Aim This cross-sectional study of a group of women with abnormal cytology and high-risk human papillomavirus (hrHPV) infection compared genotyping HPV DNA and mRNA assays according to two age categories of women (S1: ≤30 and S2: >30 years). Methods The hrHPV DNA positive results of 105 cervical samples of women were pooled and those harbouring HPV-16, 18, 31, 33 and/or 45 DNA were tested for the type specific HPV oncogene E6/E7 overexpression (mRNA). Results Although HPV DNA testing showed a higher proportion of women infected by any of five hrHPVs in S1 group, total agreement of hrHPV DNA and mRNA positive results was higher in S2 group of women (75.8% v. 83.9%). The most prevalent type in both age groups was HPV-16. A 100% agreement of positivity of both tests was noted for HPV-18 and 33 in S1 group, and for HPV-18 in S2 group. Increasing concordance of HPV-16 and 31 DNA and mRNA positive results with the severity of cervical cytology was observed in S1 group of women. Absolute matching (100.0%) of positivity of both diagnostic tests was recorded in S2ASCUS group (for HPV-16, 18 and 33), in S1HSIL (for HPV-16, 18, 31 and 33), in S1LSIL category (for HPV-18 and 33) and in S2HSIL group (for HPV-18). Conclusion The results indicate the possibility of predicting the risk of persistent infection only by HPV DNA typing test, with no need for additional RNA testing in categories of infected women showing a high (absolute) agreement of positivity of both tests.

OBJECTIVE The aim of this research was to establish the incidence of smoking habits and the level of nicotine dependence in education workers in the Central Bosnia Canton (CBC). MATERIALS AND METHODS The research was conducted in the 2017/2018 school year. It covered education workers in all elementary (N=53) and high schools (N=23), in the area of the CBC. A total of 857 subjects were included. For the purpose of this research a special questionnaire was designed that included information on smoking, how long people had smoked, age and gender, smoking habits, and a modified Fagerstrom test for assessment of nicotine dependence. RESULTS In relation to smoking status, the subjects were divided into two categories: 646 (75.38%) non-smokers and 211 (24.62%) of those who declared themselves to be active smokers. All subjects were considered in relation to four age groups. The average age of the subjects was 42.14 years, and the average age of the subjects who were smokers was 43.61 years. Of the total number of smokers (n=211), the number of those who believed that the consumption of cigarettes by staff members encourages pupils to smoke was 76 (36.01%). The largest number of subjects (746, 87%) believed that during their time in school or the school yard, pupils are in a situation where they are able to see educational workers smoking. The degree of nicotine dependence in education workers in the CBC was mostly mild (53.55%, N=113) and then moderate (44.54%, N=94) and severe (1.89%, N=4). CONCLUSION There is a significant number of smokers (24.62%) amongst education workers in schools in the CBC. The level of nicotine dependence in education workers is most often mild (53.55%) then moderate (44.54%) and severe (1.89%).

Aim To evaluate the frequency of refractive errors in premature children in retinopathy of prematurity (ROP) screening to find mutual connection of the prematurity level, disease activity and refractive errors. Methods A retrospective study was conducted in the Eye Clinic of the University Clinical Centre Sarajevo, between December 2013 and January 2017. A total of 126 patients of gestational age ≤ 34 weeks and birth weight ≤ 2000 g underwent ROP screening program. The patients were divided into three groups: patients without ROP (n=15), patients with spontaneous regression (n=106) and those with active form of ROP (n=5). Results There were 68 (54.0%) patients with refractive errors: 45 (35.7%) had hyperopia, 17 (13.5%) myopia and six (4.8%) astigmatism. There were three (60.0%) patients with an active form of ROP who had refractive errors: two (40.0%) had myopia and one (20.0%) hyperopia. The group without active ROP had hyperopia as most frequent refractive error, with 10 (66.7%) patients. The average birth weight of the patients without refractive errors was 1403.9±43.4 g compared to 1390.3±104.2 g of the patients with refractive errors (p=0.498). The average gestational age was 29.7±0.3 weeks in patients without and 29.0 ± 0.3 weeks in patients with refractive errors (p=0.126). Conclusion The birth weight and the gestational age were significantly lower in patients with the active form of ROP. Lower gestational age and birth weight of premature children increase the chance for the development of refractive errors such as hyperopia in all premature children and myopia in patients with active form of ROP.

