Introduction: Pathology of thyroid nodules is present in all ages and it is frequently encountered in clinical practice. Thyroid nodules do not represent a single disease, but they are the clinical manifestation of a wide range of different thyroid diseases. Aim: The objective of this study is to evaluate the frequency and localization of malignancy in solitary scintigraphic cold nodules, as well as the sensitivity, specificity and diagnostic accuracy of FNAB in comparison with histopathological findings. Methods: The study was included 49 patients with palpatory findings of the solitary nodule located in the both lobes or isthmus of thyroid gland. All subjects underwent the scintigraphy and FNAB, followed by a cytologic results that was compared to the final histopathological diagnosis, after surgery. Results: The study results show that the highest number of solitary nodules (81,6%) is localized in the lower pole of the both lobes of the thyroid gland. The cytologic results were benign 8 cases, malignant in 23 and indeterminate (follicular neoplasm) in 18 cases. The highest number of thyroid cancer is histopathologically confirmed in the patients with cytological diagnosis of follicular neoplasms, i.e. follicular cancer is found in 66.7% and papillary cancer is found in 33.3% of subjects. The most common cancer is papillary cancer found in 61,2%. Since the pathohistological diagnosis of all our patients responded to cancer, it was done indirect statistical evaluation of the diagnostic sensitivity of cytological method in the estimation of malignant thyroid lesion, which was 83,7%. Conclusion: FNAB is a highly sensitive method in the diagnostics of malignant thyroid lesions with the sensitivity Se=83,7%. The highest number of thyroid cancer is histopathologically confirmed in the patients with cytological diagnosis of follicular neoplasm (66.7%). The highest number of patients had a cytological diagnosis of papillary cancer.

Aim: The aim of this paper was to evaluate the incidence of thyroid gland diseases in relation to age, sex, existing associated symptoms and thyroxine and thyroid-stimulating hormone levels, in correlation with morphological characteristics and corresponding clinical diagnosis for thyroid gland. Methods: Retrospective research was conducted in the period 1-Dec-2017 to 31-Dec-2017 and included a total of 500 subjects of both sexes aged 1 to 80 years. All subjects had clinical examination, which included anamnestic data, palpatory examination of thyroid gland, as well as functional status of thyroid gland. Results: The results of the research have shown that majority of subjects were females (78.6% vs. 21.4%). The largest number of subjects was in the age group 41 to 60 years. The average age of females was 43.22 years and 42.86 for males. The most common associated symptom for both sexes was related to cardiovascular system disorder (61.2%). Subclinical hypothyroidism was the most prevalent thyroid gland disease (12.8%), while diffuse enlargement of thyroid gland (4.60 %) was the most common in morphological classification. The mean value for free thyroxine for the overall sample was 14.39 pmol/L and 3,4 mlU/L for thyroid-stimulating hormone. Thyroid-stimulating hormone levels were highest in the age group 41-60 years (p=0.043). Conclusion: The overall incidence of thyroid gland diseases was 18.57% for females and 13.08% for males. Free thyroxine levels were highest in thyroid gland with nodular changes and subclinical hypothyroidism (p=0.0001). Thyroid-stimulating hormone levels had the highest value in a thyroid gland with diffuse changes and subclinical hypothyroidism (p=0.0001).

It has been reported in recent years that elevated thyroglobulin antibody (TgAb) values can be associated with thyroid malignancy. The aim of this study is to determine whether serum TgAb have a predictive role in thyroid cancer in patients with thyroid nodules. The crossed study included 100 patients with scintigraphic cold thyroid nodules divided in two groups. Demographic data, TgAb levels and final histopathological findings were recorded. The first group consisted of 50 patients with histopathological verified malignant nodules and the second group of 50 patients with histopathological verified benign nodules. TgAb were estimated by the radio-immunity assay (RIA) method. The median of TgAb in the group with benign nodules were 14.3 (10-32) IU / mL and in the group with malignant nodules 42.9 (13-156) IU / mL. TgAb values were significantly higher in patients with malignant nodules (p = 0.02 The increase in values of TgAb by 1 IU / mL increased the risk for malignancy by 0.7%. The cut-off for TgAb of > 35 IU / mL discriminates between diagnosis of the malignant and benign thyroid nodule. TgAb of > 35 IU / mL, with a sensitivity of 56% and a specificity of 78%, was found to be a limit value for predicting malignant thyroid lesion. TgAb serum values were predictor of malignant thyroid lesion and their preoperative measurement in combination with other risk factors could assist in preoperative diagnosis in patients with cytological indeterminant thyroid nodules.

Introduction: Psoriasis is a chronic skin ailment which can be connected with an increased occurrence of other illnesses, including the metabolic syndrome. Examinees and methods: A prospective study has been conducted which included 70 patients affected by psoriasis, both genders, older than 18 years. Average age being 47,14 (SD=±15,41) years, from that there were 36 men or 51,43 and 34 women or 48,57%. The average duration of psoriasis was 15,52 (SD= ±12,54) years. For purposes of diagnosing the metabolic syndrome, the criteria of National Cholesterol Education Program Adult Treatment Panel III, (NCEP ATP III) were used. For purposes of detecting the severity and spread of psoriasis, Psoriasis Area and Severity Index (PASI) was used. Results: The incidence of metabolic syndrome in patients with psoriasis was 38,57%. Average values of PASI score were 16,65. The increase in values of PASI score and metabolic syndrome were statistically highly connected. (r=0,3, p=0,0001). Conclusion: Psoriasis is connected with metabolic syndrome, there is a positive correlation between the severity of psoriasis and frequency of metabolic syndrome.

