Dysfunction of neutrophils in patients with cystic fibrosis (CF) is best characterized in bronchoalveolar lavage (BAL), whereas peripheral blood neutrophils are less examined, and the results are contradictory, especially in younger populations. Therefore, this work aimed to study functional and phenotypic changes in circulating neutrophils in children with CF. The study included 19 CF children (5–17 years) and 14 corresponding age-matched healthy children. Isolated neutrophils were cultured either alone or with different stimuli. Several functions were studied: apoptosis, NET-osis, phagocytosis, and production of reactive oxygen species (ROS), neutrophil elastase (NE), and 11 cytokines. In addition, the expression of 20 molecules involved in different functions of neutrophils was evaluated by using flow cytometry. CF neutrophils showed reduced apoptosis and lower production of NE and IL-18 compared to the healthy controls, whereas IL-8 was augmented. All of these functions were further potentiated after neutrophil stimulation, which included higher ROS production and the up-regulation of CD11b and IL-10 expression. NET-osis was higher only when neutrophils from moderate–severe CF were treated with Pseudomonas aeruginosa, and the process correlated with forced expiratory volume in the first second (FEV1). Phagocytosis was not significantly changed. In conclusion, circulating neutrophils from children with CF showed fewer impaired changes in phenotype than in function. Functional abnormalities, which were already present at the baseline levels in neutrophils, depended on the type of stimuli that mimicked different activation states of these cells at the site of infection.

Although a strong relationship between periodontal disease (PD) and atherosclerosis was shown in adults, little data are published in younger PD patients. Therefore, this study aimed to investigate and correlate clinical parameters of PD, pro- and immunoregulatory cytokines in gingival crevicular fluid (GCF) and serum, biochemical and hematological parameters associated with atherosclerosis risk, and carotid intima-media thickness (IMT) in our younger study participants (n = 78) (mean age 35.92 ± 3.36 years) who were divided into two equal groups: subjects with and without PD. PD patients had higher values of IMT, hs-CRP, triglycerides, total cholesterol, and LDL; most proinflammatory and Th1/Th17-associated cytokines in GCF; and IL-8, IL-12, IL-18, and IL-17A in serum compared to subjects without PD. These cytokines in GCF positively correlated with most clinical periodontal parameters. Clinical periodontal parameters, TNF-α and IL-8 in GCF and IL-17A, hs-CRP, and LDL in serum, had more significant predictive roles in developing subclinical atherosclerosis (IMT ≥ 0.75 mm) in comparison with other cytokines, fibrinogen, and other lipid status parameters. Hs-CRP correlated better with the proinflammatory cytokines than the parameters of lipid status. Except for serum IL-17A, there was no significant association of clinical and immunological PD parameters with lipid status. Overall, these results suggest that dyslipidemia and PD status seem to be independent risk factors for subclinical atherosclerosis in our younger PD population.

Introduction: During the last two and a half years, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread around the world. Most of the SARS-CoV-2 vaccines are designed to produce anti-SARS-CoV-2 immunoglobulin G (IgG) against the viral S-glycoprotein. The aim of this study was to measure the anti-S antibody titres among the medical personnel who had been fully vaccinated with different types of vaccines, and to compare them with those who were COVID-19 convalescents. Material and methods: In this study serum was collected from 261 healthcare workers, of whom 227 were vaccinated, while 34 were recovered participants who were not immunised. Serum samples were collected 21 days after the first dose and 60 and 180 days after the second dose of the vaccines and tested with a commercial ELISA kit. Results: The highest antibody level (12 AU/ml) was measured in the Pfizer-BioNTech group, followed by Sinopharm (9.3 AU/ml), Sputnik V (5.9 AU/ml), Sinovac (4.6 AU/ml) and Oxford/Astra- Zeneca vaccine (2.5 AU/ml) 60 days after the second dose of the vaccines (90 days after the first dose). The seropositivity rate for mRNA vaccine was 88.5%, for vector vaccines 86.2% and for inactivated vaccines 71.4%. When comparing these antibody levels with COVID-19 convalescents, higher antibody titres were found in vaccinated participants (5.76 AU/ml vs 7.06 AU/ml), but the difference was not significant (p = 0.08). Conclusions: Individuals vaccinated with mRNA and vector vaccines had a higher seroconversion rate compared to the group vaccinated with inactivated vaccines, or convalescents.

Background: Response to the outbreak of poliomyelitis in mid-1950 led to recognition and consequent development of critical care. Seventy years later the humankind was struck by COVID-19, another major challenge for critical care medicine which was especially big in Low-Resources-Settings where more than two thirds of the world population live, including the population of the Republic of Srpska (RS). Design and methods: The main aim was to show an overview of all interventions in order to boost hospitals’ capacities to the level which is sufficient to manage high amount of critically ill COVID-19 patients in the RS. A before-after cohort study design was conducted to evaluate the effects of interventions for increase in preparedness and capacity of ICUs for admission and treatment of COVID-19 critically ill patients in nine hospitals in the RS. Results: Following interventions, the biggest and university affiliated hospital in the RS has increased ICU capacities: total number of ICU beds increased by 38% and number of ventilators by 114%. Availability of machines for veno-venous extracorporeal membrane oxygenation (vvECMO) increased by 100%. Number of doctors who were involved in treatment of critically ill patients increased by 47% and nurse/patient’s ratio reached 1:2.5. Similarly, all other hospitals experienced boosting of ICU beds by 189% and ventilators by 373% while number of doctors increased by 108% and nurse/patient’s ratio reached 1:4. Conclusion: All interventions implemented during COVID-19 pandemic outbreak in the RS resulted in increasing capacity for treatment of critically ill patients, but the education of health care professionals was identified as the most important conducted intervention.

