Editor-in-Chief: Husref Tahirović EDITORIAL CONTACT INFORMATION Acta Medica Academica Academy of Sciences and Arts of Bosnia and Herzegovina Bistrik 7, 71000 Sarajevo, Bosnia and Herzegovina Tel.: + 387 33 560 718; Fax.: + 387 33 560 703 Contact Person: Nerma Tanović; E-mail: amabih@anubih.ba This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
Academy of Sciences and Arts of Bosnia and Herzegovina
Indications and Complications of Total Thyroidectomy in the Management of Thyroid Diseases: A Five-Year Retrospective Study in a Greek Population
Objective. This retrospective study aimed to record, analyze, and evaluate data concerning patients who underwent total thyroidectomy, focusing on the main indications that led to surgical therapy, as well as postoperative complications and oncological outcomes. Materials and Methods. A retrospective study was conducted on 312 patients who underwent total thyroidectomy or lobectomy at the First Department of Surgery of Sismanogleio General Hospital in Athens between 2019 and 2024. Demographic data, indications, intraoperative parameters, complications, and histological findings were recorded. Statistical analyses were performed using SPSS v29.0. Results. Among the 312 patients, 222 (71.2%) were female, and 90 (28.8%) were male, with a mean age of 54.3±13.3 years. Total thyroidectomy was performed in 96.5% of the cases. The main indications were nodular hyperplasia (31.4%), autoimmune thyroiditis (18.9%), multinodular goiter (12.8%), and papillary carcinoma (17.3%). The overall complication rate was 31.7%, with transient postoperative hypocalcemia being the most common complication (25.3%). Permanent hypocalcemia occurred in 1.9% of patients, hemorrhage in 3.5%, and recurrent laryngeal nerve palsy in 1.3% of patients. Papillary carcinoma was the most frequent malignancy, followed by follicular, medullary, and anaplastic carcinomas. Approximately 20% of patients were diagnosed with incidental carcinoma—mostly papillary microcarcinoma—emphasizing the importance of total thyroidectomy, even for benign thyroid diseases. Conclusions. Total thyroidectomy is a safe and effective therapeutic option with low rates of permanent complications. The systematic identification and preservation of the parathyroid glands, intraoperative nerve monitoring, and meticulous hemostasis are key factors for minimizing inadvertent complications and optimizing outcomes.
Copyright (c) 2026 Georgios Kaklamanis, Dimosthenis Chrysikos, Panagiotis Voulgaris, Vaios Primikiris, Maria Piagkou, Theodoros Troupis https://creativecommons.org/licenses/by/4.0/
Genomic and Molecular Characterisation of Respiratory Syncytial Virus in the National SARI Surveillance System Across Three Consecutive Seasons in North Macedonia (2022-2025)
Objective. To describe the epidemiological, molecular, and genomic characteristics of respiratory syncytial virus (RSV) detected through the national severe acute respiratory infection (SARI) surveillance system in North Macedonia across three consecutive seasons (2022/2023-2024/2025). Materials and Methods. This study analysed SARI surveillance data from seven hospital-based sentinel sites. RSV detection and subgroup determination were performed using reverse transcription quantitative polymerase chain reaction (RT-qPCR), following season-specific testing strategies, which should be considered when interpreting seasonal differences in RSV positivity. Consensus genomes were generated, and phylogenetic analyses were performed using contemporaneous European reference sequences. Amino acid substitutions in the G and F proteins were assessed descriptively. Results. Among 1,899 laboratory-tested SARI cases, 53.3% were tested for RSV, of which 24.8% were positive. RSV-A predominated overall, although seasonal shifts in subgroup dominance were observed. RSV infections were concentrated among young children, particularly those aged 0-2 years. Whole-genome sequencing of 85 RSV-positive samples revealed a dynamic seasonal turnover of RSV-A lineages, whereas RSV-B circulation remained largely confined to a single dominant lineage across seasons. Analysis of antigenically important genes showed greater variability in the G gene compared with the more conserved F gene in both subgroups. Conclusion. The integration of epidemiological, molecular, and whole-genome data within routine SARI surveillance provides a comprehensive overview of RSV circulation and evolution in North Macedonia. These findings contribute genomic data from an under-represented region and provide a foundation for future evaluation of RSV vaccination and mono- clonal antibody effectiveness by detecting viral genetic changes, should such measures be implemented in North Macedonia.
Copyright (c) 2026 Teodora Karevska, Gorica Popova, Marija Andonovska, Milica Simova, Enkela Polozhani, Kristina Stavridis, Dragan Kochinski, Aneta Peshnachka, Gordana Nikolovska, Gala Matevska, Senada Karishik, Maja Vukovikj, Elizabeta Jancheska, Golubinka Boshevska, Icko Gjorgoski https://creativecommons.org/licenses/by/4.0/
Propranolol in the Treatment of Infantile Hemangiomas: A Single-CenterExperience
Objective. Infantile hemangiomas (IH) are common benign vascular tumors of infancy that typically undergo gradual spontaneous regression over several years, although a minority require treatment. Propranolol, a non-selective β-adrenergic antagonist, is the first-line therapy for complicated or high-risk IH, demonstrating both efficacy and a favorable safety profile. Materials and Methods. We retrospectively analyzed 37 infants treated with oral propranolol at a single center. Patients were monitored in-hospital during treatment initiation and at regular, outpatient visits. The response was assessed using clinical measurements, ultrasonography, and standardized photographs. Results. Most patients had solitary lesions predominantly located in the head region. Complete regression occurred in 26 patients (70.3%) and partial regression in 11 (29.7%). Treatment duration ranged from 2 to 24 months (mean 10.1 months). Adverse events were rare and mild, including one case of hypoglycemia and one of transient somnolence. Conclusion. Oral propranolol is a safe and effective first-line therapy for IH, particularly when initiated early during the proliferative phase.
Copyright (c) 2026 Jelena Roganović, Andrea Kevrić, Ana Đorđević https://creativecommons.org/licenses/by/4.0/
The Impact of the Russo‑Ukrainian War on Ukrainian Scholarly Publishing andResearch Directions: A Bibliometric Analysis
Objectives. Russia’s aggression against Ukraine has unfolded in two phases: the onset of the Donbas war and the annexation of Crimea in 2014, and the full-scale invasion in 2022. We examined the changes in Ukrainian scholarly publishing across these disruption periods. Methods. Using Web of Science Core Collection and InCites data (1991–2024), we analyzed publication trends in Ukraine and Croatia, disciplinary composition, leading universities, city-level output in occupied territories, and international collaboration. Interrupted time series (ITS) models were specified with breakpoints at 2014 and 2022. Results. Ukraine’s output increased from 331 articles in 1991 to 12,475 in 2021, then declined by 14.6% to 10,649 in 2024, whereas Croa- tia’s output remained comparatively stable. The segmented ITS showed significant growth before 2014, a steeper upward trend after 2014, and a decline after 2022. Croatia showed continued growth with a smaller, non-significant post-2022 slowdown. In Ukraine, the largest post-2022 declines were observed in Physical Sciences and Social Sciences, while Engineering and Technol- ogy appeared more resilient. City-level analyses in occupied territories showed an early break in 2014 in Donetsk and Luhansk, while output linked to Simferopol and Sevastopol was rapidly reclassified after 2014, with records increasingly indexed under Russia. After 2022, collaboration with Russia collapsed, whereas partnerships with Poland, Germany, and the USA expanded. Conclusion. Ukrainian scholarly publishing showed phase-specific shifts in output and collaboration patterns that coincided with major geopolitical disruptions.
