Red fox, Vulpes vulpes, is a globally distributed species characterized by its high adaptability to diverse habitats and a broad range of food resources. This remarkable adaptability has allowed the red fox to thrive in various environments, from urban areas to remote wilderness. In this study, we used a set of microsatellite markers for the comparative genetic analysis of red fox populations from two countries. We included populations from the Eastern Alps and the northern Dinaric Mountains in Slovenia, as well as the Central Dinaric Mountains in Bosnia and Herzegovina. We successfully isolated DNA and genotyped 118 red fox samples. Our analyses, which included Bayesian clustering techniques, revealed a weak genetic differentiation among the studied populations. However, it is noteworthy that statistically significant differences in estimates of genetic differentiation were only apparent when comparing the populations between the two countries. Further spatial genetic clustering analyses provided additional insights, unveiling a differentiation into four genetic clusters. These clusters comprised two distinct groups in Bosnia and Herzegovina and two in Slovenia. This pattern of differentiation suggests that isolation by distance is a key factor influencing the genetic structure of the red fox in this studied region. Additionally, our findings highlighted that populations from the Alps and northern Dinaric Mountains exhibit higher genetic diversity and observed heterozygosity compared to their counterparts in the Central Dinaric Mountains. The genetic diversity is also notable when compared to other European red fox populations. Studying genetic diversity is crucial for the resilience and adaptability of populations, ensuring their survival amid environmental changes and human-induced pressures.
AIM To determine the prevalence of aerobic vaginitis (AV) caused by Enterococcus faecalis (E. faecalis) in human papilloma virus (HPV)-positive women with pathological Pap test and to determine the most prevalent HPV type associated with E. faecalis infection. METHODS This prospective study was conducted at the Gynaecology Centre "Dr. Mahira Jahić" Tuzla and Primary Health Care Centre Tešanj (Bosnia and Herzegovina) in the period between February 2023 and March 2024. The research included 200 women aged 25 to 50 years. The examined group consisted of 100 women with a pathological (examined group) and 100 with a normal (control group) Pap test result. RESULTS Pathological Pap smears were found in 60 (out of 100; 60 %) women in the examined group: cervical intraepithelial neoplasia (CIN) 1 and CIN 2 in two women, respectively, CIN 3 in seven, atypical squamous cells of undetermined significance (ASCUS) in 29 and atypical squamous cells-high-grade cannot be excluded (ASC-H) in two women. Overall (both groups) prevalence of E. faecalis was 25.5% (51women); in 45 (22.5%) women E. faecalis was the only bacterial isolate, of which 42 (21%) in the examined group and three (1.5%) in the control group. High-risk HPV types were found in 62 (out of 100; 62%) women with the pathological Pap smear test. The association of E. faecalis and high-risk HPV positive women was found in 35 (35%) cases (moderately positive correlation; r=0.198). CONCLUSION E. faecalis is very common in HPV 16 and 18 positive women and may represent a risk factor in the development of cervical intraepithelial lesions.
AIM To determine whether demographic data, clinical features, and laboratory variables at disease onset can predict the response to methotrexate in juvenile idiopathic arthritis (JIA) patients. METHODS A cohort of 143 newly diagnosed JIA patients initially treated with methotrexate was enrolled in this study. Demographic, clinical, and laboratory parameters were analysed using univariate and multivariate logistic regression to identify predictors of response to methotrexate. The variables included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelets, IgA, IgG, the number of active joints and age at disease onset. Treatment response was assessed at six months, with patients classified as responders (those who achieved clinically inactive disease according to the American College of Rheumatology - ACR criteria) or non-responders. RESULTS Poor response to methotrexate was associated with the number of active joints (p=0.0001; OR=2.7), baseline levels of CRP (p=0.044; OR=1.138), IgA (p=0.004; OR=2.159), and platelet count (p=0.01; OR=1.05). IgG level (P=0.236) did not correlate with the treatment response. CONCLUSION We identified widely available and clinically acceptable biomarkers that can be utilized as predictive indicators of response to methotrexate in JIA patients.
