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To evaluate the defense mechanisms (DM) in patients with drug-resistant epilepsy and, to determine whether displacement is associated with seizures.Following an examination, 50 patients were diagnosed in accordance with the 2005 proposal of the International League Against Epilepsy and the definition of drug-resistant epilepsy from 2010. The neuropsychological examination used the Defense Style Questionnaire (DSQ-40). We measured the intensity of individual DMs. Mature DMs: sublimation, humor, suppression and anticipation; neurotic DMs: undoing, pseudo-altruism, idealization and reactive formation; and immature DMs: projections, passive aggression, acting out, isolation, devaluation, autistic fantasies, denial, displacement, dissociation, splitting, rationalization and somatization. The values were compared with 50 subjects without epilepsy.Patients with drug-resistant epilepsy use immature defensive styles significantly more (p=0.0010). Displacement have a positive correlation with frequency of seizure (p=0.0412).Blaming others is a characteristic of the behavior of patients with drug-resistant epilepsy, especially if they have seizures. As such, they may be less adaptable in a micro social environment.

It has been reported in recent years that elevated thyroglobulin antibody (TgAb) values can be associated with thyroid malignancy. The aim of this study is to determine whether serum TgAb have a predictive role in thyroid cancer in patients with thyroid nodules. The crossed study included 100 patients with scintigraphic cold thyroid nodules divided in two groups. Demographic data, TgAb levels and final histopathological findings were recorded. The first group consisted of 50 patients with histopathological verified malignant nodules and the second group of 50 patients with histopathological verified benign nodules. TgAb were estimated by the radio-immunity assay (RIA) method. The median ​​of TgAb in the group with benign nodules were 14.3 (10-32) IU / mL and in the group with malignant nodules 42.9 (13-156) IU / mL. TgAb values ​​were significantly higher in patients with malignant nodules (p = 0.02 The increase in values ​​of TgAb by 1 IU / mL increased the risk for malignancy by 0.7%. The cut-off for TgAb of > 35 IU / mL discriminates between diagnosis of the malignant and benign thyroid nodule. TgAb of > 35 IU / mL, with a sensitivity of 56% and a specificity of 78%, was found to be a limit value for predicting malignant thyroid lesion. TgAb serum values ​​were predictor of malignant thyroid lesion and their preoperative measurement in combination with other risk factors could assist in preoperative diagnosis in patients with cytological indeterminant thyroid nodules.

Haemodiafiltration (HDF) is a renal replacement modality that combines diffusion and enhanced convection in order to remove smalland middle-molecular-weight com‐ pounds, respectively. They are removed along solvent drag effect of ultrafiltration through increased transmembrane pressure (TMP), whereas the replacement solution is infused intravenously at equal amount minus the desired fluid volume removal for achieving dry weight. Limiting factors for high-volume on-line haemodiafiltration (HV oHDF) are blood flow and viscosity (haematocrit, protocrit), filter performance and technical features of HDF monitor. Most recent advanced technology of dynamic analysis of pressure pulses along the blood flow pathway in the dialyser has enabled optimal ultrafiltration flow performances. HV oHDF offers today the best compromise of cardioprotective option by reducing cardiovascular risk factors in end-stage kidney disease patients. Recent randomised controlled trials (RCTs), individual participant data meta-analyses and a number of observational studies have shown the evidence of survival advantage of HDF over conventional haemodialysis (HD). The convective volume has become the key quantifier for HV oHDF as the measure of dialysis dose. Its cut-off values for better survival have been recognised, but the research is still needed in the years to come to set the required optimal volumes tailored to individual patients’ needs.

