Introduction. The harmful effect of cigarette use has been proven through existing studies, but the recent advanced use of heat-not-burn-tobacco-products (HNB) and its effect remains under observation. Results. After six months, HNB users exhibited better-preserved FEV1 and peripheral oxygenation values. Conclusion. Patients using HNB tobacco products achieved better 6MWT and spirometry testing results and showed lower cholesterol and hs-CRP levels after six months of follow-up. Keywords: smoking, spirometry, heat-not-burn, lung function decline, respiratory health.

Freedom of contract is a fundamental principle of obligation law, but in modern legal systems it functions as a relative and normatively oriented category. The paper examines the theoretical foundations of this institute, starting from the liberal conceptual core of the autonomy of the will and its historical development, to the modern, functional concept that views contractual freedom in the broader framework of public law restrictions, market discipline, and protection of the weaker party. The analysis includes domestic and comparative law, including standards of European contract law and modern economic indicators (EFW index), in order to indicate the connection between economic and contractual freedom. Special attention is paid to the position of business entities, where contracting has a specific dimension due to their professional status, the complexity of market transactions, and pronounced information asymmetry. Through the analysis of imperative norms, standard and adhesion contracts, regulated markets, and unequal bargaining power, the key practical and systemic limits of business autonomy are pointed out. The results of the work show that these restrictions do not represent a negation of the freedom of contract, but a mechanism for its functional realization - through the provision of legal certainty, fair market conditions, protection of competition, and stability of the economic order. The paper contributes to a better understanding of the modern conception of contractual autonomy in the economy, indicating that the balance between freedom of disposition and public law regulation is the key assumption of an efficient, fair, and sustainable contractual system.

Izgradnja poslovne infrastrukture, naročito poslovnih zona, podrazumijeva ispunjenje cijelog niza pretpostavki koje su često međusobno uslovljene. U vezi s tim u bosanskohercegovačkom pravnom okviru do izražaja dolaze brojni faktori ustavnopravne, ali i stvarnopravne prirode. Najprije treba poći od činjenice složenosti ustavnog sistema u Bosni i Hercegovini, gdje se moraju uvažiti legislativne postavke, naročito u dijelu nadležnosti za uređenje određene oblasti. Tako, kad je riječ o izgradnji poslovnih zona, posebno mjesto imaju jedinice lokalne samouprave, ali s bitno promijenjenom ulogom u odnosu na period u okviru bivše države (SFRJ). Zapravo, u odnosu na raniji (socijalistički) period, kada su jedinice lokalne samouprave imale gotovo ključnu uloge u smislu planiranja te izgradnje proizvodnih kompleksa, danas imaju bitno drugačiji položaj, koji se u pravilu svodi na planiranje prostornih obuhvata budućih poslovnih zona te na izdavanje potrebnih dozvola. To je rezultat napuštanja komandne privrede u okviru koje je izgradnja proizvodnih kompleksa vezana za državnu regulaciju. Dakle, rezultat tranzicijskih procesa u ovoj oblasti rezultirao je situacijom da je proces izgradnje poslovnih zona iz javnopravnog sektora prešao isključivo u privatnopravnu sferu, gdje ključnu ulogu imaju privatni investitori, dok jedinice lokalnih samouprava imaju servisnu ulogu. Upravo je saradnja između javnopravnih subjekata, pri čemu se dominantno misli na jedinice lokalne samouprave, i potencijalnih investitora, ključni segment u smislu da li će se uopće izgraditi određena poslovna zona. U tom odnosu, pored ustavnopravnog okvira, od izuzetnog je značaja uređenost imovinskopravnih odnosa, za šta su u pravilu zadužene jedinice lokalne samouprave, bilo kroz stvaranje imovinskog (nekretninskog) portfelja jedinice lokalne samouprave koji će poslužiti za buduću poslovnu zonu, bilo kroz uključivanje u rješavanje određenih, često naslijeđenih imovinskopravnih problema, koji su preduslov za izgradnju, primjera radi, proizvodnih objekata u okviru poslovne zone. U vezi s tim, od presudne je važnosti poznavanje limitirajućih faktora koji su vezani za zakonodavstvo te traženje optimalnih modela za realizaciju poslovnog poduhvata. Na koncu, ali ne manje važno, jest nužnost uvažavanja relevantnih odluka Ustavnog suda Bosne i Hercegovine, koje su u značajnoj mjeri oblikovale de lege lata prizmu u pogledu pravnog statusa značajnog broja nekretnina koje se, pored ostalog, nalaze u obuhvatu sadašnjih, ali i budućih poslovnih zona.

