AIM Acute kidney injury (AKI) presents a high mortality complication in patients with acute myocardial infarction (AMI). Yet, its correlation with non-ST elevation myocardial infarction (NSTEMI) remains neglected in the literature. This study aims to investigate the prevalence, risk factors, clinical features, and short-term outcomes associated with AKI development in patients with acute NSTEMI. METHODS A one-year prospective observational cohort study involved 170 consecutive patients hospitalized in the Intensive Care Department of the Internal Medicine Clinic at the University Clinical Centre Tuzla diagnosed with acute NSTEMI. Patients were subsequently categorized into AKI and non-AKI groups based on AKI development within 48 hours. Demographic characteristics, laboratory findings, and short-term clinical outcomes were compared between the groups. RESULTS Of 170 patients, 31 (18.2%) developed AKI within 48 hours of acute NSTEMI. Significant age differences, blood urea nitrogen (BUN), creatinine, estimated glomerular filtration rate (eGFR), blood glucose level (BGL), C-reactive protein (CRP), and high sensitivity (hs) troponin were observed, making patients with lower baseline kidney function, more extensive myocardial infarction, and a heavier systemic inflammatory response following acute NSTEMI more susceptible to AKI development. In the follow-up period, mortality rates were significantly higher in the AKI group, amounting to 35.5% compared to 10.1% in the non-AKI group. Additionally, mortality increased with the severity of AKI, reaching 100% in AKI stage 2. CONCLUSION This study highlights demographic, clinical and laboratory findings in patients with acute NSTEMI, which contribute to AKI development. Early detection and tailored interventions are crucial in mitigating AKI-associated morbidity and mortality.

ABSTRACT Background: The triglyceride/high-density lipoprotein (TG/HDL) ratio emerges as a promising marker for cardiovascular risk. However, the relationship between overall serum lipid levels and hemorrhagic stroke (HS) remains uncertain. Therefore, our study aims to explore the association between this novel index and mortality in HS patients. Methods: Utilizing a retrospective-prospective framework from January 2020 to August 2023, we scrutinized data from 104 hospitalized patients diagnosed with HS, with particular attention to their medical backgrounds and lipid profiles. Results: Age (odds ratio [OR], 1.078; 95% confidence interval [CI], 1.032–1.125; P = 0.001), atrial fibrillation (OR, 0.237; 95% CI, 0.074–0.760; P = 0.015), glucose level (OR, 1.121; 95% CI, 1.007–1.247; P = 0.037), and TG/HDL index (OR, 0.368; 95% CI, 0.173–0.863; P = 0.020) emerged as independent predictors for in-hospital mortality, as determined by both univariable and multivariable logistic regression analyses. Conclusion: Our results add weight to the growing evidence backing the utility of the TG/HDL index in assessing cardiovascular risk among HS patients. They emphasize the necessity of adopting a comprehensive risk assessment and management strategy that incorporates both traditional markers and novel indicators.

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Background and Objectives: This study aimed to investigate the novel adiponectin–resistin (AR) index as a predictor of the development of metabolic syndrome (MetS) in individuals with type 2 diabetes mellitus (T2DM). MetS is common in T2DM and increases cardiovascular risk. Adiponectin and resistin, adipokines with opposing effects on insulin sensitivity and inflammation, make the AR index a potential marker for metabolic risk. Materials and Methods: This prospective observational study included 80 T2DM participants (ages 30–60) from Sarajevo, Bosnia and Herzegovina, over 24 months. The participants were divided into two groups: T2DM with MetS (n = 48) and T2DM without MetS (n = 32). Anthropometric data, biochemical analyses, and serum levels of adiponectin and resistin were measured at baseline and every six months. The AR index was calculated using the formula AR = 1 + log10(R) − 1 + log10(A), where R and A represent resistin and adiponectin concentrations. Logistic regression identified predictors of MetS. Results: T2DM patients who developed MetS showed a significant decline in adiponectin levels (40.19 to 32.49 ng/mL, p = 0.02) and a rise in resistin levels (284.50 to 315.21 pg/mL, p = 0.001). The AR index increased from 2.85 to 2.98 (p = 0.001). The AR index and resistin were independent predictors of MetS after 18 months, with the AR index showing a stronger predictive value (p = 0.007; EXP(B) = 1.265). Conclusions: The AR index is a practical marker for predicting MetS development in T2DM participants, improving metabolic risk stratification. Incorporating it into clinical assessments may enhance early detection and treatment strategies.