Aim To evaluate the efficacy of step-up approach to infected necrotising pancreatitis. Methods Retrospective analysis of 86 patients treated by step-up approach from 1989 to 2009. Infection was confirmed by examination of aspirated material or by presence of free pancreatic gas at contrast-enhanced computed tomography. Conservative treatment was initially attempted in all patients; percutaneous catheter drainage was performed when conservative therapy failed; surgery was planned only if no clinical improvement was observed. Primary outcome was mortality. Results Fifteen patients (17.4%) were successfully treated with conservative treatment only. Percutaneous catheter drainage was performed in 69 (80.2%). Eight patients (9.3%) died, two at week 1 without drainage or surgery and six after percutaneous catheter drainage and surgery. Eleven patients were converted to surgery (12.8%). Organ failure occurred in 59/86 (68.6%) and multiorgan failure in 25/86 (29.1%). Median (interquartile ranges) hospital stay and catheter dwell times were 13 (9–47) and 15 (7–34) days, respectively. There were 2.61 catheter problems and 1.68 catheter changes per patient. Conclusions The step-up approach is an effective and safe strategy for the treatment of infected necrotising pancreatitis. Percutaneous drainage can avert the need for surgery in the majority of patients.

Background and Objectives: Currently, there is no consensus about immunosuppressive therapy following kidney transplantation. Acute rejection rates and allograft survival rates are the clinical outcomes traditionally used to compare the efficacy of various immunosuppressive regimens. Therefore, we conducted this study to evaluate whether patient survival rates improved in the era of modern immunosuppressive treatment during living-related kidney transplantation. Design and Setting: Retrospective cohort study in a university-based tertiary internal medicine teaching hospital performed between 1999 and 2009 and patients followed up to 7 years. Patients and Methods: Survival rates were assessed in 38 patients receiving basiliximab and mycophenolate mofetil (regimen A) and 32 patients receiving antithymocyte globulin and azathioprine (regimen B). The rest of the regimen (cyclosporine A and steroids) remained the same. A secondary end point was acute rejection episode. Results: Seven-year survival rates were 100% and 72% (P=.001) and 7-year acute rejection-free survival rates were 82% and 53% (P=.03), in groups A and B, respectively. Conclusion: Long-term survival after living-related kidney transplantation has improved in the era of modern immunosuppressive treatment.

Aim: The clinical course and outcome of patients with haemorrhagic fever with renal syndrome (HFRS) caused by Puumala (PUUV) and Dobrava viruses (DOBV) were analyzed and whether it left long-term consequences on kidney function after 10 years was evaluated. Methods: Cross-sectional studies were conducted to test the kidney function and blood pressure of HFRS-affected patients and to follow them up 10 years after. Eighty-two PUUV- and 53 DOBV-induced HFRS patients and 14 and 31 participants 10 years after having contracted PUUV- and DOBV-related diseases, respectively were evaluated. Results: Serum creatinine concentrations were 279.5 and 410 mcmol/L in PUUV and DOBV groups, respectively (P = 0.005). There were six and 13 anuric (P

OBJECTIVE: To evaluate the relationships between simple renal cysts and arterial hypertension and whether their evacuation decreases the blood pressure (BP). METHODS: In a cross-sectional design, we analyzed 184 study participants with cysts and compared hypertensive and nonhypertensive among them. Outcomes were the number, the size and the location of a cyst. In a cross-over design, we first evaluated the change in absolute value of SBP, DBP and mean BP in 62 hypertensive patients who underwent percutaneous evacuation of a cyst and then the decrease of BP as a categorical variable that comprised all study participants. RESULTS: There were 55% giant renal cysts among hypertensive and 24% among nonhypertensive patients (P = 0.0001). The prevalence rates of multiple and peripheral cysts in hypertensive and nonhypertensive patients were similar to those of single and perihilar cysts, respectively. Significant differences in SBP, DBP and mean BP were found between pretreatment readings and 3 days, 1 month, 3 months and 6 months after cyst evacuation (P < 0001). The differences were significant in all hypertensive patients (P < 0.001). There were less hypertensive patients 3 days after treatment than before treatment (P < 0.0001). CONCLUSION: An apparent association between the size of a simple renal cyst and hypertension was found, and aspiration of cysts resulted in a reduction of BP. Location and number of cysts were not related to BP.

