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Papers by Azra Husic-selimovic
Background: Heteromorphic variants including Yq12 material, being inserted or added to autosomal ... more Background: Heteromorphic variants including Yq12 material, being inserted or added to autosomal chromosomes have been reported for chromosomes 1, 7, 11, 13, 14, 15, 21 and 22. Here we describe a novel insertion of Yq12 heterochromatin into a chromosome 17; to the best of our knowledge no similar cases have been reported previously. Methods: GTG-, C-banding, fluorescence in situ hybridization (FISH), and homemade human heterochromatin specific multicolor FISH probes set (HCM-mix) were used to define the abnormality. A whole chromosome painting (wcp) probe for #17 together with a probe for Yq12 heterochromatin was hybridized to the patient sample. Additionally, Y microdeletion PCR was done to detect possible AZF subregional deletions. Results: The male patient had normal sperm analysis and no AZF deletions on Y chromosome. GTG and Cbanding showed an additional band on chromosome 17q21. FISH studies revealed that the insertion was derived from Yq12 heterochromatin. Conclusions: The heterochromatin insertion on 17q21 originating from Yq12 chromosome did not affect the spermatogenesis of aberration carrier and is probably not the cause of infertility in these partners. However, a new heteromorphic variant was identified in this case.
Diseases, Oct 4, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Clinical Gastroenterology and Hepatology, 2019
BACKGROUND & AIMS: Despite recent advances in treatment of viral hepatitis, liver-related mortali... more BACKGROUND & AIMS: Despite recent advances in treatment of viral hepatitis, liver-related mortality is high, possibly owing to the large burden of advanced alcohol-related liver disease (ALD). We investigated whether patients with ALD are initially seen at later stages of disease development than patients with hepatitis C virus (HCV) infection or other etiologies.
PubMed, Jun 1, 2022
Background: The Brixia scoring system interpreted chest X-ray changes, serves as an indicator of ... more Background: The Brixia scoring system interpreted chest X-ray changes, serves as an indicator of the extent of changes in the lung parenchyma. Objective: To indicate the effect of D-dimer and C-reactive protein (CRP) on Brixia score in patients with positive polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: The research had prospective, descriptive and analytical character, and included patients (n=104) with Coronavirus disease 2019 (COVID-19) diagnosis. Chest X-ray, as well as calculation of Brixia score was done on admission, in the first week of hospitalization, on discharge, and 10 days after discharge (the patient was considered a post-COVID patient. Maximum CRP and D-dimer values were taken into account, along with data about dependence of mechanical ventilation and oxygen therapy. Results: Initial Brixia score was significantly associated with the values of CRP (r = .23, p <.05). Higher level of CRP affected the higher result on the Brixia score after the initial X-ray. High CRP and D-dimer were significantly associated with oxygen use in patients, while high D-dimer was also statistically significantly associated with comorbidity. The mean value of Brixia score (during four time points) was significantly related to the values of CRP, D-dimer, the use of mechanical ventilation and oxygen therapy, but also with the existence of comorbidities. The largest statistically significant positive correlation of Brixia scora is with the values of D-dimer (r = .45, p <.000), but also with the values of CRP (r = .36, p <.000). Conclusion: Values of CRP have an impact on Brixia score. Investigation of clinical characteristics and outcomes of severe clinical presentation of COVID-19 along with CXR scoring system will contribute to early prediction, accurate diagnosis and treatment as well as to improve the prognosis of patients with severe illness.
Bosnian Journal of Basic Medical Sciences, Aug 20, 2006
The aim of the study was to ascertain presence of Helicobacter pylori in gastric carcinoma as a r... more The aim of the study was to ascertain presence of Helicobacter pylori in gastric carcinoma as a responsible promoter of inflammatory-regenerative changes, which lead to pathological differentiation and transformation of normal epithelial cells into intestinal type and, in progression, cause epithelial dysplasia that develops into early gastric carcinoma. The paper presents prospective study that includes clinical, pathohistological and microbiological aspects of carcinogenesis initiation in gastric mucosa. The subjects are patients treated at Gastroenterohepatology Clinic divided into two groups. One group included patients with gastric carcinoma while the control group included patients with chronic atrophic H. pylori positive gastritis. All the patients were subjected to endoscopy as well as biopsy targeted at antrum, lesser curvature and corpus and at the region - cm removed from tumor lesion. We used HUT test to verify H. pylori presence in biopsy samples. We analyzed the samples for presence, frequency and severity of inflammatory-regenerative, metaplastic and dysplastic changes in gastric mucosa and evaluated their meaning for the prognosis. Our study confirmed Helicobaster pylori responsibility for inflammatory events in gastric mucosa in patients with gastric carcinoma. Slight and mild epithelial dysplasia with chronic atrophic gastritis grade I and II coupled with intestinal metaplasia may be considered an indicator for early detection of carcinoma. Such patients represent risk group for gastric carcinoma development.
PubMed, 2003
In chronic HBV infection, studies of outcome have shown that successful antiviral treatment under... more In chronic HBV infection, studies of outcome have shown that successful antiviral treatment undertaken early in course of diseases, may improve health and quality of life. Aims of treatment are: decrease of aminotransferase level to normal, histological necroinflammatory reduction, sustain loss of HbeAg and HBV DNA, antibodies on Hbe occurrence and loss of HbsAg with complete eradication of viral infection. Three therapeutical options are available: thymosine, lamivudine and standard interferon alpha. In future options, promising results are expecting from pegylated interferon, adefovire and entecavire.
PubMed, 2003
Advantages in diagnostic and treatment of hepatitis C during the last decade have changed the fin... more Advantages in diagnostic and treatment of hepatitis C during the last decade have changed the final outcome of disease. Most important improvements were: development of sensitive, specific and standardized tests for hepatitis C nucleic acid identification, combined treatment with ribavirin and alpha interferon, pegylation of alpha interferon and prove that sustained viral response is optimal surrogate for treatment outcome. Combination of pegyinterferon and ribavirin offered the most efficacious and most suitable treatment with SVR between 54-56%. Results are still dependent of viral genotype and viral load. Due to possible side effects appropriate patient seletion is mandatory.
PubMed, 2004
Recent achievements in fields of physics, microelectronical devices and informatical sciences ope... more Recent achievements in fields of physics, microelectronical devices and informatical sciences opened huge possibilities of applications in medical specialities. Spread imaging over routine high-resolution instruments continue to be in focus of scientific researches varying from simple staining techniques to most sophisticated photodynamical techniques. Magnetic resonance imaging and computed tomography are radiological specialties, however; we mentioned them for promising achievements in computed data analysis and further improvements of virtual colonoscopy. During the last few years techniques of magnifying endoscopy have been improved including trials with narrow band endoscopy, autoflourescence endoscopy, elastic scattering spectroscopy and laser confocal microscopy. In many indications capsula endoscopy have been applied successfully.
