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Place 3. Marketing and Market Research 3. Customer Interface 3. Market Segmentation 3. Increasing the Complexity of the Product 3. Embedded Software 3. Embedded Firmware 3. Physical Attributes of Software Not Visible 3. Capabilities of Software Not Externally Obvious 3. Embedded Hardware 3. System Complexity 3. Distributed Product Development 3. Outsourced Coordinated Development 3. Questions Answered in this Chapter 4. Introduction 4. Serialization 4.
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Armstrong PW, Collen D. Fibrinolysis star, AMI would be hospitalized in optimal for acute myocardial infarction, Current Re- time interval and subjected to PCI. Status and New Horizonts for Pharmago- perfuziona terapija akutnog infarkta cological Reperfusion.
Vojnosanit Pregl. Comparative efect of cardiographic and coronography re- S- S. An Interna- ports only when patients are divided cardiogram and angiogram signs of myo- tional Randomized Trial Comparing into alteplase and streptokinase sub- cardial reperfusion in ST segment ele- Four hrombolytic Strategies for Acute vation acute myocardial infarction].
Srp groups according to time from begin- Myocardial Infarction. N Engl J Med. Arh Celok Lek. No mat- ; Large scale Trials of GUSTO 1. Goals: fatalities. In-hospital outcome was present with quentially leads to development of bac- 32 And the chi-square test for independence showed both dependence of the preceding antibiotic treatment and the place of the infection origin in both categories of patients.
All patients were hospital- cantly larger percentage of hospital infections with the preceding antibiotic therapy, which puts ized in the Clinic for Infectious Dis- in focus possible rationalization of including antibiotic therapy. Corresponding author: Aida Pitic, MD. Department of Epidemiology, Clinical Centre University of 3.
Bolnicka 25, Sarajevo, Bosnia and Herzegovina. E-mail: rbaljic gmail. In spite of the constant improve- Further, data from Relation of bacteremia and sepsis according to the place of the disease origin ries of patients.
In the studies by Cassetari 5. Arch Intern associates 83 , it was proven that one centage of methicillin-resistant types Med.
Lowy FD. Staphylococcus aureus in- fections. And our results when proscribing antibiotic therapy. Pallesen at al.
Increasing incidence but tibiotic treatment and the place of the in- ReFeReNCeS decreasing in-hospital mortality of adult 1. Staphylococcus aureus bacteremia be- fection origin at both categories of the pa- tween and Based on the information about 6th ed. Elsevier: Churchill K, Hasan H. Methicillin-resistant Staph- 2. Zagreb: tion trends in Hospital University Sains viewing deined subcategories, staphy- Malaysia during Ann Saudi Proil International; Sara Singhal, MathiasW.
Allen, John- Med. National estimates of It mortality? Braz J Infect Dis. Greg S Martin. Sepsis, severe sepsis and the patients with hospital staphylococ- septic shock: changes in incidence, Expert Rev AW.
Epidemiological comparison of true Anti Infect her. Ha l l MJ, Wi l liams SN, DeFra nces susceptible coagulase-negative staphylo- or without previous antimicrobial ther- coccal bacteremia at hospital admission. CJ, Golosinskiy A. Many researches were done to show the causes and antibiotics which was resistance.
In most 8 in a way that the 3rd and 4th genera- researches the methods of classifying and reporting this resistance were made by researcher, so tions of Cephalosporin are used now. Considering the cost of antibiotic Methods and materials: his is a descriptive cross section study; data was collected from labora- production 9 , and resistance to the tory of Boo Ali Sina hospital, during Variables were age, bacterial agent, specimen, and antibiotics.
In addi- statistics. Conclusion: tients, and knowing the side efects of he results showed that by using the ICD codes, the study of multiple causes and resistance is the antibiotics 5.
Key words: Bacteria, Antibiotics resistance, ICD the mechanism of antibiotic resistance should be cleared 1, 2, 11, E-mail: siamian46 gmail. Unifor- mity of reporting in all countries, make possible comparing and international 1. Improper administration exchange of the obtained data and ben- Discovery of antibiotics made a ma- of antibiotics 3 self medication 4 con- eiting the other relevant data Study on the eases.
In the past, the antibiotics ad- ment period 5 , changes in the biolog- classiication and reporting on the an- ministration was the absolute treat- ical structure of the pathogen 6 and tibiotic resistance were done in difer- ment of the infectious diseases, but in using of unsuitable antibiotics are the ent methods. Some what Karami in his study reported on the resistance is concern of medical care this problem could be solved by devel- resistance of E.
