Introduction. We report a case of a sixty-year-old man diagnosed with gluteal compartment syndrome caused by traumatic rupture of the superior gluteal artery associated with fracture of the inferior pubic ramus and blunt trauma. Case report. A patient was injured falling from a height of four meters. Signs of compartment syndrome and sciatic nerve compression developed three hours after the injury. The patient went through a computerized tomography (CT) scan procedure with contrast, which showed a hematoma in the gluteal region, but without signs of active bleeding. However, after observation and monitoring of the patient, CT angiography was performed which revealed a rupture of the superior gluteal artery. Fasciotomy and debridement were performed and the patient was diagnosed with gluteal compartment syndrome and rupture of the superior gluteal artery. Surgery resulted in a significant improvement of the patient’s condition. Conclusion. Traumatic gluteal compartment syndrome is a rare condition. Gluteal compartment syndrome should be taken into consideration in each patient with pelvic trauma and hematoma in the gluteal region whose neurological status is affected. Prompt diagnosis and fasciotomy are crucial in the treatment and fasciotomy presents the gold standard in the treatment.

Autoimmune diseases occur in 3−5% of the population. Study included 30 patients with clinically diagnosed SLE and 30 healthy controls (American college of Rheumatology, 1997). SLE was diagnosed according to criteria issued in 1997 by the American College of Rheumatology (ACR). The aim of this study was to evaluate concentration values of each antigen of ENA-6 profile in SLE, to investigate possible correlation between the concentration of Sm antibodies and CIC, and to test their use as possible immunobiological markers in SLE. Furthermore, the aim of our study was to determine whether there is a correlation between Sm antibodies and CIC and SLE activity. The results revealed that all of these ENA-6 and Sm antibodies as biomarkers complement diagnoses of active SLE but their use as solo markers does not allow classifying patients with SLE. Our study has shown that based on calculations from ROC curves, Sm/RNP was clearly a very important marker for diagnosis of SLE (cut off ≥ 9.56 EU, AUC 0,942). The high incidence of Scl-70 (10%) reactivity suggests that ELISA monitoring of this antibody produces more false positive results than other multiplex assay. An important conclusion that can be drawn from the results of our study is that laboratory tests are no more effective than clinical examination for detecting disease relapse, but are helpful in the confirmation of SLE activity.

The basis of autoimmune diseases such as SLE (Systemic Lupus Eritematodes), Sjogren's syndrome, scleroderma, dermatomyositis and polymiositis is the creation of auto-antibodies to the following specific extractable nuclear antigens (ENA):Jo-1, Ssl-70, SS-A, SS-B, Sm and Sm/RNPs. Some of these antigens are in fact enzymes (Jo-1-histidil-tRNA synthetase, Scl-70-topoisomerase) which are inhibited by specific autoantibodies--this leads to disturbance in the metabolism of DNA and protein biosynthesis. During 2009, we analyzed total of 87 serum samples of patients suspected for autoimmune disorder using ANA-IFA and ELISA-ENA-6 methods. After establishing IFA-ANA positivity (83.9%), all serum specimens; ANA positive and negative, were subtypized by ELISA ENA-6 test. Analysis showed the highest incidence of anti-SS-A (56%), and incidence of anti-SS-B (29.8%), anti-Sm/ RNP (11.5%), anti-Jo-1 (2.3%) and anti-Scl-70 (1,1%) auto-antibodies. Also, 78.5% of IFA-ANA negative serum specimens showed high level of positivity (212.50 and 277.0 IU/ml) to SS-A (78.5%) and SS-B (21.4%) antigenes using ELISA-ENA-6 subtypization. Following these results, we conclude that it is necessary to introduce Western blot confirmation testing. After comparing with other clinical findings, we diagnosed the following autoimmune diseases: SLE, Sjogren's syndrome and dermatomiosytis.

