bluuebunny/crossref_metadata_2025 huggingface dataset:
The importance of education in patients with metabolic syndrome with regard to their knowledge and attitudes about the disease, and the impact of education on laboratory parameters
Authors: Bureković Azra , Đozo Elvira , Divanović Anida
Published: April 2024

Aim
A metabolic syndrome (MetS) increases the risk of heart disease and diabetes mellitus type 2, thus the aim of this study is to
correlate the clinical and laboratory parameters in patients suffering from MetS who have previously had education compared to patients who have not had any education about a healthy lifestyle, and to check their knowledge and attitudes about healthy lifestyle.
Methods
The study included patients of both genders aged 18 - 70 years, diagnosed with MetS, who are members of the Association
of Diabetics in Canton of Sarajevo. It used anthropometric parameters, laboratory findings, and an original, structured questionnaire about diet and frequency of physical activities.
Results
Clinical and laboratory parameters did not differ significantly between educated and uneducated patients, as well as
habits in diet, physical activity, and knowledge about metabolic syndrome. The questions from the questionnaire have shown a good value of variance, suggesting that the questionnaire can be considered reliable.
Conclusion
This study showed that people with metabolic syndrome are not educated and motivated enough to change their lifestyle. The need for education of such patients is necessary.
Distal biceps tendon repair and posterior interosseous nerve injury: clinical results and a systematic review of the literature
Authors: Chiossi Silvio , Spoliti Marco , Sessa Pasquale , Arceri Valerio , Basile Attilio , Rossetti Francesca Romana , Maria Lanzetti Riccardo
Published: April 2024

Aim
To report clinical, functional and radiographic results of oneincision distal biceps tendon repair with Toggle Loc (Zimmer-Biomet, Warsaw, Indiana, USA) at an average 4-year follow-up and to assess posterior interosseous nerve injury complications after reconstruction.
Methods
We conducted a retrospective review of 58 consecutive distal biceps tendon repairs performed at our department between
2010 and 2018. Disabilities of Arm, Shoulder and Hand (DASH) score, Visual Analogue Scale (VAS) scale and elbow range of motion (ROM) were recorded at each follow-up and an ultrasound examination was also performed to assess the repaired biceps brachii tendon.
Results
Clinical evaluation showed good and excellent results at medium- and long-term follow-up. A temporary posterior interosseous nerve (PIN) palsy developed in four (6.81%) patients and always resolved in 8 weeks. PIN palsy prevalence is in accordance with the results of the previous studies.
Conclusion
Distal biceps tendon repair with Toggle Loc is an effective surgical procedure. PIN injury is a relatively rare complication after one-incision anterior repair. Our complication rate did not differ significantly from other studies that have used cortical
button fixation, reported in current literature. Our results confirm that accidental injury of PIN may also happen to experienced surgeons and suggest extreme care and an appropriate surgical technique to reduce this iatrogenic risk. 
Mesenchymal stem cells under hypoxia condition inhibit peritoneal adhesion by suppressing the prolonged release of interleukin-6
Authors: Muhar Adi Muradi , Putra Agung , Ekasaputra Vito Mahendra , Darlan Dewi Masyithah , Paramita Desiree Anggia , Adeputra Nasution Iqbal Pahlevi
Published: April 2024

Aim
To investigate the role of hypoxia-preconditioned mesenchymal stem cells (H-MSCs) in preventing peritoneal adhesion
by regulating IL-6 at days 6 and 12.
Methods
Twenty-four PAs rat model weighing 250 g to 300 g were randomly allocated into 4 groups: sham (Sh), control (C),
H-MSCs treatment group at dose 1.5 x 106  (T1) and 3 x 106 (T2). To induce H-MSCs, all MSCs population were incubated under hypoxia state (5% O2), 5% CO2, and 37o C for 24 hours. Expression level of IL-6 was performed using ELISA. Morphological appearance of adhesion was observed by visualizing the existence of adhesion formation in intestinal.
Results
In this study we found that there was a trend of decrease of IL-6 level on day 6 following MSCs treatments. Interestingly,
there was a significant decrease of IL-6 level on day 12 in all treatment groups. Also, no adhesion occurred in T2 group.
Conclusions
H-MSCs prevent PA development by suppressing the prolonged release of IL-6 at proliferation phase.
A new technique of flexor carpi ulnaris transfer in multilevel surgery for upper extremity deformities in spastic cerebral palsy
Authors: Chibirov Georgy , Pliev Mairbek , Popkov Dmitry
Published: April 2024

Aim
 To assess treatment outcomes of cerebral palsy (CP) patients who underwent upper limb surgical treatment including new technique of flexor carpi ulnaris (FCU) transfer.
Methods
 The study included an outcome of orthopaedic surgeries in 30 upper limbs of 25 CP patients aged 10 to 24 years (mean age of 15.1 years). In addition to standard orthopaedic assessment, we used the integral scales of the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS). Functional disorders of the upper limb were also evaluated with classifications of Van Heest, House, Gshwind and Tonkin.
Results
 A total of 30 surgical interventions were performed. In seven patients with hemiparesis, surgical treatment was accompanied by simultaneous intervention on the lower limb. Improvement of the functional capabilities and cosmetic appearance was noted in all cases in a follow-up over 12 months, as evidenced by an improvement in the functional class according to Van Heest classification.
Conclusion
A new technique of FCU transfer to the radius showed to be an effective method to address pronation contracture of the
forearm joints and can be used in combination with other elements of surgical intervention for elbow and thumb contractures. The FCU rerouting and transfer to distal radius is a good option in the absence of active supination. Distal release of FCU weakening flexion forces with a simultaneous procedure restoring active wrist extension provides satisfactory outcomes in the treatment of associated flexed wrist contracture.
Navigated percutaneous screw fixation of the pelvis with O-arm 2: two years’ experience
Authors: Ciolli Gianluca , Caviglia Daniele , Vitiello Carla , Lucchesi Salvatore , Pinelli Corrado , De Mauro Domenico , Smakaj Amarildo , Rovere Giuseppe , Meccariello Luigi , Camarda Lawrence , Maccauro Giulio , Liuzza Francesco
Published: April 2024

