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Publikacije (18)

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Šefika Umihanić, Lora Novakovic, Lejla Alidzanovic, Medina Bandovic Kuduzovic, Anida Sehic, Almedina Muhić, Amila Kovčić, Nejra Selak

Background/Objectives: Squamous cell lung cancer (SCC) presents a significant treatment challenge due to its poor prognosis and limited therapeutic options. In many resource-limited countries, access to advanced molecular testing is often unavailable, making the identification of novel and reliable prognostic markers crucial for improving patient selection for systemic treatments. Methods: This single-center, retrospective study investigated the prognostic value of inflammatory biomarkers, including the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), in 134 patients diagnosed with SCC. Patients were stratified into groups based on optimal cut-off values determined by ROC analysis for each biomarker. Results: Elevated levels of the SII, NLR, and PLR were significantly associated with shorter overall survival in patients with SCC (all p < 0.05). Conclusions: These easily accessible and cost-effective laboratory parameters are particularly valuable in settings where molecular testing is not available, aiding in the identification of high-risk patients and optimizing treatment selection for chemotherapy.

Amila Kovčić, Šefika Umihanić, Hasan Osmić, Almedina Muhić, Enida Trumić, Eldar Hamzić, E. Bećirović, Semir Hadžić et al.

AIM To investigate the predictors of biochemical relapse (BCR) among patients with non-metastatic prostate cancer treated with radiotherapy as the first-line therapy. METHODS The study included 91 patients diagnosed with prostate cancer at the University Clinical Centre in Tuzla, Bosnia and Herzegovina. After the radiation treatment as the first line of treatment, the patients were monitored for the next 36 months. If patients were classified in medium and high-risk groups, hormone therapy was administered. The occurrence of BCR was determined based on prostate-specific antigen (PSA) values. Potential prognostic parameters, including Gleason score (GS), PSA, tumour size (TNM), and standardised risk classification (RC), were monitored. RESULTS A total of 46 (50.5%) patients were aged 66-75, with a median PSA of 14.50 ng/mL. A Gleason score <6 was found in 72 (79.1%) of patients, and 31 (34.1%) had T2c tumours. The BCR occurred in 32 (35.2%) patients, with a median relapse time of 18 months. Significant predictors of BCR were Gleason score ≥6 (OR:4.46; p=0.006) and tumour stage >T2b (OR:3.59; p=0.021). The RC showed an Area Under Curve (AUC) of 0.634 (p=0.050), indicating its potential diagnostic accuracy. CONCLUSION Gleason score ≥6 and TNM>T2b are significant predictors of biochemical relapse in prostate cancer patients treated with radiotherapy. These results emphasize the need for additional monitoring and timely treatment of clinical disease progression in patients with Gleason score ≥6 and tumour stage >T2b.

The objective of this paper was to present basic clinical characteristics and outcomes of treating Covid 19 patients during the second wave of the pandemic. In the retrospective study for the period from September 2020 to February 2021 it was analyzed disease history data and radiological lung changes, time from the initial start of the disease until hospitalization, parameters of blood gas analysis, comorbidities, and the outcome. The research covered 409 patients, out of which 263 (64.3%) were males. Average age was 67.07± 12.44 years (min. 20; max. 93). A high comorbidities prevalence (82.9%) was noticed out of which arterial hypertension (69.2%), diabetes mellitus (37.7%) and obesity (24.7%). On the radiological lung scan the most noticed changes were consolidation (46.2%), “ground glass” (41.3%) and interstitial changes (13%). Bilateral lung infiltration was noticed in 91.9% of the patients. Average oxygen saturation was 84.29%±10.28% (min. 35; max. 98; med. 87%). In patients with unilateral lung infiltration, average oxygen saturation was 85.09%±8.60% (med. 89%, min.61% max 98%), while in patients with bilateral lung infiltration average was 84.22%±10.42% (med. 87%, min. 35%, max. 98%). From the total all patients’ death was noticed in 35.7% cases. Morbidity of patients with unilateral lung infiltration was 27.3% and in patients with unilateral infiltration 36.4%. Hospital admission in the first week of the disease indicates the severity of the clinical condition and can be a predictor of poor outcome. Bilateral pulmonary infiltration, obesity and diabetes mellitus are risk factors for high mortality.

Background: Covid-19 primarily manifests itself as a respiratory disease, but also with numerous extrapulmonary symptoms and complications. The clinical form of the disease before hospitalization, has a great influence on the further course and occurrence of complications of the disease. Objective: To analyze the clinical and laboratory characteristics of patients with moderate and severe clinical form of the disease, the complications that developed in these patients during hospitalization and the outcome of the disease. Methods: The retrospective study included 520 patients from the Tuzla Canton, treated in the COVID-19 Hospital at University Clinical Center Tuzla in the period from March 27 to October 1, 2020. The source of data were the medical records of hospitalized patients. The clinical and laboratory characteristics of patients with moderate and severe clinical form of the disease and the complications that developed in these patients during hospitalization were analyzed. Results: The number of hospitalized men was statistically significantly higher, p=0.000. Most patients were in the age group of 60-69 years: 152 (29.3%), then in the age group of 50-59 years: 119 (22.9%). Women <70 years had more often a moderate, and women >70 years more often a severe clinical form of the disease, p<0.01. Patients with hypertension, diabetes mellitus, chronic lung diseases, cardiovascular diseases, hematological diseases and tumors of solid organs, with leukopenia and lymphopenia, elevated LDH, CRP, transaminases and serum ferritin, significantly more often had a clinically severe form of the disease (p<0.01). Patients with a severe clinical form of the disease on admission to the hospital had more frequent complications and death as outcome (p<0.01). Conclusion: Patients who were hospitalized with a severe form of COVID-19 had significantly more frequent disease complications and death as outcome.

