bluuebunny/crossref_metadata_2025 huggingface dataset:
Heterogén vastagbéldaganat: a fogazott útvonalon kialakuló, sporadikus laesiók jelentősége a klinikai gyakorlatban
Authors: Ágoston Emese Irma , Horváth Evelin , Győrffy Balázs , Harsányi László , Szász A. Marcell
Published: February 2018

Abstract:

Today, colorectal cancer is regarded as a heterogeneous disease. Its heterogeneity is caused by genetic alterations, molecular aberrations, different developing pathways as well as by micro- and macroenviromental agents. In the last decade, beside the classic genetic model for colorectal tumuorgenesis that follows the adenoma-carcinoma sequence, an alternative pathway has been identified. This pathway is called the serrated pathway and it is responsible for approximately one third of all colorectal lesions. Beyond their dissimilar molecular characteristics, these tumours also show different macroscopic and histologic appearance. Moreover, their malignant potency and progressive ability distinguish them from tumours of the classic genetic model. The aim of this review is to summarize the molecular and pathologic features of serrated lesions and the serrated pathway to colorectal cancer and to highlight their clinical impact. Orv Hetil. 2018; 159(6): 206–2014.
A páciensek véleményének figyelembevétele az egészségügyi ellátás tervezése és értékelése során. A páciensek egészségértékelése
Authors: Kullmann Lajos , Kullmann Tamás
Published: February 2018

Abstract:

Provision of patient-centred health care is impossible without the knowledge of the patient’s perceptions, feelings and expectations. In contrast, participants feel the available time limited for satisfactory communication. This shortage may partially be compensated by measurements belonging to the concept of Patient Reported Outcomes. Concept definition, invention circle and use of the methods are largely diverse, eventually leading to misinterpretation of outcomes. For this reason, some organizations developed instructions, guidelines supporting uniform interpretation and application. Measures so far have rather served research goals yet may be applied in the clinical practice as well. They are not only appropriate for the evaluation of outcomes, judgement of adequacy and safety of care on systemic or institutional level, but also for the planning of individual patient care and supporting communication and co-operation. The present paper aims to provide general information and references for introducing the details. Orv Hetil. 2018; 159(6): 215–222.
First pediatric bilateral lobar lung transplantation for cystic fibrosis in Russian Federation
Authors: Gautier S. V. , Golovinskiy S. B. , Poptsov V. N. , Tsiroulnikova O. M. , Nechaev N. B. , Spirina E. A. , Krasovskiy S. A.
Published: February 2018

Lung transplantation is not a routine treatment option of the pediatric lung diseases. Nowadays, there are performed not more than 100 of these operations per year worldwide due to the obvious difﬁ culty of obtaining the pediatric donor organs. One of the ways to solve this problem is using the adult donor lungs which have been previously reduced or anatomically partitioned. This is not a standard method of pediatric lung transplantation, but in case of the donor organs deﬁ ciency it takes its place in the world medical practice. In this case we report the ﬁ rst successful pediatric lung transplantation from adult donor in Russian Federation.
Modern approaches to correction mineral and bone disorders in kidney transplant recipients
Authors: Vetchinnikova O. N.
Published: February 2018

The syndrome of mineral and bone disorders in patients with chronic kidney disease after kidney transplantation include hypophosphatemia, hypercalcemia, hypovitaminosis D, and decreased bone mineralization (secondary osteoporosis). The modern strategy of prevention and treatment of post-transplantation mineral and bone disorders is based on the principles of individual approach, taking into account the assessment of risk factors and minimizing the factors that caused these disorders. An attempt to compensate for phosphorus deﬁ ciency is usually ineffective and even dangerous due to complications. This review analyzes different correction´s methods of symptomatic hypercalcemia and hypercalcemia after kidney transplantation secondary to hyperparathyroidism. Also in this review presented modern approaches to the prevention and treatment of posttransplant osteoporosis. Also it shows the effects and indications for use steroid sparing/withdrawal, vitamin D and vitamin D receptor activator, drug and surgical correction of hyperparathyroidism, bisphosphonates and other medications.
Angiogenesis mechanisms in transplantation of tissue-engineered constructions
Authors: Nakokhov R. Z. , Gubareva E. A. , Kuevda E. V. , Sotnichenko A. S. , Gumenyuk I. S. , Mogilnaya G. M. , Kade A. H.
Published: February 2018

There is a number of problems regarding bioengineered structures creation that require further study in the ﬁ eld of regenerative medicine. One of the critical tasks that require solution is the fact that tissue engineered constructions, as a rule, are large, which signiﬁ cantly limits the possibility of diffusion of nutrients and oxygen in them. Thus, the key task of fundamental medicine is to ﬁ nd a technology for restoring the perfusion of the structures created. The article presents a modern overview of the mechanisms of angiogenesis and possible ways of its stimulation during transplantation of tissue engineered constructions.
Efficiency of late conversion from mycophenolate mofetil to everolimus in kidney graft recipients with posttransplant malignancy
Authors: Kim I. G. , Tomilina N. A. , Fedorova N. D. , Ostrovskaya I. V. , Skryabina I. A.
Published: February 2018

Malignancy is one of the leading causes of death in recipients with a kidney grafts. The use of proliferative signal inhibitors (PSI) is one of the approaches to solve this problem.