Aim
To evaluate the case series of the patients operated with percutaneous fixation by the navigation system based on 3D fluoroscopic images, to assess the precision of a surgical implant and functional outcome of patients.
Methods
A retrospective study of pelvic ring fractures in a 2-year period included those treated with the use of the O-Arm 2 in combination with the Stealth Station 8. Pelvic fractures were classified according to the Tile and the Young-Burgess classification. All patients were examined before surgery, with X-rays and CT scans, and three days after surgery with additional CT scan. The positioning of the screws was evaluated according to the Smith score, the outcome with the SF-36.
Results
Among 24 patients 18 were with B and six with C type fracture according to Tile, while eight were with APC, 10 LC, and
six with VS type according to Young-Burgess classification. All patients were treated in the supine position, except two. A total of 41 iliosacral or transsacral screws and five anterior pelvic ring screws were implanted. The medium surgical time per screw was 41 minutes. There was a perfect correspondence of screw scores value from post-operative CT and intraoperative fluoroscopy. The mean screw score value was 0.92. There were no cases of poor positioning. The median follow-up was 17.5 months. The patients were satisfied with their health condition on SF-36.
Conclusion
The use of the O-arm guarantees great precision in the positioning of the screws and reduced surgical times with excellent
clinical results in patients.
Allogenic platelet concentrates from umbilical cord blood for knee osteoarthritis: preliminary results
Authors: Caiaffa Vincenzo , Ippolito Francesco , Abate Antonella , Nappi Vittorio , Santodirocco Michele , Visceglie Domenico
Published: April 2024

Aim
To investigate the role of cordonal blood platelet-rich plasma (PRP) intra-articular injections for treating the patients with knee
osteoarthritis in terms of procedure safety and clinical outcomes.
Methods
Twenty-five patients affected by knee osteoarthritis were enrolled and received one single intra-articular knee injection of
umbilical cord PRP in a volume of 10 mL. A follow-up was investigated at time 0, 4, 8, 12 weeks and 6 months, evaluating clinical parameters and functional performances.
Results
No serious adverse events were identified. The paired ttest analysis showed a significant difference between baseline and
each follow-up times for all clinical scales (p<0.05), with a significant improvement of clinical outcomes.
Conclusion
 Allogeneic PRP can generate reliable therapeutic effect. The high content of tissue regenerative factors in cord blood platelets makes cordonal blood one of the ideal sources of PRP. 
Holly Sacrament: the medicine of spiritual immortality or a vehicle for contamination?
Authors: Anyfantakis Dimitrios
Published: April 2024

The Holy Communion is the oldest Christian practice, through which a gathered group of people partake bread and wine with
a shared spoon. The pandemic of COVID-19 produced unexpected social instability and chaos. In Greece, a recent bishop’s death from COVID-19 re-awaked the issue of infection transmission by using a common chalice and spoon. This review evaluates the available medical literature on this topic from the beginning of the pandemic until today.
Dog bites and attacks on athletes: lack of effective prevention mechanisms
Authors: Katica Muhamed , Kapo Nadža , Ahmed Nasreldin Hassan , Kapo-Gurda Anida , Kapo Safet
Published: April 2024

Athletes who train in public places in urban and rural areas are just
as attacked and injured by dogs of known owners as they are by
dogs with no owners, in a relatively equal proportion. The largest
number of bites occurs in the summer, what makes up half of all
bites, just when sports activity is most pronounced. Athletes who
are most often exposed to potential attacks and bites are cyclists, long-distance athletes, marathon runners, recreational athletes, etc. both during training and competitions. Off-road cyclists
are at a significantly higher risk of dog attacks because cycling
takes place off-road, that is, away from urban areas. Dog attacks
can adversely affect the psycho-physical readiness of athletes. In
Bosnia and Herzegovina there have been no cases of injuries to
athletes recorded by competent medical institutions or umbrella
sports associations. It is necessary to work on more efficient administration (registration and recording of attacks and bites of dogs).
It is of utmost importance to educate athletes on dog behaviour, the
reasons for their aggressive behaviour and causal mechanisms of
dog attacks as well as the first aid education, what can have a great
impact on reducing further complications.
Fasting state requirements for blood sampling: a survey of patients in Cantonal Hospital Zenica, Bosnia and Herzegovina
Authors: Kadić Damira , Avdagić-Ismić Aida , Hasić Sabaheta , Bošnjak Ferhana
Published: April 2024