Hande Ikitimur, Betul Borku Uysal, B. Ikitimur, Šefika Umihanić, J. Smajić, Rahima Jahić, A. Olcay

ABSTRACT Two cases are presented with coronavirus disease 19 (COVID-19)-related hiccups: one during initial presentation and one 10 days after COVID-19 diagnosis. Hiccups in both patients were resistant to treatment and responded only to chlorpromazine. COVID-19 patients may present with hiccups and also may have hiccups after treatment. Resistant hiccups without any underlying disease other than COVID-19 should be considered in association with COVID-19 and may respond well to chlorpromazine.

Fuad Brkić, Š. Umihanić, Hasan Altumbabić, A. Ramaš, Almir Salkić, Šefika Umihanić, Majda Mujić, Lejla Softic et al.

Aim: To analyze the rate of mortality in children with foreign body aspiration (FBA). Methods: We outlined a retrospective review of hospital data of patients between 1971 and 2013. FBA occurring in children 0 year to 14 years was considered for inclusion (patient ages ranged from 0.6 to 15 years, with a median age of 2.2 years). The gender structure within the investigated cases was 75.8% males and 24.2% females. During the study period, 772 patients undergoing rigid bronchoscopy with the diagnosis of FBA were included. Deaths on arrival were excluded. Results: Total rate of mortality (for whole investigated period) was 0.785. For last fifteen years of the investigated period the rate of mortality was zero. Conclusion: For prevention of foreign body aspiration in children and its mortality should be taken two strategies: non-medical (alterations in product design and public education campaigns) and medical (education of medical staff and improvement of equipment).

Š. Umihanić, Fuad Brkić, M. Osmić, Šefika Umihanić, Suad Imamovic, S. Kamenjaković, Samir Hodžić

Introduction: Surgical and medical treatments of nasal obstruction are a common parts of otolaryngologist practice. The definitive treatment of deviated nasal septum is septoplasty. Aim: In this study was to evaluate the values of subjective parameters, and active anterior rhinomanometry parameters prior and three months after the septoplasty. Patients and Methods: We analyzed the subjective parameters (“NOSE” scale), the active anterior rhinomanometry parameters according to International Committee on Standardization of Rhinomanometry, on 40 patients. Thirty healthy adult volunteers participated belonged to the control group. None of the patients or healthy volunteers had previous history of nasal surgery or active rhinological disease. Results: The post-operative improvement in symptoms of nasal obstruction obtained in 92,5% patients and improvement parameters of the active anterior rhinomanometry in 42,5% patients. Conclusion: The correlation between the findings with rhinomanometry and subjective sensation of nasal patency remains uncertain. There still seems to be only a limited argument for the use of rhinomanometry for quantifying surgical results. Three months postoperative findings are very early results to interpret the permanent effects.

Š. Umihanić, Fuad Brkić, Šefika Umihanić, Samir Hodžić

OBJECTIVES This study aims to report our experience in the management of foreign body (FB) impaction in esophagus in the Ear-Nose-Throat Clinic, University Clinical Center of Tuzla, Bosnia and Herzegovina. PATIENTS AND METHODS Seventy-one patients (44 males, 27 females; mean age 32.99±28.57 years; range 1 to 81 years) who admitted to our clinic between January 2003 and December 2013 with a history of a FB in esophagus were retrospectively analyzed including head and neck examination. All patients were performed rigid esophagoscopy under general anesthesia. RESULTS A total of 32 FBs were detected in children (23 males, 9 females; mean age 4.6 years; range 1 to 11, mod 1) with coins being the most common (56.31%). A total of 39 FBs were detected in adults (21 males, 18 females; mean age 56.2 years; range 16 to 81) with bones and food being the most common (43.6%). Foreign bodies impacted in the upper esophageal sphincter in 87.5% of children and in 66.7% of adults. The duration of localization of FBs in esophagus was between one hour and six months. All procedures were performed without complications; the FBs were completely extracted without the requirement to repeat the procedure. CONCLUSION Our study results suggest that use of rigid endoscope is reliable in removing FBs in the esophagus.

ABSTRACT Introduction: Central Venous Catheters (CVC) are essential in everyday medical practice, especially in treating patients in intensive care units (ICU). The application of these catheters is accompanied with the risk of complications, such as the complications caused during the CVC insertion, infections at the location of the insertion, and complications during the use of the catheter, sepsis and other metastatic infections. Patients and methods: This study is a retrospective-prospective and it was implemented in the period 1st January 2011- 31st December 2012. It included 108 examinees with CVC placed for more than 7 days. Results: The most common complications occurring in more than 2 attempts of CVC applications are: hearth arrhythmias in both groups in 12 cases, 7 in multi-lumen (12.72%) and 5 in mono-lumen ones (9.43%). Artery puncture occurs in both groups in 7 cases, 5 in multi-lumen (9.09%) and 2 in mono-lumen ones (3.77%). Hematoma occurred in both groups in 4 cases, 3 in multi-lumen CVCs (5.45%) and 1 in mono-lumen ones (1.88%). The most common complication in multi-lumen catheters was heart arrhythmia, in 20 cases (36.37%). The most common complications in mono-lumen CVCs was hearth arrhythmias, in 20 cases as extrasystoles and they were registered in 16 catheter insertions (30.18%). Out of total number of catheters of both groups, out of 108 catheters the complications during insertion occurred in 49 catheters (45.40%). The most common complications in both groups were heart arrhythmias, artery punctures and hematomas at the place of catheter insertion.

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