Rahbar in his study on escherichia coli B In the Klebsiella B In the study Streptococcus, group D B Total was increasing from to The isolates resistance to antibiotic, based on the ICD in the work was as follow: the patients referring to the medical diagnostic laboratory of Boo Ali showed the antibiotic resistance After isolation identii- Sina Hospital in In U Hargreares U Analy- through , Z06 code the same in- referring to the Boo Ali Sina Hospital medical diagnostic laboratory sis of the data were per- creased to cases.
For data for Staphylococcus aureus B In the study of Schweizer using the province, northern Iran. Since ative for bacteria or were susceptible to ally booked and tried to collect data the WHO statistical data are reported antibiotics including To reference laboratory of the Mazan- tional Classiication of Disease ICD my knowledge this study is done for the daran University of Medical Sciences are given in the table 1, 2. Escherichia irst time in Iran and aimed at to inves- the methodology was agar disk dif- coli in Karami reported B In the study of Hargreaves the increase of resistance Table 3.
The classiication of diseases based on the ICD from through was from 59 Resistance to other cases to cases 1, Due to drug re- U The extended classes from the ICD matched with the other books of classiication such and control of drug resistance If One of these limitations was the ples Staph, aureus 36 Of course we could ex- resistance to several antibiotics were re- reported late, would lead to the collect- tend some classes to be able show the ported in On the other hand, if in the soft- books correspondent with the interna- ples and in In conclusion, the present study to 14 years, E.
Rahbar the other health centers of Iran and the this investigation the issue of drug re- studied vibrio cholera 7 and Klantar to world. Regarding the 6. In this study using ICD we could epidemiologic studies and even for the pathogenic agents indings indicate the classify all of the isolates in two general insurance companies. Acknowledgement ilar to the other studies, but with mi- We could classify extended the he authors would like to thank Dr nor diference in prevalence 1, 12, 14, pathogenic agents.
Of course due to Sh. Antibiotic resistance et. Pattern of antibiotics resistanct duo oratories administration and the Ma- pattern of cholera epidemy in Guilan to staphylococcus areous to methicillin zandaran University of Medical Sci- provience. Journal of Guilan University in teaching hospitals of Gorgan during ences reference laboratory and to Dr of Medical Sciences.
Journal of medical microbi- M. Ghasemi and Dr R. Nakhaiee Moghdam Mahbobeh, Nader- ology. K Janet. N Engl J Med, ; 1. Hargeraves Jenny, Kok Jenny. Australian Mohammad Yosef. Determining the re- lates of Klebsiella Pnumoniae in Msh- hospital morbidity data on antibiotic sistancy to antibiotics of E coli isolated had.
Journal of Medicine Daneshvar. Common Dis Intell. Journal , 19 96 : Tucker E Miriam. Cost of antibiotic resis- Validity of hid. Antibiotics sensation of E coli from www. ICDCM coding for identifying inci- urinary tract infection in lablatory cen- Antibiotics prophylaxis before surger- infection coded as a chronic disease? In- 3. Shokuhi SHervin, Aminzadeh Zohreh, ies. Journal of Iranian Surgeons. Pat- 19 3 , Savari Mohammad, Abdolahi Hamid, Za- Clinical Laboratory Standards Institute.
Performance standards for antimi- fection. Helicobacter Pylori resistanc to antibi- standard-9th Ed. CLSI document M2- 4. Molaabbaszadeh Ha med, Mobin otics in Kerman in Journal of Ker- A9. Study of sistance: synthesis of recommendation briz. Journal of Biomicrob technology of antibiotic resistance pattern of staphy- by expert policy group. WHO publica- Azad University, , 3 9 : Journal of Jentashapier. Avail- scriptin in Kermanshah GP.
Journal of International statistical classiication of able at: www. WHO publication, Ge- International statistical classification Derkhshan Solmaz, Biranvand Sohaila, neva.
Avaliable at: www. Determining of resistanc Efect of silver nanoparti- Avaliable at: www. International Statistical Classiication , 3 8 : Journal of laboratoty science, of diseases and related health problem 7. Rahbare Taromsari Morteza, Khosh , 5 2 : Amooz Halimeh, Hosseini Simin, Badsar Aim: to assess theepidemiological and clinical char- lenceof celiac diseasein the adult popu- acteristicsof CDin the adult populationin Tuzla Canton in northeast of Bosnia and Herzegovina.
