bluuebunny/crossref_metadata_2025 huggingface dataset:
Parameters in predicting the risk of a prolonged hospital stay in patients with acute exacerbation of chronic obstructive pulmonary disease: a single-centre experience
Authors: Mujaković Aida , Paralija Belma , Prnjavorac Besim , Lepara Orhan , Fajkić Almir , Begić Edin , Kurtović Avdo , Čizmić Midhat , Odobašić Mirad
Published: April 2024

Aim
To identify clinical and laboratory parameters on admission and/or during a hospital stay that would predict prolonged hospital stay in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
Methods
A retrospective cross-sectional study was conducted at the Clinic for Pulmonary Diseases and Tuberculosis, Clinical Centre University of Sarajevo for the period 2019-2021 accounting patients admitted due to AECOPD. The need for hospitalization was evaluated according to the current GOLD criteria and certain clinical parameters. Spirometry testing and laboratory analysis were performed for all patients on the day of admission and on the 10th day of hospital stay. Linear regression was used to show the relationship between multiple independent predictor variables
and LOS.
Results
A total of 50 patients were evaluated during their hospital stay due to AECOPD. Median of LOS was 22.02±1.06, with 90%
hospital survival rate. Due to AECOPD the median of LOS in the intensive care unit (ICU) was 4±0.68 days with pH<7.35 in 34% of hospitalized patients. According to spirometry classification on the day of admission, 56% of patients were assigned to group 3 and 16% to group 4 with significant improvement identified on spirometry findings on discharge. Platelets on the day of admission were the only statistically significant positive predictors of the length of hospital stay.
Conclusion
Identifying chronic obstructive pulmonary disease patients at risk of frequent exacerbations and appropriate disease
management could reduce the disease burden.
Risk of anterior cruciate ligament injury in population with elevated body mass index
Authors: Alsayed Hasan N. , Alkhateeb Mohammed Abdulrahman , Aldossary Asma Abdulaziz , Houbani Khalid Mohsen , Aljamaan Yousef Mohammed , Alrashidi Yousef A.
Published: April 2024

Aim
Anterior cruciate ligament (ACL) injury is among the most common orthopaedic injuries. The elevated body mass index
(BMI) can contribute to non-contact ACL injury. This study aims to assess the risk of ACL injury among elevated BMI population people (BMI ≥25 Kg\m2).
Methods
This is a cross sectional study that was conducted in a tertiary care centre in the Kingdom of Saudi Arabia. A total of 302
patients, who had an ACL reconstruction surgery in a ten-year-period (January 2008 to December 2018) were included.
Results
 Sport related injury is significantly higher among the overweight and obese groups (p=0.002). Moreover, the combined ACL tear was higher among the overweight and obese groups (p=0.001). In univariate regression analysis for the selected baseline characteristics, it was found that individuals with higher BMI have chance to develop combined (ACL) injury 2
times higher when compared to those with isolated ACL injury (p=0.003). Also, the ACL type, mode of injury, types of injury
and type of sports were statistically significant in univariate regression analysis. However, only the mode of injury was statistically significant after controlling the confounding factors. Other selected variables like type of sport, type of injury and
ACL type were not significant.
Conclusion
Elevated BMI was associated with a higher risk of developing combined ACL tear as well as reinjured individuals.
Correlation between clinical outcomes and patients’ satisfaction using tarsoconjunctival - Hughes flap for the reconstruction of eyelid defects
Authors: Jovanović Nina , Reisz-Majić Patricia , Mehic-Fazlić Sunita , Terzić Selma , Alajbegović Halimić Jasmina , Dizdarević Admira
Published: April 2024

Aim
To examine and quantify patients’ satisfaction and correlate with the objective clinical presentation after the treatment and to present a comprehensive literature review on tarsoconjunctival/ Hughes flap technique.
Methods
A review of more than 159 peer-review articles and a combined retrospective-prospective two-centres case series of 17
patients who underwent a two-stage modified Hughes flap procedure (2019-2021) to repair a lower eyelid defect caused by epithelial cancer was conducted. All patients were followed up for a minimum of six months. Patient macroscopic evaluation of redness, lid position, retraction, trichiasis, conjunctival overgrowth, tissue inflammation/infection and hypertrophic scarring were obtained, and findings were graded on a scale of 1 to 5 or binary YES/NO scale. Patients’ satisfaction using a Likert-type scale and correlation with the clinical presentation were analysed.
Results
Pearson correlation coefficient between patients’ satisfaction and clinical presentation was 0.534. Out of 510 (the highest
summed score for patients’ satisfaction), the total score was 479 (93.9%); out of 187 (the highest summed score for clinical presentation), the total score was 162 (86.6%). Although both scores were high, a lower correlation coefficient and the higher satisfaction score can be explained by more realistic expectations in oncological patients compared to cosmetic ones.
Conclusion
Hughes flaps provide multiple benefits in the reconstruction of selected patients with large defects, especially when
poor wound healing is expected, or when local advancement flaps do not provide tension-free reconstruction. The rate of complications is low and manageable, whereas additional therapy is usually observational or symptomatic. 
Correlation of the inclination of the tentorium cerebellum and the volume of the posterior cranial fossa
Authors: Direković Redžib , Bečulić Hakija , Krivokuća Zdenka
Published: April 2024

