Introduction: The best treatment for intertrochanteric fractures remains controversial. Many methods have been recommended. Aim: We aimed to assess the results of osteosynthesis using the Proximal Femoral Nail Antirotation (PFNA) system. Patients and Methods: We retrospectively analyzed 113 consecutive patients with intertrochanteric fractures treated with PFNA. Fractures were classified in accordance with the AO/OTA classification system into the groups A1, A2 and A3. The postoperative quality of fracture reduction was described as good, acceptable or poor. The location of the blade within the head was recorded as per the Cleveland method. Tip-apex distance (TAD) was used as a method for evaluating screw position. Pre-fracture and postoperative functional level were evaluated by the new mobility score (NMS). Results: The average age at the time of surgery was 75.9 years. The majority, 75 (66.3 %), were unstable fracture types. The reduction was good in 67 (61.4 %) cases. Of the 24 deaths, 19 patients had comorbidities (p < 0.001). The number of deaths in the first 6 months was significantly higher than in the next 6 months (p = 0.001). The mean TAD was 25.6 mm. The Cleveland zone centre-centre was the most common placement of the blade, accounting for 33 (29 %) of the cases. Reoperation was required in four patients. There were four patients with cut-out. The pre-facture mean value NMS was 8.6 (SD 1.1) and the postoperative mean value was 4.3 (SD 3.6). Conclusion: We concluded that PFNA offers biomechanical advantages, but the best position of the blade is still unknown.

Introduction: Obesity in children is becoming from year to year enormous medical and socio-epidemilogical problem according to increasing number of overweight and obese children. Overweight and obesity in children mostly affects on cardiovascular, respiratory and endocrine system disturbances. Adenoidectomy and adenotonsillectomy belong to group of most often done operation in children population. Anesthesiology complications during adenodecotomy and adenotonsillectomy in children are known as very disturbing and dramatic. Methods: Retrospective-prospective study includes 162 children, both genders, 3 to 12 years old, who are hospitalized and operated (adenoidectomies and adenotonsillectomies) on Otorihinolaryngolic clinic of University clinical centre Tuzla in the four year period. Purpose of the study is to show the influence of overweight in children on appearance of anesthesiology complications such as difficult intubation, bronchospasm and laryngospasm. Body mass index (BMI), which is used as universal measure, is adapted with gender specific scales of National statistic centre of United States of America. All children with BMI over 25 are referred as overweight and those over 30 as obese. These children categories were compared to those with normal BMI according to anesthesiology complications incidence. Results: Overweight in operated children is noticed in 21%, and 11% of children was obese and there wasn’t distinction between boys and girls. Anesthesiology complications are evaluated in 12 of them (7.4%). Total analyzed sample show significant connection and influence of overweight with appearance of anesthesiology complications. Separate comparison for two types of operations is indicating that during adenoidectomies there hasn’t been noticed connection between overweight and anestehesiological complications, while in case of adenotonsillectomies direct and significant correlation is proven. Conclusions: According to increased risk of anesthesiology complications in overweight and obese children during adenodectomies and adenotonsillectomies it is important for anesthesiologists to do much serious preoperative evaluation of obese children, and to be more prepared for every of possible unwished supersize during perioperative period.

Purpose: The aim of this study was to assess knowledge and attitude of dentists in Bosnia and Herzegovina (BH) regarding signs and symptoms of child abuse and neglect (CAN), reporting procedure and level of education. Methods: Data were collected through a self-administrated structured questionnaire adopted and modified from previous studies. It was administrated to 300 dentists out of which a total number of 210 subjects were in final sample for statistical analyses. Response rate was seventy percent. Descriptive statistics, Chi-square and Kruskal-Wallis H test were used to analyze statistical differences in responses. The level of significance was set at p<0.05. Results: Dentists in BH are very rarely provided (80%) with training related to recognition and reporting of CAN. Sixty six percent of dentists had never suspected CAN in their practice. Only nine percent of dentists would report suspicious of CAN. Prevailing reasons for not reporting suspected case of CAN was lack of knowledge of the reporting procedure (43%), and combination of indicated answers that never had a case and lack of knowledge about the procedure (31%). Conclusion: Results of this study suggest that dentists need an effective education to increase their knowledge and awareness of all aspects of CAN.