Aim
To explore patient’s awareness and appliance of the fasting state requirements for blood sampling.
Methods
This observational survey was performed at the Department of Medical Biochemistry and Immunology Diagnostics,
Cantonal Hospital Zenica, from June to July 2019. An anonymous questionnaire was conducted on 200 consecutive outpatients older than 18, who were admitted to the laboratory for routine blood
testing.
Results
A total of 134 (67%) patients were informed that they needed to be at fasting to perform laboratory tests. Patients were
mostly informed by a requesting physician or a nurse, 68 (50.8 %), and by other patients, members of the family and friends, 58 (43.3%); only seven (5.2%) patients were informed in the laboratory. A total of 75 (37.5%) patients arrived to the laboratory properly prepared.
Conclusion
Most patients were not well informed about fasting state requirements for blood sampling and consequently they were
not adequately prepared for laboratory tests. Laboratory should establish updated fasting recommendations available to patients and healthcare professionals, and conduct continuing education of patients and health care staff.
Relapses of traumatic peroneal tendons subluxation already treated surgically: a new surgical approach
Authors: Tomarchio Alessandro , Meccariello Luigi , Ghargozloo Dariush , Pasquino Andrea , Leonardi Enrico
Published: April 2024

Aim
To illustrate the surgical treatment of relapses of traumatic peroneal tendons subluxation.
Methods
We came across a young woman, who sustained a sprain in her dominant ankle after a trauma; we noticed subluxation of
the peroneal tendons during eversion and extension of the foot. She referred to a previous accident some years before with peroneal tendon subluxation treated by superior peroneal retinaculum (SPR) sutures with a synthetic braided absorbable material. We prescribed conventional radiography, magnetic resonance imaging (MRI) and performed surgery: we removed scar tissue, reattached the retinaculum using suture anchors strengthening it with an acellular dermal matrix allograft patch.
Results
Periodic clinical follow-ups until 24 months were performed evaluating the stability of the ankle, checking the range of
movement, and the Visual Analogic Scale (VAS) and American Orthopedic Foot and Ankle Society Score (AOFAS) was administered. At the first check the subluxation was resolved and the ankle was stable. The VAS scale had the value of 0 at the 3-month follow-up maintained until the final check.
Conclusion
Relapsing traumatic peroneal tendons subluxation is rare, as well as the possibility of a re-intervention years later. This
technique seems to guarantee an excellent result even in the long term, allowing resolution of pain and joint stability. In fact, the use of acellular dermal patch is an already commonly described technique for the augmentation in rotator cuff and hip capsular repair; no reports are available in literature in relation to the use of graft for the repair of the superior peroneal retinaculum.
Association of rs211037 GABRG2 gene polymorphism with susceptibility to idiopathic generalized epilepsy
Authors: Milanovska Marija , Cvetkovska Emilija , Panov Sasho
Published: April 2024

Aim
This case-control study aimed to determine a possible association of single nucleotide polymorphism rs211037 of the
gamma-aminobutyric acid receptor subunit gamma-2 (GABRG2) gene with the susceptibility to idiopathic generalized epilepsy (IGE) in the Macedonian population.
Methods
It enrolled 96 patients with clinically verified IGE and 51 healthy individuals without personal and family history of epilepsy or other neurological disorders as controls. A determination of the GABRG2 rs211037 polymorphism was performed using the TaqMan-based genotyping assay.
Results
A significant dominant association of the CC genotype (odds ratio - OR=2.100, 95% CI=1.018-4.332; p=0.043) and allelic association of C allele (OR=1.902, CI=1.040-3.477; p=0.035) with susceptibility to IGE was found. Carriers of CC genotype
had approximately a 2-fold higher probability of developing IGE than the carriers of CT and TT genotypes. Carriers of the C allele had a 1.9-folds higher probability for IGE than the carriers of the T allele.
Conclusion
The polymorphism rs211037 of the GABRG2 gene increases the risk of the development of idiopathic generalized
epilepsy in the Macedonian population.
C-reactive protein and haemoglobin level in acute kidney injury among preterm newborns
Authors: Aprilia Kadi Fiva , Yuniati Tetty , Sribudiani Yunia , Rachmadi Dedi
Published: April 2024

Aim
To explore the possibility of C-reactive protein (CRP) and haemoglobin (Hb) in prediction and risk assessment of acute kidney injury (AKI) among preterm newborns. This is believed to be closely related to the incidences of AKI, and could be the most affordable in early detection of AKI.
Methods
A case control study was carried out at Dr Hasan Sadikin Hospital in Bandung with a total of 112 preterms divided into
two groups: with and without AKI based on the neonatal KDIGO (Kidney Disease: Improving Global Outcomes). CRP and creatinine serum were measured within 6 hours and at 72-96 hours after birth. The routine blood count included haemoglobin, haematocrit, leucocyte, and thrombocyte in the first 24 hours of life.
Results
CRP increase was the most influential factor for AKI with sensitivity of 80.6% and specificity of 60.2%. An increase in CRP
>0.04 had an aOR (95% CI) of 5.64 (1.89–16.84). Haemoglobin <14.5 g/dL had slightly increased aOR (95% CI) of 1.65 (1.05- 8.63)
Conclusion
 CRP increases >0.04 and level Hb <14.5 g/dL showed acceptable as an early warning for AKI in preterm newborns. 
Anatomy of septocutaneous blood vessels of the anterior forearm
Authors: Jović Darko , Bišćević Mirza , Milisavljevic Milan , Aleksić Zoran , Jakovljević Milica , Tešović Nevena , Kremenović Mićo
Published: April 2024