Introduction. Primary rectal signet-ring cell adenocarcinoma represents one of the rarest subtypes (1.39% of cases) and is associated with poor prognosis. Case report. We report the case of a 31-year-old female patient with rectal signet-ring cell adenocarcinoma who developed cutaneous metastases. Conclusion. Despite early initiation of treatment, survival in patients with rectal signet-ring cell adenocarcinoma remains poor. Key words: Rectal Neoplasms, Adenocarcinomas, Signet-Ring Cell, Skin Neoplasms.

Tionite is a solid residue formed during the production of titanium dioxide through the chloride process. This material is acidic and contains a high concentration of titanium, which makes it a potential secondary resource for titanium recovery. Instead of being disposed of as hazardous waste, tionite can be processed to extract valuable metals, particularly titanium. In this study, the recovery of titanium from tionite was carried out using an autoclave leaching method under high-pressure oxygen conditions. The presence of oxygen under pressure promotes the formation of titanium oxysulfate, which enhances the dissolution of titanium into solution. This approach enables selective leaching of titanium while limiting the dissolution of other unwanted elements. The leaching experiments were designed to explore optimal conditions for efficient titanium recovery, including temperature, pressure, and leaching time. The main objective of this research is to present a viable route for the valorisation of tionite by turning a hazardous acidic waste into a valuable source of titanium. This process contributes to waste reduction in the titanium dioxide industry and supports more sustainable resource management.

Background Biological mesh derived from porcine small intestinal submucosa (SIS) has a higher porosity and is more hydrophilic than tissue derived from bovine and cow dermal tissues. Therefore, we believe SIS mesh will lead to a milder inflammatory reaction than other, polypropylene and polypropylene-polydioxanone meshes, fewer adhesions, and less mesh shrinkage. Methods Ninety rats were divided randomly into three groups: in group 1, polypropylene mesh was implanted; in group 2, polypropylene-polydioxanone; and in group 3, the SIS mesh. The meshes were fixed intra-abdominally, in the upper part of the abdomen. Ten animals from each group were sacrificed on days 7, 28, and 60 after the implantation. Relaparotomy was performed, with a left paramedial incision and the adhesions formed were assessed according to the Surgical Membrane Study Group (SMSG) score, along with the percentage of shrinkage of the mesh, and any inflammation. Results There were no differences in terms of inflammatory reaction or the formation of adhesions between the meshes tested on the 7th day after implantation. However, the shrinkage of the SIS mesh was more expressed. On days 28 and 60, the SIS mesh caused less inflammatory reaction and formation of adhesions in relation to the other meshes tested. On day 60, there was no significant difference in the size of the meshes. Conclusion This study confirmed that, despite conflicting views on biological mesh, SIS mesh results in less inflammatory reaction, less adhesion formation, and a lesser degree of shrinkage, and can take its place in hernia repair.

