The vascular approach is a prerequisite for performing hemodialysis, but their "weak points" are different and frequent complications. Modern guidelines recommend native arteriovenous fistula (AVF) as the first choice of vascular approach because it is characterized by the longest survival and the least complications compared to other vascular approaches. All complications of AVF can be divided into intraoperative, early, and late postoperative. This paper presents the late postoperative complications of AVF, their frequency, causes, diagnosis and treatment. The most important late postoperative complications are: stenosis, thrombosis, aneurysm or pseudoaneurysm formation, infection, hand edema, hematoma, ischemic steal syndrome, ischemic neuropathy, congestive heart failure. Large differences in the frequency of each complication in earlier studies can be explained by differences in surgical technique, localization of AVF, diagnostic methods, but, above all, differences between the presented groups of patients. It is described that the age of patients, sex, underlying disease, the presence of comorbid conditions and various metabolic and immune disorders characteristic of chronic renal failure, as well as the way of using and caring for AVF significantly affect the occurrence of AVF complications. One of the main predictors of AVF success and survival is the quality of the patients' blood vessels, and therefore careful examination of blood vessels before approaching AVF creation is of particular importance. The creation, use and care of AVF is the task of the team of health professionals who take part in the treatment of these patients, and successful treatment requires their good cooperation, as well as cooperation with patients.

Introduction/Objective. Chronic obstructive pulmonary disease (COPD) is a primary lung disease. Today, pulmonary rehabilitation (PR) is the basis of non-pharmacological treatment of these patients, with numerous confirmed effects on the most significant symptoms of the disease and quality of life (QoL). The aim of this study was to determine the relationship between certain risk factors and the outcome of PR, as well as to determine the percentage of respondents who had a positive outcome of PR. Methods. The study included 500 patients with COPD, determined according to the guidelines of the GOLD, all stages I-IV, in the stable phase of the disease, who completed the outpatient PR program. Disease stage, comorbidities, forced expiratory volume in the first second, 6-minute walk test (6MWT), COPD Assessment Test (CAT) and Medical Research Council dyspnea scale, BODE index, were measured before and after the program. The last four parameters have been observed as risk factors that affect the outcome of PR, but also as parameters by which we monitor the outcome of PR. Results. A successful outcome of PR was achieved by as many as 452 (90.4%) patients. As independent predictors of a positive outcome of PR were determined: lower number of comorbidities, absence of heart failure, higher BMI and CAT ? 10. Conclusions. PR in our group of patients leads to statistically significant improvements in most of the examined subjective and objective parameters, in patients at all stages of the disease.

Introduction/Objective. The presence of epidermal growth factor receptor (EGFR) mutations is the best predictor of response for therapy with tyrosine kinase inhibitors. In this study, we investigate association between EGFR mutations and clinicopathological characteristics and thyroid transcription factor (TTF-1) expression in lung adenocarcinomas (AD). Methods. We analyzed 142 surgical samples from patients with histologically confirmed lung AD from January 2010 to December 2015. All tumor tissues were reclassified according to the World Health Organization criteria and EGFR mutations detected by real-time polymerase chain reaction. TTF-1 expression was detected by immunohistochemistry in 83 out of 142 cases. The association between EGFR and TTF-1 expression was analyzed using the ?2 test or Fisher?s exact test with SPSS software version 20.0. Results. This study included 78 male and 64 women with a median age of 61.6 (range, 42?82) years. Acinar (ACN) and solid (SOL) were the most common histological types (47.9% and 38.7%, respectively). TTF-1 expression was present in 69 of 83 (83%) ADs. The EGFR mutation was found in 7%, more frequently in women, and patients with smoking history, and acinar type of AD, whereas it had no association with age and pathological stage and TTF-1 expression. Conclusion. In conclusion, the results of this study demonstrate that the presence of EGFR mutations is associated with some clinical characteristics and histologic type of ADs, but not with TTF-1 expression.