To evaluate if percutaneous drainage of sterile fluid collections recurring after initial aspiration in acute pancreatitis yields better results than their conservative management.Fifty-eight patients with fluid collections in acute pancreatitis were followed up prospectively. Forty of them with sterile fluid collections that recurred after initial aspiration were randomly assigned to two groups of 20 in each. One group was initially treated with conservative management and the other group with prolonged catheter drainage. Patients with unsuccessful initial treatment were converted to more aggressive procedure. Outcome measure was conversion rate to more aggressive procedure.Conversion to more aggressive procedure was done in 11 and 3 patients treated conservatively and with catheter drainage, respectively (p = 0.02). Four and 11 patients had bacterial colonization of their fluid collections in conservative management and drainage group, respectively (p = 0.048). Conservative treatment was successful in all six patients with sterile liquid collections30 ml. However, this treatment was unsuccessful in all seven patients with multiloculated and liquid collections100 ml.Prolonged catheter drainage is more efficient for management of recurrent sterile fluid collections in acute pancreatitis than is conservative treatment. Conservative treatment is successful for patients with small fluid collections.

The purpose of this study was to evaluate whether continuous percutaneous catheter drainage with negative pressure yields better results than single-session alcohol sclerotherapy in the management of symptomatic simple renal cysts.Eighty-five patients with 92 simple renal cysts were randomly assigned to two groups in a prospective controlled trial. One group was treated with sonographically guided continuous catheter drainage with negative pressure and the other group with single-session alcohol sclerotherapy. Patient demographics, clinical characteristics, treatment outcome, and complications were analyzed.The initial volume of the cysts did not differ significantly between the groups, but the final volume was significantly smaller in the continuous drainage group (p = 0.026). During the 24-month follow-up period, 37 (40%) of the cysts disappeared completely: 24 (52%) of the 46 cysts in the drainage group and 13 (28%) of the 46 cysts in the sclerotherapy group (p = 0.033). In the sclerotherapy group, the probability of disappearance of the cysts was highly dependent on cyst size, being less for giant cysts (p = 0.01). Cyst size was not a significant factor in probability of disappearance in the drainage group (p = 0.15). The probability of disappearance of giant cysts (volume500 mL) differed significantly between the groups (p = 0.009), but there was no difference in probability of disappearance of moderately large cysts (p = 0.16). Three of 14 patients with giant cysts in the drainage group and 10 of 13 such patients in the sclerotherapy group had recurrences that necessitated additional treatment (p = 0.007). They were successfully treated with continuous catheter drainage.Continuous catheter drainage with negative pressure is more efficient than single-session alcohol sclerotherapy in the management of giant cysts. For moderately large cysts, the two methods have similar results.

Currently used diagnostic criteria in different endemic (Balkan) nephropathy (EN) centers involve different combinations of parameters, various cut-off values and many of them are not in agreement with proposed international guidelines. Leaders of EN centers began to address these problems at scientific meetings, and this paper is the outgrowth of those discussions. The main aim is to provide recommendations for clinical work on current knowledge and expertise. This document is developed for use by general physicians, nephrologists, urologist, public health experts and epidemiologist, and it is hoped that it will be adopted by responsible institutions in countries harboring EN. National medical providers should cover costs of screening and diagnostic procedures and treatment of EN patients with or without upper urothelial cancers., JOURNAL ARTICLE, SCOPUS: re.j, info:eu-repo/semantics/published

Purpose was to evaluate the prognostic value of acute fluid collections (AFC) diagnosed by conventional transabdominal ultrasound in the early assessment of severity acute pancreatitis (AP). We studied 128 consecutive patients with AP between March 2006 and March 2011. The predictor was the number of AFC. Outcome measure was the occurrence of complications. Abdominal sonogram, contrast-enhanced CT, and pancreatitis-specific clinical and laboratory findings were performed. Results. AFC were associated with complications (p< 0.0001), Balthazar grade (p = 0.004), Ranson score (p < 0.0001), and the majority of clinical, radiologic, and biochemical parameters for predicting complications of AP (p < 0.05). Univariate logistic regression also revealed significant association between the number of AFC and the occurrence of complications (OR 4.4 ; 95% CI 2.5–7.6). After the adjustment for covariates, AFC remained prognostic for complications and a cutoff point of >1 AFC was prognostic of their occurrence with 88% sensitivity and 82% specificity. AFC are related to the clinical course of AP and can predict its severity.

