Reform of medical education in Bosnia-Herzegovina: luxury or necessity?

We present the current status of medical education in Bosnia-Herzegovina to set the stage for the curriculum reform. Two principal questions are asked: is the reform necessary, and is it possible? In spite of the differences in size and tradition of medical schools in Bosnia and Herzegovina (BH), they have more features in common than not: all of them are under internal and external pressures for change and reform, which will eventually be inevitable. The history and strategy of reform in Heidelberg, Germany, and Vienna, Austria, are described and recommendations are made on the basis of their experience. The consensus on the need for reforms has to be reached by all parties involved, ie, faculty, administration, students, and the medical community. After that, the reform process must proceed according to the agreed timetable. The job should be delegated to a dedicated task force and work coordinated through the ongoing "Dictum" project, directed exclusively at reform of medical curricula in BH. The project is funded by a European Union TEMPUS program.     

200th anniversary (1804-2004) of the publication of the poem: Vaccinatio; De Jenneriano invento optime merito; Carmen elegiacum; by Croatian scientist Luko Stulli

Luko Stulli (1772-1828) was a physician who in 1800 performed the first vaccination in Dubrovnik. He was one of the last Latin poets in the Croatian literature. In 1804, Stulli wrote the poem Vaccinaio; De Jenneriano invento optime merito; Carmen elegiacum (Vaccination; On the Outstanding Jennerian Invention; Elegiac Poem). Thus, the vaccination effort in Dubrovnik has a historical and a literary significance. This paper presents a critical reading of the poem Vaccinatio by Luko Stulli, together with important medical historical and literary background relevant to it. The complete, original Latin poem and its English and Croatian translation are found in the appendix of the article (p. 661).     

Academic medicine--experiences from Finland and suggestions for the future

This article presents the basic facts about education, health care system, and academic medicine in Finland. The issue of the academic medicine in the world is discussed and Finnish models compared with those of the rest of the world. Possible solutions for the recovery of academic medicine, education, and research are proposed.     

Exercise and allergic diseases

The aim of this study was to compare exercise-induced bronchial reaction between healthy control subjects and subjects with allergic rhinitis (AR) and allergic asthma (AA). It included 16 controls, 16 subjects with AR and 19 subjects with AA. A skin prick test, pulmonary function test, histamine challenge test and exercise challenge test (ECT) were performed in all subjects. Bronchial reaction to exercise was expressed as the fall index FEV1 (%), AUC(0-30) (min x %), and fall index FEF(25-75) (%). After ECT, subjects with AA had a significantly greater bronchial reaction to exercise than subjects with AR and controls (respective fall index FEV1 8.4, 2.9, and 2.4%, P=0.0083; AUC(0-30) 127.7, 29.6, and 33.1 min x %, P=0.025; and fall index FEF(25-75) 14.6, 0.06, and 1.9%, P<0.001). No difference was found between subjects with AR and controls. In conclusion, ECT induced a significantly greater bronchial reaction in patients with AA and bronchial hyperreactivity to histamine than in patients with AR and bronchial normoreactivity to histamine and controls. This difference was not found between subjects with AR and controls.     

Hypersensitivity to pollen allergens on the Adriatic coast

This paper describes a study of air concentrations of pollens and a calendar of pollination around the town of Split on the Croatian Adriatic in 1994. High pollen concentrations of Parietaria officinalis dominated during the year (up to 20% from April to June) followed by the pollens of Pistacia lentiscus, Olea europaea, Pinus halepensis, Juniperus oxycedrus, Acacia baileyana, Artemisia vulgaris, Ambrosia elatior and Cistus monspeliensis. In 1994-95, skin prick tests using commercially available standard inhalation allergens and specially prepared pollen allergens were performed on 3,500 patients with allergic respiratory symptoms. About 30% were allergic to standard pollen allergens (mixed grass pollen, mixed tree pollen, Parietaria officinalis and Pittosporum tobira). Hypersensitivity to more than one allergen was found in 45% of patients, whereas 15% did not react to any of the standard allergens. Additional testing with newly prepared individual allergens (P. lentiscus, O. europaea, P. halepensis, A. baileyana, C. monspeliensis, A. vulgaris, A. elatior) revealed hypersensitivity in a number of patients, but 36% showed no reaction. This finding suggests that further studies of this kind are needed for additional identification, isolation, and characterisation of pollen allergens that are present in the Adriatic coast.