OBJECTIVE The objective of our study was to investigate the effects of carbamazepine (CBZ) and lamotrigine (LTG) treatment on bone metabolism in epileptic patients. PATIENTS AND METHODS A cross-sectional study was performed on normal controls (N=30) and 100 patients with symptomatic epilepsy caused by a primary brain tumor, divided into two groups according to the treatment: LTG monotherapy group (N=50) and CBZ monotherapy group (N=50). For each participant serum levels of 25-OHD and osteocalcin (OCLN) were measured, and bone mineral density (BMD) was evaluated by the dual-energy X-ray absorptiometry method. RESULTS There was no statistically significant difference in the average values of vitamin D in serum between the CBZ and LTG groups (Vitamin D CBZ 17.03±12.86 vs. Vitamin D LTG 17.97±9.15; F=0.171, P=0.680). There was no statistically significant difference in the average values of OCLN between the CBZ and LTG groups (OCLN CBZ 26.06±10.87 vs. OCLN LTG 27.87±28.45; F=0.171, P=0.674). The BMD value was lower in both groups using antiepileptic agents compared to the controls, but when comparing the CBZ group to the LTG group, a statistically significant difference was only observed for the Z score (T-score CBZ: 0.08± 1.38 vs. T-score LTG: 0.37± 1.02; F=1.495, P=0.224; Z score CBZ: -0.05±1.17 vs. Z. score CBZ: 0.38±0.96; F=4.069, P=0.046) (Table 3). CONCLUSION The choice of antiepileptic agents for treating seizures in patients with brain tumors should be carefully evaluated in relation to their impact on bone health. These patients could benefit from supplementation and regular measurement of biochemical markers of bone turnover and BMD.

Previous research suggested that several genetic polymorphisms are associated with increased risk of ischaemic stroke (IS) in young adults. However, the predictive biomarkers of IS in young adults are still unclear. Our aim was to assess the contribution of modifiable and genetic factors in IS in young adults. In total, 40 stroke patients and 40 healthy controls aged 20 to 50 years were recruited. Data on modifiable factors were collected, then participants were genotyped for seven SNPs linked to thrombophilia: ACE rs1799752, PAI-1 rs1799889, APOE rs1412 and rs429358, FV rs6025 and rs1800595, and FII rs62623459. Significantly increased risk factors: hypertension and dyslipidaemia in stroke patients compared with the controls: 50.0 % vs 27.5 % and 75.0 % vs 40.0% (P = 0.039 and P = 0.002, respectively) were observed. Stroke patients compared with controls did not differ in distribution of ACE, APOE, FV, and FII variants. The 4G4G homozygotes of the PAI-1 gene were significantly more prevalent in stroke patients compared to the controls: 42.5 % vs 17.5 %, (P = 0.033). In the group with the small vessel occlusion subtype of stroke, statistically significant overrepresentation of 4G4G homozygotes and frequency of the 4G allele compared with controls: 57.1 % vs 17.5 % and 0.7 vs 0.45 (P = 0.026 and P = 0.03, respectively) were observed. Independent predictors of stroke incident were: dyslipidaemia (OR (95% CI) = 4.2 (1.4-12.4)) and 4G4G genotype (OR (95% CI) = 3.9 (1.1-13.7)). These results confirm the contribution of dyslipidaemia and 4G4G genotype in the increased risk of IS in young Bosnian adults.

Introduction/Objective. Tarsal dislocations are rare injuries. Usually, they are caused by high-energy trauma. Depending on the type of dislocation, surgical treatment or closed reduction is used. In this study, 13 patients are presented with the aim to analyze the type of feet dislocations, their treatment, and outcome. Methods. Tarsal dislocation cases treated in the University Hospital in Foca were analyzed during the period 2009?2016. All the cases were clinically and radiographically examined and monitored on control examinations at least three years. The mobility of joints was measured and pain existence was estimated by visual analogue scale. Results. All 13 patients with tarsal dislocation were male. Four patients were treated surgically (two patients with tarsometatarsal and one with cuboid and navicular dislocation) and other patients had non-surgical treatment. In 10 patients, an excellent functional result has been achieved and in two patients with tarsometatarsal dislocation a good functional result. In one patient with cuboidal dislocation satisfactory functional result has been achieved. Conclusion. Out of the 13 reviewed patients with tarsal dislocations, functional results were rated as excellent in 10 dislocations, good in two, and satisfactory in one. Diagnosis and treatment of foot dislocations are demanding, but a favorable functional outcome can be expected with an adequate treatment of these injuries.

