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Ferid Krupic

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Aim To investigate how immigrants from the Balkan region experienced their current life situation after living in Sweden for 30 years or more. Materials The study was designed as a qualitative study using data from interviews with informants from five Balkan countries. The inclusion criteria were informants who were immigrants to Sweden and had lived in Sweden for more than 30 years. Five groups comprising sixteen informants were invited to participate in the study, and they all agreed. Results The analysis of the interviews resulted in three main categories: "from someone to no one", "labour market", and "discrimination". All the informants reported that having an education and life experience was worth-less, having a life but having to start over, re-educating, applying for many jobs but often not being answered, and finally getting a job for which every in-formant was educated but being humiliated every day and treated separately as well as being discriminated against. Conclusion Coming to Sweden with all their problems, having an education and work experience that was equal to zero in Sweden, studying Swedish and re-reading/repeating all their education, looking for a job and not receiving answers to applications, and finally getting a job but being treated differently and discriminated against on a daily basis was experienced by all the in-formants as terrible. Even though there are enough similar studies in Sweden, it is always good to write more to help prospective immigrants and prospective employers in Sweden.

Objectives. The purpose of this study was to determine whether fear and prejudice in relation to organ donation and the transplantation of organs may influence the decision to become an organ donor. Materials and Methods. Data were collected through four group interviews using open-ended questions and qualitative content analysis. Forty participants, 16 males and 24 females from seven countries, participated in the focus group interviews. Results. The analysis resulted in three main categories, and nine subcategories. Fears and prejudice caused by tradition and customs, approval of organ donation by family members, perception of the body as a gift from parents, the influence of religious leaders, knowledge about the religious understanding of organ donation, influence of social ambience on respondents, knowledge of the donation process in the healthcare system, including knowing about life after eventual organ donation, were some of predictors in the decision to agree to organ donation. Conclusion. More education on the factors that influence organ donation, more information in schools, health institutions and through the media, as well as more research with the aim of “dispelling” fears and prejudice about organ donation would significantly improve the current situation and result in a larger number of potential organ donors.

Jelena Kovačević Prstojević, M. Hasanbegović, J. Alić, V. Mišanović, Almira Lujinović, Azra Metović, F. Krupic, Danka Miličić Pokrajac, Admir Hadžimuratović et al.

Introduction Inflammation can arise as a consequence of both extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS) treatments. Alterations in inflammatory parameters may serve as indicators of kidney injuries and the ensuing inflammation. This study aims to investigate the effects of ESWL and URS procedures on inflammatory parameters for proximal ureteral stone treatment. Materials and methods A prospective interventional study comprised 120 patients with confirmed stones measuring less than 10 mm in the upper half of the proximal ureter. These patients were randomly assigned to either the ESWL or URS treatment groups. Laboratory analyses encompassed interleukin-6 (IL-6), leukocyte count, fibrinogen levels, and erythrocyte sedimentation rate (ESR), which were assessed prior to the intervention, on the first postoperative day, and six months later. IL-6 levels in the serum were determined using a chemiluminescence immunoassay (CLIA). Results There was no significant difference in IL-6 levels between pre-intervention and the first post-intervention day in patients treated with ESWL (1.8 (1.4-2.59) pg/mL vs. 2.33 (1.22-3.19) pg/mL). However, for patients treated with URS, the pre-intervention IL-6 value was 2.9 (1.9-3.34) pg/mL, and it increased significantly to 7.1 (3.85-28.07) pg/mL on the first post-intervention day (p<0.001). On the first post-intervention day, levels of IL-6, CRP, leukocyte count, and ESR were significantly higher in patients treated with URS compared to ESWL (p<0.001; p<0.001; p=0.03; p=0.03, respectively). Conclusion Our research findings suggest that monitoring IL-6 levels can offer valuable insights into the degree of inflammation and tissue damage during and following observed procedures, particularly among patients undergoing URS, even within the initial days post-procedure.

K. Grbić, O. Čustović, J. Alić, Kenan Kadić, M. Dapčević, Z. Lepara, Hajrudin Spahović, F. Krupic

Background: The Lung adenocarcinoma, a subtype of non-small cell lung cancer, exhibits diverse histopathological patterns, impacting prognosis and therapeutic outcomes. Objective: This study explores the correlation between smoking habits and the prevalence of different histopathological subtypes in invasive lung adenocarcinoma (IAC). Methods: A single-center, cross-sectional study included 140 patients with surgically treated, histopathological verified lung adenocarcinoma. The patients were classified based on the World Health Organization’s (WHO) histopathological patterns, and smoking status data were collected from medical records. Descriptive and inferential statistical analyses were performed using SPSS software. Results: The predominant histopathological subtypes were acinar (47.9%) and solid (30.7%) IAC. Smokers constituted 84.3% of the patients, with a majority (61.7%) consuming more than 20 cigarettes per day. A weak, statistically significant correlation was found between histopathological patterns and smoking habits among smokers (rho=0.054; p=0.04). Acinar IAC was more common in those consuming up to 20 cigarettes daily, while the solid pattern predominated in those smoking more than 20 cigarettes (rho=0.189; p=0.04). No significant correlation was observed with the duration of smoking history. Conclusion: The study reveals a predictive relationship between smoking habits, including the number of cigarettes consumed, and the histopathological pattern of IAC in resected specimens. Acinar and solid subtypes were more prevalent, with distinct associations to smoking behaviors. Understanding these relationships can contribute to personalized treatment approaches and further research on lung adenocarcinoma.