Aim
To investigate the influence of the inclination and insertion of the cerebellar tentorium on the posterior cranial fossa (PCF)
volume.
Methods
A retrospective, non-randomized study including 174 patients (117 females and 57 males) who underwent magnetic resonance imaging in the period from 31 December 2020 to 1 June 2021 under the indication (mostly headache) set by a competent ordinary. Acute or chronic intracranial events were not verified in the patients.
Results
The average value of the PCF volume was 138.93 cm3 and the slope of the tentorium was 44.15°. Comparing the volume of
the PCF and the slope of the tentorium in males and females no significant difference was found. A correlation was found in the females age groups 18-24 and 45-54 years.
Conclusion
Understanding dimensions of the posterior cranial fossa morphometry has clear implications for reducing morbidity
and mortality in surgery, especially in the case of applying lateral approaches and their variations.
Magnetic resonance morphometry of the lumbar spinal canal in Zenica - Doboj Canton in Bosnia and Herzegovina
Authors: Jaganjac Belma , Džidić-Krivić Amina , Bečulić Hakija , Šljivo Armin , Begagić Emir , Šišić Adis
Published: April 2024

Aim
To investigate morphometric determinants of lumbar canal in patients treated in Cantonal Hospital Zenica, and their variation
according to gender.
Methods
Morphometry of lumbar spinal canal was assessed in 52 patients treated at the Department of Neurosurgery of Cantonal
Hospital Zenica in the period between September 2022 and November 2022. Data were collected retrospectively: anteroposterior and transverse diameter of lumbar vertebrae and intervertebral discs, as well as anteroposterior diameter of the spinal canal.
Results
Gender appeared to be an important morphometric determinant, since it significantly differed when it comes to lumbar vertebral anteroposterior and transverse diameter, being mostly larger in males.
Conclusion
This study increases anatomical knowledge of the vertebras and spinal canal of the lumbar region. Therefore, the measured dimensions of the lumbar vertebrae and spinal canal could be used as a baseline point for evaluation of patients presenting
with low back pain and potential spinal canal stenosis. 
Lung cancer screening in the healthcare system of Bosnia and Herzegovina
Authors: Gavran Larisa , Fatahi Gina , Račić Maja
Published: April 2024

Lung cancer incidence in Bosnia and Hercegovina is high. The implementation of evidence-based lung cancer screening based on low-dose computed tomography (LDCT) may detect lung cancer early and decrease mortality specific to lung cancer. However, LDCT receipt may be unsatisfactory in Europe due to a low distribution of scanners and radiologists or poor access to care. In this paper, we propose a framework for the implementation of lung cancer screening in primary healthcare of Bosnia and Herzegovina based on the United States Preventative Services Task Force recommendation from 2021 and the American College of Radiology Lung CT Screening Reporting & Data System from 2022. 
The most common indications for measuring metanephrine and normetanephrine in plasma – a rational approach
Authors: Marušić Romana , Dragila Željka , Levaković Adriana , Lekić Ivan , Mihaljević Dubravka , Debeljak Željko , Bačun Tatjana
Published: April 2024

Aim
To determine the most common indications for measuring metanephrine and normetanephrine in plasma by gender and age and to compare the concentrations of metanephrine and normetanephrine by indication, gender and age.
Methods
The study was conducted on 224 patients whose plasma metanephrine and normetanephrine concentrations were measured at the Clinical Institute for Laboratory Diagnostics at the University Hospital Centre Osijek for one year, until 1st January 2020.
Results
The most frequent indications for biochemical testing were adrenal incidentaloma, 138 (6.6 %), and symptoms of pheochromocytoma, 41 (18.3%). Metanephrine concentration was lower in females (p=0.009). No significant correlation was found between age and metanephrine concentration, while age and normetanephrine concentration were positively correlated (p=0.01). Of the 224 patients, only one patient was diagnosed with pheochromocytoma, whose indication for measurement of metanephrine and normetanephrine was adrenal incidentaloma.
Conclusion
Adrenal incidentalomas and symptoms suggestive of pheochromocytoma are very common in the general population, while the incidence of pheochromocytoma is extremely low. Clear guidelines for the referral of patients for biochemical testing are needed to avoid unnecessary costs and to identify the correct diagnosis promptly
Helicobacter pylori resistance to clarithromycin and quinolones in patients with dyspepsia in Tuzla Canton, Bosnia and Herzegovina
Authors: Hasukić Ismar , Salkić Nermin , Tihić Nijaz , Alibegović Ervin , Hasukić Šefik , Jahić Alan
Published: April 2024

Aim
To evaluate Helicobacter pylori (H. pylori) resistance to clarithromycin and quinolones in patients with dyspepsia in Tuzla
Canton, Bosnia and Herzegovina, a region with no data on clarithromycin or quinolones resistance.
Methods
A prospective cross-sectional study was conducted at the Department of Gastroenterology and Hepatology at University
Clinical Centre Tuzla between January 2021 and June 2022. The study included 99 patients who underwent esophagogastroduodenoscopy (EGDS) due to dyspepsia. In all patients biopsies were taken for rapid urease test (RUT) and histology findings, concomitantly with blood samples for IgG serology. All RUT positive patient samples were tested for clarithromycin and quinolones susceptibility with GenoType HelicoDr, a PCR method which detects point mutations in 23S rRNA and mutations in the gyrA gene.
Results
Out of 99 dyspeptic patients, 67 (67.7%) were serologically positive to H. pylori, 46 (46.4.%) were RUT positive, and
19 (19.2 %) had a positive histology finding. Antibiotic (AB) resistance was tested in the total of 46/99 (46.4%) patients. Resistance to clarithromycin was detected in 28.26% (13/46), quinolones resistance in 36.96% (17/46) , and resistance to both AB was detected in 8.69% (4/46) tested biopsies.
Conclusions
Due to high clarithromycin and quinolones resistance rates, we recommend the use of bismuth quadruple or non-bismuth concomitant quadruple therapy for H. pylori eradication in Tuzla Canton, Bosnia and Herzegovina.
Renal function in patients with chronic hepatitis B during antiviral therapy
Authors: Čustović Nerma , Alić Lejla , Rašić Ismar , Saray Aida , Mehmedović Amila , Zubčević Nadža
Published: April 2024

