OBJECTIVE The aim of this paper was to analyze the distribution of stress and deformation on the mandibular first premolar under two types of loading (axial and para-axial load of 200 N) using the FEM computer method. MATERIALS AND METHOD For this research a µCT scan of the first mandibular premolar was used, and the method used in this research was FEM analysis under two types of loading. RESULTS The values of the von Mises stress measured in the cervical part of an intact tooth under axial load were up to 12 MPa, and under paraaxial load over 50 MPa. The values of the stress measured on the bottom of the noncarious lesion are very high ≈ 240 Mpa. Stress values in the cervical part of the intact tooth are higher in the zone of the sub-surface enamel. The deformation values of the tooth under para-axial loading were ≈ 10 times higher than the value of the deformation under axial load. The greatest deformations were seen in the area of the tooth crown. CONCLUSIONS Occlusal loading leads to significant stress in the cervical part of teeth. The values of the measured stress are greater under the action of paraxial load. The values of stress in abfraction lesions measured under a paraxial load are extremely high. Exposing the lesion to further stress will lead to its deepening. The total deformation of the entire tooth under paraxial load was ≈ 10 times higher compared to the deformation value of the tooth under axial load.

Introduction: Abdominal aortic aneurysm represents a local pathological dilatation of the abdominal aorta. It is caused by structural weakness of aortic wall but there are many other risk factors that may positively correlate with incidence of AAA like hypertension, smoking, male gender, older age, family history etc. Aim: The purpose of the study was to evaluate the correlation of atherosclerotic risk factors and the size of aortic aneurysm in patients that were admitted for the surgical treatment at the Clinic for cardiovascular surgery in Sarajevo during period 2016-2019. Methods: The study was designed as a retrospective study with one group of patients that was conducted at the Clinical Center of the University of Sarajevo at the Clinic for Cardiovascular Surgery. It included 150 patients, 126 males and 24 females, all of them with infrarenal localization of AAA. From medical records we have collected relevant anamnestic data (age, gender, positive family history, diabetes mellitus, hypertension, hyperlipidemia, smoking, alcohol consumption and obesity). The size of aneurysm was determined by both ultrasound and CT arteriography. The data are processed in the Statistical Package for Social Sciences Ver. 22.0. The results are tabulated or graphically showed, and level of statistical significance was set at p <0.05. Results: Total amount of 129 of patients (86%) had hypertension, 57.3% (n=86) of them were smokers, 18.7% (n = 28) were former smokers, and 24% (n = 36) were non-smokers Blood lipid level analysis have shown that 44% (n = 66) of patients were normolipemic, while elevated blood lipid levels were found in 56% (n = 84) of patients. Diabetes mellitus was present in 17.3% (n = 26) of patients, 2.7% (n = 4) of them had an insulin-dependent form, while 14.7% (n = 22) of the analyzed patients had insulin independent DM. Almost half of total number of patients (46%, n = 69) were obese. 19.3% (n = 29) of patients consumed alcohol while the 80.7% (n = 121) denied alcohol consumption. Ratio of males in comparison to females was 5:1. The average age in males was 69.79 ± 8.16 years and 72.13 ± 9.11 years in females. Significant statistical correlation of AAA size and risk of atherosclerosis factor has not been established. We have found that there is a significant positive correlation between size of aneurysm and risk of rupture (p= 0,000<0,05). Conclusion: Although risk factors of atherosclerosis were present, statistically positive correlation was not confirmed between the size of AAA and analyzed risk factors.

Gross hematuria caused by rupture of an artery in the urinary tract is a rare but potentially fatal condition. Iliac artery aneurysms, pelvic surgery with radiation, vascular reconstructive surgery, surgery for stenosis of the ureteropelvic junction, and transplantation are reported to be associated with this condition. In the vascular reconstructive surgery group, the most common etiology is rupture of the degenerated artery or synthetic graft in the ureter. We present a case of rupture of the small anastomotic pseudoaneurysm at the proximal anastomosis of a right iliofemoral autogenous vein extra-anatomic graft in the urinary bladder. To our knowledge, this is the first report of a rupture of an autogenous vein graft in the urinary bladder. Our patient, a 24-year-old Albanian farmer, was admitted to the emergency department in severe hemorrhagic shock induced by exsanguinating hematuria. He underwent immediate surgery, during which direct sutures to the bladder were placed and the saphenous graft was replaced with a synthetic one. The patient recovered completely, was free of hematuria, and showed no signs of pathological communication between the urinary and arterial tracts on postoperative cystoscopy and computed tomographic angiography during 2 years of follow-up. The incidence of artery-to-urinary tract fistulas is growing due to the increasing use of urologic and vascular surgery, pelvic oncologic surgery, and radiation therapy. In addition to fistulas involving a degenerated artery and ureter or synthetic grafts and ureter, they can also involve an autogenous vein graft and the urinary bladder. In our patient, the fistula was a result of erosion of the bladder from a pseudoaneurysm at the proximal anastomosis of an autogenous vein iliofemoral bypass in an extra-anatomic position. Open surgery remains the best treatment option, although there is increasing evidence of successful endovascular treatment.