Gingiva-Derived Mesenchymal Stromal Cells (GMSCs) have been shown to play an important role in periodontitis. However, how P. gingivalis, one of the key etiological agents of the disease, affects healthy (H)- and periodontitis (P)-GMSCs is unknown. To address this problem, we established 10 H-GMSC and 12 P-GMSC lines. No significant differences in morphology, differentiation into chondroblasts and adipocytes, expression of characteristic MSCS markers, including pericyte antigens NG2 and PDGFR, were observed between H- and P-GMSC lines. However, proliferation, cell size and osteogenic potential were higher in P-GMSCs, in contrast to their lower ability to suppress mononuclear cell proliferation. P. gingivalis up-regulated the mRNA expression of IL-6, IL-8, MCP-1, GRO-α, RANTES, TLR-2, HIF-1α, OPG, MMP-3, SDF-1, HGF and IP-10 in P-GMSCs, whereas only IL-6, MCP-1 and GRO-α were up-regulated in H-GMSCs. The expression of MCP-1, RANTES, IP-10 and HGF was significantly higher in P-GMSCs compared to H-GMSCs, but IDO1 was lower. No significant changes in the expression of TLR-3, TLR-4, TGF-β, LAP, IGFBP4 and TIMP-1 were observed in both types of GMSCs. In conclusion, our results suggest that P-GMSCs retain their pro-inflammatory properties in culture, exhibit lower immunosuppressive potential than their healthy counterparts, and impaired regeneration-associated gene induction in culture. All these functions are potentiated significantly by P. gingivalis treatment.

The aim of the study was to assess the seroprevalence of SARS-CoV-2 in the Republic of Srpska, Bosnia and Herzegovina, and to analyse the knowledge, attitudes and practices of the population toward COVID-19. This population-based study was conducted in a group of 1,855 randomly selected individuals from all municipalities from 1 December 2020 to 15 January 2021. All individuals were asked to sign a consent form and to fill in a questionnaire, following which a blood samples were collected. Total anti-SARS-CoV-2 antibodies were determined in serum specimens using the total Ab ELISA assay. The overall seroprevalence rate was 40.3%. Subjects aged <65 years were 2.06 times more likely to be seropositive than those aged ≥65, and 30% of seropositive individuals presented no COVID-19 symptoms. The household members of seropositive individuals were 2.24 times more likely to develop COVID-19 symptoms than the household members of seronegative individuals. More than 95% of respondents believe that preventive measures are very important to control the infection transmission. Majority of respondents wear the masks properly, maintain the required physical distance whenever possible and wash hands with soap. Nearly 50% of individuals were of the opinion that the vaccine could prevent the infection. This study showed that an overall SARS-CoV-2 seropositivity rate by the middle of January 2021 was very high. Attitudes and practices regarding the COVID-19 indicate that additional efforts should be taken in order to improve the health education with a focus on preventive measures and vaccination.

Introduction. Cardiac magnetic resonance imaging (CMR) is considered the reference diagnostic method for quantifying right ventricular size and function, and pulmonary regurgitation in patients with tetralogy of Fallot surgery. The aim of this paper is to confirm the importance of magnetic resonance continuous postoperative monitoring of right and left heart function parameters as a diagnostic method that provides the most precise and accurate assessment. Methods. The prospective observational study included subjects with TOF surgery who were diagnosed with residual morphological and/or functional disorders on control postoperative echocardiographic examinations. All subjects underwent magnetic resonance imaging of the heart on a 1.5 T scanner with dedicated coils for the heart surface according to the standard protocol for a period of one year from the beginning of the study. Criteria for exclusion from the study were: significant residual pulmonary stenosis, condition after pulmonary valve replacement, existence of residual shunt lesions, contraindications for cardiac magnetic resonance imaging (pacemaker, ICD, claustrophobia). Depending on the time elapsed since the tetralogy of Fallot surgery, the subjects were divided into groups: more than 15 years, 11-15 years, 6-10 years, less than 5 years. Results. The study included 131 subjects with an average age of 24.18 ± 11.57 years with complete correction of TOF. Intergroup differences in values of right ventricular end-diastolic volume, right ventricular ejection fraction, and left ventricular ejection fraction were demonstrated, but there was no statistically significant intergroup difference in values of pulmonary regurgitation fraction. The negative interaction of the right and left ventricles intensifies during the years of follow-up of patients after TOF surgery, which is especially true fifteen years after surgery. Conclusion. CMR has the most significant role in research efforts aimed at improving the outcomes of operated patients with tetralogy of Fallot.

