ABSTRACT Introduction: The incidence of preterm delivery has been increasing even in developed countries and remains a serious problem for fetuses and neonates. Although many predictors for preterm delivery have been proposed, complete prediction and prevention have not yet been established. Aims: To examine the potential association between sonographic measurement of cervical length and threatened preterm birth (TPTB) in pregnant woman at 24-36 weeks of gestation. Materials and methods: A cross-sectional study included a total of 360 pregnant woman at 24-36 weeks of gestation categorized in two groups: TPTB group (n=160) and non TPTB group (n=200). The study was carried out at the Department of Obstetrics and Gynecology of the Clinical Center University of Sarajevo (KCUS). Sociodemographic and clinical characteristics of patients were obtained from medical records and physical examination by gynecologist. Transvaginal sonography was carried out by GE Voluson 730. Results: There was a significant association between TPTB and sonographic measurement of cervical length <25 mm (P<0.001). The logistic regression model was statistically significant, x2(7) = 281.530, P<0. 001. The model explained 72.6% of the variance in TPTB and correctly classified 88.1% of cases. Sensitivity was 83.8%, specificity was 91.5%, positive predictive value was 88.7% and negative predictive value was 87.6%. Out of the 7 predictor variables only 5 were statistically significant: cervical length, cervical consistency, rupture of membranes, uterine contractions and amine odor test. Conclusion: The findings of this study suggest association between sonographic measurement of cervical length and TPTB.

Abstract The aim of this study was to determine the occurrence and distribution of Cryptosporidium spp. and Giardia duodenalis among free-living red foxes (Vulpes vulpes) in Bosnia and Herzegovina. For this purpose, a total of 123 fecal samples from red foxes, shot during hunting seasons between January 2011 and March 2012 were examined using immunofluorescent microscopy. Overall, observed prevalences of Cryptosporidium spp. and Giardia duodenalis were 3.2 % (4/123) and 7.3% (9/123), respectively. The results show that foxes might play the role of potential reservoirs of Cryptosporidium and Giardia parasites, but further molecular analysis are necessary to elucidate the source of infection, routes of transmission and zoonotic potential of these two pathogens.

The effect of ELF-EMF on DNA through changes in antioxidative enzyme activities has not been sufficiently explored yet. The aim of this study was to determine ELF-EMF effect on antioxidative enzymes in cancer cell line and genotoxic potential on normal human lymphocytes. K562 cells were exposed to 50 Hz ELF-EMF (40 μT, 100 μT; 3 h, 24 h) and spectrophotometric determination of lipid peroxidation and antioxidative enzyme activities was conducted. Genotoxicity of ELF-EMF (50 Hz, 100 μT) was investigated by cytokinesis-block micronucleus assay in a normal human lymphocytes (exposure 24 h and 48 h). Results demonstrated that ELF-EMF did not alter the process of lipid peroxidation and superoxide dismutase activity. Catalase activity was increased only after application of 100 μT EMF for 24 h. Glutathione-S-transferase and -reductase activities were increased. Treatment with 100 μT ELF-EMF (24 h, 48 h) significantly reduced micronuclei incidence, while cell proliferation was significantly increased. Results indicate that 50 Hz ELF-EMF (40 μT, 100 μT) are week stressors which alone cannot generate enough ROS to induce process of lipid peroxidation in cancer cell line but strong enough to induce response of antioxidative system. Furthermore, 100 μT ELF-EMF in human lymphocytes did not exhibit genotoxic potential during 24 h and 48 h treatment, but stimulated cell proliferation.

ABSTRACT Introduction: Patient-oriented therapy represents a modern approach in the treatment of patients with diabetes, an approach which is supported in the most recent guidelines by the ADA and the European Association for the Study of Diabetes (EASD). The progressive nature of diabetes demands the introduction of insulin therapy much earlier in order to prevent the development of late complications of the disease. Material and methods: The study included 30 patients who had been treated with long-acting insulin analogue and metformin in doses of 3 x 850 mg at least 6 months prior to study entry and in which a good glycaemic control had not been achieved, or with HbA1c > 7%. Patients who had a BMI > 28 kg /m2 were included in the study. Results and discussion: At the beginning of the study the patients were switched to combined therapy with long-acting basal analog, metformin and liraglutide in a dosage of 0.6 mg of 1x1. After 12 weeks of the new therapeutic regimen we recorded a significant reduction in the parameter levels that we monitored in the study. BMI value after the test was 28.2±1.39 kg/m2, p=0.025, HbA1c 7.24±0.47%, p=0.030, fasting blood glucose level 7.04±0.32 mmol/l, p=0.023, postprandial glucose level 7.6±0.46 mmol/l, p=0.012, systolic blood pressure level 123±5.75 mmHg, p=0.015, diastolic blood pressure level 79.1±2.91 mmHg, p=0.03. During research that we have conducted over 12 weeks, a reduction of body weight was achieved while improving the value of parameters significant for the study. Conclusion: There was a significant lowering of HbA1c, fasting blood glucose levels, postprandial glucose levels and better blood pressure control by which we have proved that GLP1 analogues in combination with basal insulin and metformin provide a good glycaemic control with a cardio protective effect, and reduce the risk of late complications.

