Abstract Adaptation mechanisms as response to water content, oxygen level and pollutants are very important and they can be interpreted by hematological analysis. The aim of this study was the analysis of hematological and immune adaptations of common carp (Cyprinus carpio Linnaeus, 1758) to thermal stress. All specimens were divided into a control and experimental group. The control group of fish was exposed to a constant water temperature of 10°C. We induced thermal stress in experimental fish by gradually heating water to 28°C, held for 30 minutes and then comparing the obtained results with the control fish. Short-term hyperthermia lead to an increase of the number of leukocytes, especially pseudoeosinophilic granulocytes and monocytes, while the number of neutrophils and lymphocytes was reduced. The analysis of the leukocyte number and differential blood count in the control group showed high individual variation of segmented granulocytes, monocytes and pseudoeosinophilic granulocytes. Statistically significant differences (p=0.00) were found for the white blood cells, nonsegmented neutrophils and pseudoeosinophils between the control and experimental group. The experimental group of males had an increased number of white blood cells, monocytes and pseudoeosinophils, where significant differences were found for nonsegmented and total neutrophils and also for pseudoeosinophils (p=0.00), lymphocytes (p=0.01) and monocytes (p=0.03). Females had an increased total number of white blood cells, lymphocytes, monocytes and pseudoeosinophils, while significant differences (p=0.00) were obtained in the number of white blood cells, nonsegmented and total neutrophils and pseudoeosinophils between the control and experimental group. Adaptation mechanisms in carp after water temperature heating are mostly reflected in the increase of pseudoeosinophils and the decrease of neutrophils.

Objectives: The main objective of the study was to identify the most frequent isolates from female outpatients with urinary tract infection. Material and methods: The retrospective study was performed at the Department of Microbiology, Parasitology and Virology Faculty of Medicine, University of Sarajevo in period of 2015. The most frequent isolates were determined in 405 first urine samples from female outpatients of Hrasno community in Sarajevo, B&H. Identification of isolates was performed by the standard microbiological testing and the standard methods of descriptive statistics as well. Results: E. coli was identified with the frequency of (67.21%), followed by Proteus spp. (9.83%), Enterococcus faecalis (7.37%) and Enterobacter (5.73%). Pseudomonas aeruginosa and Pseudomonas spp. were found in (2.45%), while the frequency of Klebsiella spp., Streptococcus spp. and Acinetobacter spp. was lower (1.63%). Conclusions: The isolated strains of E. coli pointed the highest frequency among female outpatients of Hrasno community.

Introduction: Modern pediatric cardiology mainly deals with congenital heart defects (CHD), as the most common congenital anomalies. In most cases CHD requires surgical or interventional treatment. Goal: The goal of the research was to evaluate CHD treatment at Pediatric Clinic, University Clinical Center (UCC) Sarajevo, Bosnia and Herzegovina (B&H). UCC Sarajevo is the only institution in B&H where cardiac treatment of CHD in pediatric population is performed. Pediatric cardiosurgery has started to develop in Bosnia and Herzegovina in April 1997. Patients and methods: Study included 745 patients (period from April 1997 to January 2017). Results: Cardiac treatment was performed on 745 patients with CHD, 541 (72.6%) of them were acyanotic patients and 204 (27.4%) were cyanotic patients. Reoperation was performed in 49 (6.5%) of patients. Out of total number of patients, 59 (7.9%) died. In 660 children (88.5%) a complete correction and in 85 (11.5%) a palliative operation/correction was performed. Defects with left to right shunt were present in 397 (53.2%) patients, complex heart defects with Tetralogy of Fallot in 173 (23.2%), obstructive heart defects in 106 (14.2%), obstructive heart defects with shunt in 53 (7.1%), and others in 16 (2.1%) of patients. During surgery, extracorporeal circulation was regulated in 554 (74.3%) patients. Peri and early postoperative complications occurred in 180 (24.1%) of patients. During this period 24 pacemakers were implanted and 24 radiofrequency ablations were performed. Conclusion: Results of CHD cardiac treatment in childhood, which took place simultaneously, followed by the contractual joint programs and individual work of the Bosnian and Herzegovinian team has reached the highest level in the last two years, not only by the number, type and complexity of corrected CHD, but also by the age and body weight of the patients who underwent surgery, and development of invasive procedures, arrhytmology, pacemaker placement, intensive peri and postoperative treatment. That led pediatric cardiac surgery of UCC Sarajevo, to a position of leading center in the region.