Aim: to evaluate the efﬁ cacy and safety of everolimus in combination with reduced dose of calcineurin inhibitors (CNI) in patients with posttransplant malignancy.

Materials and methods.62 kidney graft recipients (KGR) with neoplasia were converted from mycophenolate mofetil to everolimus in combination with reduced dose of CNI at 83.5 ± 69.3 months after transplantation. The duration follow-up was 35.5 ± 26.9 month. The effectiveness of management was assessed by patient survival, type of immunosuppression therapy, renal function and proteinuria. The patient survival in PSI group was compared with the survival in the patients in control group (n = 145), who did not receive everolimus.

Results.10-year and 15-year patient survival was 92% and 85,7% in patients treated with PSi versus 61.1% and 52.8% in control group (p < 0.0003). Patients survival with everolimus-therapy after 1 year was 86.5%, after 3 year it was 64.2%, and by the end of 5 years the possibility of treatment with everolimus decreased to 50.8%, mainly due to the proteinuria and other adverse events. The recurrence rate of tumors among patients, who was treated with everolimus for 35 (26; 60) months was 13.2%. Creatinine level in serum increased from 0.13 ± 0.04 to 0.15 ± 0.09 mmol during the treatment (p < 0.031), and the daily proteinuria increased from 0.18 ± 0.25 g/day to 0.75 ± 1.63 g/day, p < 0.011.

Conclusion.The usage of PSi improves long-term survival of KTR with posttransplant malignancy and demonstrates a relatively low tumors recurrence rate (13.2%) over a period of 35 months. However this treatment is not suitable for many patients and it was stopped in almost half of them due to increasing proteinuria or serious adverse events.
Liver transplantation from ab0-incompatible donor in patient with high level of ab0-antibodies and previous surgery
Authors: Dzhanbekov T. A. , Monakhov A. R. , Tsiroulnikova O. M. , Latypov R. A. , Mironkov B. L. , Gautier S. V.
Published: February 2018

Biliary atresia is a congenital disease characterized by a progressive course with the lesion of primarily extrahepatic bile ducts leading to the development of cholestasis. Treatment consists in performing an operative intervention such as, Kasai portoenterostomy, or liver transplantation. This clinical case shows the experience of left lobe living donor liver transplantation in child, who underwent complicated portoenterstomy in young years. In case of AB0-compatible donors is absence, the AB0-incompatible living donor can become useful opportunity for urgent recipient. Endovascular embolization of the branches of the splenic artery can become a «bridge» to AB0-incompatible liver transplantation.
Treatment of distal bronchial stenosis after bilateral lung transplantation
Authors: Golovinskiy S. V. , Nechaev N. B. , Poptsov V. N. , Rusakov M. A.
Published: February 2018

The efﬁ ciency of lung transplantation is considerably limited by the complications associated with the bronchial pathologies. Despite the progress of the treatment methods, bronchial complications are still remaining as an actual problem in the postoperative period with frequency of occurrence from 7 to 29%. However, the bronchial stenosis are the most common bronchial complications after lung transplantation with mortality from 2 to 4%.

Aim. To study an experience of our center of bronchial stenosis treatment in lung recipients. Materials and methods. 34 patients underwent lung transplantation from September 2014 to January 2017. 6 (16%) of them had a stenosis of lobar or segmental bronchi from 84 to 494 postoperative day. 5 (83%) of them have demonstrated multifocal lesions. In all of the cases there was performed an endoscopic bougienage, which involved a balloon dilatation and electrocoagulated incision of granular tissue under X-ray control. After that the patients were administrated by everolimus.

Results. Restenosis was formed in 132,0 ± 94,2 postoperative day after primary treatment in all patients. In four cases (67%) we used nitinol stent placement under X-ray control. There were no complications. In 3 cases stents were dislocated distally, so we needed to use repeated endoscopic bougienage to replace the stent. Using of everolimus has allowed to decrease the rate of restenosis, but it need future research.

Conclusion. Distal bronchial stenosis after lung transplantation can be managed with endoscopic bougienage and stent placement. Adding everolimus has not signiﬁ cantly affected the risk of frequency of restenosis.
Outcomes and risk factors of mechanical circulatory support by peripheral venoarterial extracorporeal membrane oxygenation in heart transplant candidates needing urgent heart transplantation
Authors: Poptsov V. N. , Zakharevich V. M. , Spirina E. A. , Uhrenkov S. G. , Dogonasheva A. A. , Aliev E. Z.
Published: February 2018

Introduction Peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) is one of the most frequently used methods of temporary mechanical circulatory support (MCS) at patients with life-threatening circulatory derangement.

Aim: to evaluate the effectiveness and risk factors of peripheral VA ECMO in patients waiting of urgent heart transplantation (HT).

Materials and methods. The study included 149 (129 (86.6%) men and 20 (13.4%) women, age 12 to 72 (43.0 ± 1.2) years) heart transplant candidates who in the period 01.01.2011–31.12.2016 were supported by peripheral VA ECMO. These patients were 21.1% of the total waiting list (n = 706) of our institute at the same period. Indication for MCS by VA ECMO was advanced heart failure corresponding to I or II level of INTERMACS classiﬁ cation.