Aim
To measure a calibre of radial and ulnar septocutaneous perforators at the anterior forearm, and to count its number in proximal, middle and distal thirds.
Methods
The study was conducted on 50 fresh amputated forearms (trauma, tumours) in the period between January 2012 and
December 2021. Forearms were collected from several hospitals in Belgrade, and analysed at the Institute of Anatomy, Medical School, University of Belgrade, Serbia. Injection of ink-gelatin and fine dissection of autopsy material was performed on 30 forearms, and corrosion method with injecting methyl methacrylate for 3D analysis on the other 20 forearms.
Results
A mean calibre of septocutaneous perforators on the radial artery was 0.53±0.46 mm (0.2-0.85). Averagely, there were
8.1 radial artery septocutaneous perforators - two perforators on the proximal third, 3.7 on the middle third, and 2.7 on the distal third. The mean calibre of ulnar artery perforators was 0.65±0.35 mm (0.18-1.8). The average number of septocutaneous perforators of the ulnar artery was 5.6; 1.2 on the proximal third, two on the
middle third, and 2.2 on distal third.
Conclusion
Determination of the origin, calibre and spreading directions of the arterial septocutaneous perforators on the anterior
forearm provide quantification of data about arborisation of radial and ulnar septocutaneous perforators at the anterior forearm. Clinical relevance of those anatomical data is in defining of safe locations and dimensions of forearm fasciocutaneous flaps in plastic surgery. 
Effect of atorvastatin on systolic and diastolic function in patients with heart failure with reduced ejection fraction (HFrEF)
Authors: Zvizdić Faris , Begić Edin , Dilić Mirza , Sokolović Šekib , Lepara Orhan
Published: April 2024

Aim
To investigate the benefit of high-dose lipophilic statin therapy on cardiac remodelling, function and progression of heart failure (HF) in patients with ischemic heart disease.
Methods
A total of 80 patients with ischemic HF diagnosis were followed during 6 months, and they were divided in two groups.
First group (n=40) was treated by high-dose lipophilic statin therapy (atorvastatin 40 mg) and conventional therapy for HF, while the second group (n=40) had no atorvastatin in the therapy.
Results
In the beginning of study, from all of the observed parameters, only the ratio of flow rates in early and late diastole (E/A
ratio) differed between the test groups (p=0.007). After six months, a statistically significant increase in left ventricular end-diastolic diameter (LVIDD) in patients who had not been treated with atorvastatin was found. In the patients treated with atorvastatin, there was a significant reduction in basal right ventricle diameter in diastole and systole (p<0.001 and p<0.001, respectively), and in tricuspid annular plane systolic excursion (TAPSE) (p<0.001); there was a reduction in LVIDD (p<0.001), and an increase of ejection fraction of the left ventricle according to Teicholtz and Simpson
(p<0.001 and p<0.001, respectively). Also, there was an increase of deceleration time of early diastolic velocity (DTE) (p<0.05) and a decrease of isovolumic relaxation time (IVRT) (p<0.001).
Conclusion
The reduction in the right and left ventricle diameters was noted after the six-month atorvastatin therapy. Atorvastatin in
the therapy resulted in increased EFLV and better systolic function and should be a part of a therapeutic modality of HF.
Relationship between depression and quality of life after myocardial infarction
Authors: Džubur Alen , Lisica Delila , Hodžić Emir , Begić Edin , Lepara Orhan , Fajkić Almir , Gogić Ena , Ejubović Malik
Published: April 2024

Aim
To examine the prevalence of depression in patients after acute myocardial infarction (AMI), as well as the relationship between the depression and quality of life.
Methods
The survey was conducted via sociodemographic questionnaire, Beck Depression Inventory (BDI), and Short Form 36
Health Survey questionnaire (SF-36). The result of SF-36 is expressed in subscales that make up the health status profile, i.e. physical functioning, physical role, emotional role, social functioning, mental health, vitality, pain and general health.
Results
The study included 120 patients, of which 70 males and 50 females aged between 41 and 88 years (mean 64.73±11.218). All patients were hospitalized at the Clinical Centre of the University of Sarajevo, Clinic for Cardiovascular Disease and Rheumatism, due to complications caused by AMI. After AMI 59 (49.17%) patients had depression. Depression was negatively associated with physical functioning, physical role, emotional role, social functioning, mental health, vitality, pain and general health. Physical functioning (r= -0.701; p<0.01) and physical role (r = -0.538; p<0.01) had the highest correlation with depression.
Conclusion
The evaluation of depressive symptoms after AMI is imperative, because the appearance of symptoms could have an
effect on the patient's quality of life.
Cancer rate of Bethesda category II thyroid nodules
Authors: Mulita Francesk , Iliopoulos Fotios , Tsilivigkos Christos , Tchabashvili Levan , Liolis Elias , Kaplanis Charalampos , Perdikaris Ioannis , Maroulis Ioannis
Published: April 2024

Aim
Thyroid nodules are very common and may be found in more than 50% of the population. Fine-needle aspiration cytology
(FNAC) of thyroid nodules is a very useful diagnostic tool with high sensitivity and predictive value for diagnosis. The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) uses six categories for thyroid cytology reporting (I-nondiagnostic, IIbenign, III-atypia of undetermined significance (AUS)/ follicular lesion of undetermined significance (FLUS), IV-follicular neoplasm/suspicious for follicular neoplasm (SFN), V-suspicious for malignancy, and VI-malignant. Our objective was to determine the malignancy rate in Bethesda II nodules.
Methods
From June 2010 to May 2020 a retrospective analysis was performed among 1166 patients who underwent thyroid surgery for benign thyroid diseases in our institution. Thyroid cytopathological slides and Ultrasound (US) reports were reviewed and classified according to the BSRTC. Data collected included age, gender, cytological features, and histological type of thyroid cancer.
Results
During the study period, 44.77% (522/1166) of patients with an FNA categorized as Bethesda II underwent thyroid surgery. Incidental malignancy was found in 1.53% (8/522) cases of Bethesda II. The most common malignant tumour type was papillary thyroid carcinoma.
Conclusion
The current study demonstrates that incidental thyroid carcinoma can be diagnosed after thyroidectomy even in patients
with an FNA categorized as Bethesda II.
Sporadic chromosome translocation frequencies in lymphocyte cultures – a retrospective study in a cohort of patients from Bosnia and Herzegovina
Authors: Haverić Sanin , Haverić Anja , Hadžić Maida , Ćetković Tamara , Čaluk Klačar Lejla , Hadžiselimović Rifat
Published: April 2024