Background/Aim: The prevention of cardiovascular risk factors and cardiovascular disease management contributes to the cardiovascular mortality reduction. The effects of these activities have been measured by quality indicators. The aim of this study was to determine the effects of family medicine team training workshop and implementation of clinical guidelines on the cardiovascular risk factors and diseases management in primary health care in the Republic of Srpska/Bosnia and Herzegovina. Methods: The "CardioVascular Risk Assessment and Management" study included a sample of 373 teams from 41 primary health care centres trained to provide adequate services and to compare the quality of cardiovascular risk management before and after the training workshop and implementation of clinical guidelines. The comparison was based on nine project defined performance indicators related to hypertension, type 2 diabetes mellitus, hyperlipidaemia, tobacco smoking and obesity. Results: Significant improvements were observed in six indicators after the training workshop and implementation of guidelines. Target values for blood pressure and HbA1c were achieved in over 80 % of patients (82.12 ± 15.81 vs 84.49 ± 12.71 and 84.49 ± 12.71 vs 85.49 ± 24.55; before and after the training workshop, respectively), while the target values for LDL cholesterol were achieved in 54.98 % ± 20.33 before and 57.64 % ± 16.66 after the training workshop. The number of teams that had less than 20 % of recorded data significantly decreased after the training workshop and guidelines implementation, and adequate recording of all indicators was improved. Conclusion: The training workshop of family medicine teams and implementation of clinical guidelines resulted in significant quality improvement of cardiovascular diseases management in primary health care.

MicroRNA-based medicines have drawn attention as a promising tool for the treatment of various diseases. Due to the poor biomembrane permeation, cellular uptake, and enzymatic instability of naked microRNA, the clinical success of gene therapy is mostly dependent on formulating efficient and safe transfection vectors [1]. Therefore, we aimed to develop cationic solid lipid nanoparticles (SLN) for gene therapy purposes. SLN containing 0.15% of stearylamine, 4.85% of Precirol ATO 5 (solid lipid), 1% of Tween 80, and 1% of Poloxamer 188, as non-ionic surfactants, were produced using a high-pressure homogenization process (800 bar and three cycles). microRNA 27-a was further complexed with SLN in the following SLN/microRNA ratios: 1:5, 1:2.5, 1:1, 2.5:1, 5:1, 10:1, 25:1 and characterized using dynamic light scattering, electrophoretic light scattering, and gel retardation assay. The SLN had a mean diameter of 112 ± 0.5 nm (PDI of 0.202 ± 0.011) and a zeta potential (ZP) value of +30.6 ± 1.25 mV. Complexation of SLNs with microRNA decreased a particle size from 244.8 ± 2.7 to 120.4 ± 0.4 nm with an increasing weight ratio of SLNs, while the biggest particle size was observed in 1:1 ratio (1146 ± 110.2 nm) due to low ZP values (3.45 ± 0.2 mV). Further, ZP increased from -14.3 ± 0.4 mV to + 39.7 ± 0.5 mV. Both ELS data and gel retardation assay results revealed that complete complexation could be attained above the weight ratio of 5:1. Our investigations suggest that SLN poses a high potential to be non-viral gene carriers in miRNA replacement therapy.

L2 MOTIVATION: THE RELATIONSHIP BETWEEN PAST ATTRIBUTIONS, THE L2MSS, AND INTENDED EFFORT Globalization has led to the spread of English, which has become the world’s international language. As a result of its importance in social, economic, and political spheres, many countries have introduced English language learning in their school curricula. However, despite its importance many learners still seem to struggle with English second language (L2) motivation, which is an Anna Martinović, Irena Burić: L2 MOTIVATION: THE RELATIONSHIP BETWEEN PAST ATTRIBUTIONS... 426 VESTNIK ZA TUJE JEZIKE/JOURNAL FOR FOREIGN LANGUAGES important element of L2 learning success. The aim of this study was to analyse the relationship between several phases of learners’ motivation, including learners’ attributions of past English L2 learning success, current motivational characteristics, and motivation to learn English in the future. Using the L2 Motivational Self System (L2MSS) as a framework, it was found that past learning experiences did not have a significant effect on current learner motivational dispositions. However, elements of the L2MSS had an effect on learners’ intentions to exert effort into future English language learning. In other words, Croatian university students’ L2 motivation was based on their visions for the future rather than on past learning experiences. Moreover, it appears that the ideal L2 self plays a much stronger role in learners’ motivation compared to the ought-to L2 self, and this motivation is tied to utilitarian motives for learning English. In addition, the results showed that other motivational components, such as interest, as well as L2 anxiety, are important elements of learners’ motivation, suggesting cognitive as well as affective aspects in this motivational profile. The complexity of motivation as shown in this study suggests the need for further investigations in various contexts.