Aim
To analyse the impact of the length of antiviral therapy with tenofovir disoproxil fumarate (TDF) on the renal function in patients with chronic hepatitis B (CHB).
Methods
 A cross-sectional study included 75 patients with CHB treated with tenofovir, who had a normal renal function at the beginning of the treatment. Renal function was determined based on glomerular filtration rate (eGFR) value using the Modification of Diet in Renal Disease formula (MDRD). Measurement of serum creatinine concentration and urinary protein excretion were performed using standard laboratory analyses. Viral load quantification (HBV-DNA) was determined by polymerase chain reaction (PCR). The degree of liver fibrosis was determined using fibrosis4 (FIB-4) and aspartate transaminase to platelet ratio index (APRI) fibrosis score.
Results
Out of 75 CHB patients, 37 were on antiviral treatment for up to 2 years (group 1) and 38 patients on antiviral treatment
longer than two years (group 2). Mean age of patients was not significantly different between the groups (p=0.076), nor was the gender distribution. There was no statistically significant difference between the mean values of the eGFR in the two groups (91.89±9.24 vs. 88.42±7.84 mL/min/1.73m2 ; p=0.42), as well as between the mean values of serum creatinine (p=0.360) and 24-hour urine protein excretion (p=0.380). There was no statistically significant correlation between renal parameters and viral load, APRI and FIB-4 fibrosis score.
Conclusion
Results of our study did not show significant changes in the measured parameters of renal function in group 1 and group
2 of patients, regardless of the length of antiviral treatment, indicating a good renal safety profile of TDF.
Prevalence of epidermal growth factor receptor (EGFR) mutations and correlation with histological patterns in lung adenocarcinoma in patients from Bosnia and Herzegovina
Authors: Udovičić-Gagula Dalma , Džananović Nejra , Dorić Mirsad
Published: April 2024

Aim
Lung adenocarcinoma (ADC) is a leading subtype of lung cancer, histologically defined with five different architectural
growth patterns: lepidic, acinar, papillary, solid and micropapillary. The aim of this study was to explore the prevalence of epidermal growth factor receptor (EGFR) mutation and a relationship between the specific histological patterns of lung ADC in the population of Bosnia and Herzegovina.
Methods
The study included tumour tissue from 102 patients with completely resected lung ADC from 2015 to 2020. Molecular testing for the presence of EGFR mutations was performed by real-time PCR method. The relationship between EGFR mutation status and clinicopathological parameters was analysed.
Results
The EGFR mutation was detected in 12 (11.8%) cases of ADC, more often in non-smokers (p=0.007). A higher percentage
of solid growth pattern presented in ADC may be an indicator of EGFR negativity (p=0.039), while a higher percentage of micropapillary growth pattern more common in the presence of EGFR mutation (p=0.047).
Conclusion
The prevalence of EGFR mutation is in accordance with the expected prevalence considering our studied population,
Caucasians from South Europe. Better understanding of the relationship between histological patterns and molecular characteristics of lung ADC will enable earlier diagnosis and optimal treatment for patients.
Percutaneous elastic-dynamic fixation for the treatment of volar displaced distal radius fractures. A solution for elderly patients?
Authors: Rocchi Lorenzo , De Vitis Rocco , Merendi Gianfranco , Fulchignoni Camillo , Pietramala Silvia , Taccardo Giuseppe
Published: April 2024

Aim
The Epibloc elastic-dynamic fixation has been applied for many years at several hand surgery centres in Italy. This technique has been considered safe and reliable in the treatment of distal meta-epiphyseal fractures of the radius with dorsal displacement. The aim of this study was to evaluate an alternative use of this method in the treatment of volar displaced wrist fractures in cases where an internal fixation could not be recommended.
Methods
The procedure consisted of two flexible pins with a trocar tip and an external plate for locking fixation with compression.
The surgical technique was derived from the original procedure, modifying the placement of the pins and performing small surgical accesses to preserve the neuro-vascular structures of the volar aspect of the wrist. To achieve and preserve the reduction of the volar fragment, a third pin was inserted into the fracture with a similar procedure to Kapandji's reduction technique.
Results
At three-month follow-up, most patients did not experience any pain. In 14 cases, the strength grip was recovered between 75% and 90%, compared to the contralateral hand (Jamar test). In 15 patients, the wrist range of motion was restored with values greater than 100. In 17 cases, forearm pronation-supination was restored to more than 120°.
Conclusion
In cases of non-comminuted, one or two fragments volar displaced wrist fractures, the elastic-dynamic fixation associated with an intrafocal pinning reduction may be proposed as an alternative to open reduction and internal fixation in elderly
patients.
Platelet rich plasma (PRP) in the surgical treatment of Haglund’s syndrome: the use of PRP membranes as an intra-operative local adjuvant
Authors: Restuccia Giuseppe , Varchetta Giorgio , Lippi Alessandro , Dolfi Lorenzo , Bizzocchi Federico , Giovannetti Stefano , Ipponi Edoardo
Published: April 2024

