Aim To measure a calibre of radial and ulnar septocutaneous perforators at the anterior forearm, and to count its number in proximal, middle and distal thirds. Methods The study was conducted on 50 fresh amputated forearms (trauma, tumours) in the period between January 2012 and December 2021. Forearms were collected from several hospitals in Belgrade, and analysed at the Institute of Anatomy, Medical School, University of Belgrade, Serbia. Injection of ink-gelatin and fine dissection of autopsy material was performed on 30 forearms, and corrosion method with injecting methyl methacrylate for 3D analysis on the other 20 forearms. Results A mean calibre of septocutaneous perforators on the radial artery was 0.53±0.46 mm (0.2-0.85). Averagely, there were 8.1 radial artery septocutaneous perforators - two perforators on the proximal third, 3.7 on the middle third, and 2.7 on the distal third. The mean calibre of ulnar artery perforators was 0.65±0.35 mm (0.18-1.8). The average number of septocutaneous perforators of the ulnar artery was 5.6; 1.2 on the proximal third, two on the middle third, and 2.2 on distal third. Conclusion Determination of the origin, calibre and spreading directions of the arterial septocutaneous perforators on the anterior forearm provide quantification of data about arborisation of radial and ulnar septocutaneous perforators at the anterior forearm. Clinical relevance of those anatomical data is in defining of safe locations and dimensions of forearm fasciocutaneous flaps in plastic surgery.

OBJECTIVE The aim of our study was to determine the etiological factors, treatment and outcome of patients with non-variceal bleeding from upper gastrointestinal tract. MATERIALS AND METHODS This study enrolled 200 patients admitted to Sarajevo University Clinical Center with signs and symptoms of upper gastrointestinal bleeding, from January 2019 to July 2020. All patients had undergone gastroscopy, confirming the cause of gastrointestinal bleeding. Clinical and laboratory data were collected retrospectively, including previous non-steroid antiinflammatory drugs (NSAIDs) and anticoagulant therapy, comorbidities, risk factors, as well as endoscopic findings, laboratory findings, treatment and clinical follow-up. RESULTS The majority of patients were men (59%) with an average age of 53±6 years. Duodenal and gastric ulcers were the most common cause, followed by other etiologies. In our study, previous NSAIDs therapy had been registered in 29.5% of patients, anticoagulants in 8%, and proton pump inhibitors (PPI) in 2.9% of patients. Endoscopic intervention was required in 34% of patients. The need for transfusion occurred in 44.5% of cases. Rebleeding during hospitalization was observed in 7.5% of patients, mortality in 1.5% and surgery in 3% of patients. CONCLUSION The patients admitted to our hospital with symptoms of acute nonvariceal upper gastrointestinal bleeding were elderly, predominantly males, with significant comorbidities and a higher incidence of NSAID use. Gastroprotection is underutilized during NSAID treatment in patients with other coexisting risk factors, with a low rate of concomitant use of PPI during NSAIDs therapy. Endoscopic therapy, together with PPI, significantly reduces rebleeding rates, mortality and the number of emergency surgical interventions.

Background and Aims: To analyze impact of atherosclerotic diseases on mortality in Department for Internal Diseases in Cantonal Hospital Zenica, Bosnia and Herzegovina. Methods: Mortality data were collected from hospital medical information system in period January 2018 - June 2020. Followed parameters were: age, sex, leading diagnosis, length of hospital stay. Results: During this period there were 780 intrahospital deaths in Department for Internal Diseases, 422(54%) men and 358(46%) women.Most deaths were recorded in age groups >60 years,as follows:in group 60-69y/o 190 deaths(24,4%), 70-79y/o 266 deaths(34.1%), 80-89y/o 226(29%).There were 14 deaths(1,8%)in age group >90y/o and 16 deaths(2,1%)in younger than 50y/o. Mean duration of hospitalization was 5.09 days,with maximum 47 days in one case and minimum 1 day in 221 cases(28,5%).Leading diagnosis were atherosclerotic cardiovascular diseases in 346cases(44,5%), followed with malignancy in 117 cases (15%),renal failure in 75 cases(9,7%),gastrointestinal diseases in 73(9,5%), respiratory diseases in 69 cases(8,9%),sepsis in 30(3,9%) cases, autoimmune diseases in 7(0,9%) cases, unknown etiology in 59(7,6%) cases. During the last 3 months of study (March-June 2020) was beginning of COVID-19 pandemia in our country. It was period of strict lockdown during which was no death cases caused by COVID-19 in our hospital. Conclusions: The leading cause of intrahospital mortality were cardiovascular diseases, almost three times more than malignancy. Although our patients live in industrial area with air pollution, percentage of respiratory deaths was surprisingly low comparing with atherosclerotic causes. Atherosclerosis remains leading cause of death in our hospital and we should expand our efforts in prevention and treatment of cardiovascular disease.

