AIM The most common type of kidney transplantation in Bosnia and Herzegovina is from living donors, but there is a lack of published data on glomerular filtration rate (GFR) values and kidney outcomes in living kidney donors. This study aimed to evaluate the safety of living kidney donation at our centre. METHODS One hundred and seventy living kidney donors at the University Clinical Centre Tuzla were analysed. Initially, there were 170 participants; however, only 31 provided all the required medical data and completed the study. GFR was estimated (eGFR) using the CKD-EPI and MDRD formulas, and a web-based calculator was used to predict GFR > 90 ml/min/1.73 m², along with measurement of creatinine clearance (CrCl). Measured GFR (mGFR) was assessed through technetium-99m diethylene triamine pentaacetic acid (DTPA) renogram, with follow-up visits to estimate post-donation GFR. RESULTS The CKD-EPI, MDRD, and web-based application showed similar diagnostic performances, with MDRD and CKD-EPI systematically underestimating mGFR. CrCl demonstrated strong diagnostic performance. Follow-up visits showed that most donors had post-donation eGFR values between 45 and 89 mL/min/1.73 m², with none progressing to pre-dialysis or the dialysis stage after kidney donation. CONCLUSION CrCl demonstrated strong diagnostic performance in our study population, and the DTPA renogram reliably assessed kidney function. Post-donation eGFR levels were satisfactory, indicating that our diagnostic workup for potential living kidney donors in our centre is safe and effective.

Objective. The aim of the research was to determine the frequency of BI-RADS category 3 findings in ultrasound examinations in relation to the total number of patients, the frequency of malignant lesions, and their average size at the time of detection in BI-RADS 3 ultrasound findings. Patients and Methods. A cross-sectional study was performed on 335 patients (aged 40-75 years) classified in BI-RADS category 3, at the Tuzla Breast Center, University Clinical Center, in the period from March 2017 to November 2020. A total of 13,760 ultrasound examinations were performed, using a Toshiba Xario 100 ultrasound machine with a 12 MHz linear probe. Patients were divided into premenopausal and postmenopausal groups, excluding patients with symptoms and those with previous breast cancer surgery. The images were stored using the Institution’s Pictures Activation and Communication System. Results. BI-RADS category 3 findings accounted for 27% of all ultrasound examinations (N=3.715). Of these, 9.02% (N=335) underwent recommended short-term follow-up. Malignancy was identified in 1.49% of these cases (N=5), with an average tumor size of 13.6 mm at detection. The malignancy rate did not differ significantly between premenopausal and postmenopausal patients (P=0.412). The overall diagnostic yield for malignancy in BI-RADS 3 findings was low, but clinically significant. Conclusion. While the malignancy rate for BI-RADS category 3 findings is low (1.49%), careful monitoring and adherence to follow-up guideline are essential to balance early detection with avoidance of unnecessary biopsies and associated costs.

Background: Endocrine disrupting air pollutants such as sulphur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), fine particle matter (PM2.5), and ozone (O3) can affect thyroid gland function on the level of synthesis, metabolism, and the action of its hormones. Objective: The aim of this study was to establish whether increased air pollution could contribute to an increased incidence of autoimmune thyroid diseases (AITD). Methods: A retrospective analysis was conducted of the medical records of 82000 patients at the University Clinical Centre in Tuzla, Bosnia and Herzegovina. The target group of this study comprised a total of 174 patients from the Lukavac area. Daily data on concentrations of air pollutants were collected from the air quality monitoring station located in Lukavac. The study covered the period from 2015 to 2020. Results: The results of the monitoring confirmed the presence of air pollutants in concentrations above the permitted limits throughout the entire observed period. Concentrations of PM2.5, SO2, NO2, CO, and O3 were in the range of 1.90–431.40 μg/m3, 3.60-620.50 μg/m3, 3.40-66.20 μg/m3, 48.00-7002.00 μg/m3, and 0.70-89.40 μg/m3, with means of 64.08 μg/m3, 77.48 μg/m3, 22.57 μg/m3, 1657.15 μg/m3, and 31.49 μg/m3, respectively. During the six-year period, 174 cases of AITD were registered, of which 150 (86.21%) were women and 24 (13.79%) men. Hashimoto’s thyroiditis was found in 33 patients (18.97%), whilst 141 patients (81.03%) were diagnosed with atrophic thyroiditis. The highest total incidence of autoimmune thyroiditis was recorded in 2017, when it reached 99.49, 95% CI. Conclusion: The effects of chronic exposure to a mixture of air pollutants on the function of the thyroid gland are still not sufficiently well-known, but the numerical tendency towards a higher incidence of AITD in this study, albeit without statistical significance (p>0.05), still underlines the need for additional research.