Aim
Haglund's syndrome may be responsible for chronic pain in the ankle and hindfoot. Although numerous therapeutic approaches have been described in the literature, to this date no consensus over a surgical treatment has been established. We report our experience in the treatment of Haglund's syndrome and pre-insertional calcifications of the Achilles tendon using an open surgical approach and platelet rich plasma (PRP) membranes as a local adjuvant.
Methods
The study retrospectively evaluated patients with Haglund syndrome treated with a direct posterior access, Achilles
tendon split, bursectomy, resection of the heel deformity and topical administration of PRP membranes. After surgery, a standardized rehabilitation protocol was performed. The preoperative and postoperative functionalities of the foot and ankle were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score. Intraoperative and postoperative complications were recorded.
Results
Twenty consecutive patients were included. The mean follow-up was 23 months. No patient had major intraoperative or
postoperative complications. After the surgery, the mean AOFAS score increased from 44.1 to 92.0, resulting in a statistically significant increase in patient functionality after the treatment (p=0.001).
Conclusion
Our results suggest that an open surgical approach consisting of a combination of bursectomy, resection of the calcaneal deformity, and topical administration of PRP membranes may be effective for the treatment of Haglund's disease.
An impact of treatment initiation timing on stroke outcome: bridging the time gap
Authors: Nikatov Kuanysh , Dyussembekov Ermek , Kastey Rauan , Zhukov Yevgeniy , Yerniyazov Niyazbek , Korabayev Mukhtar , Akhanov Gani , Saliev Timur , Fakhradiyev Ildar
Published: April 2024

Aim
Stroke treatment is a time-critical condition. Understanding the impact of timing and types of treatment on patient outcomes can help develop and optimize stroke management strategies. The study aimed to analyse the effect of different time intervals and mechanical thrombectomy methods on outcomes of stroke patients in Kazakhstan.
Methods
The patient data, including demographic information, clinical characteristics, and specific time intervals from stroke onset to hospital admission, stroke onset to surgery initiation, and hospital admission to surgery initiation were collected. A total
of 100 patients were analysed. Patients’ neurological status was evaluated using the National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), and Glasgow Coma Scale (GCS) before and after the surgical treatment.
Results
Most patients had concomitant arterial hypertension, and almost 25 % had diabetes mellitus. The average time from stroke onset to hospital admission was 123.2±7.6 minutes, and from hospital admission to surgery initiation, it was 134.7±13.1 minutes. A shorter duration from the onset of stroke to hospitalization and surgery was associated with better clinical outcomes. Our results demonstrated a statistically significant decrease in NIHSS, mRS after surgical treatment compared to baseline. The association between the extended time from stroke onset to hospitalization and
reduced survival rates was observed.
Conclusion
Our findings indicate the essential role of timely intervention in managing stroke patients, as well as the need for a
comprehensive and patient-centred approach to stroke care. 
ChatGPT's contributions to the evolution of neurosurgical practice and education: a systematic review of benefits, concerns and limitations
Authors: Bečulić Hakija , Begagić Emir , Skomorac Rasim , Mašović Anes , Selimović Edin , Pojskić Mirza
Published: April 2024

Aim
This study provides a comprehensive review of the current literature on the use of ChatGPT, a generative Artificial Intelligence (AI) tool, in neurosurgery. The study examines potential benefits and limitations of ChatGPT in neurosurgical practice and education.
Methods
The study involved a systematic review of the current literature on the use of AI in neurosurgery, with a focus on
ChatGPT. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to ensure a comprehensive and transparent review process. Thirteen studies met the inclusion criteria and were included in the final analysis. The data extracted from the included studies were analysed and synthesized to provide an overview of the current state of research on the use of ChatGPT in neurosurgery.
Results
The ChatGPT showed a potential to complement and enhance neurosurgical practice. However, there are risks and limitations associated with its use, including question format limitations, validation challenges, and algorithmic bias. The study highlights the importance of validating machine-generated content for accuracy and addressing ethical concerns associated with AI technologies. The study also identifies potential benefits of ChatGPT, such as providing personalized treatment plans, supporting surgical planning and navigation, and enhancing large data processing efficiency and accuracy.
Conclusion
The integration of AI technologies into neurosurgery should be approached with caution and careful consideration of
ethical and validation issues. Continued research and development of AI tools in neurosurgery can help us further understand their potential benefits and limitations. 
Single-centre experience with the treatment of high-prevalence metabolic syndrome in kidney transplant patients in Bosnia and Herzegovina
Authors: Dugonjić-Taletović Maida , Tulumović Denijal , Alečković-Halilović Mirna , Pjanić Mirha , Hajder Mithad , Halilčević-Terzić Alma , Lončar Danijela , Jašarević Amila
Published: April 2024