Last data from 2005 shows that Bosnia and Herzegovina has 37.6 % current smokers between 18-65 years. 29.7% of them are female and 49.2 % male. In the region of Sarajevo 13.8% pupils are active smokers (16.8% boys, and 10% girls). We have evaluated smoking impact on patients in Clinical Center Sarajevo treated for occlusive arterial disease who had finished their treatment with amputation after exhausting efforts of vascular surgery and angiological therapy measures. Evaluation covers period of ten years (from 1998 to 2007) and patients treated in Vascular Surgery Department and Orthopaedic and Traumatology Department. Average age of patients was 56 year. The youngest patient was 22 and the oldest was 88 year. 70.3% of total number (990 patients) were smokers. From total number of 387 above knee amputations, 159 was done in diabetic patients - smokers which means 41.08%, or 16.06% of total number of amputations. 699 (70.6%) smoking patients underwent major amputation operations (above and below knee amputations). Only 63 patients (6.36%) without major risk factors (smoking and diabetes) had amputation as a final result of treatment. In 52 (5.25%) patients with major or other amputations we have found obliterative thromboangiitis (Buerger’s disease). In 23 patients (2.32%) with amputation we have found other inflammatory thrombotic diseases. In some cases amputation was done as urgent measure in which surgeons had no time for details in diagnostic evaluation. Smoking rates among the general population in Bosnia and Herzegovina are extremely high, and national campaigns to lower smoking rates have not yet begun.

Diagnosis and management of patients with SLE (Systemic Lupus Eritematosus), autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), involves specific diagnostic tests, such as IFA-AMA, IFA anti-dsDNA and immunoblotting for the detection of autoantibodies for specific autoantigens (mitochondria, dsDNA, M2, LKM-1, LC-1, SLA/LP). We established specific correlation between the detected autoantibodies and corresponding clinical findings. The total of 813 serum specimens were probed with IFA-anti-dsDNA, 98 of which tested positive. We also performed dilution analysis to the end point for all the positive specimens. Numerous specimens were tested by IFA, AMA and immunoblotting.

Interleukin 1 (IL-1) contains two proteins, which are the products of distinct genes, but which recognize the same cell surface receptors. In the liver, IL-1 initiates the acute phase response resulting in an increase in hepatic protein synthesis and decreased albumin production IL-1 also plays an important role in immune functions, having effects on macrophages/monocytes, T lymphocytes, B lymphocytes, NK cells, and LAK cells. Interleukin-6 (IL-6) is a cytokine that regulates immune responses. We analyzed total 160 serum specimens of patients from Clinical Center University of Sarajevo with different inflammatory diseases by ELISA method on interleukins: IL-1alfa and IL-6. Tests that we performed with IL-lalfa and IL-6 by ELISA method confirmed that serum specimens with IL-6 ELISA showed increased values of tested specimens, than the lowest standard and blank. We had average levels of IL-1alfa 3.7 pg/ml which was below the level of the lowest standard. All obtained results were in accordance with the results in IBL protocol for blank and lowest standard values, as well as the average levels of serum specimen values.

Rheumatoid arthritis is a multi systematic progressive illness of connective tissue, mostly with joint changes, but also with non-joint changes. The objective of the paper is to compare laboratory and clinical parameters between two groups of examinees, who live in different material, hygienic conditions and different level of health protection. One hundred and forty five patients (core group) were examined and 50 patients (control group). Laboratory and clinical monitoring shows differences in the core group and control group. It is primarily reflected in the status of cell immunity, clinical forms of rheumatoid arthritis, but also other parameters. Cell immunodeficiency is dominating in the core group, heavy clinical forms of rheumatoid arthritis but also visceropathy. The reasons for higher potential of evolution of rheumatoid arthritis in the core group should be sought in the bad material, hygienic living conditions, as well as the level of health protection in the core group compared to the control group.

INTRODUCTION In this report we present our experience in "post war" environment in our institution. Any king of pelvic surgery is challenging and impacts significantly on limb and visceral function. Any surgeon has to ask a question "is heroic surgery justifiable". We aim to asses functional, oncologic and surgical outcomes following pelvis tumor resections. MATERIALS AND METHODS Between 1998-2005, 7 patients (mean age 48.2 years) underwent pelvic tumor resections. All of them were primary malignant tumors. We did not identify secondary tumors and benign tumors in our series. Bone tumors were 3 osteosarcomas and 4 chondrosarcomas. Tumors involved the ilium, acetabulum, pubic bones, sacrum or a combination of these. No patient had metastases at presentation. RESULTS All 7 patients underwent hindquarter amputations. Surgical margins were marginal (4), wide (2), and radical (1). There was 1 intraoperative death, 2 local recurrences and 2 metastases. Death from disease occurred at a mean of 12.4 months with mean follow-up of 24 (1-72) months. Emotional acceptance was surprisingly high. Pelvic resections are complex. Functional outcome is significantly affected by surgery. Disease control is similar to limb tumors. Emotional acceptance of surgery in survivors was surprisingly high. CONCLUSION Major pelvic resection for malignancy appears justified.