Copyright (c) 2026 Maryna Kreslova, Livia Puljak, Damir Sapunar https://creativecommons.org/licenses/by/4.0/
A Meta-Analysis of Whole Blood Cholinesterase Activity in Healthy RuminantsUsing a Modified Electrometric Measurement Method
Objective. This meta-analysis aimed to compile and analyze WBChE activity using the modified electrometric method to estab­lish normal or baseline enzyme activity values in ruminants (sheep, goats, cattle, and buffalo). Materials and Methods. This is a one-group randomized-effect-size meta-analysis model applied to the mean ± SD of WBChE activities in sheep, goats, cattle, and buffaloes. Results. Using PRISMA selection, we identified 16 records from five studies that measured WBChE activity in sheep (N=267), goats (N=165), cattle (N=197), and buffaloes (N=31) using a modified electrometric method. The studies included both sexes and were published between 2007 and 2025. The forest plot showed that the WBChE activities of sheep, goats, cattle, and buffaloes were 0.40, 0.32, 0.51, and 0.42 Δ pH/enzymatic reaction incubation time, respectively. Their 95% CI were 0.19-0.60, 0.16-0.49, 0.31-0.70, and 0.39-45, respectively. The weights of the individual records across the four species varied from 0.91% to 14.77%. The I2 heterogeneity index of 61% was moderate and significant (Q=38.35; P=0.001). Despite the low pseudo-R2 value (24.24%), the I2 of subgroup analysis was significant only in sheep (64.2%, Q=14, P=0.016). The funnel plot showed the possibility of publication bias in five imputed studies. However, Egger’s regression analysis was not statistically significant (t=1.91, P=0.077). The overall risk of bias in the studies was low. Conclusion. This study is the first meta-analysis to establish the reference WBChE activity in healthy ruminants, including sheep, goats, cattle, and buffaloes. This is an additional contribution to the existing literature, as the modified electrometric method is recommended for measuring blood or tissue ChE activity in various animal species. These findings provide valuable refer
Copyright (c) 2026 Fouad Kasim Mohammad, Maha Ahmed Ramadhan https://creativecommons.org/licenses/by/4.0/
Uvodna riječ (VIII. Javni sastanak) Postupak hemafereze (plazmafereza i citofereza) u terapeutske svrhe, već nekoliko godina izaziva možda i pretjerani entuzijazam ljekara, a takav entuzijazam nosi koji put i znatan rizik za pacijenta. Medutim, upravo taj entuzijazam u posljednjih deset godina bio je glavna pokretačka snaga u primjeni hemafereza-tretmana, pa je ovaj terapeutski postupak već oproban na nekoliko desetina raznih oboljenja. Možda takav tretman može da bude kurativna terapija kada plazmaferezom uspijevamo odstraniti unesene štetne supstance, koje u određenoj količini mogu da ugroze život, jer djeluju kao toksini, a, zatim, ta metoda liječenja može da bude i vrlo korisna kao dopunska terapija, na primjer u slučaju endogenih intoksikacija, prisustva antitijela, imunih kompleksa i dr. INDIKACIJE ZA TERAPIJSKU PLAZMAFEREZU Zajedničko za sve bolesti je otklanjanje određenih komponenti iz plazme, a to su: 1. abnormalna koncentracija metabolita (npr. familijarna hiperholesterinemija'), 2. toksini, koji se vežu za proteine, 3. antitijela — imuni kompleksi. Kod sljedećih bolesti je u potpunosti prihvaćen plazmafereza tretman: — Goodpastures syndrome, — lupns crytheniatosus (otporan na lijekove), — familijarna hiperholesterinemija, — myasthenia gravis (otporna na lijekove), — hiperviskozni sindrom. MOGUCA KORIST OD PLAZMAFEREZA-TRETMANA 1. Hematologija: — cirkulirajući antikoagulansi (antifaktor VIII), — posttransfuziona purpura, — idiopatska trombocitopenična-trombotična purpura, — haemolitični uremični sindrom, — crioglobulinemija, — stečena hemolitična anemija, — akutne i kronične leukoze, — multipli mielom, — Waldenstremova makroglobulinemija, 2. Nefrologija: — glomerulonefritis u toku E.S.L., — progresivni rapidni glomerulonefritis, — membrano-proliferativni glomerulonefritis, — prijeteće odbacivanje transplantata, 3. Endogene intoksikacije i poremećaj metabolizma: — tireotoksicna kriza, — hepaticna koma, — lipidoze, — stecena hiperholesterinemija, — stecena hipertrigliceridinemija, Poslije gotovo jedne decenije kliničke primjene hemafereza-tretmana, a u nas od prije nekoliko godina, potrebno je kritički procijeniti ulogu i mogućnosti ovog tretmana u kazualnoj, kurativnoj i dopunskoj terapiji. Možemo ponekad da konstatiramo uzbudljive uspjehe u pojedinim slučajevima, ali mi još uvijek, zapravo, ne znamo koje su prave indikacije za hemafereza-tretman? Odgovarajuća istraživanja još nisu završena, nije ni sasvim tacno poznato u kakve se rizike po pacijenta upuštamo, a još nisu jasno definisani, ni ekonomski efekti procedure, mada mnogi od nas smatraju da naročito plazmafereza može da bude veoma korisna i u terapiji, a posebno u istraživačkom radu. Ali hemafereza-tretman je agresivan pristup liječenju oboljenja i zato moramo jasno definisati uslove za ovaj tretman, jer je to u interesu pacijenta i u interesu dostojanstva i etike medicinske nauke. Poseban interes u istraživanju hemafereza-tretmana, predstavljaju mogući komplikacije. Te komplikacije mogu biti rane ili relativno kasne; mogu biti jedva prepoznatljive pa do dramatičnih, kada se tretman mora prekinuti, kao na primjer kod: — pojava epileptičnog napada, — cerebralnog spazma, — hipertenzivne krize, — i — diseminirane intravaskularne koagulacije. Ne zna se tacno zašto ove komplikacije nastupaju. Posebnu oblast komplikacija predstavlja: — narušavanje proteinskog statusa, — pad imunoglobulina ,,M”, — metabolične alkaloze, — i — poremećaj hemostatskog statusa (pad faktora sekundarne hemostaze, zatim fibrinogena, antitrombina III). Komplikacije su češće kod bolesnika sa lošom kondicijom, naročito sa deficitarnim biofiziološkim statusom, deprimiranim imunološkim statusom uslijed dugotrajne terapije citostaticima ili kortikoidima. Takav organizam nije sposoban da brzo restituiše ono što gubi, a naročito ako je ljekar samouvjeren i preambiciozan pa nekritički vrši ceste i obilne hemafereze bez striktne i potpune kontrole. U oblasti komplikacija posebnu dramu predstavljaju pojave poremećaja srčanog ritma, sve do fibrilacije pretkomora i komora, što može i smrtno da se završi. Eto, iz tih razloga ovakav tretman može jedino i isključivo de se vrši u dobro ekipiranim i educiranim hospitalnim miljeima. Cijenjeni prisutni, sa čim večeras izlazimo pred Vas? Ispitivanje kretanja antitijela i imunog kompleksa veoma je značajno za svrsishodnu primjenu plazmafereze kod oboljenja koja su