Results: during the 3-year period we registered 42 cases tsinBiH. Prevalence among men was 4. Conclusions: he incidence of CD in our region is demonstrating a steep rise and apparently low prevalence in our region is merely a result of poor availability of diagnostics in previous years. Key words: celiac 2. We tine and caused by inadequate immune 1. We excluded all patients that cally predisposed people.
Celiac disease patients with celiac disease 3. It is be- did not reside in Tuzla Canton. We also re- lence of 1 per of residents based on a reliable report that this ratio may be corded age, gender, date of initial di- serological screening 1.
We ease can clinically manifest at any age- manypatients haveatypicalsymptoms excluded patients with incomplete re- with high incidence registered even in orno symptoms at all. According to cords. Med Arh. Now- of diagnosis was used to adays, estimated prevalence in gen- Table 1. Clinical characteristics of celiac disease in patients date incidence. Approximately 3 million people in the appropriate December 31 , in women. Ninety ive per cent incidence during the time period temperate climates.
Although the actual occurrence of dence rates were estimated assuming a The sum prevalence during the celiac disease has been underestimated Poisson distribution of cases. Crudean- study period calculated for population for years, the prevalence of the disease nual incidence rates were calculated numbers on Prevalence among men was vances in diagnostic methods and im- nosed and the number of inhabitants 4.
Un- lated based on number of study years. As demonstrated in- fortunately, as with many other con- Age standardized incidence rates were cidence rates are demonstrating steady ditions, the data about epidemiology calculated using European standard increase. Prevalence es- cording to gender and age is presented for both pediatric and adult popula- timate during observed period was es- in Figure 2.
Figure Figure 1. Annual incidenceofofceliac Annual incidence celiac disease disease in Tuzla in Tuzla region region of and Herzegovina. And of celiac disease during the observed this is the case for a coun- period was 2. Diarrhoea as a large multicenter study. Doll R, Cook P. Summarizing indices for comparison of cancer incidence data. Int nostics in our region. We estimate that ported diarrhea as the irst symptom J Cancer.
Non- 7. Aliment Pharmacol her. As with many other autoimmune was recorded in lesst han one-third of 8. According described pattern of clinical representa- tions: a systematic review.
Gastroenter- toour study, there is also a comparable tion with most of them presenting with ology. Clin Immunol Im- and immunoregulation is subject to here are several limitations of our munopathol.
Interestingly, patients is a hospital-based series and there is a disease in a population-based Swed- over 60 who are diagnosed with celiac possible limitation of referral bias. Also, ish cohort. Celiac disease can be diagnosed at gle hospital. Yet, our hospital is the only One must bear in mind that our disease so almost all patients eventually Nevertheless, we Characteristics of adult celiac dis- and we detected peak incidence in age allow for possibility that small number ease in the USA: results of a national sur- group 36 to 45 years.
However it is im- of patients remains undetected. Am J Gastroenterol. Symptoms and signs in individuals with serology positive for celiac disease sis of celiac disease in advanced age is top of the iceberg when dealing with but normal mucosa. BMC Gastroenterol. Celiac of the disease. Nevertheless there are apparently low prevalence in our re- disease diagnosed in the elderly. J Clin Gastroenterol. Vilppula A, Kaukinen K, Luostarinen L, ies in favor of diagnostic delay and other ity of diagnostic in previous years.
Ce- et al. Increasing prevalence and high in- in favor of late development 13, 14, BMC Gas- symptoms of diarrhea, steatorrhoea should be taken into account in each troenterol. Dig Dis Sci. Fasano A, Catassi C.
Current approaches Gluten challenge in borderline gluten- large variety of changes in the intestinal sensitive enteropathy. Am J Gastroen- to diagnosis and treatment of celiac dis- mucosa 16, According to a survey terol. Gastroenter- in the pediatric population in the area ology. Dig Dis North India. J Trop Pediatr. Our patients- S. Klin Lab Diagn. Co- of cases according to the BMI value.
Numerous studies have shown a survival. Coll Antropol. Celiac sprue. N Engl of symptoms and signs of celiac disease, J Med. Objective of the study: Determine the efect of parity and the area of Tuzla Canton in the period menarche as risk factors in the time of menopause occurrence.
Patients and methods: his from January to December Each patient has undergone an interview based he basic criterion for inclusion in on the questionnaire, following the verbal consent of the patient who was previously explained the study was that the woman is in the nature of the research.