Aim
Chromosome translocations are considered as one of the most severe forms of genome defects. Because of the clinical significance of chromosome translocations and scarce data on the incidence of sporadic translocations in population of Bosnia and Herzegovina, we aimed to report sporadic translocation frequencies in samples karyotyped in our laboratory.
Methods
The study group consisted of 108 samples. Whole blood was cultivated in complete medium for 72 hours with the thymidine application at 48th hour to synchronize the cell culture. Metaphases were arrested by colcemid 60 minutes before harvesting. Following hypotonic treatment, cells were fixed and cell suspension was dropped on coded slides. Dried slides were subjected to conventional GTG (G-banding with trypsin-Giemsa) banding and analyzed under 1000x magnification in the accordance with ISCN (International System for Human Cytogenetic Nomenclature) and
E.C.A. Cytogenetic Guidelines and Quality Assurance.
Results
The incidence of all detected sporadic translocations was 27.81 x 10-4 per metaphase. The incidence of sporadic translocations involving chromosomes 7 and 14, being considered as the most frequent sporadic translocations of the human karyotype in phytohaemagglutinin (PHA) stimulated lymphocytes, was 15.89 x 10-4 per metaphase. The most frequent breakpoints were 7p21, 14q11 and 14q21. Other detected sporadic translocation breakpoints were: 1q25, 3p22, 7p13, 7q11.22, 7q33, 14q23 and 19q13.4.
Conclusion
Higher incidence of sporadic translocations compared to the similar studies was registered. Since potential explanations
for this issue are smaller sample size and higher exposure of examined population to genotoxic agents, further monitoring of sporadic translocation incidences is recommended.
Psychosocial influence of COVID-19 on healthcare workers
Authors: Pašić Aleksandra , Štraus Slavenka , Smajić Emina , Begović Ermin , Haxhibeqiri-Karabdić Ilirijana , Spasojević Nada
Published: April 2024

Aim
To assess a psychosocial impact of the Coronavirus disease 2019 (COVID-19) on health care workers and to quantify the size of depression symptoms, anxiety and stress levels.
Methods
This cross-sectional study used an anonymous online survey questionnaire as a research instrument and it included 114
health workers of all profiles from the Sarajevo Canton employed in private and public institutions. The research was voluntary, non-commercial and all participants provided an oral informed consent. Depression, Anxiety and Stress Scale (DASS-21) questionnaire was used for assessing emotional status of depression, anxiety and stress.
Results
The mean age of participants was 40.5±8.44 years with male:female ratio of 0.28. Prevalence of depression was 46.5%,
anxiety61.4%, and 36.9% stress. Age and gender had no effect on emotional status, but it was revealed that women achieved higher depression, anxiety and stress scores than men (without statistical significance). The most notable effect on the emotional state was found for direct or indirect contact with COVID-19 patients. Medical workers in direct contact with COVID-19 patients achieved greater depression (p=0.005), anxiety (p=0.001), stress (p=0.030)
and total DASS-21 (p=0.003) scores.
Conclusion
High prevalence of health workers affected by various psychological ailments during the COVID-19 pandemic was found. This evidence underscores the need to address adverse effects of the pandemic on mental health of health care workers.
Bone and cartilage condition in experimental osteoarthritis and hypothyroidism
Authors: Sergeevich Nosivets Dmytriy
Published: April 2024

Aim
To investigate changes in bone and cartilage tissue during the use of non-steroidal anti-inflammatory drugs and paracetamol in experimental osteoarthritis and hypothyroidism by the markers CTX-I and CTX-II.
Methods
The experiments were performed on 75 white nonlinear rats of both sexes, which recreated osteoarthritis and hypothyroidism. Experimental osteoarthritis was performed by single intra-articular administration of monoiodoacetic acid solution in the knee joint and experimental hypothyroidism was reconstructed by enteral administration of a solution of carbimazole. After the formation of the experimental models on the 42nd day of the experiment, the animals were divided into 14 groups and drug administration began daily for 5 days. The quantitative level of markers of blood serum was performed by specific kits, which are based on ELISA on 42 and 47 days of the experiment.
Results
The degree of influence on degenerative-dystrophic processes in bone tissue, which was assessed by the level of the marker СTX-I in the serum of rats, the studied drugs were as follows: diclofenac sodium > ibuprofen > nimesulide = meloxicam > celecoxib > paracetamol. According to the degree of influence on degenerative-dystrophic processes in cartilage tissue, which were assessed by the level of marker СTX-II in the serum of rats, the studied drugs were as follows: nimesulide > celecoxib > meloxicam > ibuprofen > diclofenac sodium > paracetamol.
Conclusion
Determination of the levels of CTX I and СTX II allows the evaluation of the bone and cartilage condition in experimental osteoarthritis and hypothyroidism.
COVID-19 clinic as a basis of quality primary health care in the light of the pandemic – an observational study
Authors: Ferenčina Jurica , Tomšič Vladimira
Published: April 2024

