Introduction: Colorectal cancer (CRC) is the third most common cancer worldwide with the incidence of about 1,8 million newly diagnosed cases in 2018. According to the World Cancer Report 2014, in Bosnia and Herzegovina 6700 people died of cancer in 2014, and CRC was the cause of mortality in 724 patients (10%). Prevention programs including screening, state-of-the-art diagnostic modalities and therapeutic approaches to CRC are being constantly improved. Aim: Our study was designed to address the diagnostic accuracy of 18F-FDG PET/CT in the follow-up of CRC in patients with normal or elevated CEA. Methods: We retrospectively analyzed 50 patients previously diagnosed with CRC who were initially surgically treated. All patients were suspicious of recurrence and were referred to as 18F-FDG PET/CT for restaging between February 2014 and February 2019. Possible recurrence was indicated by rising CEA, equivocal radiological findings or clinical findings. Results: Out of a total of 50 patients for whom the follow-up of at least six months was available, 27 had CRC confirmed with the gold standard, and all 27 patients had 18F-FDG PET/CT positive for recurrence, giving a sensitivity of 18F-FDG PET/CT in detecting the recurrence of CRC of 100.0% (0.0% of false-negative – FN results). Out of 23 patients with no signs of CRC recurrence on the gold standard, 19 were also 18F-FDG PET/CT negative, giving a specificity of 18F-FDG PET/CT in detecting the recurrence of CRC of 82.6%, and 17.4% of false-positive – FP results. Out of 31 patients who were 18F-FDG PET/CT positive, 27 had it confirmed pathophysiologically or clinically, giving positive predictive value (PPV) of 18F-FDG PET/CT in detecting CRC recurrence of 87.1%; negative predictive value (NPV) was 100.0%, meaning all 19 patients showing no signs of CRC recurrence when imaged with 18F-FDG PET/CT were gold standard negative as well. Conclusion: 18F-FDG PET/CT proves to be a valid diagnostic tool in detecting recurrence in patients with CRC.

Introduction: Peritoneal dialysis (PD) is an established treatment for patients with end-srage kidney disease. The method was developed as an alternative to hemodialysis (HD) presenting a patient survival rate equivalent to HD and better preservation of residual renal function. Peritoneal dialysis (PD) patients have different peritoneal membrane permeability (transport) characteristics. High peritoneal membrane permeability is associated with increased mortality risk in the patient population. Aim: The aim of this study was to analyze the importance of the peritoneal membrane transport status in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Methods: The study included 60 adult continuous ambulatory peritoneal dialysis (CAPD) patients, 29 male and 31 female, mean age 56.63±15.06 years. All patients treated with conventional glucose- based PD fluids. For the short term (within 3 month after start of PD) and long term (more than 12 months) peritoneal dialysis analysis of peritoneal transport characteristics has been used peritoneal functional test (PFT). With the test, categorisation of patients was possible into high (H), high-average (HA), low average (LA), and low (L) transporters. Results: Dialysate–to plasma ratio (D/P) of creatinine showed significantly increased over time (0.654±0.141 vs... 0.705±0.13, p<0.001). In multivariate analysis age, gender, time on dialysis, comorbid diseases, diabetes mellitus (DM), serum albumin, were considered as independent factors influencing the PFT. The high transporter group had higher D/Pcreat (H 0.84±0.03 vs... LA 0.57±0.05, p<0.001), higher proportion of man (H 100% vs... LA 39.5%, p<0.05), higher proportion of patients with comorbid diseases (H 60% vs... LA 20.9%, p<0.05), lower serum albumin concentration (H 29±6.0 vs... LA 37±5.2, p<0.001), lower D4/D0 glucose ( H 0.23±0.07 vs... LA 0.42±0.14, p<0.001), and lower drained volume (H 600±173 vs... LA 1016±355, p<0.001). Conclusion: The PFT was en easy, inexpensive, reliable test to assess peritoneal transport type and it also provided information about peritoneal clearance of solutes and ultrafiltration. Peritoneal transport type classification was recognized not only as aid for prescription, but also as a prognostic index.

Introduction: Idiopathic Idiopathic membranous nephropathy (iMN) is an immune-complex mediated renal disease which is usually associated with the nephrotic syndrome (NS). The course of the disease is variable. Some patients maintain normal kidney function with or without a spontaneous remission of proteinuria, while others progress to end-stage renal failure or die from complications related to the nephrotic syndrome. Whether or not to treat a patient with idiopathic membranous nephropathy is still controversial. The controversy is mainly related to the toxicity of the therapy and the variable natural course of the disease-spontaneous remission occurs in 40–50% of patients. Aim: The aim of this study was to describe our experience of treatment of an idiopathic membranous nephropathy (iMN), efficacy and complications rate. Case report: Our patient was older, mail gender, in high-risk group with persistent proteinuria 10,68 g/day and stable renal function. We have taken these factors into consideration, along with age and other comorbidities, that may significantly elevate the risk of treatment. We chose to start with early treatment, following the Ponticelli’s group protocol based on high dose corticosteroids (odd months) alternating with clorambucil (even months) for six months. This treatment was accompanied by the steroid side effects, including hyperglycaemia dependance on insulin therapy and pulmonary thromboembolism despite administered prophylactically low molecular weight heparin. The six-month treatment was successfully completed with the reduction of proteinuria to nephritic values 2,86 g/day, despite many complications. Complete remission of the disease with non-significant proteinuria and with stable renal function was achieved in 14 months which has been maintained for 2 years. Conclusion: We suggest that decisions on the timing of start of therapy, whom to treat, best sequence of the use of the various immunosuppressive drugs must be based on an individualized assessment of risks and benefits.