posljedica poremećenog imunološkog odgovora. Takvu patofiziološku situaciju susrećemo kod agresivnih oboljenja bubrega, gdje humoralni faktori, fiksiranje cirkulirajućih antitijela i ponašanje imunih kompleksa cine osnovu patogenetskog principa. Pokušaji da se takvi patogenetski faktori eliminišu intenzivnim plazmaferezama, izazvali su zapažen klinički interes, iako se plazmafereza u takvim kliničkim situacijama ni u kojem slučaju ne može prihvatiti kao kauzalna terapija. Većeras će nam o tome govoriti, na bazi vlastitih posmatranja i ispitivanja na kliničkom materijalu, naš imunonefrolog prof. dr Momir Macanovic. Doktor Midhat Haračić, transfuziolog, koji je kod nas posebno zaslužan za smjeliju primjenu hemafereza-tretmana, iznijeće svoja zapažanja i rezultate u primjeni ovog tretmana kod bolesnika sa prisustvom inhibitora faktora VIII (AHA) u cirkulaciji, što se nerijetko susrece kao komplikacija u hemofilicara u toku opetovanih supstitucija i aplikacija hemoderivatima. Također ce nam iznijeti svoje rezultate plazmafereza-tretmana kod jednog izuzetno teškog oboljenja — miasthenia gravis. To je oboljenje, kako vam je poznato, vjerovatno uslovljeno pojavom visokog titra antitijela na acetil-holinske receptore. Jedan vid hemafereza-tretmana, leukofereza, može da bude korisna u programu liječenja akutnih i kroničnih leukoza. Namjera je da odstranjenjem mase blasta kod akutnih leukoza stvorimo pogodniji biološki teren za primjenu citostatika, dok kod kroničnih leukoza, posebno, kod kronične mieloicne leukoze, odstranjenjem mase leukocita korigiramo i hiperviskoznost, koja kao hemodinamska komplikacija nerijetko stvara pogodne uslove za intravaskularne hemostatske poremećaje. I o tom će nam govoriti doktor Haračić.
Javni sastanci Odjeljenja (III., IV., VII. i VIII.)
Copyright (c) 1984 Džemal Rezaković https://creativecommons.org/licenses/by/4.0/
Šta bi se moglo napraviti za unapređenje medicinskih nauka? Ja imam tri prijedloga. Prvo: neophodno je u Jugoslaviji kao cjelini i u BiH posebno, u sva područja nauke ulagati mnogo više tekućega i minuloga rada i sredstava neophodnih za taj posao. Koliko? Ja ne znam, ali znam da ne bi bilo teško to izračunati za svaku oblast nauke posebno. Mislim da samo opredjeljenje da je neophodno razvijati naučno istraživanje puno ne vrijedi ako se mi, odnosno naša društvena zajednica uprkos svim poteškoćama oko para ne opredijelimo da iz godine u godinu dajemo sve veći postotak nacionalnog dohotka za istraživanje i nauku uopće. Koliko? Druge zemlje troše 2—8%posto nacionalnog dohotka u ovu svrhu, a čuli smo da naš SIZ nauke raspolaže sa 0,14 posto nacionalnog dohotka Bosne i Hercegovine. Mislim da bi trebalo intenzivno da agitujemo da dođe do čvrstog opredjeljenja društva u prilog stalnog i planskog povećanja udijela sredstava za nauku u nacionalnom dohotku. Ja lično mislim da bi, recimo, godišnje dodavanje od 0,3 posto nacionalnog dohotka omogućilo da u toku narednih deset godina prevladamo naše zaostatke i slabosti i učinimo nauku i tehnologiju istinskim motorom koji će omogućeni brži razvoj privrede i našeg društva u cjelini. Tek to bi obezbijedilo da se vodi nekakva smišljena naučna politika. Mislim da se ne može voditi uspješna naučna politika ako se ne zna koliko će se sredstava ulagati u nauku. Za razvoj kadrova, za razvoj infrastrukture svuda treba 5—10 godina, a isto toliko godina traje i izvođenje nekog ozbiljnijeg naučnog projekta. Planovi za naucni rad i razvoj, bez jasnih i sigurnih sredstava za tu svrhu računi su bez krčmara. Zato mislim da bi i mi medicinari trebalo da vršimo određeni upliv na naše društvo da ono preuzme čvršće obaveze u pogledu naučne politike. Sad evo i drugog prijedloga. Kad su u pitanju medicinska istraživanja, mislim da mi medicinari imamo još jednu opciju, nezavisno od toga kakav će biti razvoj nauke u cjelini. Mislim da se u zaštiti zdravlja cjelokupni ciklus proste i proširene reprodukcije zdravstva mora finansirati jednim kanalom. Taj kanal su sada SIZ zdravstva, pa preko njega treba finansirati ne samo liječenje i preventivu nego i odgoj zdravstvenih radnika i medicinska istraživanja. To bi omogućilo da se razvoj medicinskog školstva i medicinskih istraživanja uskladi sa potrebama zaštite zdravlja stanovništva, te da se raspoloživa sredstva najracionalnije koriste. Uz ovakvu organizaciju finansiranja vjerujem da bi se datim sredstvima ostvarivali veći efekti i da bismo prevazišli štetne posljedice sadašnjeg „trojstva” u upravljanju i finansiranju našim klinikama i institutima, koji su po svojoj funkciji i zdravstvene, i stručne i naučne ustanove. Tvrdim da bi ovakva reorganizacija bila od velike koristi za zdravstvo i da ono nikad neće valjati ukoliko od ukupnih rashoda zdravstva nastava i nauka ne budu vukle makar jedno 8 posto. U tom pravcu bi trebalo ici i stvarati odgovarajuću klimu. Treći moj prijedlog se odnosi na organizaciju finansiranja nauke. Tvrdim da je štetno finansiranje cjelokupne nauke putem SlZ-a nauke. Mislim na finansiranje univerziteta i fakulteta. Štetna je koncepcija da su univerziteti samo nastava i da samo nastave treba finansirati. Fakulteti medicinskih i srodnih nauka treba da dobiju kompletan paket zadataka i odgovarajući paket sredstava za tu svrhu. Besmislica je da se fakulteti finansiraju po broju đaka, časova predavanja i vježbi i sl. Još nekoliko rijeci o zajedništvu u naučnom istraživanju. Ja mislim da se treba odreci iluzije da republička državnost znaci da svako mora imati i raditi u nauci sve. Dovoljno dugo je trajao period kada su republike i pokrajine nastojale da svako ima sve. Došli smo dotle da niko više nema ništa čestito. Umjesto da idemo na određeno zajedništvo u nauci i nastavi, mi smo posljednjih petnaestak godina takve prijedloge etiketirali kao centralizam. Centralizam je jačanje centralne državne vlasti. Zajedništvo je zajedničko rješavanje zajedničkih pitanja. Kadgod nešto možemo napraviti zajednički bolje i jeftinije ili kada to uopće ne možemo učiniti pojedinačno. Za zajedništvo u tom smislu uopće nam ne treba Federacija, nego samo dogovor za zajedničko finansiranje zajedničkih poslova. Mnogo je toga u medicini što možemo da obavimo zajednički, a ne možemo svako za sebe. Primjer je kompjuterizacija traženja bibliografije. Nema razvoja kadrova ako ne stvorimo jedan zajednički centar za bibliografsku informatiku. Bibliotekarstvo je druga stvar bez koje nema razvoja nauke. U Jugoslaviji ne postoji nijedna čestita medicinska biblioteka koja bi držala onih 5 — 6 hiljada medicinskih časopisa koji se indeksiraju. Naši naučni i nastavni kadrovi ne mogu ozbiljno