Aim
To analyse prevalence of metabolic syndrome (MS) in kidney transplant recipients at the University Clinical Centre Tuzla in
Bosnia and Herzegovina (B&H), and determine effects of a modern drug therapy in achieving target metabolic control in kidney transplant patients.
Methods
A single-centre prospective study that included 142 kidney transplant patients over one year follow-up period was conducted. Patient data were collected during post-transplant periodical controls every 3 months including data from medical records, clinical examinations and laboratory analyses.
Results
Out of 142 kidney transplant patients, MS was verified in 85 (59.86%); after a pharmacologic treatment MS frequency was
decreased to 75 (52.81%). After a one-year period during which patients were receiving therapy for MS, a decrease in the number of patients with hyperlipoproteinemia, decrease in average body mass index (BMI), glycemia and haemoglobin A1C (HbA1C) were observed. Hypertension did not improve during this period, which can be explained by transplant risk factors in the form of immunosuppressive drugs and chronic graft dysfunction.
Conclusion
A significant reduction in components of the metabolic syndrome after only one year of treatment was recorded, which
should be the standard care of kidney transplant patients.
Significance of parathyroid scintigraphy and correlation of findings with parathyroid hormone values in patients undergoing hemodialysis
Authors: Ahmetbegović Nermana , Suljagić Nadira , Katica Vahidin
Published: April 2024

Aim
 To compare finding of thyroid gland scintigraphy with serum concentration of parathyroid hormone in patients undergoing hemodialysis.
Methods
This retrospective-prospective study included 50 patients undergoing hemodialysis with established hyperparathyroidism who were treated at Cantonal Hospital Zenica in the period 2009-2014. Besides anthropological data, concentration of parathyroid hormone in serum of patients was monitored too. Scintigraphy was performed at the Department of Nuclear Medicine using two-headed gamma camera Prism 2000xp.
Results
 Of the total number of 50 patients, 24 (48%) were males and 26 (52%) were females. The average age was 49.34±11.82 years. A total of 17 (34%) patients had normal findings of scintigraphy, 11 (22%) had mildly pronounced uptake of radiopharmaceuticals (score of 1), 14 (28%) had moderately pronounced uptake (score of 2), and eight (16%) had intensive uptake of radiopharmaceuticals (score of 3). A statistically significant difference was established in the length of hemodialysis treatment and scintigraphy finding (p=0.041).
Conclusion
 Scintigraphy of parathyroid glands in patients undergoing hemodialysis allows us to select them for parathyroidectomy. Scintigraphy of parathyroid glands and a value of parathormone in serum should be incorporated into the test algorithm for patients with secondary hyperparathyroidism caused by chronic kidney disease.
Socioeconomic and demographic factors associated with abdominal obesity in women of childbearing age
Authors: Kurspahić-Mujčić Amira , Zećo Emir
Published: April 2024

Aim
To determine socioeconomic and demographic factors associated with abdominal obesity in women of childbearing age. Methods
This cross-sectional study was carried out in family medicine outpatient departments of the Primary Health Care Centre of Canton Sarajevo, Bosnia and Herzegovina. The study included 300 respondents who were divided into two groups: non-abdominal obesity (n=150) and abdominal obesity (n=150). Abdominal obesity was estimated measuring waist circumference. Data concerning socioeconomic and demographic factors (age, marital status, "live alone", place of residence, formal education level, self-perceived financial status) were collected using a designed questionnaire. Logistic regression analysis was used to estimate the association between socioeconomic, demographic factors and abdominal obesity.
Results
 Abdominal obesity was significantly associated with the life in the urban area (OR=2.174, 95%CI=1.362-3.471), university education (OR=9.881, 95%CI=3.222-30.301) and slightly better financial status than average (OR=2.412, 95%CI=1.302-4.470). Marital status (OR=0.190, 95%CI=0.104-0.347) and no living alone (OR=0.357, 95%CI=0.165-0.773) protect from abdominal obesity. Respondents aged between 20-29 years represent a particularly vulnerable group in terms of abdominal obesity (OR=1.030, 95%CI=0.097-10.946).
Conclusion
The strongest associations have been found between abdominal obesity and education. Public health programs that aim to reduce abdominal obesity in women of childbearing age should mainly focus on women with university education.
Is post-treatment standardized uptake value a prognostic factor in unresectable non-small cell lung carcinoma?
Authors: Yılmaz Ufuk , Zehra Yasar , Korkmaz Esra , Yalcın Burcu , Koparal Hakan , Ozbilek Engin
Published: April 2024

Aim
 Concurrent chemoradiotherapy (CRT) is the standard of care for locally advanced, unresectable non-small cell lung carcinoma (NSCLC). The aim of this study was to assess the prognostic value of maximum standardized uptake values (SUV max) in patients with unresectable stage III NSCLC treated with concurrent CRT.
Method
 18 F-FDG PET-CT scans were obtained before and after treatment in patients with unresectable stage III NSCLC treated with concurrent CRT. To determine the prognostic value of SU-V max of the primary tumor (PT), univariate and multivariate Cox regression model were carried out.
Results
Between January 2008 and December 2013, this study included 43 patients (median age 56 years, 95% male). Univariate analysis showed that having a high post-treatment PT-SU-V max was associated with a higher risk of death and having a high post-treatment PT-SUV max with a higher risk of disease recurrence. Multivariate analysis showed that having a low post-treatment PT-SUV max (cut off 3.9) was associated with longer overall and progression free survival (HR 8.55, 95% CI; 2.56-28.55, p=0.000 and HR 2.854, 95% CI; 1.43-5.67, p=0.003, respectively).
Conclusion
Post-treatment PT-SUV max may be an independent prognostic factor in patients with unresectable stage III NSCLC treated with concurrent chemoradiotherapy.
Cytotoxic and genotoxic studies of essential oil from Rosa damascene Mill., Kashan, Iran
Authors: Shokrzadeh Mohammad , Habibi Emran , Modanloo Mona
Published: April 2024