Results. 135 (90.6%) from 149 patients were successfully supported to HT. 14 (9.4%) deed following MCS. Before of VA ECMO these patients (n = 14) had more severe (p < 0.05) hemodynamic disorders, organ dysfunction, electrolyte and metabolic disorders compared to patients TC successfully supported to HT. Left atrium (n = 24)/left ventricle drainage (n = 8) was performed for volume decompression of left heart (n = 32 (21.5%)). In a single-factor analysis, statistically signiﬁ cant pre VA ECMO risk factors for the lethal outcome were: creatinine ≥ 140 mmol/l, urea ≥ 15 mmol/l, total bilirubin ≥ 80 μmol/l, ALT ≥ 300 U/l, AST ≥ 300 U/l, INR ≥ 3.0, procalcitonin ≥ 3.0 ng/ml, preexisting left ventricular thrombosis complicated thromboembolic stroke with brain death following VA ECMO (n = 3). Statistically signiﬁ cant factors for the lethal outcome following MCS were: transthoracic left ventricle drainage (n = 8) compared to transcutaneous transfemoral transseptal left atrium drainage (n = 24) for volume decompression of left heart; hemolysis ≥ 300 mg%.

Conclusion. VA ECMO is high efﬁ ciency method of temporary MCS in 90.6% heart transplant candidates needed at urgent HT. VA ECMO must be begin before development of potential lethal multiorgan and septic complications. Preexisting left ventricular thrombosis increase risk of lethal thromboembolic brain injury following VA ECMO. Patients with transcutaneous transfemoral transseptal left atrium drainage for left heart volume decompression had better outcome following MCS by VA ECMO.
Three-dimensional analysis of micro- and nanostructure of biomaterials and cells by method of scanning probe nanotomography
Authors: Eﬁmov A. E. , Agapova O. I. , Safonova L. A. , Bobrova M. M. , Agapov I. I.
Published: February 2018

Aim: to perform a three-dimensional analysis of micro- and nanosctucture and quantitative morphological parameters of alginate spherical microcarriers and porous regenerated silk macrocarriers modiﬁ ed by microparticles of decellularized rat liver matrix and human hepatoma HepG2 cells adhered to micro- and macro carriers.

Materials and methods. Three-dimensional porous matrices made from regenerated silk by salt leaching technique and alginate spherical microcarriers fabricated by encapsulation were vitalized by human hepatome HepG2 cells. Study of three-dimensional structure of cells and micro- and macro carriers was carried out at –120 °С by scanning probe cryonanotomography technique with use of experimental setup combining cryoultramicrotome and scanning probe microscope.

Results. Three-dimensional nanotomographical reconstructions of HepG2 cells adhered to macropore wall of regenerated silk macrocarrier and to spherical alginate microcarrier are obtained. Morphological parameters (mean roughness, effective surface area and autocorrelation length) are determined for surfaces of macro and microcarriers and adhered cells. The determined mean roughness of alginate microcarrier surface is 76.4 ± 7.5 nm, while that of surface of macropore wall of regenerated silk macrocarrier is 133.8 ± 16.2 nm. At the same time mean roughness of cells adhered to micro- and macrocarriers are 118.5 ± 9.0 и 158.8 ± 21.6 nm correspondingly. Three-dimensional reconstructions of intracellular compartments with dimensions from 140 to 500 nm are also obtained.

Conclusion. Obtained as a result of study quantitative morphology characteristics of surfaces of cell carriers and adhered cells show signiﬁ cant degree of correlation of morphological parameters of cells and their carriers. Use of scanning probe cryonanotomography technique for three-dimensional analysis of structure and characteristics of biomaterials, cells and bio-artiﬁ cial cellular systems enables to improve efﬁ ciency of development of novel cell-engineered constructions with predicted morphological, physical, chemical and biological characteristics for tasks of tissue engineering and regenerative medicine.
Injection Pressure as a Marker of Intraneural Injection in Procedures of Peripheral Nerves Blockade
Authors: Vučković Ilvana , Dilberović Faruk , Kulenović Amela , Divanović Kučuk-Alija , Voljevica Alma , Kapur Eldan
Published: February 2018

The blockade of peripheral nerves carries a certain risk of unwanted complications, which can follow after unintentional intraneural injection of a local anesthetic. Up till today, the research of measuring injection pressure has been based on animal models, even though the histological structure of periphery nerve is different for animal and human population, so the application pressure which presages intraneural injection in human population is still unknown. As material in performing this study there have been used 12 Wistar rats and 12 delivered stillborns. After bilateral access to the median nerve, we applied 3 ml of 2% lidocaine with epinephrine, with the help of automatic syringe charger. The needle was at first placed perineural on one side, and then intraneural on the other side of both examination groups. During every application the pressure values were monitored using the manometer, and then they were analyzed by special software program BioBench. All perineural injections resulted with the pressure < or = 27.92 kPa, while the majority of intraneural injections were combined with the injectionpressure > or = 69.8 kPa. The difference between intraneural and perineural injection pressures for the two different examination groups (rats and delivered stillborns) was not statistically significant (P>0.05). As prevention from intraneural injections today are in use two methods: the method of causing paresthesia or the method of using the peripheral nerve stimulator. However the nerve injury can still occur, independent from the technique used. If our results are used in clinical practice on human population, than the high injection pressure could be the markerof intraneural lodging of a needle.
Hepatitis C infection in risk groups
Authors: Ahmetagić Sead , Muminhodžić Kasim , Čičkušić Elmir , Stojić Vildana , Petrović Jasminka , Tihić Nijaz
Published: February 2018