raditi i stvarati ako im treba godinu, dvije i više da dođu do knjige ili časopisa. Odsustvo zajedništva je također katastrofalno i za našu medicinsku publicistiku. Mi imamo mnogo medicinskih časopisa, ali nemamo nijedan medicinski časopis svjetskog ranga. To ne valja i to je štetno. Ne mogu ljekarska društva sama da finansiraju uređivanje i izdavanje časopisa. To ne mogu ni pojedini regionalni i republički SlZ-ovi, ali bismo to zajednički mogli. Slično odsustvo zajedništva postoji i u planiranju i izvođenju istraživačkih projekata. Zbog rascjepkanosti njihovog finansiranja i odsustva duha zajedništva na području medicinskih istraživanja praktično više i ne postoje međurepublički istraživački projekti. Naša će delegacija u Zagrebu pokušati da inicira da zajednički razmotrimo ova pitanja. Prije svega, treba da razbijemo iluziju da svako može za sebe napredovati brže nego što bismo napredovali radeći i stvarajući zajednički. Ja duboko vjerujem da dobre ideje imaju veliku pokretačku snagu. Ako se dovoljan broj ljudi složi u nečemu i to ponavlja i predlaže, stvari će se prije ili poslije riješiti. Mislim da mogućnosti za procvat medicinskih nauka nisu loše jer imamo velike resurse. Prije tridesetak godina situacija je bila mnogo gora i teža. Nije bilo kadrova, ni institucija, ni novca. Od onda do danas mi smo stvorili obilje kadrova. Nama dolaze na medicinu najbolji od najboljih đaka. Mi imamo na fakultetima volju i želju za naučnim radom. Imamo i ponešto prostora i opreme, ali nemamo dovoljno finansijskih sredstava. Kadrovska i naučna infrastruktura su veliko bogatstvo koje se ne bi smjelo držati van upotrebe. Naše je bogatstvo u mozgovnim resursima i potrebno je samo da omogućimo ljudima normalne uslove za naučni rad. Ja vjerujem da to nije cilj za daleku budućnost, nego neposredno ostvarivi zadatak. Od svih nas zavisi da li ćemo se i kada ćemo se ujediniti u jednoj zajedničkoj politici unapređivanja medicinskih nauka.
Copyright (c) 1984 Grujica Žarković https://creativecommons.org/licenses/by/4.0/
Zahvaljujem svim govornicima i diskutantima, koji su ukazali na više problema nego što su imali vremena da ih obrade. Očigledno je da naša praksa vrvi od problema kako u zdravstvu tako i u nastavi i nauci. Diskusija je pokazala da bi mnogo toga moglo biti bolje. Stvari se, na žalost, ne rješavaju same od sebe. Bez evaluacije naše prakse nećemo stici daleko. Evaluacija je neophodna forma u ciklusu radnji od kojih se sastoji dobro upravljanje. Nju radi toga treba unijeti svugdje gdje se donose samoupravne odluke, počevši od radnog mjesta, radne organizacije i SlZ-a, pa do delegatskih skupština. Analogno tome, u odgoju zdravstvenih kadrova i medicinskim naučnim istraživanima neophodno je primjenjivati odgovarajući proces evaluacije. Svim referentima, diskutantima i ostalim učesnicima ovog skupa hvala.
U ime Odjeljenja medicinskih nauka Akademije nauka i umjetnosti Bosne i Hercegovine čast mi je da pozdravim vas koji ste se odazvali pozivu na naš III javni sastanak, koji je posvećen problemima korištenja evaluativnih ili evaluacijskih istraživanja u područjima medicinskih nauka, medicinske nastave i zaštite zdravlja. Za informaciju onima koji su prvi put prisutni na ovom sastanku, želim da kažem da je prošle godine naše odjeljenje odlučilo da pokuša proširiti krug lica koja će učestvovati u naučnim raspravama naše akademije. Vaš današnji odaziv i prisustvo na raspravi o evaluativnim istraživanjima je za nas ohrabrenje i podstrek da i u buduće nastavimo zajedničku obradu naučne problematike iz oblasti medicinskih istraživanja. Evoluirati znaci odrediti vrijednost nečega. Izbor predmeta za evaluaciju ovisi o onome šta želimo ocijeniti, počevši od djelovanja nekog lijeka ili terapeutskog postupka pa do kvaliteta ljekarskih usluga, ili rada određene grane zaštite zdravlja, ili efikasnosti rada neke zdravstvene ustanove u cjelini ili, još šire, efikasnosti određenih zdravstvenih programa ili zdravstva u cjelini. Evaluacijska istraživanja su posljednjih dvadesetak godina u svijetu počela dobijati sve veći zamah. Što se tiče zdravstva i medicinskih nauka, uključivši i medicinsku nastavu, ova istraživanja su krenula naprijed zahvaljujući Svjetskoj zdravstvenoj organizaciji. Članovi našeg odjeljenja su odlučili da evaluacijska istraživanja stave na dnevni red naučne i stručne javnosti zato što ona mogu mnogo doprinijeti naporima za privrednu stabilizaciju i bolje poslovanje u zdravstvenoj djelatnosti, kao i u ostalim društvenim službama i privredi. Nemoguće je sutra raditi bolje ako čovjek ne zna da li danas radi dobro i da li bi mogao bolje. Da li je ono što danas radimo najbolje, da li je to najjeftinije i da li je to najuspješnije ili se može nešto učiniti da bude više i bolje? To je društveni smisao evaluacije. Kada pratimo rad zdravstvenih ustanova, ili gledamo šta i kako rade samoupravne interesne zajednice za zaštitu zdravlja ili šta i kako odlučuju zajednice za naučni rad ili visoko školstvo, onda vidimo da one uglavnom ne zasnivaju svoju odluku na prethodnoj evaluaciji ranijeg rada. U najvećem dijelu zdravstva evaluacija se praktično ne primjenjuje, nego finansiranje iz godine u godinu ide prema onom kako se radilo ranije a da se ni ne postavlja pitanje da li je to dobro ili nije, može li bolje ili ne može. Ima ljudi koji kažu da to što nema evaluacije nije slučajno, da to nije stvar nedostatka novca ni nepoznavanja metodologije (iako tu ima dosta složenih metoda}, nego da je posrijedi strah od ocjene da ne bi neko došao pa kazao: ,,ovaj vam rad nije dobar''', ili ,,ovaj SIZ ne radi dobro" ili ,,ova ustanova ne radi dobro". Za one koji se boje, bolje je ne evoluirati, jer ćemo u tom slučaju svi ostati dobri. Medutim, svrha evaluacije nije da nekoga osramoti i obruka, nego samo da otkrije može li nešto bolje da se uradi. Malo ima djelatnosti u kojima se ne bi moglo bolje raditi. U želji da stimuliramo nastojanje da na području medicinskih nauka, odgoja kadrova i zaštite zdravlja počnemo raditi bolje, kvalitetnije, ekonomičnije, i si., jednom rijeci — efikasnije, mi smo sazvali današnji sastanak. Sastanak je zamišljen tako da će trojica referenata u svom izlaganju prikazati problematiku i mogućost na svakom od ovih sektora, a zatim ste pozvani svi ovdje prisutni da dadete svoj prilog razmatranju ove teme. Niko od vas nije početnik. Svi imate dosta znanja i iskustva. Danas nam se pruža prilika da zajednički razmišljamo šta bi se moglo bolje i više napraviti i koje bi korake trebalo učiniti da na svim pomenutim sektorima krenemo uspješnije naprijed, bolje se koristeći onim što imamo.
