A 11-years old female with growth problem and chronic renal failure was admitted for arteriovenous fistula (AVF) formation for long-term haemodialysis in the pediatric ward. During her hospital stay, continue to have a cuffed central venous catheter (CVC) as the first choice for vascular access. AVF the cubital artery vena cephalica was performed with a standard end-to-side anastomosis with a continuous running 8-0 prolene monofilament suture. The patient was discharged on the second post operative day, subsequent to a normal AVF primary patency. We recommend that vascular and pediatric Hemodialysis centers establish a strategy supporting AVF creation in small children when peritoneal dialysis is contraindicated and pre-emptive kidney transplantation is not feasible. *Correspondence to: Dragan Piljic, M.D., Ph.D., Department of Cardiovascular Surgery, University Clinical Center Tuzla, Bosnia & Herzegovina, Tel: +38735303202; E-mail: dragan.piljic@dr.com

It is very important to make the smallest possible surgical paraumbilical transperitoneal incision, the so-called minilaparotomy 8-10 cm long, which is generally sufficient to perform surgery, and significantly reduces pain after surgery, significantly accelerates wound healing, and reduces the risk of postoperative hernia to a minimum [1]. If necessary, the surgical incision can always be further expanded.

This study is concerned with modelling and analyses of a vibro-impact system consisting of a crank-slider mechanism and one oscillator attached to it, where the system can be exposed to ideal or non-ideal excitation. The impact occurs during the motion of the oscillator when it hits a base, and the excitation of the driving source is affected by this behaviour. The aim is to determine the interaction between a driving torque and the motion of the oscillator. To achieve this aim in a methodologically sound manner, both vibro-impact systems with ideal and non-ideal excitation are analysed. For these system differential equations are formed and the impact model is provided in the paper. The impact causes a strong nonlinearity in the system. The mathematical model of the vibro-impact system with ideal excitation is presented as a second order differential equation where the vibro-impact system with non-ideal excitation is given as a coupled system of nonlinear second order differential equations. Numerical simulations are carried out for the two systems and the results obtained are shown in terms of frequency response diagrams as well as in terms of time-displacement diagrams. The results found for different systems are compared mutually, and the differences between them are pointed out. Impact solutions for different regions of the excitation frequency are shown. For a specific value of the excitation frequency in the frequency response diagram where multiple solutions are found, basin of attractor diagrams are formed. Average value of the excitation frequency is used for the vibro-impact system with non-ideal excitation.

Background and Objectives: Titanium DS clips are made to secure the appendiceal stump during laparoscopic appendectomy. The assumption is that they behave like stapler clips in the body, being made from titanium. However, the construction and weight of DS clips differs from staplers. Their biocompatibility may have implications for their clinical use. Methods: One hundred and twenty rats were randomized into four experimental groups: in the first group the appendiceal stump was secured by Vicryl® ligature, in the second by linear staplers, in the third by Hem-o-lok® plastic clips, and in the fourth by DS titanium clips. Ten animals from each group were sacrificed 7, 28, and 60 days post-surgery. Histopathological data and adhesion formation were assessed. Results: On postoperative day 7, a statistically significant difference was found in the occurrence of inflammation between the Hem-o-lok® and stapler groups. The adhesion score was significantly higher in the Vycril® and Hem-o-lok® in comparison to the DS and stapler groups. On postoperative day 28, a statistically significant difference was found in the occurrence of inflammation between the Vycril® and stapler groups. The adhesion score was significantly higher in the Vycril® than in the DS and stapler groups. On postoperative day 60, there were no statistical differences between any of the groups. The adhesion score was significantly higher in the Hem-o-lok® group in comparison to the DS and stapler groups. Conclusion: Staplers and DS clips have advantages over other methods of securing the appendiceal stump, because of their high biocompatibility and lower adhesion score.

Introduction: The technique of closing the appendiceal stump using linear titanium stapler clips is being used more and more frequently in laparoscopic surgery, despite the good practice in the use of resorbable single endoloop vicryl ligatures and/or the non-resorbable plastic hem-o-lok clips. No light has been shed on potential undesirable effects on the haemathological profile of the use of titanium stapler clips. This experimental study aimed at establishing any possible undesirable effect of linear titanium stapler clips and single resorbable vicryl endoloop ligatures on the blood cells in rats following appendectomy. Methods: A total of 70 adult rats were used, divided into a control group (n = 10), and two experimental groups (n = 30 + 30). The appendices were removed from the rats in the first experimental group using titanium stapler clips and in the second experimental group the appendiceal stump using resorbable endoloop vicryl ligatures was closed. In both experimental groups three sub-groups with ten animals each were formed, from which peripheral blood from a tail vein on days 7, 28 and 60 was removed postoperatively, in order to assess the usual haematological parameters. Stained blood smears were also analysed in order to establish any poikilocytotic erythrocytes present. Results: In the first experimental group, with the titanium stapler clips, more than 25 % neutrophils were found on day 7, which is a significantly different result (p < 0.05) to the control group. In the second experimental group, there were more neutrophils than in the titanium stapler clips group, especially on days 7 and 60 and the results of these two sub-groups differ statistically significantly, p < 0.05. Hypochromia was found in the endoloop vicryl ligatures group, as well as in the titanium stapler clips sub-group on day 28, due to lower haemoglobin values which were significantly different to the control group, p < 0.05. Moderate levels of annulocytes, spherocytes and stomatocytes were found in most experimental groups. Conclusion: The results of this study favour the use of linear titanium stapler clips over resorbable single endoloop vicryl ligatures, because a less unfavourable effect was established on the blood cells of the experimental rats with their use.