Hepatitis C infection is important global health problem with wide spectrum of health, social and economic consequences. The goal of this research was to estimate prevalence of hepatitis C virus infection in risk groups, and to determine association hepatitis C virus (HCV) infection and risk factors. Research included 4627 subjects divided in two groups. Test group included 2627 subjects divided in 4 subgroups with risk for HCV infection: those who received blood transfusion without screening on HCV (it was introduced in 1995) (700); intravenous drug users (60); patients on hemodialysis (168) and health care workers (1699). Control group included 2000 healthy volunteer blood donors. In all subjects anti-HCV antibodies were tested with third generation ELISA test. Positive serum samples were tested for presence of HCVRNA, using reaction of reverse transcription and polymerase chain reaction. In all anti-HCV positive subjects further epidemiological and clinical workup was performed. Prevalence of HCV infection in risk groups was: 4.6% in subjects who have received blood transfusions without HCV blood screening, 35% in intravenous drug users, 58.9% in patients on chronic dialysis, and 0.4% in health care workers. In control group prevalence was low (0.2%). In the group of 158 anti-HCV positive subjects, 73.4% had HCVRNA. The largest number of subjects with HCV infection was in the age group of 30-49 years (45.8%). This study showed that multiple blood transfusions before introducing the blood screening for HCV, longer duration of intravenous drug abuse, longer duration of hemodialysis treatment, larger number of accidental injuries in health care workers are independent and statistically significant risk factors for those groups examined. Results of this study confirm that general screening for HCV infection is recommended in risk groups for HCV infection in order to identify to prevent and to treat it.
The Role of Pineal Gland and Exogenous Melatonin on the Irradiation Stress Response of Suprarenal Gland
Authors: Aličelebić Selma , Mornjaković Zakira , Šuško Irfan , Ćosović Esad , Beganović-Petrović Amira
Published: February 2018

Pineal gland has and antistressogenic role. Its main hormone, melatonin, has radio protective effect on endocrine and other dynamic tissues. In our previous study, we have shown that pinealectomy changes the behavior of suprarenal gland in totally irradiated rats. The aim of this study is to evaluate the effect of exogenous melatonin on suprarenal gland of rats with or without pineal gland. Four months after pinealectomy (experimental group) or shampinealectomy (control group), adult Wistar male rats were daily treated with 0,2 mg of melatoninintraperitoneally, during two weeks. Thereafter, all animals were totally irradiated with 8 Gy of Gamma rays produced from Cobalt 60. Animals who survived were sacrificed on the 17(th) post irradiation day. Qualitative and quantitative characteristics of the suprarenal gland were studied using histological methods. The results show that exogenous melatonin had protective role on suprarenal gland in totally irradiated rats and that those effects were more pronounced in the presence of pineal gland.
Treatment of Left Anterior Descending Artery Aneurysm
Authors: Kacila Mirsad , L.S. Matteucci Marco , Bevilacqua Stefano , Granov Nermir , Glauber Mattia
Published: February 2018

Coronary artery aneurysms (CAAs) are rare and their management is controversial. Their incidence varies from 1,5% to 5% of the coronary angiographies, with predilection of the right coronary artery. Unruptured coronary aneurysms are often silent and may remain undiagnosed. The etiology can be either congenital or acquired. We describe a case of a left anterior descending artery (LAD) aneurysm treated with an off-pump surgical revascularization with a LIMA to LAD without exclusion or ligature of the aneurysm.
Osteometry of Mandibular Joint Surface
Authors: Šuljak-Lončarević Azijada , Ajanović Muhamed
Published: February 2018

Anatomically and functionally, temporomandibular joint (articulatio temporomandibularis) is specific, It consists of incongruent joint surface. The size of mandibular joint surface and its position in relation to facies articularis fossae mandibularis in different positions of mandibulae (central occlusion, central relation) are still subject to the interest of prosthetics. The aim of the research is measuring the lower joint surfaceby special 3D device that enables acribic precise measuring. Macerated human skulls, property of the Anatomy Institute, Faculty of Medicine, University Sarajevo, were used for the research that has been carried out. Results of measuring of articulating surface caput mandibulae along longer axis (mediolateral diameter) indicate that there are no differences in size of this surface between right and left joints. Results of measuring of articulating surface caput mandibulae along shorter axis (anteroposterior diameter) indicate differences in values of this diameter between right and left sides. Judging by statistical evaluation, differences are highly significant on the level of probability p<0.01. The research has shown differences in the size of this joint surface, on right and left sides, but only in antero-posterior direction. This original scientific work will help better of relationship of TMJ surfaces, what is necessary for treatment of TMD and occlusal imbalances.
The Role of Collateral Circulation in Preserving Myocardial Function
Authors: Hasanović Aida , Kulenović Amela , Šišić Fuad
Published: February 2018

