ABSTRACT Two cases are presented with coronavirus disease 19 (COVID-19)-related hiccups: one during initial presentation and one 10 days after COVID-19 diagnosis. Hiccups in both patients were resistant to treatment and responded only to chlorpromazine. COVID-19 patients may present with hiccups and also may have hiccups after treatment. Resistant hiccups without any underlying disease other than COVID-19 should be considered in association with COVID-19 and may respond well to chlorpromazine.

Backgroud: Intervertebral disc herniations are caused by rupture of the fibrous ring and migration of one part of the nucleus pulposus towards the spinal canal. The most commonly affected levels are C5-C6 and C6-C7. Surgical treatment of cervicobrachialgia is indicated in the presence of long-term intense pain syndrome with or without radicular sensory-motor deficit and magnetic resonance (MRI) verified disc herniation with a compressive effect. Objective: The most common surgical treatment is anterior lateral microdiscectomy with or without the use of implants. In addition to this method, dorsolateral microsurgical treatment can be used for foraminal hernias. Methods: This retrospective study included 110 (58 / 52.7% male and 52 / 47.3% female) patients with cervical disc herniations who were surgically treated at the Neurosurgery clinic of Clinical Center of Sarajevo University (CCUS) in a five-year period. Stability, postoperative curvature, arthrodesis, implants, and changes in adjacent segments were radiographically analyzed. In the outcome assessment, functional outcome and patient satisfaction were analyzed using the Pain Self-Evaluation Scale (VAS), Prolo functional and economic score, and White’s classification of treatment outcomes. Results: The dominant prevalence of changes was recorded at the levels of C5-C6 (58%) and C4-C5 (28%) with a ventrolateral approach performed in 90% of patients. The largest representation is hard dorsolateral discs (n = 77). In the group of patients with placed implant, hard discs were present in 96 (90%) cases (p <0.001), while soft discs were dominant in patients without implant placement (p <0.001). In the group of subjects with implant, the most common are hard dorsolateral discs and those of mixed localization in 41 of 55 patients (65.5%; p = 0.001). The most common implant is PEEK cage (74.5%). From complications, we had partial vertebral body fractures in 4.5% of patients. Furtehr, the most common are sensory disturbances in 2.73% of respondents. Reduction of symptoms and improvement of preoperative neurological status were observed in over 95% of patients. Conclusion: Surgical treatment of cervical disc herniation is a safe method with a minimal percentage of complications. Microsurgical discectomy significantly contributes to the improvement of the functional status of patients, the reduction of pain, and the improvement of neurological deficit and overall mobility.

Background: Infantile hemangiomas (IH) are the most common vascular, benign tumors of childhood with a prevalence of 4-5%. Due to intense vasculogenesis, they proliferate during infancy, then involute at an unpredictable rate, extent of involution, and quality of residual tissue. Depending on the location, they may be associated with anomalies of other organ systems (PHACE, PELVIS syndroms). In recent decades, knowledge about hemangiomas has improved, and therefore therapeutic possibilities have improved. Today, the non-selective beta blocker–propranolol is considered the drug of first choice in the treatment of infantile hemangiomas. It is desirable to start treatment in the proliferative phase of hemangioma growth for the best possible effect. The dynamics of drug administration, time interval of dose increase and monitoring of patients during treatment vary from one Institution to another and are still the subject of discussion. Objective: We presented the case of a child with infantile hemangioma of the lumbo-sacral region, treated with combination therapy with systemic propranolol and topical timolol, with satisfactory effect in the end. Conclusion: Propranolol is considered a drug with well-studied side effects and a safety profile. During 6 months of treatment, it leads to complete or almost complete withdrawal of the hemangioma. Treatment should be started in the hemangioma proliferation phase for the best possible therapeutic effect.

OBJECTIVES The aim of this systematic review was to critically analyze available data on gene polymorphisms in odontogenic keratocysts and ameloblastomas, including their possible relationship with clinical and histological features of these lesions. MATERIALS AND METHODS A comprehensive search of Web of Science Scopus, PubMed, Cochrane Central Register of Controlled Trials and EMBASE was conducted using relevant key terms and supplemented by a gray literature search. Quality assessment of included studies was performed using criteria from the Strengthening the Reporting of Genetic Association (STREGA) statement. RESULTS Ten studies were included in the final review. Survivin -31G/C, interleukin IL-1α -889 C/T, p53 codon 72 G/C, tumor necrosis factor TNF-α (-308G>A) and its receptor TNF-R1 (36A>G), glioma-associated oncogene homolog 1 rs2228224 and matrix metalloproteinase 2 rs243865 gene polymorphisms were reported to be associated with odontogenic keratocysts. For ameloblastomas, p53 - codon 72 G/C, X-ray repair cross-complementing protein 1 - codons 194 and 399 and matrix metalloproteinase 9 rs3918242 gene polymorphisms were identified as risk factors. It wasn't possible to establish a relationship between specific polymorphisms and clinical and histological features of investigated lesions. CONCLUSIONS Several gene polymorphisms might be considered as a risk factor for the development of these lesions. Future studies should investigate whether these polymorphisms might be used to identify patients with increased risk of recurrence or aggressive disease.

