Background The purpose of this study is to establish whether the lymph node metastases of the papillary thyroid carcinoma are a significant factor in recurrence of the disease by analyzing the time until recurrence of the disease and frequency of recurrence of the disease. Methods From 1 January 1995 until 30 June 2017, 102 patients were treated at the Public Health Institute Hospital “Sveti Vracevi” in Bijeljina for PTC. In all patients, surgery of the thyroid gland and/or lymph nodes of the neck was performed. Total thyroidectomy (TT) was performed in 20 patients and near-total thyroidectomy leaving <1 g thyroid tissue adjacent to the recurrent laryngeal nerve in 7 patients. TT and lymph nodes dissection were performed in 71 patients. Palliative surgery and biopsy due to locally advanced disease were performed in 3 patients. Results In our study, 102 patients with PTC were analyzed. 82 patients experienced pure PTC (80.4%), the other 20 patients (19.6%) experienced other variants of PTC. 24 patients (23.5%) experienced multi centric or bilateral tumors. 71 patients (69.6%) experienced histologically verified metastases in the lymph nodes of the neck. 7 patients (6.8%) experienced distant metastases. 20 patients underwent total thyroidectomy (TT), and 7 near-total thyroidectomy. Total thyroidectomy + dissection of central and lower jugular lymph nodes with frozen section histopathology verification was performed in 71 patients (69.6%). Out of these 71 patients, in 50 patients (70.4%) metastases were verified in the lower jugular lymph nodes. A modified lymph node dissection (MRND) was also performed in these patients. Conclusion Lymph node metastases of the papillary thyroid carcinoma are a plausible prognostic factor. They are important for recurrence of the disease, but not for survival.

Sažetak: Uvod: Jedan od najčešćih malignih tumora glave i vrata jeste karcinom larinksa. Totalna laringektomija dovodi do trajnog gubitka larinksa čime se narušavaju normalni anatomski odnosi u vratu, što izaziva poremećaj komunikacije i socijalne interakcije pacijenta. Cilj: Cilj ovog istraživanja je da se utvrdi koliki uticaj ima radioterapija na kvalitet života laringektomiranih pacijenata nakon vokalne rehabilitacije. Metod rada: U istraživanju je učestvovalo 50 pacijenata nakon totalne laringektomije. Starost ispitanika kretala se od 51 do 83 godine. Jednofaktorskom analizom varijanse (ANOVA) izvršeno je testiranje razlika između prosečnih postignuća na VHI i HNQOL skali pre i posle vokalne rehabilitacije. Ovim skalama možemo doći do informacije o stepenu govorne invalidnosti koju doživljava sam pacijent, zatim zadovoljstvom pacijenta primenjenim lečenjem ili tretmanom i uticaju koji ima vokalna rehabilitacija na kvaliteta njegovog života pre i nakon tretmana. Rezultati: U našoj studiji pacijenti koji su podvrgnuti radikalnoj hirurškoj intervenciji prijavili su bolji kvalitet života u poređenju sa pacijentima koji su bili podvrgnuti drugim kombinovanim modalitetima lečenja. Ustanovljeno je da statistički značajne razlike postoje na svim supskalama obe skale. Statistička značajnost definisana je na nivou verovatnoće nulte hipoteze od p ≤ 0,05 do p < 0,001. Zaključak: Uspešna vokalna rehabilitacija je važan faktor kvalitetnog života pacijenata nakon totalne laringektomije i predstavlja izlaz iz društvene izolacije. Ključne reči: tumori larinksa, laringektomija, vokalna rehabilitacija, kvalitet života, VHI skala, HNQOL skala

Thrombus aspiration during primary percutaneous coronary intervention (pPCI) has been used to improve myocardial perfusion through a re du ction of the thrombotic burden eventually resul ting with better clinical outcomes.1,2 After the initial enthusiasm derived from the mortality reduction shown in early randomized and observational studies,3-7 disa ppointing results have been yielded in more recent larger scale trials testing the routine use of thrombus aspiration in pPCI.8-12 As a consequence, this technique has lost its initial appeal and currently is often neglected or even considered as a useless by the interventional cardiologists. The recent meta-analysis by Jolly et al.13 conducted in more than 18,000 patients once again re in forces the evidence that overall there is no benefit in the routine use of thrombus aspiration during pPCI. However, it has the merit to shed light on the residual potential of this technique, which has pro bably been dismissed too quickly. First, there were no significant differences in the occurrence of cardio va scular events up to 1-year post-pPCI between patients treated conventio nally versus those treated with routine adjunctive thrombus aspiration. Of interest, in the sub group of patients with large angiographic thrombus burden (i.e., TIMI thrombus grade ≥3), thrombus aspira tion was associated with a significant reduction in cardiovascular death [2.5 % vs. 3.1 %; hazard ratio 0.80, 95 % confidence interval (CI), 0.65–0.98, P=0.03]. This meta-analysis in fact assessed data from the three lar gest randomized trials on this topic, namely Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS),4,5 Throm bus Aspiration in ST elevation Myocardial Infarction in Scandinavia (TASTE)8,9 and