The need for interval appendicectomy (I.A) after successful conservative management of appendiceal mass has recently been questioned. Furthermore, emergency appendicectomy for appendiceal mass is increasingly performed with equal success and safety to that performed in non-mass forming acute appendicitis. There is an increasing volume of evidence -although mostly retrospective- that if traditional conservative management is adopted, there is no need for routine I.A except for a small number of patients who continue to develop recurrent symptoms. On the other hand, the routine adoption of emergency laparoscopic appendicectomy (LA) in patients presenting with appendiceal mass obviates the need for a second admission and an operation for I.A with a considerable complication rate. It also abolishes misdiagnoses and deals promptly with any unexpected ileo-cecal pathology. Moreover, it may prove to be more cost-effective than conservative treatment even without I.A due to a much shorter hospital stay and a shorter period of intravenous antibiotic administration. If emergency LA is to become the standard of care for appendiceal mass, I.A will certainly become ‘something’ of the past.

Cilj rada je utvrditi da li rana rehabilitacija već od prvog postoperativnog dana nakon operacije lumbalne diskus hernije poboljšava funkcionalni status bolesnika u odnosu na rehabilitaciju koja započinje 3 tjedna nakon operacije. Za ocjenu funkcionalnog statusa korišten je Oswestry index, a rađen je kod 60 bolesnika prije operacije i nakon rehabilitacije, podijeljenih u 2 skupine, skupinu rane rehabilitacije i kontrolnu skupinu rehabilitacije nakon 3 tjedna od operacije. U svakoj skupini bilo je po 30 ispitanika. Vrijednosti Oswestry indexa prije operacije i nakon rehabilitacije u skupini rane rehabilitacije su bile 78,4±17 odnosno 19,6±9,9 (p, The aim of this study was to determine whether early rehabilitation from the first postoperative day after lumbar disc herniation surgery improved functional status of patients compared to the rehabilitation that started 3 weeks after surgery. Oswestry index was used for functional status assessment before surgery and after rehabilitation in 60 patients divided in 2 groups, i.e. early and control group of rehabilitation strated 3 weeks after surgery, 30 in each. Oswestry index values before surgery and after rehabilitation in the early rehabilitation group were 78.4±17 and 19.6±9.9, respectively (p

Purpose The aim of the study was to present and evaluate the long-term results of percutaneous catheter drainage (PCD) in the treatment of symptomatic pancreatic pseudocysts (PPC). Methods We performed a retrospective analysis of 128 patients with 140 PPC treated by PCD from 01/01/1989 to 12/31/2008. All procedures were performed under ultrasound control. Surgical treatment was planned only in patients with failed PCD. The patients were followed up monthly with sonography for 12 months. The primary outcome was conversion rate to surgery. Secondary outcomes were disappearance of PPC, requirement for additional treatment, length of hospital stay, and catheter dwell time. Results During the follow-up, 42 of the 140 cysts (30%) recurred. 19/42 cysts were small and they were followed up without intervention and 23/42 cysts required further intervention. These patients were offered a second attempt but 5 patients declined it and they chose to undergo surgery. The remaining 18 patients underwent second PCD and 10 of them developed recurrence. All of them underwent third PCD and 6 of the 10 patients developed recurrences. Four and 2 of them necessitated surgery and follow-up, respectively. In total, 9 of the 128 patients (7%) underwent surgery during the study period. Medians (interquartile ranges) of hospital stay and catheter dwell time were 19 (14–23) and 23 (15–43) days, respectively. There were no complications related to the procedure. Conclusion PCD is a safe and effective management for PPC, with low recurrence rates and complication rate and it can eliminate the need for surgery in majority of patients with PPC.