Aim To analyse available breastfeeding data in Croatia and to describe the process of gathering, collecting, recording and reporting on them to the official institutions. Methods Infant nutrition data collected at maternity wards and infant nutrition data from primary health care units during the period 2005 to 2016 have been used. Descriptive statistics was used to analyse the data and to show the trends in breastfeeding. Results More than 85% of newborns were exclusively breastfed in the maternity wards. Data on breastfeeding from primary health care showed growth in exclusive breastfeeding up to 2011, followed by a fall in 2013. From 2012, paediatric teams had the obligation to join information system (CEZIH), but electronic forms did not contain infant nutrition information. Similarly in the E-Newborn project (E-novorođenče) the question on the feeding method in the application was not designated as mandatory. Conclusion The routinely collected data on breastfeeding did not allow us to draw any conclusion regarding breastfeeding trends in Croatia. In order to improve the process of gathering, recording and reporting data on breastfeeding to the proper authorities, it would be necessary to clearly align definitions, employ a uniform methodology, and upgrade the computer applications in primary health-care. Only then may the reports required for compulsory health insurance be obtained via the CEZIH, as well as the public health reports necessary to monitor preventive work in care of children's health, and monitoring public health indicators.

OBJECTIVE The aim of the study was to evaluate knowledge and behavioural risks related to sexually transmitted infection (STIs) among high school students. METHODS The cross sectional study was conducted among students aged 15-18 years old from two high schools in the Sarajevo Canton in the period from October 2017 to March 2018. An anonymous self-administered questionnaire was used. The survey investigated their socio-demographic characteristics, sexual habits and level of knowledge about STIs. The data were analysed using SPSS version 25 and MS Excel 2016. RESULTS In total 278 high school students participated in the study, with a mean age of 17.79±1.026 years, of which 89 (32%) were male, and 189 (68%) were female. There was no significant difference in age in relation to sex distribution (P=0.074). Regarding the number of participants, 234 (84.2%) were from the dental school, while 44 (15.8%) were from a gimnazija (grammar high school). There was no significant difference in gender-based distribution by school (P=0.080). Students from the grammar high school had significantly better knowledge about the impact of STI on the foetus (P=0.025) and infected individuals (P=0.001), also about the impact of STI on sterility (P=0.005). CONCLUSION Our study confirmed the need for implementation of sexual education programs in the final grades of elementary school or in first grades of high school, aimed at improving knowledge of sexually transmitted infections and improving sexual and reproductive health.

Introduction: In this study we wanted to examine the hormonal responses due to stress exposure during laparoscopic cholecystectomy with standard (12-15 mm / Hg) (LCSP) and low (6-8 mm / Hg) (LCLP) intraabdominal pressure and open cholecystectomy (OC), with particular emphasis on stress hormone responses. Aim: Determination of adrenocorticotropic hormone (ACTH) and cortisol stress hormones before and after laparoscopic cholecystectomy with standard and low insufflation pressure, determination of ACTH and cortisol values before and after open cholecystectomy and comparison of ACTH and cortisol values between the patient sub-groups. Methods: In a prospective study conducted between July 2016 and February 2018, we involved 110 patients which were divided into two groups: 70 patients with laparoscopic cholecystectomy (LC) and 40 patients with open cholecystectomy (OC). The first group of patients was further divided into two subgroups of 35 patients, (subgroup LC with standard and subgroup LC with low intraabdominal pressure). All patients met the preset inclusion and exclusion criteria of the study. There were no statistically significant differences in the demographic characteristics of patients between the investigated groups. The stress hormones determined were adrenocorticotropic hormone (ACTH) and cortisol. Results: During the first, second and seventh day postoperative day (POD),ACTH values were significantly lower (p <0.0001) in LCLP than in LCSP and OC groups. This was also the case for comparison in LCSP and OC groups. By comparing LC and OC groups during first, the second and seventh POD, there was a significant difference (p <0.0001) in the ACTH levels. The concentration of this hormone was higher in the OC group in all three cases. The first, second and seventh POD were also statistically significant (p <0.0001) in cortisol values and between LC and OC groups there was an increase in cortisol levels in patients operated by open method. There was also a significant difference (p <0.0001) in cortisol values measured between LCLP and LCSP groups in the investigated days. Cortisol levels were higher in patients in the LCSP group. Conclusion: During open and laparoscopic cholecystectomy the response of the body to stress increased. The stress response of the organism during laparoscopic cholecystectomy was less than during open cholecystectomy. The stress response of the organism during laparoscopic cholecystectomy with low insufflation pressure ( 6-8mmHg) was less than during laparoscopic cholecystectomy with standard insufflation pressure (12-15mmHg).