Aim
The COVID-19 pandemic has had a major impact on societies and has required adjustments of health systems and changes in work processes, especially in the light of an aging population with increased morbidity and mortality. The primary health care level has a key role in maintaining access to healthcare and in addressing the largest proportion of patients with COVID - 19 and should therefore take steps to manage the condition. The aim is to determine the adequacy of COVID-19 clinic model for patients, who are suspected or have a confirmed infection with COVID-19.
Methods
In Health Centre Sevnica we have formed a model of the COVID Outpatient Clinic with unlimited access to safe and efficient health care. The introduction of COVID-19 disease diagnostic protocols, regular monitoring of patients, early detection of severe course of the disease and complications have made it possible to treat most patients at the primary health care level without the need for hospitalization.
Results
In our COVID clinic in the period 12 March 2020 - 31 January 2021 a total of 22,259 examinations were performed, of
which only 284 patients were referred to the hospital level. As expected, the largest share of referrals was in the age group of 65 and over.
Conclusion
We believe that the established organization of work represents an optimal solution for managing the COVID-19 pandemic and is also a model with which we can manage future threats.
SARS-CoV-2 infection in adults and HIV: an update
Authors: Bousis Dimitrios , Mulita Francesk , Marlafeka Ioanna , Paraskevas Themistoklis , Velissaris Dimitrios
Published: April 2024

Aim
COVID-19 pandemic caused by SARS-CoV-2 is spreading throughout the world affecting both healthy individuals and people with underlying immune-deficiencies. People living with human immunodeficiency virus (HIV) consist a group multiply affected by this universal crisis.
Methods
Literature search aiming to identify relevant publications referring to the consequences of the COVID-19 pandemic in
HIV infected population.
Results
A body of literature is rapidly growing in regard to epidemiological data, the interaction between HIV and SARS-CoV-2,
and clinical outcome in people living with HIV. Intensive research is warranted to identify any interactions of the co-existence of the two viruses in the immune system of HIV infected patients as common pathophysiology and molecular aspects are recognized. Human relations are diminished as a result of the social measures, and detailed recording of the consequences in this population is needed.
Conclusion
Further research could shed light on the common underlying molecular mechanisms of both conditions in an attempt to
discover treatment regimens for SARS-CoV-2 infection.
Recanalization rate of proximal deep venous thrombosis related to therapeutic modality during six months follow-up
Authors: Begić Alden , Begić Edin , Dilić Mirza , Loga - Zec Svjetlana , Babić Nermina , Gojak Refet , Šljivo Armin
Published: April 2024

Aim
To evaluate the efficacy (rate of recanalization) of therapy with novel oral anticoagulants (NOAC; rivaroxaban, apixaban)
compared to conventional treatment (low molecular weight heparin - LMWH and vitamin K antagonist) in the treatment of deep vein thrombosis (DVT) of the proximal segments of lower extremities.
Methods
The first group consisted of patients diagnosed with DVT and treated with NOAC (n = 100), while the second group consisted of patients diagnosed with DVT, who were treated by conventional treatment (low molecular weight heparin and vitamin K antagonists) (n = 100). In the first group, NOAC was included in the initial treatment. Patients in the second group were treated with LMWH for four days, and on the fifth day vitamin K antagonist was included in therapy, international ratio (INR) was titrated to therapeutic values (2.0-3.0), and then low molecular weight heparin was excluded from the therapy.
Results
There was a statistically significant difference in the estimated values of free lumen of the blood vessel between the examined groups after 30 days (p=0.0001), after 90 days (p=0.0001) and after 180 days (p=0.0001). After 180 days, the average free lumen values in the NOAC group were 85% (81-89%), which was significantly higher than the free lumen values in the second group, 73% (69-79%).
Conclusion
The use of NOAC represents more efficient treatment of DVT comparing to vitamin K antagonists.
The role of soluble urokinase plasminogen activator receptor (suPAR) in patients with cancer: a review of the current literature
Authors: Paraskevas Themistoklis , Mulita Francesk , Michailides Christos , Verras Georgios-Ioannis , Liolis Elias , Oikonomou Eleousa , Perdikaris Ioannis , Perdikaris Panagiotis , Bouchagier Konstantinos , Panagiotopoulos Ioannis , Kasartzian Dimitrios-Ioannis , Filis Dimitrios , Tchabashvili Levan , Spyropoulou Despoina , Velissaris Dimitrios
Published: April 2024

Aim
Several biomarkers are currently used as diagnostic and prognostic tools in patients with cancer. Soluble urokinase plasminogen activator receptor (suPAR) is elevated in acute and chronic inflammatory procedures and several observational studies during the last 20 years have investigated its role in oncology. The purpose of this article was to review the current literature regarding suPAR’s role in clinical practice.
Methods
A systematic literature search of PubMed, Scopus, OpenGrey and Cochrane Library databases through September
2021 was conducted using the following search terms: “supar” or “soluble urokinase plasminogen receptor” and “cancer” or “malignancy”. Original articles reporting on suPAR’s role in the diagnosis, prognosis and prediction of therapeutic outcomes in patients with confirmed or suspected cancer were included.
Results
Among 45 found articles, the most were observational cohort studies. The included studies were further categorized by
cancer site. SuPAR level was higher in patients with cancer compared to healthy controls, but its diagnostic and prognostic accuracy differs depending on the site of cancer.
Conclusion
SuPAR has promising aspects in the field of oncology and public health and future research should further investigate
its use in clinical practice. As it is elevated in different types of cancer, it could potentially serve as an adjunctive tool for the mass screening of patients with non-specific signs of cancer, but larger cohort studies that support these findings must be conducted.
TGF-1 biomarker level evaluation on fracture healing in a murine model with a bone defect after stromal vascular fraction application
Authors: Sananta Panji , Dradjat Respati S , Rosandi Rizqi Daniar , Siahaan Lasa Dhakka
Published: April 2024