Aim To identify laboratory tests for early detection and the development of more severe illness and death in COVID-19 hospitalized patients. Methods A prospective study was done on 66 hospitalized COVID-19 patients (males: 54.5%; mean age 70.1 ± 9.6 years) who were stratified into: moderate (n=36; 54.5%), severe (n=12; 18.2%), and critically ill (n=18; 27.3%). Besides clinical findings, a wide spectrum of laboratory parameters was monitored at admission and control during the first seven days of hospitalization and used to predict progression from non-severe to severe illness and to predict the final outcome. Results Critically ill patients showed a higher control value of white blood cell count, C-reactive protein, lactate dehydrogenase, ferritin, but lower lymphocyte count and O2 saturation. Patients with fatal outcome (23; 34.85%) showed a higher control value of neutrophil, lactate dehydrogenase, ferritin, and lower lymphocyte and O2 saturation. Progression from moderate to severe or critical illness was predicted by increasing lactate dehydrogenase (95% CI 0.5803 to 0.8397;p=0.003729), increase in ferritin (95% CI 0.5288 to 0.8221;p=0.03248), and by drop in O2 saturation (95% CI 0.5498 to 0.8179;p=0.01168). A fatal outcome was predicted by increase in ferritin (95% CI 0.5059 to 0.8195;p=0.04985), as well as by drop in O2 saturation (95% CI 0.5916 to 0.8803; p=0.001861). Conclusion Increase in ferritin, and drop in O2 saturation could be the most important prognostic parameters for the development of more severe clinical illness and death in COVID-19 hospitalized patients.

Heat shock protein 70 (Hsp70) engages Toll-like receptors (TLR) 2 and 4 when found in the extracellular compartment and contributes to inflammation in chronic obstructive pulmonary disease (COPD). Since there is growing evidence for the genetic risk factors for COPD, the gene expression of HSP70, TLR2 and TLR4 was determined, as well as the association between HSP70, TLR2 and TLR4 single nucleotide polymorphisms, (SNPs) and COPD. The gene expression was assessed in peripheral blood cells of 137 COPD patients and 95 controls by a quantitative polymerase chain reaction (qPCR), while a total of nine SNPs were genotyped by TaqMan allelic discrimination real-time PCR. HSP70 and TLR2 gene expression was increased in COPD patients compared to the controls, regardless of the disease severity and smoking status of participants. The rs6457452 SNP of HSP70 was associated with COPD, indicating the protective role of the T allele (OR = 0.46, 95% CI = 0.24–0.89, p = 0.022). Furthermore, COPD C/T heterozygotes showed a decreased HSP70 mRNA level compared to COPD C/C homozygotes. In conclusion, HSP70 and TLR2 may have a role in the pathogenesis of COPD, and the HSP70 rs6457452 variant might influence the genetic susceptibility to COPD in the Croatian population.

Aim To determine the relationship between seasonal changes in ambient temperature, humidity and general and specific mortality rates in the area of Zenica-Doboj Canton. Methods Changes in the average monthly mortality in the period from 2008 to 2019 were analysed (linear regression) in relation to the average temperatures and humidity in those months in the same time period in Zenica-Doboj Canton. Results Overall mortality increased from 7.9 ‰ in 2008 to 10.2 ‰ in 2019. Overall and specific mortality rates for cardiovascular, malignant, respiratory and metabolic diseases followed seasonal change of ambient temperature and humidity. The monitoring trend showed strong determination degree for overall mortality and mortality for cardiovascular, malignant and respiratory diseases, while for metabolic diseases it was somewhat lower. The highest mortality rates were found in January (cold month), and in August (warm month); the lowest one was in May, September and October. There was a strong significant negative correlation between temperature and mortality rates, while the correlation between humidity and mortality rates was not significant. Conclusion As we have proven that mortality rates followed seasonal changes in ambient temperature and determined months with the least mortality rate, the community must take measures to ensure microclimatic conditions for the survival of patients with cardiovascular, malignant, respiratory and metabolic diseases.