Introduction: One of the most severe complications of atherosclerosis is arterial occlusive disease (AOD) and with diabetic angiopathy (DA), is a common chronic problem in clinical practice worldwide. Hyperbaric oxygen (HBO) therapy is a therapeutic modality for solving all forms of hypoxia. Aim: To compare the treatment with HBO therapy in patients with AOD and DA ischemic symptomatology with standard treatment i.e. vasodilators, antibiotics, antiplatelets and statins, and to demonstrate the benefit of the therapeutic modality itself. Methods: We conducted a clinical prospective study and included a total of 80 patients, divided into two groups: 40 patients with the arterial occlusive disease and lower-extremity wounds, with sub-group (n=20) treated with HBO therapy on the top of the standard therapy and 40 patients with diabetic angiopathy and diabetic lower-extremity wounds, with sub-group (n=20) treated with HBO therapy on top of the standard therapy. Results: The efficacy of therapy in patients treated with HBO therapy on the top of standard therapy was significantly higher than in the group of HBO non-treated patients. There was a significant improvement in 9 patients treated with HBO therapy, while in HBO non-treated patients the significant improvement effect was observed only in one patient. Conclusion: HBO therapy is an effective therapeutic component in the healing of diabetic lower-extremity wounds in the patients with AOD and DA. In our patients HBO therapy on the top of standard therapeutic protocol has an effect of reducing the number of lower-limb amputations in patients with AOD and DA. These results support clinical use of HBO therapy for diabetic lower-extremity wound healing.

OBJECTIVES In silico bioinformatical analysis suggested that the expression of two genes, CCL5 (C-C Motif Chemokine Receptor 5) and ep300 (Histone acetyltransferase p300), could be used as potential new biomarkers in differentiation between periapical granulomas and radicular cysts. Thus, we hypothesized that gene expression of CCL5 and ep300 in periapical lesions would classify the lesions as either granuloma or cyst. MATERIALS Patient samples (n=122) included 46 periapical granulomas, 38 radicular cysts and 38 healthy gingival samples as controls. Real-time PCR analysis of CCL5 and ep300 transcripts was compared to SDHA (Succinate dehydrogenase complex, subunit A) as the reference. Clinical parameters (e.g., intensity of inflammation and lesion size) were measured and correlated with CCL5 and ep300 expression. ROC (Receiver operating characteristic) and logistic regression analyses were used to establish the diagnostic character of ΔCt values. RESULTS Granulomas and radicular cysts had significantly higher expression of CCL5 and ep300 compared to controls (P<0.05). However, no differences were observed when comparing granulomas and radicular cysts. ROC analyses showed that CCL5 and ep300 have good diagnostic accuracy, but low accuracy for distinguishing between the lesions. CONCLUSIONS This study confirmed that expression of CCL5 and ep300 is relevant for the pathogenesis of periapical inflammatory lesions but cannot be used as a distinctive marker between these lesions.

OBJECTIVE Lysozyme is a natural antimicrobial and immunomodulatory enzyme, which is produced as a host response to infectious agents. The objective of this study was to compare the efficacy and safety of lysozyme-based versus benzydamine and chlorhexidinebased oral spray in patients with an acute tonsillopharyngitis associated with a common cold. PATIENTS AND METHODS A prospective twoarm pilot study (lysozyme/cetylpyridinium/lidocaine spray versus: benzydamine spray-arm 1; chlorhexidine/lidocaine spray-arm 2) was conducted in the primary health care unit. Efficacy was evaluated by the patient's self-assessment of pain, difficulty in swallowing and the throat swelling, by using the visual analog scale (VAS) at baseline and three follow-up visits. Safety was evaluated by the assessment of the frequency and severity of adverse effects. RESULTS Lysozyme-based spray reduced pain faster than benzydamine-based spray and slower than chlorhexidine-based spray. Lysozyme-based and chlorhexidinebased sprays similarly reduced difficulty in swallowing, but were faster than benzydamine-based spray. Similar effects on the reduction of throat swelling were seen in all treated groups. All tested products showed proper safety and were well tolerated, with no serious adverse events reported. CONCLUSIONS The lysozyme-based oral spray was shown to be effective and safe in the reduction of pain, difficulty in swallowing and throat swelling in patients with acute tonsillopharyngitis associated with a common cold. Lysozyme-based oral spray (containing natural compound with advantages of influencing immune system and preventing recurrences) had similar activity to benzydamine and chlorhexidine-based oral antiseptic sprays.

