Folia Medica Facultatis Medicinae Universitatis Saraeviensis, Jun 23, 2018
Objectives: The aim of this study was to investigate the effects of carvedilol treatment through ... more Objectives: The aim of this study was to investigate the effects of carvedilol treatment through improvement of New York Heart Association (NYHA) class, ejection fraction (EF) and blood pressure (BP) values in patients with chronic heart failure (CHF). Methods: This multicenter, observational, non-interventional was conducted in 25 medical centers in Bosnia and Herzegovina, from April 2015 until December 2015 (nine months). It included 167 patients of both genders, older than 50 years, who were diagnosed with CHF according to the NYHA classification and had EF <50%. The patients were administered carvedilol tablets and were followed during six visits: baseline and five follow-ups, over the period of 24 weeks. Results: At the beginning of the study, CHF NYHA class I was present in 5 (3.0%) patients, NYHA class II in 76 (45.5%) and NYHA class III in 66 (39.5%) patients. After 24 weeks, CHF NYHA class I was present in 43 (25.7%) patients, NYHA class II in 75 (44.9%) and NYHA class III in 21 (12.6%) patients. There is a statistically significant change of NYHA class before and after 24 weeks of treatment with carvedilol (rho=0.272; p=0.002). At the baseline observation, mean value of EF was 43.06±9.6%. after 24 weeks of treatment, the mean value of EF increased to 48.15±10.51% (p=0.0001). Average increase of EF after the treatment was 5%, or ranging from 1.5-7.5%. Systolic and diastolic blood pressure significantly decreased from baseline to final observation (-15.4 mmHg and -9.18 mmHg; p=0.0001). Conclusion: Carvedilol is effective in improvement of NYHA class and ejection fraction as well as in reduction of high blood pressure in patients with congestive heart failure. Keywords: chronic heart failure, NYHA classification, carvedilol, treatment efficacy
Emergency Department of Zenica Canton Hospital, from its beginning of the existence dated on Febr... more Emergency Department of Zenica Canton Hospital, from its beginning of the existence dated on February 1, 1994, is trying to implement within its work the following basic issues of urgent medicine: continued education in a field of treatment life threatening diseases and injures; co-operation with different medical specialists; human and unselfish care of patients; widely open readiness for perception of new knowledge's and giving support in the education of other people. Thanks to the supervision of doctors from USA, Australia and Canada, which lasted from February 1, 1994 until September 30, 1997, Emergency Department stuff members, managed to go over beginning birth difficulties of this Department, followed by continued education and implementation of basic organisation issues. Work organisation is based on receiving of the patients, treatment of life threatening diseases. Triage of patients depending on the cause, co-ordination with different medical specialists with the purpose of final treatment, as well as the education of stuff members in particular separated spaces such as: reanimation room, surgery room, paediatric room, receiving room, observation room and education room at the end (slides). During the wartime ED affectedly infected on other departments in a field of primary treatment of the patients, adequate triage, preparation of the patient for the surgery, as well as in the observation of cold and unclear cases. Statistics of treated patients during six months time period in 1995 and 1996 shows the increase of the number of patients with final treatment ED and almost equal number of surgery and internal cases (graphic presentation). Problematic of ED has its own specifics, which needs to be presented in special way (graphic presentation).
Objectives: An open-label prospective, combined basic and clinical controlled study was done to i... more Objectives: An open-label prospective, combined basic and clinical controlled study was done to investigate the effects of biological therapy using rituximab, and cytotoxic drug treatment with methotrexate on morphology and quantifitiation of chromosomes in rheumatoid arthritis patients. Methods: This study is follow-up of a prior publication, with new observations in comparison with control subjects. A total of 16 subjects were divided into two groups. Group Ⅰ comprised 8 seropositive rheumatoid arthritis patients who were analysed for the primary end point of possible cytotoxic effects of rituximab and methotrexate. Group Ⅱ included 8 healthy individuals who served as controls. Assessment was done before treatment with rituximab, and 4 weeks after initiation of therapy. Patients were randomly assigned to receive infusion of rituximab in a full dose of 2.0 g divided into two doses of 1.0 g on days 1 and 15. The lymphocytes from periphereal blood was cultured by the Moorhead method. Results: Normal male and female Karyograms were observed after full courses of therapy with rituximab. In one female patient who had been receiving longstanding cytotoxic therapy with methotrexate, 2% of chromosomal mitosis showed structural abnormalities. Following the discontinuation of methotrexate and the administration of rituximab, her karyogram became normal. Conclusion: The results from this study indicated that rituximab therapy was safe for the number and structure of human chromosomes, while methotrexate showed chromosomal aberration in one female RA patient. After discontinuation of this longstanding treatment, the karyogram of the same patient returned to normal.
