Acute kidney injury (AKI) is associated with an increased risk of progression to a severe form in every disease and, moreover, is associated with an increased mortality, and so it is also with coronavirus disease 2019 (COVID-19). AKI is a frequent complication in COVID-19 patients admitted to ICU for severe respiratory failure. ICU treatment itself indirectly could cause or exacerbate renal damage, through suboptimal fluid management, drug toxicity, or low human resources. The aims of this study were to assess AKI prevalence, fluid balance and glomerular filtration rate as a predictor of outcome in COVID-19 patients treated in the intensive care unit. We retrospectively analysed all adult patients admitted to the ICU at a regional hospital in northern Bavaria, from 1st March to 31st December 2020. Clinical data and laboratory results were retrospectively retrieved from the hospital information system and electronic case files. According to the severity of AKI based on the KDIGO criteria, and laboratory values were followed on the first 7 days on the ICU. In total 320 patients patients were included in the study. Level of significance was set to p<0.05. The mean age was 65 ± 19 years, 135 (42%) patients were females, 185 (58%) were males. Median length of ICU stay was 7 (2-13 days) in females, and 8 days (4- to 21 days) in males. At the ICU, 177 patients needed some form of ventilation, from which 109 (needed Invasive mechanical ventilation). During ICU stay, 81 patients have died, with fatality rate of 25%. Patients with AKI (n=48, 15%) at the admission to the ICU, had 2.1 times higher risk of death at the ICU than patients without AKI. There was a statistically significant difference in ICU survival based on a glomerular filtration rate, fluid balance, CRP and leukocyte values, F=1.957, p=0.026; Wilk's Λ=0.724, partial η2 = 0.276 Acute kidney injury is common in coronavirus disease 2019, and it is associated with poor clinical outcomes. Even first couple of days at the ICU could point to the outcome, with markers of inflammation, glomerular filtration rate, and fluid balance being most valuable variables.

Surgical aortic valve replacement (SAVR) in kidney transplant recipients (KTR) is associated with high morbidity and mortality, and an increased risk of postoperative graft failure potentially leading to graft loss. Transcatheter aortic valve implantation (TAVI) emerged as an alternative in high-risk patients. However, data on TAVI in KTR are limited. We performed a retrospective analysis of 40 KTR in which aortic valve replacement was performed at our center between 2005 and 2015. The outcomes and follow-up of TAVI (n = 20; 2010-2015) and SAVR (n = 20; 2005–2015) were analyzed with respect to patient and graft survival. Baseline characteristics in both groups were comparable. Hospital stay after TAVI was significantly shorter compared to SAVR (19 [11.5–21.75] days vs. 33 [21–62] days, p = 0.001). Acute graft failure occurred more frequently after SAVR (45% vs. 89.5%; p = 0.006). Thirty-day mortality was 10% in both groups. However, in-hospital mortality reached 25% in the SAVR group (TAVI 10%), indicating a more complicated course after surgery. Moreover, during a median follow-up time of 1928 days in TAVI patients and 2717 days in patients after SAVR, graft loss occurred only in the surgically treated group (n = 7). While one-year survival after TAVR was 90% compared to 69% after SAVR, long-term follow-up showed comparable results (at 5 years: TAVI 58% vs. 52% SAVR; log-rank-test: p = 0.86). In KTR, TAVI can be performed with good mid- to long-term results. Compared to SAVR, renal outcomes seem to be improved after TAVI, suggesting better graft survival.