Background: The study used data from medical and counselling of patients who were diagnosed with hormone-dependent breast cancer. Aim: The objective of the paper is to identify within a group of patients diagnosed with hormone sensitive breast cancer and those who have received adjuvant tamoxifen, and then to isolate the patients with whom the therapeutic effect of tamoxifen stopped (resistance to tamoxifen). Methods: The study analyzed 153 patients in the period from 2005 to 2011, at the Public Health Institution Hospital, Sveti Vracevi" in Bijeljina. Resistance to tamoxifen was developed by 60 patients (39.2%) and 93 patients (60.8%) did not develop resistance to it. Results: More common emergence of resistance is in the premenopausal group of patients (p<0.001). Statistically significant difference in frequency of resistance to tamoxifen was observed in the group of patients with ER-/PrR+ status of steroid receptors (p<0.001). In relation to HER-2 status of diagnosed cancer, a statistically significant difference in frequency of resistance emergence during tamoxifen therapy in patients with HER2-positive status (p<0.001) was observed. We found that there is a statistically significant difference between patients with metastatic in lymph nodes compared to patients who had no metastases in lymph nodes (X 2 =39.494; p<0.001). Conclusions: The analysis of menopausal status of patients, status of ER/PgR receptors status, HER-2 status of diagnosed cancer and status of lymph nodes trying to sort out the parameters on the basis of which a group of patients who can be expected to develop resistance to tamoxifen could be differentiated.

Background: Laparoscopy or endoscopically examining the peritoneal cavity was first attempted in 1901 by George Kelling who called this examining procedure celioscopy. Laparoscopy provides direct visual access to inner pelvic anatomy without a major abdominal surgery so that anatomy of uterus, ovaries, and fallopian tubes can be studied in more details and abnormalities can be treated at the same time. Methods: This was a retrospective study which presents the results of laparoscopic treatment of various gynecological diseases in Cantonal hospital Travnik, Bosnia and Herzegovina in the period from 2003 to 2016. Total 295 cases were enrolled. All underwent laparoscopic surgery in general anesthesia. The results were statistically analyzed. Results: The total number of patients is 295. The incidence is highest in the age 20-49 with a peak of 30-39 years (41.35%). Ovarian cysts are most common pathological condition in 43.60%, Infertility in 16.39% and Ectopic pregnancy in 12.13%. The most commonly treatment was cystectomy 40.06%, then chromopertubation with ovarian drilling 18:29% in infertility, and adnexectomy 10.72%. Conclusions: Laparoscopy involves a minimal damage to body tissues. It is safer than open surgery. Laparoscopic treatment has contributed to faster treatment, faster recovery and reducing the cost of treatment, and thus raise the level of efficiency.

Background: Endometrial cancer is the most developed countries the most common invasive neoplasms of the female reproductive system. The most frequently mentioned risk factors, which are associated with the occurrence of endometrial cancer are obesity, infertility, high blood pressure, diabetes, liver disease, hormone-active tumors of the ovary, and the use of external estrogen. Methods: This paper deals with data of the patients treated for endometrial carcinoma in Public Hospitals in Travnik, gynecological department in the period from 01 January 2007 to 01 January 2013 the sample consisted of 90 women with endometrial carcinoma, with ages ranging from 42 to 90 years (mean of 64 years). Results: 65 cases (73%) were of endometrioid and 25 (27%) nonendometrioid carcinoma. Obesity is an important risk factor for endometrial carcinoma, in our sample of 90 patients most of the patients was obese, and this risk factor was statistically processed and presented. Endometrioid carcinoma had 16 (45%) patients with a BMI 30 kg / m 2 had endometrioid carcinoma, and 16 patients (30%) had Non-endometrioid carcinoma. Conclusions: Obesity is the strongest risk factor for the development of endometrial cancer due to the mechanism of increased exposure to non-opposed estrogen. Consequently, the link between obesity and endometrial cancer is stronger in cases of tumor type 1, typical estrogen-dependent tumors.

Investigation of the polycrystalline solar modules energy efficiency in relation to their tilt angle and geographical orientation in the real meteorological conditions are presented in this paper. The experimental system comprises five polycrystalline silicon modules, with single power 50 Wp, three of which are placed vertically and oriented towards the East, South and West, respectively, the fourth is horizontal, while the fifth is oriented toward the South at the angle of 33º (optimally inclined solar module). The measurement period was from 01 August to 01 December, 2014. The optimally inclined solar module generated the most of total monthly energy for all four months. The most of total monthly energy was generated in August, by the optimally inclined solar module (6.07 kWh), horizontal solar module (5.69 kWh), the vertical solar module oriented toward the East (2.42 kWh) and the vertical solar module oriented toward the West (2.52 kWh), respectively. Energy efficiency of optimally inclined solar module for the entire measurement period was 14.27%, 11.41% for the horizontal, 10.37% for the South, 5.79% for the East and 5.23% for the West module. The obtained results can be used in modern architecture, for the application of the solar modules as roof and façade elements.