Cryptogenic stroke is an ischemic stroke of unknown cause after a comprehensive diagnostic workup and accounts for a significant percentage of all strokes. This paper presents the case of a 37-year-old female patient with recurrent ischemic strokes, in whom a patent foramen ovale (PFO) was diagnosed and subsequently closed via catheter-based intervention. Despite this therapeutic procedure, further recurrences occurred. During electrophysiological evaluation and ablation of paroxysmal supraventricular tachycardia, paroxysms of atrial fibrillation were detected, leading to the initiation of anticoagulant therapy. During follow-up, the patient remained free of symptomatic recurrences. This case highlights the importance of prolonged monitoring for the detection of atrial fibrillation in patients with cryptogenic strokes, which can significantly influence therapeutic strategies and recurrence prevention.

Background. Patent foramen ovales are very common in the population. Thrombus entrapped in a patent foramen ovale is very rare and can cause paradoxical embolism with a high mortality rate. We present the case of a patient diagnosed with a massive pulmonary embolism and a huge thrombus stuck over the interatrial septum. Case presentation. An 83-year-old female patient was admitted to our Coronary care unit with the diagnosis of massive pulmonary embolism confirmed by contrast-enhanced chest CT scan. At admission, the patient complained of chest pain and shortness of breath for the last 24 hours. Transthoracic echocardiography (TTE) showed the presence of a thrombus entrapped in a patent foramen ovale and floating in both atria. Transesophageal echocardiography was done as well to confirm the diagnosis. Deep vein thrombosis was diagnosed by duplex ultrasonography. After discussing the risks and benefits of surgical versus medical treatment, the patient was treated with unfractionated heparin during hospitalization and rivaroxaban on discharge. Seven days later, follow-up TTE showed no clot in the heart. Conclusion. Although rare, the thrombus stuck in patent foramen ovale presents a clinical emergency so early diagnosis and treatment is mandatory.

Acute myocardial infarction with ST elevation (STEMI) is a disease of the elderly, rarely of people younger than 40 years, predominantly men with comorbidities. The incidence of STEMI infarction in the general population in women younger than 40 years is very low. This paper presents the case of a young woman who was admitted with a diagnosis of STEMI infarction, which was understood as SCAD after coronary angiography. Repeated invasive diagnostics with intracoronary imaging determined that it was a classic infarction with plaque rupture/erosion and a large intraluminal thrombotic mass that partially embolized with occlusion of the apical part of the anterior descending artery (LAD). She was treated during hospitalization with dual antiplatelet therapy (DAPT) using a potent P2Y12 inhibitor and low molecular weight heparin, high dose of statins. Control coronary angiography revealed insignificant narrowing of the distal part of the main trunk of the left coronary artery (LM) and the proximal segment of the LAD with almost complete resolution of the thrombus. DAPT treatment was continued without stent implantation.

Introduction. When considering revascularization modalities, for patients with stable presentation, with appropriate coronary anatomy suitable for both PCI and CABG and low predicted surgical mortality, the recommendations are specifically focused on patients with main stem stenosis. In these cases, patients should be individually assessed according to the complexity of the anatomical disease, as determined by the anatomical SYNTAX score. In the last few years, the results of four randomized studies have been published comparing PCI with newer-generation DES and CABG in patients with left-main stenosis. The latest 2024 ESC guidelines for the management of chronic coronary syndromes recommend CABG over PCI when the anatomical SYNTAX score exceeds 22, as indicated by recent trials. The aim of this study was to examine whether the indications for CABG or PCI, as determined by the well-informed intuitive judgment of PCI operators in everyday clinical practice, align with the treatment recommendations outlined in the recently published ESC guidelines. Methods. Between January 1, 2023, and December 31, 2023, patients were recruited from the University Clinical Centre of the Republic of Srpska in Banja Luka, Bosnia and Herzegovina, utilizing the hospital information system. The study included consecutive patients diagnosed with significant unprotected left main coronary artery disease (≥50% diameter stenosis) confirmed through angiography, who did not exhibit major hemodynamic instability and received PCI at our facility. Patients were divided into two groups, based on the anatomical SYNTAX score i.e. those with SYNTAX ≤ 22 and those with SYNTAX > 22. Results. Following inclusion criteria, a total number of 38 patients were included in the analysis. The included patients had either previously diagnosed coronary artery disease or a high suspicion of coronary artery disease. The majority of the participants were male, with an average age of 65.6 years, with the youngest participant being 31 years old and the oldest 83 years old. A large majority of both sexes suffered from arterial hypertension, dyslipidemia, and type 2 diabetes. Participants in whom SYNTAX score was ≤ 22 were younger (p=0.049) and had less complex coronary artery disease i.e. fewer MEDINA 1,1,1 (p< 0.001) with less stents implanted (p=0.040). Over the course of one year of follow-up, three patients passed away, two of whom had a SYNTAX score exceeding 22. Additionally, two patients were lost to follow-up. Conclusion. The present study demonstrates that an intuitive decision-making process by experienced interventional cardiologists for choosing the optimal myocardial revascularization method for the individual patient with left main stenosis led to a discordance of the definitely chosen methods vs. the recommended method based on the SYNTAX score and ESC guidelines. This discordance between the recommended and the finally performed revascularization strategy led to a higher shortterm mortality.

