Aim To determine a correlation between the localization of the parathyroid gland (PTG), based on ultrasound (US) examination and the operative findings, as well as the correlation between the size of the parathyroid glands measured by ultrasonography (USG) with pathological findings+, and prevalence of enlarged parathyroid glands in various forms of hyperparathyroidism. Methods A total of 83 patients with hyperparathyroidism who had undergone parathyroidectomy over a period of seven years were included in the study. US examinations of the neck and scintigraphy were performed before surgery in 83 and 42 patients, respectively. In the pathohistological analysis, in addition to diagnosis, the size and weight of the parathyroid gland were measured. Results US examination revealed 125 enlarged parathyroid glands and two normal-sized glands. Scintigraphy revealed 52 enlarged and three normal-sized parathyroid glands. Enlarged parathyroid glands were more frequently found in the projection of the lower pole thyroid glands. A significantly higher number of enlarged upper parathyroid glands were found by the operative findings than by US. There was no statistically significant difference in the diagnosis of enlarged parathyroid glands in all three forms of hyperparathyroidism. There was a positive correlation between the size of the parathyroid glands obtained by US and the size of the operative finding (κ=0.51; p=0.00 and p<0.0005, respectively). The relationship between parathyroid gland size measured by ultrasound and pathological analysis showed a positive correlation. Conclusion Ultrasound was useful in evaluating enlarged parathyroid glands, especially in combination with scintigraphy.

Abstract Background Foreign Body (FB) injuries in children are a relevant public health problem associated with significant morbidity and mortality. The characterization of objects causing the injuries is an essential step for developing effective prevention strategies. Scanning the objects causing the injuries would help identify characteristics that make the objects dangerous for young children. The study aims to use 3D scanning within a large series of FB injuries collected in the Susy Safe database to develop a system able to identify the risk profile of everyday objects based on information collected through the scanning study. Methods The Susy Safe is the largest international registry collecting data on FB injuries in children under the age of fifteen. It collects almost 35,000 cases. For each case, information about the child, the object, and the circumstances of the injuries are collected. Furthermore, whenever possible (according to the object type and the approach used for FB removal) also the object is collected. Such objects are undergoing 3D scanning with structured light technology, a common non-contact scanning method allowing for 3D digitization of all dimensions and appearances. Results Currently, 383 objects have undergone 3D scanning. Most objects were made of a stiff material (60%). The scanning of the objects is still ongoing. The digitalized information for each object is collected in a REDCap repository together with all information about the FB injury and the picture of the object. Conclusions The final aim of the project is to develop a web-based application able to identify dangerous objects, based on shape and size parameters, according to the data collected through the scanning. Its objective is to make people aware of the risks posed by particular objects, especially parents and guardians of children. Furthermore, through the web-based application, parents will be able to report injuries and share images on FBs. Key messages • 3D scanning would be a promising opportunity to improve primary prevention of foreign body injuries. • Integrating data from 3D scanning and surveillance systems would represent the basis for the development of a web application able to assist families in identifying hazardous objects.

Aim: The aim of this study was to analyze all the factors (disease symptoms, sinthigraphic findings, biochemical parameters) that occur in patients with hyperparathyroidism, and since hyperparathyroidism itself is a common endocrine disorder. Methods: We analyzed 79 patients with primary, secondary, and tertiary hyperparathyroidism, who underwent surgery. We analyzed mean of age, male: female ratio, representation of different forms of hyperparathyroidism. In our study, we examined the indications for examination and surgery, as well as the most common symptoms and comorbidities. For localization PTG, scintigraphy was performed by a nuclear medicine specialist (at the Clinic of Radiology and Nuclear Medicine) preoperatively. Preoperative values of calcium (Ca), phosphorus (P), and parathyroid hormone (PTH) were determined in all patients, and the same values were measured postoperatively. We also analyzed correlation of dialysis length and parathyroid gland hyperplasia in patients with secondary hyperparathyroidism. Results: In our study mean of years was 51.13 ± 11.83 and most of the respondents were female. The most common operation was subtotal parathyroidectomy. The most common indication for examination of parathyroid glands (PTG) was renal failure. The most common comorbidity was arterial hypertension, which was found in 43 (53.2%) subjects, and the rarest gastrointestinal diseases and pancreatitis, in 1 (1.3%) patients. Scintigraphy showed an equal representation of enlarged lower parathyroid glands (both right and left). The mean values determined preoperatively for PTH were 796.24 pg/ml, Ca 2.58 mmol / l and P 1.35 mmol / l. The mean postoperative values for PTH were 222.33 pg/ml, Ca 2.06 mmol/l and P 1.17 mmol/l. We also showed that was a large correlation between dialysis length and hyperplasia. Conclusion: Hyperparathyroidism is a common endocrine disease, carrying potential complications of many organic systems. In most cases, regardless of the form (primary, secondary, or tertiary), it ultimately requires surgical treatment. For this reason, the clinical picture must be well known, the necessary preoperative diagnostic methods (which are complex), all with the aim of better effect of treatment of such patients.