Introduction: Psoriasis is a common chronic skin disorder characterized by inflammation and abnormal epidermal proliferation. Its severity ranges from a chronic plaque psoriasis (CPP) to generalized psoriatic erythroderma (PE). The cause of psoriasis is unknown although most evidence supports the hypothesis that psoriasis is an immunologically mediated disease. The T-helper (Th) 1 and Th17 cells are responsible for the inflammation of psoriasis. Immunoglobulin E (IgE) is a class of immunoglobulin essential for the allergic response. There is some evidence that IgE may take a part in the pathogenesis of psoriasis. Aim: The aim of the study was to compare serum levels of total IgE between patients with psoriasis and healthy subjects, and to assess the difference between localized form (CPP) and extensive form of disease (PE). Methods: Seventy-five patients with psoriasis and 30 healthy subjects were enrolled in this study. Data on age, gender, personal and family history, clinical type and duration of disease were collected and analyzed. Serum levels of IgE were measured using nephelometric method. Results: Serum levels of total IgE were significantly higher in patients than in controls (46.7% vs.. 10%; p<0.05). Statistical difference of IgE concentration was also observed between CPP and PE. Comparison between patients and controls with regard to the median of the serum level of total IgE levels showed a statistically highly significant elevation in patients (425 IU/ml) compared with controls (54.5 IU/ml) (p<0,05). A higher total IgE concentration was observed in the group of patients with a longer period of skin changes. No relation was found between the serum level of IgE and family history of psoriasis, age or sex (p>0.05). Conclusions: This study supports the evidence that elevation of total serum IgE is associated with psoriasis. The exact role of serum IgE in psoriasis should be additionally investigated in future studies.

Objectives The development of third molars can be helpful in dental age estimation of adolescents and in early adult period. We tested the repeatability and accuracy of the three dental age radiographic methods (Olze, Demirjian and Solari and Abramovitch) and evaluated which method is more useful. We also aimed at testing to find the correlation of estimated dental and chronological age by these three methods. Material and methods The orthopantomographs (OPGs) of 1007 individuals (8 - 25 years) were divided into two groups (cca 500 OPGs) - one group of OPGs has been presented with all four third molars, while another one was registered with third molar/s hypodontia. And all of OPGs were assessed, to verify the three methods (Olze, Demirjian and Solari and Abramovitch) for age estimation based on third molar development. Results There was a high Spearman's correlation coefficient between stages of development of wisdom tooth and chronological age of subjects by all these three methods. Conclusion We may recommend using third molars for assessing the dental age by Olze, Demirjian and Solari and Abramovitch dental method as well, on Bosnian and Herzegovinian population.

A questionnaire on biomarker testing previously used in central European countries was extended and distributed in Western and Central European countries to the pathologists participating at the Pulmonary Pathology Society meeting 26–28 June 2019 in Dubrovnik, Croatia. Each country was represented by one responder. For recent biomarkers the availability and reimbursement of diagnoses of molecular alterations in non-small cell lung carcinoma varies widely between different, also western European, countries. Reimbursement of such assessments varies widely between unavailability and payments by the health care system or even pharmaceutical companies. The support for testing from alternative sources, such as the pharmaceutical industry, is no doubt partly compensating for the lack of public health system support, but it is not a viable or long‐term solution. Ideally, a structured access to testing and reimbursement should be the aim in order to provide patients with appropriate therapeutic options. As biomarker enabled therapies deliver a 50% better probability of outcome success, improved and unbiased reimbursement remains a major challenge for the future.

This paper investigates the influence of user dynamics on small-scale fading characteristics in off-body channels. A statistical channel model employing a mobility model for wearable antennas on dynamic users is presented. The model is used to analyze the effects of both user’s linear forward motion and periodic wearable antenna displacement due to changes in posture, for walking and running. The time-variant Doppler shift exhibited by signals arriving from different directions is considered for wearable antennas on the chest, wrist and lower leg. A strong influence of the on-body placement is observed, with antennas on the arms and legs yielding up to a 2.2 times higher maximum Doppler frequency than with the antenna on the torso. Furthermore, the small-scale fading dynamics for these antennas vary considerably during the motion cycle, where one can distinguish between slow and fast phases. The latter is found to yield up to 4 times as high root-mean-square level-crossing rates than the former, in the case of the antenna on the lower leg. These findings imply an important effect of the periodic antenna displacement on fading dynamics in off-body channels, which is typically neglected in literature.