The aim of the study was to compare ultrasound findings of morphometric measurements and registration of Doppler signs of kidneys between children and adolescents with diabetes mellitus type 1 (DMT1) with microalbuminuria, and metabolic control with duration of the disease. Retrospective-prospective study included 80 patients, who got DMT1 in the age from 2 to 16 years. In relation to the duration of the disease, all patients were divided into two groups: the first was whose illness had lasted less than 10 years, the second group was with duration of DMT1 more than 10 years. In patients with duration of DMT1 more than 10 years, the frequency of microalbuminuria, pathological findings of the volume of right kidney, and higher HbA1C were significantly greater. The significant difference was found in the frequency of pathological findings of the resistance index (RI) in the interlobar arteries in both kidneys. Alongside microalbuminuria, monitoring the dimension and volume of the kidneys may indicate the existence of the early phases of diabetic nephropathy.

Background Despite significant reduction in acute rejection rates and improvements in one year kidney allograft outcomes over the past decade, there is an overall lack of improvement in long-term allograft outcomes. We conducted this study to evaluate whether immunosuppressive regimens involving basiliximab and mycophenolate mofetil improved allograft outcomes in living-related kidney transplantation beyond the first year. Methods In a retrospective cohort study we analyzed kidney graft survival, acute rejection-free survival, kidney function, delayed graft function, and primary non-function in patients receiving an immunosuppressive regimen that included basiliximab and mycophenolate mofetil (group A), and compared to patients receiving antithymocyte globulin and azathioprine (group B). The rest of the treatment protocols remained the same, including cyclosporine A and steroids in both groups. Results Seven-year graft survival rates in groups A and B were 83% and 44%, respectively (p = 0.005), 7-year acute rejection-free survival rates were 82% and 53%, respectively (p = 0.03), kidney function was better (p = 0.004) and its deterioration rate was lower (p = 0.006) in patients receiving regimen A. In group A 1 primary non-function event was observed in contrast to 4 composite events of delayed graft function and primary non-function in group B (p > 0.05). Conclusion Long-term graft outcomes in living-related kidney transplantation have improved with substitution of basiliximab and mycophenolate mofetil for antithymocyte globulin and azathioprine in immunosuppressive protocols.

The aim of the study was to compare ultrasound findings of kidneys in children and adolescents with diabetes mellitus type 1 (DMT1), establish the association with microalbuminuria, blood pressure values and metabolic control of the disease, and creatinine clearance. In 80 children and adolescents with DMT1, in whom illness occurred in period between 2 and 16 years of age, morphometry measurements with ultrasound were performed. Nephelometric method of three consecutive samples of urine determined microalbuminuria. In patients with microalbuminuria, creatinine clearance was also measured. Demographic data were obtained from the parents and from the patients medical records. In relation to the duration of the disease, all patients were divided into two groups: the first group of patients with illness lasting for less than 10 years, and the second were those whose illness had lasted more than 10 years. In patients with duration of DMT1 of more than 10 years, the frequency of pathological findings of the longitudinal diameter and volume of both kidneys in relation to age and anthropometric standards was statistically significantly greater. Also, the finding of microalbuminuria was more frequent. In the group of patients with DMT1 lasting for more than 10 years, the mean value of HBA1c was statistically significantly higher In patients with microalbuminuria the total mean value of creatinine clearance was within the bounds of the reference values and was statistically significantly higher in patients in whom the illness had lasted less than three years, which indicates hyperfiltration of the kidneys. Alongside microalbuminuria, monitoring of the dimension and volume of the kidneys may indicate the existence of the early phases of diabetic nephropathy and result in its prevention and prevention of illness progression.