The objective of this paper was to present basic clinical characteristics and outcomes of treating Covid 19 patients during the second wave of the pandemic. In the retrospective study for the period from September 2020 to February 2021 it was analyzed disease history data and radiological lung changes, time from the initial start of the disease until hospitalization, parameters of blood gas analysis, comorbidities, and the outcome. The research covered 409 patients, out of which 263 (64.3%) were males. Average age was 67.07± 12.44 years (min. 20; max. 93). A high comorbidities prevalence (82.9%) was noticed out of which arterial hypertension (69.2%), diabetes mellitus (37.7%) and obesity (24.7%). On the radiological lung scan the most noticed changes were consolidation (46.2%), “ground glass” (41.3%) and interstitial changes (13%). Bilateral lung infiltration was noticed in 91.9% of the patients. Average oxygen saturation was 84.29%±10.28% (min. 35; max. 98; med. 87%). In patients with unilateral lung infiltration, average oxygen saturation was 85.09%±8.60% (med. 89%, min.61% max 98%), while in patients with bilateral lung infiltration average was 84.22%±10.42% (med. 87%, min. 35%, max. 98%). From the total all patients’ death was noticed in 35.7% cases. Morbidity of patients with unilateral lung infiltration was 27.3% and in patients with unilateral infiltration 36.4%. Hospital admission in the first week of the disease indicates the severity of the clinical condition and can be a predictor of poor outcome. Bilateral pulmonary infiltration, obesity and diabetes mellitus are risk factors for high mortality.

Background: The most common patohistological finding in primary hyperparathyroidism is adenoma of the parathyroid gland, followed by hyperplasia and the rarest is carcinoma. However, hyperplasia of the parathyroid glands (PTG) is most commonly found in secondary and tertiary hyperparathyroidism. Objective: The aim of this study was to determine the relationship between the localization of the parathyroid glands and pathological diagnosis, as well as the prevalence of individual pathological diagnosis after surgery in patients with hyperparathyroidism. Methods: Analysis of retrospective-prospective database of 79 patients who underwent parathyreoidectomy for hyperparathyroidism in the 7-year study period. Diagnostic methods were used to identify enlarged parathyroid glands as well as to determine their localization: ultrasound examination, scintigraphy and operative finding. Standard hematoxylin eosin staining was used for pathophysiological diagnosis. A correlation analysis between parathyroid gland localization and pathophysiological diagnosis was performed. Results: The median age of the patients were 51 age (range 20-73) and 67,1% of the patients were female. In the total number of surgically removed parathyroid glands (182), the most common pathophysiological diagnosis was hyperplasia. Parathyroid adenoma was found in 21 cases. Other diagnoses (thyroid nodule / tissue, lymph node, thymus, cancer) were found in 11 cases, while a normal finding was found in 12 glands. Pathophysiological diagnosis of hyperplasia and adenoma were more common in the lower parathyroid glands. Using the chi-square test, no association was found between pathophysiological diagnosis and localization of enlarged parathyroid glands. Conclusion: The most common pathophysiological diagnosis in hyperparathyroidism was hyperplasia and was most commonly found in the inferior parathyroid glands. Adenoma as pathophysiological diagnosis is also most commonly found in the lower parathyroid glands, but without statistical significance.

