardiac defect, recurrent respiratory infections and developmental deficiency. Definitive diagnosis is made by Fluorescence In Situ Hybridization analysis (FISH). Children underwent surgical correction of congenital heart defects. During surgery thymic aplasia was confirmed in both children, postoperative course proceeded without major complications. Our report suggests that the criteria in searching for microdeletion 22q11.2 should be expanded and applied in patients with conotruncal and non-conotruncal congenital heart defects and at least one typical feature of this syndrome

    Correlation of Body Mass Index and Waist Hip Ratio with lipid and hormone profile in women in menopausal transition

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    Introduction: Menopausal transition is a period characterised by psychic, somatic changes as well as changes in reproductive capabilities of a woman. It occurs as a consequence of ovarian’s function termination, and pertains to the periods of different meanings: perimenopause, menopause and postmenopause. Although there are numerous assessments of behaviour of the lipids and lipoproteins during menopausal transition, their relation to sexual hormones and body mass is still being assessed. The aim of this study is to determine the differences and connections between body mass index (BMI) and waist-hip ratio (WHR) and lipid and hormone profile among the assessees in premenopause, perimenopause and postmenopause.Methods: The assessment was done on 150 assessees divided in three groups of 50, such as: premenopause, perimenopause and postmenopause. The assessment included the following: interview, determination of BMI, WHR, and taking of blood sample and processing of hormone, lipid and lipoprotein concentration.Results: Based on the obtained results, it may not be concluded that BMI has a positive correlation with cholesterol and VLDL concentration in postmenopause, positive correlation with apo A in perimenopause and postmenopause, and positive correlation with Lp (a) and apo B in premenopause and perimenopause, while negative correlation with HDL and estradiol concentrations in premenopause.Conclusion: WHR has negative correlation with HDL concentration in premenopause and perimenopause, and a negative correlation with estradiol concentrations in premenopause

    Evaluation of tumor marker HE4 assay on the Elecsys 2010 analyzer

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    Introduction: Whey-acidic protein human epididymis protein 4 (HE4) is a new promising biomarker for epithelial ovarian cancer. The measured HE4 values may depend on the testing procedure used. The aim of this study was to evaluate theMethods: We evaluated a HE4 method on Elecsys 2010 analyzer. The method for quantitative determination of HE4 is direct, competitive chemiluminescent immunoassay. For quality control we use Elecsys PreciControl HE4 1 and 2. HE4 was measure on sera obtained from 56 women ( 20 healthy and 36 with epithelial ovarian cancer).Results: The Roche HE4 assays showed a good linearity (r=0.99) and precision (intrassayed total CV<5%). The median HE4 serum concentrations was significantly higher among EOC patients than healthy females (p<0,05). Elevated levels HE4 were found in 78 % patients with epithelial ovarian cancer.Conclusions: The presented results of the analytical evaluation methods for the determination of HE4 on the Elecsys 2010 analyzer showed an acceptable accuracy and precision

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