Introduction: The invasion of blood and lymph vessels with tumor tissue represents a negative prognostic factor of the disease course in patients with non-small cell lung cancer. Aim: The aim of the study was to determine the marker value of a preoperatively determined size of pulmonary squamous cell carcinoma and adenocarcinoma and its impact on lymphovascular invasion (LVI) in resected lung tissue. Materials and Methods: The conducted observational cross-sectional study included 322 patients with a complete resection of confirmed squamous cell lung carcinoma and lung adenocarcinoma. Preoperative size and type of tumor were determined by a preoperative chest computed tomography scan and cytological/histological analysis of obtained samples, while LVI status was determined by pathohistological analysis of resected tumor lung tissue. Receiver operating characteristic (ROC) curve analysis was performed to assess whether tumor size could serve as a reliable marker for LVI. P < 0.05 was considered statically significant. Results: A statistically significant difference in the frequency of tumor size (P = 0.580) along with LVI (P = 0.656) was not established between the patients with squamous cell lung cancer and lung adenocarcinoma. A ratio between the size of lung adenocarcinoma and LVI status (P < 0.001) was determined as statistically significant, while such a difference was not established in squamous cell lung cancer (P = 0.052). The ROC analysis revealed that tumor size >39 mm in patients with lung adenocarcinoma has obtained a sensitivity of 70.8% and a specificity of 60.9% to differentiate patients with a LVI (areas under the curve [AUC] = 0.70; 95% CI 0.60‒0.79; P < 0.001). A tumor size >4.6 cm in patients with squamous cell lung cancer obtained a sensitivity of 56.5% and a specificity of 60.3% to differentiate patients with a LVI (AUC = 0.59; 95% CI 0.50‒0.67; P = 0.043). Conclusion: The preoperative size of lung adenocarcinoma could be an acceptable marker of LVI presence in resected lung tissue, while in the squamous cell lung cancer, a potential biomarker role of the preoperative size of the tumor was inadequate.

Background Health campaign interventions, particularly those tailored to the target audience’s needs and preferences, can cost-effectively change people’s attitudes and behaviors towards better health decision-making. However, there is limited research on how to best tailor seasonal influenza vaccination campaigns for young adults. Vaccination is vital in protecting young adults and their social circles (vulnerable populations like older adults) from the influenza virus and critical in shaping these emerging adults’ vaccination habits in the long run. However, amid the prevalence of easily-accessible, attention-grabbing, and often malicious false and misinformation (e.g., COVID-19 vaccine conspiracy theories), it may be more challenging to develop vaccination messages that resonate with young adults well enough to attract their attention. Therefore, to bridge the research gap, this study examines young adults’ preferences for seasonal influenza vaccination campaigns to inform effective intervention design and development. Methods Qualitative survey questions were developed to gauge young adults’ preferences for seasonal influenza vaccination campaigns. A total of 545 young adults (73.9% female, Mage = 19.89, SD = 1.44) from a large University offered complete answers to a cross-sectional online survey. Braun and Clarke’s thematic analysis procedures were adopted to guide the data analysis process. Results Thematic analysis revealed that young adults prefer seasonal influenza vaccination campaigns that rely on (1) quality and balanced information from (2) credible information sources, positioned in the (3) relevant health contexts, (4) emphasize actionable messages, and incorporate (5) persuasive campaign design. Interestingly, while many participants underscored the importance of fear-appeal messages in persuading them to take health actions, some young adults also suggested avoiding fear campaigns due to discomfort. Conclusions Insights of the study can inform seasonal influenza vaccination design and development, and have the potential to shed light on vaccination messaging in other vaccine contexts, such as COVID-19 vaccines. Results also underscore the need for health experts and government officials to adopt a more nuanced approach when selecting persuasive campaign appeals. While some young adults may resonate well with fear appeals, others may not. Future research could examine the underlying mechanisms that drive young adults’ preference for vaccination campaign intervention to enrich the literature further.

