A noninvasive diagnostic procedure that allows for in vivo microscopic examination of the epidermis, the dermoepidermal junction, and the papillary dermis. This aids in the identification of specific diagnostic patterns related to color and cell structure to aid in differentiating malignant and benign lesions.

Aim To describe the experience of healthcare professionals in assessing pain and communication in patients with hip fractures and dementia in an emergency department. Methods Data were collected through focus group interviews using open-ended questions, following an interview guide and qualitative content analysis. Twenty one registered nurses participated in the interviews, five male and 16 female, aged 26 to 55 years. Results The analysis of the interviews resulted in three main categories: "Arrival at the emergency department", "Hip track" and "Handover to the ward", including a number of subcategories. All nurses reported that the assessment of pain and communication with patients with dementia and hip fractures was a complex process. A great deal of stress, fast and brief communication, quick decisions and quick treatments in assessment of pain were only some of the difficulties the nurses emphasized. They also suggested a whole series of improvements for those patients. Conclusion The situation of patients with hip fracture and dementia on the emergency department and healthcare professionals who communicate and assess their pain can be said to be untenable. The care environment in the emergency department is not adapted to patients and can of course depend on several factors. To meet the needs of the future and increased numbers of those patients, some improvements such as more extensive research and more studies on the experiences of both the patients and healthcare professionals are required.

Aim To compare the localization of lung adenocarcinoma with tumour size and lymphovascular invasion (LVI) presence, and to determine the frequency of metastasis findings in hilar and mediastinal lymph nodes depending on the localization of the tumour and status of lymphovascular invasion. Method This observational cross-sectional study included 261 patients with complete resection of confirmed lung adenocarcinoma. The dependence between categorical variables were performed with χ2 and Fisher's exact tests. A p<0.05 was considered as statistically significant. Result Metastases to hilar lymph nodes at lung adenocarcinoma with central localization and presented lymphovascular invasion were more frequently found than tumours with peripheral localization (p<0.001). In tumours with peripheral localization, lymphovascular invasion was less frequent; even in tumours greater than 7 cm in the largest dimension the presence of LVI was not 100%. Metastases to mediastinal lymph nodes in tumours with central localization and presented lymphovascular invasion were less frequent than in tumours with peripheral localization and presented lymphovascular invasion (p=0.002). Conclusion In invasive adenocarcinoma, lymphovascular invasion was much more common in centrally positioned than in peripherally positioned tumours. Metastases to the hilar and mediastinal lymph nodes, regardless of the findings of lymphovascular invasion, usually originated from upper lobe tumours.

Aim To explore the experiences of registered nurses in assessing postoperative pain in hip fracture patients suffering from dementia in nursing homes. Methods The study was designed as a qualitative study using data from a self-reported questionnaire form. Data were collected through the self-administered questionnaire with 23 questions, mainly addressing demographic and social data, information about communication and pain assessment. Results All nurses reported that large part of verbal communication with dementia patients was lost, and non-verbal communication was very important to optimize the care of these patients in postoperative situations. An assessment of pain in patients with dementia and hip fractures was a complex process because cognitive ability of these patients was reduced. Conclusion Registered nurses need to know various and different forms of evaluation and tools to assess the experience of pain in patients with dementia who had undergone surgery for hip fractures. This is a complicated task, which requires a great deal of time, and means that nurses must work together with other medical staff, using a holistic approach.

Aim To compare the prevalence of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM) between adolescent and adult pregnancies, and the influence of gestational age and adolescent pregnancy on the frequency of occurrence of PROM and PPROM. Methods This prospective study included 300 pregnant patients, 13 to 35 years of age, divided into two groups. The first group consisted of 150 pregnant women aged 13-19 (experimental group) and the second group consisted of 150 pregnant women aged 20-35 (control group). Results There was a statistically significant higher incidence of both PPROM and PROM in the group of adolescent pregnant women compared to adult pregnant women (p<0.000001). Preterm delivery with PPROM was significantly more common in the group of adolescent pregnant women (p<0.004). Term delivery with PROM was statistically significantly more common in the adolescent pregnancy group than in the adult pregnancy group (p<0.001). Term delivery with PROM was statistically significantly more common than preterm delivery with PPROM in the group of adolescent pregnant women (p<0.0001). Conclusion Adolescent pregnancy has a greater impact on the frequency of PROM and PPROM.