Cationic nanostructured lipid carriers (cNLCs) represent promising non-viral carriers for nucleic acids, such as miRNAs, forming stable self-assembled miRNA complexes due to electrostatic interactions. Prepared by high-pressure homogenization, cNLC formulations, both with and without Nile Red dye demonstrated stable particle sizes in the range of 100-120 nm and positive surface charges (> 30 mV), which are necessary for effective cellular uptake. The miRNA complexes formed at mass ratios of 1:2.5 and 1:5 showed similar stability and size, with positive zeta potentials, as well as high cell viability (> 80%) in 3T3-L1 and MCF-7 cell lines. The cellular uptake studies of miRNA:cNLC complexes in both cell lines revealed that uptake was time- and concentration-dependent, with rapid initial uptake in 30 minutes and a zig-zag pattern over 24 hours. To elucidate the endocytosis mechanism of miRNA:cNLC complexes, 3T3-L1 and MCF-7 cells were incubated with different inhibitors (chlorpromazine, 5-[N-ethyl-N-isopropyl] amiloride, dynasore, nystatin, or sodium azide with 2-deoxy-D-glucose). Results showed significant inhibition of uptake at low temperatures and with ATP depletion, suggesting endocytosis, particularly macropinocytosis, as the main uptake mechanism in 3T3-L1 cells. In MCF-7 cells, the uptake was less inhibited by the substances, indicating the need for more specific methods to fully decipher the endocytic mechanisms involved. Confocal laser scanning microscopy images revealed that the complexes are internalized in vesicles, and are primarily localized in the juxtanuclear region, suggesting trafficking through the endolysosomal system. Colocalization study with LysoTracker™ Green DND-26 showed significant colocalization of miRNA:cNLC complexes with lysosomes in 3T3-L1 cells, indicating trafficking through the endolysosomal system. In MCF-7 cells, colocalization was lower, suggesting macropinocytosis as the primary uptake mechanism. Additional studies showed partial colocalization between labeled NLCs and miRNA, indicating that about 50% of miRNA is released from NLCs within 30 minutes post-transfection.

OBJECTIVES Testicular torsion (TT) is an emergency requiring timely surgery to prevent testicular loss. There is a lack of reports on the clinical significance of the time of admission (on-hours vs. off-hours) on the long-term surgical outcome of TT. METHODS We retrospectively reviewed all consecutive patients <18 years who were admitted to the hospital and treated for TT during the ten years. Patients were classified according to their admission time: weekday (on-hours), outside working hours, and weekends (off-hours). They were also classified based on their testicular outcome: salvaged and non-salvaged testis. RESULTS Seventy-two patients were included. Their median age was 14.2 years. Thirty-three patients (46 %) were admitted during on-hours, whereas 39 patients (54 %) were admitted during off-hours. Forty-three patients (59.7 %) required orchidopexy and, out of those, during the long-term follow-up, only 27 (37.5 %) had definitive testicular salvage. Forty-five patients (62.5 %) were with no testicular salvage. On-hours vs. off-hours admission had no impact on the clinical outcome (p = 0.25). However, significant differences in the duration of symptoms (DoS) between the orchidopexy and orchidectomy groups were observed (p < 0.001). CONCLUSION Testicular torsion is a time-dependent diagnosis, and any delay in treatment could cause testicular loss. Our data suggest that the DoS before admission, rather than the admission time, influences the testicular outcome. The efficient management of emergencies regardless of the time of day is a key factor for the reduced probability that admission timing affects outcomes.