O javnim sastancima Odjeljenja medicinskih nauka Akademije nauka i umjetnosti Bosne i Hercegovine
Počevši od jeseni 1982, Odjeljenje medicinskih nauka Akademije nauka i umjetnosti Bosne i Hercegovine je uvelo običaj da na neke od svojih sastanaka poziva učesnike van svog sastava, i to prvenstveno naučne radnike i istaknute stručnjake u određenim područjima medicine. Zbog svoje otvorenosti ovi sastanci su i dobili naziv „javni sastanci” Odjeljenja medicinskih nauka. Cilj javnih sastanaka Odjeljenja medicinskih nauka je višestruk. Ti sastanci omogućuju kontinuirano funkcionisanje jedne javne tribine na kojoj naučni radnici i stručnjaci iz raznih područja biomedicinskih znanosti iz Bosne i Hercegovine i drugih republika, a povremeno i iz inostranstva, raspravljaju o: — stanju naučnih istraživanja određenog problema, — vlastitim dostignućima i rezultatima, — primjeni rezultata istraživanja u praksi, — razvoju i korištenju novih metoda istraživanja te — mjerama za unapređivanje biomedicinskog naučnoistraživačkog rada. Prema tome, za razliku od cisto naučnih skupova koje ovo odjeljenje povremeno priređuje, referenti i diskutanti na javnim sastancima mogu iznositi ne samo rezultate vlastitog istraživanja nego i bibliografske osvrte, ili davati kritički prikaz rješavanja pojedinih zdravstvenih problema ili, napokon, mogu prikazivati naučni rad, svoj i svojih suradnika, u dužem vremenskom periodu. Nakon nekoliko održanih javnih sastanaka Odjeljenje medicinskih nauka je zaključio da je većina referata i diskusija bila dovoljno interesantna i vrijedna da zaslužuje da se objavi u seriji „Radovi” ovog odjeljenja. Tako će čitalac, počevši od ovog broja, u našoj seriji „Radovi” pored originalnih istraživačkih radova, nalaziti povremeno, još i tekstove referata i diskusija iznesenih na našim javnim sastancima. Sekretar Odjeljenja medicinskih nauka Prof. dr GRUJICA ŽARKOVlĆ
Workplace Violence Against Nurses in Croatia: A Cross-Sectional Study on ItsFrequency, Impact, and Solutions
Objective. This study aimed to analyze the frequency of workplace violence against nurses in Croatia, its psychological consequences, and existing institutional measures to address this issue. Materials and Methods. A cross-sectional online survey was conducted among Croatian nurses in October and November 2023 using a convenience sample recruited via a social media platform. The questionnaire included 38 closed-ended questions covering socio-demographic data, experiences of physical, verbal, and sexual violence, and measures implemented to prevent or address workplace violence. Results. A total of 318 nurses participated in the study. Most participants (70%) reported experiencing some form of workplace violence in the past 12 months. Verbal violence was most frequent (66%), followed by physical (21%) and sexual violence (13%). Patients were the most common perpetrators of physical violence (84%), followed by relatives and healthcare staff. No statistically significant differences were found between the reporting of violent incidents and the level of nurses’ education, nor between the intensity of psychological consequences and years of nurses’ work experience. Nearly half of the participants (48%) stated that no formal measures existed in their workplace to prevent or respond to violence. Conclusion. Among nurses participating in this study, workplace violence was frequently reported, while work experience was not associated with psychological consequences. The findings indicate that workplace violence remains a relevant issue and may inform future efforts to improve preventive measures in healthcare settings.
Copyright (c) 2026 Danela Relić, Ivica Matić, Livia Puljak, Marta Čivljak https://creativecommons.org/licenses/by/4.0/
Criterion Validity of the Yale Physical Activity Survey (YPAS) in Croatian OlderAdults
Objective. The Yale Physical Activity Survey (YPAS) is one of the most commonly used questionnaires to assess physical activity (PA) levels in older adults. Although previous studies have explored its validity properties against accelerometry, to date, no evidence has been provided in Croatian older adults. Therefore, the primary purpose of this study was to examine whether the YPAS is a valid tool for measuring PA levels. Materials and methods. A total of 46 older women (mean age 72.3±1.2 years) were recruited from three randomly selected public residential aged-care facilities. During the first stage, all participants wore a triaxial GENEActiv accelerometer on their non-dominant hand for 7 consecutive days. After the wearing period, the participants completed the YPAS questionnaire. The correlations between the YPAS and GENEActiv data were calculated using Spearman’s order-rank coefficients. Results. The YPAS total PA was positively and moderately correlated with the number of steps, light and moderate PA, and moderate-to-vigorous PA (MVPA; ρ=0.48−0.64), yet a low positive correlation was found with vigorous PA (ρ=0.33). The YPAS total energy expenditure (EE) and the number of stairs performance showed similar correlation patterns with GENEActiv accelerometry data as the total PA (ρ=0.33−0.64). The summary index score exhibited moderate and positive correlations with the number of steps, light, moderate, and vigorous PA and MVPA (ρ=0.28−0.49). Conclusion. This study shows that the YPAS is a valid tool for assessing PA patterns in older Croatian adults.