Introduction/Objective. Introduction/Objective Following the failure of the single-wire technique in percutaneous coronary intervention (PCI) for chronic total occlusions (CTO), two principal anterograde escalation strategies are commonly employed: the parallel-wire technique and antegrade wire escalation (AWE). Despite their widespread use, comparative data on the procedural characteristics and long-term clinical outcomes of these strategies remain scarce. This study aims to compare the procedural parameters and long-term outcomes of the parallel-wire and AWE techniques after single-wire failure in CTO PCI. Methods. This retrospective, single-center study included patients who underwent successful CTO PCI between January 2018 and December 2023 using either the parallel-wire or AWE technique following single-wire failure. The primary endpoint was a composite of cardiac death, myocardial infarction, stroke, or target vessel revascularization (TVR). Secondary outcomes included procedure duration, fluoroscopy time, contrast volume, and total radiation dose. Median follow-up duration was 1222 days (IQR 580-1969 days). Results. Among 270 CTO PCI procedures, 112 (41.5%) required escalation: 90with AWE and 22 with the parallel-wire technique. Baseline clinical and angiographic characteristics were comparable. The primary composite outcome occurred in 14.4% of the parallel-wire group and 9.1% of the AWE group (p = 0.73). No significant differences were observed in individual clinical events. Procedure duration was longer (95.5 ? 43.6 vs. 77.0 ? 30.7 min; p = 0.064) and contrast volume higher (336.4 ? 113.3 vs. 271.6 ? 90.6 mL; p = 0.014) in the AWE group, with similar fluoroscopy time and radiation dose. No clinically or ?ngiographically significant complications occurred during the periprocedural period. Conclusion. Both AWE and parallel-wire techniques demonstrate comparable safety and efficacy following single-wire failure in CTO PCI. While procedural efficiency slightly favored the parallel-wire strategy, overall outcomes support either approach, pending further prospective validation.

Venous leg ulcers (VLUs) account for most lower extremity wounds. Wound management include cleansing, debridement, infection control and applying wound dressing. There exist various types of dressings which can maintain adequate moisture, offer protection, and support the reepithelization of VLUs. The aim of this study is to evaluate the cost-effectiveness of the antimicrobial wound dressing containing ionic silver (Aquacel® Ag+Extra™) in the treatment of VLUs compared to conventional gauze dressing in Serbia. The data regarding the effectiveness and frequency of dressings for both the Aquacel® Ag+Extra™ and conventional dressing were obtained from literature sources. Only direct costs were considered, and values were taken from the published price list of health services or procurement procedures. Sensitivity analyses were performed. The total cost per patient for Aquacel® Ag+Extra™ was 34,178.76 RSD, while the total cost for gauze was 82,800.90 RSD. Besides lower costs, antimicrobial wound dressing shows higher effectiveness than the gauze, implying that Aquacel® Ag+Extra™ is the dominant strategy. The sensitivity analysis supports the robustness of the results. The use of antimicrobial wound dressing containing ionic silver is the preferred option for the treatment of VLUs due to lower costs and the higher curing rate of the wounds.

The aim of this study was to analyze the clinical course and outcome of the disease in patients with chronic obstructive pulmonary disease (COPD) who were hospitalized at the Clinic for Infectious Diseases of the University Clinical Center of the Republic of Srpska (UCCRS), in the period from November 30, 2024 to April 1, 2025, due to confirmed influenza. The study included 125 hospitalized patients with microbiologically confirmed influenza. Among them, 20.8% had COPD, of which 48% were male and 52% female, with an average age of 68.6 years and the majority had influenza A (76%), while 24% had influenza B. The mortality rate among patients with COPD was 8%, compared to 32% in patients without COPD. Laboratory findings showed higher levels of C-reactive protein and procalcitonin in patients with COPD, indicating a more pronounced inflammatory response. Additionally, COPD patients had higher levels of D-dimer, suggesting an increased tendency toward thrombosis. Radiological analyses revealed various forms of pneumonia, with 48% of COPD patients showing negative radiological findings despite elevated CRP levels. Oxygen therapy and de-obstructive treatments were more frequently administered in COPD patients, while antibiotics were included in the treatment of all COPD patients. The results suggest the need for a specific therapeutic approach in this group of patients patient group. Also, vaccination against influenza is a key preventive measure that can prevent influenza, reduce the severity of the disease if it occurs, and improve the outcome, especially in patients with COPD, who are more susceptible to more serious complications.