The imperatively excellent performance of wavelength-division multiplexing (WDM) transmission over a fiber optic link, demands flat, i.e. not wavelength-selective transfer function. This implies that, mostly during installation and commissioning of a WDM-aimed fiber link, it is of interest to measure its frequency response, by complex stimulus-response tests using a tunable laser source coupled with an optical spectrum analyzer. On the contrary, a simple and practically costless alternative that we propose here, is testing in time domain by means of the ubiquitous optical time-domain reflectometer (OTDR), considering its distinctly reflective trace pattern as approximation of the fiber channel two-way power-delay profile, whose rms delay spread is the straightforward indicator of the fiber attenuation vs. wavelength characteristics’ unflatness qualifying the fiber as either appropriate for WDM transport, or requiring piecewise “flattening” of the transfer function by applying coherent optical orthogonal frequency-division multiplexing (CO-OFDM). Specifically, the proposed OTDR – aided WDM suitability fiber test model applied on the exemplar traces, showed significant peak-to-peak DWDM spectrum unflatness, i.e. the pronounced frequency selectivity strongly indicating the need for introducing CO-OFDM on top of WDM. This was found to be monotonically tracked by the WDM transmission performance – the bit-error rate (BER) values in particular, measured with and without the CO-OFDM applied.

Introduction: Medullary thyroid carcinoma (MTC) is an aggressive tumor associated with a significantly poorer prognosis compared to other types of thyroid cancer. Doppler ultrasound and familiarity with the Thyroid Imaging Reporting and Data System (TIRADS) nodule classification are essential. Objective: This case highlights the significance of precise ultrasound imaging, crucial for early detection and subsequent management of such aggressive disease. Case report: We describe the case of a 31-year-old woman who underwent systemic ultrasound imaging. Upon ultrasound examination, a 5 mm x 4 mm x 3 mm hypoechoic, ill-defined solid nodule with echogenic foci (TIRADS 4, score 6) was identified in the mid portion of the left thyroid lobe. Given the suspicious ultrasound features, the location of the nodule, and the elevated serum calcitonin level, the micronodule raised concerns for malignancy, particularly suggesting medullary thyroid microcarcinoma. The patient underwent thyroidectomy, and histopathological analysis confirmed the diagnosis. The histopathology report described a small white nodule (5 mm) in the left lobe. There was no remarkable necrosis, and amyloid deposits were inconspicuous. Lymphovascular invasion was not observed, and mitoses were rare. The tumor stage was T1 (pTNM), and no distant metastases were found. C-cell hyperplasia was noted around the tumor. Immunohistochemical analysis showed positive reactions for calcitonin, chromogranin, and mCEA. The proliferative index was low, approximately 4%. After surgery, serum calcitonin levels decreased. Three years after the surgery, the patient is in good general condition and is under regular monitoring. In the meantime, the patient has become a mother. Conclusion: Early detection and treatment of micro-MTC are crucial, as these tumors have the potential for aggressive behavior. Adequate ultrasound imaging assessment could significantly improve the prognosis and outcome for these patients.

