Медицински факултет [Научни радови] / Faculty of Medicine [Scientific papers]

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    Development and implementation of internationalization in Bosnia and Herzegovina higher education
    (Emerald Publishing Limited, 2021) Markovic, Nenad; Bokonjic, Dejan; De Lepeleer, Geert
    Purpose – The main reason for writing this paper was the systematic determination of the state of internationalization of public higher education for the first time in Bosnia and Herzegovina (B&H). This paper aims to compare the state of internationalization with the results of comparative European and world research in higher education in order to determine the direction of public universities inB&Hfollowing globalization and connection with the European Higher Education Area (EHEA), as well as to determine future steps for mandatory inclusion into global higher education flows. Furthermore, the aim was to determine the treatment of mobility and student exchange programs and the ways of recognizing acquired qualifications abroad. Design/methodology/approach – The paper opted for a research study by conducting questionnaires that were divided into questions of elimination, questions of qualification and questions of the main survey. A total of 2,822 final year students were surveyed, as well as 386 representatives of the management of public universities. Within the paper, 25 different SWOT analyses of internationalization were performed by public universities, ministries and state/regional agencies, which was the basis for the SWOT analysis of the internationalization of B&H public higher education. The data were supplemented with a qualitative analysis of the obtained results compared with the International Association of Universities (IAUs) and European Association for International Education (EAIE) research, as well as an overview of the most significant achievements in the field of internationalization of higher education. Findings – The paper provides empirical results on the barriers of students to study abroad, the existence of strategies and indicators for internationalization, the benefits of internationalization, internal and external drivers of internationalization and the potential risks of internationalization. These empirical results for B&H were compared with complementary IAUs and EAIE research and provided the basis for SWOT analysis of internationalization, development of institutional internationalization strategies and indicators, B&H recognition model, new criteria for accreditation with emphasis on internationalization and criteria for assessing internationalization. The paper suggests that virtual mobility and internationalization at home are future logical trends of development internationalization in B&H. Research limitations/implications – Suggestions for future research related to the examination of identified potential risks to the management of the internationalization of individual institutions, as well as to future comparisons of the new state of internationalization of higher education in B&H with current similar research in Europe and the world. Regarding the limitations in the research, it was possible that a larger number of participants participated in the survey with questionnaires, although the target set at the beginning of the survey was achieved. Practical implications – Most of the research results are the basis for improving the practical situation in the internationalization of public higher education in B&H. The paper presents a special chapter (undertaken improvement activities) dedicated to the practical implications based on the conducted research and comparison of results. Considering that this is a preliminary work related to the internationalization of higher education, based on the researched results, the context of the internationalization of public higher education in B&Hwas changed by the activities described in the mentioned chapter. The contribution to these activities was given by the approved project of the European Commission (EC) “strengthening of internationalization in B&H higher education” - STINT. Also, the research results of this paper offered a comparison with the research results of research conducted by IAUs and EAIE. Social implications – Different research groups participated in this research study: students, teachers, administration, representatives of ministries and state/regional agencies. All target groups supported the implementation of the questionnaire, the development of SWOT analyses and various reports, as well as the undertaking of various practical activities. In accordance with the research results, all these target groups were subsequently educated on issues of internationalization and recognition of qualifications. Stronger and better internationalization certainly increases the social impact on future students, higher education funders, as well as other interested stakeholders. Originality/value – This is a preliminary study whose main goal was to review the state of internationalization and to identify the most important undertaken activities in B&H. For the higher education area in B&H, the research study is new and has undertaken internationalization activities, but on the other side, in other developed European countries, similar studies and activities are not new. For the field of higher education in B&H, this work and research results are important because they will be the basis for future internationalization activities and will also serve as a basis for future activities to be undertaken in this field. The value of this paper is significant for both internal and external stakeholders of higher education.
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    IL 33 Correlates With COVID-19 Severity, Radiographic and Clinical Finding
    (Frontiers, 2021) Sekulic Markovic, Sofija; Jovanovic, Marina; Gajovic, Nevena; Jurisevic, Milena; Arsenijevic, Nebojsa; Jovanovic, Milan; Mijailovic, Zeljko; Lukic, Snezana; Zornic, Nenad; Vukicevic, Vladimir; Stojanovic, Jasmina; Maric, Veljko; Jocic, Miodrag; Jovanovic, Ivan
    Objective: The increased level of interleukin (IL)-33 is considered as a predictor of severe coronavirus disease 2019 (COVID-19) infection, but its role at different stages of the disease is still unclear. Our goal was to analyze the correlation of IL-33 and other innate immunity cytokines with disease severity. Methods: In this study, 220 patients with COVID-19 were included and divided into two groups, mild/moderate and severe/critical. The value of the cytokines, clinical, biochemical, radiographic data was collected and their correlation with disease severity was analyzed. Results: Most patients in the severe/critical group were male (81.8%) and older (over 64.5 years). We found a statistically significant difference (p < 0.05) in these two groups between clinical features (dyspnea, dry cough, fatigue, and auscultatory findings); laboratory [(neutrophil count, lymphocyte count, monocyte count, hemoglobin, plasma glucose, urea, creatinine, total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), albumin (ALB), lactate dehydrogenase (LDH), creatinine kinase (CK), D-dimer, C-reactive protein (CRP), procalcitonin (PCT), Fe, and Ferritin)], arterial blood gases (oxygen saturation-Sa02, partial pressure of oxygen -p02), and chest X-rays (CXR) lung findings (p = 0.000). We found a significantly higher serum concentration (p < 0.05) of TNF-a, IL-1b, IL-6, IL-12, IL-23, and IL-33 in patients with COVID-19 with severe disease. In the milder stage of COVID-19, a positive correlation was detected between IL-33 and IL-1b, IL-12 and IL-23, while a stronger positive correlation between the serum values of IL-33 and TNF-a, IL-1b, IL-6, and IL-12 and IL-23 was detected in patients with COVID-19 with severe disease. A weak negative correlation (p < 0.05) between pO2 and serum IL-1b, IL-12, and IL-33 and between SaO2 and serum IL-33 was noted. The positive relation (p < 0.05) between the serum values of IL-33 and IL-12, IL-33 and IL-6, and IL-6 and IL-12 is proven. Conclusion: In a more progressive stage of COVID-19, increased IL-33 facilitates lung inflammation by inducing the production of various innate proinflammatory cytokines (IL-1b, IL-6, TNF-a, IL-12, and IL-23) in several target cells leading to the most severe forms of the disease. IL-33 correlates with clinical parameters of COVID-19 and might represent a promising marker as well as a therapeutic target in COVID-19.
