The main goal of our study was to evaluate possible perioperative risk factors for occurrence of atrial fibrillation in the postoperative period in patients after CABG operations. The study included 140 patients after CABG, divided into two groups - Group I - 64 patients with new onset of POAF and Group II - 76 patients without postoperative atrial fibrillation occurrence. In both groups possible risk factors for atrial fibrillation onset (preoperative and postoperative) were analyzed.Results showed that we can predict new onset of atrial fibrillation after CABG if the following preoperative factors are present - low ejection fraction (less than 40%), LAd > 40mm, higher body mass index (BMI over 30), presence of COPD and older age. Important perioperative factors for onset of atrial fibrillation in our study were longer extracorporeal circulation, increased dose/number of inotropic drugs, blood transfusion and elevated WBC count postoperatively.

We have evaluated objectively pain tolerance in transrectal ultrasound-guided prostate biopsy (TRUS) using local periprostatic per rectal anesthesia as compared to the conventional method. From November 2008 to May 2009, 90 patients underwent transrectal ultrasound-guided prostate biopsy at Department of Urology, Clinical Center University Sarajevo. 90 patients who fulfilled the inclusion criteria were randomized into 3 groups of 30 patients each. Group 1 received periprostatic local anesthesia with 2% lidocaine, group 2 received Voltaren supp placed in rectum an hour before biopsy while group 3 received no local anesthesia. Pain scale responses were analyzed for each aspect of the biopsy procedure with a visual analog scale of 0-none to 10-maximal. There was no difference between the 3 groups in pain scores during digital rectal examination, intrarectal injection and probe insertion. The mean pain scores during needle insertion in group 1 receiving periprostatic nerve block and in group 2 receiving Voltaren supp were 3,10 +/- 2,32 and 5,15 +/- 2,01 respectively. In group 3 (no local anesthesia), mean pain scores were 6,06 +/- 2,95 which was found to be significantly different (p < 0,001). However, morbidity after the biopsy was not statistically different between all 3 groups. TRUS-guided prostate biopsy is a traumatic and painful experience, but the periprostatic blockage use is clearly associated with more tolerance and patient comfort during the exam. It is an easy, safe, acceptable and reproducible technique and should be considered for all patients undergoing TRUS biopsy regardless of age or number of biopsies.

Use of an autologous latissimus flap in breast reconstruction accounts for a supple and natural look of reconstructed breast. Most common postoperative complication, seroma, became more of a rule then an exception when it comes to postoperative evaluation of the patients who underwent this reconstructive procedure. A retrospective study analysing and evaluating different complication rates in 20 patients who underwent breast reconstruction by autologous latissimus flap, was conducted. All patients included in the study were operated at the Department of plastic surgery of Hôpital Civil in Strasbourg, France, between 1996 and 2008. The complication rates were noted as follows: seroma in 19 of our 20 patients (95%), late hypertrophic scarring in 3 patients (15%), postoperative surgical site hematoma in 3 patients (15%), and 2 patients (10%) presented postoperative chronic back pain. Different options used in seroma treatment and prevention (subcutaneous-fascia anchor sutures of donor site, application of corticosteroids by injection into donor site postoperatively, passive drainage) can reduce seroma formation and thus overall complication rates, leading to much faster patient's recovery time and return to normal daily activities.

Introduction: Melanoma is a malignant tumor of melanocytes and it is the most malignant tumor of skin and mucous membranes. We do not have any data about incidence and characteristics of skin melanoma in Bosnia and Herzegovina. Aim: We aimed to analyze hospital records on skin melanoma cases from the region of Tuzla during the 5-year period in order to obtain preliminary data about melanoma incidence and clinical characteristics. Patients and methods: This retrospective study included all patients surgically treated at the University Clinical Center Tuzla, from January 2001 to December 2005, who were initially diagnosed with skin melanoma. Results: Most of pathologically verified skin melanoma, disregarding primary tumor (T), were presented in both genders at stage T4 (41.67 %) and T2 (28.33 %). Histological analysis showed that the majority of observed skin melanoma were diagnosed in Clark level III (36.36 %) and Clark level IV (33.33 %) stage. The average tumor thickness of the examined sample, according to Breslow’s classification, was found to be over than 4.0 mm. Conclusion: Our findings are similar to those reported in other countries in the region. Further studies are necessary in order to asses the burden of the disease in the national level. A national melanoma register is of great importance for further surveilance.

The move to filmless is newer easy. It is important to have a vision, and of course to have the right people to implement a complete project. Implementing a picture archiving and communications system and radiology information system is not only about replacing film, but how the technology can improve an organization, its services, and its financial picture. Going filmless provides a prime opportunity to reassess and revitalize the way a center does business.

We study the cohomology of spaces of string links and braids in...   2000 Mathematics Subject Classification. Primary: 57M27; Secondary: 81Q30, 57R40