Aim
 Rosa damascene Mill. belongs to the family of Roseaceae and its essential oil is produced in large amounts in Iran. The wide application of rose oil has raised questions about potential adverse health effects. We have investigated cytotoxic activity and genotoxic effects of Rosa oil from Kashan, Iran.
Methods
 The cytotoxic effect and IC50 of the essential oil on the cell lines was studied followed by MTT assay. In this assay mitochondrial oxidoreductase enzymes with reducing the tetrazolium dye MTT (3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) reflect the number of viable cells. Genotoxic effect of the oil was evaluated by micronucleus assay by evaluating produced micronuclei due to cytogenetic damage in binucleated lymphocytes.
Results
 The results showed that essential oil significantly had cytotoxic and genotoxic effects at doses over 10µg/mL (p<0.05). Also, essential oil of Rose showed lower IC50 in cancer cell line (A549) in comparison with the normal cell line (NIH3T3). Conclusion
 Cytotoxic and genotoxic properties of essential oil of Rose in Kashan, Iran, are safe at a dose of 10µg/mL. Also, a good cytotoxic effect was shown and could be introduced as an anticancer compound. Further studies are needed with regard to anti-cancer effects of Rose essential oil.
Warfarin should not be used for thromboprohylaxis in elective major orthopaedic surgery: a Croatian perspective
Authors: Kolundžić Robert , Šimić Jovičić Marijana , Ðinkić Maja , Petrović Tadija , Crnković Tomislav , Trkulja Vladimir
Published: April 2024

Aim
 To identify modes of venous thromboembolism (VTE) prophylaxis in patients undergoing elective major orthopaedic surgery (total hip or knee arthroplasty, THA/TKA) at a single university-associated hospital in Croatia.
Methods
 A retrospective analysis of consecutive patients subjected to THA or TKA over a two-year period (2014-2015) with a focus on anticoagulation during the first 15 post-surgical days (period of highest VTE risk).
Results
 Of 603 identified patients three (0.5%) were not anticoagulated (haemophilia) and others received perioperative doses of low molecular weight heparins (LMWH). Overall, 228 (37.8%) patients received prophylaxis not involving warfarin, and 372 continued with short-term LMWH with switching to warfarin. They contributed a total of 1218 international normalized ratio (INR) values (median=3, range=1-8). These were consistently below the target INR range across the observed period. Between post-surgical days 6 and 15 (after the initial titration), 438 values were taken in patients treated with LMWH+warfarin and 92.7% were below, and only 6.8% within the target range; 580 values were taken in patients already switched to warfarin, 74% were below and only 25% within the range.
Conclusion
 The prevailing mode of VTE prophylaxis was in a clear contrast to (then) actual professional guidelines, with inadequate monitoring and poor anticoagulation. There is no reason to expect a substantially different situation at other institutions across the country. The prevailing practice of VTE prophylaxis in major orthopaedic surgery in Croatia should be promptly abandoned and updated in agreement with the current state of the art.
Croatian rotatory oblique three-dimensional osteotomy (CROTO) – a modified Wilson’s osteotomy for adult hallux valgus intended to prevent dorsal displacement of the distal fragment and to reduce shortening of the first metatarsal bone
Authors: Kolundžić Robert , Mađarević Mladen , Trkulja Vladimir , Crnković Tomislav , Šmigovec Igor , Matek Daniel
Published: April 2024

Aim
To evaluate biomechanical and clinical outcomes of a newly developed modification of the Wilson's osteotomy for hallux valgus: a three-dimensional subcaptial correction of the metatarsal head position with a simultaneous lateral and plantar shift with derotation intended to reduce displacement of the distal fragment and shortening of the first metatarsal bone.
Methods
 Thirty four feet (28 female patients) underwent the new procedure and were evaluated before and 12 to 84 months (medi-an=25.5) after the surgery.
Results
 Plantar shift of the distal fragment was achieved in all feet. Shortening of the first metatarsal was moderate: ≤6 mm in 32/34 feet, 7 and 10 mm in the remaining two. Median difference in metatarsal index post-vs. pretreatment was-4.0. The hallux valgus angle, intermetatarsal and distal metatarsal articular angles were reduced in all feet. The American Orthopaedic Foot and Ankle Society score improved in all feet (median increase= 51.5).
Conclusion
 The method allows for a lateral and plantar shift with derotation of the distal fragment and a mild/moderate shortening of the first metatarsal bone.
Efficacy of carbocisteine in the treatment of chronic obstructive pulmonary disease and impact on the quality of life
Authors: Alibašić Esad , Skopljak Amira , Čengić Aida , Krstović Gorana , Trifunović Nataša , Čatić Tarik , Kapo Belma , Mehić Meliha , Hadžimuratović Amila
Published: April 2024

Aim
 To investigate the effects of carbocisteine treatment in the reduction of frequency of productive cough episodes, preventing disease progression and improving the quality of life as well as the tolerability of the administered treatment and patient compliance during the study.
Methods
 This observational, non-interventional, multicenter, cohort study included 501 patients with chronic obstructive pulmonary disease (COPD) who were administrated carbocisteine capsules 375 mg and followed up during the next 15 days. The patients were observed at 3 points, baseline and two additional assessments. General clinical condition of patients, along with the spirometry testing at all three points were examined. Thr quality of life was assessed on the 1st and 3rd observation with Leicester Cough Questionnaire. Tolerability and patient compliance were measured throughout the study.
Results
 There was a significant change of forced expiratory volume in 1 second (FEV1) status between the second and third observation (p=0.002). Examination of general symptoms showed a statistically significant reduction in cough by 74.9%, in sputum production by 48.5%, in dyspnea by 29% and in fatigue by 50%. After the administration of carbocisteine the median value of overall quality of life was 3.79 (3.63-3.89).
Conclusion
375mg carbocisteine capsules were found to be effective and well-tolerated in the treatment of COPD, with a small percentage of reported mild adverse reactions and with a significant improvement of quality of life.
The effect of functional insulin therapy on glycaemic parameters in children with diabetes mellitus type 1
Authors: Štimjanin-Koldžo Diana , Alajbegović Salem , Štimjanin Ena , Mehinagić Jasmina
Published: April 2024