OBJECTIVE The aim of our study was to investigate the predictors of morbidity (age, gender, smoking habits, obesity and the presence of chronic diseases) and COVID-19 outcomes. SUBJECTS AND METHODS The research was an observational descriptive study, conducted at The Family Medicine Education Center, The Primary Health Care Center, Banja Luka, in the period from 26th June to 31st December 2020. During the research period, seven family medicine teams followed their patients with COVID- 19, and recorded possible predictors for morbidity and their influence on the disease outcome. RESULTS The study included 934 patients, 46.90% of whom were male. The majority of subjects were non-smokers and overweight. Diabetes was found in 5.57% patients, hypertension in 29.44%, chronic respiratory diseases in 5.25%, cancer in 4.39% patients. In the observed sample, 29.23% subjects contracted pneumonia, 18.52% were hospitalized, while 19 (2.03%) patients with severe clinical features had a fatal outcome. Multivariable regression analysis showed a high risk of pneumonia in male patients [OR=2.45, 95% CI (1.73- 3.46)], elderly [OR=1.07, 95% CI (1.06-1.09)] and obese patients with Body Mass Index ≥30.0 kg/m2 [OR=2.55, 95% CI (1.73- 3.77)]. Male gender [OR=2.19, 95% CI (1.11-4.31)], older age [OR=1.08, 95% CI (1.05-1.11)] and hypertension [OR=2.51, 95% CI (1.06-5.91)] were the most important predictors for the development of severe clinical features in COVID 19. The statistically significant predictors of mortality were male gender [OR=7.16, 95% CI (1.56-32.86)] and older age [OR=1.12, 95% CI (1.06-1.18]. CONCLUSION Being familiar with the predictors of morbidity and poor outcome in COVID-19 is helpful for carrying out preventive measures, early diagnosis and treatment of risk groups of patients.

OBJECTIVE The purpose of this study was to evaluate the efficacy of daily transcutaneous tibial nerve stimulation (TTNS) versus weekly percutaneous tibial nerve stimulation (PTNS) on the quality of life of patients with idiopathic overactive bladder (OAB). PATIENTS AND METHODS The study was designed as a randomized controlled trial. The diagnosis of OAB was made on the basis of clinical symptoms, and urodynamic tests were performed to check whether uncontrolled contractions of the derusor during bladder filling were responsible for the OAB symptoms. The tests used to assess symptoms and quality of life were Overactive Bladder Questionnaires (OAB-q) SF. The patients were divided into 2 groups of 30 patients each. The first group was treated with TTNS every day for 3 months and the second group with PTNS once a week, also for 3 months. RESULTS Stimulation with both TTNS and PTNS led to the reduction of all clinical symptoms of OAB and improved quality of life, with statistical significance (P<0.05) and with no side effects. When comparing these two groups, the improvement was statistically more significant in the group treated with PTNS. When the quality of life scores and symptoms were compared to the type of treatment, it was found that the improved quality of life parameters and the reduced OAB symptoms were more statistically significant in the treatment with PTNS than TTNS therapy (P<0.001). CONCLUSION The results of the study suggest good efficacy of both TTNS and PTNS in the treatment of OAB. Better effects are achieved with weekly PTNS, as it leads to a statistically significant reduction in symptoms as well as an improvement in quality of life, without side effects.

Abstract Pattern recognition techniques are applied to various morphological descriptors to monitor the formation and propagation of surface defects of materials subjected to thermal shock. A low-cement high-alumina castable was synthesized, cured, sintered, and exposed to thermal stability testing using the water quench test. After a certain number of thermal shock cycles, photographs of the samples’ surfaces were taken and subjected to image analysis. The influence of the sintering temperature on the morphology of the detected defects was studied using principal component analysis (PCA) as a pattern recognition technique that is the most informative for extracting possible differences. The morphological descriptors of the defects correspond to the previous results regarding the influence of sintering temperature on the structure of a castable during thermal shocks.

A study of the trichomes types and distribution and pollen morphology was carried out in nine Micromeria taxa (M. cristata ssp. cristata, M. cristata ssp. kosaninii, M. croatica, M. graeca ssp. graeca, M. graeca ssp. fruticulosa, M. juliana, M. kerneri, M. longipedunculata and M. microphylla) and five closely related Clinopodium species (C. dalmaticum, C. frivaldszkyanum, C. pulegium, C. serpyllifolium and C. thymifolium) from the Lamiaceae family of the Balkan Peninsula. By scanning electron microscope, non-glandular trichomes, peltate and capitate trichomes were observed on the calyx, leaves and stem of the studied species. Two subtypes of capitate trichomes were observed in Micromeria species: subtype 1 (consisting of a basal epidermal cell and an elliptically shaped head cell) and subtype 2 (consisting of a basal epidermal cell, two to three stalk cells and a round head cell). In Clinopodium species, three types of capitate trichomes were observed: subtype 1, subtype 3 (consisting of a basal epidermal cell, a short peduncle cell, and a single round head cell), and subtype 4 (consisting of a basal epidermal cell, a stalk cell, and an elongated head cell). These results support the recent transfer of Micromeria species from the section Pseudomelissa to the genus Clinopodium.