The technology of computer-assisted six-axis frames is rapidly evolving. In this case report, we describe two cases of pediatric lower limb deformities treated by a novel hexapod device, the iFIXation system. For our knowledge, this is the first report in literature for its usage. The first case was a 14-years-old girl with posttraumatic shortening, varus and external rotation deformities of her lower limb around the ankle. All the deformities and shortening were corrected simultaneously with the iFIXation system. The second case was an 8-years-old girl with postinfection valgus and external rotation of the knee as well as shortening of the femur. Distal femoral deformities and shortening were simultaneously corrected by the iFIXation system and growth modulation to prevent recurrence of the deformity was done. The reported cases represent our earliest experience with the iFIXation system.

Sepsis is a life-threatening condition characterized by a systemic inflammatory response of the body caused by a severe infection. The aim of this study was to examine the importance of hematological parameters and c-reactive protein (CRP) in the diagnosis of sepsis, assessment of disease severity, and prediction of final outcome of these patients. The prospective study included 106 hospitalized patients with a clinical diagnosis of sepsis. Haematological parameters and CRP correlated with sepsis stage, and using ROC (Receiver operating characteristic) analysis were evaluated in the prediction of the final outcome of these patients. Among haematological parameters, patients with sepsis had a significantly higher proportion of total unsegmented neutrophil granulocytes, a lower percentage of lymphocytes, as well as a lower total platelet count (p<0.05 for all measurements). An excellent positive correlation was found between serum CRP concentration and disease stage (r=0.77). The best predictive value for the presence of sepsis was shown by CRP at the cut- off value of 165 mg/L (AUC 0.98), followed by the percentage of unsegmented neutrophil granulocytes for the cut-off value of 15.5 (AUC 0.67), and the percentage of lymphocytes less than 9.9 (AUC 0.66), platelets lower than 118x109/L (AUC 0.63). At the CRP cut-off value of 294.7 mg/L (AUC 0.84; 95% CI 0.74-0.93), death could be predicted in 80.95% of patients with sepsis, with the sensitivity of 43.75% and the specificity of 89.71% (p<0.0001). By monitoring changes in haematological parameters and CRP concentration in combination with other clinical and laboratory indicators, disease severity and final outcome in patients with sepsis can be predicted. Key words: CRP, lymphocytes, platelets, SIRS, sepsis

Introduction: Thanks to ever-growing advances in medical science, couples who are in the in vitro fertilisation (IVF) now have more options than ever to encase their chances at a successful pregnancy. One of the options is the use of EmbryoGlue (EG), that creates a bridge between the embryo and the uterus and provides protection to the embryo itself during the transfer process. Aim of this study was to determine whether EG medium is of greater importance for embryo implantation than conventional medium in assisted reproductive technology and compare the rate of embryo implantation with EG and conventional medium in relation to the quality of the embryo, the age of the patients and tobacco smoking. Methods: The retrospective study included 50 patients who used EG medium in embryo transfer (ET) and 50 patients in the control group using conventional medium. All patients underwent ET after stimulation of the cycle according to a short protocol. ETs were done on Day 2, 3, or 5 in the blastocyst stage. Age and smoking status were recorded. Results: Out of a total of 100 patients, 42 patients had successful implantation and positive β-hCG 15 days after ET. In a control group 38 % had positive β-hCG and in the group of patients who used EG 46 %. A higher rate of embryo implantation success was observed on the second day of transfer in the group of patients using EG. In the EG group a significant increase in the embryo implantation rate was observed in patients older than 35. In tobacco smokers the implantation rate was higher if they used EG during ET. Conclusion: EG medium had a positive effect on the second day of ET, patients above the age of 35 and patients who were tobacco smokers.

Advances in the development of neuromarketing research methods and techniques, over the past two decades, have enabled their application not only for scientific purposes, but also for commercial purposes of researching consumer behavior. This paper will review various methods and techniques of neuromarketing research, highlighting the advantages and disadvantages of using these, for the purpose of consumer behavior research. As a research part of the paper, combined laboratory neuromarketing research (EEG and eye tracking) was conducted, that examined implicit attitudes of consumers (attention and emotions, in real time, from second to second), whose goal was to examine how consumers react implicitly to different marketing stimuli (TV commercials for Coca Cola and Pepsi Cola brands). The research additionally examined whether there is an overlap of conscious consumer attitudes, collected by the research method through a questionnaire, with the results of the combined neuromarketing research. The research found that the tested marketing stimuli have a positive impact on the implicit positioning of tested FMCG brands. In addition, by comparative analysis of explicit and implicit consumer attitudes, it was found that there is agreement between them. Finally, the research found that neuromarketing research has the potential to improve marketing communication (tested TV commercials), and thus the positioning of FMCG brands.

In this paper, the authors explore the conditions for the development of innovation in the Republic of Serbia. The paper analyzes the factors influencing the development of the innovation environment. The influences of state institutions, international institutions and programs as well as the influences of the NGO sector on the development of the innovation environment in Serbia are discussed. In order to valorize these efforts to develop the innovation environment in the right way, the authors also analyzed Germany, as the leading economy in supporting the innovation environment and building innovation infrastructure.

In this work, the absorption spectra of cobalt(II) nitrate and bromide complexes in the composition 0.3Ca(NO3)2 – 0.7NH4NO3 – H2O have been investigated in the 400-800 nm range of wavelength at T = 328.15 K and atmospheric pressure P = 101.3 kPa. Spectra were recorded in solutions with variable water content (R = H2O/salt mole ratio; R = 1.0, 1.2 and 1.6). The blue shift of the absorption maximum with the water content increase (R) suggest simultaneous coordination by water molecules and nitrate ions. From an analysis of the spectra, it can be concluded that the following: [Co(NO3)4(H2O)2]2−, [Co(NO3)2Br2]2− and [CoBr4]2− complexes were formed. The overall stability constants of these complexes species spectra were calculated at T = 328.15 K.