AIM To investigate clinical and morphometric characteristics of patients with lower urinary tract symptoms (LUTS) due to lumbar spinal stenosis (LSS). METHODS This study evaluated LSS patients using clinical assessments of motor, sensory, bladder, and bowel functions, and functional disability scores from the Oswestry Disability Index (ODI) and Swiss Spinal Stenosis Questionnaire (SSSQ). Morphometric analysis included MRI measurements of the anteroposterior diameter of the intervertebral disc and dural sac, and the modified Torg-Pavlov ratio (mTPR), with follow-up re-evaluations at 6 months. RESULTS Of 159 patients, 49 (30.8%) had LUTS and 110 (69.2%) were in the control group. LUTS patients had a significantly higher prevalence of neurogenic claudication (100% vs. 47.3%; p<0.001), lower back pain (93.9% vs. 77.3%; p=0.011), and lower extremity pain (57.1% vs. 34.5%; p=0.008). The LUTS group also had higher ODI (54.0 vs. 50.0; p=0.019) and SSSQ score (44.0 vs. 34.0; p<0.001). Morphometric analysis showed significantly lower mTPR in LUTS patients (median 0.31 vs. 0.45; p<0.001), with an AUC of 0.704 (95%CI 0.627-0.774). mTPR ≤0.31 predicted surgical revision within 6 months (OR:3.4, CI: 1.2-9.8), motor deficiency (OR:2.1, 95%CI: 1.4-5.2), and persistent LUTS post-surgery (OR:4.5, 95%CI: 1.1-18.9). mTPR ≤0.34 was associated with worse follow-up outcome, including increased ODI (β:3.2; 95%CI: 1.1-5.3; p=0.004) and SSSQ score (β:4.8; 95%CI:2.1-7.5). CONCLUSION LUTS patients with LSS exhibit more severe symptoms and poorer outcome, with mTPR ≤0.34 being a predictor of adverse clinical outcome and the need for surgical revision within 6 months.
AIM To compare the impact of electrical cardioversion (ECV) and pharmacological cardioversion (PCV) on left atrial size (LA) and left ventricular ejection fraction (LVEF), as well as to identify predictors of rhythm disorder recurrence in patients with atrial fibrillation (AF) or atrial flutter (AFL). METHODS A prospective observational cohort study was conducted on 105 patients with persistent AF or AFL at the University Clinical Centre Tuzla. The patients were divided into two groups: 53 underwent ECV and 52 received PCV. Demographic and clinical data, including ECG and transthoracic echocardiography, were collected. Follow-up assessments were conducted at 7 days, 1 month, and subsequently every 3 months for a year. RESULTS Baseline characteristics were similar between the groups. Recurrence of rhythm disorder within one year was observed in 52.4% of cases, with ECV showing a slightly lower, though not significantly different, primary failure rate at 7 days compared to PCV (13.2% vs. 23.1%). Significant predictors of recurrence included longer duration of disorder (p< 0.001), hypertension (p=0.016), lack of pre-cardioversion amiodarone (p=0.027), and larger LA (p< 0.001). Both ECV and PCV significantly reduced LA over time, with no significant differences in LVEF between groups. CONCLUSION Both ECV and PCV are effective in restoring sinus rhythm, with a trend towards lower recurrence in the ECV group. Predictors such as disorder duration, hypertension, lack of pre-cardioversion amiodarone, and LA should be considered when planning cardioversion to optimize patient outcomes.