Bosnia and Herzegovina (B&H) is one of the Eastern European countries with lacking data on thyroid cancer (TC) epidemiology. We aimed to assess the incidence of TC in Tuzla Canton of B&H during a 10-year period (1999-2008). We retrospectively evaluated 65000 hospital records of both inpatients and outpatients with possible thyroid symptoms residing in Tuzla Canton of B&H (total of 496280 inhabitants) between 1999 and 2008. Patients with histological proof of TC were included in study. Incidence rates were calculated with age standardisation using European standard population. Trends in incidence were evaluated as moving three-year averages. During observed period 117 patients met the diagnostic criteria for TC with male to female ratio of 1:4.85. Median age of all cases was 51 years (interquartile range: 41 to 60) with men in average 9 years older than women at the time of diagnosis. The mean annual standardized incidence was found to be 2.30/10(5) (% 95 CI = 1.38-3.22) inhabitants ranging from 1.0 to 3.2 per 10(5). The average crude incidence in men was 0.82/10(5) and 3.83/10(5) in women. The prevalence of TC, at the end of the observed period was found to be 23.58/10(5) (% 95 CI = 19.3-27.58). There is a slight decline of incidence in our region during the observed period, but with the increase in the latest years of the study. This increase is probably the result of combination of various factors, mainly the better detection of new cases due to wider availability of diagnostics. Based on depicted trends, we believe that in the future years, TC incidence in our region will continue to rise.

AIM To investigate hospital morbidity and incidence of colorectal cancer (CRC) in the Tuzla Canton between 2000 and 2004, as well as mortality incidence and degree of disease progression. METHODS A total of 383 patients were enrolled in this study, all of them with CRC. Pathohistological analyses were performed in all patients after colonoscopy. Afterwards, the patients underwent surgery and obtained material was also pathohistologically analyzed in order to perform the Astler-Coller classification and the classification of the location of CRC. RESULTS In the period 2000-2004 in the Tuzla Canton there were 383 newly diagnosed patients with CRC. The average age of the patients was 62 ± 12 years, and the incidence was equally distributed per genders. Rectal tumour was noted in 145 (37.9%) patients, and in 238 (62.1%) tumor was found elsewhere in the colon. Average incidence of the CRC was 15.73/100,000, with a dramatic increase in incidence in 2003 of 27.40/100,000. The average mortality incidence during the study was 6.89/100,000, and the largest number of the patients (339, 88.6%) was in an advanced stage of the disease. CONCLUSIONS There has been a significant increase in the number of newly detected cases of CRC in the Tuzla Canton during 2000- 2004, which implies the need for initiating a National Early CRC Detection Programme.

Malignant tumors of the thyroid gland account for about 1% of thenewly diagnosed malignant tumors each year, and their incidence inwomen is twice the incidence in men. According to the WHO classification (2004) thyroid tumors are divided into: carcinoma of the thyroid,adenoma and similar tumors, and other thyroid tumors whichinclude: teratomas, angiosarcomas, paragangliomas and others, as wellas primary lymphomas and plasmacytomas. Primary thyroid lymphomasare defi ned as lymphomas which originate in the thyroid gland.Th is study presents the case of a 68-year-old patient with a thyroidlymphoma, which caused compression of the airways. In the patientpresented there was reduced activity of the thyroid gland. Th e dominantsymptoms were: breathing diffi culties, hoarse voice and the enlargementof the thyroid. An ultrasound examination was performedbefore surgery on the neck, which showed a multinodular thyroid,with compromised and compressed trachea to the right and rear. Anemergency surgical procedure was performed to reduce the tumor.Pathohistological diagnosis confi rmed diff use large B cell lymphoma.Th e aim of the study was to present a patient with a thyroid lymphoma,who had previously not had any immunological changes to the gland,that is, she had not had any chronic lymphocyte thyroiditis, but due tothe compressive syndrome it was necessary to perform an emergencysurgical procedure to reduce the tumor.

The period following ischemic stroke can be considered as a reaction to a stressful event. Changes in cortisol secretion are one of the indicators of stress reaction. The aim of the study was to determine morning serum levels of cortisol in stroke patients within 48 hours and 15 days of ischemic stroke onset. Study group included 40 patients, 20 of them were females, mean age 65.3 +/- 10.3 years. The patients did not receive any corticosteroid agents or spironolactone, and did not suffer from Cushing's or Addison's syndrome. Ischemic stroke was verified by computed tomography of the brain. The fluorometric method with DELFIA Cortisol immunoassay was used to determine morning serum cortisol levels. Reference values of the measured hormone were 201-681 nmol/l. The mean level of serum cortisol within 48 hours of stroke was 560.9 +/- 318.9 nmol/l, and on day 15 it was 426.2 +/- 159.3 nmol/l, i.e. significantly lower (p < 0.02). On the first measurement, the level of serum cortisol was elevated in 32%, and on the second measurement in only 7.5% patients, which was also significantly lower (p < 0.001). It was concluded that the stress reaction in ischemic stroke patients was more pronounced within the first 48 hours of stroke onset. Judging from the morning cortisol levels, the reaction to stress was considerably less pronounced 15 days after stroke onset.