The main goal of soft computing technologies (fuzzy logic, neural networks, fuzzy rule-based systems, data mining techniques...) is to find and describe the structural patterns in the data in order to try to explain connections between data and on their basis create predictive or descriptive models. Integration of these technologies in sensor nodes seems to be a good idea because it can significantly lead to network performances improvements, above all to reduce the energy consumption and enhance the lifetime of the network. The purpose of this paper is to analyze different algorithms in the case of fire confidence determination in order to see which of the methods and parameter values work best for the given problem. Hence, an analysis between different classification algorithms in a case of nominal and numerical data sets is performed with the goal to realize which of applied techniques obtain higher accuracy and less error

ABSTRACT Objectives: The present study evaluates our experience with aorto-coronary bypass grafting in patients with severe dysfunction of left ventricle (LV) and low ejection fraction-EF(<35%). Revascularization of myocardium in this settings remains contraversial because of concerns over morbidity, mortality and quality of life. Material and Methodes: Forty patients with severe coronary artery disease and dysfunction of LV (low ejection fraction <35%) underwent coronary artery bypass grafting in period of 3 years. Preoperative diagnostic of 40 patients was consisted of anamnesis, clinical exam, non-invasive methods EHO, MR and invasive diagnostic methods-cateterization. The major indication for surgery was severe anginal pain, heart failure symptoms and low ejection fraction. Internal mammary artery was used in all operated patients. Results: Average age of patients who have been operated was 59,8. In the present study, 81,3% were male and 18,8% female. We found one-vessel disease present in 2,5% (1/40) of patients, two -vessel disease in 40% (16/40), three-vessel disease in 42,5% (17/40) and four -vessel disease in 15% (6/40) of patients. One bypass grafting we implanted in 2,5% patients, two bypasses in 42,5%, three bypasses in 45 5%, and four bypasses in 10% of patients. Left ventricular ejection fraction assessed preoperativly was 18%-27% and postoperatively was improved to 31, 08% in period of 30 days. Conclusion: In patients with left ventricular dysfunction, coronary artery bypass grafting can be performed safely with improvement in quality of life and in left ventricular ejection fraction.

ABSTRACT Introduction: Correction of pediatric spine deformities is challenging surgical procedures. This fragile group of patients has many risk factors, therefore prevention of most fearing complication-paraplegia is extremely important. Monitoring of transmission of neurophysiological impulses through motor and sensor pathways of spinal cord gives us an insight into cord's function, and predicts postoperative neurological status. Goal: Aim of this work is to present our experiences in monitoring of spinal cord motor function - MEP during surgical corrections of the hardest pediatric spine deformities, pointing on the most dangerous aspects. Material and methods: We analyzed incidence of MEP changes and postoperative neurological status in patients who had major spine correcting surgery in period April ‘11- April ‘14 on our Spine department. Results: Two of 43 patients or 4.6% in our group experienced significant MEP changes during their major spine reconstructive surgeries. We promptly reduced distractive forces, and MEP normalized, and there were no neurological deficit. Neuromonitoring is reliable method which allows us to “catch” early signs of neurological deficits, when they are still in reversible phase. Although IONM cannot provide complete protection of neurological deficit (it reduces risk of paraplegia about 75%), it at least afford a comfort to the surgeon being fear free that his patient is neurologically intact during long lasting procedures.

