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Journal Cover Acta Medica Academica
  [SJR: 0.262]   [H-I: 4]   [0 followers]  Follow
  This is an Open Access Journal Open Access journal
   ISSN (Print) 1840-1848 - ISSN (Online) 1840-2879
   Published by Academy of Sciences and Arts of Bosnia and Herzegovina Homepage  [1 journal]
  • Symmetry, asymmetry and hypoplasia of the intracranial internal carotid
           artery on magnetic resonance angiography

    • Authors: Svjetlana Mujagić, Duško Kozić, Haris Huseinagić, Dževdet Smajlović
      First page: 1
      Abstract: Objective. The aim of this study was to determine the prevalence of symmetry, asymmetry and hypoplasia of the intracranial internal carotid artery (ICA), and the possible presence of other variants of the ICA by magnetic resonance angiography (MRA). Subjects and methods. This prospective-retrospective study included 1000 subjects who underwent consecutively MRA of the cerebral arteries. 3D–time of flight angiograms were performed according to the standard protocol. We measured the diameter of the ICA and the diameter of the A1 segment of the anterior cerebral artery (ACA). The symmetry, asymmetry and hypoplasia of the ICA, as well hypoplasia of the A1 segment of the ACA were analysed using the vascular asymmetry coefficient. Results. The right and left ICA were symmetrical in 93.9% examinees, and asymmetrical in 6%, while ICA hypoplasia was found in only one patient (0.1%). Other variants of the ICA were not found. There was no significant difference in the prevalence of individual variations between male and female patients, and no significant frequency difference was found between anatomical variations in terms of the right and left ICA. In 38.3% patients with asymmetrical ICAs, aplasia or hypoplasia of the A1 segment of the ACA was found on the side of the ICA with a reduced diameter. Conclusion. Congenital hypoplasia of ICAs is a very rare abnormality, while asymmetry of ICAs is more common. After evaluating severe asymmetry of intracranial ICAs by MRA, MRA of the neck is recommended, especially in patients with a complete anterior part of the circle of Willis.
      PubDate: 2016-05-23
      Issue No: Vol. 45, No. 1 (2016)
  • Retrospective analysis of the role and performance of family medicine
           versus emergency medical services in the pre-hospital management of
           patients with AMI in Banja Luka

    • Authors: Biljana Lakić, Maja Račić, Duško Vulić
      First page: 10
      Abstract: Objective. The aim of this study was to investigate the differences in pre-hospital care of patients with acute myocardial infarction between emergency medical services and family medicine. Patients and methods. This retrospective descriptive study included patients treated for acute myocardial infarction at the University Clinical Centre of Banja Luka, in the period from 1st January to 31st December 2011. The patients were divided into two groups: patients who received a hospital referral from the family medicine service and those who received one from the emergency medical service. Results. The majority of patients (54.8%) received pre-hospital care from emergency medical services, while in 24.8% of cases the care was provided by family medicine physicians. The analysis showed that the time that passed from the onset of symptoms to the visit to the health institution of first medical contact was shorter in the emergency medical service (p<0.001). The average time from the onset of symptoms to arrival at the family practice was 24 hours, and to the emergency service 2 hours. The patients who established their first medical contact with the emergency service reported more severe symptoms than the ones who visited a family practice over the same period of time. Conclusion. The severity of symptoms affected the patients’ decisions to seek help in a timely manner and to choose the facility of first medical contact. Interventions to decrease delay must focus on improving public awareness of acute myocardial infarction symptoms and increasing their knowledge of the benefits of early medical contact and treatment. Continuing education of family practitioners in this field is required.
      PubDate: 2016-05-23
      Issue No: Vol. 45, No. 1 (2016)
  • The prevalence and severity of early childhood caries in preschool
           children in the Federation of Bosnia and Herzegovina

    • Authors: Lejla Šačić, Nina Marković, Amra Arslanagić Muratbegović, Amila Zukanović, Sedin Kobašlija
      First page: 19
      Abstract: Objective. The aim of this study was to assess caries prevalence and severity in preschool children in the Federation of Bosnia and Herzegovina. In addition, the relationship between the frequency and
      clinical types of early childhood caries and behavioral factors, oral hygiene and eating habits were assessed. Subjects and methods. An oral health survey was performed in line with the World Health
      Organization methodology and criteria. The research consisted of clinical examinations of children to determine dentition status, oral hygiene and severity of caries distribution according to Wyne’s classification. Information about behavioral factors was collected by means of a questionnaire administered to parents/guardians. Results. The sample consisted of a total of 165 preschool children aged 3-5 years. Mean dmft (decay, missing, filled teeth index for primary dentition) was 6.79. The percentage of caries-free children was 17.0%. The results showed a statistically significant correlation between oral hygiene and eating habits, and also the frequency and types of early childhood caries. Conclusion. The present study demonstrates high caries prevalence in preschool children in the Federation of Bosnia and Herzegovina. Community based preventive programs should be developed and urgently implemented, in order to achieve the WHO goals, improve oral and general health, thus improving the quality of life of these populations.
      PubDate: 2016-05-23
      Issue No: Vol. 45, No. 1 (2016)
  • The business process management software for successful quality management
           and organization: A case study from the University of Split School of