Aim
Bone defect is a challenge even for experienced orthopaedic surgeons and it is a significant cause of morbidity in patients and a source of high economic burden in health care. A severe bone defect is a condition whereby the bone tissue cannot undergo natural healing despite surgical stabilization and requires further surgical intervention. Stromal vascular fraction (SVF) is a heterogeneous cell population derived from adipose tissue that results from minimal manipulation of the adipose tissue itself. TGF is essential in maintaining and expanding mesenchymal stem cells or progenitors of osteoblasts. Furthermore, TGF-β signalling also triggers osteoprogenitor cell proliferation, early differentiation, and maintenance of osteoblasts in the bone healing process. The aim of this study was to determine the effect of administering SVF on bone
defects’ healing process assessed based on the TGF- β1.
Methods
This was an animal study involving twelve Wistar strain Rattus norvegicus. They were divided into three groups: negative
group (normal rats), positive group (rats with bone defect without SVF application), and SVF group (rats with bone defect with SVF application). After 30 days, the rats were sacrificed, the TGF- β1 biomarker was evaluated (quantified using ELISA).
Results
TGF- β1 biomarker expressions were higher in the group with SVF application than in the group without SVF application. All comparisons of the SVF group and positive control group showed significant differences (p=0,000), respectively.
Conclusion
Giving SVF application could aid the healing process in a murine model with bone defect, marked by an increased level
of TGF- β1.
Ultrasound guided fine needle aspiration cytology (FNAC): an assessment of the diagnostic potential in histologically proven thyroid nodules
Authors: Krišto Branko , Vidović Krželj Ivana , Krželj Ana , Perković Roberta
Published: April 2024

Aim
Results of ultrasound guided fine needle aspiration cytology (FNAC) as the compatibility of cytological findings with histopathological diagnoses (the "gold standard") in the diagnosis of nodular thyroid lesions are inconsistent. The aim of this prospective study was to determine the validity of FNAC, as well as the compatibility of findings with histopathological diagnoses.
Methods
The study included 92 patients who underwent FNAC and later surgery and histopathological assessment with a final diagnosis.
Results
FNAC showed 95% specificity, 78% sensitivity and 90% accuracy. The compatibility of the cytological and histopathological findings was good (Kappa coefficient of 0.756; 95% CI). The cytology results proved to be very good at predicting malignant histopathological findings, (OR=72.33; p˂0.001). Also, the result of ROC analysis (AUC=0.866) confirmed FNAC as a very good method of distinguishing benign and malignant thyroid nodules.
Conclusion
The results confirmed the correctness of the algorithm in which, following clinical or ultrasound confirmation of nodular
thyroid lesions with suspicious changes, FNAC is indicated. The FNAC results should guide a clinician to further diagnostic and therapeutic procedures. Certainly, in case of suspected follicular/ Hurthle cell lesions one should be vigilant and aware of the fact that in these cases malignancy is defined by the invasion of blood vessels and/or the capsule, which FNAC is unable to detect. 
Interferon alpha and non-specific markers of inflammation in patients with systemic lupus erythematosus
Authors: Zečević Lamija , Begić Edin , Aziri Buena , Aganović - Mušinović Izeta
Published: April 2024

Aim
To determine the value of IFN (intzerferon)-α in the patients with systemic lupus erythematosus (SLE) and to correlate IFN-α
with values of non-specific biochemical parameters of inflammation (C-reactive protein, leukocytes values, erythrocyte sedimentation rate, albumins and globulins).
Methods
Research included 55 patients with SLE diagnosis and a control group consisted of 25 healthy subjects (during period
2019-2020). IFN (Interferon)-α and non-specific biochemical parameters of inflammation were obtained using standard protocols.
Results
IFN-α values were independent of gender (p=0.95). The difference in serum IFN-α values in relation with the age in the
SLE group was statistically significant (p=0.036). Only serum globulin was significantly higher (p=0.0023) in IFN-α positive compared to IFN-α negative SLE patients. A statistically significant correlation between the values of IFN-α and globulin was proved (r=0.315; p=0.019). No significant correlation was found between other non-specific biochemical parameters and IFN-α values.
Conclusion
Increased IFN-α values were observed in younger patients, and the correlation between IFN and globulin was proved.
Serum glucose, sodium and potassium concentrations in patients with diabetic ketoacidosis
Authors: Dragila Željka , Rudić Dora , Ćosić Klara , Bačun Tatjana
Published: April 2024

