Introduction: Hypothyroidism is a common disorder of the endocrine system caused by insufficient biologically active hormones at the tissue level or the inability of the tissue to utilize thyroid hormones. Iron plays a crucial role in the synthesis and metabolism of thyroid hormones, and it is stored in the body as ferritin. We aimed to evaluate the correlation between serum ferritin (SF) levels and thyroid hormone panel levels in both hypothyroid and euthyroid subjects. Methods: In 2022, a matched case–control study was conducted. The study involved participants with hypothyroidism and a control group (n = 53). The levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and SF were measured using the chemiluminescence immunoassay on a Mindray Cl 900-i analyzer (Shenzhen Mindray Bio-Medical Electronics Co., China). Results: The hypothyroid group had TSH levels that were significantly higher (10.76 [8.54-18.76] vs. 1.76 [1.26-2.58]; p < 0.001) and SF concentrations that were significantly lower (39.08 [21.15-45.70] vs. 54.09 [41.41-71.82]; p < 0.001) compared to the control group. In both male and female subjects of the hypothyroid group, a strong negative correlation was found between SF concentration and TSH levels ([Rho = −0.855,p < 0.01]; [Rho = −0.747; p < 0.01]). In female subjects of the hypothyroid group, a weak positive correlation was found between SF concentration and fT3 (Rho = 0.488; p < 0.05). In the euthyroid group, a correlation of the same strength and direction was found for fT4 (Rho = 0.366; p < 0.05). Conclusion: Research results indicate a correlation between lower SF concentrations and hypothyroidism, which is of particular importance for understanding the etiopathogenesis, diagnosis, monitoring, and treatment modalities of patients with hypothyroidism.

Pravilnom pripremom hrane moguće je spriječiti većinu hranom prenosivih bolesti. Značajni napori uloženi u usaglašavanje legislative na širim geografskim područjima, rezultovali su formiranjem općeprihvaćenog stava da je većina kupljenih namirnica sigurna za konzumiranje. Međutim, neophodno je da potrošači nastave dobre prakse rukovanja, pripremanja i čuvanja namirnica u domaćinstvima. Ovo istraživanje je provedeno kao presječna, deskriptivno-analitička i eksperimentalna studija u periodu novembar 2020. – juli 2021. godine. Mikrobiološka analiza briseva je provedena u akreditovanoj laboratoriji Odjela za mikrobiološku analizu namirnica, voda i predmeta opšte upotrebe pri Zavodu za javno zdravstvo Federacije Bosne i Hercegovine. U domaćinstvima je uzorkovano po 7 briseva radnih površina i pribora u kuhinjama (n = 2681) u skladu sa smjernicama standardne metode BAS EN ISO 18593:2019 – Horizontalne metode za uzimanje uzoraka sa površine. U više od polovine domaćinstava (61,5%) izolovane su ciljane bakterije u vrijednostima iznad referentnih. Najveća odstupanja u bakteriološkoj ispravnosti utvrđena su na radnim površinama u kuhinjama (45,8%), daskama za rezanje (34,1%) i slavinama (34,1%). Staphylococcus aureus je izolovan u 153, Enterobacteriacea u 151, a aerobne bakterije u 286 domaćinstava. Prema kategorizaciji ukupnog rizika, 17% domaćinstava na području Kantona Sarajevo spada u kategoriju visokog rizika od hranom prenosivih bolesti u svojim domaćinstvima. Obzirom da javnost nije upoznata sa rizikom u kojem se nalazi, smatramo da je što hitnije potrebno poduzeti korake u podizanju kolektivne svijesti o javno-zdravstvenom značaju sigurnosti hrane u domaćinstvima.