Received 2018-11-12 Received in revised form 2019-05-22 Accepted 2019-05-29 INTRODUCTION Breast cancer is the most common malignant disease in women (1). It makes up about 26.5% of all newly discovered malignancies in the European female population and is responsible for 17.5% of the deaths. In males, this type of cancer is rare (one man per 100 women) (2). The frequency of the disease differs in various parts of the world. It is rarely seen before the age of 30, it rises with age and reaches its maximum around the age of 50 (3). The incidence of breast cancer in the world increases by 1-2% per year, and it is estimated that in the first decade of the third millennium, almost one million of women will suffer from breast cancer (4). However, in spite of the increasing possibilities of treatment, survival depends primarily on the extent and stage of the disease at the time of detection. In the early stage of the disease in which the largest number of patients is detected, healing is quite possible. Still, 24-30% of patients with lymph node negative and 50-60% with lymph node positive breast cancer will develop relapse. At the moment of diagnosis metastatic disease is present in 6-10% of patients (5). Treatment of breast cancer is multidisciplinary. Combination of surgical treatment, radiation and systemic therapeutic treatment ensure good results in patient survival. The type and order of particular treatments must be planned multidisciplinary by surgeons-oncologists, radiotherapists and internists-oncologists (6). Clinical features of tumor such as size, the existence of tumor cells in the armpit lymph nodes, and distant metastases are considered essential in determining prognosis and choices of treatment. Prognostic factors, derived from breast tissue after biopsy or surgery, have significance in measuring tumor aggressiveness and general disease prognosis. The standard prognostic parameters are patient (menopausal status, age) and tumor related (tumor size, histological type, axillary lymphatic status, tumor gradient, ER, PR and HER2 status). Some of them (ER, PR and HER2 status) have a predictive value because the best therapeutic modality is chosen based on these. According to St. Gallen Consensus and ESMO recommendations from year 2013 breast cancers fall into different types according to histopathological findings and results of predictive and prognostic tests. Based on this, specific therapeutic approach is recommended. When luminal A type patient receive only endocrine therapy, and chemotherapy is considered only in cases of high risk tumor (with four or more positive lymph nodes, tumor size T3 or tumor grade 3). When luminal B-like type (HER2 negative) patient is treated using chemotherapy and endocrine therapy. When luminal B-like (HER2 positive) patient is treated using chemotherapy, anti-HER2 and endocrine therapy. In case of non-luminal (HER2 positive) breast cancer type chemoand anti-HER2 therapy is recommended. In patients with basal-like (triple-negative) cancer application of chemotherapy is indicated (7).

There is a daily increase in the number of patients with malignant diseases, but with the advances in modern oncology research, the number of survivors treated with malignant diseases is becoming larger and larger. The survival rate after completing oncology therapy is increasing on a daily basis, so that malignant diseases belonging to the category of terminal diseases are now referred to as 'chronic illnesses'. In this specific group of patients, the risk from cardiovascular diseases is increasing nowadays. A new challenge for the future cardiologists will certainly pose the treatment of this group of patients. A cardiological approach in oncological patient treatment is an important issue. The cardiologist focuses on risk stratification and prevention of cardiovascular complications in the oncological patient in relation to his or her pre-existing condition, and in relation to the type of specific oncology therapy applied, and on further follow-up during therapy and after its completion. This implies that it is necessary to create cardio-oncology teams in our institutions treating the oncological patients. There is a considerable need for education in a new field, which presents the intersection between two clinical disciplines, i.e. cardiology and oncology, and for special education of cardiologists concerning all types of chemotherapy and their potential cardiotoxic effects. The oncologist, on the other hand, must be trained to recognize any possible early signs and symptoms of cardiac complications concerning the therapy applied and to seek further cardiac care for the patients. The aim of this review article is to assist the doctors treating this group of patients in their daily practice and to highlight the need for a multidisciplinary approach, as well as the creation of a cardio-oncology team for a comprehensive and integrative approach to a cardio-oncological patient.

