The main goal of this paper is to elaborate the importance of health literacy in cost-effective utilization of health care services which influence the efficiency of the entire health care sector. In order to complement the theoretical framework of the economic implications and the circular influence of health literacy on the economy, an empirical analysis was carried out using S-TOFHLA. The results suggest that the patients' personal characteristics and the accessibility to health care services influence the level of health literacy which affects the health care costs.

The HERe2cure project, which involved a group of breast cancer experts, members of multidisciplinary tumor boards from healthcare institutions in Bosnia and Herzegovina, was initiated with the aim of defining an optimal approach to the diagnosis and treatment of HER2 positive breast cancer. After individual multidisciplinary consensus meetings were held in all oncology centers in Bosnia and Herzegovina, a final consensus meeting was held in order to reconcile the final conclusions discussed in individual meetings. Guidelines were adopted by consensus, based on the presentations and suggestions of experts, which were first discussed in a panel discussion and then agreed electronically between all the authors mentioned. The conclusions of the panel discussion represent the consensus of experts in the field of breast cancer diagnosis and treatment in Bosnia and Herzegovina. The objectives of the guidelines include the standardization, harmonization and optimization of the procedures for the diagnosis, treatment and monitoring of patients with HER2-positive breast cancer, all of which should lead to an improvement in the quality of health care of mentioned patients. The initial treatment plan for patients with HER2-positive breast cancer must be made by a multidisciplinary tumor board comprised of at least: a medical oncologist, a pathologist, a radiologist, a surgeon, and a radiation oncologist/radiotherapist.

Uvod. Hematopoeza je proces stvaranja krvnih ćelija i uobličenih elemenatakrvi. Ovaj dinamičan proces se postnatalno odvija u koštanoj srži, dok jeprenatalna hematopoeza raspršena na više lokalizacija. Počinje u žumančanojkesi, u intraembrionalnim ostrvcima hematopoeze, nastavlja se ujetri, slezini i koštanoj srži, a prema novim saznanjima i u placenti. Jetra jekao najveći hematopoetski organ intrauterinog razvoja izvor matičnih ćelijahematopoeze. Cilj rada je identifikacija i kvantifikovanje CD34 i CD117imunoreaktivnih hematopoetskih ćelija u jetri humanog embriona i fetusa.Metode. Korišćeno je 5 jetri humanih embriona i 25 jetri humanog fetusastarosti od 7 do 38 nedelja gestacije. Uzorci jetre podvrgnuti su rutinskojobradi do parafinskih kalupa. Tkivni presjeci, debljine 5 μm bojeni su hematoksilinomi eozinom, kao i imunohistohemijskim dokazivanjem CD34i CD117 antigena. Kvantifikacija je urađena morfometrijski određivanjemnumeričke arealne gustine. U statističkoj analizi korišćen je Hi-kvadrat test.Rezultati. Numerička arealna gustina CD34 imunoreaktivnih hematopoetskihćelija u jetri u embrionalnom periodu razvića je iznosila 0,35%, 0,30%u prvom trimestru (koji obuhvata i embrionalni i fetalni period), 0,46% udrugom trimestru i 0,10% u trećem trimestru. Numerička vrijednost arealnegustine CD117 imunoreaktivnih hematopoetskih ćelija u jetri za embrionalniperiod je iznosila 0,28%, 0,50% u prvom trimestru (koji obuhvata i embrionalnii fetalni period), 0,11% u drugom trimestru i 0,09% u trećem trimestru.Zaključak. Jetra embriona i fetusa predstavlja značajan izvor CD34 i CD117imunoreaktivnih hematopoetskih ćelija.

Malignancy is one of the major public health problems in Bosnia and Herzegovina. Along with breakthroughs in specific oncological therapy, improving the quality of life of cancer patients and management of therapy-induced side effects need to be recognized as a priority in the comprehensive cancer patient care. Fertility loss after cancer treatment is a field requiring special attention due to its various consequences on patients themselves.  Although oncofertility is well-recognized area of oncology, low- to middle-income countries are facing issues with its implementation in everyday practice. Increased awareness about fertility preservation is of high priority for all specialists who participate in the medical care of cancer patients. The absence of a systemic solution and lack of expertise led to the founding of Fertility Preservation Working Group of the Oncology Association of Bosnia and Herzegovina. We have made recommendationsas an expert consensus with the ultimate goal of making the first step towards enhancement of oncofertility implementation in Bosnia and Herzegovina.