Background: The most common patohistological finding in primary hyperparathyroidism is adenoma of the parathyroid gland, followed by hyperplasia and the rarest is carcinoma. However, hyperplasia of the parathyroid glands (PTG) is most commonly found in secondary and tertiary hyperparathyroidism. Objective: The aim of this study was to determine the relationship between the localization of the parathyroid glands and pathological diagnosis, as well as the prevalence of individual pathological diagnosis after surgery in patients with hyperparathyroidism. Methods: Analysis of retrospective-prospective database of 79 patients who underwent parathyreoidectomy for hyperparathyroidism in the 7-year study period. Diagnostic methods were used to identify enlarged parathyroid glands as well as to determine their localization: ultrasound examination, scintigraphy and operative finding. Standard hematoxylin eosin staining was used for pathophysiological diagnosis. A correlation analysis between parathyroid gland localization and pathophysiological diagnosis was performed. Results: The median age of the patients were 51 age (range 20-73) and 67,1% of the patients were female. In the total number of surgically removed parathyroid glands (182), the most common pathophysiological diagnosis was hyperplasia. Parathyroid adenoma was found in 21 cases. Other diagnoses (thyroid nodule / tissue, lymph node, thymus, cancer) were found in 11 cases, while a normal finding was found in 12 glands. Pathophysiological diagnosis of hyperplasia and adenoma were more common in the lower parathyroid glands. Using the chi-square test, no association was found between pathophysiological diagnosis and localization of enlarged parathyroid glands. Conclusion: The most common pathophysiological diagnosis in hyperparathyroidism was hyperplasia and was most commonly found in the inferior parathyroid glands. Adenoma as pathophysiological diagnosis is also most commonly found in the lower parathyroid glands, but without statistical significance.

The infection with SARS-CoV-2 virus in cats and dogs raised issue of human-to-animal transmission of SARS-CoV-2 in domestic pets in close contacts with their owners. Our study was designed to research this in the framework of Bosnia and Herzegovina. Using ELISA, AFIAS fluorescent immunoassay, RT-qPCR and WGS on Nanopore MinION platform with ARTIC Network Amplicon sequencing protocol for SARS-CoV-2, we showed that three out of thirteen dogs and one out of five cats from the households with confirmed human cases of COVID-19 in Bosnia-Herzegovina were infected with SARS-CoV-2. The high viral RNA load was detected in samples collected from a 4-year-old male Havanese (Ct = 12.52), a 6-year-old German Shepherd (Ct = 21.36) and a 9-year-old female American Staffordshire terrier (Ct = 25.74). The antibody response in dogs and one cat was observed. The viral genetic sequences from dogs were identical to the sequences detected in the owners suggesting the human-to-animal transmission of the virus. These findings, especially the low initial Ct values detected, from the public health perspective additionally stress the need for precautionary measures to protect both humans and animals.

Background Since the beginning of the COVID-19 pandemic, several inflammatory markers have been investigated as possible predictors of survival. Ferritin and from recently LDH have emerged as a possible marker that could serve to this purpose, with different cut-off levels than standard. Furthermore, serum elevations of these markers were reported in other viral infections such as dengue fever; while it has not been reported in MERS and SARS outbreaks and possibly making a biochemical distinction between COVID-19 and other similar diseases. The aim of this research was to establish independent admission levels of ferritin and LDH that predict lethal outcome more accurately. Methods In this prospective cohort study all the patients were hospitalized at UKC, B&H (n=137), between 28th of March and 1st of August 2020. The criteria for hospitalization was based on MEWS score, and all the inflammatory markers were evaluated in the first 72 hours of admission. Cut-off values of serum ferritin levels were set at 1500 ng/mL and LDH 350 U/L. Results Patients with serum ferritin levels >1500 ng/mL had 7.304 OR (CI95% 1.956-27.277; p=0.003) higher for lethal outcome than the group with <1500 ng/mL. Also, patients with levels of LDH >350 U/I had 5.560 (CI95% 2.480-12.468; p<0.001) higher OR of lethal outcome than patients with LDH <350 U/L. With the significant statistical difference between group means for both ferritin and LDH (p<0.001).Discussion Serum levels of ferritin >1500 ng/ml and LDH >350 U/L increase OR of lethal outcome. The levels of these inflammatory markers indicate the degree of inflammatory response and severity of the disaese as well as the possible outcome of the disease. Together these two markers could be used as predictors in clinical settings and treatment planning of patients with COVID-19.Conclusion: Together these two markers could be used as predictors in clinical settings and treatment planning of patients with COVID-19.