Statistical analysis of data was carried out by the usual statistical methods natural menopause, i. Results : he average age of menopause occurrence in women who struation.
In the study group there was terview based on the questionnaire. Key words : parity, menarche, menopause, factors.
Trnovac bb, Tuzla. E-mail: dr. We ob- menstruation and represents a crucial women still do not feel old. Men- ning of menopause is subject to individ- health: age of menarche, the average age opause as complex process encompasses: ual luctuations and it cannot be encom- of menopause, number of deliveries, the endocrine, genitourinary, cardiovascu- passed exactly.
Recent researches em- number of abortions. It increases earlier and it is amined groups 4. Increased level of FSH 2. AIM at the time of menopause occurrence results in faster follicle maturing, so the Objective of this study was to deter- in relation to the individual chosen pa- menstruation cycles are shorter. When mine inluence of parity and menarche rameters were used. For comparison there are no follicles able to respond to as risk factors to time of menopause oc- of means of age of occurrence of men- stimulus of gonadotropin, production of currence.
With Cox 1, 2, 3. By extension of the age, meno- in the natural menopause who came regression for certain factors we eval- Med Arh. For processing Parity as factor which inluences of data we used statisti- years of age of menopause was taken cal programme PASW 18 into account in many researches. Development Core Team, Velez with associates 6 researching Shows age of patients at the time of interview came to conclusion that null parity, and cluded patients from multiparty women with 5 and more de- Tuzla Canton who were livered children earlier enter the men- in the natural menopause opause.
Shows 46 number of deliveries in patients. Women who did not higher Shows hazard curve for menopause occurrence in relation I n f luenc e of me – years of pubescence when woman does to delivery.
Are the efects inf luences the age of 70 of risik factors for timing of menopause Starost kod pojava menopauze godine menopause occurrence is modiied by age? Result from British co- 60 published in the studies chort study. Stud- 50 Factors associated age and natural meno- 0 with age at natural menopause in multi- pause.
Am J there is group of genes Starost kod menarhe godine Epidemiol. Shows connection between age at menarche occurrence 8. Predictors of the ture or delayed puberty and age at menopause occurrence timing of natural menopause in the Mul- which is connected with tiethnic Cohort Study. Am J Epidemiol. Kaczmarek M. The timing of natural menopause in Poland and associated fac- ture aging of ovary is connected with at the same time respecting and ac- tors.
As knowledging data given by the patients. Am J Epidemiol Re- tion menarche at the age of 11, earlier he average age of menopause oc- view. Secular trend in the menopausal age menarche at 12 year of age and later was somewhat higher In the comparative study carried comparison to women who did not de- with socioeconomic, reproductive and out by Bernis and associates in the re- liver Kriplani A, Banerjee K.
An overview of dicated connection between menarche connection between age of menarche age of onset menopause in northern In- and years of age at menopause Klimakterij, menopausa i menarche and age at natural menopause. Zagreb, Naklada Ljevak, Corerelates tween menarche and years of age at the In our research the results 2. Ciglar S. Menopause and hormone re- rocco. Ann Hum Biol. W hich way to Bernis C, Reher DS.
Enteroviral contexts between menarche and years of age at proced? Am J Gynaecol Perinatol. Zdravo starenje. In extreme cases the disease can lead to kidney and liver failure, tem: Eclampsia seizures , Cerebral DIC and central nervous system disorders. Objective: To present the type and number haemorrhage stroke , Cerebral oe- of maternal complications of preeclampsia in women hospitalized in Gynecology and Obstetrics dema, Cortical blindness, Retinal oe- Clinic in Prishtina, Kosovo.
Methods: A transversal cross-sectional study with combined method dema, Retinal blindness. Renal system: retro and prospective which included pregnant women in period time September to Renal cortical necrosis, renal tubular May Results: In the group of maternal complications based on our analysis 14 out of necrosis.
Respiratory system: Pulmo- subjects have advanced in eclampsia. Liver damage have been found in 4. Liver: impairment. Detachment of the placenta abruption has encountered in 30 cases and 3 patients Jaundice, HELLP syndrome haemoly- had an epileptic attack.