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    Different methods for subgingival application of chlorhexidine in the treatment of patients with chronic periodontitis
    (Taylor & Francis, 2016) Lecic, Jelena; Cakic, Sasa; Janjic Pavlovic, Ognjenka; Cicmil, Ana; Vukotic, Olivera; Petrovic, Vanja; Cicmil, Smiljka
    Objective: The aim of this study was to evaluate clinical efficacy of different chlorhexidine gluconate (CHX) preparations applied subgingivally as an adjunct to scaling and root planing (SRP). Material and methods: A total of 120 periodontal pockets was included in this randomized, controlled, split mouth designed study. According to protocols used in treatment, periodontal pockets were assigned to experimental and control groups as follows: CHX solution as an addition to SRP versus control SRP group; CHX gel as an addition to SRP versus control SRP; CHX chip as an addition to SRP versus control SRP group. Following clinical parameters were recorded at baseline, one and three months after the baseline: plaque index (PI), probing pocket depth (PPD), bleeding index (BI) and clinical attachment level (CAL). Results: The most significant improvements were found concerning PI in CHX solution with SRP and CHX gel with SRP groups over controls at one month recall, as well as concerning BI and PPD in CHX chip with SRP group over SRP alone at three-month recall. Conclusion: Results of this study favour combination therapy using CHX chip as an adjunct to SRP due to greater improvements in BI and PPD compared to those obtained by SRP alone in the treatment of chronic periodontitis.
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    Medicine Availability and Prescribing Policy for Non-Communicable Diseases in the Western Balkan Countries
    (Frontiers, 2017) Pekez-Pavlisko, Tanja; Račić, Maja; Kusmuk, Srebrenka
    Background: During the transition processes, the Western Balkan countries were affected by conflicts and transition-related changes. Life expectancy in these countries is lower, while the mortality from non-communicable diseases (NCDs) is higher in comparison with western and northern parts of Europe. The primary aim of this study was to analyze the treatment possibilities for the most common NCDs in the Western Balkan countries. The secondary aim was to understand and compare the policies regarding prescribing-related competencies of family physicians. Methods: In June and July 2017, a document analysis was performed of national positive medicines lists, strategic documents, and clinical guidelines for the treatment of the most frequent NCDs; arterial hypertension, diabetes, hyperlipidemia, asthma, and chronic obstructive pulmonary disease (COPD). All text phrases that referred to medicines prescribing were extracted and sorted into following domains: medicine availability, prescribing policy, and medication prescribing-related competencies. Results: Possibilities for treatment of arterial hypertension, diabetes, hyperlipidemia, asthma, and COPD vary across the Western Balkan countries. This variance is reflected in the number of registered medicines, number of parallels, and number of different combinations, as well as restrictions placed on family physicians in prescribing insulin, inhaled corticosteroids, statins and angiotensin II receptor blockers (ARBs), without consultant’s recommendation. Conclusion: Western Balkan countries are capable of providing essential medicines for the treatment of NCDs, with full or partial reimbursement. There are some exceptions, related to statins, newer generation of oral antidiabetic agents and some of the antihypertensive combinations. Prescribing-related competences of family physicians are limited. However, this practice is not compliant to the practices of family medicine, its principles and primary care structures, and may potentially result in increased healthcare financial ramifications to both the system and patients due to frequent referrals to the specialists.
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    Salivary Cortisol Levels as a Biological Marker of Stress Reaction
    (Academy of Medical Sciences of Bosnia and Herzegovina, 2013) Bozovic, Djordje; Račić, Maja; Ivkovic, Nedeljka
    Aim: To determine the validity and psychobiological significance of salivary cortisol as a biomarker of stress in the experiments. Results: Stress is defined as a state in which homeostasis is jeopardized by the action of various external and internal stressors. he effect of cortisol is made through specific receptors located in the cytoplasm of the target cells. Determining blood cortisol levels, which has been the most widely used method, is characterized by certain shortcomings. he process of taking blood samples from the vein is accompanied by additional stress, which results in falsely positive results. Another law is found in the fact that cortisol taken and measured from serum or plasma represents total cortisol, not the free, biologically active one. Cortisol response lags behind ACTH by 5-20 minutes, with peak blood levels achieved in 10-30 min. he transfer of cortisol from blood to saliva takes place rather quickly, within no more than 2-3 min. Conclusion: Although, the studies on correlation between saliva cortisol concentrations and free levels of this hormone in blood samples are lacking, salivary cortisol offer a novel approach in research of stress biomarkers with its ease of collection and potentially wide scope for application.