SummaryRationale: Vitamin D deficiency/insufficiency/ is a worldwide epidemic in general populati... more SummaryRationale: Vitamin D deficiency/insufficiency/ is a worldwide epidemic in general population. The investigation of vitamin D concentrations in Bosnia and Herzegovina has never been conducted. Main results: A total of 82% from 2483 examined patients have deficient/insufficient/ Vitamin D level. Significance: These results encourage future studies to be focused on more specific details.IntroductionThe goal of this paper was to evaluate the vitamin D concentrations in different cohort patients. Vitamin D deficiency is a global health problem. In Europe, hypovitaminosis D is even more prevalent. Vitamin D deficiency plays a significant role in a dozens of numerous disorders.MethodsThe cross-sectional epidemiological analysis was performed, and data were statistically analyzed. A total of 2483 screened individuals were examined for the serum 25(OH)D concentrations. The cutoff points that we used was <20 ng/mL.ResultsAmong 2483 examined patients for vitamin D level, females were in majority with 76% and males with 24% in total. Deficient vitamin D level was found in 60.6% of patients, and insufficient vitamin D level was detected in 21.4%. The highest rate of severe deficiency was found among elderly people (32.9%). In total, the decreased level of vitamin D concentration in Bosnia and Herzegovina is 82%.ConclusionsVitamin D serum concentrations in Bosnia and Herzegovina are decreased in a majority of study population, and the results are within the average levels compared to other countries, particularly to findings in Central Europe.This analysis was based on patients, who have some health issues which may affect mobility, ability to go outside, food intake etc., so the level of 25(OH)D seen in this paper may be an underestimate, and further research is required in the general and healthy population.
Objective: To investigate the efficiency and safety of the fixed combination of perindopril/amlod... more Objective: To investigate the efficiency and safety of the fixed combination of perindopril/amlodipin in a treatment if grade I and grade II arterial hypertension and arterial stiffness values after only two weeks of treatment. Design and method: The open clinical prospective controlled study was designed. The study was designed for two weeks and two group were formed. The first group was comprised of arterial hypertension grade I patients and group 2 of arterial hypertension grade 2. The cardiovascular risk profile was notified for all patients. The peripheral and central blood pressure, pulse wave velocity, stroke volume, augmentation index, pulse pressure, heart rate, the reflection index were analyzed before and two weeks after treatment. For the grade I arterial hypertension the fixed combination of perindopril/amlodipin was used in a dose of 5 mg/5 mg, and for grade 2 arterial hypertension dosage was 10 mg/10 mg. Therapy was given as a single tablet advised to be taken in the evening. The average grade I hypertension values were 158/92mmHg, and for grade II the average value was 162/102mmHg. The average vascular age for grade I arterial hypertension was 4,5 years, and for grade II arterial hypertension the average vascular age was 8,5years. Results: Results obtained from this short study showed significant lowering of blood pressure and the improvement of arterial stiffness values and in the vascular age was detected as well in both group. The average values of arterial hypertension felt within normal range after treatment in a both groups after two weeks of therapy. Patient compliance and satisfaction was notified. There were no side effects. Conclusions: The fixed combination of perindopril/amlodipin in a dose of 5 mg/5 mg for grade I arterial hypertension and 10 mg/10 mg for grade II arterial hypertension was proven to be effective in all patients. No adverse events were observed. The compliance of patients was excellent and evening dose is more preferable than morning regime. The arterial stiffness values are not constant and permanent. They are rather flexible and arterial hypertension values major dependent. The lower arterial hypertension, the lower arterial stiffness and vasc ular age.