Aim To examine the correlation between personality traits, learning styles, and academic achievement and a difference between students' gender, residency status and academic achievement. Methods The study included 95 students of first year of the School of Medicine, University of Sarajevo. The survey used the sociodemographic questionnaire, Index of Learning Style and Big Five Inventory. Academic achievement was represented by a cumulative grade point of each student. Results There was significant difference between the students' gender, information processing style, i.e. active/reflective learning style and academic achievement. Academic achievement was correlated with extraversion (negatively), conscientiousness and active/reflexive learning style. Conclusion With this study we wanted to improve awareness of teachers about the importance and use of different styles during lecture, to show the importance of students knowing their own preferences and learning styles, and how personality traits can affect students' academic achievement. Academic performance is an important outcome for students. It can increase motivation, student participation in class and wish to volunteer in different activities.

Aim To evaluate vertebral bone marrow adiposity (BMA) using magnetic resonance spectroscopy (MRS) in postmenopausal women and to determine an association of bone density with bone marrow fat content. Methods This cross-sectional study included 120 postmenopausal women referred for osteoporosis screening. All women underwent assessment of bone mineral density by dual X-ray absorptiometry (DXA), who were divided based on T scores into osteoporosis (OST; n=60) and control group (CG; n=60). MRS was used to measure fat fraction (FF), lipid/water ratio (LWR) and fat content (FC) at vertebral spine (L1-L4). Results Mean age, menopause or reproductive period duration was not significantly different between women in OST and control group. Median LWR in OST group was significantly higher compared to CG, 31.5 (22.9-38.8) vs. 28.7 (13.7-37.3) (p=0.039). Median FC was significantly higher in OST compared to the control group, 47.0 (46.3-78.8) and 46.4 (44.3-48.6), respectively (p=0.011). FC was significantly negatively associated with BMD at lumbar spine (Rho=-0.042; p<0.001) and with BMD at hip (Rho=-0.64; p<0.001). In logistic regression model, FC remained independently associated with osteoporosis after controlling for confounders (age, menopause duration, reproductive period duration and body mass index) (OR=1.3; 95% CI 1.1-1.6). Conclusion Bone marrow adiposity is an independent predictor of low bone mass in postmenopausal women suggesting its role as a therapeutic target in postmenopausal osteoporosis management.

Background: The effect of conventional anti-platelet agents is limited in secondary stroke prevention, and their effects are further blunted under conditions of high shear stress in the presence of increased levels of circulating VWF. VWF mediates platelet adhesion to collagen under high shear stress and is thereby critically involved in thrombus formation at sites of stenotic extracranial intracranial arteries (reviewed by Buchtele et al. 2018). We have created a novel anti-VWF aptamer (BT200) which could be useful for secondary stroke prevention, because the anti-VWF aptamer ARC1779 effectively reduced cerebral embolization after carotid endarterectomy (Markus et al. 2011). Aims: To characterize the effects of BT200 in blood of patients with large artery atherosclerosis stroke. Methods: Blood samples were obtained from 30 patients with acute stroke Inhibition of VWF activity by BT200 was quantified by REAADS ELISA and VWF ristocetin cofactor activity (VWF:RCo), platelet function under high shear rates with the PFA-100, and ristocetin-induced platelet aggregation in whole blood. Results: The majority of stroke patients had elevated VWF:RCo levels (mean: 198%; range 55-330%). Of 15 patients receiving clopidogrel with or without aspirin, only two had a prolonged collagen adenosine diphosphate closure time (CADP-CT) >123s, and only one patient had a ristocetin induced aggregation of <20U. BT200 concentration dependently inhibited VWF activity to <3% and VWF dependent platelet function (p<0.001): BT200 invariably prolonged CADP-CT to target levels of >300s, and decreased aggregation to <20U in blood samples from all patients. Conclusions: BT200 effectively inhibits VWF activity and VWF-dependent platelet function in blood from patients with acute stroke. Results from this study proved useful for planning of the ongoing phase I and planned phase II trial.