Copyright (c) 2026 Maja Ban, Toni Ćosić, Irena Canjuga, Ivica Matić, Vesna Mijoč https://creativecommons.org/licenses/by/4.0/
Gastrocolic Trunk: Anatomical Variations and Surgical Significance
Objective. This review aims to summarize the Henle trunk configurations and tributary patterns presented in cadaveric, intraoperative, and imaging studies. Background. The Henle gastrocolic trunk is a highly variable venous structure formed by the confluence of the gastric, colic, and pancreatic veins. It has notable surgical importance, particularly during laparoscopic procedures, such as right colectomy and pancreaticoduodenectomy. Methods. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted using the PubMed/MEDLINE and Google Scholar databases. Discussion. Twenty-one publications comprising 2,454 cases were analyzed to classify Henle trunk configurations and tributary patterns. The trunk was iden- tified in 92.5% of the cases, with the gastropancreatocolic (GPC) type being the most prevalent (73.1%). A total of 38 unique venous confluences were recorded, highlighting the considerable anatomical complexity and variability of the trunk. The Henle gastrocolic trunk is a common anatomical structure with significant heterogeneity in its venous configurations. The GPC type, most frequently formed by the confluence of the right gastroepiploic vein, the anterior superior pancreaticoduodenal vein, and either the right colic vein or the superior right colic vein, predominates across cadaveric, intraoperative, and imaging studies. Understanding this variability is crucial for ensuring safe dissection during pancreatic and colorectal resections. Conclusion. Comprehensive knowledge of the Henle trunk anatomy and its variations enhances operative planning, minimizes the risk of vascular injury, and supports safer and more efficient minimally invasive abdominal surgery.
Copyright (c) 2026 Grigorios Stefanou, Dimosthenis Chrysikos, Dimitrios Filippou, George Tsakotos, Theodore Troupis https://creativecommons.org/licenses/by/4.0/
A Rare Cadaveric Case Report of the Median Nerve Passing Through the Brachialis Muscle
Objective. To describe a rare cadaveric topographical variation of the median nerve (MN) involving an atypical relationship with the brachialis muscle (BM). Such variations, although uncommon, may complicate surgical procedures, regional anesthesia, and imaging interpretation. This report documents a variation in which the MN traverses the BM without providing motor innervation. Case Report. During the routine dissection of the right upper limb of a 75-year-old male donated cadaver, a unilateral (right-sided) topographical variation of the MN was identified. The MN diverged from its usual close association with the brachial artery (BA) and followed a medial and posterior course toward the BM. Within the middle third of the arm, the nerve penetrated a macroscopically distinct bundle of BM fibers, traversed the muscle belly, and exited in its distal third. Distally, the MN resumed a superficial course, re-approached the BA, and continued normally through the cubital fossa. No motor or accessory branches from the MN to the BM were identified during its intramuscular course. The surrounding muscle fibers closely encircled the nerve along its intramuscular segment, indicating a restricted anatomical corridor. The musculocutaneous nerve, BA, and the remaining neurovascular structures followed their typical anatomical pathways. Conclusion. This anatomical configuration may represent a potential anatomical substrate for proximal MN irritation or compression and may clinically resemble pronator teres syndrome. Awareness of such variants is important for clinicians evaluating MN neuropathies and for surgeons, anesthesiologists, and radiologists working in the anterior compartment of the arm.
Copyright (c) 2026 Georgios Paraskevas, Christos Lyrtzis, Georgios Trikoilis, Alexia Maistrellis, Maria Piagkou https://creativecommons.org/licenses/by/4.0/
Developmental Trajectories and Outcomes of Online Child Sexual Abuse: A Systematic Review of Longitudinal Studies
Background. OCSA includes adult grooming or solicitation and peer electronic sexual coercion. Due to its negative conse- quences, it has become a public mental health concern. While prevalence is well established, the developmental timing of onset, predictors, and outcomes can only be clarified through longitudinal studies. Objective. This review synthesizes longitudinal evidence on online child sexual abuse (OCSA) in minors, with an emphasis on developmental timing, prospective risk and pro- tective factors, and downstream outcomes. Methods. A systematic review was conducted according to the PRISMA 2020 guide- lines. Eligible studies enrolled participants under 18 years of age at baseline, used a longitudinal design, and examined OCSA. Twelve studies were identified through database searches (2000-2025) and citation chasing, all of which were published from 2013 onwards. Discussion. The narrative synthesis identified that the risk for OCSA was concentrated in mid-adolescence. Peer electronic coercion rose through early-mid adolescence and plateaued around the age of 16-17. The cumulative onset reached approximately one in three by age 18. The predictors included depressive symptoms, maltreatment, adverse childhood experi- ences, and risky digital behaviors. Protective parental monitoring buffered escalation, especially in early adolescence. In terms of consequences, adult solicitation predicted poorer quality of life and emotional distress, whereas peer coercion increased depres- sion and delinquency. Bidirectional feedback loops emerged between adolescent sexting and adult solicitation. A school-based trial demonstrated that even brief prevention efforts can reduce the risk of OCSA. Conclusion. Longitudinal evidence suggests that OCSA follows an age-graded developmental pattern and is associated with potentially modifiable risk and protective fac- tors. Prevention should focus on mid-adolescent hazard windows, minority-sensitive support, family-based monitoring, and digital safety education. The proposed Developmental-Online-Trajectories of Sexual abuse (DOTS) framework integrates these findings to guide future research, practice, and prevention.
Copyright (c) 2026 Krešimir Prijatelj https://creativecommons.org/licenses/by/4.0/
Cervical Cytology and Age in HPV-Infected Women in North Macedonia: A Cross-Sectional Study
Objective. HPV infection is a key etiological factor in cervical epithelial alterations and neoplasia. Its prevalence and cytological impact vary with age, co-infections, and screening practices. This study investigated the association between HPV infection, age, and cervical cytological findings in women from North Macedonia. Materials and Methods. This cross-sectional study included 300 women aged 26–66 years, who were screened over a 13-month period (June 2023–July 2024). The participants were divided into two age groups (26–36 and 37–66 years). All participants underwent Pap testing, HPV screening, and micro- biological evaluation. Ordinal regression analysis was used to examine the associations between age, microbial factors, and HPV positivity. Results. HPV prevalence was higher in the 37–66 group (12.33%) than in the 26–36 group (6.0%). However, younger age showed a stronger statistical association with HPV positivity (OR=2.10; P<0.1). Cytological abnormalities, particularly LSIL/CIN I, were more prevalent in HPV-positive participants. The use of conventional Pap smears was associated with lower HPV detection (OR=0.16; P<0.05). Co-infection with Candida spp. and atrophic inflammation were inversely associated with HPV positivity. Conclusion. This study confirmed the association between HPV infection and cytological changes, particularly in younger age groups. These results highlight the importance of age-tailored screening approaches and support the continued use of conventional Pap smears as cost-effective tools. Integrating virological and microbiological assessments may further re- fine cervical cancer prevention strategies, particularly in transitional healthcare systems across the Western Balkans.