The coronary collateral circulation is an alternative source of blood supply to the myocardium jeopardized by the failure of the original stenotic or occluded vessel to provide adequate blood flow to this region. One hundred coronary angiograms and left ventriculograms of patients with coronary artery disease from the Cardiology Department of University Clinics Centre in Sarajevo were reviewed. The role of collateral circulation in preserving myocardial function was assessed by comparing regional left ventricular contractility in 34 instances of total arterial occlusion and adequate colateral circulation with that in 34 instances of total arterial occlusion and inadequate collateral circulation. Among the group with adequate collaterals, regional left ventricular contraction was normal in 41%, hypokinetic in 53% and akinetic or dyskinetic in only 5%. Among the group with inadequate collaterals, regional contraction was normal in 9%, hypokinetic in 20 % and akinetic or dyskinetic in 70%. These data indicate that collateral circulation plays an important role in preserving myocardial contractility in patients with coronary artery disease.
Erythropoietin in Cardiorenal Anemia Syndrome
Authors: Fazlibegović Emir , Hadžiomerović Mustafa , Ćorić Slavica , Babić Emil , Fazlibegović Fadila
Published: February 2018

Incidents of heart and renal failure (HF, RF) together, are increasing in our country and all over the world, so a great attention has been dedicated to this problem recently. These diseases together have shown bad results because of the process of accelerated arteriosclerosis, structural changes of myocardium, oxidative stress, inflammation, increased activities of sympathetic nervous system (SNS), increased activities of a renin-angiotensin-aldosterone system (RAAS). These factors are crucial in the development of patho-physiological process and consequential development of anemia, that together with heart and renal failure through interaction, cause serious disorder that we call the cardio-renal anemia syndrome. We examined effects of erythropoietin (Epoetin beta) at 90 (60 men and 30 women) pre-dialysed and dialysed patients with HF signs during a period of three years in individual dozes of 2000-6000 units subcutaneous (sc) weekly. Using computer S PLUS and SAS multiple variant analysis we have got correlations by Pearson. Epoetin beta significantly develops anemiaparameters: number of erythrocytes (r=0.51779; p<0.0001), hemoglobin (r=0.38811; p<0.0002), MCV (r=0.59876; p<0.0001) at patients with HF. Positive effects are seen at NYHA class (r=0.59906; p<0.0001), on quality of life before and after prescribing medicine. Parameters of renal functions are improving: more urea (r =0.45557; p<0.0001) than creatinine (r=0.26397; p<0.00119) and potassium values K(+)) are not changed significantly (r=0.02060; p<0.8471). Epoetin beta has been useful in treatment of pre-dialysed and dialysed patients with HF and anemia by improving functional ability of myocardium and quality of life.
Lymphoscintigraphy and Radiation – Occupational Exposure During Sentinel Node Assay
Authors: Kučukalić-Selimović Elma , Skopljak-Beganović Amra , Bešlić Nermina , Begić Amela , Begović-Hadžimuratović Sadžida , Dražeta Zdenka
Published: February 2018

Ionizing radiation has many practical applications, but it is also, as it is well known, dangerous to human health. The purpose of this study was to estimate the dose and exposure for medical staff involved in sentinel node assay and to determine how safe this assay really is. The theoretical method was used for calculation. Three groups of medical staff were selected: nuclear medicine specialist, nuclear medicine technologist and a surgeon. The results obtained show that the most exposed staff member is nuclear medicine specialist and that dose received by the surgeon is smaller then the dose limit.
Laparoscopy After Previous Laparotomy
Authors: Godinjak Zulfo , Idrizbegović Edin , Begić Kerim
Published: February 2018

Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for laparoscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previouslaparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured.
Incomplete Intestinal Metaplasia as an Indicator for Early Detection of Gastric Carcinoma in The Events of Helicobacter Pylori Positive Chronic Atrophic Gastritis
Authors: Vukobrat-Bijedić Zora , Radović Svjetlana , Husić-Selimović Azra , Gornjaković Srđan
Published: February 2018

The aim of the study was to ascertain the existence of intestinal metaplasia in gastric mucosa of patients with gastric carcinoma coupled with H. pylori positive chronic atrophic gastritis and possible connection of IM with the development of gastric carcinoma. The paper presents prospective study that included 50 patients with gastric carcinoma and 50 patients with chronic atrophic H. pylori positive gastritis. All the patients were subjected to gastroscopy as well as biopsy targeted at antrum, lesser curvature and corpus and at the area 1-2 cm removed from tumor lesion. Biopsy samples were sliced by microtome and stained. We analyzed presence, frequency and severity of inflammatory-regenerative, metaplastic and dysplastic changes in the mucosa and evaluated their prognostic value. We typed IM immunohistochemically. This study confirmed responsibility of H. pylori for inflammatory events in gastric mucosa in patients with gastriccarcinoma. According to our findings incomplete IM of types IIa and IIb as precancerous lesion is responsible for the development of gastriccarcinoma and is associated with chronic atrophic gastritis grade I and II (92% of subjects, p=0.0097, h=1, p=0.01). Thus, the finding of incomplete intestinal metaplasia may be used as an indicator for early gastric carcinoma detection. Patients with patho-histologically verified incomplete intestinal metaplasia associated with active chronic atrophic gastritis of levels I and II represent risk group for the development of gastric carcinoma of intestinal type.
Effect of War and Postwar Genotoxins on Micronuclei Frequency in Sarajevo Study Group
Authors: Ibrulj Slavka , Haverić Sanin , Haverić Anja , Durmić-Pašić Adaleta , Marjanović Damir
Published: February 2018