Aim
 The aim of the study is to evaluate the effect of a prospectively conducted interactive 5-day education programme based on Düsseldorf model on glycated haemoglobin (A1C), and total daily dose of insulin in type 1 diabetes patients.
Methods
A total of 67 type 1 diabetes patients was analysed; mean age of 11±0.68 years, 43 females and 24 males. The programme was led by a trained team of diabetes specialist doctors and nurses. All subjects and their parents completed a knowledge test about diabetes at beginning, and at the end of education, and after 12 months (30 questions). Subjects were evaluated for total daily insulin, and HbA1c at baseline, as well as 3, 6, 9 and 12 months after the end of the education programme. Results
 Results of the knowledge test after the education have shown higher knowledge at baseline. At the end of the education programme an average of total daily insulin dose was significantly lower. There was a 3.17% reduction in HbA1c values over 9 months, and 1.8% over 12 months in the comparison to the baseline values (p<0.001).
Conclusions
Structured education programme of functional insulin therapy was associated with improved glycaemic control in type 1 diabetes patients and their parents. It motivated patients and parents to improve glycaemic control. One year after the follow up, glycaemic control was worsening, due to lack of patients' motivation, therefore, there is a need for yearly re-education.
The association between the serum levels of matrix metalloproteinase 9 and colorectal cancer
Authors: Rašić Ismar , Rašić Azra , Akšamija Goran , Radović Svjetlana , Šehović Nedžad
Published: April 2024

Aim
 To determine the serum levels of matrix metalloproteinase 9 (MMP-9) concentration and their association with the stage and histopathologic sizes of colorectal cancer (CRC).
Methods
 One hundred and two patients with clinically diagnosed and histologically confirmed colorectal cancer ready for surgical treatment were included in the study. In each patient, preoperative peripheral venous blood samples were taken for determination of the concentration of MMP-9 using ELISA immunoassay test. Resected tumour specimens were studied pathologically according to the criteria of the TNM classification. All patients were divided into groups according to the TNM classification. The control group presented 30 subjects of the appropriate age and gender with no family history of cancer, clinical signs of malignancy or inflammatory bowel disease.
Results
 The serum levels of MMP-9 were progressively increased in patients with CRC reaching the highest value in the fourth stage of CRC. It was also confirmed that the serum concentrations of MMP-9 were significantly higher in patients with pericolonic lymph nodes involvement compared to the patients with no involvement of lymph nodes, 456.4 (445.9-464.7) ng/mL vs. 438.4 (418.4-447.8) ng/mL (p<0.001). Significantly higher serum levels of MMP-9 were found in the patients with metastatic CRC, 458.5 (452.0-468.1) ng/mL compared with the CRC patients without metastasis, 445.8 (436.9-456.5) ng/mL (p<0.001). Conclusion
 It was confirmed that serum concentration of MMP-9 presented the significant independent risk factors for the progression of CRC.
Importance of inflammatory markers and IL-6 for diagnosis and follow up of patients with type 2 diabetes mellitus
Authors: Malenica Maja , Šilar Mira , Dujić Tanja , Bego Tamer , Semiz Sabina , Škrbo Selma , Prnjavorac Besim , Čaušević Adlija
Published: April 2024

Aim
To analyse the long-term impact of altered metabolism on the level of mediators of inflammatory response in female patients with type 2 diabetes.
Methods
This study included 97 female patients with type 2 diabetes and 107 female, nondiabetic control subjects, who were recruited at the Clinical Centre University of Sarajevo and the General Hospital Tešanj. The effects of glycaemic control on markers of inflammatory response represented by C-reactive protein (CRP), fibrinogen, leukocytes, sedimentation rate, and cytokine IL-6 were tested. All subjects were free of evidence of infections, surgery, thyroid disease, polycystic ovarian syndrome, active liver and kidney damage. All biochemical analyses were performed according to standard International Federation of Clinical Chemistry (IFCC) protocols.
Results
 A significant increase of fibrinogen (p<0.001), CRP (p=0.001), interleukin-6 (p=0.013), leukocytes (p<0.001) and sedimentation rate (p=0.008) in diabetic female population compared to control subjects was found. A significant correlation between CRP and haemoglobin A 1c (p=0.035), interleukin-6 and glucose (p=0.032), IL-6 and body mass index (p=0.007) was found.
Conclusion
 Our data suggest that inflammation plays an important role in the pathogenesis of diabetes in female diabetic population. A more detailed study on a far larger number of subjects is needed if they were to be used effectively as biomarkers in the primary prevention of type 2 diabetes in this population.
Spontaneous brain and arachnoid herniation into the dural venous sinuses: a rare anatomic variation or clinical entity?
Authors: Bečulić Hakija , Skomorac Rasim , Jusić Aldin , Imamović Melica , Alić Fahrudin , Mašović Anes , Mekić Abazović Alma , Efendić Alma , Burazerović Eldin , Halilović Benjamin
Published: April 2024