    • Authors: Damir Sapunar, Ivica Grković, Davor Lukšić, Matko Marušić
      First page: 26
      Abstract: Objective. Our aim was to describe a comprehensive model of internal quality management (QM) at a medical school founded on the business process analysis (BPA) software tool. Methods. BPA software tool was used as the core element for description of all working processes in our medical school, and subsequently the system served as the comprehensive model of internal QM. Results. The quality management system at the University of Split School of Medicine included the documentation and analysis of all business processes within the School. The analysis revealed 80 weak points related to one or several business processes. Conclusion. A precise analysis of medical school business processes allows identification of unfinished, unclear and inadequate points in these processes, and subsequently the respective improvements and increase of the QM level and ultimately a rationalization of the institution’s work. Our approach offers a potential reference model for development of common QM framework allowing a continuous quality control, i.e. the adjustments and adaptation to contemporary educational needs of medical students.
      PubDate: 2016-05-23
      Issue No: Vol. 45, No. 1 (2016)
  • Management of teaching processes using Share point platform: A case study
           from the University of Split School of Medicine

    • Authors: Damir Sapunar, Ivica Grković, Davor Lukšić, Matko Marušić
      First page: 34
      Abstract: Objective. To develop a software tool that will combine teaching timetables with the generation of reports on teaching load. Methods. The University of Split School of Medicine project team and the external experts from the company LAMA, LLC. determined necessary functionalities and developed the software platform as an extension of the existing software solutions already in use by the Croatian academic community. Results. By combining comprehensive scheduling functionality with planned and performed teaching activities we determined the teaching load and realized automatic generation of payments for adjunct lecturers. The implementation required perfecting of the human resources services, brought about a manifold alleviation of the work of the entire school’s administration and substantially increased the effectiveness of the quality management. The software is currently managing 54,676 teaching hours, 841 teaching staff member, 111 teaching rooms, 8 study programs, and 645 courses. Conclusion. The program resolved several administrative problems of the school and is an example of successful implementation of IT technology in medical school management.
      PubDate: 2016-05-23
      Issue No: Vol. 45, No. 1 (2016)
  • Stethoscope vs. ultrasound probe - what can we rely on more in children
           with suspected pneumonia'

    • Authors: Jovan Lovrenski, Slobodanka Petrović2, Svetlana Balj-Barbir, Radoica Jokić, Gordana Vilotijević-Dautović
      First page: 39
      Abstract: Objective. To compare lung ultrasound (LUS) with auscultation findings in children with clinical suspicion of pneumonia. Patients and methods. A prospective study including 95 patients (age: from 2 months to 17.5 years; mean age: 5.1 y, SD 4.5 y) with referral diagnosis of suspected pneumonia. In all patients LUS and auscultatory examinations were performed within an hour. These findings were compared separately in each hemithorax. The radiologist performing LUS was blinded to the patient’s clinical information. Positive auscultatory findings included: crackles and/or abnormal breath sounds (decreased, asymmetric, absent, or bronchial). For LUS examinations a combined transthoracic – transabdominal approach was used. A pneumonia-positive LUS finding included subpleural consolidation with air-bronchogram, or an adjacent area of interstitial edema. For each subpleural consolidation the cranio-caudal (CC) diameter was measured, and 95% confidence intervals (CI) of the sizes of subpleural consolidations for positive and negative auscultatory findings were compared. The p-value between LUS and auscultation was calculated using McNemar’s test. Results. LUS and auscultation showed pneumonia-positive findings in 98 and 64 hemithoraces, i.e. in 67 and 45 patients respectively. In positive auscultatory findings the CI for CC diameters of subpleural consolidations ranged from 32.46 to 54.14 mm, and in negative auscultatory findings the CI was between 16.52 and 29.83 mm, which showed a statistically significant difference. McNemar’s test showed a statistically significant difference between LUS and auscultation. Conclusions. LUS showed positive findings in more hemithoraces than auscultation in children with suspected pneumonia. A cranio-caudal size of subpleural consolidation of less than 30 mm significantly reduces the possibility of auscultatory detection.
      PubDate: 2016-05-23
      Issue No: Vol. 45, No. 1 (2016)
  • The ultrasonographic determination of the position of the mental foramen
           and its relation to hard tissue landmarks