A matching M in a graph G is maximal if it cannot be extended to a larger matching in G . In this paper we show how several chemical and technical problems can be successfully modeled in terms of maximal matchings. We introduce the maximal matching polynomial and study its basic properties. Then we enumerate maximal matchings in several classes of graphs made by a linear or cyclic concatenation of basic building blocs. We also count maximal matchings in joins and corona products of some classes of graphs.

Malignant phyllodes tumor is a rare breast malignancy with sarcomatous overgrowth and with limited effective treatment options for recurrent and metastatic cases. Recent clinical trials indicated a potential for anti-angiogenic, anti-EGFR and immunotherapeutic approaches for patients with sarcomas, which led us to investigate these and other targetable pathways in malignant phyllodes tumor of the breast. Thirty-six malignant phyllodes tumors (including 8 metastatic tumors with two cases having matched primary and metastatic tumors) were profiled using gene sequencing, gene copy number analysis, whole genome expression, and protein expression. Whole genome expression analysis demonstrated consistent over-expression of genes involved in angiogenesis including VEGFA, Angiopoietin-2, VCAM1, PDGFRA, and PTTG1. EGFR protein overexpression was observed in 26/27 (96%) of cases with amplification of the EGFR gene in 8/24 (33%) cases. Two EGFR mutations were identified including EGFRvIII and a presumed pathogenic V774M mutation, respectively. The most common pathogenic mutations included TP53 (50%) and PIK3CA (15%). Cases with matched primary and metastatic tumors harbored identical mutations in both sites (PIK3CA/KRAS and RB1 gene mutations, respectively). Tumor expression of PD-L1 immunoregulatory protein was observed in 3/22 (14%) of cases. Overexpression of molecular biomarkers of increased angiogenesis, EGFR and immune checkpoints provides novel targeted therapy options in malignant phyllodes tumors of the breast.

The search for biomarkers that characterize specific aspects of inflammatory bowel disease (IBD), has received substantial interest in the past years and is moving forward rapidly with the help of modern technologies. Nevertheless, there is a direct demand to identify adequate biomarkers for predicting and evaluating therapeutic response to different therapies. In this subset, pharmacogenetics deserves more attention as part of the endeavor to provide personalized medicine. The ultimate goal in this area is the adjustment of medication for a patient's specific genetic background and thereby to improve drug efficacy and safety rates. The aim of the following review is to utilize the latest knowledge on immunopathogenesis of IBD and update the findings on the field of Immunology and Genetics, to evaluate the response to the different therapies. In the present article, more than 400 publications were reviewed but finally 287 included based on design, reproducibility (or expectancy to be reproducible and translationable into humans) or already measured in humans. A few tests have shown clinical applicability. Other, i.e., genetic associations for the different therapies in IBD have not yet shown consistent or robust results. In the close future it is anticipated that this, cellular and genetic material, as well as the determination of biomarkers will be implemented in an integrated molecular diagnostic and prognostic approach to manage IBD patients.

Abstract Background. Endovascular embolization is a treatment of choice for the management of unruptured intracranial aneurysms, but sometimes is complicated with perianeurysmal oedema. The aim of our study was to establish incidence and outcomes of perianeurysmal oedema after endovascular coiling of unruptured intracranial aneurysms, and to reveal possible risk factors for development of this potentially serious complication. Methods. In total 119 adult patients with endovascular embolization of unruptured intracranial aneurysm (performed at Department for Interventional Neuroradiology, Clinical Center, Kragujevac, Serbia) were included in our study. The embolizations were made by electrolite-detachable platinum coils: pure platinum, hydrophilic and combination of platinum and hydrophilic coils. Primary outcome variable was perianeurysmal oedema visualized by magnetic resonance imaging (MRI) 7, 30 and 90 days after the embolization. Results. The perianurysmal oedema appeared in 47.6% of patients treated with hydrophilic coils, in 21.6% of patients treated with platinum coils, and in 53.8% of those treated with mixed type of the coils. The multivariate logistic regression showed that variables associated with occurrence of perianeurysmal oedema are volume of the aneurysm, hypertension, diabetes and smoking habit. Hypertension is the most important independent predictor of the perianeurysmal oedema, followed by smoking and diabetes. Conclusions. The results of our study suggest that older patients with larger unruptured intracranial aneurysms, who suffer from diabetes mellitus and hypertension, and have the smoking habit, are under much higher risk of having perianeurysmal oedema after endovascular coiling.