During the 1992-1995 siege, as well as after the war activities, citizens of Sarajevo were most probably exposed to various potential genotoxic agents. The effects of those potential genotoxins were evaluated by micronucleus-cytokinesis blocked assay. The study included 30 individuals who resided in the area of Sarajevo during the war and the postwar period. Point bi-serial coefficient analysis did not reveal any relationship between the frequencies of binuclear cells with micronuclei as well as total number of micronuclei and smoking habits or gender. Simple linear regression revealed statistically significant positive correlation between the age and micronuclei formation. Due to the war related environmental contamination more extensive study is recommended.
Cyclooxygenase-2 Expression Determines Neoangiogenesis in Gallbladder Carcinomas
Authors: Legan Mateja , Luzar Boštjan , Ferlan-Marolt Vera , Cör Andrej
Published: February 2018

Neo-angiogenesis may have an important role in the poor prognosis of gallbladder carcinoma. An enhanced expression of COX-2 was found in precancerous lesions and in gallbladder carcinoma, likely to be involved in carcinogenesis as well as in angiogenesis. To study the relationships between the COX-2 expression and degree of vascularization, as well as to evaluate their role in the prognosis of patients with gallbladder carcinoma. 27 cases of gallbladder adenocarcinoma were included, classified grading I-III according the WHO classification. The COX-2 and endothelial antigen CD105 expressions were assessed immunohistochemically. COX-2 expression was evaluated according to the percentage and staining intensity of positive cells into "COX-2 positive" and "COX-2 negative" groups. In order to assess tumor microvessel density (MVD), CD105 positively stained microvessels were counted for each specimen in predominantly vascular areas (hot spots) at 200 x magnification. The MVD ranged from 9 to 46 microvessels/field. 15 tumors belonged to the hypervascular group (MVD > or = 25) and 12 to the hypovascular group. There were 16 (59.2%) COX-2 positive cases. There was difference in the degree of angiogenesis between COX-2 positive vs. COX-2 negative group: 11 (68.8%) out of 16 "COX-2 positive" tumors were hypervascular, in comparison with just 4 (36.4%) of "COX-2 negative" tumors. Our data show that the MVD corresponds to the COX-2 overexpression in gallbladder carcinomas. Augmented tumor neovascularization induced by COX-2 might be responsible for the poor prognosis in gallbladder carcinoma patients.
Effects Of Amitryptilin Administration on Rat Sera and Brain Beta-endorphins
Authors: Jadrić Radivoj , Hasić Sabaheta , Kiseljaković Emina , Radovanović Jovan , Ićindić-Nakaš Emina , Winterhalter-Jadrić Mira
Published: February 2018

The aim of our study was to establish the influence of antidepressive drugs on serum and brain beta-endorphins in experimental animals. Experiment was performed on albino Wistar rats. Antidepressant amitryptiline was used, and for quantification of sera and brain beta-endorphins RIA technique. Our results showed difference between sera and brain beta-endorphins concentration in amitryptiline pretreated animals, vs. those in serum and brain of control group treated with 0.95% NaCl. This study shows that use of psychoactive drugs have influence on sera and brain beta-endorphins concentration. Beta-endorphins could be of great importance, used as markers for evaluation of antidepressant drug effects.
Cancer Mortality, Recent Trends And Perspectives
Authors: Nikšić Dragana , Kurspahić-Mujičić Amira , Pilav Aida , Nikšić Haris
Published: February 2018

Considering that a register for cancer was established in Federation of Bosnia and Herzegovina only recently, basic reliable source for the analysis of cancer mortality trends are the data on death cases caused by such diseases. Lack of census as well as standardized mortalityrate data makes the study even more difficult to make. The aim of the study is the analysis of the malign diseases trend in the post-war period according to the available data. The study is the descriptive work on the analysis of the system using linear regression methods for expected trend for the total population and age group from 0 to 64 years. Registered rate of cancer mortality in Federation of Bosnia and Herzegovina in 2004 was 142 per 100000 inhabitants, and indicates input stream in the analyzed period. Total increase in mortality of males and females is 2.5% per year. It is expected that in 2020 around 5000 inhabitants of Federation of Bosnia and Herzegovina will die of some malign disease. Trend of mortality of malign diseases in males is higher than in females and more probable in older population. There is a tendency of mortality decrease in the group of 0-64 years of age. Mortality list of the most frequent locations of cancer has undergone changes. Liver cancer, colon cancer, sigma and rectum cancer as well as lung and breast cancer lead the list. Objective ageing of the population, technological drawbacks, insufficient primary and secondary prevention worsened by socio-economic life conditions will affect the increase in number of people with malign diseases in Bosnia and Herzegovina.
Specificity of Electrocardiography and Echocardiography Changes at the Patients with the Pulmonary Embolism
Authors: Macić-Džanković Amra , Pozderac-Memija Meliha
Published: February 2018

We evaluated electrocardiographic and echocardiographic changes of 40 patients with pulmonary thrombo-embolism proved by perfusion scintigrams. ECG-changes included sinus tachycardia or absolute tachyarrhythmia de novo, changes type Q1S3T3 and changes in right precordial leads. Analyses of echocardiography included hyperkinesis and then dilatation and apical hypokinesis of right ventricule and tricuspid regurgitation with maximal transvalvular gradients. We emphasize such a sensibility of echocardiographic changes in early estimation of pulmonary thrombo-embolism severity and necessity for echocardiography as early as possible in suspected patients.
Azythromicin Versus Amoxicillin-clavulanate in the Treatment of Acute Sinusitis in Children
Authors: Alagić-Smailbegović Jasminka , Saračević Ediba , Šutalo Kamenko
Published: February 2018