The clinical outcome of chronic mitral regurgitation (MR) in children and adolescents, specifically the time it takes for Mr to develop significant changes in the configuration and function of the left atrium (LA), is a relatively understudied area. Numerous echocardiographic parameters demonstrate significant changes in the size, volume, and functional behavior of the LA; however, they lack the ability for early and fine detection of LA dysfunction. Left atrial strain (LAS) analysis represents a newer non-invasive technique for assessing LA function and early detection of its deformation and dysfunction. In the analysis of patients with chronic and significant Mr, it emerges as a method that could verify early deformative, functional, and possibly fibrotic changes in the LA and thus predispose rhythm disturbances and clinical manifestations. This study relates to strain analysis of LA function, which can have prognostic and clinical implications in pediatric cardiology and be of great assistance in deciding when to initiate Mr treatment.

Sarajevo and Mostar, the most visited destinations in Bosnia and Herzegovina (BiH), are well known for their gastronomic offerings. Influenced by diverse traditions and cultures, their culinary scenes reflect a notable influence of the Ottoman Empire. Both destinations boast numerous restaurants serving delicious dishes from both local and international cuisines. As online review platforms are a leading source of information in hospitality and tourism, this paper analyses TripAdvisor reviews of 56 restaurants in Sarajevo and 21 restaurants in Mostar that specialize in offering local cuisine. Given that traditional dishes have become a key factor in destination selection and tourist attraction, the aim of this study is to assess tourist satisfaction and highlight similarities and differences in perceptions of the local gastronomic offer in Sarajevo and Mostar. The research findings indicate that the most influential factor in tourist satisfaction is the balance between food quality and price. Interestingly, in both destinations, tourists perceive the local cuisine as Bosnian cuisine. The results of this analysis may serve as a valuable tool for policymakers and businesses to develop and effectively promote local gastronomic offerings.

Background: HLA-A gene is one of the most polymorphic loci in human genome and its variants influence disease susceptibility and immune checkpoint inhibitor (ICI) therapy response. HLA-A*03 allele has been identified as a biomarker associated with poor ICI response. Objective: This study aimed to characterize HLA-A allele and genotype frequencies in the Bosnian population, assess sex specific differences, and evaluate the prevalence of HLA-A*03. Methods: Blood samples from 75 individuals were analyzed. Genomic DNA was isolated using the Miller method, and HLA-A typing was performed using PCR with sequence specific primers (PCR-SSP). Polymorphism parameters were calculated using PowerMarker v3.25. Differences between males and females were assessed using chi square and Fisher’s exact tests. Results: Twelve HLA-A allelic groups and 28 genotypes were identified. The most frequent alleles were HLA-A*02 (33.33%), A*01 (16.67%), A*24 (11.33%), A*03 (10%), and A*11 (8%). The most common genotypes were HLA-A*01/*02 (12%), A*02/*02 (12%), and A*02/*03 (8%). Females showed significantly higher frequencies of HLA-A*02, A*03, and A*31, as well as genotypes HLA-A*02/*03, A*02/*11, and A*02/*31. The population exhibited high polymorphism (heterozygosity 0.8667; gene diversity 0.8232; PIC 0.8054). Strong similarity with European and Western groups and substantial divergence from East Asian and African populations were detected. Conclusion: The Bosnian population demonstrates high HLA-A polymorphism, with HLA-A*02 as the most common allele. Females more frequently carry the HLA-A*03 allele and several related genotypes, suggesting potential sex specific implications for ICI therapy response. These findings provide a foundation for future studies investigating the clinical relevance of HLA-A variation in Bosnian cancer patients undergoing immunotherapy.

The aim was to investigate sex differences regarding shooting position, shooting technique, and shot placement preceding open-play goal scoring in the Swedish Super League (SSL) in floorball. Video recordings of 3751 goals were analysed to determine the goal scorers’ positions on the pitch when they took the shots and which type of shots they used. In addition, the placement of the ball when it entered the goal was determined. The proportion of goals from the playing zone closest to the goal was higher for women (P < 0.001), whereas the relative number of goals from the playing zones to the left of the goal and from the central playing zone farthest from the goal was higher for men (all P < 0.001). Women used wrist shots and backhand shots more frequently to score goals than men (both P < 0.01); conversely, the proportion of goals scored using slap shots and volley shots was higher for men (both P < 0.001). In terms of shot placement, the percentage of goals scored in top-left corner was higher for male players (P < 0.05). Hence, there are sex-related goal-scoring differences in SSL and the findings may inform coaches in refining tactics and training. Keywords: Sex difference, video analysis, unihockey, shooting technique.