Abstract Hearing aids continue to acquire increasingly sophisticated sound-processing features beyond basic amplification. On the one hand, these have the potential to add user benefit and allow for personalization. On the other hand, if such features are to benefit according to their potential, they require clinicians to be acquainted with both the underlying technologies and the specific fitting handles made available by the individual hearing aid manufacturers. Ensuring benefit from hearing aids in typical daily listening environments requires that the hearing aids handle sounds that interfere with communication, generically referred to as “noise.” With this aim, considerable efforts from both academia and industry have led to increasingly advanced algorithms that handle noise, typically using the principles of directional processing and postfiltering. This article provides an overview of the techniques used for noise reduction in modern hearing aids. First, classical techniques are covered as they are used in modern hearing aids. The discussion then shifts to how deep learning, a subfield of artificial intelligence, provides a radically different way of solving the noise problem. Finally, the results of several experiments are used to showcase the benefits of recent algorithmic advances in terms of signal-to-noise ratio, speech intelligibility, selective attention, and listening effort.

Aim To identify predictive factors related with noninvasive ventilation (NIV) failure that are not based on the patient's respiratory status or acid base gas analyses in COVID-19 critically ill patients, and to create a predictive model of NIV failure. Methods A total of 73 COVID-19 critically ill patients who developed acute respiratory failure and underwent NIV were divided into two groups: Group 1, patients who required endotracheal intubation and invasive mechanical ventilation after NIV and Group 2, patients with successful weaning from NIV. Demographic data, clinical symptoms and signs, clinical index and scores, duration indicators and laboratory data were analysed. Predictive factors of NIV failure were assessed using univariate and multivariate regression analyses followed by the receiver operating characteristic (ROC) curve. Results In the Group 1 (NIV failure) there were 54 (73.97%) patients. Predictive factors for NIV failure were: the presence of dyspnoea on the day of admission at hospital (p<0.05; sensitivity 44.40%; specificity 84.20%), higher radiographic assessment of lung oedema score (RALES) on the day of starting NIV (p<0.009; sensitivity 70.40%; specificity 73.75%), higher length of NIV (p<0.014; sensitivity 48%; specificity 84.10%) and higher urea on the day of starting NIV (p<0.004; sensitivity 70.44%; specificity 73.72%) Conclusion NIV treatment in COVID-19 critically ill patients has a high failure rate. In addition to respiratory parameters, dyspnoea, higher RALES, higher length of NIV and increased urea value could predict NIV failure. These factors should be considered in treatment decision making.

Aim To analyse demographic data, clinical symptoms and signs, laboratory data and comorbidities in patients with COVID-19 pneumonia admitted to the intensive care unit (ICU), mechanically ventilated with fatal outcome. Methods Medical records of 92 patients were retrospectively analysed. Demographic data, clinical symptoms and comorbidities were collected on the day of hospital admission. Clinical signs and laboratory data were collected on the day of hospital admission (T1), on the day of starting non-invasive ventilation (T2), and on the day of starting invasive ventilation (T3). Results Average age of the patients was 60.05 years. Patients over 50 years of age, 71 (77.1%) (p=0.000), and males, 62 (67.4%; p=0.001) were predominant. The most common patient symptoms were exhaustion, myalgia, dyspnoea and cough. Hyperthermia was recorded on the day of hospital admission. Tachycardia, hyperglycaemia, hypoxemia were recorded at all observed study times. The most common comorbidity was hypertension arterialis with a very strong correlation with fatal outcome, followed by diabetes mellitus and chronic heart disease that were moderately correlated with fatal outcome. Conclusion The treatment of COVID-19 patients in ICU with mechanical ventilation has a high failure rate. Demographic data, clinical symptoms and signs as well as accompanying comorbidities can be a significant component in making decisions about diagnostic-therapeutic procedures.

The SARS-CoV-2 (COVID-19) pandemic has emerged as one of the greatest problems of the 21st century worldwide. Efforts to fight this pandemic require a global co-operation and a multidisciplinary approach. An application of information and communication technologies (ICT) to a great degree contributes to fighting the pandemic as these technologies are one of the key services that assist patients, researchers, health institutions and other interested parties in different activities in an effort to fight the pandemic and its consequences. The present paper presents the features of certain mobile applications (apps) that are being used for different purposes such as: tracking patients, COVID-19-related warnings, keeping tracks of statistical data, organising life and business, etc. Aside from presenting the features of a certain number of applications, a review of technologies used for the development of these applications will also be presented. Furthermore, the paper addresses certain challenges that come along with the mobile technologies applications and offers suggestions for future research.