F. Krupic, S. Manojlović, S. Čustović, Mirsad Fazlić, Sahmir Šadić, Johan Kärrholm

Background: Despite the overall success of THA, between 5 and 20% report unsatisfactory results. Several factors may cause this variable outcome. 1 of them might be ethnicity which, because of its potential social impact on living conditions, may influence quality of life too. It should be studied whether patients born and being operated in their home country Bosnia and Herzegovina (BH) had similar results as immigrants being operated in Sweden (IS). Methods: Data of 280 patients were collected prospectively from questionnaires in the BH group. Patients of the IS group were eligible if both of their parents were born outside the Nordic countries, not having Swedish as their native language. Data were gained from the Swedish Arthroplasty Registry (SAR), 449 patients were included. Outcomes were pain VAS, satisfaction VAS, EQ-VAS, and the EQ-5D. Logistic and linear regression models including age, sex, diagnosis, type of fixation, surgical incision, marital status and educational level were analysed to compare those 2 groups. Results: There were considerable differences in patient demographics between the 2 groups. Before the operation, patients in the BH group reported more problems with self-care and usual activities, even after adjustment for confounding factors (p < 0.0005). Patients in the IS group reported a higher EQ-VAS and more pain VAS (p < 0.0005), the difference in the EQ-VAS was not significant after adjustment for confounding factors (p = 0.41). After 1 year patients in the BH group reported better scores in all dimensions of the EQ-5D (p ⩽ 0.005) apart from self-care. After adjustment for confounding factors, patients in the BH group were more satisfied too (p < 0.0005). Conclusions: Immigrated patients (IS group) seemed to experience less benefit from THA 1 year after the operation despite more symptoms preoperatively. There were considerable limitations affecting the results. Nevertheless, the data are a point of concern, and it is suggested to take more multidimensional care of immigrant patients.

Edin Ališić, Melissa Krupić, J. Alić, K. Grbić, Nejra Mašić, Shariet Parvaneh, F. Krupic

Introduction The World Health Organization (WHO) Surgical Safety Checklist is a tool developed by the WHO to promote safer surgical practices and reduce the incidence of surgical errors and complications. This study aims to describe the role of assistant nurses in the implementation of this checklist by surgical teams. Materials and methods This descriptive study utilized a questionnaire-based survey conducted between September 2018 and March 2019 among 196 healthcare professionals at two surgical units in a university hospital in Sweden. The questionnaire covered demographic information such as age, gender, and occupation, as well as details about their workplace, experience, education/training on using the WHO checklist, the adaptation of the checklist to their department, their responsibilities in implementing and using the checklist, the frequency of use in emergency situations, and the impact on patient safety. Results The results of the study showed that assistant nurses, despite having the lowest level of education among healthcare professionals, were highly trusted and valued by other members of the surgical team. Most healthcare professionals were unsure who was responsible for using the WHO checklist but believed it was the assistant nurse's responsibility to ensure its implementation. Assistant nurses reported little to no training on using the checklist but noted that it had been adapted to the department's needs. Almost half (48.8%) of assistant nurses believed that the checklist was often used in emergency surgery, and most believed that it improved patient safety. Conclusions Improved understanding of the significance of assistant nurses in implementing the WHO Surgical Safety Checklist may enhance adherence to the checklist and potentially improve patient safety, as they were the most valued and trusted healthcare professionals in the surgical team according to the study's findings.

E. Dervišević, A. Jogunčić, Muamer Dervisevic, A. Salihbegovic, Haris Vukas, Samra Kadić-Vukas, S. Prasko, F. Krupic

Background: The correlation between diabetes mellitus and acute myocardial infarction is greater every day. The mean platelet volume (MPV), which is the determinant of platelet function, is an independent risk factor for the cardiovascular disease. The aim of the study was to investigate the effect of each disease (hypothyroidism, hypertension, myocardial infarction) individually and combined on MPV in diabetic patients.Methods: The cross-sectional study included 102 patients who suffer from diabetes mellitus type 2 (DMT2), of both sexes (46 females, 56 males), with the average age of 58.91 (SD=12.93). All the patients were treated at the Primary Health Centre in Zenica from May to July 2017. All patients had diabetes mellitus and the disease had lasted for 10 years in both sexes.Results: Mean platelet volume was significantly higher in patients with myocardial infarction than in those without myocardial infarction. Age, sex, HbA1c, BMI, lipids and platelet count did not show any significance in either group of patients. Regression analysis showed that the prevalence of myocardial infarction had the highest predictive significance for MPV values, (predictor importance 0.49; coefficient 1.275, p<0.001).Conclusions: Mean platelet volume was significantly higher in patients with diabetes mellitus and myocardial infarction than in DM patients without myocardial infarction. Regression analysis showed correlation with acute myocardial infarction in patients with DMT2, but not with other chronic illnesses. The highest platelet volume indices were observed in patients with myocardial infarction. MPV can be used as a specific indicator in diabetic patients with myocardial infarction.   

C. Bitar, Ivan Moberg, F. Krupic, P. Wretenberg, Volker Otten, S. Crnalic

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