Folia Medica Facultatis Medicinae Universitatis Saraeviensis, Jun 23, 2018
Objectives: The aim of this study was to investigate the effects of carvedilol treatment through ... more Objectives: The aim of this study was to investigate the effects of carvedilol treatment through improvement of New York Heart Association (NYHA) class, ejection fraction (EF) and blood pressure (BP) values in patients with chronic heart failure (CHF). Methods: This multicenter, observational, non-interventional was conducted in 25 medical centers in Bosnia and Herzegovina, from April 2015 until December 2015 (nine months). It included 167 patients of both genders, older than 50 years, who were diagnosed with CHF according to the NYHA classification and had EF <50%. The patients were administered carvedilol tablets and were followed during six visits: baseline and five follow-ups, over the period of 24 weeks. Results: At the beginning of the study, CHF NYHA class I was present in 5 (3.0%) patients, NYHA class II in 76 (45.5%) and NYHA class III in 66 (39.5%) patients. After 24 weeks, CHF NYHA class I was present in 43 (25.7%) patients, NYHA class II in 75 (44.9%) and NYHA class III in 21 (12.6%) patients. There is a statistically significant change of NYHA class before and after 24 weeks of treatment with carvedilol (rho=0.272; p=0.002). At the baseline observation, mean value of EF was 43.06±9.6%. after 24 weeks of treatment, the mean value of EF increased to 48.15±10.51% (p=0.0001). Average increase of EF after the treatment was 5%, or ranging from 1.5-7.5%. Systolic and diastolic blood pressure significantly decreased from baseline to final observation (-15.4 mmHg and -9.18 mmHg; p=0.0001). Conclusion: Carvedilol is effective in improvement of NYHA class and ejection fraction as well as in reduction of high blood pressure in patients with congestive heart failure. Keywords: chronic heart failure, NYHA classification, carvedilol, treatment efficacy
Emergency Department of Zenica Canton Hospital, from its beginning of the existence dated on Febr... more Emergency Department of Zenica Canton Hospital, from its beginning of the existence dated on February 1, 1994, is trying to implement within its work the following basic issues of urgent medicine: continued education in a field of treatment life threatening diseases and injures; co-operation with different medical specialists; human and unselfish care of patients; widely open readiness for perception of new knowledge's and giving support in the education of other people. Thanks to the supervision of doctors from USA, Australia and Canada, which lasted from February 1, 1994 until September 30, 1997, Emergency Department stuff members, managed to go over beginning birth difficulties of this Department, followed by continued education and implementation of basic organisation issues. Work organisation is based on receiving of the patients, treatment of life threatening diseases. Triage of patients depending on the cause, co-ordination with different medical specialists with the purpose of final treatment, as well as the education of stuff members in particular separated spaces such as: reanimation room, surgery room, paediatric room, receiving room, observation room and education room at the end (slides). During the wartime ED affectedly infected on other departments in a field of primary treatment of the patients, adequate triage, preparation of the patient for the surgery, as well as in the observation of cold and unclear cases. Statistics of treated patients during six months time period in 1995 and 1996 shows the increase of the number of patients with final treatment ED and almost equal number of surgery and internal cases (graphic presentation). Problematic of ED has its own specifics, which needs to be presented in special way (graphic presentation).
Objectives: An open-label prospective, combined basic and clinical controlled study was done to i... more Objectives: An open-label prospective, combined basic and clinical controlled study was done to investigate the effects of biological therapy using rituximab, and cytotoxic drug treatment with methotrexate on morphology and quantifitiation of chromosomes in rheumatoid arthritis patients. Methods: This study is follow-up of a prior publication, with new observations in comparison with control subjects. A total of 16 subjects were divided into two groups. Group Ⅰ comprised 8 seropositive rheumatoid arthritis patients who were analysed for the primary end point of possible cytotoxic effects of rituximab and methotrexate. Group Ⅱ included 8 healthy individuals who served as controls. Assessment was done before treatment with rituximab, and 4 weeks after initiation of therapy. Patients were randomly assigned to receive infusion of rituximab in a full dose of 2.0 g divided into two doses of 1.0 g on days 1 and 15. The lymphocytes from periphereal blood was cultured by the Moorhead method. Results: Normal male and female Karyograms were observed after full courses of therapy with rituximab. In one female patient who had been receiving longstanding cytotoxic therapy with methotrexate, 2% of chromosomal mitosis showed structural abnormalities. Following the discontinuation of methotrexate and the administration of rituximab, her karyogram became normal. Conclusion: The results from this study indicated that rituximab therapy was safe for the number and structure of human chromosomes, while methotrexate showed chromosomal aberration in one female RA patient. After discontinuation of this longstanding treatment, the karyogram of the same patient returned to normal.