AIM Care for the inflammatory bowel disease (IBD) patients presents unique challenges as decisions regarding therapy must consider numerous distinct characteristics of each patient. The aim of the study was to recognize patients' characteristics as predictors of success in vedolizumab treatment. METHODS In a retrospective observational study, data regarding age, gender, body mass index (BMI), length of disease, previous exposure to anti-tumour necrosis factor (TNF), drugs, and smoking status were extracted from the routine clinical practice. Patients were assessed for clinical remission and steroid-free remission after the 26-week treatment with vedolizumab. RESULTS The study included 76 patients with UC and 63 with CD. A total of 63 (out of 76; 82.9%) (Cl: 72.5-90.6% ) of UC and 54 (out of 63; 85.7%) (Cl: 74.6-93.3%) CD patients achieved clinical remission in the 26-week vedolizumab treatment. Over five years, illness was noticed in 32 (53.1%) CD patients. Clinical remission was not achieved in six (out of 13; 46.1%) UC patients aged 40-49 years and six (out of nine; 66.6%) CD patients aged 30-49 years. Among CD patients, remission was achieved in 22 (85.7%) females and 23 (63.6%) males. Remission rates were generally higher in patients with a BMI of 18.6-25 and 25.1-30. Previous exposure to anti TNF drugs and smoking status did not influence treatment outcomes. CONCLUSION The efficacy of vedolizumab is a viable treatment option for both ulcerative colitis and Crohn's disease. The exploration of individual patient characteristics holds promise in predicting a treatment outcome.
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.
Precision medicine is a developing trend in oncology, and it includes the prognosis and treatment of advanced-stage ccRCC. New predictive factors and therapeutic targets for this disease are steadily needed. The aim of this study was to explore the tumor expression of inversin as a potential prognostic factor and/or therapeutic target in ccRCC. We compared the expression of inversin between primary ccRCC and normal renal tissues by using immunohistochemistry and rtPCR in our cohort, and we also analyzed publicly available data from the TCGA-KIRC cohort. We found that the expression of inversin was significantly lower in primary tumor tissue, in comparison to solid normal tissue. Data from the KIRC study confirmed that a lower INVS expression level in ccRCC was significantly related with the overall and disease-specific survival, as well as with a shorter progression-free interval (p < 0.05). Four out of ten inversin interactome partners were significantly related with the overall and disease-specific survival in ccRCC. A lower expression of ANKS6 was a negative survival predictor, while a higher expression of NPHP3, DVL1, or DVL3 was related with a lower survival. The expression of INVS and its interactome partners in ccRCC was correlated with the differentiation of the tumor and metastasis. The expression of INVS and its partners was also correlated with tumor leukocyte infiltration and the expression of immune checkpoint genes. The results of this study point to inversin and a distinguished group of its interactome partners as potential prognostic factors in ccRCC, with their predominant involvement in the modulation of the inflammatory infiltration of the tumor microenvironment and a strong relationship with the metastatic potential of the tumor.
Background and Objectives: This study aimed to investigate the novel adiponectin–resistin (AR) index as a predictor of the development of metabolic syndrome (MetS) in individuals with type 2 diabetes mellitus (T2DM). MetS is common in T2DM and increases cardiovascular risk. Adiponectin and resistin, adipokines with opposing effects on insulin sensitivity and inflammation, make the AR index a potential marker for metabolic risk. Materials and Methods: This prospective observational study included 80 T2DM participants (ages 30–60) from Sarajevo, Bosnia and Herzegovina, over 24 months. The participants were divided into two groups: T2DM with MetS (n = 48) and T2DM without MetS (n = 32). Anthropometric data, biochemical analyses, and serum levels of adiponectin and resistin were measured at baseline and every six months. The AR index was calculated using the formula AR = 1 + log10(R) − 1 + log10(A), where R and A represent resistin and adiponectin concentrations. Logistic regression identified predictors of MetS. Results: T2DM patients who developed MetS showed a significant decline in adiponectin levels (40.19 to 32.49 ng/mL, p = 0.02) and a rise in resistin levels (284.50 to 315.21 pg/mL, p = 0.001). The AR index increased from 2.85 to 2.98 (p = 0.001). The AR index and resistin were independent predictors of MetS after 18 months, with the AR index showing a stronger predictive value (p = 0.007; EXP(B) = 1.265). Conclusions: The AR index is a practical marker for predicting MetS development in T2DM participants, improving metabolic risk stratification. Incorporating it into clinical assessments may enhance early detection and treatment strategies.
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