Given that in times of crisis the burden of chronic disease is increasing, preventive interventions are becoming more important as they affect the maintenance and improvement of the population’s health, therefore reducing government spending on the sick leave and disability benefits. As public healthcare is characterized by administrative decision-making and relying on non-market mechanisms in the resource allocation, it requires the implementation of economic evaluations. This discussion shows that because the specifics of public healthcare complicate the data collection of revealed (market) preferences, it is necessary to rely on stated preferences of respondents in order to evaluate the economic value of health interventions as well to improve public health care interventions and make them more patients oriented. Also, this article explores the method of discrete choice experiment along with its applications in healthcare, which seeks to identify the marginal rate of substitution between relevant attributes of public healthcare intervention and its impact on the patients’ choice, hence enabling a broad application of the method.

Background: Of all breast cancers 20-25% are HER2 positive. Overexpression of HER2 protein on the surface of the malignant cell leads to excessive cell proliferation through different signaling pathways. Trastuzumab is a human monoclonal antibody that binds to domain IV of HER2 receptor and blocks signaling pathway for proliferation. The result is an improved prognosis for HER 2 positive breast cancer patients, even when compared to patients with other types of breast cancers. Methods: The study presents 74 women patients with early HER2 positive breast cancer who were previously operated (either radicaly or using breast conserving surgery), and received adjuvant chemo- and radiotherapy. Fourty four patients received adjuvant trastuzumab for one year, and 30 patients did not (control group). Observed time to relapse of the disease was 60 months. Results: There was a significant difference in survival in favor of the group that received trastuzumab (p<0.001). Application of trastuzumab also delayed relapse of the disease by 51.7%. No significant difference was observed between estrogen receptor positive and estrogen receptor negative cancers., In the control group there was a significant difference in relapse free survival in favor of estrogen and progesteron receptor positive tumors (p<0.001). Conclusion: Survival of patients with a HER2 positive breast cancer whose prognosis was initially worse compared to HER2 negative patients, significantly improved after administration of trastuzumab.

There is a daily increase in the number of patients with malignant diseases, but with the advances in modern oncology research, the number of survivors treated with malignant diseases is becoming larger and larger. The survival rate after completing oncology therapy is increasing on a daily basis, so that malignant diseases belonging to the category of terminal diseases are now referred to as 'chronic illnesses'. In this specific group of patients, the risk from cardiovascular diseases is increasing nowadays. A new challenge for the future cardiologists will certainly pose the treatment of this group of patients. A cardiological approach in oncological patient treatment is an important issue. The cardiologist focuses on risk stratification and prevention of cardiovascular complications in the oncological patient in relation to his or her pre-existing condition, and in relation to the type of specific oncology therapy applied, and on further follow-up during therapy and after its completion. This implies that it is necessary to create cardio-oncology teams in our institutions treating the oncological patients. There is a considerable need for education in a new field, which presents the intersection between two clinical disciplines, i.e. cardiology and oncology, and for special education of cardiologists concerning all types of chemotherapy and their potential cardiotoxic effects. The oncologist, on the other hand, must be trained to recognize any possible early signs and symptoms of cardiac complications concerning the therapy applied and to seek further cardiac care for the patients. The aim of this review article is to assist the doctors treating this group of patients in their daily practice and to highlight the need for a multidisciplinary approach, as well as the creation of a cardio-oncology team for a comprehensive and integrative approach to a cardio-oncological patient.

<p><strong>Objective</strong>. Patients and medical professionals have a common misconception that cardiovascular diseases (CVD) predominantly affect men, which can lead to less prescribing of cardiovascular drugs to women. This study examined whether there were sex differences in the administration of cardiovascular (CV) drugs in patients admitted to the intensive care unit of the Internal Medicine Clinic of Foča University Hospital (ICFUH).</p><p><strong>Materials and Methods</strong>. The study comprised 332 patients hospitalized at the ICFUH from January 1st to June 30th, 2019. The following data on leading CVD and risks related to CV drug administration were collected: age, hyperlipidemia (HLD), diabetes mellitus (DM), chronic kidney disease (CKD), liver disease (LD), heart failure (HF), hypertension (HTN), myocardial infarction (MI), and stroke (S). The amount of the CV drugs of interest (statins, antiplatelet drugs, calcium channel blockers, ACE inhibitors, beta blockers, diuretics) administered during hospitalization was expressed as the Defined Daily Dose (DDD)/100 bed-days (BD) for patients of both sexes separately.</p><p><strong>Results</strong>. During hospitalization in the intensive care unit of ICFUH, female patients were less likely to be treated with statins than male patients (30.1 vs. 57.5 DDD/100 BD, P&lt;0.05). There was no difference between sexes regarding the use of antihypertensive drugs. Women were less likely to be treated by antiplatelet therapy, more precisely by acetylsalicylic acid (30.4 vs. 36.9 DDD/100 BD, P&lt;0.05).</p><p><strong>Conclusion</strong>. Our study indicates that there were sex differences in CV drug administration in ICFUH. Presuming that drugs used during hospitalization were at least partially a continuation of the previous therapy prescribed by the family doctor, it is possible that such differences exist in primary care.</p>