Introduction. The patient and his safety should be at the center of quality health care, which is a challenge for every health system. Adverse patient outcomes (APO) are defined as damage caused by a drug or other intervention in a primary, secondary or tertiary health care facility, which results in a complication of the primary or the emergence of a new disease or injury. The aim of our study was to determine how frequent the APO are, and to determine the differences between nurses and doctors in the frequency, causes and attitudes towards APO. Methods. This cross-sectional study included 100 health professionals, nurses and medical doctors employed at the primary and secondary level of health care. The research was conducted in the period from May to October 2020. The questionnaire was partially taken from a general questionnaire offered on the website of the Agency for Healthcare Research and Quality and the standardized Perceived stress scale was used to measure the degree of subjective stress. Results. Forty-four health professionals (44%) experienced adverse patient outcomes in their career, doctors (52%) significantly more often than nurses (36%) (p = 0.039). More than a half of respondents (52.3%) declared that APO happens few times a month. Seventy percent of the respondents blame their own stress burden as the main factor associated with APO. Doctors more often than nurses (69.2%) blame problems in communication between health professionals as the main cause of APO (27.8%) (p = 0.046). Conclusion. For doctors, the main cause of APO is problem in communication, while nurses more often think that patient safety is priority when compared to doctors. Almost two thirds of respondents blame their own stress burden as a factor associated with APO.

Background / Aim. Asthma is a chronic inflammatory lung disorder. The effect of asthma drugs on oral health is still the subject of debate among researchers in dentistry. The aim of this study was to evaluate dental status in asthmatic children and evaluate the possible effect of drugs treating asthma on dental health. Methods. Participants were divided into two groups: the asthma (AG) and the non-asthma (NAG) group. Based on symptoms of the asthma and possibility for effective control of the disease, the asthma group was divided into two subgroups. The oral examination of the teeth was performed by the use of probe and mouth mirror under artificial light in accordance with World Health Organization recommendations. Saliva analysis was carried out by GC Saliva-Check Buffer. Results. The present study included 136 children aged from 6 to 16 years. The mean dmft/DMFT (decayed, missing, filled, teeth) of children in the AG group (6.0?4.0/3.3?4.4) was higher than in the NAG group (4.8?4.4/2.5?3.4), but significant differences were not observed between the groups. Salivary pH values were found to be similar in both groups, but a stimulated salivary flow rate was found to be significantly lower in the AG group (p<0.01). Conclusion. Although the prevalence of dental caries in the AG group was similar to the NAG group in this study, decreased stimulated salivary flow rate in the AG group may contribute to higher values of dental caries in asthmatic children in future.

Introduction. Serological testing for SARS-CoV-2 virus infection is a valuable method of estimating the extent of COVID-19 disease prevalence. The study aims to assess the seroprevalence of SARS-CoV-2 virus infection in a specific group of respondents employed in the health insurance sector, to determine the ratio of symptomatic and asymptomatic cases, as well as to examine susceptibility to COVID-19 in relation to the ABO blood group system. Methods. This research was conducted among 150 randomly selected employees from the health insurance sector of the Republic of Srpska. All respondents completed the survey, voluntary consent to participate, and had a blood sample taken. Serum samples were tested for the presence of SARS-CoV-2 specific IgG antibodies. Results. The seroprevalence of SARS-CoV-2 virus infection was 70.7%. Out of the 100 seropositive respondents, 48% had the presence of a symptom of COVID-19, while 52% had no symptoms of the disease in the period from 1 March 1 2020 until the day of testing. Examining the association between ABO blood group system and seropositivity in our study, we found that the highest seroprevalence of SARS-CoV-2 IgG antibodies among respondents was in blood group B (83.3%), followed by blood group AB (80.0%) and blood group A (75.0%), while the lowest seroprevalence was among respondents with blood group O (54.1%). Conclusion. Among employees in the health insurance sector, SARSCoV-2 seroprevalence of 70.7% was registered. Among respondents with a positive serological result on IgG, 52% were asymptomatic. The seroprevalence of SARS-CoV-2 virus infection is the lowest among subjects with blood group O.

Introduction. Deja vu (franc. Déjà vu) is a phenomenon experienced by two thirds of all people. However, this phenomenon can follow aura during the temporal lobe epilepsy. It is believed that it originates from hippocampus, which plays a major role in generating epileptic discharges. Some authors emphasize that in these patients déjà vu phenomenon is not an aura but rather it sometimes refers to the attack itself. Method. In this case report, an eightyear-old girl suffering from repeated crisis of consciousness is described. Case report. The aim of the study was to present the case of an eightyearold girl who underwent three crisis of consciousness, headache behind the forehead as well as the repeated déjà vu phenomenon. The girl was hospitalized, after which medical history was taken and physical examination, as well as other diagnostic tests, were performed. EEG recording revealed an increased electrocortical epileptic activity above the right frontotemporal region. An antiepileptic therapy (Karbapin) leading to attack control was introduced. Conclusion. It is necessary to give temporal lobe epilepsy in children with déjà vu phenomenon serious consideration.