Copyright (c) 2026 Vjollca Shabani, Mije Reçi, Veselievska Stojkovska https://creativecommons.org/licenses/by/4.0/
Sociodemographic Characteristics of Patients with Schizophrenia: A ComparativeStudy with Healthy Controls
Objective. This study aimed to assess selected sociodemographic characteristics of patients with schizophrenia and compare them with those of a healthy control group, as well as within the group of patients with schizophrenia. Patients and Methods. A retrospective observational study was conducted involving 400 patients with schizophrenia and 200 healthy controls from the Herzegovina-Neretva Canton. The diagnosis of schizophrenia was made according to ICD-10 criteria, and sociodemographic data were obtained through structured interviews. Results. Individuals with schizophrenia are more likely to be older, less edu- cated, unemployed, single, and smokers compared to healthy controls. Among patients with schizophrenia, analyses controlling for age showed that gender was significantly associated with both age of onset and duration of illness, with significant gender- by-age interactions. Marital status was significantly related to age at onset and demonstrated a significant interaction with age in relation to illness duration. Education level was associated with age at onset but not with illness duration. No significant differences in illness onset were found across employment groups. Conclusion. Sociodemographic characteristics are closely associated with key clinical features of schizophrenia, including age at onset and illness duration. These findings highlight the importance of considering gender, marital status, and educational background when interpreting illness trajectories. The results further underscore the need for early intervention strategies, psychoeducation, and integrated social and healthcare support aimed at improving functional outcomes and quality of life for individuals with schizophrenia and their caregivers.
Copyright (c) 2026 Pejana Rastović, Marko Pavlović, Josip Kvesić, Ana Džidić Bevanda, Maja Pandža Topić https://creativecommons.org/licenses/by/4.0/
Treatment Stability of Warfarin and Acenocoumarol in Patients With MechanicalHeart Valves and Atrial Fibrillation: A One-Year Cohort Study
This study aimed to investigate which of the two vitamin K antagonists, warfarin or acenocoumarol, provides more stable anticoagulation control in patients with mechanical heart valves and atrial fibrillation. Patients and Methods. This was a prospective, one-year clinical cohort study. In total, 73 outpatients with mechanical heart valves and atrial fibrillation who were already treated with warfarin or acenocoumarol were recruited from the Blood Transfusion Institute of the Federation of Bosnia and Herzegovina. The prothrombin time target values, expressed as the international normalized ratio (INR), were 2.0–3.0/4.0. Numerical data between the treatment groups were summarized descriptively. Results. Patients in the warfarin (N=35) and acenocoumarol (N=38) treatment groups were similar in terms of sex, age, body mass index, body surface area, and number of concomitant drugs known to interact with vitamin K antagonists. The number of INR measurements per patient, number of INR measurements within the therapeutic range per patient, mean time interval between successive INR measurements, and mean INR values across consecutive measurements were similar in both groups. However, compared to acenocoumarol, warfarin treatment seemed to be associated with more stable anticoagulation, i.e., with a higher mean time in the therapeutic range (TTR) (76.1±24.2 vs. 69.1±21.5%) and a smaller proportion of patients below all predefined TTR thresholds (<60%, <65%, and <70%). Conclusion. Our unadjusted descriptive results suggested that warfarin, compared to acenocoumarol, may provide more stable and therefore safer anticoagulation control in patients with mechanical heart valves and atrial fibrillation. To confirm this, larger prospective clinical studies are needed in patients with mechanical heart valves with or without atrial fibrillation.
Copyright (c) 2026 Šahza Hajdari Toskić, Asija Mević, Aida Kulo Ćesić https://creativecommons.org/licenses/by/4.0/
Subpopulations of B- And T-Lymphocytes and NK (Natural Killer) Cells (LGL – Large Granular Lymlphocytes) in Patients With Infectious Mononucleosis
In a group of 54 patients with verified diagnoses of infectious mononucleosis values of leukocytes, lymphocytes and atypical mononuclear cells (AMNC) in the peripheral blood were measured and the number of B-lymphocytes, T11 T4, T8-lymphocytes and large granular lymphocytes (LGL) and NK (natural killer) cells respectively identified and determined by appropriate immunological tests. Maximal leukocyte values in the peripheral blood did not exceed 14 x 109/1 and were recorded in the first three weeks of the disease. Lymphocytes and AMNC were predominating cells in the differential leukocyte formula. Their maximal values amounted up to 88 percent and were largest in the first three weeks of the disease. The values of antibodies to VCA (viral capsid antigen) and of antibodies to EBNA (Epstein-Barr nuclear antigen) were in accord with data reported in the literature. In direct immunofluorescence tests (polyvalent and monovalent anti-immunoglobulin antibodies) we found increased values of B-lymphocytes, which culminated in the first week of the disease. In most cases we recorded elevated values of B-lymphocytes which carried on their membranes IgG 4 + IgM + IgA or IgG + IgM. The rise B-lymphocyte values was most likely due to the action of EB virus as polyclonal activator of B-cells resulting in their proliferation and differentiation. In indirect immunofluorescence tests with use of anti-TH, anti-T4 and anti-T8 monoclonal antibodies we found increased Tll-lymphocytes values and marked rise in the values of suppressor-cytotoxic T-lymphocytes (T8) throughout the entire duration of the disease. There was also a mild upward trend in the values of T-helper lymphocytes (T4). Infection of B-lymphocytes with EB virus was accompanied by intensive immune stimulation and the activation of, and increase in the values of, T-lymphocytes, in the first place of those with a cytotoxic and suppressor function (T8), which also seemed to have been primarily activated. The tendency of a light increase in T-helper lymphocytes (T4) values might have been the result of the activation of this subspecies of T-lymphocytes in acute infectious mononucleosis. In the smears of whole blood and in the smears of separated lymphocytes, and with the use of monoclonal NKH’ antibodies, we found increased values of large granular lymphocytes (LGL) and NK (natural killer) cells, respectively, which tallies with the results reported by other researchers. The increase in the mean values of NK cells was greatest between the fifteenth and thirtieth days of the disease. An intact function of NK cells is a precondition for normal protection against herpes simplex virus, so that these cells would behave in a similar way also against Epstein-Barr (EB) virus. NK cells alone could directly act on EB virus-infected B-cells, thus immediately taking part in defence processes, and could together with activated cytotoxic T-cells act on the plasma cells whose appearance is the result of virus-induced transformation of B-lymphocytes and could eliminate them. T-suppressor lymphocytes would restrict the growth of EB virus-infected B-cells by acting antiproliferously.
Copyright (c) 2026 Nijaz Softić, Tatjana Jeren https://creativecommons.org/licenses/by/4.0/
Alprenolol Metabolites Structure Study by Using the Method of Gass Chromatography — Mass Spectrometry
Alprenolole is subject to a fast-metabolic transformation like other beta blocking agents. Until now 4-hidroxy alprenolol and N-dcsizopropyl alprenolol are identified as products of such metabolic transformations. In the paper Identification of methoxy-hydroxy alprenolol, a new metabolite of alprenolol, performed by selective derivatization and GC-MS structure examination. is described.