Endurance training (ET) has multiple beneficial effects on cardiovascular health (CVH), but there is an evident lack of knowledge on differential effects of various types of ET on indices of CVH in women. The aim of this study was to analyse the effectiveness of two different types of ET on changes in indicators of CVH in apparently healthy adult women. The sample included 58 women (24 ± 3 years; height: 165 ± 6 cm, mass: 66.7 ± 7.2 kg, BMI: 24.3 ± 2.5 kg/m2, at baseline) divided into one control non-exercising group (n = 19), and two exercising experimental groups (EE). The first EE participated in choreographed aerobic-endurance training (CAT; n = 19), while the second participated in treadmill-based endurance exercise (TEE; n = 20) during the experimental protocol (8 weeks, 24 training sessions). The testing included pre- and post-exercise protocols and measures of anthropometric/body composition indices, lipid panel, and endurance capacity. Two-way analysis of variance for repeated measurements with consecutive post hoc analysis was applied to the “group” and “measurement” variables. The main significant ANOVA effects found for measurement, and “Group x Measurement” interaction (p < 0.05) were found for all variables but body height. The EE induced positive changes in lipid panel variables, anthropometric/body-build status, and endurance capacity. However, TEE improved endurance capacity to a greater extent than CAT. The results suggest that that the optimal exercise intensity and self-chosen type of physical-activity may result in positive effects on indices of CVH, even in women of young age and good health status.

Accessory mitral valve tissue (AMVT) is an extremely rare congenital cardiac abnormality in adults. Patients typically present with symptoms and signs of left ventricular (LV) outflow tract (LVOT) obstruction. LVOT obstruction caused by AMTV was diagnosed mostly in the first decade of life. However, isolated cases of AMVT with LVOT obstruction in adulthood are uncommon (1, 2). This paper reports a case of an adult patient aged 56 years with severe LVOT obstruction and severe mitral regurgitation (MR) caused by AMVT.

OBJECTIVE To present the characteristics of the AKT1E117K gene variant and a description of the clinical application in a patient with metastatic breast cancer. RESULTS 63 y/o woman with Stage IV Invasive lobular carcinoma at diagnosis was treated with Palbociclib and aromatase inhibitors (AI). At progression, tissue was sent for comprehensive genomic profiling to Foundation Medicine (FM) which revealed AKT1E17K mutation. In lieu of available clinical data within the patient's tumor type (HR+ HER2- breast cancer), extrapolated data from the Flatiron Health-FM (FH-FMI) Clinico-genomic Database (CGDB) was discussed at our Molecular Tumor Board (MTB). After multidisciplinary discussion, the consensus recommendation was to start treatment with the combination of mTOR inhibitor everolimus, and AI, exemestane. Patient tolerated treatment without major side effects. By the second clinical visit the patient's breast showed signs of improvement. PET/CT showed diminished left axillary uptake, decreased right paratracheal lymph node PET avidity, and stable bone disease consistent with a partial response. The most recent office visit in January 2021, breast exam revealed a normal-appearing skin with only faint erythema. All other skin lesions have resolved. Although, the role of AKT1 variant described here is not well defined and therapeutic significance of M-Tor inhibitors not established in metastatic breast cancers, comprehensive approach to this case unraveled new and successful therapeutic option in this patient. CONCLUSION This demonstrates that applying available Precision Medicine tools like MTB and real world data sets from patient populations with similar clinical and genomic profiles may provide more options for treatment.

Purpose: The primary purpose of this paper is to identify the most important factors related to the successful implementation of TQM in the literature and to compare the identified factors with the existing research. Methodology/Approach: By conducting a systematic literature review in three main stages, this research analyzes 13 empirical papers published between 1995 and 2017. Three main stages included: formulation of the problem to be solved by the systematic literature review; definition of inclusion criteria and exclusion of articles; and article search and selection. Findings: Analysing previous research and conducting a literature review, we identify six main critical success factors (CSF): top management leadership and commitment, customer focus, training (employees), procurement management (suppliers), information and analysis, and process management. Research Limitation/Implication: In this paper, we focused solely on the influence of TQM practices on the financial performance of a company. As such, the non-financial performance indicators were not considered. Originality/Value of paper: This paper adds value to the existing literature as it focuses on critical factors of TQM implementation examined in relation to the financial performance of the company and provides a good basis for understanding and developing more complex models. Category: Literature review