Goal: The goal of this study was the determination of the effects in treatment of early stage (<IIB) and locally advanced stages (≥IIB) of uterine cervical carcinoma by using MRI. Material and Methods: The study was a prospective, comparative, analytical, and observational and included 74 patients with cervical cancer (PH confirmed). All 74 patients have initially gone through the pre-therapeutic MRI to determine the tumour FIGO stage. At a renewal of the initial MRI findings, patients were divided into two study groups: group A and group B. Group A consisted from 39 patients with early-stage cervical carcinoma (<IIB) and group B comprised from 35 patients with locally advanced stage (≥IIB). Postterapeutic MRI control, were perfomed in both group (A and B). Further MRI examinations were set for the patients from both groups. Results: An analysis of treatment outcomes in group A showed that most patients had no local recurrence or residuum disease in 89.7%, while local recurrence was observed in only 10.3% cases. An analysis of treatment outcomes in group B showed that most patients had complete regression after local chemoradiotherapy in 68.8%, while 25.7% of patients had local progression of the disease, while the 5.7% cases recorded partial local tumour regression(p<0.05). It has been shown that a complete local regression was more frequent in the case of squamous cell carcinoma in 74.2% vs 25% in adenocarcinoma cases. Also local and partial regression was observed more frequently in the case of squamous cell carcinoma in 6.5% compared to 0% in adenocarcinoma, while progression was more common in adenocarcinoma at 75% compared to 19.4% for squamous cell (p<0.05). MRI results showed positive outcome of treatment group A and B in our study, showed a statistically significant difference in favour of group A (89.7%) compared to group B 68.8% (p<0.05). Conclusion: The results obtained from our studies show that early stage cervical cancer (<IIB) shows a better outcome in treatment of advanced stages (≥IIB). In the treatment of advanced stages (≥IIB), concomitant radio chemotherapy shows significant results in terms of complete tumour regression, especially in squamous cell type of cervical cancer.

Objective: This study objective was to evaluate interobserver agreement between individual pairs of three nuclear medicine physicians in interpretation of renal cortical scintigraphy in children with respect to the mode of acquisition (planar vs. SPECT), diagnoses and kidney site (left vs. right). Materials and Methods: Thirty children were imaged in planar and SPECT mode per protocol upon the injection of Tc-99m DMSA dose adjusted to their body weight. Patients were classified according to diagnoses into four groups. Three nuclear medicine physicians interpreted the findings blindly and independently. Renal defects were interpreted as focal and diffuse, per three renal segments. For the raters we calculated simple percentage agreement, the Cohen kappa statistic with 95% confidence intervals, and the overall kappa defining the levels of reliability as almost perfect or perfect, substantial, moderate, fair and slight agreement. Results: Interobserver agreement in planar interpretation was 77,2% (kappa=0.59; 95% confidence interval, 0.41 to 0.75) and SPECT 72,9% (kappa= 0,57; 95% confidence interval, 0,41 to 0,72). In planar interpretation, all individual pairs had moderate agreements except one that had a substantial agreement. In SPECT, all the pairs had moderate agreements except one that had an almost perfect agreement. Overall agreement per kidney site was on planar 73,4% for the left (kappa=0,54, moderate agreement), and 81,1% for the right kidney (kappa 0,63, substantial agreement). On SPECT, there was 72,2% agreement for the left (kappa=0,59, mode rate agreement), and 73,7% for the right kidney (kappa=0,54, moderate agreement). Overall agreement per diagnoses ranged from 70-88,9% on planar (kappa= -0,04 to 0,79), and 50-100% on SPECT (kappa=-0,02-1,000) indicating agreements from slight to substantial. Discussion: Our results suggest acceptable levels of interobserver agreement in all individual pairs of raters with respect to the mode of acquisition (planar vs. SPECT), diagnoses and kidney site (left vs. right). For the mode of acquisition, we would recommend hybrid imaging SPECT/CT method to be used whenever possible in the detection of renal cortical defects on Tc-99m-DMSA scintigraphy.

Introduction: In recent years the quality of life of patients is very important in monitoring the treatment and therapeutic procedure success. It has become a significant factor in assessing the therapeutic procedure accomplishment, and for the first time the patient alone can access the success of the respective therapy. Cancer of the oral cavity is one of the most common cancers of the head and neck, and is one of the ten most common causes of death in the world. In the majority of cases, cancer of the oral cavity is detected in an advanced stage when therapeutic options are reduced, and the prognosis is much worse. Cancer of the oral cavity is 10 times more common in men. Assessment of quality of life should be an indicator of the multidisciplinary treatment success and it should point to areas in which the affected person requires support. Aim of the study: To examine the quality of life of patients with oral cavity cancer. Materials and methods: The study was conducted at the Clinic of Maxillofacial Surgery of the Clinical Center University of Sarajevo (CCUS), through a survey on patients with verified oral cavity cancer, questionnaire related to socio-demographic characteristics of the patients and the University of Washington Quality of Life Questionnaire (UW-QOL). The results were included in the database and statistically processed in the SPSS program, 19.0 version for Windows. Afterwards, the results were thoroughly analyzed and documented, presented in absolute numbers and statistical values using statistical indicators in simple and understandable tables and figures. Results: The study results showed that out of the total score of 100, the median value of quality of life of patients with oral cavity cancer, for the physical health component in the definition of quality was M=69.75 ±29.12 and for social-emotional health M=65.11 ± 27.47. Conclusion: This could be considered as satisfactory quality of life, in the sphere above half of the rating scale, although both values significantly deviate from the UW-QOL scale norm. Physical and socio-emotional health components are in a strong positive correlation, R2=0.750, p=0.0001.

