The goal of research was to determine the frequency, intensity, time of occurrence, duration and causes of breakthrough pain (BTP) in patients whose carcinoma pain was treated by transdermal fentanyl. (TDF). A prospective study was conducted in a hospice for recumbent patients of the Centre for Palliative Care (hospice) University Clinical Centre Tuzla from October 2009 to December 2010. 33 patients in terminal stage of carcinoma, who had been treated by transdermal fentanyl due to their excruciating pain (7-10 mark on numerical scale) with initial dosage of 25 microg as a strong opiate analgesic, were monitored within the time period of 10 days. In the statistics we used the even T - test, the Wilcox test and Mann-Whitney test. The difference was seen to be significant at p < 0.05. Treatment by transdermal fentanyl significantly reduces the intensity of strong carcinoma pain (p < 0.0001), with a frequent requirement for dose increase with bone metastasis. The intensity of BTP is higher compared to the pain experienced upon reception. The frequency and intensity of BTP are significantly reduced already in the second day of treatment by transdermal fentanyl (p = 0.0024). The BTP is most intense in patients with neck and head tumours (9.26 +/- 0.66), and most frequent with abdomen and pelvic tumour. The biggest number of BTP (68.3 %) occurs within first three days of treatment. BTP most frequently occurs in the evening or at night (between 18:00 and 06:00 h in 62.2 % of the cases), with the duration of usually less than 15 minutes (65.2 % of the cases). In 61.6 % cases the occurrence of BTP is related to physical activities or psychosocial incidents, while the cause is undetermined in 38.4 % of examinees. BTP is most frequent within first three days of treatment by TDF. Using the optimal dosage a good control of carcinoma pain is enabled, regardless of the occurrence of bone metastasis, while it also helps reduce the frequency and intensity of BTP.

The aims of the study were to estimate the prevalence of excessive weight in infants and school-age children in Sarajevo Canton, to isolate the main causative agents and to propose a strategy for its efficient prevention. The methods included anthropometry and originally designed questionnaire. Calculated body mass index was classified according to the criteria proposed by Centre for Disease Control and Prevention (CDC). The research included 3608 students from elementary and secondary schools from Sarajevo Canton. Nearly 1/5 of subjects had excessive body weight while 12.49% of students were malnourished. Elementary school lower graders had the highest grade of excessive weight, while the secondary school students exhibited the lowest grade of excessive weight. During school hours, about 42.47% of students were fed on bakery produces and snacks. Non-sparkling, thickened juices are frequently consumed beverages (20.65%), second only to water (51.82%). 58.15% of children consume sweets on daily basis. This is even more prominent among secondary school students (80.85%). Only 1/3 of students practice sports on daily basis, while 8.51% of them rarely engage in sports. Elementary school lower grade students had the lowest level of activity while the secondary school students were the most active. As many as 27.56% students spend two hours or more sitting by the computer or TV set. The most significant mediators of excessive weight gain are sedentary life-style, frequent consumption of sweets and thickened juices and unsuitable nutrition during school hours. Continuous preventive and therapeutically activities must be undertaken among as wide population as possible.

The aim of this study was to assess echocardiographic changes in female patients with untreated dysfunctional thyroid states and whether the therapy aimed to normalize the thyroid dysfunction could lead to improvement in cardiac systolic and diastolic function. The study included 90 female subjects who performed control of thyroid hormonal status at the Institute of Nuclear Medicine at the University of Sarajevo Clinics Centre and who previously were untreated for the thyroid functional disorders. The study sample was divided in three groups based on the thyroid hormones levels: a) hyperthyroid group (n= 30) b) hypothyroid group (n=30) and c) euthyroid (control). Echocardiography measurements were performed on commercially available Toshiba, SSH 140. Before the therapy no statistically significant differences in the peak early and late mitral inflow velocities (E/A) values between the study groups was observed, but the mean left ventricular ejection fraction (LVEF) in hypothyroid group was significantly lower (58.30+/-1.05) compared to control (64.96+/-0.71) and hyperthyroid group (64.69+/-1.31) (p<0.001). In hypothyroid group we found significant increase in mean LVEF (58.30+/-1.05 vs. 64.95+/-0.86, p<0.01) and E/A (1.06+/-0.07 vs. 1.17+/-0.08; p=0.01) values after the normalization of thyroid hormone status.Thyroid dysfunctional states were not associated with impaired diastolic function, probably due to the short duration of thyroid dysfunction and timely and successful conversion therapy. Systolic function however was significantly reduced in hypothyroid patients but subsequently improved after the adequate therapy. Early diagnostic approach in patients with thyroid dysfunctional states is important for avoidance of cardiac complications that accompany these disorders.