This research includes all banks in Bosnia and Herzegovina and testing internal and external variables on bank profitability indicators. In addition, the profitability of banks in B&H is also influenced by the financial result of operations, which is determined by price and interest rate risk. The primary goal of this paper is to determine, through correlation and regression analysis, the strength and significance of external and internal variables on bank profitability in Bosnia and Herzegovina. The research period covered from 2008: q1 to 2019: q4 on a quarterly database. Also, in this paper, the STATA 13.0 software package will be used. The following dependents variable were used: return on asset (ROA) and return on equity (ROE). The following independent variables were used: the growth rate of net gross/loss (GRNGL), the growth rate of non-performing loans (GRNPL), GDP growth rate (GRGDP), concentration ratio of loans of the largest banks in the system (CR Loans), concentration ratio of deposits of the largest banks in the system (CR Deposits), capital adequacy ratio (CAR) and loan-to-deposit ratio. The total number of observations was 48. The results showed that the significant influence on the dependent variables were the return on equity (ROE) and return on asset (ROA), which has been achieved by the following independent variables, such as the growth rate of net gross/loss, the growth rate of non-performing loans and concentration ratio of loans and deposit of the largest banks.

The phenomenon of financial stability has gained importance as monetary and fiscal policies aiming at price stability in the global crises are not sufficient to prevent financial crises. After 2007 global crisis, the importance of bank stability better understood. This paper investigates the determinant of bank stability in selected Balkan countries and Turkey. For this aim, we used to Z-score and NPL as dependent variables. We used bank performance, financial structure and macro variables as independent variables. According to ANOVA test and regression analysis, the strongest correlation between non-performing loans as the dependent variable of the Western and some EU Member countries (Bosnia and Herzegovina, Serbia, Croatia, Slovenia, Montenegro, Macedonia) and Turkey was achieved with the following independent variables: the total non-interest income to total income and foreign bank assets to total bank assets. Observed on the other hand, the weakest link between NPLs as a dependent variable was achieved with the following independent variables: the gross domestic product, the net interest margin ratio, Lerner index and the cost to income. Another dependent variable, i.e., Z-score was recorded the strongest correlation with the following independent variables in the model: the gross domestic product, the Lerner index, the net interest margin and the cost to income. The weakest link was achieved with the following independent variables: the total non-interest income to total income and the foreign bank assets to total assets.

Atherosclerosis is the leading cause of cardiovascular disease (CVD) worldwide. Recently, mortality and morbidity from CVD have shown a trend in its occurrence in earlier years, while these diseases have been associated with older age until recently. In developed countries, mortality from diseases caused by atherosclerosis has decreased over the last 50 years. However, such a trend is not reflected in both underdeveloped and developing countries where mortality remains high. Risk factors have been identified and their control can influence the reduction in morbidity and mortality from CVD associated with atherosclerosis. Among these, the so-called variable risk factors are the following: increased concentration of LDL cholesterol fraction (LDL) and/or decreased concentration of HDL cholesterol fraction (HDL), hypertension, cigarette consumption, diabetes mellitus/metabolic syndrome, improper diet, while genetic predisposition is still considered to be an invariable risk factor. In order to reduce the incidence of atherosclerosis, the World Health Organization recommends a two-pronged approach that includes public health interventions to reduce population risk factors and medical interventions for individuals at high risk with stricter surveillance of risk factors. Examples of multisectoral public health interventions include increasing taxes on cigarettes and alcohol, followed by a massive campaign to promote physical activities and healthy diet, that is to promote healthy lifestyles.

Modern society has not forgotten yet epidemics that killed millions in the last millennium and the COVID-19 pandemic caused by the SARS CoV-2 has recently emerged With the onset of the Wuhan epidemic in the Chinese province of Hubei, the initially called new corona virus due to the similarity of 80 % to the 2002 SARS virus was renamed to SARS CoV-2 The virus was originally isolated from bronchoalveolar aspirate specimens Viral RNK was detected in 6 of 41 blood samples with clinical signs of infection A senior Chinese expert told to the media that the median incubation period was 7 days, ranging from 2 -1 2 The International Health Regulations Emergency Committee for Epidemics gives a preliminary estimate basic reproduction number R0 of 1 4 - 2 5 COVID-19 is mainly transmitted by close contact with the infected by drops due to sneezing and coughing Fever, cough, myalgia and fatigue are the predominant initial signs and symptoms The clinical picture is non-specific Exacerbation occurs suddenly, as bilateral interstitial pneumonia that requires admission to intensive care Initial lethality in hospitalised cases was 15 %, but these estimates had to be taken with reserve as the situation evolved According to recent data, the global fatality rate is 3 7 %, the lethality rate in China is 3 9 % and in Italy 6 8 % According to data from the Chinese Centre for Disease Control and Prevention, of 44,672 confirmed cases 1,023 people died, therefore lethality was 2 3 % In the absence of specific prevention and control measures, mankind is limited to general prevention measures [ABSTRACT FROM AUTHOR] Copyright of Scripta Medica is the property of Scripta Medica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )