This paper presents the results of an experimental method for determining the efficiency of worm gears. Research into worm gears is primarily aimed at increasing the load carrying capacity, prolongation of life cycle and/or achieving higher efficiency, which can result in a reduction in exploitation costs. A larger share of sliding movement with respect to sliding-rolling movement of gearing contributes to the quiet operation but, on the other hand, causes a significant power loss. Very often, the load limit is not put by the load carrying capacity of gearing but by the ability to carry away the heat caused by friction. In order to design a worm gearbox that would be closer to the optimal solution from the temperature point of view (the heat), it is necessary to determine the operation losses. Besides the geometry of gearing, which influences the efficiency by forming conditions required for the creation of hydrodynamic lubrication, the applied lubricant also plays a significant role. In the research presented in this paper, mineral and synthetic oils were used for the combination of materials CuSn12/16MnCr5 used for gears operating at variable output load and two different rotational speeds.

Type 1 diabetes (T1D) is an autoimmune disease in which an inappropriate self-directed immune response affects and destroys insulin-producing β-cells in pancreatic islets leading to dysregulated blood glucose levels. T1D may affect people of any age, its clinical presentation is highly variable, and its incidence is increasing worldwide (1). The initial triggering events of T1D are unknown and their elucidation is of pivotal importance. Several factors might lead to the breakdown of β-cell–specific T-cell tolerance, including genetics, exogenous infectious pathogen, noninfectious environment agents, endogenous superantigens, or physiological stress events (2). The hallmark of autoimmune diabetes is insulitis, which progresses to a destruction of β-cells that results in clinical T1D. An altered balance between proinflammatory T-helper type 1 (Th1)/Th17 cells (γ-interferon [IFN-γ], interleukin [IL]-17) and Th2 immune response (IL-4, IL-10) leads to T1D (3,4). Evidence also suggests that both genetic and environmental factors may induce local inflammatory response, where activated intraislet dendritic cells (DCs) prevent peripheral T-cell tolerance (5). Moreover, it has been recently demonstrated that the development of destructive insulitis is partly due to impaired islet-resident Foxp3+ regulatory T cells (6,7). Several animal experimental models have been used for the investigation of the pathogenesis of T1D and it appears that a NOD mouse is the model of choice. NOD mice spontaneously develop early peri-insulitis and later intraislet insulitis caused by autoreactive T cells, …

Objective – The aim of this study was to examine the prevalence of attention deficit/hyperactivity disorder ( ADHD) and to identify comorbid disorders according to subtype of ADHD. Method – The study sample included 404 children aged from 6-12 years old. Parents completed The Child Behaviour Checklist/4-18 to detect internalizing and externalizing psychological difficulties in children. Assessment of ADHD was performed using the Attention-Deficit/Hyperactivity Disorder Test. Results – ADHD symptoms were found in 15% of girls and 12.1% of boys. The differences in the frequency of different subtype of ADHD in terms of the gender were obtained for the subtype of hyperactivity (Z=-2.075, p=0.038). Boys had more pronounced symptoms of hyperactivity compared to girls. There was no statistically significant gender difference for the subtype of impulsivity (Z=-1.422, p=0.155) and inattention subtype (Z=-0.234, p=0.815). The results obtained showed a higher prevalence of internalized and externalized difficulties with the combined subtypes of ADHD compared to other subtypes. Conclusion – ADHD is a complex condition, affecting a significant number of children and therefore it needs to be better identified. Children who seek medical or psychological help have at least one or more comorbid disorder and these problems also need to be appropriately identified and treated.

Objective – The aim of this case report is to present the results of surgical treatment of a patient with the pineal germinoma. Case report – A 12-year-old patient presented with two months history of headache, nausea, and vomiting, following by neuro-ophthalmologic disturbances (Parinaud syndrome). Computed tomography of the head showed a 3 cm mass in the pineal region, followed by obstructive hydrocephalus, and magnetic resonance imaging showed a pineal gland lesion with heterogeneous enhancement on contrast studies, with surrounding peritumoral edema, suggesting pineal germinoma. The patient underwent surgery to place a ventricular-peritoneal shunt, and second surgery using the occipital interhemispheric transtentorial approach to remove the tumor totally. Conclusion – Pineal germinomas that compress adjacent structures result in a typical clinical syndrome with endocrine malfunction, hydrocephalus or neuro-ophthalmological disturbances. A multimodality approach, including chemotherapy, radiotherapy and surgery, can offer excellent chances of free survival, and even cure.

Objective – To analyze the clinical and histological characteristics, as well as to evaluate the results of surgical treatment of pediatric neuroepithelial tumors. Patients and methods – A retrospective study was conducted, including 40 pediatric patients surgically treated at the Clinic of Neurosurgery, University Clinical Hospital Tuzla in the period 2002-2012. During the study we formed groups and the analysis was conducted by age, gender, clinical signs, histopathologic types and type of surgical treatment. The results are presented in tables and expressed by relative values. Results – Neuroepithlial tumors are more common in male patients. There was no statistically significant difference in distribution of neuroepithelial tumors (I‡2=0.400; p=0.527) related to supratentorial and infratentorial localization. Infratentorial neuroepithelial tumors are most common at a younger age (F=6.516; p=0.015). Increased intracranial pressure and seizures are the most common initial presentation of neuroepithelial tumors (I‡2=0.022; p=0.882). There was no statistically significant difference between types of surgical resection and localization of the tumor. Usually we performed total resection (I‡2=0.246; p=0.620). There was a statistically significant difference in tumor grade regarding supratentorial and infratentorial localizations (p=0.013). Infratentorial tumors are higher grade (I‡2=5.495; p=0.019). Conclusion – The most common initial presentations of neuroepithelial tumors are increased intracranial pressure and seizures. Infratentorial tumors are higher grade. The most common initial treatment of neuroepithelial tumors is radical surgical resection.

Objective – We present a case of osteoarthritis in a ten day old newborn who underwent aspiration and drainage on the fifth day after admission instead of on the first day . The aim of this case report is to describe the importance of a team approach and clinical management algorithms for the successful treatment of septic arthritis in newborns. Case report – We describe a 3580 g male baby, who underwent aspiration and drainage on the fifth day after admission to our Unit for septic arthritis of the right knee. After the surgical drainage of the joint, local signs of inflammation began to improve. Microbiological analysis did not reveal the causative agent. Conclusion – Septic arthritis requires early diagnosis, prompt administration of antibiotics and rapid removal of pus by surgical treatment, due to the possible development of serious and irreversible damage, and even lethal outcome. A team approach with treatment guidelines of septic arthritis in newborns is mandatory.

A 40-year-old man was hospitalized in the coronary care unit with chest pain and abnormal electrocardiogram. Twenty days earlier, the patient underwent laparoscopic gallbladder surgery. Due to chest pain and ischemic ECG changes, patient was subjected to coronary angiography. The selective coronary angiography revealed multiple multilateral fistulae arising from the left anterior descending artery, circumflex artery, and the right coronary artery draining to the left ventricle. Multislice computed tomography showed hypoplastic coronary sinus and minor cardiac venous system.

We used a combination of whole-genome sequencing and in vitro validation to show that mutations that activated at least two pro-growth/survival pathways mediated intrinsic resistance to BRAF inhibition in a melanoma patient. These data demonstrate how in-depth analysis can reveal intrinsic resistance to standard of care, providing an opportunity for alternative therapeutic strategies for patients who are likely to fail first-line treat-575 ment.