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.

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.

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.

Background: Bleeding and hematuria can be a consequence of both ESWL and URS treatment.Changes in hematological parameters may be indicative of bleeding events.Objective: The aim of the present study was to explore the hematological parameters after ESWL and ureterorenoscopy for the treatment of kidney stones. Methods: A prospective study included patients (120) with verified ureterolithiasis <10 mm in the upper half of the proximal third of the ureter. Patients were divided into two groups using the random sample method for the application of active stone removal methods ESWL or URS with contact disintegration.Patients were evaluated with routine hematological, biochemical blood parameters, and non-contrast enhanced computed abdominal tomography (CT) before the procedure.Routine laboratory analyzes were performed using standard methods and included determination of the number of erythrocytes, platelets, hemoglobin, hematocrit, glucose, INR, APTTwhich were measured preintervention, the first postoperative day and six months after the intervention. Results: The preintervention hemoglobin value in patients with urolithiasis treated with URS treatment was 140 g/L (136.2–155.7), and was statistically significantly higher compared to the measurement on the first post-intervention day [137.5 g/L (127, 2–156.7) (p<0,05)], as well as in relation to the measurement after six months [139 g/L (134.2–151.7), (p<0,05).The pre-interventional hematocrit value in patients with urolithiasis treated with URS treatment was 0.42 (0.41–0.47), but it dropped statistically significantly on the measurement on the first post-intervention day to a value of 0.41 (0.38–0, 47) (p=0.003). The hematocrit value after six months was 0.44 (0.41–0.47) and was statistically significantly higher compared to the pre-intervention measurement (p=0.002), as well as compared to the measurement on the first post-intervention day (p< 0.001). The pre-intervention INR value in patients with urolithiasis treated with URS treatment was 0.90 (0.86–1.1), and on the first post-intervention day, it increased statistically significantly to a value of 0.99 (0.89–1.1), (p=0.005).The INR value after six months continued to grow to a value of 1.02 (0.96–1.2), which was statistically significantly higher compared to the INR value measured on the first post-intervention day (p<0.001), as and in relation to the INR value measured before the intervention (p=0.007).Conclusion: The results of this study, in terms of hematological parameters, showed more favorable outcomes in patients treated with ESWL compared to URS lithotripsy. Significantly lower hemoglobin values six months after URS treatment, as well as a decrease in the number of platelets on the first postoperative day, lead to the conclusion that URS lithotripsy, which represents a more aggressive method compared to ESWL, may have less favorable consequences for patients.

Introduction The optimal management of distal ureteral stones remains a matter of debate since current guidelines favor ureteroscopy over extracorporeal shock wave lithotripsy (ESWL). We aimed to evaluate the efficiency of ESWL for distal ureteral stones and to identify factors that affect treatment outcomes. Materials and methods The retrospective study included records of 115 patients with distal ureteral stones, 5 mm to 18 mm in size, undergoing 223 ESWL sessions as an outpatient procedure. Early fragmentation and three-month follow-up stone-free rate (SFR) was assessed through radiographic imaging. Treatment was successful if there were no residual fragments or they were ≤4 mm, three months after the last session. Results The mean ±standard deviation (range) stone size was 9.68 ±3.10 (5.00-18.0) mm. The mean body mass index (BMI) was 24.3 ±2.67 (18.4-29.8) kg/m² with a significant correlation between BMI and stone size (r2 =0.324, p <0.001). Patients underwent ESWL an average of 1.7 ±1.36 times (1-5), while 68 patients (59.1%) became stone-free after one session. The overall SFR was 82.6%; for patients with stone sizes ≤10 mm and >10 mm, it was 99% and 9.4%, respectively. Cumulative SFR after the second session was 77%. In 20 (17%) patients the treatment was a failure. Complications occurred in 10.4%, while auxiliary procedures were needed in 8.7% of cases, both significantly affected by the stone size (p <0.001). The efficiency quotient (EQ) was 0.76. Treatment outcome was significantly different depending on stone size, BMI, number of sessions, complications, and auxiliary procedures (p <0.001, p =0.022, p <0.001, p <0.001, p <0.001, respectively). Univariate regression analysis identified stone size and BMI as significant predictors of treatment outcome (odds ratio (OR) 3.84, 95% confidence interval (CI): 2.31-8.97, p =0.001, and OR 1.25, 95% CI: 1.04-1.54, p =0.024, respectively). Conclusions Extracorporeal shock wave lithotripsy continues to be a safe and effective option for managing simple calculi in distal ureters with a diameter of ≤10 mm. The stone size and BMI remain significant predictors of treatment outcome.