Copyright (c) 2026 Meliha Lekić, Ljiljana Kudra, Miroslav Šober, Branko Nikolin https://creativecommons.org/licenses/by/4.0/
Influence of Pharmaceutical Dosage Form on Quality of Therapy
Some biopharmaceutical factors related to drug dosage form were presented. These factors might influence the rate and extent of absorption, changing thus time of onset, intensity and duration of pharmacodynamic effect.
Copyright (c) 2026 Sabira Hadžović, Jela Milić-Aškrabić, Aida Mehmedagić, Ljiljana Savković https://creativecommons.org/licenses/by/4.0/
Deterioration of pharmaceutical products, especially those containing water, may result from Chemical changes, oxygen, light, moisture and microorganism contamination. Those changes can be prevented or minimised by addition of a suitable antioxidant or an antimicrobial preservative. Their properties, potential side effects and interactions are discussed in this paper. Many pharmaceutical products ought to be coloured for psychological and practical reasons, which is very important both for the patient and industrial pharmacist. Colouring agents, used as colours for pharmaceutical preparations have been reviewed in this paper.
Copyright (c) 2026 Biljana Ivković https://creativecommons.org/licenses/by/4.0/
Quality Assurance for Drugs — Yugoslav Pharmaceutical Industry Situation in Relation to WHO Requirements
Analysis of situation in Yugoslav pharmaceutical industry is described from the point of view of quality assurance introducing. A critical review to legal regulations in the area of drug manufacturing in relation to EEC, FDA and WHO requirements is given and quality assurance system and WHO requirements for manufacture certification are presented. A support is given to the trend of activities taken by other European countries, which are preparing themselves carefully to resist the challenge of requirements regarding EUROPA 92 supported by harmonized standards and rules.
Copyright (c) 2026 Slavko Marković, Dženana tatarević https://creativecommons.org/licenses/by/4.0/
Good Laboratory Practice a Process to Assure Reliable Data in the Testing of Chemicals
Good laboratory practice is an expression of a need for harmonization of the work in laboratory Services to ensure adequate product quality. The system of laboratory work should be accompanied by an inspection and study audit. The document Principles of Good Laboratory Practice in Chemicals investigation, adopted by the OECD Council in 1981, represents a basis for international exchange of information of toxicological and other data. The GLP includes responsibilities in management, quality of work, facilities, documentation, study plan, objectives of the study, equipment, personnel etc. The inspection and study audit on GLP performance should be realized through relevant authority (government).
Copyright (c) 2026 Milan Škrlj https://creativecommons.org/licenses/by/4.0/
Specific Properties of the Drugs Produced by Dna Recombinant Biotechnology
Products produced by DNA recombinant biotechnology processes may be considered a new possibility in the field of therapy. In the period from 1985 to 1989 the following recombinant DNA drugs were approved: human insulin, human growth hormones, interferon alpha 2a and 2b, interleukin 2, alteplase, muromanab CD 3, erythropoietin and hepatitis B vaccine. Many new products are being developed. Since a number of peptides and proteins are rapidly destroyed in the body, new formulations and systems have been developed in order to increase the steady drug concentration in blood circulation or locally at the site of application, further, to increase the efficacy of drugs and to minimize the incidence and severity of adverse side effects. The proteins and peptides are unable to reach secluded organs or sites where the therapeutic effect is desirable, therefore more selective routes of administration than the venous one is being introduced. The cost of some biological drugs may result in their limited use, thus guidelines for a proper administration have been issued.
Copyright (c) 2026 Anton Štalc https://creativecommons.org/licenses/by/4.0/
Quantitative Determination of Tannins in Plants of Bosnia and Herzegovina
The quality of medicinal herbs containing tannin as an active component depends on the kind and content of tannin. Tannin is determined by using various methods which are usually mentioned in pharmacopoeias. In our paper we examined the content of tannin in plant material using the following methods: a method according to Ph. Yug. II, Ph. Yug III, Ph. Yug IV, a method with casein, a method of precipitation with brucine, and a method of relative astringency (RA) determination (tbl. 1 and 2). Our results showed that the obtained values of the content of tannin depended on the method which was used. Therefore, it is necessary to specify the method with the obtained value for the content of tannin. In spite of numerous examinations of the content of tannin in the plant material which were performed by the authors, it was difficult to determine the best method since, beside tannin, there were other phenolic and also non-phenolic substances in the plant material more or less influencing the content of tannin. The results obtained in this paper contribute to a better knowledge of the analytics and quality of tannin and the plant material which contains tannin as an active component.
Copyright (c) 2026 Jela Grujić-Vasić, Tamara Bosnić, Salko Ramić, Sejfudin Tokić, Sulejman Redžić https://creativecommons.org/licenses/by/4.0/
Autobioassay in the Quality Control of Drugs
Autobioassay can be used in analyses of drug effects in two ways. It can be used as an instrument or as a place of drug activity. In the first case it can replace a lacking apparatus and in the second case it can show the effect of drugs that could not otherwise be recorded. By autobioassay on isolated organs an analysis of exogenously added drugs is meant with a simultaneous stimulation of pertaining motor nerves. By applying autobioassay with isolated tissues vivisection can be avoided, especially the one done by repetition, to satisfy certain standards. The described IIO can be used in analyses of neurotransmission and cotransmission. Autobioassay can be used in the quality control of drug effects.
Copyright (c) 2026 Seid Huković, Nedžad Mulabegović, Elvedina Kapić, Iris Rajman, Biljana Ivković, Nedim Huković https://creativecommons.org/licenses/by/4.0/
In the year of the quality of health care quality of drug research was stressed. One of the first steps in the pharmacological evaluation of substances is in vitro investigation. The isolated organs with extrinsic and intrinsic nerve electrical stimulation could be used to get the results for the first decision about the quality of future drugs. Using the isolated organs with a simultaneous stimulation of their motor nerve, the danger of false-positive or false-negative results could be decreased. It is a danger to accept substance for further investigation or to abandon the substance which could be a useful future drug. The isolated and innervated organs as model-systems could help to make adequate decisions.
Copyright (c) 2026 Seid Huković, Dubravka Potkonjak https://creativecommons.org/licenses/by/4.0/
Copyright (c) 2026 Jela Grujić-Vasić https://creativecommons.org/licenses/by/4.0/
Application of the Method of Chromatographic Identification of Lipid Compoments of Tissue in Ecotoxicology
In the work we tried to describe the method of detection and quantitative chromatogram analysis of neutral lipids extracted from different tissue extracts obtained from 6 types of fishes. This technique can be applied for the identification and characterization of lipid tissue components in the species exposed to exotoxin. The method of detection and chromatogram analysis involves detection on photo-material, densitometry. The results of quantitative analysis of neutral lipids which are presented in 6 tables show a high degree of reproducibility and are compatible with those obtained with classical analytical and quantitative methods. Qualitative analysis of phospholipids showed that phosphatidylcholine and phosphatidyl ethanolamine represent the types of lipids which dominate in all the types of tissues. This corelates well with Smirnov’s (1970) and Femagalli’s (1976) results that also detected same tissue types in the fishes of different sorts.
Copyright (c) 2026 Koviljka Stojkov https://creativecommons.org/licenses/by/4.0/