Cilj rada bio je usporediti ultrazvučni nalaz morfometrijskih mjerenja i registracije Dopplerovih signala bubrega među djecom i adolescentima s dijabetesom melitusom tipa 1 (DMT1) s mikroalbuminurijom i metaboličkom kontrolom u odnosu na trajanje bolesti. U retrospektivno-prospektivnu studiju uključeno je 80 ispitanika, oboljelih od DMT1 u dobi od 2 do 16 godina. Svi ispitanici podijeljeni su u dvije grupe: jedna grupa s trajanjem DMT1 kraćim od 10 godina i druga grupa s više od 10 godina. Ispitanici s trajanjem DMT1 dužim od 10 godina imaju učestalije mikroalbuminuriju, povećan volumen desnog bubrega, veći HbA1C i povišen indeks rezistencije u arteriji interlobaris. Pored mikroalbuminurije, praćenje dimenzija i volumena bubrega može upozoriti na postojanje ranih faza dijabetičke nefropatije., The aim of the study was to compare ultrasound findings of morphometric measurements and registration of Doppler signs of kidneys between children and adolescents with diabetes mellitus type 1 (DMT1) with microalbuminuria, and metabolic control with duration of the disease. Retrospective-prospective study included 80 patients, who got DMT1 in the age from 2 to 16 years. In relation to the duration of the disease, all patients were divided into two groups: the first was whose illness had lasted less than 10 years, the second group was with duration of DMT1 more than 10 years. In patients with duration of DMT1 more than 10 years, the frequency of microalbuminuria, pathological findings of the volume of right kidney, and higher HbA1C were significantly greater. The significant difference was found in the frequency of pathological findings of the resistance index (RI) in the interlobar arteries in both kidneys. Alongside microalbuminuria, monitoring the dimension and volume of the kidneys may indicate the existence of the early phases of diabetic nephropathy.

The aim of this study was to evalúate whether anemia identified earlier than 3 months postengraftment in modern era could be predictive of anemia at 12 months. Cross-sectional and cohort studies based on retrospective analysis of existing clinical records were performed. Data on recipient’s age at transplantation, follow-up serum creatinine (SCR) and hemoglobin (Hb) on day 7 (D7), at month 1 (M1) and at month 3 (M3) postengraftment were collected. Outcome was anemia identified at 12 months (M12) postengraftment. There were 75 patients on D7, 74 at M1 and 61 at M3. Multiple linear regression model that included recipient’s age at transplantation, Hb and creatinine on D7 and tested the risk for anemia at M12 retained only the age in the model, with the coefficient of 0,84 (P=0,001). The same model at M1 retained Hb and age, with the coefficients of 0,26 (P=0,03) and 0,81 (P=0,0002), respectively and at M3 it retained Hb and age, with the coefficients of 0,41 (P=0,004) and 0,70 (P=0,003), respectively. Anemia identified at M1 after renal transplantation is predictive of anemia at M12.

SUMMARY: Aim: To evaluate whether microalbuminuria could be a marker of early tubular damage in individuals at risk of developing Balkan endemic nephropathy (BEN). Methods: A cross-sectional study was used to determine urinary albumin-to-creatinine ratio (UACR) in a test group of 61 participants from a BEN endemic region and control group of 64 participants from a nearby non-endemic region, both recruited from the general population of Bosnia and Herzegovina. The correlation between UACR and urinary b2 microglobulin-to-creatinine ratio (UBCR) and the receiver operating characteristic curve for UACR were analyzed in the test groups of 58 participants. The correlation analysis was also performed in a subset of nine subjects with elevated UBCR. Results: Medians, interquartile ranges and confidence intervals (CI) for medians of UACR in the test and control groups were 2 mg/mmol, 0.975–8.247 mg/mmol, 1.3472–3.2691 mg/mmol and 1 mg/mmol, 0.695–1.41 mg/mmol, 0.8466–1.2053 mg/mmol, respectively (P = 0.0001). Microalbuminuria was found in 30 of the 61 examinees in the test group, in contrast to six of the 64 examinees in the controls (P