Objectives. The present study aimed to assess changes in the perception of and willingness to participate in organ donation (OD) among immigrants from Bosnia and Herzegovina living in Sweden from the perspective of gender differences. Materials and Methods. A cross-sectional study with 60 participants born in Bosnia and Herzegovina and living in Sweden was performed. Data were collected using a self-administrative questionnaire, providing demographic characteristics, information about opinions, awareness, and knowledge on the donation process and religious approach to the subject, willingness to donate/receive organs, and possession of a donor card. Results. Our results showed significant differences between genders regarding the definition of transplantation (P<0.0001), information about OD (P<0.0001), knowledge (P<0.0001) and importance of OD (P<0.003), religious permitting (P=0.0001), and religious opposing (P=0.0007) to OD. Furthermore, a significant difference was observed regarding the preferred recipient (P=0.0062) and the possession of the donor card (P<0.0001). Regression analysis showed that female gender and higher income were statistically significant in prediction of positive attitudes toward OD (P=0.0027, P=0.0002, respectively). Conclusion. Change of social background and integration into Swedish society undoubtedly led to change in the attitudes toward OD, regardless of the perspective of gender differences. However, women were found to have more positive attitudes toward OD.

Background For many patients with end-stage disease, organ transplant often provides the only chance for survival. Organ donation (OD) is affected by legislation, cultural and ethnic background, and knowledge and attitudes play a crucial role in promoting that concept. The present study aimed to assess differences in education level, perception, and willingness towards OD among Bosnian immigrants living in Sweden and respondents living in Bosnia and Herzegovina. Study design We performed a quantitative cross-sectional study using a self-administered questionnaire among 204 participants. Methods The questionnaire provided demographic characteristics, information about opinions, awareness, and knowledge on the donation process and religious approach to the subject, willingness to donate/receive organs, and possession of a donor card. Results All respondents supported OD, regardless of their education level. Only 2% of university-educated individuals from Bosnia and Herzegovina claimed to be donor card owners (p<0.001). Most of the university-educated respondents in Sweden, compared to Bosnia and Herzegovina, agreed that OD is needed and should be promoted (73.8% vs. 46.9%, p=0.007), opposite to the non-university-educated (51.4% vs. 66.0%, p=0.024). University-educated respondents stated that the donor card was informative enough (p=0.014) and considered self-perceived knowledge about OD to be sufficient or excellent (p<0.001). Most respondents were married and employed, practicing Muslims. Most of non-university-educated respondents from both countries believe their religion does not oppose OD (p=0.032). However, university-educated individuals strongly believe that OD does not have to be within the same religious group (p=0.016), while other participants did not have a definitive opinion. Conclusions Public behavior towards OD is affected by the social environment and the educational level. The study highlights the importance of achieving a suitable social climate for donation. Also, it suggests that more efforts are needed to harvest the benefits of the substantial support for OD among the Bosnian population.

Introduction Although extracorporeal shock wave lithotripsy (ESWL) is minimally invasive and highly efficient for the management of kidney stones, adverse effects have been described. Available indicators of renal function exhibit insufficient sensitivity in acute renal injury (AKI). We aimed to evaluate the severity of the kidney tissue response to ESWL injury by measuring the urinary neutrophil gelatinase-associated lipocalin (uNGAL), which can indicate AKI in its early phase. Material and methods The prospective, controlled study included 62 patients with nephrolithiasis undergoing single ESWL treatment. uNGAL level was measured before the procedure, and 6 h and 12 h after. Results The median uNGAL level increased by 126.0%, 6 h after ESWL (p <0.001). The growth rate continued and 12 h after was higher by 583.7%, compared to the pre-treatment level (p <0.001). The median value of estimated glomerular filtration rate (eGFR) dropped by 15.3% 12 h after the treatment (p <0.001). It increased by 5.0% in the period 7 days to 3 months after (p <0.001) and after 3 months it was lower by 10.1% compared to pre-ESWL values (p <0.001). uNGAL level after 12 h was significantly negatively associated with eGFR, 12 h, 7 days and 3 months after the ESWL. The sensitivity of uNGAL 12 h after ESWL was 60.6%; its specificity was 75.0%, with a positive predictive value of 74.0% and negative predictive value of 61.7%. Conclusions uNGAL appears to be a useful biomarker for the assessment and prediction of AKI. It was noticed that uNGAL had the highest predictive value 12 h after the ESWL treatment.