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract and are generally asymptomatic. A 39-year-old female patient was hospitalized in 2012 at Clinical Department of Internal Medicine, Sestre milosrdnice University Hospital Center, for a focal hypodense irregular circular lesion located in segment III of the left hepatic lobe, accidentally found by ultrasonography and verified by computed tomography. The findings were also verified with nuclear magnetic resonance and esophagogastroduodenoscopy. A biopsy sample of the lesion was analyzed by histologic and immunohistochemical methods and identified as GIST. The patient underwent surgical operation (tumor excision with terminoterminal anastomosis created between the second segment of duodenum and jejunum and resection of liver segment III). The histopathologic findings matched GIST with a high probability of relapse according to the localization, size, mitotic activity and Ki-67 values. Therefore, therapy with imatinib at a dose of 400 mg/day was administered. Three years after the operation, the patient is still in remission.

Summary Anxiety, depression and fear in general are the most common emotional problems in people with cancer and it is necessary to recognize them. The patients’ attitude towards the side effects of chemotherapy has changed significantly in recent years and psychological effects, rather than physiological ones, are becoming increasingly important. The aim of this study was to develop and validate a reliable questionnaire that can measure cancer patients’ fear of the chemotherapy side effects (CheSeFS). A cross-sectional observational study involved 208 oncology and haematology patients at the Clinical Centre of Kragujevac, Serbia and the Institute for Oncology and Radiology of Vojvodina in Sremska Kamenica. The internal reliability of the questionnaire was estimated by calculating Cronbach's alpha coefficient, while the external reliability was calculated by the split-half method with approximately the same number of respondents. In order to test the construct validity of the CheSeFS, all participants filled out the Scale of Depression, Anxiety and Stress-21 (DASS-21) and the Short Subjective Well-being Scale (SSWS), validated in Serbian language. Cronbach’s α coefficient reveals strong internal consistency, with a value of 0.922. The questionnaire demonstrated good structure and uniformity when randomly split into two parts. Exploratory component analysis revealed two factors with the same number of items that explain 61.691% of variance. The components are objective physiological effects of the treatment, and factor that depends on the patient’s psychological and sociological status, with approximately the same percentage of variance. The CheSeFS was positively correlated with the DASS-21 scale (ϱ = 0.595, p = 0.000). CheSeFS is a unique, reliable and valid two-factor 14-item instrument, a clinically useful tool to assess fear of the chemotherapy side effects in cancer patients.

Summary The Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form is the most often used scale for measuring the quality of life of patients with psychiatric diseases. The aim of this research was to analyze the possibilities for measuring the quality of life in clinical conditions on the sample of patients with schizophrenia by using this scale. The study was conducted on the group including 153 patients with schizophrenia at the Institution for Accommodation of Adults “Male Pčelice”, Kragujevac. The study was observational and cross-sectional. The reliability of questionnaire was examined by using Cronbach’s alpha. The two tests of factor analysis adequacy were used, Spherical Bartlett’s Test and Keiser-Meyer-Olkin test (sampling adequacy). Validation was performed by calculating the correlation (validation by criteria). The Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form was reliable (Cronbach’s alpha coefficient was 0.730) and valid. According to Catell criterion two domains were applied. This two-component solution explained the total of 37.80% variance, whereby the contribution of the first domain was 27.1% and the second 10.7%. The Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form is suitable for everyday clinical evaluation of the patients with schizophrenia.

Introduction: Subarachnoid hemorrhage (SAH)represents hemorrhage in the space between arachnoidea and pia mater, due to aneurysm burst, spontaneously or as a consequence of trauma. It is condition that occurs more common in women than men, and its most common complications are rebleeding and vazospasm. As a result of vasospasm, develops ischemia in the portion of brain tissue that can cause additional neurological deficit. Transcranial Doppler Sonography (TCD) is a noninvasive ultrasound diagnostic method that allows monitoring of the state of intracerebral hemodynamics. Goal: The goal is to follow the occurrence of vasospasm after SAH, by the TCD method. Material and methods: We have analyzed 47 patients with SAH, by analyzing the presence of aneurysm, hypertension and smoking, and by the TCD method monitor the state of intracerebral hemodynamics during the first four days, then in the second and third week. Results: SAH was more common in women (61.7%) than men (38.3%), and in the age range from 22 to 64 years. Aneurism was demonstrated in 61.7% of patients, more common in women, with hypertension 68.1% also more common in women and smoking in 87.2% of patients, also more common in women. By TCD method are recorded milder, elevated blood flow velocities at a quarter of patients in the first measurement, during the second measurement at all and it had significantly greater value, and the third measurement also more increased in about a quarter of patients, so that there is a statistically significant difference in the first and second, second and third measurement for each vessel separately, but not between the first and third measurement. Conclusion: Predilection factors for SAH are aneurysms, hypertension and smoking. By using TCD method were recorded milder elevated blood flow velocity in the first days of SAH, with about a quarter of patients, significantly greater increase in blood flow velocity during the second week in all patients and also milder increase blood flow velocity in the third week of the start of SAH is a quarter of patients. TCD is the method of choice in the evaluation and management of vasospasm after SAH, which allows the prevention of delayed cerebral ischemia.