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Almira Lujinović

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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.

Aim Examination of the effectiveness of STR loci in proving sibship of the Bosnian-Herzegovinian village of Orahovica and the formation of a "grey zone". Methods The probability of sibship was determined by calculating the likelihood ratio (LR) parameter for each of the 15 observed STR loci and for each of the pairs of relatives and non-relatives. Cumulative sibship index (CSI) was calculated for each of the pairs by multiplying the LR values of all 15 loci and obtained values are used as CSI limit for separating relatives from non-relatives. By creating a grey zone for local populations, an attempt was made to obtain a line of demarcation between siblings and non-siblings. Results An analysis of the origin of the respondents' relatives was performed, up to the level of sibship in the third generation. The results of the CSI for pairs of relatives from the village of Orahovica showed that the highest CSI value, and therefore the sibship probability was recorded among relatives from the village of Orahovica (CSI=534211727.203;SP=99.999999812%). On the contrary, incredibly low CSI value was recorded among non-relatives,ranging from CSI=0.0000001 to 0.5261434 (SP=0.000009999% to 34.475357951%). Conclusion For the threshold value CSI=1 and for CSI=3, this method determined sibship in 100% of pairs of relatives and the absence of biological sibship in 100% of pairs of non-relatives in the village of Orahovica. The STR system is proved to be a successful method in determining sibship or absence of sibship in small local populations.

Aim To determine the value of angles between the left coronary artery main trunk (LMT) and its branches, the anterior interventricular branch (LAD) and the circumflex branch (CX), and their possible relationship with the LMT length. Methods A total of 29 cadaveric hearts were used. The left coronary artery and its branches were dissected. The hearts were then classified according to the number of branches. The LMT length was measured with a digital gauge, and the LAD-CX angle, LMTLAD angle and LMT-CX angle with a manual goniometer. Results The average value of the LMT length was 9.0 mm (6.0-13.5). In 20 (68.97%) samples, the LMT was divided into two terminal branches. There was no statistically significant difference (p=0.321) in LMT length between the hearts with a bifurcation and without it. The average value of the LAD-CX angle was 89.0⁰ (74.5-93.0), with a statistically significant difference (p=0.020) comparing to hearts with trifurcation. The mean value of the LMT-LAD angle was 30.83±9.23⁰ and it was significantly lower (p=0.006) in the group of hearts with bifurcation compared to the group with trifurcation of the main trunk. Conclusion The LMT length shows great variability and is not related to the LAD-CX, LMT-LAD or the LMT-CX angle. Knowledge of the left coronary variation is essential in order to avoid misinterpretation of arteriogram.

Abstract Objectiv: Anatomic characterization of the nutrient artery of upper extremity long bones differs among the several textbooks on human anatomy. To elucidate the anatomical features of the nutrient foramen (NF) through which the nutrient arteries pass, we examined the morphology and topography of the NF on the diaphysis of the long bones of the upper extremities. Methods: A total of 150 (50 humeri, 50 radii, 50 ulnae) macerated and degreased adults, long bones of the upper extremities, unknown age, and gender were used as material in this study. The following parameters were determined for each bone: total number of NF, foramina index (FI), total bone length, position of the NF based on the FI value and the surface of the shaft/body of the bones, and obliquity of the nutritional canal (NC). Results: The largest number of NF was found on the middle third of the anteromedial side of the humerus diaphysis, with NC directed distally, that is, towards the elbow. Radius and ulna had predominantly one NF, on middle third of anterior surface, with NC directed proximally. Conclusion: This study provides additional and important information on the location and number of NF in the long bones of the upper and lower extremities in the Bosnian and Herzegovinian population.

Background: The genetic structure of each population can be explained according to the frequency of genes and their allelic variants, genotypes, and phenotypes. Objective: To analyze the genetic heterogeneity of the working-age population from the area of Sarajevo Canton based on classic genetic markers. The studied parameters of genetic heterogeneity were assessed by the relative frequency of the recessive allele for static-morphological traits (earlobe shape, chin shape, hairiness of the middle digital phalanx, bending of the distal phalanx of the little finger and digital index) and dynamic-morphological traits (rolling of the tongue into a groove, extensibility of the proximal thumb knuckle, extensibility of the distal thumb knuckle, the way the forearms are crossed, and the way the fists are made). Results: The results of the t-test showed a significant difference in the manifestation of the recessive homozygote for the observed parameters of qualitative variation in the subsamples of men and women. Only for two traits (attached earlobe and hyperextensibility of the distal knuckle of the thumb). The selected sample represent a relatively genetically homogenous population. Conclusion: This study serves as a valuable source of data for future research and the formation of a genetic database in Bosnia and Herzegovina.

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 human heart is in most cases vascularized by two coronary arteries, the right coronary artery (RCA) and the left coronary artery. The supernumerary coronary artery, which arises independently from the right aortic sinus and passes through sub-epicardial adipose tissue of the pulmonary conus and anterior side of the right ventricle is called the third coronary artery (TCA). Methods: This study consisted of 28 formalin-fixed adult human cadaveric hearts. The presence of the TCA was determined. The position of the orifice of the right and excess arteries in relation to the sinotubular junction was determined, and then also the position of the orifice of the excess arteries “on the o’clock level” in relation to the orifice of the RCA. The radius of these orifices and their distance from the orifice of the RCA were measured. The angle between the aorta and TCA, as well as RCA and conus branch, was measured. Results: A total 11 of specimens had supernumerary arteries. A supernumerary artery was found in two hearts. The angle formed by the aorta with the TCA was 60.09 ± 17.57, while the angle between the aorta and the conus branch had an average value of 89.88 ± 15.92. The orifices of all supernumerary arteries were located below the level of the sinotubular junction. The average diameter of the TCA was 1.49 mm ± 0.41. The average distance between the TCA orifice and the RCA orifice was 2.21 mm ± 1.03. In 45.45% cases, the orifice of TCA was located at the 10 o’clock level. Conclusion: The present study highlights the presence of the TCA. It may constitute a significant collateral circulation contributing to apical and septal perfusion. Interpretation of signs and symptoms of coronary occlusion should therefore include possible contribution of this vascular channel.

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