OBJECTIVE The purpose of this study was to evaluate the efficiency of the anticholinergic therapy with oxybutynin and the effects of daily transcutaneous tibial nerve stimulation (TTNS) on the quality of life of patients with an overactive bladder (OAB) and multiple sclerosis (MS). PATIENTS AND METHODS The study was designed as a randomized controlled trial. The patients who suffer from MS underwent urodynamic tests which showed that they had an OAB. The tests used to assess symptoms and quality of life were Overactive Bladder Questionnaires (OAB-q) SF. Patients were divided into 2 groups of 30 patients each. The first group received a 5 mg oxybutynin tablet twice a day for 3 months and the second group had TTNS every day for 3 months. RESULTS The anticholinergic therapy showed a statistically significant improvement in all symptoms and quality of life (P<0.001). Side effects such as dry mouth were observed in about 35% of patients. The results of the study TTNS daily therapy showed good performance in the reduction all clin ical symptoms of the bladder and improved quality of life, with statistical significance (P<0.05) and with no side effects. It was found that the improved quality of life parameters and the reduced symptoms were more statistically significant in the treatment with oxybutynin tablets than TTNS therapy (P<0.001). CONLCUSION Our recommendation for the treatment of OAB is oxybutynin in doses of 2x5 mg. If a patient can not tolerate anticholinergic drugs, daily TTNS is recommended to reduce OAB symptoms and improve quality of life, without side effects.

Objectives: To assess the prognostic value of pentraxin 3 (PTX3) in patients with ST-elevation myocardial infarction (STEMI) after bare-metal stent (BMS) implantation. Methods: In this prospective study, PTX3, interleukin (IL-6), IL-10, high-sensitivity c-reactive protein (hsCRP), and cardiac troponin I (cTnI) plasma values were determined before and 24hours after BMS implantation in 97 consecutively enrolled patients with STEMI who were admitted to University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina between February 2016 and February 2017. Patients were followed for 24 months to assess major adverse cardiovascular events (MACEs). Results: At 24 hours after percutaneous coronary intervention (PCI), plasma values of PTX3, IL-6, hsCRP, and cTnI were significantly increased; and IL-10 levels were significantly decreased compared with the values determined before PCI. Patients with MACEs had significantly higher plasma PTX3 levels at 24 hours after BMS-PCI than in patients without MACEs. Patients with PTX3 plasma values ≥5042 ng/ml had a significantly higher risk of MACEs than patients with PTX3 levels <5.042 ng/mL. Pentraxin 3 levels exhibited strong and significant correlations with IL-6 and IL-10 levels. Pentraxin 3, cTnI, and IL-6, but not hsCRP levels have showed independent association with MACEs, according to the multivariate Cox regression analysis. Conclusion: Pentraxin 3 might be better serum prognostic marker than IL-6, IL-10 or high sensitivity CRP for MACEs after BMS-PCI. It might help to make better risk stratification of those patients who are undergoing BMS-PCI.

Introduction: Although sense of security in mothers is not clearly specified in literature, most important factors that make it up in women that do not have issues in pregnancy are social support, prenatal health care and partner’s support. Psychological factors play a key role in recognizing fear of childbirth, distinguishing anxiety from clinical depression. Recognizing risk factors and adequate intervention support would significantly reduce fear. Aim: to analyze development of mother’s sense of security during the postnatal period and establish the differences between two study groups. Methods: The Cross section study was conducted in 2017 in the Public Institute for Health care Protection of Women and Maternity in Canton Sarajevo. Using random method in the study were included 395 mothers. The research instrument was PPSS-instrument and modified questionnaire. Results: Postnatal sense of security in n=395 of the mothers on average was 49, 61±7, 6. Mothers’ sense of security during the first week after their child’s birth differed significantly (p=0.004) between mothers whose husband actively participated in psychophysical preparation for childbirth. Development of parents sense of security is in direct connection with psycho-physical preparations of pregnant women for labor only when both partners took active part in preparations for labor. Conclusion: Postnatal sense of security in parents is a term that has not been researched enough and it requires further studies. Bachelor degree in health care/graduated nurse/midwife, especially in primary health care field, according to her competencies would be able to independently create and work on promoting prevention programs through holistic approach with individuals and families.