Aim To determine the prevalence of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) and its effect on 6-month cardiovascular outcomes. Methods This prospective study included 40 patients diagnosed with LMCAD, in the period from 2017 to 2018. The patients with LMCAD and low or intermediate SYNTAX score were randomized to PCI with zotarolimus-eluting stents versus CABG. Outcomes were analyzed according to the development of NOAF during the initial hospitalization following revascularization. Results Among 40 patients without atrial fibrillation on presentation, NOAF developed 3.1±1.3 days during hospitalization in three CABG treated patients, and one PCI treated patient. One patient that was CABG treated developed NOAF after two months. Patients with versus patients without NOAF had a significantly longer duration of hospitalization, probably because they were discharged on anticoagulant therapy. Myocardial infarction was presented in one CABG treated patient after 3 months, and also in one PCI treated patient after 4 months. One patient died 2 months after the operation, and one developed stroke 5 months after the CABG operation. Conclusion The NOAF was common after CABG, but extremely rare after PCI, and it occurred almost exclusively following CABG. There was a clear statistical tendency for all-cause death, cardiovascular death and stroke at 6-month follow-up period.

Introduction: Acute kidney injury (AKI) is one of the major public health issues with constantly increasing incidence, with epidemiology and outcomes that vary substantially across the world. Aim: Aim of our study was to determine epidemiological characteristics and causes of AKI and to provide a comparison of our findings with data from other low and middle income countries. Methods: This retrospective observational study conducted during an 18-month period included 84 patients. Data were collected from hospital information system and patients’ medical records. All data were analyzed using descriptive statistics. Results: More than two-thirds of patients were older than 56 years. Most cases of AKI (54,76%) were hospital-acquired and predominantly developed in intensive care units (32,14%). Dominant risk factor was underlying chronic kidney disease (48,81%) and chronic heart failure (45,24. In majority of patients (73,81%) were identified multiple factors that may have contributed to AKI: infection (90,48%), prerenal factors (77,38%), nephrotoxic agents (69,05%), and sepsis (28,57%). Multiple organ failure was identified in 94,05% of patients: cardiovascular (64,56%), respiratory (58,23%) and hematological (56,96%) system. Half of all patients were alive at last observation day. Leading cause of death was infection/sepsis (21,43%), followed by cancer (16,67%) and shock (14,28%). Conclusion: Data on AKI show great variation, but general picture of AKI resembles more that from high income countries. The need for dialysis and overall mortality remains high. This highlights the importance of early recognition of AKI, timely referral to nephrologist and need for national guidelines and standardized protocols for AKI.

Abstract Proteins diffuse to their sites of action within cells in a crowded, strongly interacting environment of nucleic acids and other macromolecules. An interesting question is how the highly crowded environment of biological cells affects the dynamic properties of passively diffusing particles. The Lorentz model is a generic model covering many of the aspects of transport in a heterogeneous environment. We investigate biologically relevant situations of immobile obstacles of various shapes and sizes. The Monte Carlo simulations for the diffusion of a tracer particle are carried out on a two-dimensional triangular lattice. Obstacles are represented by non-overlapping lattice shapes that are randomly placed on the lattice. Our simulation results indicate that the mean-square displacement displays anomalous transport for all obstacle shapes, which extends to infinite times at the corresponding percolation thresholds. In the vicinity of this critical density the diffusion coefficient vanishes according to a power law, with the same conductivity exponent for all obstacle shapes. At the fixed density of obstacles, we observe that the diffusion coefficient is higher for the smaller obstacles if the object size is defined as the highest projection of the object on one of the six directions on the triangular lattice. The dynamic exponent, which describes the anomalous transport at the critical density, is the same for all the obstacle shapes. Here we show that the values of critical exponents estimated for all disordered environments do not depend on the microscopic details of the present model, such as obstacle shape, and agree with the predicted values for the underlying percolation problem. We also provide the evidence for a divergent non-Gaussian parameter close to the percolation transition for all obstacle shapes.