Diabetes mellitus type 1 is a chronic metabolic disorder, and its main characteristic is Hyperglycemia. It usually occurs in the early years because of the absolute or relative absence of the active insulin that is caused by the autoimmune disease of the beta cells of the pancreas. Despite the numerous researches and efforts of the scientists, the therapy for Diabetes type 1 is based on the substitution of insulin. Even though the principles of the therapy have not changed so much, still some important changes have occurred in the production and usage of insulin. Lately, the insulin pumps are more frequent in the therapy for Diabetes type 1. The functioning of the pump is based on the continuing delivery of insulin in a small dose ("the basal dose"), that keeps the level of glycemia in the blood constant. The increase of glycemia during the meal is reduced with the additional dose of insulin ("the bolus dose"). The use of the insulin pumps and the continuing glucose sensors has provided an easier and more efficient monitoring of the diabetes, a better metabolic control and a better life quality for the patient and his/her family. This work presents the way of automatic regulation of the basal dose of insulin through the synthesis of the functions of the insulin pump and the continuing glucose sensor. The aim is to give a contribution to the development of the controlling algorithm on the insulin pump for the automatic regulation of the glucose concentration in the blood. This could be a step further which is closer to the delivery of the dose of insulin that is really needed for the basic needs of the organism, and a significant contribution is given to the development of the artificial pancreas.

The open prospective combined cytogenetic and clinical study investigated the impact of biological therapy Rituximab on number and structure of chromosomes in Rheumatoid arthritis patients. The purpose of this study was to investigate safety of Rituximab on chromosomes as well as cytotoxic therapy Methotrexate. A total of 8 seropositive Rheumatoid arthritis patients were analyzed for primary end point of eventual cytotoxic effect of Rituximab. Assessment was done before and 1 month later, actually 2 weeks after the administration of full course of Rituximab in infusion. Patients suffering from active Rheumatoid arthritis were randomly assigned according to established protocol to receive infusion of Rituximab in a full dose of 2.0 grams divided in a two doses of 1.0 gram on days 1 and 15. The lymphocytes from peripheral blood were cultured according to Moorhead method. The results obtained from this investigation showed that normal male and female karyogram was found after the full therapy of Rituximab. The results from this study, that was done on a rather small number of subjects, indicate that Rituximab does not express either clastogenic or aneugenic effects. But, co-finding of this study was that Methotrexate had a side effect on chromosomal aberration in one female RA patient, and after discontinuation of this treatment the normal karyogram was observed.

We evaluated possible roles of interleukin-8 gene polymorphisms (1633T/C-rs2227543, 251A/T-rs4073) and interleukin-18 gene polymorphisms (-607C/A-rs1946518, -137G/C-rs187238) in the development of diabetic retinopathy (DR) in Caucasians with type 2 diabetes. 271 patients with DR and 113 without diabetic retinopathy were enrolled in this cross-sectional study. We did not observe an association between either interleukin-8 gene polymorphisms (1633T/C, 251A/T) or interleukin-18 gene polymorphisms (-607C/A, -137G/C) and diabetic retinopathy in Caucasians with type 2 diabetes. We did not find statistically significant differences in interleukin-8 serum levels between diabetics with the TT and AA genotype and those with other genotypes. The interleukin-18 serum levels between diabetics with the CC genotype of the -607C/A polymorphism and those with other genotypes (AA, AC) were not significantly different. Moreover, we did not observe a statistically significant effect of the tested polymorphisms of either interleukin-8 or interleukin-18 genes on serum levels in diabetics. In conclusion, our study indicates that the examined polymorphisms of interleukin-8 (1633T/C, 251A/T) and interleukin-18 (-607C/A or the -137G/C) genes are not genetic risk factors for diabetic retinopathy. Therefore, they may not be used as genetic markers for diabetic retinopathy in Caucasians with type 2 diabetes.

We read with great interest the article by Tang et al published in issue 4 of World Journal of Gastroenterology 2010. The results of their study indicate that percutaneous catheter drainage in combination with choledochoscope-guided debridement is a simple, safe and reliable treatment procedure for peripancreatic infections secondary to severe acute pancreatitis. However, there are some points that need to be addressed, including data about the patients in the study and their clinical characteristics, data about infection and superinfection during the treatment and type of treatment of patients with acute necrotizing pancreatitis.