The aberrant DNA methylation plays a critical role in a number of different malignancies, including melanoma. DNA methylation is catalyzed by DNA methyltransferases (DNMTs), involved in methylation maintenance (DNMT1) and de novo DNA methylation (DNMT3A and DNMT3B). The current study investigated the association of genetic variants in the DNMT1 and DNMT3B with the clinicopathologic features and the clinical course of melanoma patients. In the present study, DNMT1 (rs2228612, rs2228611, and rs2114724) and DNMT3B (rs406193 and rs2424932) polymorphisms were examined in 123 melanoma patients. Single nucleotide polymorphisms were assessed using TaqMan SNPs Genotyping Assays according to the manufacturer's protocols. The carriers of the variant genotype of DNMT1 rs2228612 had poorer overall survival and recurrence-free survival, (P=0.000 and 0.000, respectively), and an increased risk for adverse outcome [hazard ratio (HR)=6.620, 95% confidence interval (CI): 2.214-19.791, P=0.001]. DNMT1 rs2228612 was also associated with ulceration (P=0.045), nodal status (P=0.030), progression (P=0. 007), and stage of disease (P=0.003). Univariate analysis indicated that tumor-infiltrating lymphocytes could be a marker of good prognosis in melanoma patients (HR=0.323, 95% CI: 0.127-0.855, P=0.025), whereas the genotype distribution of the DNMT3B rs406193 polymorphism correlated significantly with the presence of tumor-infiltrating lymphocytes (P=0.012). The multivariate analysis showed that the DNMT1 rs2228612 polymorphism (HR=12.126, 95% CI: 2.345-62.715, P=0.003) is an independent predictor of poor overall survival in melanoma patients. As expected, disease progression was also found to be an independent prognostic factor in melanoma patients (HR=37.888, 95% CI: 3.615-397.062, P=0.002). DNMT1 rs2228612 was found to be an independent predictor of poor overall survival in melanoma patients. DNMTs polymorphisms could serve as a potential target for novel therapeutic approaches.

OBJECTIVE The aim of this study was to assess the relationship between the use of neuroenhancing substances, exam anxiety and academic performance among first-year Bosnian-Herzegovinian (BH) university students. METHODS In a cross-sectional study, an ad hoc questionnaire was delivered to a sample of BH first-year university students. The following data were collected: socio-demographic features, consumption of neuroenchancing substances, the Westside Test Anxiety Scale (WTAS) and academic performance. RESULTS A total of 214 students were included. Consumption of lifestyle substances, coffee, energy drinks, nicotine, alcohol, and marijuana, for the purpose of neuroenhancement increased during the week before the exams. OTC cognitive enhancer use was reported by 31.0%, and of benzodiazepines by 1.5% of students. No psycostimulants were used. A high to extremely high exam WTAS score was reported in 38.3% students. The exam WTAS score was positively correlated with consumption of coffee (rho=0.31; P<0.001), energy drinks (rho=0.18; P=0.009), and nicotine (rho=0.22; P=0.001), and negatively correlated with last exam grade (rho=-0.33; P<0.001). The exam WTAS score was a significant independent predictor (OR=0.55; 95% CI 0.31 to 0.97, P=0.039) for self-assessed academic performance. Self-assessed academic performance was positively correlated with last exam grade (rho=0.15; P=0.043). CONCLUSIONS Although first-year BH university students do not seem to use either prescription or illicit psycostimulants, the consumption of nicotine, alcohol, and marijuana is worrying. However, the consumption of these neuroenhancing substances seems not to be related to better self-assessed academic performance. Finally, exam anxiety seems to be a significant problem among BH first-year university students.

SUMMARY This review article is focused on the impact of antioxidants and prooxidants on health with emphasis on the type of antioxidants that should be taken. Medical researchers suggest that diet may be the solution for the control of chronic diseases such as cardiovascular complications, hypertension, diabetes mellitus, and different cancers. In this survey, we found scientific evidence that the use of antioxidants should be limited only to the cases where oxidative stress has been identified. This is often the case of specific population groups such as postmenopausal women, the elderly, infants, workers exposed to environmental pollutants, and the obese. Before starting any supplementation, it is necessary to measure oxidative stress and to identify and eliminate the possible sources of free radicals and thus increased oxidative stress.

SUMMARY The aim of this paper is to determine nutritive, functional, microbiological and sensory properties of probiotic beverages produced from different volume ratios of cow's milk and soy beverage (25:75, 50:50 and 75:25). Pure cow’s milk and soy beverage served as control samples. Fermentation was performed at 43 °C by a combined culture consisting of the probiotic strain Lactobacillus acidophilus La5 and yoghurt culture. Viable counts of La5 strain in the produced beverages ranged from 7.52 to 8.20 log CFU/mL, which is above the probiotic minimum (106 CFU/mL). Lactic acid was the most prevalent organic acid in all samples (660.1 to 1003.0 mg/100 mL). The fatty acid profiles of fermented beverages were as follows: the mass fraction of saturated fatty acids was 22.2-82.7%, of unsaturated fatty acids 22.3-77.8% and of polyunsaturated fatty acids 15.5-65.9%. The main soy sugars were transformed well (80% stachyose and 50% raffinose conversion) into lactic acid during fermentation. Functional probiotic beverages were successfully produced from different volume ratios of cow's milk and soy beverage by L. acidophilus La5 and yoghurt culture. Mixing cow's milk with soy beverage significantly improved the sensory properties of the product, especially its smell, taste and colour. The acceptability test showed good acceptance by potential consumers of all fermented beverage samples except for the sample made from 100% soy beverage. In the end, the obtained results represent a good basis for further optimisation of the ideal volume ratios of cow's milk and soy beverage for production of fermented beverages characterised by good viability of probiotic bacteria as well as by good functional, nutritive and sensory characteristics.