Abstract Background  Many recent studies show that exoscopes are safe and effective alternatives to operating microscopes (OM). Developments of robotics and automation are present in neurosurgery with the appearance of a newer device such as RoboticScope (RS) exoscope with a digital three-dimensional (3D) image and a head-mounted display. The body of the RS is connected to a six-axis robotic arm that contains two video cameras, and serves as stereovision. This robotic arm allows accurate 3D camera motions over the field of view, giving the user a great degree of freedom in viewpoint selection. The surgeons may specify the direction and speed of the robotic arm using simple head movements when the foot pedal is pressed. Since its development in 2020, the RS has occasionally been used in neurosurgery for a multitude of procedures. Methods  This study showcases vessel microanastomosis training on chicken legs using the RS. The aim of this study is to demonstrate the feasibility of the RS without a comparative analysis of the standard OM. The study was conducted in 2023 during a month-long trial period of the device at the Department of Neurosurgery of the Clinical Center of the University of Sarajevo. All procedures including RS-assisted anastomosis were performed by a neurosurgeon in anastomosis training (A.A.) supervised by a senior vascular neurosurgeon (E.B.). For the purpose of the study, we evaluated occlusion time in minutes, bypass patency with iodine, and overall satisfaction of the trainee in terms of light intensity, precision of automatic focus, mobility of the device, ergonomics, and convenience of the helmet. Results  Ten RS-assisted microanastomoses were performed by interrupted suturing technique with 10.0 nylon thread. Bypass training included seven “end-to-side,” two “end-to-end,” and one “side-to-side” microanastomoses. The smallest vessel diameter was 1 mm. Occlusion time improved by training from 50 to 24 minutes, with contrast patency of the anastomoses in all cases without notable leakage of the contrast, except one case. Complete satisfaction of the trainee was achieved in 7 out of 10 cases. During this period, we also performed different RS-assisted surgeries including a single indirect bypass, convexity brain tumor resection, and microdiscectomies. Conclusion  RS provides a new concept for microanastomosis training as an alternative or adjunct to the standard microscope. We found a full-time hands-on microsuturing without the need for manual readjustment of the device as an advantage as well as instant depth at automatic zooming and precise transposition of the focus via head movements. However, it takes time to adapt and get used to the digital image. With the evolution of the device helmet's shortcomings, the RS could represent a cutting-edge method in vessel microanastomosis in the future. Nevertheless, this article represents one of the first written reports on microanastomosis training on an animal model with the above-mentioned device.

Background. The management of breast cancer treatments within the limitations of family, social, and professional life is emotionally burdening and negatively affects physical, psychological, and social well-being, reducing the overall quality of life of patients and their families. Methods: This cross-sectional descriptive–analytical study was conducted from March to August 2023 at the “Dr. Radivoj Simonović” General Hospital in Sombor. A total of 236 breast cancer patients participated in this study. The research was conducted using the following instruments: a questionnaire on sociodemographic and clinical characteristics of patients, the Berlin Social-Support Scales—for assessing social support—and the Connor–Davidson Resilience Scale—for assessing resilience. This study aimed to determine the predictors and levels of social support and resilience of breast cancer patients. We also wanted to examine whether resilience is a mediator between patients’ sociodemographic and clinical characteristics and levels of social support. Results: The total average value of social support was 3.51 ± 0.63, while on the resilience scale, the respondents achieved a total average score of 52.2 ± 9.63. Perceived and actually received social support of breast cancer patients were positively correlated with resilience [p < 0.01], while no statistically significant correlations were found for the need for support and satisfaction. The sets of predictors can significantly predict their effects on all types of perceived social support (emotional social support: 9%; perceived instrumental social support: 9%) and all types of received social support (actually received emotional social support: 8%; actually received instrumental social support: 7%; actually received informational social support: 8%). There is a potential mediating role of resilience in relation to sociodemographic factors, clinical characteristics, and the need for support. Conclusion: This study confirms that a strong connection exists between social support and resilience. However, the analysis did not confirm the mediating role of resilience between the sociodemographic and clinical characteristics on the one hand and social support on the other.

Objectives This study aimed to determine the status of training of adult congenital heart disease (ACHD) cardiologists in Europe. Methods A questionnaire was sent to ACHD cardiologists from 34 European countries. Results Representatives from 31 of 34 countries (91%) responded. ACHD cardiology was recognised by the respective ministry of Health in two countries (7%) as a subspecialty. Two countries (7%) have formally recognised ACHD training programmes, 15 (48%) have informal (neither accredited nor certified) training and 14 (45%) have very limited or no programme. Twenty-five countries (81%) described training ACHD doctors ‘on the job’. The median number of ACHD centres per country was 4 (range 0–28), median number of ACHD surgical centres was 3 (0–26) and the median number of ACHD training centres was 2 (range 0–28). An established exit examination in ACHD was conducted in only one country (3%) and formal certification provided by two countries (7%). ACHD cardiologist number versus gross domestic product Pearson correlation coefficient=0.789 (p<0.001). Conclusion Formal or accredited training in ACHD is rare among European countries. Many countries have very limited or no training and resort to ‘train people on the job’. Few countries provide either an exit examination or certification. Efforts to harmonise training and establish standards in exit examination and certification may improve training and consequently promote the alignment of high-quality patient care.