PubMed, 2005
Introduction: Endoscopic ultrasonography (EUS) is a well-established method of evaluating patient... more Introduction: Endoscopic ultrasonography (EUS) is a well-established method of evaluating patients with gastrointestinal diseases, especially malignancies. EUS is like other similar endoscopy techniques, based on high frequency ultrasonography. This high level technology allows examination of tissue to almost microscopic level, not only in digestive system but its surrounding structures. Objective: The aim of this study was to determine the contribution of endoscopic experience, based on the number of endosopic ultrasonography examination performed in the three years period, to obtain 80% diagnostic accuracy with staging of the disease in order to achieve a 30-60% change rate in treatment decisions which is accepted standard. Results: First group with 210 patients was examined in the first year of work; 325 examined in the second year of work and 295 in the third year. Diagnostic: Accuracy in the first year of work, were 45% (p<0.001 for the choledocholithiasis; p=0.197 for the pancreatic cancer; p=0.195 for LN detection in the gastric cancer). In the second year of work diagnostic accuracy were 78%/p=0.550 for the choledocholithiasis; p=0.228 for the pancreatic cancer; p=0.503 for LN detection in the gastric cancer/. Diagnostic accuracy in the third year of work were 81%/p<0.001 for the choledocholithiasis; p=0.018 for the pancreatic carcinoma; p=0.042 LN detection in the gastric cancer/. Conclusion: Application of Endoscopic ultrasonography in diagnostics, based on number of EUS examination performed, after three years of work, achieved 80% diagnostic accuracy, compared to standard imaging methods and results of surgery in staging of the disease. EUS results made a change in treatment decisions in 30-60% of patients which is world standard and completely justify use of endoscopic ultrasonography in clinical practice.
Journal of US-China Medical Science, Sep 25, 2010
Background and Aims: Hepatic steatosis seems to be a risk factor for poor response to interferon ... more Background and Aims: Hepatic steatosis seems to be a risk factor for poor response to interferon and ribavirin therapy in patients with chronic hepatitis C. The aim of this study was to determine presence of hepatic steatosis in chronic hepatitis C and its influence on early virological response in patients treated with combined antiviral therapy (pegylated interferon and ribavirin). Methods: We studied 96 patients treated at Gastroenterohepatology Department, in the period of four years (2005-2009). There were 71 males and 25 females enrolled in this study. 72 patients had genotype 1, 5 patients had genotype 2, 17 patients had genotype 3 and 2 patients had genotype 4. Liver histology was evaluated in order to establish presence of inflammation, fibrosis and steatosis. HCV RNA levels in sera were measured by real time PCR. Early virological response (EVR) was defined as negative serum HCV RNA at week 12. In order to measure the effect influence of steatosis on early response to therapy, as well as genotype and response to therapy, we calculated relative risk and the corresponding p-value after 12 and 48 weeks. Results: The overall rate of EVR was 70%. The rate was significantly lower in the group with steatosis, regardless of the presence of micro or macrosteatosis, amounting to 60%. Serum cholesterol level was significantly higher in females than in males (7.4±0.7 vs. 5.1±0.3 mg/mL). The values of relative risks (and p-values) for effect of steatosis on the response are RRS12=8.4615 (2.87E-05), and RRS48=0.9844 (0.7399), while the values for the effect of genotype to therapy were RRG12=1.3378 (0.7543), and RRG48=3.5862 (0.2709). Conclusions: Our findings suggested that hepatic steatosis may have a strong influence on interferon therapy response in the sence that it is eight times more probable to not respond in the presence of steatosis. The presence of steatosis was highly associated with progressive disease and failure to achieve the EVR; therefore it can be a predictor of poor response to antiviral therapy.
Kliničko zapažanje UVOD DWI/ADC kod MRI ima sve veće značenje jer se pokazuje kao senziti van par... more Kliničko zapažanje UVOD DWI/ADC kod MRI ima sve veće značenje jer se pokazuje kao senziti van parametar za mikroskopsku karakterizaciju tkiva i pruža jedinstvene kvantitativne informacije o celularnosti fokalnih jetrenih lezija (1). DWI postiže kontrastnost slike zahvaljujući slobodnom mikroskopskom (Brownovom) gibanju molekula vode u tkivu. U biološkim tkivima kretanje vode zavisi o odnosu tkivnih odjeljaka, staničnih membrana i unutarstaničnih organela. Zbog mobilnosti i viskoznosti molekule vode mogu biti evaluirane kao i odnos u intracelularnom i ekstracelularnom prostoru. Slikovni prikaz difuzije nudi mogućnost anatomske i funkcionalne karakterizacije lezija neovisno o primjeni kon-trastnih sredstava, koristeći koei cijent difuzije na ADC karti in vivo. U MRI praksi se često i nakon primjene kontrasnog sredstva događaju dileme u karakterizaciji jetrenih lezija. Upotreba DWI dodatno poboljšava dijagnostiku i time smanjuje broj dijagnostičkih punkcija ili nepotrebnog dijagnostičkog praćenja. Osobito je značajna kod pacijenata kod kojih je kontraindicirana primjena kontrastnog sredstva (2-4). CILJ RADA Cilj rada bio je ispitati mogućnosti i korist mjerenja ADC vrijednosti (apparent dif usion coei cient) s me
PubMed, Sep 1, 2016
The aim of this study was to examine the possibilities of measuring ADC/DWI values with the ROI m... more The aim of this study was to examine the possibilities of measuring ADC/DWI values with the ROI method for precise differentiation of focal liver lesions from normal liver parenchyma. The study included 100 liver lesions sized ≥1 cm, previously detected in patients by ultrasound and computed tomography. It is done by measuring the diffusion coefficient ADC folder (MRI 3T), setting the ROI on the periphery of hepatic lesions, on the liver parenchyma around the focal hepatic lesions and on liver parenchyma that is distant to hepatic lesions. In our study, difference between the average ADC value of focal liver lesions (1.24 x10(-3) mm(2)/s) and normal liver parenchyma around focal liver lesions (1.001x10(-3) mm(2)/s) was statistically confirmed. There was statistically proven difference in the average ADC values between normal liver parenchyma around focal lesions and liver parenchyma located distant from focal lesions of (1.003x10-3 mm2/s). Wilcoxon rank test yielded differences in the average (median) ADC values between total lesions in patients and liver parenchyma directly around focal lesions (p<0.0005). Wilcoxon rank test showed no differences in the average (median) ADC between liver parenchyma directly around focal lesions and distant of focal hepatic lesions (p<0.0005). The results obtained for each focal liver lesion were compared with histopathology findings obtained by puncture or surgery, and for cystic lesions radiological follow up was sufficient. For all liver lesions, the resulting overall DWI/ADC sensitivity was 92% and specificity 77%. Kendall’s tau-b coefficient of concordance showed a statistically significant correlation between our DWI diagnosis and histopathology verification for all liver lesions (p<0.0005). He mangiomas and cysts showed greatest difference in ADC values as compared with healthy liver. ADC values of hepatocellular carcinoma (HCC) and the surrounding normal liver parenchyma were not statistically different, which can be explained by similarities in their cell structure. Related articles conclude that DWI has inadequate sensitivity in detecting HCC, explaining this minimal difference in cellularity of well differentiated HCC and liver parenchyma. DWI/ADC has the potential to differentiate and reliably define the limits of focal lesions of the normal liver parenchyma. ADC delimitation of focal lesions of the liver parenchyma is most reliable for hemangiomas and cysts, while ADC delimitation of HCC can pose diagnostic difficulties.
Medicinski arhiv, 2018
Introduction: Prior to the 1990s, the most common sources of HCV infections were blood transfusio... more Introduction: Prior to the 1990s, the most common sources of HCV infections were blood transfusions, unsafe injections and I.V drug use. Screening of blood products for HCV has eradicated transfusion-transmitted hepatitis C in most countries since 1992-in Bosnia and Herzegovina, however, since 1995, due to the war. Aim: To investigate the impact of the source of HCV infection on the therapeutic response in patients treated for chronic HCV infection with dual combined therapy. Methods: We diagnosed chronic HCV infections amongst 246 patients over a period of five years and selected them according to the reported source of infection. Pegylated interferon alfa 2a or alfa 2b with ribavirin was administered during the time that was genotype-dependent. HCV RNA levels in sera were measured by real time PCR. Liver histology was evaluated in accordance with the level of necroinflammation activity and the stadium of fibrosis. Results: Regardless of the genotype of the virus and the source of infection, SVR was achieved in 67% of the patients. Therapeutic response (ETR) was not achieved in 25% of the patients who were infected with an untested blood transfusion and 6% of the patients who had had wartime surgery. Amongst the different sources of infections, patients with a war-surgery source of infection responded better to therapy than those with a blood transfusion source of infection (p = 0.023). A blood transfusion source of infection implies a larger fibrosis stage than in blood donors; (g = 1.177; s 2 = 0.577). A blood transfusion source of infection implies a significantly larger necroinflammatory activity than in blood donors; (g = 1.456; s 2 = 0.618). Conclusions: An untested blood transfusion was a significant risk factor for more advanced liver diseases in regards to necroinflammatory activity and the fibrosis stage. This source of infection was also a risk factor for low responses to antiviral therapy. At the same time, I.V. drug users had more progressive necroinflammatory activity, but a high therapeutic response to antiviral therapy.
Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : časopis Društva za medicinsku informatiku BiH, 2016
The aim of the study is to define the MRI appearance of disorder in the Junctional zone (JZ) in w... more The aim of the study is to define the MRI appearance of disorder in the Junctional zone (JZ) in women with adenomyosis compared to those without it, given the importance of the JZ in the regulation of various reproductive events. Materials and methods: This was a prospective, comparative and open study. Patients with adenomyosis have been sorted in target group, n = 82, while the control group consisted of patients without adenomyosis, n = 82. All patients, from both groups have undergone a magnetic resonance imaging of the pelvis. Using a software tool for measurement, the thickness of the JZ was measured in T2w sag sequences in all patients from both groups (target and control) n = 164. Patients in the target group type adenomyosis were assessed and categorized either as: diffuse, focal, or Adenomyoma and the results were compared. The presence of endometriosis and myomas in both groups was evaluated and its coexistence with adenomyosis was analyzed as well. Results: Of the 82 patients in the target group, 81.7% of the patients had diffuse adenomyosis, while 18.3% had focal type with statistically significant difference (p <0.05). The results of the Mann-Whitney U test showed that p <0.05, implying that there is a statistically significant difference in the thickness of the JZ between the control and target group, therefore patients from the target group with adenomyosis had a statistically significantly thicker junctional zone than the patients in the control group. The JZ in the target group was on average M = 14,3mm, SD = 1.3mm, while the thickness of JZ in the control group without adenomyosis was M = 5,6mm, SD = 1,3. Chi-square shows that p <0.05, implying that there is a statistically significant difference in the number of patients with myomas between the two groups, where the myomas significantly over-represented in the target group with 32,9 % vs.6 %). Conclusion: MRI is the method of choice for imaging and evaluation of JZ as an important diagnostic marker in the diagnosis of adenomyosis. It is important to recognize this condition as early as possible and distinguish it from other pathologies in order for timely and appropriate treatment.
Bosnian Journal of Basic Medical Sciences, Aug 20, 2009
Th e role of ferritin in fi brogenesis of liver parenchyma in patients with alcoholic liver disea... more Th e role of ferritin in fi brogenesis of liver parenchyma in patients with alcoholic liver disease has been investigated in previous studies. Ferritin was shown to be an indirect marker of ferum deposition in liver parenchyma in alcohol liver disease. Th e aim of the present study was to examine the role of nitric oxide (NO) in the pathogenesis of alcoholic liver disease as well as the infl uence of NO on iron (ferritin) metabolism in patients with alcoholic liver disease. Serum concentrations of NO and iron markers (iron, total iron binding capacity, ferritin) were measured in male patients (aged - years) with alcoholic liver disease, as well as from a control group ( male patients (aged - years) without liver disease). NO concentration was detected by measuring production of nitrates and nitrites using classical colorimetric Griess reactions. Th ere was a statistically signifi cant increase in serum NO concentration in patients with alcoholic liver disease compared to the control group (mean ± SEM; , ± , vs. , ± , mmol/dm , respectively; p<,). Similarly, serum iron levels (, ± , vs. , ± , g/ cm , respectively; p<,) and serum total iron binding capacity (, ± , vs. , ± , μmol/dm , respectively; p<,) were also significantly higher in patients with alcoholic liver disease compared to control patients. Th e serum concentration of ferritin was higher in patients with alcoholic liver disease than in the control group; however this was not statistically signifi cant (, ± , vs. , ± , g, respectively; p<,). Th ere was no correlation between NO and ferritin in the investigated groups. Th ese results suggest a possible role of NO and iron in the pathogenesis of alcoholic liver disease. NO and iron may be used as non-invasive predictors of liver damage. Also the role of iron in sera, and its deposition in liver parenchyma, could be used in clinical practice, especially in regards to assessing the fi brogenesis of liver parenchyma induced by ferritin.
Medicinski arhiv, 2020
Introduction:Upper gastrointestinal bleeding can be a life-threatening condition and requires car... more Introduction:Upper gastrointestinal bleeding can be a life-threatening condition and requires careful evaluation from the very first episode in order to reduce the risk of rebleeding, hemorrhagic shock and death. The outcome of a patient with upper gastrointestinal bleeding depends on resuscitation measures taken during admission to the hospital and an adequate assessment of the patient’s risk level.Aim:The aim of the study is to compare Glasgow Blatchford score and Rockall score and to identify the most accurate score used in predicting unfavorable outcomes and the need for intervention.Methods:This study involves 237 patients with upper gastrointestinal bleeding. The accuracy of the scoring systems was assessed by plotting receiver-operating characteristic curves (ROC curves) and was calculated for GBS and RS with 95% confidence interval (CI).Results:As for mortality prediction, RS was superior to GBS (AUC 0.806 vs. 0.750). The GBS had a higher accuracy in detecting patients who needed transfusion units and was superior to the RS (AUC 0.810 vs.0.675). In predicting the need for intervention, RS was superior to GBS (AUC 0.707 vs. 0.636.Conclusion:GBS and RS are developed to help clinicians to triage patients appropriately in order to assess endoscopic therapy within a suitable time frame, as well as identify low risk patients for possible outpatient management. High accuracy of the GBS in predicting a need for transfusion represents an important endpoint to assess. RS was superior to GBS in predicting a need for intervention as well as mortality. Currently, a combination of these scoring systems is the best way for proper assessment.
Medicinski arhiv, 2016
Introduction: Renin-angiotenzin system (RAS) is frequently activated in patients with chronic liv... more Introduction: Renin-angiotenzin system (RAS) is frequently activated in patients with chronic liver disease. Angiotenzin-II (AT-II), produced by angiotenzin converting enzyme (ACE), has many physiological effects, including an important role in liver fibrogenesis. Combined antiviral therapy with PEG-IFN and ribavirin besides its antiviral effect also leads to a reduction in liver parenchyma fibrosis. Aim of the study: Determining the value of ACE in serum of patients with chronic hepatitis C before and after combined antiviral therapy, as well as the value of ACE activities in sera of the control group. Materials and methods: We studied 50 patients treated at Gastroenterohepatology Department, in the time-period of four years. Value of ACE in serum was determined by Olympus AU 400 device, with application of kit "Infinity TN ACE Liquid Stable Reagent". HCV RNA levels in sera were measured by real time PCR. HCV RNA test was performed with modular analysis of AMPLICOR and COBAS AMPLICOR HCV MONITOR test v2.0, which has proved infection and was used for quantification of the viruses and monitoring of the patients' response to therapy. Liver histology was evaluated in accordance with the level of necroinflammation activity and stage of fibrosis. Results: Serum activities of ACE in chronic hepatitis C patients is statistically higher than the values in the control group (p=0.02). Antiviral therapy in chronic hepatitis C patients statistically decreases serum activities of ACE (p= 0.02) and indirectly affects fibrogenesis of the liver parenchyma. Correlation between ACE and ALT activity after the therapy was proved (0.3934). Conclusion: Our findings suggest that the activity of ACE in serum is a good indirect parameter of the liver damage, and could be used as an indirect prognostic factor of the level of liver parenchyma damage. Serum activity of ACE can be used as a parameter for non-invasive assessment of intensity of liver damage.
Bosnian Journal of Basic Medical Sciences, Nov 20, 2006
Th e aim of the study was to ascertain the existence of intestinal metaplasia in gastric mucosa o... more Th e aim of the study was to ascertain the existence of intestinal metaplasia in gastric mucosa of patients with gastric carcinoma coupled with H. pylori positive chronic atrophic gastritis and possible connection of IM with the development of gastric carcinoma. Th e paper presents prospective study that included patients with gastric carcinoma and patients with chronic atrophic H. pylori positive gastritis. All the patients were subjected to gastroscopy as well as biopsy targeted at antrum, lesser curvature and corpus and at the area - cm removed from tumor lesion. Biopsy samples were sliced by microtome and stained. We analyzed presence, frequency and severity of infl ammatory-regenerative, metaplastic and dysplastic changes in the mucosa and evaluated their prognostic value. We typed IM immunohistochemically. Th is study confi rmed responsibility of H. pylori for infl ammatory events in gastric mucosa in patients with gastric carcinoma. According to our fi ndings incomplete IM of types IIa and IIb as precancerous lesion is responsible for the development of gastric carcinoma and is associated with chronic atrophic gastritis grade I and II ( of subjects, p=,, h=, p=,). Th us, the fi nding of incomplete intestinal metaplasia may be used as an indicator for early gastric carcinoma detection. Patients with patho-histologicaly verifi ed incomplete intestinal metaplasia associated with active chronic atrophic gastritis of levels I and II represent risk group for the development of gastric carcinoma of intestinal type. KEY WORDS:intestinal metaplasia (IM), epithelial dysplasia, Helicobacter pylori (H. pylori), chronic atrophic gastritis (CAG).
Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : časopis Društva za medicinsku informatiku BiH, 2012
Medicinski arhiv, 2013
I ntroduction: Ulcerative colitis (UC) is a common disease with a chronic and relapsing presentat... more I ntroduction: Ulcerative colitis (UC) is a common disease with a chronic and relapsing presentation requiring regular clinical follow up. Epidemiological and microbiologic studies suggest that enteropathogenic microorganisms play a substantial role in the clinical presentation and extent of inflammatory bowel disease. Goal: To evaluate the presence of intestinal infections by Entamoeba hystolitica in patients with ulcerative colitis, their impact on clinical outcome, and to identify associated risk factors. Material and methods: A total of 31 patients hospitalized on Gastroenterohepatology Department with patohystologically proved ulcerative colitis were studied. Fresh feces samples taken from 20 patients were examined immediately using Eosin and Lugol-staining methods and analyzing the presence of vegetative and MIFC (Meriolat and Iod staining). Results: A total of 16 female and 15 male hospitalized UC patients were analysed in a period of two years (2010-2011). The mean age at diagnosis was 43 years. We analyzed relation of amoeba infection with localization of ulcerative colitis. Our results indicate that amoeba infection is related to extent of disease (they were mostly present in pancolitis). Presence of amoeba is not related to age nor gender. Furthermore, presence of amoeba was not associated with more severe clinical course of disease. Similarly, higher value of serum marker of inflammation was not associated with amoeba infection. Discussion and conclusion: Amoeba infections in UC patients treated at Gastroenterohepatology Department was not related to the grade of disease activity, and other clinical variables such as gender, age and parameters of inflammation. These microorganisms could be a contributing cause of extended localization of disease.
Background: Heteromorphic variants including Yq12 material, being inserted or added to autosomal ... more Background: Heteromorphic variants including Yq12 material, being inserted or added to autosomal chromosomes have been reported for chromosomes 1, 7, 11, 13, 14, 15, 21 and 22. Here we describe a novel insertion of Yq12 heterochromatin into a chromosome 17; to the best of our knowledge no similar cases have been reported previously. Methods: GTG-, C-banding, fluorescence in situ hybridization (FISH), and homemade human heterochromatin specific multicolor FISH probes set (HCM-mix) were used to define the abnormality. A whole chromosome painting (wcp) probe for #17 together with a probe for Yq12 heterochromatin was hybridized to the patient sample. Additionally, Y microdeletion PCR was done to detect possible AZF subregional deletions. Results: The male patient had normal sperm analysis and no AZF deletions on Y chromosome. GTG and Cbanding showed an additional band on chromosome 17q21. FISH studies revealed that the insertion was derived from Yq12 heterochromatin. Conclusions: The heterochromatin insertion on 17q21 originating from Yq12 chromosome did not affect the spermatogenesis of aberration carrier and is probably not the cause of infertility in these partners. However, a new heteromorphic variant was identified in this case.
Diseases, Oct 4, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Clinical Gastroenterology and Hepatology, 2019
BACKGROUND & AIMS: Despite recent advances in treatment of viral hepatitis, liver-related mortali... more BACKGROUND & AIMS: Despite recent advances in treatment of viral hepatitis, liver-related mortality is high, possibly owing to the large burden of advanced alcohol-related liver disease (ALD). We investigated whether patients with ALD are initially seen at later stages of disease development than patients with hepatitis C virus (HCV) infection or other etiologies.
PubMed, Jun 1, 2022
Background: The Brixia scoring system interpreted chest X-ray changes, serves as an indicator of ... more Background: The Brixia scoring system interpreted chest X-ray changes, serves as an indicator of the extent of changes in the lung parenchyma. Objective: To indicate the effect of D-dimer and C-reactive protein (CRP) on Brixia score in patients with positive polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: The research had prospective, descriptive and analytical character, and included patients (n=104) with Coronavirus disease 2019 (COVID-19) diagnosis. Chest X-ray, as well as calculation of Brixia score was done on admission, in the first week of hospitalization, on discharge, and 10 days after discharge (the patient was considered a post-COVID patient. Maximum CRP and D-dimer values were taken into account, along with data about dependence of mechanical ventilation and oxygen therapy. Results: Initial Brixia score was significantly associated with the values of CRP (r = .23, p <.05). Higher level of CRP affected the higher result on the Brixia score after the initial X-ray. High CRP and D-dimer were significantly associated with oxygen use in patients, while high D-dimer was also statistically significantly associated with comorbidity. The mean value of Brixia score (during four time points) was significantly related to the values of CRP, D-dimer, the use of mechanical ventilation and oxygen therapy, but also with the existence of comorbidities. The largest statistically significant positive correlation of Brixia scora is with the values of D-dimer (r = .45, p <.000), but also with the values of CRP (r = .36, p <.000). Conclusion: Values of CRP have an impact on Brixia score. Investigation of clinical characteristics and outcomes of severe clinical presentation of COVID-19 along with CXR scoring system will contribute to early prediction, accurate diagnosis and treatment as well as to improve the prognosis of patients with severe illness.
Bosnian Journal of Basic Medical Sciences, Aug 20, 2006
The aim of the study was to ascertain presence of Helicobacter pylori in gastric carcinoma as a r... more The aim of the study was to ascertain presence of Helicobacter pylori in gastric carcinoma as a responsible promoter of inflammatory-regenerative changes, which lead to pathological differentiation and transformation of normal epithelial cells into intestinal type and, in progression, cause epithelial dysplasia that develops into early gastric carcinoma. The paper presents prospective study that includes clinical, pathohistological and microbiological aspects of carcinogenesis initiation in gastric mucosa. The subjects are patients treated at Gastroenterohepatology Clinic divided into two groups. One group included patients with gastric carcinoma while the control group included patients with chronic atrophic H. pylori positive gastritis. All the patients were subjected to endoscopy as well as biopsy targeted at antrum, lesser curvature and corpus and at the region - cm removed from tumor lesion. We used HUT test to verify H. pylori presence in biopsy samples. We analyzed the samples for presence, frequency and severity of inflammatory-regenerative, metaplastic and dysplastic changes in gastric mucosa and evaluated their meaning for the prognosis. Our study confirmed Helicobaster pylori responsibility for inflammatory events in gastric mucosa in patients with gastric carcinoma. Slight and mild epithelial dysplasia with chronic atrophic gastritis grade I and II coupled with intestinal metaplasia may be considered an indicator for early detection of carcinoma. Such patients represent risk group for gastric carcinoma development.
PubMed, 2003
In chronic HBV infection, studies of outcome have shown that successful antiviral treatment under... more In chronic HBV infection, studies of outcome have shown that successful antiviral treatment undertaken early in course of diseases, may improve health and quality of life. Aims of treatment are: decrease of aminotransferase level to normal, histological necroinflammatory reduction, sustain loss of HbeAg and HBV DNA, antibodies on Hbe occurrence and loss of HbsAg with complete eradication of viral infection. Three therapeutical options are available: thymosine, lamivudine and standard interferon alpha. In future options, promising results are expecting from pegylated interferon, adefovire and entecavire.
PubMed, 2003
Advantages in diagnostic and treatment of hepatitis C during the last decade have changed the fin... more Advantages in diagnostic and treatment of hepatitis C during the last decade have changed the final outcome of disease. Most important improvements were: development of sensitive, specific and standardized tests for hepatitis C nucleic acid identification, combined treatment with ribavirin and alpha interferon, pegylation of alpha interferon and prove that sustained viral response is optimal surrogate for treatment outcome. Combination of pegyinterferon and ribavirin offered the most efficacious and most suitable treatment with SVR between 54-56%. Results are still dependent of viral genotype and viral load. Due to possible side effects appropriate patient seletion is mandatory.
PubMed, 2004
Recent achievements in fields of physics, microelectronical devices and informatical sciences ope... more Recent achievements in fields of physics, microelectronical devices and informatical sciences opened huge possibilities of applications in medical specialities. Spread imaging over routine high-resolution instruments continue to be in focus of scientific researches varying from simple staining techniques to most sophisticated photodynamical techniques. Magnetic resonance imaging and computed tomography are radiological specialties, however; we mentioned them for promising achievements in computed data analysis and further improvements of virtual colonoscopy. During the last few years techniques of magnifying endoscopy have been improved including trials with narrow band endoscopy, autoflourescence endoscopy, elastic scattering spectroscopy and laser confocal microscopy. In many indications capsula endoscopy have been applied successfully.
PubMed, 2005
Introduction: Endoscopic ultrasonography (EUS) is a well-established method of evaluating patient... more Introduction: Endoscopic ultrasonography (EUS) is a well-established method of evaluating patients with gastrointestinal diseases, especially malignancies. EUS is like other similar endoscopy techniques, based on high frequency ultrasonography. This high level technology allows examination of tissue to almost microscopic level, not only in digestive system but its surrounding structures. Objective: The aim of this study was to determine the contribution of endoscopic experience, based on the number of endosopic ultrasonography examination performed in the three years period, to obtain 80% diagnostic accuracy with staging of the disease in order to achieve a 30-60% change rate in treatment decisions which is accepted standard. Results: First group with 210 patients was examined in the first year of work; 325 examined in the second year of work and 295 in the third year. Diagnostic: Accuracy in the first year of work, were 45% (p<0.001 for the choledocholithiasis; p=0.197 for the pancreatic cancer; p=0.195 for LN detection in the gastric cancer). In the second year of work diagnostic accuracy were 78%/p=0.550 for the choledocholithiasis; p=0.228 for the pancreatic cancer; p=0.503 for LN detection in the gastric cancer/. Diagnostic accuracy in the third year of work were 81%/p<0.001 for the choledocholithiasis; p=0.018 for the pancreatic carcinoma; p=0.042 LN detection in the gastric cancer/. Conclusion: Application of Endoscopic ultrasonography in diagnostics, based on number of EUS examination performed, after three years of work, achieved 80% diagnostic accuracy, compared to standard imaging methods and results of surgery in staging of the disease. EUS results made a change in treatment decisions in 30-60% of patients which is world standard and completely justify use of endoscopic ultrasonography in clinical practice.
Journal of US-China Medical Science, Sep 25, 2010
Background and Aims: Hepatic steatosis seems to be a risk factor for poor response to interferon ... more Background and Aims: Hepatic steatosis seems to be a risk factor for poor response to interferon and ribavirin therapy in patients with chronic hepatitis C. The aim of this study was to determine presence of hepatic steatosis in chronic hepatitis C and its influence on early virological response in patients treated with combined antiviral therapy (pegylated interferon and ribavirin). Methods: We studied 96 patients treated at Gastroenterohepatology Department, in the period of four years (2005-2009). There were 71 males and 25 females enrolled in this study. 72 patients had genotype 1, 5 patients had genotype 2, 17 patients had genotype 3 and 2 patients had genotype 4. Liver histology was evaluated in order to establish presence of inflammation, fibrosis and steatosis. HCV RNA levels in sera were measured by real time PCR. Early virological response (EVR) was defined as negative serum HCV RNA at week 12. In order to measure the effect influence of steatosis on early response to therapy, as well as genotype and response to therapy, we calculated relative risk and the corresponding p-value after 12 and 48 weeks. Results: The overall rate of EVR was 70%. The rate was significantly lower in the group with steatosis, regardless of the presence of micro or macrosteatosis, amounting to 60%. Serum cholesterol level was significantly higher in females than in males (7.4±0.7 vs. 5.1±0.3 mg/mL). The values of relative risks (and p-values) for effect of steatosis on the response are RRS12=8.4615 (2.87E-05), and RRS48=0.9844 (0.7399), while the values for the effect of genotype to therapy were RRG12=1.3378 (0.7543), and RRG48=3.5862 (0.2709). Conclusions: Our findings suggested that hepatic steatosis may have a strong influence on interferon therapy response in the sence that it is eight times more probable to not respond in the presence of steatosis. The presence of steatosis was highly associated with progressive disease and failure to achieve the EVR; therefore it can be a predictor of poor response to antiviral therapy.
Kliničko zapažanje UVOD DWI/ADC kod MRI ima sve veće značenje jer se pokazuje kao senziti van par... more Kliničko zapažanje UVOD DWI/ADC kod MRI ima sve veće značenje jer se pokazuje kao senziti van parametar za mikroskopsku karakterizaciju tkiva i pruža jedinstvene kvantitativne informacije o celularnosti fokalnih jetrenih lezija (1). DWI postiže kontrastnost slike zahvaljujući slobodnom mikroskopskom (Brownovom) gibanju molekula vode u tkivu. U biološkim tkivima kretanje vode zavisi o odnosu tkivnih odjeljaka, staničnih membrana i unutarstaničnih organela. Zbog mobilnosti i viskoznosti molekule vode mogu biti evaluirane kao i odnos u intracelularnom i ekstracelularnom prostoru. Slikovni prikaz difuzije nudi mogućnost anatomske i funkcionalne karakterizacije lezija neovisno o primjeni kon-trastnih sredstava, koristeći koei cijent difuzije na ADC karti in vivo. U MRI praksi se često i nakon primjene kontrasnog sredstva događaju dileme u karakterizaciji jetrenih lezija. Upotreba DWI dodatno poboljšava dijagnostiku i time smanjuje broj dijagnostičkih punkcija ili nepotrebnog dijagnostičkog praćenja. Osobito je značajna kod pacijenata kod kojih je kontraindicirana primjena kontrastnog sredstva (2-4). CILJ RADA Cilj rada bio je ispitati mogućnosti i korist mjerenja ADC vrijednosti (apparent dif usion coei cient) s me
PubMed, Sep 1, 2016
The aim of this study was to examine the possibilities of measuring ADC/DWI values with the ROI m... more The aim of this study was to examine the possibilities of measuring ADC/DWI values with the ROI method for precise differentiation of focal liver lesions from normal liver parenchyma. The study included 100 liver lesions sized ≥1 cm, previously detected in patients by ultrasound and computed tomography. It is done by measuring the diffusion coefficient ADC folder (MRI 3T), setting the ROI on the periphery of hepatic lesions, on the liver parenchyma around the focal hepatic lesions and on liver parenchyma that is distant to hepatic lesions. In our study, difference between the average ADC value of focal liver lesions (1.24 x10(-3) mm(2)/s) and normal liver parenchyma around focal liver lesions (1.001x10(-3) mm(2)/s) was statistically confirmed. There was statistically proven difference in the average ADC values between normal liver parenchyma around focal lesions and liver parenchyma located distant from focal lesions of (1.003x10-3 mm2/s). Wilcoxon rank test yielded differences in the average (median) ADC values between total lesions in patients and liver parenchyma directly around focal lesions (p<0.0005). Wilcoxon rank test showed no differences in the average (median) ADC between liver parenchyma directly around focal lesions and distant of focal hepatic lesions (p<0.0005). The results obtained for each focal liver lesion were compared with histopathology findings obtained by puncture or surgery, and for cystic lesions radiological follow up was sufficient. For all liver lesions, the resulting overall DWI/ADC sensitivity was 92% and specificity 77%. Kendall’s tau-b coefficient of concordance showed a statistically significant correlation between our DWI diagnosis and histopathology verification for all liver lesions (p<0.0005). He mangiomas and cysts showed greatest difference in ADC values as compared with healthy liver. ADC values of hepatocellular carcinoma (HCC) and the surrounding normal liver parenchyma were not statistically different, which can be explained by similarities in their cell structure. Related articles conclude that DWI has inadequate sensitivity in detecting HCC, explaining this minimal difference in cellularity of well differentiated HCC and liver parenchyma. DWI/ADC has the potential to differentiate and reliably define the limits of focal lesions of the normal liver parenchyma. ADC delimitation of focal lesions of the liver parenchyma is most reliable for hemangiomas and cysts, while ADC delimitation of HCC can pose diagnostic difficulties.
Medicinski arhiv, 2018
Introduction: Prior to the 1990s, the most common sources of HCV infections were blood transfusio... more Introduction: Prior to the 1990s, the most common sources of HCV infections were blood transfusions, unsafe injections and I.V drug use. Screening of blood products for HCV has eradicated transfusion-transmitted hepatitis C in most countries since 1992-in Bosnia and Herzegovina, however, since 1995, due to the war. Aim: To investigate the impact of the source of HCV infection on the therapeutic response in patients treated for chronic HCV infection with dual combined therapy. Methods: We diagnosed chronic HCV infections amongst 246 patients over a period of five years and selected them according to the reported source of infection. Pegylated interferon alfa 2a or alfa 2b with ribavirin was administered during the time that was genotype-dependent. HCV RNA levels in sera were measured by real time PCR. Liver histology was evaluated in accordance with the level of necroinflammation activity and the stadium of fibrosis. Results: Regardless of the genotype of the virus and the source of infection, SVR was achieved in 67% of the patients. Therapeutic response (ETR) was not achieved in 25% of the patients who were infected with an untested blood transfusion and 6% of the patients who had had wartime surgery. Amongst the different sources of infections, patients with a war-surgery source of infection responded better to therapy than those with a blood transfusion source of infection (p = 0.023). A blood transfusion source of infection implies a larger fibrosis stage than in blood donors; (g = 1.177; s 2 = 0.577). A blood transfusion source of infection implies a significantly larger necroinflammatory activity than in blood donors; (g = 1.456; s 2 = 0.618). Conclusions: An untested blood transfusion was a significant risk factor for more advanced liver diseases in regards to necroinflammatory activity and the fibrosis stage. This source of infection was also a risk factor for low responses to antiviral therapy. At the same time, I.V. drug users had more progressive necroinflammatory activity, but a high therapeutic response to antiviral therapy.
Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : časopis Društva za medicinsku informatiku BiH, 2016
The aim of the study is to define the MRI appearance of disorder in the Junctional zone (JZ) in w... more The aim of the study is to define the MRI appearance of disorder in the Junctional zone (JZ) in women with adenomyosis compared to those without it, given the importance of the JZ in the regulation of various reproductive events. Materials and methods: This was a prospective, comparative and open study. Patients with adenomyosis have been sorted in target group, n = 82, while the control group consisted of patients without adenomyosis, n = 82. All patients, from both groups have undergone a magnetic resonance imaging of the pelvis. Using a software tool for measurement, the thickness of the JZ was measured in T2w sag sequences in all patients from both groups (target and control) n = 164. Patients in the target group type adenomyosis were assessed and categorized either as: diffuse, focal, or Adenomyoma and the results were compared. The presence of endometriosis and myomas in both groups was evaluated and its coexistence with adenomyosis was analyzed as well. Results: Of the 82 patients in the target group, 81.7% of the patients had diffuse adenomyosis, while 18.3% had focal type with statistically significant difference (p <0.05). The results of the Mann-Whitney U test showed that p <0.05, implying that there is a statistically significant difference in the thickness of the JZ between the control and target group, therefore patients from the target group with adenomyosis had a statistically significantly thicker junctional zone than the patients in the control group. The JZ in the target group was on average M = 14,3mm, SD = 1.3mm, while the thickness of JZ in the control group without adenomyosis was M = 5,6mm, SD = 1,3. Chi-square shows that p <0.05, implying that there is a statistically significant difference in the number of patients with myomas between the two groups, where the myomas significantly over-represented in the target group with 32,9 % vs.6 %). Conclusion: MRI is the method of choice for imaging and evaluation of JZ as an important diagnostic marker in the diagnosis of adenomyosis. It is important to recognize this condition as early as possible and distinguish it from other pathologies in order for timely and appropriate treatment.
Bosnian Journal of Basic Medical Sciences, Aug 20, 2009
Th e role of ferritin in fi brogenesis of liver parenchyma in patients with alcoholic liver disea... more Th e role of ferritin in fi brogenesis of liver parenchyma in patients with alcoholic liver disease has been investigated in previous studies. Ferritin was shown to be an indirect marker of ferum deposition in liver parenchyma in alcohol liver disease. Th e aim of the present study was to examine the role of nitric oxide (NO) in the pathogenesis of alcoholic liver disease as well as the infl uence of NO on iron (ferritin) metabolism in patients with alcoholic liver disease. Serum concentrations of NO and iron markers (iron, total iron binding capacity, ferritin) were measured in male patients (aged - years) with alcoholic liver disease, as well as from a control group ( male patients (aged - years) without liver disease). NO concentration was detected by measuring production of nitrates and nitrites using classical colorimetric Griess reactions. Th ere was a statistically signifi cant increase in serum NO concentration in patients with alcoholic liver disease compared to the control group (mean ± SEM; , ± , vs. , ± , mmol/dm , respectively; p<,). Similarly, serum iron levels (, ± , vs. , ± , g/ cm , respectively; p<,) and serum total iron binding capacity (, ± , vs. , ± , μmol/dm , respectively; p<,) were also significantly higher in patients with alcoholic liver disease compared to control patients. Th e serum concentration of ferritin was higher in patients with alcoholic liver disease than in the control group; however this was not statistically signifi cant (, ± , vs. , ± , g, respectively; p<,). Th ere was no correlation between NO and ferritin in the investigated groups. Th ese results suggest a possible role of NO and iron in the pathogenesis of alcoholic liver disease. NO and iron may be used as non-invasive predictors of liver damage. Also the role of iron in sera, and its deposition in liver parenchyma, could be used in clinical practice, especially in regards to assessing the fi brogenesis of liver parenchyma induced by ferritin.
Medicinski arhiv, 2020
Introduction:Upper gastrointestinal bleeding can be a life-threatening condition and requires car... more Introduction:Upper gastrointestinal bleeding can be a life-threatening condition and requires careful evaluation from the very first episode in order to reduce the risk of rebleeding, hemorrhagic shock and death. The outcome of a patient with upper gastrointestinal bleeding depends on resuscitation measures taken during admission to the hospital and an adequate assessment of the patient’s risk level.Aim:The aim of the study is to compare Glasgow Blatchford score and Rockall score and to identify the most accurate score used in predicting unfavorable outcomes and the need for intervention.Methods:This study involves 237 patients with upper gastrointestinal bleeding. The accuracy of the scoring systems was assessed by plotting receiver-operating characteristic curves (ROC curves) and was calculated for GBS and RS with 95% confidence interval (CI).Results:As for mortality prediction, RS was superior to GBS (AUC 0.806 vs. 0.750). The GBS had a higher accuracy in detecting patients who needed transfusion units and was superior to the RS (AUC 0.810 vs.0.675). In predicting the need for intervention, RS was superior to GBS (AUC 0.707 vs. 0.636.Conclusion:GBS and RS are developed to help clinicians to triage patients appropriately in order to assess endoscopic therapy within a suitable time frame, as well as identify low risk patients for possible outpatient management. High accuracy of the GBS in predicting a need for transfusion represents an important endpoint to assess. RS was superior to GBS in predicting a need for intervention as well as mortality. Currently, a combination of these scoring systems is the best way for proper assessment.
Medicinski arhiv, 2016
Introduction: Renin-angiotenzin system (RAS) is frequently activated in patients with chronic liv... more Introduction: Renin-angiotenzin system (RAS) is frequently activated in patients with chronic liver disease. Angiotenzin-II (AT-II), produced by angiotenzin converting enzyme (ACE), has many physiological effects, including an important role in liver fibrogenesis. Combined antiviral therapy with PEG-IFN and ribavirin besides its antiviral effect also leads to a reduction in liver parenchyma fibrosis. Aim of the study: Determining the value of ACE in serum of patients with chronic hepatitis C before and after combined antiviral therapy, as well as the value of ACE activities in sera of the control group. Materials and methods: We studied 50 patients treated at Gastroenterohepatology Department, in the time-period of four years. Value of ACE in serum was determined by Olympus AU 400 device, with application of kit "Infinity TN ACE Liquid Stable Reagent". HCV RNA levels in sera were measured by real time PCR. HCV RNA test was performed with modular analysis of AMPLICOR and COBAS AMPLICOR HCV MONITOR test v2.0, which has proved infection and was used for quantification of the viruses and monitoring of the patients' response to therapy. Liver histology was evaluated in accordance with the level of necroinflammation activity and stage of fibrosis. Results: Serum activities of ACE in chronic hepatitis C patients is statistically higher than the values in the control group (p=0.02). Antiviral therapy in chronic hepatitis C patients statistically decreases serum activities of ACE (p= 0.02) and indirectly affects fibrogenesis of the liver parenchyma. Correlation between ACE and ALT activity after the therapy was proved (0.3934). Conclusion: Our findings suggest that the activity of ACE in serum is a good indirect parameter of the liver damage, and could be used as an indirect prognostic factor of the level of liver parenchyma damage. Serum activity of ACE can be used as a parameter for non-invasive assessment of intensity of liver damage.
Bosnian Journal of Basic Medical Sciences, Nov 20, 2006
Th e aim of the study was to ascertain the existence of intestinal metaplasia in gastric mucosa o... more Th e aim of the study was to ascertain the existence of intestinal metaplasia in gastric mucosa of patients with gastric carcinoma coupled with H. pylori positive chronic atrophic gastritis and possible connection of IM with the development of gastric carcinoma. Th e paper presents prospective study that included patients with gastric carcinoma and patients with chronic atrophic H. pylori positive gastritis. All the patients were subjected to gastroscopy as well as biopsy targeted at antrum, lesser curvature and corpus and at the area - cm removed from tumor lesion. Biopsy samples were sliced by microtome and stained. We analyzed presence, frequency and severity of infl ammatory-regenerative, metaplastic and dysplastic changes in the mucosa and evaluated their prognostic value. We typed IM immunohistochemically. Th is study confi rmed responsibility of H. pylori for infl ammatory events in gastric mucosa in patients with gastric carcinoma. According to our fi ndings incomplete IM of types IIa and IIb as precancerous lesion is responsible for the development of gastric carcinoma and is associated with chronic atrophic gastritis grade I and II ( of subjects, p=,, h=, p=,). Th us, the fi nding of incomplete intestinal metaplasia may be used as an indicator for early gastric carcinoma detection. Patients with patho-histologicaly verifi ed incomplete intestinal metaplasia associated with active chronic atrophic gastritis of levels I and II represent risk group for the development of gastric carcinoma of intestinal type. KEY WORDS:intestinal metaplasia (IM), epithelial dysplasia, Helicobacter pylori (H. pylori), chronic atrophic gastritis (CAG).
Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : časopis Društva za medicinsku informatiku BiH, 2012
Medicinski arhiv, 2013
I ntroduction: Ulcerative colitis (UC) is a common disease with a chronic and relapsing presentat... more I ntroduction: Ulcerative colitis (UC) is a common disease with a chronic and relapsing presentation requiring regular clinical follow up. Epidemiological and microbiologic studies suggest that enteropathogenic microorganisms play a substantial role in the clinical presentation and extent of inflammatory bowel disease. Goal: To evaluate the presence of intestinal infections by Entamoeba hystolitica in patients with ulcerative colitis, their impact on clinical outcome, and to identify associated risk factors. Material and methods: A total of 31 patients hospitalized on Gastroenterohepatology Department with patohystologically proved ulcerative colitis were studied. Fresh feces samples taken from 20 patients were examined immediately using Eosin and Lugol-staining methods and analyzing the presence of vegetative and MIFC (Meriolat and Iod staining). Results: A total of 16 female and 15 male hospitalized UC patients were analysed in a period of two years (2010-2011). The mean age at diagnosis was 43 years. We analyzed relation of amoeba infection with localization of ulcerative colitis. Our results indicate that amoeba infection is related to extent of disease (they were mostly present in pancolitis). Presence of amoeba is not related to age nor gender. Furthermore, presence of amoeba was not associated with more severe clinical course of disease. Similarly, higher value of serum marker of inflammation was not associated with amoeba infection. Discussion and conclusion: Amoeba infections in UC patients treated at Gastroenterohepatology Department was not related to the grade of disease activity, and other clinical variables such as gender, age and parameters of inflammation. These microorganisms could be a contributing cause of extended localization of disease.