INTRODUCTION The objective of this study was to assess perceptions and attitudes among dental practitioners in relation to antibiotic usage and antibiotic resistance. METHODS Self-administered questionnaire was given to dental practitioners employed in south Croatia, west Herzegovina and Sarajevo, Bosnia and Herzegovina (N=115). RESULTS 81.7% of respondents agreed the usage of antimicrobials is frequently uncritical and unnecessary. 83.5% of dental practitioners reported that have used guidelines in their practice, however, only 9 out of 115 stated valid guidelines. One third of the respondents agreed or were undecided that the usage of antimicrobials in every oral inflammatory process treatment is justified. Furthermore, 13% was undecided and 26% agreed that pregnant women and breastfeeding women should not use any antimicrobials. However, three quarters of respondents considered they had satisfactory knowledge on antimicrobials. DISCUSSION The respondents considered they had satisfactory knowledge on antimicrobials, which was in contrast with the knowledge shown, but also expressed the need for additional education. Therefore, adequate measures include the creation of the local guidelines, their implementation, and updating the practitioners' knowledge on antibiotic use and resistance through continuous educational courses.

Background: Measurements of electrode impedance values are routinely performed after cochlear implantation. The primary objective of the study was to determine if pediatric, prelingually deafened patients with different postoperative performances showed significantly different impedance values one year after implantation. Methods: This study comprised 42 pediatric cochlear implant recipients provided with the device in a single academic tertiary referral center between 1 January 2000, and 31 December 2016. Medical chart analysis was performed in order to assess evolution of impedance values during the first postoperative year on a monthly basis. Electrode impedance values measurements one year postoperatively were compared between children with successful and unsuccessful auditory and language skills development assessed using the EARS protocol (a name of a performance test). Furthermore, values were compared among recipients of different implant types and among different cochlear segments. Results: A gradual rise of average impedance values was found during the first months of implant use (1st month, 7.32 kΩ; 3rd month, 7.86 kΩ) with the peak at the 4th postoperative month (7.96 kΩ), followed by a gradual decrease towards the 12th month (6th month, 7.62 kΩ; 12th month, 6.86 kΩ). Lower values at the 12th postoperative month were observed in recipients with successful development compared to patients presented with unsuccessful development (6.22 kΩ vs. 7.82 kΩ; p = 0.001). Mean impedance values were different when compared among cochlear segments and among different implant types. Conclusion: High electrode impedance values one year after implantation in pediatric patients may imply insufficient auditory and language skills development. Further studies are needed in order to validate our results.

Background: Endurance training (ET) and resistance training (RT) are known to be effective in improving anthropometric/body composition and lipid panel indicators, but there is an evident lack of studies on differential effects of these two forms of physical exercise (PE). This study aimed to evaluate the differential effects of 8-week ET and RT among young adult women. Methods: Participants were women (n = 57; age: 23 ± 3 years; initial body height: 165 ± 6 cm; body mass: 66.79 ± 7.23 kg; BMI: 24.37 ± 2.57 kg/m2) divided into the ET group (n = 20), RT group (n = 19), and non-exercising control group (n = 18). All participants were tested for cardiovascular risk factors (CRF), including total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, glucose, and anthropometric/body composition (body mass, body mass index, skinfold measures, body fat %) at the beginning and at the end of the study. Over the 8 weeks, the ET group trained three times/week on a treadmill while the RT group participated in equal number of circuit weight training sessions. Both types of training were planned according to participants’ pre-study fitness status. Results: A two-factor analysis of variance for repeated measurements (“group” × “measurement”) revealed significant main effects for “measurement” in CRF. The “group × measurement” interaction was significant for CRF. The post-hoc analysis indicated significant improvements in CRF for RT and ET. No significant differential effects between RT and ET were evidenced. Conclusions: The results of this study evidence improvements of CRF in young adult women as a result of 8-week ET and RT. The lack of differential training-effects may be attributed to the fact that all participants underwent pre-study screening of their fitness status, which resulted in application of accurate training loads.