Introduction/Objective. Gunshot residue (GSR) on the skin of a victim are important evidence, with far better precision, for reconstructive questions in the forensic investigation of cases involving gunshot wounds. The aim of this experimental study was to analyze if there was any significant difference in macroscopic characteristics of wounds that were caused with different types of weapons from three different distances. Methods. This study was conducted at the Department of Ballistic and Mechanoscopic Expertise, Federal Police Directorate. Experiments were done on pigskin and 55 samples were made. Shooting was conducted using a system for safe firing. Samples of the pigskin were shot by firing projectiles from four different weapons and from three different distances, (contact wound, five centimetres and 10 centimetres). Results. At the contact range, wounds caused by automatic rifle had horizontal, vertical diameters larger than those made by pistols. Diameters on the wounds that were caused with different pistols, were similar. At the range of five centimetres, the narrowest part of contusion ring significantly differs even through pistol wounds. Diameters at the range of 10 centimetres are in favor of these results. Gunpowder residue scattering area was statistically different depending of type of weapon (p = 0.004). Conclusion. Wound diameters and surface area are useful for differentiation between pistol and rifle caused wounds. It is unsecure method for determination of pistol caliber or fire range. GSR have much greater potential for future analyses, but even GSR cannot be used to determine pistol caliber.

The aim of this study was to look for any secular trend in the stature of Balkan populations from the time of World War II (1939-1945) to the Balkans War (1991-1995). The research was based on the examination of exhumed skeletons of 202 men killed in World War II in the area of the Republic of Slovenia, and 243 men killed in the Bosnian War in Bosnia and Herzegovina. The length measurements of the right and left humerus, femur, tibia and fibula were taken. Since the results revealed no significant differences and the left-sided bones were more complete and recurrent in the sample, the bones of the left side were used in the analysis. Since the increase in height depends mostly on the increase in length of the long bones, with an average absolute change of about 0.28 cm for humerus, 0.55 cm for femur, 0.49 cm for tibia and 0.20 cm for fibula per decade in our case, these results suggest a significant increase of the height of the Balkans population. The difference of the sum of the average femur and tibia length for the study period was 4.13 cm. Recalculated average length increase of the sum length of femur and tibia per decade was 0.88 cm for the left side. Our study revealed that there was a trend towards increased long bone lengths, at least in the male population analyzed.

Introduction: The aim of the study was determining the type of weapon and shooting distance depending on chemical analysis of inorganic gunshot residue from the skin gunshot wounds in experimental animals (pigs).Methods: Experimental study was conducted in order to determine components and their percentage in gunshot residue (GSR). In 60 samples, pig skin was shot by fi ring projectiles from four different weapons and from three different distances (contact wound and near contact wound from 5 cm and 10 cm). The methodology included determining the presence of inorganic material: antimony, barium, lead, nickel, zinc and copper in the skin and subcutaneous tissue using atomic absorption spectrophotometry (AAS).Results: Formula for determining weapon type was provided cutt-off points for different weapons, with 78.6% of original grouped cases being correctly classifi ed. Formula for determining weapon type was provided cutt-off points for different distances, with 58.9% of original grouped cases being correctly classified, which was slightly less reliable compared to weapon type discrimination analysis.Conclusion: The presented study showed that chemical analysis of GSR in entrance wound with AAS could be useful in determining the type of weapon, as well as the shooting distance, i.e. in our study, determiningwhether the wound is contact or near contact. This could be particularly useful in postmortally putrefi ed or charred bodies with gunshot wounds.

Suchey-Brooks method based on morphological features of pubic symphysis is a common method of age evaluation of human skeletal remains. The aim of the study was the classification of the examined samples into a particular phase according to Suchey-Brooks method, comparing the estimated age according to Suchey-Brooks with living age of the identified persons. The study was conducted on 120 pairs of pubic bones symphysis of male who disappeared from the area of north-west Bosnia during previous war, who were exhumed and the process of their identification was previously finished. The youngest person was 19 years old and the oldest 86. The study was retrospective, made by comparing the morphological characteristics of pubic symphysis pairs of the examined sample with Suchey-Brooks standards. The statistical analysis of data obtained by the survey showed that the smallest deviations from the average were in phase II by Suchey-Brooks, while the maximum deviation was in phase IV. The standard deviation generally increases from phase to phase, which is to be expected. The span of age obtained for Bosnian population is smaller at all stages in relation to Suchey Brooks-standards, as well as standard deviation, except in phases IV and VI. There was a significant difference noticed in phase V in the estimation of age between the original method and Bosnian population. In general, Suchey-Brooks method leads to underestimation of age, but the underestimation or overestimation in relation to the actual age is possible at each stage, which indicates the individual biological variation.