HELLP syndrome is presented only in 4. Coagulation Conclusions: Preeclampsia is the most common medical complication of pregnancy and is as- system: Disseminated intravascular co- sociated with substantial morbidity and mortality for mother. Delivery is the key for saving life. Placenta: Placental infarction and Corresponding author: Minire Alilaj. E-mail: drminire yahoo. GOAL 1. Death, related to pre- women hospitalized in Gynecology and gestation.
Often it causes only slight eclampsia can occur as a result of cere- Obstetrics Clinic in order to enhance increases in blood pressure.
But, if left brovascular seizure, renal failure, liver care for this category and the possibil- untreated, this condition can cause se- failure, HELLP syndrome ore by other ity of taking preventive measures for rious injuries, including fatal complica- hypertensional complications Preeclampsia-eclampsia needs in- According to the author Kee-Hak tensive care antepartum, intrapar- 3. MeTHODS Lim, from Harvard Medical School, tum as well as postpartum for success- he study is transversal cross-sec- preeclampsia is classiied as mild and ful pregnancy outcome.
Preeclampsia tional with combined study methods severe. Study is done presented as severe. In extreme cases ment if appropriate timing of delivery in Clinic for Gynecology and Obstetrics the disease can lead to kidney and liver is delayed 4.
Of Pregnancy twins 15 3. It consisted of the com- that Start time of receipt mild preeclampsia. Liver damage yes 14 3. Detachment of Liver damage no All statistical analysis of data has encountered in 30 Renal impairment no At the age in 12 cases and only one DIC no Nulltipar- with encephalopathy.
Encephalopathy no Maternal complication — type and frequency years. No prior history for pre- Preeclampsia devel- eclampsia was found in Risk fac- cases and 0.
One pregnancy has had tors according to many researchers are: leptic attack. HELLP syndrome as a had only Based on the analysis we have done the subjects, DIC was found in 2. With just one symptom, ar- Lana K. Maternal mortality In the paper of Rathore B et al. Baha M. Lelia Duley, Shireen Meher, Edgardo Ab- Proteinuria and hypertension are nancy, which is consistent with data alos; Management of preeclampsia, BMJ the dominant clinical manifestations in published by several authors 2, Volume , 25 February , 7.
Rathore R et al. Preeclamp- material death in preeclampsia is pul- lampsia Presenting to Medical Wards of sia can cause kidney failure, liver dam- monary edema. Impact of pre- eclampsia and gestational hypertension author has found that in these cases medical complication of pregnancy and on birth weight by gestational age. De- Women prophylaxis in preeclampsia: Lessons learned from recent trials. Wagner, at high risk should be referred to the Gynecol.
Most stud- Age over 30 years is more vulnerable J Med ;8 august 21, , ies show that preeclampsia related to to develop preeclampsia and its com- Peter von Dadelszen et al; Prediction age appears in the form of a curve with plications.
Design: Open, observational, ment intensiication. Despite new ther- multicentric, noncomparative, prospective product registry. Total of subjects were documented in the study.
Fasting plasma glucose values decreased from Insulin tre- Conclusion: Results from the study suggest that basal-bolus regimen consisting of insulin glargine signiicantly improves glycaemic control without increasing hypoglycaemia risk in atment is introduced when non-phar- DMT2 population with inadequate glycaemic control on previous premixed therapy. Keywords: macological measures and treatment Type 2 diabetes mellitus, insulin glargine, HbA1c, premixed insulins.
Clinic for Endocrinology, Clinical cient for maintaining adequate glycae- Center of University of Sarajevo, Bolnicka 25, Sarajevo. E-mail: mic control. Multiple types of insulin ascicbuturovic hotmail.
Howe- particularly in developing countries, in compulsory health insurance scheme. Al- mixed insulin 4. Although premix analogs, in he principal providers of diabetes ten in the domain of secondary and ter- comparison to regular premix insu- care in Bosnia include people with dia- tiary care.
Prior ration, mainly due to unavailability for intensiied insulin treatment 5. Study was approved V. For continuous variables, the observational study was carried on to Drug Agency. For categorical sulin glargine in T2 patients with hy- the purpose of this study and investiga- variables, the frequency, percentages pothesis that such treatment would im- tors were instructed how to complete it.
Simens Dimension device. A total of 18 patients did short-acting insulin administered to pa- titration algorithms were suggested in not complete the 9 month follow-up pe- tients with DMT2 who did not achieve the protocol but not mandatory to use.
Severe hypoglycemia, lipidaemia combined representing as single-arm cohort study was a 9-month also considered a serious adverse event, well the most common comorbidities. Table 1.
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