In this prospective study we compared the efficiency of azithromycin and amoxicillin-clavulanate in treatment of acute sinusitis in children. Seventy patients were included in the age between 5 and 15 years. Beside ENT and pediatricians examination, nasal and throat smear on culture and antibiogram is taken from all the patients, as well as, X-ray of paranasal sinuses and laboratory findings, followed by check-up of nasal and throat smear and X-ray of paranasal sinuses. Azithromycin in single daily dose of 10 mg/kg during three days showed same efficiency as amoxicillin-clavulanate given three times per day in dose of 45 mg/kg during ten days.
Central Nervous System Birth Defects in Surgically Treated Infants in Sarajevo Region of Bosnia and Herzegovina
Authors: Aličelebić Selma , Arslanagić Alma , Mornjaković Zakira
Published: February 2018

Congenital anomalies of the central nervous system (CNS) are common. The prevalence of these anomalies shows considerable geographical variation and female predominance. The aim of this work was to obtain the frequency of different CNS congenital anomalies types and their sex distribution among cases hospitalized in a Department of Neurosurgery, University of Sarajevo Clinics Center, Bosnia and Herzegovina, during the period January 2001 to December 2004. Retrospective study was carried out on the basis of the clinical records. Standard methods of descriptive statistics were performed for the data analysis. A total of 103 cases were surgically treated in the period from 2001 through 2004. Out of that number 56 (54,4%) were female patients, while 47 (46,6%) were male patients. Seven different CNS birth defect types were found in this investigation. These were: spina bifida (42 cases or 40,78%), congenital hydrocephalus (35 cases or 33,98%), arachnoid cyst (15 cases or 14,56%), Dandy-Walker syndrome (5 cases or 4,85%), dermoid cyst (4 cases or 3,88%), one of Arnold-Chiari syndrome (0,98%) and one of encefalocele (0,98%). According to this investigation, CNS congenital birth defects were slightly higher in females (54,4%). The most frequent types were spina bifida (40,78%) both in females (22,33%) and in males (18,45%), hydrocephalus (33,98%) and arachnoid cyst (14,56%). The anomalies of the other organ systems, associated with CNS anomalies obtained in this investigation, were pes equinovarus, cheiloshisis, cardiomegalia and palatoshisis. They were found in six cases (5,82%), equal in both sexes.
Research on Spontaneously Emerged Chromosomal Aberrations in the Periphery Blood Lymphocytes in Cattle (‘Buša’ Breed)
Authors: Hasanbašić Danica , Rukavina Dunja , Hodžić Aida , Brka Muhamed , Vegara Mensur , Hamamdžić Muhidin
Published: February 2018

Knowledge of spontaneous aberrations, namely, of their frequency in non-irradiated cells is of paramount importance not only in cytogenetic research, but also in contemporary animal production.The paper deals with research on spontaneously emerged chromosomal aberrations in the peripheral blood lymphocytes in the cattle of ‘Buša’ breed.To obtain metaphase chromosomes the conventional method of lymphocyte cultivation was used, albeit slightly modified and adapted to the examined animals and the laboratory conditions.The research findings indicate that a certain percent of spontaneously emerged chromosomal aberrations of chromatid type (gap and break) have been found in the peripheral blood lymphocytes in the cattle of ‘Buša’ breed.
N-Terminal Pro-Brain Natriuretic Peptide (Nt-proBNP) Serum Concentrations in Apparently Healthy Bosnian Women
Authors: Hadžović-Džuvo Almira , Kučukalić-Selimović Elma , Nakaš-Ićindić Emina , Zaćiragić Asija , Dražeta Zdenka
Published: February 2018

Brain natriuretic peptide (BNP) is a cardiac hormone secreted predominantly from the ventricles. This hormone is produced as pre-prohormone BNP (pro BNP), than cleaved by corine to biologically active 32-aminoacid BNP and non-biologically active N-terminal-pro brain natriuretic peptide (NTproBNP). NTproBNP has been found to be a useful marker for the diagnosis of heart failure and left ventricular systolic dysfunction. Recent studies showed that concentration of BNP and NTproBNP predict cardiovascular disease in apparently healthy individuals but their full screening characteristics are not firmly established. As NTproBNP serum concentration is altered by numerous factors there are also interindividual variations in NTproBNP values.There are no previous results for Bosnian population so the aim of this study was to asses normal range of NTproBNP serum concentrations in apparently healthy women using electrochemiluminescence immunoassay (Elecsys, Roche Diagnostic). A group of 45, healthy females, aged 39,19 (±6,62), were enrolled in this study. Mean serum concentration of NTproBNP was 60,32 (±36,25) pg/ml, with the range of 112,60 pg/ml (minimum-maximum:13,6-126,00 pg/ml).We conclude that NTproBNP serum concentration in apparently healthy Bosnian women was not different from the average values of NTproBNP obtained on Europen’s population. Thus, we suggest that the NTproBNP serum upper cut off values measured by using electrochemiluminescence immunoassay “ECLIA” (Elecsys 2010, Roche Diagnostic) for Bosnian females, aged <50 years, should be 155 pg/ml as reported by Roche Diagnostic.
Chromosome Aberrations as Bioindicators of Environmental Genotoxicity
Authors: Ibrulj Slavica , Haverić Sanin , Haverić Anja
Published: February 2018