Aim
 To investigate the presence, type and distribution of spontaneous brain and arachnoid herniation into the dural venous sinuses as well as a clinical significance of these herniations.
Methods
 This retrospective-prospective, non-randomised anatomical and clinical study included 990 patients who were referred to Magnetic Resonance Imaging at the Department of Radiology of the Cantonal Hospital in Zenica in the period from January to December 2016. The T1 and T2 sequences in axial, sagittal, and coronary section were used for brain or arachnoid herniation analysis. In all patients with intra-sinusal herniation health records were analysed and symptoms and reasons to refer for MRI examination were evaluated.
Results
In 26 (2.6%) patients (19 females; 73.08%) the arachnoid or brain herniation was found. Average age of patients was 40.269±16.496 years. Arachnoid herniation was presented in 15 (57.69%) and brain herniation in 11 (42.31%) patients. Statistical significance in relation to type of herniation was not found (p=11.070). Statistical significance between the symptoms and localisation of herniation (except for nausea and vomiting and posterior fossa herniations) (p=0.05) as well us between symptoms and type of herniation was not found (p>0.05).
Conclusion
 The results suggest that there is a possibility of interconnection between arachnoid or/and brain herniations and some clinical symptoms such as nausea and vomiting.
Tongue metastasis as an initial presentation of renal cell carcinoma
Authors: Ðanić Petar , Ðanić Davorin , Macan Darko
Published: April 2024

Aim
Distal metastases to oral cavity are very rare. Adenocarcinoma, renal cell carcinoma (RCC) and squamous cell carcinoma are the most common metastatic tumours. The aim of this study was to assess the diagnostic relevance of metastatic renal cell carcinoma on tongue manifestations in large patient series.
Methods
 A patient with distal RCC metastases to the tongue and neck lymph nodes as the first manifestations of malignancy was presented. Also, all reports described during 106-year period relating to distal RCC metastasis to the tongue were evaluated. Results
 In the presented patient, initial presentation of RCC was metastasis to the tongue. Three months after nephrectomy, tongue tumour resection and radical neck dissection were performed. Histopathological analysis confirmed RCC metastasis. Postoperatively, the patient underwent radiotherapy and polychemotherapy. Tongue metastasis from RCC is extremely rare with only 51 cases reported during the 106-year period. In only 7 patients tongue metastasis was reported as an initial presentation of RCC.
Conclusion
The RCC metastasizing to the tongue is extremely rare and thus it poses a diagnostic challenge especially when it is the first sign of malignancy. Therapeutic decisions should maximize patient comfort and minimize morbidity considering the poor long-term prognosis.
A study of enterocyte membranes during activation of apoptotic processes in chronic carrageenan–induced gastroenterocolitis
Authors: Tkachenko Anton , Marakushyn Dmytro , Kalashnyk Iuliia , Korniyenko Yevgen , Anatolii Onishchenko , Gorbach Tatyana , Nakonechna Oksana , Posokhov Yevgen , Tsygankov Alexander
Published: April 2024

Aim
 To investigate the lipid membranes of rat enterocytes in chronic carrageenan-induced gastroenterocolitis accompanied by the activation of apoptotic processes.
Methods
 Steady-state fluorescence spectroscopy: a study by fluorescent probes-by ortho-hydroxy derivatives of 2,5-diaryl-1,3oxazole. Activity of apoptosis signal-regulating kinase 1 and poly (ADP-ribose) polymerase in small intestinal homogenates, blood serum levels of matrix metalloproteinase-2 and caspase-3 and the level of DNA fragmentation in small intestinal homogenates were determined.
Results
 Biochemical analysis revealed that an activation of apoptotic processes occurred in the intestinal epithelium of rats during chronic carrageenan-induced gastroenterocolitis. The fluorescence probes showed that activation of apoptotic processes in carrageenan-induced gastroenterocolitis was accompanied by changes in polar regions of rat enterocyte membranes, while no changes were revealed in more hydrophobic regions of the membranes.
Conclusion
 The increase in hydration of membranes was attributed to the activation of the apoptosis of enterocytes. It has been shown that a fluorescent probe (2-(2′-hydroxyphenyl)-5-phenyl-1,3-oxazole) can be used for the detection of apoptosis of enterocytes.
Antibacterial potential of Croatian honey against antibiotic resistant pathogenic bacteria
Authors: Gobin Ivana , Goranka Crnković , Magdalenić Maja , Begić Gabrijela , Babić Ana , Lušić Dražen , Vučković Darinka
Published: April 2024

Aim
 To determine antimicrobial activity of honey against clinical bacterial strains and their respective reference strains.
Methods
 Twelve samples of Croatian honey from various botanical origin were evaluated for their antimicrobial activity against four clinical antibiotic resistant pathogens and their respective reference strains: Staphylococcus aureus, Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli. Antibacterial susceptibility was checked out by using broth microdilution method and interpreted according to the European Committee for Antimicrobial Susceptibility Testing (EUCAST) recommendations.
Results
 Significant differences in the antibacterial activity of tested honey samples were noticed. Fir honeydew honey and Mint honey showed the best antibacterial potential, while the Locust tree honey, Rapeseed honey and Spring pasture honey expressed the weakest antimicrobial activity.
Conclusion
 Croatian honey, prominently honeydew honey, has the potential to become an important additive to therapeutic techniques available to a medical practitioner against resistant pathogens, but the exact mechanisms of its activity should be investigated further.