Aim
To investigate possible differences in serum glucose and sodium and potassium concentrations with respect to age, gender and severity of diabetic ketoacidosis.
Methods
Medical records from 1 January 2017 to 31 December 2019 were reviewed and patients with the diagnosis of diabetic
ketoacidosis were selected.
Results
The study included 52 patients. Glucose concentration was significantly higher in the age group of 25-44 and >65 years
compared to the group of 18-24 years (p=0.02). Sodium concentration was significantly higher in the age group 18-24 and >65 years compared to groups 25-44 and 45-65 years (p=0.002). Females had significantly higher sodium concentration than males (p=0.002). Potassium concentration was significantly higher in the age group 25-44 years compared to other groups (p=0.01). Males had significantly higher potassium concentration (p =0.01).
Conclusion
This study showed that significant differences exist in electrolyte concentration between specific age groups, male and
female gender as well as DKA severity. Knowing these differences could help clinicians to promptly recognize and treat electrolyte derangements, leading to better outcome of patients with DKA.
Bystanders’ cardiopulmonary resuscitation involvement in the treatment of out-of-hospital cardiac arrest events and educational status regarding basic life support measures and automated external defibrillator usage among residents in Canton Sarajevo, Bos
Authors: Zalihić Adem , Šljivo Armin , Ribić Emina , Gavranović Aida , Brigić Lejla
Published: April 2024

Aim
To investigate bystanders’ CPR involvement in out-of-hospital cardiac arrest (OHCA) events, their current knowledge regarding OHCA and BLS measures, their willingness to learn BLS measures with the usage of AEDs, as well as current practices.
Methods
This cross-sectional study included: data regarding all OHCA events treated at the Emergency Medical Service of Canton
Sarajevo between January 2015 and December 2019, and an online anonymous questionnaire that examined knowledge, attitudes and practices regarding basic life support (BLS) and automated external defibrillators (AEDs).
Results
A total of 328 (24.0 %) of 1362 OHCA events achieved the return of spontaneous circulation (ROSC). OHCA incidence was 62/100.000 inhabitants per year. Male gender (p=0.043) and younger age (p<0.001) were significantly associated with obtaining ROSC. Only 44 (3.2%) OHCA events were assisted by bystanders, who were mostly medical professionals 38 (86.4%), followed by close family members 6 (13.6%). There was no report of AED usage. BLS and AED knowledge test score was in the range 12.0-89.8% with generally poor knowledge. Our residents agreed that BLS measurements are essential, 1604 (86.7 %) and that BLS should be a part of their curriculum, 1678 (90.7 %).
Conclusion
The prevalence of OHCA events in Bosnia and Herzegovina is similar to the region; ROSC among OHCA events was
lower than European average, but among highest in the region. There was an extremely low rate of bystander engagement and no AEDs usage. Governmental institutions and health agencies should intervene to increase population knowledge thus increasing OHCA survival rate.
Correlation between severity of knee osteoarthritis with gender of patients in Secondary Referral Hospital in Indonesia
Authors: Sananta Panji , Rahmanda Avicenna , Widasmara Dhelya , Fuzianingsih Eka Noviya
Published: April 2024

Aim
Knee osteoarthritis is a common osteoarthritis, which limits individual’s activity and affects aspects of daily life and quality of life. The prevalence of osteoarthritis in Indonesians is still high, reaching 12.7% in women and 15.8% in men. Based on the WHO, the prevalence of osteoarthritis in the world is still high, with 18% in women and 80% in men. This study aimed to determine the relationship between gender and the severity of knee osteoarthritis at Baptis Hospital, Batu City.
Methods
This cross-sectional study involved 27 female patients and 10 male patients who suffer from knee osteoarthritis at Baptis
Hospital, Batu City. Data on gender and the severity of osteoarthritis were collected from medical records. The severity of knee osteoarthritis was assessed using the Kellgren-Lawrence system.
Results
Among 27 female (73%) and 10 male patients (27%), seven patients suffered from osteoarthritis grade 1, 13 from osteoarthritis grade 2, 16 from osteoarthritis grade 3, and one patient suffered from osteoarthritis grade 4. There was no significant relationship (p>0.05) between the severity of knee osteoarthritis and patients gender.
Conclusion
There was no significant relationship between the severity of knee osteoarthritis between males and females.
Risk factors in the development of postoperative complications after reconstructive surgery on the thoracic aorta
Authors: Krdžalić Alisa , Tabaković Mustafa , Iveljić Ivana , Tahto Ema , Krdžalić Goran
Published: April 2024

Aim
To determine risk factors responsible for developing postoperative complications after the thoracic aorta reconstructive surgery.
Methods
Medical records of 100 patients, who had undergone elective or emergency thoracic aorta reconstructive surgery at the
Clinic for Cardiovascular Surgery, University Clinical Center Tuzla, were analysed. Intraoperative data as cross-clamp time (CCT), duration of cardiopulmonary bypass (CPBT) and hypothermic circulatory arrest time (HCAT) were evaluated. Univariate analysis was used to show risk factors for developing postoperative cardiac, respiratory, surgical and renal complications.
Results
Between May 2019 and April 2021, 48 Bentall procedures (BP), 23 ascending aortic replacements (AAR), 20 BP and coronary artery bypass grafting (CABG) and 9 aortic valve replacements (AVR) with AAR were performed. Incidence of postoperative complications in the elective and emergency groups was as follows: respiratory 20% vs 38% (p=0.049), cardiac 18% vs 70% (p=0.015), renal 16% vs 48% (p=0.027) and surgical 4% vs 6% (p>0.05). Intrahospital 30 days morbidity was 44% with mortality rate of 13%. The results showed that CPBT>180 minutes was a risk factor for respiratory (p=0.034), cardiac (p=0.020) and renal (p=0.027) postoperative complications after acute type A aortic
dissection surgery.
Conclusion
CPBT > 180 min is a risk factor for postoperative development of respiratory, cardiac and renal complications. Postoperative cardiac and renal complications were associated with longer HCAT.