SummaryRationale: Vitamin D deficiency/insufficiency/ is a worldwide epidemic in general populati... more SummaryRationale: Vitamin D deficiency/insufficiency/ is a worldwide epidemic in general population. The investigation of vitamin D concentrations in Bosnia and Herzegovina has never been conducted. Main results: A total of 82% from 2483 examined patients have deficient/insufficient/ Vitamin D level. Significance: These results encourage future studies to be focused on more specific details.IntroductionThe goal of this paper was to evaluate the vitamin D concentrations in different cohort patients. Vitamin D deficiency is a global health problem. In Europe, hypovitaminosis D is even more prevalent. Vitamin D deficiency plays a significant role in a dozens of numerous disorders.MethodsThe cross-sectional epidemiological analysis was performed, and data were statistically analyzed. A total of 2483 screened individuals were examined for the serum 25(OH)D concentrations. The cutoff points that we used was <20 ng/mL.ResultsAmong 2483 examined patients for vitamin D level, females were in majority with 76% and males with 24% in total. Deficient vitamin D level was found in 60.6% of patients, and insufficient vitamin D level was detected in 21.4%. The highest rate of severe deficiency was found among elderly people (32.9%). In total, the decreased level of vitamin D concentration in Bosnia and Herzegovina is 82%.ConclusionsVitamin D serum concentrations in Bosnia and Herzegovina are decreased in a majority of study population, and the results are within the average levels compared to other countries, particularly to findings in Central Europe.This analysis was based on patients, who have some health issues which may affect mobility, ability to go outside, food intake etc., so the level of 25(OH)D seen in this paper may be an underestimate, and further research is required in the general and healthy population.
Objective: To investigate the efficiency and safety of the fixed combination of perindopril/amlod... more Objective: To investigate the efficiency and safety of the fixed combination of perindopril/amlodipin in a treatment if grade I and grade II arterial hypertension and arterial stiffness values after only two weeks of treatment. Design and method: The open clinical prospective controlled study was designed. The study was designed for two weeks and two group were formed. The first group was comprised of arterial hypertension grade I patients and group 2 of arterial hypertension grade 2. The cardiovascular risk profile was notified for all patients. The peripheral and central blood pressure, pulse wave velocity, stroke volume, augmentation index, pulse pressure, heart rate, the reflection index were analyzed before and two weeks after treatment. For the grade I arterial hypertension the fixed combination of perindopril/amlodipin was used in a dose of 5 mg/5 mg, and for grade 2 arterial hypertension dosage was 10 mg/10 mg. Therapy was given as a single tablet advised to be taken in the evening. The average grade I hypertension values were 158/92mmHg, and for grade II the average value was 162/102mmHg. The average vascular age for grade I arterial hypertension was 4,5 years, and for grade II arterial hypertension the average vascular age was 8,5years. Results: Results obtained from this short study showed significant lowering of blood pressure and the improvement of arterial stiffness values and in the vascular age was detected as well in both group. The average values of arterial hypertension felt within normal range after treatment in a both groups after two weeks of therapy. Patient compliance and satisfaction was notified. There were no side effects. Conclusions: The fixed combination of perindopril/amlodipin in a dose of 5 mg/5 mg for grade I arterial hypertension and 10 mg/10 mg for grade II arterial hypertension was proven to be effective in all patients. No adverse events were observed. The compliance of patients was excellent and evening dose is more preferable than morning regime. The arterial stiffness values are not constant and permanent. They are rather flexible and arterial hypertension values major dependent. The lower arterial hypertension, the lower arterial stiffness and vasc ular age.
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