Objective: Ventricular arrhythmias are the primary arrhythmias that cause sudden cardiac death. We address the problem of classification between ventricular tachycardia (VT), ventricular fibrillation (VF) and non-ventricular rhythms (NVR). Methods: To address the challenging problem of the discrimination between VT and VF, we develop similarity maps – a novel set of features designed to capture regularity within an ECG trace. These similarity maps are combined with features extracted through learnable Parzen band-pass filters and derivative features to discriminate between VT, VF, and NVR. To combine the benefits of these different features, we propose a hierarchical multi-stream ResNet34 architecture. Results: Our empirical results demonstrate that the similarity maps significantly improve the accuracy of distinguishing between VT and VF. Overall, the proposed approach achieves an average class sensitivity of 89.68%, and individual class sensitivities of 81.46% for VT, 89.29% for VF, and 98.28% for NVR. Conclusion: The proposed method achieves a high accuracy of ventricular arrhythmia detection and classification. Significance: Correct detection and classification of ventricular fibrillation and ventricular tachycardia are essential for effective intervention and for the development of new therapies and translational medicine.

Bariatric surgery has emerged as the most effective treatment for morbid obesity, offering substantial and sustained weight loss and improvement in comorbid conditions. This paper reviews the development, implementation, and outcomes of bariatric surgery at the University and Clinical Centre Tuzla based on a retrospective analysis of patients who underwent bariatric surgery over a three-year period. A significant weight loss was observed, postoperative complications were minimal, with no in-hospital mortality. The bariatric surgery program demonstrates a significant progress in treating morbid obesity in Bosnia and Herzegovina.

Background/Objectives: The study of microbiome composition shows positive indications for application in the diagnosis and treatment of many conditions and diseases. One such condition is autism spectrum disorder (ASD). We aimed to analyze gut microbiome samples from children in Bosnia and Herzegovina to identify microbial differences between neurotypical children and those with ASD. Additionally, we developed machine learning classifiers to differentiate between the two groups using microbial abundance and predicted functional pathways. Methods: A total of 60 gut microbiome samples (16S rRNA sequences) were analyzed, with 44 from children with ASD and 16 from neurotypical children. Four machine learning algorithms (Random Forest, Support Vector Classification, Gradient Boosting, and Extremely Randomized Tree Classifier) were applied to create eight classification models based on bacterial abundance at the genus level and KEGG pathways. Model accuracy was evaluated, and an external dataset was introduced to test model generalizability. Results: The highest classification accuracy (80%) was achieved with Random Forest and Extremely Randomized Tree Classifier using genus-level taxa. The Random Forest model also performed well (78%) with KEGG pathways. When tested on an independent dataset, the model maintained high accuracy (79%), confirming its generalizability. Conclusions: This study identified significant microbial differences between neurotypical children and children with ASD. Machine learning classifiers, particularly Random Forest and Extremely Randomized Tree Classifier, achieved strong accuracy. Validation with external data demonstrated that the models could generalize across different datasets, highlighting their potential use.

Red fox, Vulpes vulpes, is a globally distributed species characterized by its high adaptability to diverse habitats and a broad range of food resources. This remarkable adaptability has allowed the red fox to thrive in various environments, from urban areas to remote wilderness. In this study, we used a set of microsatellite markers for the comparative genetic analysis of red fox populations from two countries. We included populations from the Eastern Alps and the northern Dinaric Mountains in Slovenia, as well as the Central Dinaric Mountains in Bosnia and Herzegovina. We successfully isolated DNA and genotyped 118 red fox samples. Our analyses, which included Bayesian clustering techniques, revealed a weak genetic differentiation among the studied populations. However, it is noteworthy that statistically significant differences in estimates of genetic differentiation were only apparent when comparing the populations between the two countries. Further spatial genetic clustering analyses provided additional insights, unveiling a differentiation into four genetic clusters. These clusters comprised two distinct groups in Bosnia and Herzegovina and two in Slovenia. This pattern of differentiation suggests that isolation by distance is a key factor influencing the genetic structure of the red fox in this studied region. Additionally, our findings highlighted that populations from the Alps and northern Dinaric Mountains exhibit higher genetic diversity and observed heterozygosity compared to their counterparts in the Central Dinaric Mountains. The genetic diversity is also notable when compared to other European red fox populations. Studying genetic diversity is crucial for the resilience and adaptability of populations, ensuring their survival amid environmental changes and human-induced pressures.