A 76-year-old male with a medical history of smoking and hypertension was admitted to our clinic with a ruptured abdominal aortic aneurysm (AAA) diagnosed by a trans-abdominal ultrasound. He was immediately brought to the emergency room (ER). His blood pressure was 80/40 mm Hg, with an HTC of less than 0.17. Six years earlier, he had noticed a painless, enlarging abdominal mass. An emergency abdominal computed tomographic angiography (CTA) with intravenous contrast showed a giant infrarenal AAA measuring 13x11 cm in diameter, with clear evidence of rupture and a large intra-abdominal hematoma (Figure 1). He was immediately brought to the operating theater (OT). Figure 1 Abdominal computed tomographic angiography with contrast showing: A) a ruptured giant abdominal aortic aneurysm (AAA), measuring 13x11 cm with B) a large inta-abdominal hematoma, that compresses the intra-abdominal organs. C) and D) showing a ruptured ... The approach to the abdomen was a classic median laparotomy. After we had opened the abdomen, we found a huge retroperitoneal hematoma that pushed beside the intra-abdominal organs rising almost to the edge of the rectal fascia. His blood pressure suddenly dropped to 45/25 mm Hg for the next several minutes. A continuous infusion of norepinephrine was administered (60 mcg/min), several doses of pure adrenalin (3 mg) and pure norepinephrine (1 mg). His blood pressure immediately rose to 80 mm Hg. During the surgery he was anuric. Autologous blood transfusion helped by cell saver was administered. Additionally, he received several doses of blood, blood derivates (fresh frozen plasma, cryoprecipitate, platelets), and other intravenous solutions totaling approximately 8 liters. We replaced the ruptured AAA using a 20 mm polytetrafluoroethylene (PTFE) vascular graft. After surgery he was transferred to the intensive care unit (ICU) where the blood pressure rose, and diuresis was established (Figure 2). Figure 2 Postoperative computed tomographic angiography (CTA) with contrast showing: A) complete sealing of the aneurysm and no endoleak detected. B) Abdominal CTA with contrast showing patency of the graft. On the first postoperative day, he was woken up without neurological deficits. Six days after surgery we performed a control CT angiography that showed normal findings on the abdominal iliac and leg vessels. Recovery was uneventful and he was discharged from hospital on postoperative day 10. Aneurysm size is the most important factor related to likelihood of rupture, and the risk increases substantially in large aneurysms. The annual rupture risk for AAA’s >8 cm is 30-50%.1 Symptomatic aneurysms present with back, abdominal, buttock, groin, testicular, or leg pain and require urgent surgical attention. Rupture of an AAA involves complete loss of aortic wall integrity, and is a surgical emergency requiring immediate repair.2 The sheer size of the aneurysm, the short length of the neck, and the dislodgment of abdominal organs that may be densely adhered to its surface with fistula formation, make surgery of this entity very challenging. Open repair of giant AAA’s is often the only available treatment, though not always with good results.3 In conclusion, open surgical repair is often the only viable treatment because aneurysm size implicates an adverse neck anatomy that makes these AAA’s not suitable for endovascular aneurysm repair.4 The repair of these giant aneurysms presents a challenge during surgery. Ruptured giant AAA’s present a significant additional surgical and anaesthetic challenge.

ABSTRACT Introduction: Central Venous Catheters (CVC) are essential in everyday medical practice, especially in treating patients in intensive care units (ICU). The application of these catheters is accompanied with the risk of complications, such as the complications caused during the CVC insertion, infections at the location of the insertion, and complications during the use of the catheter, sepsis and other metastatic infections. Patients and methods: This study is a retrospective-prospective and it was implemented in the period 1st January 2011- 31st December 2012. It included 108 examinees with CVC placed for more than 7 days. Results: The most common complications occurring in more than 2 attempts of CVC applications are: hearth arrhythmias in both groups in 12 cases, 7 in multi-lumen (12.72%) and 5 in mono-lumen ones (9.43%). Artery puncture occurs in both groups in 7 cases, 5 in multi-lumen (9.09%) and 2 in mono-lumen ones (3.77%). Hematoma occurred in both groups in 4 cases, 3 in multi-lumen CVCs (5.45%) and 1 in mono-lumen ones (1.88%). The most common complication in multi-lumen catheters was heart arrhythmia, in 20 cases (36.37%). The most common complications in mono-lumen CVCs was hearth arrhythmias, in 20 cases as extrasystoles and they were registered in 16 catheter insertions (30.18%). Out of total number of catheters of both groups, out of 108 catheters the complications during insertion occurred in 49 catheters (45.40%). The most common complications in both groups were heart arrhythmias, artery punctures and hematomas at the place of catheter insertion.