    • Authors: Abdullah Ebrahim Laher, Zeyn Mahomed
      First page: 51
      Abstract: Objective. The goal of this ultrasound based cross-sectional study was to make use of ultrasound to determine the position of the mental foramen in relation to hard tissue landmarks. Material and methods. One hundred Black and Caucasian subjects were included. An ultrasound transducer was used to locate the mental foramina. Distances to various landmarks were measured and compared. Results. All mental foramina were visualised ultrasonographically. The mean distances to various landmarks from the mental foramen for the entire group on the right and left sides respectively were as follows: a) 22.8 mm (SD 2.04 mm) and 22.8 mm (SD 2.0 mm) to the cusp of the related tooth, b) 13.2 mm (SD 1.6 mm) and 13.2 mm (SD 1.6 mm) to the inferior border of the mandible. The mean position of the mental foramen was found to be 63.4% (SD 1.8%) of the distance from the cusp of the related tooth to the inferior border of the mandible on the right and 63.3% (SD 1.7%) on the left. There were statistically significant differences between race groups and genders, but not between age groups. Conclusion. These results suggest that ultrasound is a sensitive modality to locate the mental foramen. There are minor, statistically significant (but clinically insignificant) differences in the position of the mental foramen with regard to various hard tissue landmarks.
      PubDate: 2016-05-23
      Issue No: Vol. 45, No. 1 (2016)
  • Transition from paternalism to shared decision making – a review of the
           educational environment in Bosnia and Herzegovina and Croatia

    • Authors: Marta Vučemilović, Mersiha Mahmić-Kaknjo, Ivančica Pavličević
      First page: 61
      Abstract: In this article we will review the benefits of a system built on partnership of physicians and their patients, highlight some of the factors which impede this transition, and propose ways to address these factors. Also, we are going to analyze the educational environment in Bosnia and Herzegovina and Croatia concerning ethics and communication skills. Personal responsibility of patients for their health should be reflected in their joint involvement in health decisions with their physicians. Patients, insecure about their individual competence surrounding their health decisions, tend to shy away from responsibility, whereas physicians, pressured by the responsibilities of the profession, do not always show sensitivity to all of the patient’s concerns. They often treat illnesses instead of patients. A more open and collaborative relationship between the patient and the physician through shared decision making would be a better alternative. In the end, the patient ultimately decides whether a health intervention was satisfactory in fulfilling his or her specific needs. Transition from a paternalistic to a
      mutual relationship between doctors and patients has already begun. In an era of intense information sharing, shared decision making is a sensitive, ethical, legal, and political concept which needs empathic doctors with well-developed communication skills to integrate their clinical knowledge with patient-centered care. Conclusion. Transition from paternalistic to partner relation between physicians and patients is moving slowly ahead in Croatia and Bosnia and Herzegovina. Educational environment is improving but needs intense efforts to develop further.
      PubDate: 2016-05-23
      Issue No: Vol. 45, No. 1 (2016)
  • The feasibility of transradial laser atherectomy for chronic total
           occlusion using the 5 Fr sheath system

    • Authors: Khaled Sherif, Yasir Yakub, Jose A. Suarez
      First page: 70
      Abstract: Objective. We present a case of chronic total occlusion (CTO) approached with LASER endovascular intervention by radial artery approach using a 5 French sheath. Case report. A 57-year-old man presented to our hospital having had retrosternal chest pain for two days. Physical examination was normal at the time of presentation. The laboratory tests were within normal limits, including cardiac enzymes except the lipid panel which showed hypertriglyceridemia. The patient underwent a myocardial perfusion scintigraphy stress test that revealed inferior wall ischemia, with normal left ventricular ejection fraction. A 5-French vascular sheath was placed in the right radial artery. Selective coronary artery angiography was performed, which showed right coronary artery (RCA) CTO. A 5-French JR4 guide
      catheter successfully engaged the RCA and Laser angioplasty was performed across the CTO into the RCA. A marked improvement of flow was evident thereafter. Conclusion. To best of our knowledge this is the first case report showing the feasibility of laser atherectomy using the 5 French sheath system in a coronary arterial CTO.
      PubDate: 2016-05-23
      Issue No: Vol. 45, No. 1 (2016)
  • The Takotsubo cardiomyopathy caused by the family drama

    • Authors: Mehmed Kulić, Elnur Tahirović
      First page: 74
      Abstract: No abstract available.
      PubDate: 2016-05-05
      Issue No: Vol. 45, No. 1 (2016)
  • Lung ultrasonography: A new imaging approach in diagnosis of pneumonia in

    • Authors: Damjana Ključevšek
      First page: 76
      Abstract: No abstract available.
      PubDate: 2016-05-24
      Issue No: Vol. 45, No. 1 (2016)
  • Lung ultrasound in children with pneumonia

    • Authors: Mark C. Liszewski
      First page: 78
      Abstract: No abstract available.
      PubDate: 2016-05-24
      Issue No: Vol. 45, No. 1 (2016)
  • Is lung ultrasound the stethoscope of the new millennium' Definitely

    • Authors: Roberto Copetti
      First page: 80
      Abstract: No abstract available.
      PubDate: 2016-05-24
      Issue No: Vol. 45, No. 1 (2016)
  • Lung ultrasound in the diagnosis of pediatric pneumonia: are we ready for
           routine use'

    • Authors: Goran Roić
      First page: 82
      Abstract: No abstract available.
      PubDate: 2016-05-24
      Issue No: Vol. 45, No. 1 (2016)
  • International publications of authors from Bosnia and Herzegovina in
           Current Contents indexed publications in the second half of 2015

    • Authors: Nerma Tanović
      First page: 84
      Abstract: No abstract available.
      PubDate: 2016-05-24
      Issue No: Vol. 45, No. 1 (2016)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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Fax: +00 44 (0)131 4513327
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