Background: Sonography plays an important role in characterizing breast masses and in guiding needle core biopsies and wire localizations of suspicious sonographis abnormalities. Objective: The aim of this study was to show the possibilities of high frequency ultrasound devices in the presentation of microcalcifications of the breast, and the use of these possibilities in performing needle biopsy under ultrasound control. Methods: This was a retrospective study conducted from May 2017 to December 2020 on 32 women, 29-86 years of age using mammograms and ultrasound to show suspected microcalcifications (radiological findings of BI RADS 4B and 4C), and needle biopsy led by ultrasound that confirmed the diagnosis of breast cancer. Patients with suspected microcalcifications on mammography that had previously had the diagnosis of breast cancer confirmed in the same or contralateral breast were excluded from the study. Histology results from each core biopsy and surgical excision were reviewed. The positive predictive values of sonography and mammography for this population were calculated, and the sensitivity, specificity, and negative predictive value of sonography were determined. For analysis of the agreement of ultrasound findings with mammography the McNemar x2-test for dependent samples was used. Results: The sensitivity of mammography in the detection of microcalcifications in this study was 100%. The sensitivity of the ultrasound apparatus with a high frequency probe in the detection of microcalcifications after mammography examination in this study was 87.55%, while the specificity was 42.85%. Conclusion: Ultrasonic devices with high-frequency probes enable the display of accumulations of microcalcifications previously verified by mammography, and thus enable the performance of needle biopsy of suspected microcalcifications under ultrasonic control. An alternative is the much more complicated and significantly more expensive stereotactic biopsy under the control of mammography.

Background: Bosnia and Herzegovina (B&H) is one of the countries of Southeast Europe with the lack of data about chronic autoimmune thyroid diseases (CAITD) epidemiology. Objective: This research aimed to assess incidence of CAITD in the Tuzla Canton of B&H during a 6-year period (2015–2020). Methods: We retrospectively evaluated 82,000 hospital records of inpatients and outpatients with possible thyroid symptoms residing in Tuzla Canton of B&H (total of 445,028 inhabitants). The study included patients with laboratory and clinical proof of autoimmune thyroid diseases (AITD). Incidence rates were calculated with age standardisation using European standard population. Trends in incidence were evaluated as moving three-year averages. Results: During the observed period, 1875 patients satisfied the diagnostic criteria for CAITD with male to female ratio of 1: 8.01. Median age of all cases was 46 years (interquartile range: 31 to 61) and women and men were on average the same age at the time of diagnosis. The overall standardized incidence was found to be 71.25 per 105 (%95 CI=63.36–79.15). The overall standardized incidence in men was 16.25 per 105 and 123.74 per 105 in women. In the end of the observed period, AITD prevalence was 427.52 per 105 (% 95 CI=408.17-446.87). Conclusion: There was a slight decline of incidence in our region during the observed period. This decrease might be the result of combination of various factors, mainly the Corona epidemics outbreak and emigration. On the basis of the lower incidence rate in the Tuzla Canton, one can assume that iodine prophylaxis carried out in order to eradicate goitre had satisfied expectations because there had not been any enormous increase in patients with AITD.