This paper presents an off-body indoor propagation channel model. The model is based on a Friis transmission equation to which it adds the orientation-dependent body shadowing loss by adopting a basic model derived from a cosine function. Furthermore, the developed propagation model accounts for human body dynamics and different material reflections coefficients, both implemented using a random variables with uniform distribution. Created model was evaluated against a set of measurements conducted in the indoor environment at mmWave frequency (60 GHz) gathered from the literature, showing a good fit. The difference between the slopes of the proposed model and measurements is less than 6%.

Introduction: Hyperuricemia is an independent risk factor for the development of many diseases. Aim: The aim of this paper is to compare the effects of allopurinol and febuxostat on the values of triglycerides and uric acid in hyperuricemic patients. Methods: This was a pharmacological-clinical retrospective-prospective study. The research sample comprised 50 examinees of both genders and different ages who were undergoing allopurinol (100 mg/day) or febuxostat (80 mg/day) therapy. Statistical Product and Service Solutions (SPSS) Software and Microsoft Excel were used for statistical analysis. Results: Examinees who were treated with allopurinol had a statistically significant decrease in uric acid concentrations (by 126.28 ± 20.36 μmol/l) at the end of the observation compared to the initial values (p = 0.006). Examinees who were treated with febuxostat had a statistically significant decrease in uric acid concentrations (by 252.80 ± 94.17 μmol/l) at the end of the observation compared to the initial values (p = 0.001). The initial value of triglycerides was 1.58 ± 0.64 mmol/l in allopurinol-treated examinees, and 1.60 ± 0.52 mmol/l in febuxostat-treated examinees. After three and six months of allopurinol use, there was a statistically significant increase in triglyceride values (p = 0.046 and p = 0.042, respectively). A statistically significant decrease in triglyceride values (by 0.16 ± 0.10 mmol/l) was noted after three months of febuxostat use (p = 0.012). Conclusion: The results of this research confirmed the previous findings and pointed out the positive pharmacological effects of allopurinol and febuxostat.

Microbiology laboratory is a type of medical laboratory and should be safe and efficient environment. Even it is not a mandatory for the accreditation in most of the countries, ISO/IEC 15189 remains the most common reference for quality of work in medical laboratories. It is mostly based on good laboratory practices and is oriented to support accurate clinical decisions. ISO/IEC 15189 has potential to become very effective instrument for development and improvement of medical laboratories. Results from laboratory should guide the majority of clinical decisions and help in providing adequate patient care. This article provides a simple approach to meet the minimum requirements set. To achieve intended goal and strictly follow the requirements proposed in the standard, the trained and well-motivated laboratory staff is necessary to implement the system. The objective of this article is for it to be used as a guideline for evaluation and implementation of the ISO 15189.

This paper presents the results of development of Artificial Neural Networks (ANNs) for prediction of medical device performance based on conformity assessment data. Conformity assessment data of medical devices was obtained from periodical inspections conducted by ISO 17020 accredited laboratory during 2015–2019 period. For the development of ANNs, 1738 samples of conformity assessment of infusion and perfusor pumps was used. Out of the overall number of samples, 1391 (80%) of them were used during system development and 346 (20%) samples were used for subsequent validation of system performance. During system development, the impact on overall system accuracy of different number of neurons in hidden layer and the activation functions was tested. Also, two neural network architectures were tested: feedforward and feedback. The results show that feedforward neural network architecture with 10 neurons in single hidden layer has the best performance. The overall accuracy of that neural network is 98.06% for performance prediction of perfusor pumps and 98.83% for performance prediction of infusion pumps. The recurrent neural network resulted in accuracy of 98.41% for both infusion pumps and perfusor pumps. The results show that conformity assessment data obtained through yearly inspections of medical devices can successfully be used for prediction of performance of single medical device. This is very important in increasing the safety and accuracy of diagnosis and treatment of patients.

Increasing incidence of cardiovascular disease and their mortality rate render them as second leading cause of death worldwide. Artificial Intelligence (AI) is used in many fields of science and industry, but also has found its use in medicine for diagnosis, treatment and prediction of diseases. This paper presents the review of AI application in cardiology. The review is based on research papers published in Medline database. Findings of the review indicate that, according to accuracy parameter, the overall performance of AI based models for cardiovascular application is above 83%. Based on the results, AI algorithms and deep learning can be rendered as accurate, hence showing possibility to be used as a diagnostic tool now and in the future. New era of modern diagnosing is coming and Artificial Intelligence has the potential to change the way in which medicine is practiced.