Introduction Much has been written and spoken about telemedicine since about two decades including an article in this journal at the start of the pandemic. It took a global catastrophe to enforce its usage across the world in various medical specialties. Telemedicine however remains unstructured, unregulated and lacks uniformity. Discussion This article highlights the practical learnings and opinions of the authors who provided over two thousand video consults and asynchronous telemedicine services through the entire pandemic. It includes lessons learnt from emerging economies where pediatric rheumatologists are scarce. Pediatric rheumatology, which relies heavily on history, musculoskeletal and skin examination is aptly suited to exploit telemedicine in its synchronous and asynchronous forms. Pediatric tele rheumatology could temporarily address the shortage and uneven distribution of specialists in vast parts of the globe, besides serving as a method of triage and shared care with the primary physician. Reduction of direct and indirect costs and family/primary physician education are additional benefits. There also exist challenges for all stakeholders and it is important to address the latter. Conclusion The learnings of the pandemic suggest a vital role for telemedicine in the practice of pediatric rheumatology. This is a fertile area for research and consensus building by international and national pediatric societies and issue position statements like some adult bodies already have. The authors speculate a hybrid system of care in the not-so-distant future.

Uvod: Jednofotonska emisiona tomografija (SPECT) značajno je unaprijedila nuklearno-medicinsku dijagnostiku. Nedostatak SPECT metode su relativno niski signal-šum odnos (SNR) kao i kontrast-šum odnos (CNR). Nizak broj fotona slike predstavlja veliki problem kod SPECT snimanja zbog smanjenja signala uz povećanje šuma (pozadine slike). Zadnjih godina veliki broj naučnika ističe značaj SPECT snimanja niskog broja signala korištenjem savremenih detektorskih sistema i naprednih softverskih modaliteta. Najznačajniji napredak rekonstrukcije SPECT snimaka predstavlja primjena metode oporavka rezolucije (RR) kod snimanja miokarda (Myovation Evolution) i koštanog sistema (Evolution for Bone) jer dugotrajna SPECT akvizicija smanjuje komfor uz pojavu artefakata micanja i smanjenje kvaliteta slike. Savremeni metod zasnovan je na principu “Half-Time SPECT” uz jednaku senzitivnost i specifičnost tomografske studije. Materijal i metode: Istraživanje je provedeno kao prospektivna klinička eksperimentalna studija na uzorku od 100 pacijenata sa potvrđenom onkološkom dijagnozom. Izvršena je komparacija snimaka pune i skraćene dužine akvizicije (skraćenje za 25 i 50% od pune akvizicije). Svi snimci su rekonstruisani sa tri različita protokola. Ukupno je ispitano 9 različitih SPECT protokola. Na svim snimcima nivo šuma, odnos signal-šum kao i odnos kontrast-šum su mjereni za isto anatomsko područje. Rezultati: Skraćenjem trajanja akvizicije zabilježen je porast vrijednosti šuma, najblaži porast zabilježen je korištenjem Evolution for Bone protokola. Smanjenjem trajanja akvizicije SNR i CNR značajno su smanjeni, dok je protokol koji je koristio RR modalitet zabilježio veću vrijednost SNR i CNR na 50% akvizicije u odnosu na punu akviziciju bez RR modaliteta. Zaključci: Analizom snimaka skraćene i pune akvizicije uz primjenu parametara rekonstrukcije došlo se do zaključka da RR modalitet omogućava skraćenje trajanja SPECT akvizicije bez značajnog uticaja na povećanje vrijednosti šuma. SNR i CNR primjenom RR modaliteta i dalje mogu ostati visoki pri čemu je omogućena jasna detekcija patoloških lezija kao i kod pune SPECT akvizicije.