Due to the exposure to various potentially genotoxic xenobiotics, derived from recent war activities such as NATO air strikes with antitank ammunition containing depleted uranium, we have evaluated chromosome aberrations in 84 peripheral blood samples from three local populations. One population sample included 30 individuals who lived in the Sarajevo area during and after the war (exposed to potential genotoxins), second population was presented with 26 employees of the tank repair facility in Hadžići (target of NATO air strikes), and 28 inhabitants of Posušje (not exposed to war-related activities) were treated as sample of control population. The mean of chromosome aberration frequencies for the population from Hadžići was significantly higher than the frequencies for the two other populations. Point bi-serial coefficient analysis did not reveal any relationship between the frequencies of chromosome aberrations and smoking habits or gender. Results suggest that depleted uranium could be a risk factor for human health.
Antioxidant Capacity in the Lipophilic Fraction of Alzheimer’s Brain Tissues
Authors: Šapčanin Aida , Sofić Emin , Tahirović Ismet , Gavrankapetanović Ismet , Kalcher Kurt
Published: February 2018

The aim of this study was to investigate the antioxidant capacity (AC) in the lipophilic fraction of postmortem motorcortex (MC), nucleus caudatus (NC) and gyrus temporalis (GT) from controls (C) and Alzheimer’s disease (AD) patients. The initial samples consisted of 50 human brain tissues of AD and C. AC of the different region of human brain were measured by using the fluorescent method of the oxygen radical absorbance capacity (ORAC). Peroxyl and hydroxyl radical generators were used in the analysis. All ORAC analysis were carried out on the Perkin-Elmer spectrofluorometer LS 55 with fluorescent filters, Ex: 485 nm; Em 520 nm. Final results were calculated using the differences between area under the quenching curve of fluorescein (FL), blank and analyzed biological samples. AC against peroxyl radicals (ORAC-ROO°) of lipophilic fraction in MC of AD was statistically significantly lower in comparison with MC of C (p < 0,008). No changes in the AC against hydroxyl radicals (ORAC-°OH) of lipophilic fraction of AD were found in comparison with C. Reduction of total protein in GT of AD (p < 0,03) was found. The results showed that in the MC of AD brain the balance between production of free radicals and the neutralization by a complex antioxidant system is disturbed. The manual fluorescent method for AC measurements proved to be sufficiently appropriate and sensitive for the AC measurements of lipophilic fraction of postmortem brain tissues from different patologica! conditions.
Serum C-Reactive Protein Concentration and Measures of Adiposity in Patients With Type 2 Diabetes Mellitus
Authors: Začiragić Asija , Huskić Jasminko , Hadžović-Džuvo Almira , Valjevac Amina , Avdagić Nesina , Mulabegović Nedžad
Published: February 2018

We investigated serum concentration of C-reactive protein (CRP) and measures of adiposity in 30 patients with type 2 diabetes mellitus (15 male, 15 female) and 30 age and sex-matched apparently healthy subjects.CRP concentration was determined by laser nephelometry (BN II Analyzer) and CardioPhase high-sensitivity CRP (DADE BEHRING) was used as reagent which consists of polystyrene particles coated with mouse monoclonal antibodies to CRP.Results have shown that serum CRP concentration in patients with type 2 diabetes mellitus was statistically significantly higher compared to control group of healthy subjects (p<0,05). Body mass index (BMI) correlated significantly with serum concentration of CRP in patients with type 2 diabetes mellitus (r=0,614; p<0,001). Statistically significant positive correlation was also found between waist to hip ratio and serum CRP concentration in patients with type 2 diabetes mellitus (r=0,426; p<0,05).Elevated serum CRP concentration in patients with type 2 diabetes mellitus is probably caused by the presence of chronic low-grade inflammation in these patients. It is possible that determined increase of CRP concentration reflects activation of innate immune system components in patients with type 2 diabetes mellitus. Implications of established association between measures of adiposity and serum CRP level in type 2 diabetes mellitus remain unclear.
Influence of Tablet Splitting on Content Uniformity of Lisinopril/Hydrochlorthiazide Tablets
Authors: Vranić Edina , Uzunović Alija
Published: February 2018

Dose-related adverse effects of medications are a major problem in modern medical practice. The “correct” dose, based on drug company guidelines in package inserts, may not be correct for many patients. Tablet splitting or dividing has been an accepted practice for many years as a means of obtaining the prescribed dose of medication.As model tablets for this investigation, two batches of lisinopril-hydrochlorothiazide scored tablets labeled to contain 20/12,5 mg were used. The aim of this study was to establish possible influence of tablet splitting on content uniformity of lisinopril/hydrochlorthiazide tablets.Determination of the content uniformity of lisinopril and hydrochlorthiazide in our batches, was carried out by HPLC method. The results of content uniformity studies for halves of tablets containing combination of lisinopril-hydrochlorthiazide (supposed to contain 50% of stated 20/12,5 mg in the whole tablet) were: 49,60 ±3,29% and 49,29±0,60 % (lisinopril); 50,33±3,50% and 50,69±1,95% (hydrochlorthiazide) for batch I and II, respectively. We can conclude that the results obtained in this study support an option of tablet splitting, which is very important for obtaining the required dosage when a dosage form of the required strength is unavailable, and for better individualization of the therapy.