Purpose To evaluate percutaneous short-term catheter drainage in the management of benign ovarian cysts in patients at increased surgical risk. Materials and Methods Thirty-eight patients with simple ovarian cysts were treated with drainage of fluid content by catheters until output stopped. All patients were poor candidates for surgery. All procedures were performed under ultrasonographic (US) control and local anesthesia. Cytologic examination was performed in all cases. The patients were followed up monthly with color Doppler US for 12 months. Outcome measure was the recurrence of a cyst. Results During the 12-month follow-up period, 10 of 38 cysts recurred. Seven of the 10 cysts required further intervention, and three were followed up without intervention. Four of the seven patients who required further intervention underwent repeat transabdominal aspiration and three declined repeat aspiration and subsequently underwent surgery. After repeated aspirations, two of four cysts disappeared, one necessitated follow-up only, and one necessitated surgical intervention. Cyst volume ( P = .009) and diameter ( P = .001) were significantly larger in the cysts that recurred. No evidence of malignancy was reported in the cytologic examination in any patient. No patients developed malignancy during follow-up. No major complications were observed. The hospital stay was 1 day for all patients. The median duration of drainage in the groups with resolved and recurrent cysts was 1 day (interquartile range, 1–1) and 2 days (interquartile range, 1–3), respectively ( P = .04). Conclusions In patients considered poor candidates for open surgery or laparoscopy, percutaneous treatment of ovarian cysts with short-term catheter drainage without sclerotherapy appears to be a safe and effective alternative, with low recurrence rates.

The aim of this study is to evaluate epidemiological status of Balkan endemic nephropathy (BEN) patients on renal replacement therapy (RRT) in Bosnia from 2003 through 2005. Incidence and prevalence rates of BEN, diabetes mellitus (DM) and RRT population and proportion of BEN RRT population in total RRT population were tracked in renal units covering the entire BEN endemic region in Bosnia. BEN incidence and prevalence rates were 52; 34;48 and 262; 265, 292, respectively. DM incidence and prevalence rates were 7; 13; 8 and 20; 28; 33, respectively. Total RRT population incidence and prevalence rates were 89; 82; 79 and 424; 436; 473, respectively. Proportions of incident BEN RRT population in incident total RRT population and proportions of incident BEN RRT population in incident total RRT population when incident diabetics were subtracted from incident total RRT population were 0,58; 0,41; 0,61, and 0,63; 0,49; 0,67; respectively. Proportions of prevalent BEN RRT population in prevalent total RRT population and proportions of prevalent BEN RRT population in prevalent total RRT population when prevalent diabetics were subtracted from prevalent total RRT population were 0,62; 0,61; 0,62, and 0,65; 0,65; 0,66, respectively. Trend of BEN RRT population was stable in Bosnia from 2003 through 2005.

To evaluate whether prolonged catheter drainage with negative pressure yields better results than single-session alcohol sclerotherapy in the treatment of symptomatic non-parasitic benign liver cysts. Forty patients were randomly assigned to two groups in a 24-month prospective controlled trial. One group was treated with ultrasound-guided prolonged catheter drainage with negative pressure (20 patients with 24 cysts) and the other group with single-session alcohol sclerotherapy (20 patients with 23 cysts). Patient demographics, clinical characteristics, treatment outcome, and complications were analyzed. The median volumes and 95% CI (confidence interval) for the medians and interquartile ranges of all 47 cysts before treatment and on last follow-up were: 389 ml, 143–1,127 ml, 136–1,300 ml, and 0 ml, 0–10 ml, and 0–23 ml, respectively (P

pends on the research question and proper selection of the confounders used to adjust for the analysis. Their study was designed to test the probability for the outcomes specified while having hemoglobin excursions outside the target range and not to test the association between them [3] , because the analysis was adjusted for hypertension and coronary artery disease which were by definition not confounders in this design being influenced by the hemoglobin level [4–6] . Thus, if one adjusts the analysis for them, the link between hemoglobin excursions and the outcomes tested may be reduced or even canceled out, thereby not revealing the possible effect of an increased hemoglobin level on the outcomes. In this study, hypertension and coronary artery disease were related to the effect of hemoglobin level [5, 6] . This allowed for only prognostic and not etiological inferences to be made because, in the prognostic model, pathophysiology was not an issue but only probabilities for the outcomes specified [3] . Dear Editor We appreciate the reply of Dr. Handelman to our comment [1] on the paper ‘Hospitalization and mortality in hemodialysis patients: association with hemoglobin variability’, published in your journal [2] . In his reply, Dr. Handelman compares the indication of impending problems secondary to having a hemoglobin level below the target range with the fever and elevated white count as indicators of infection as well as with the association between severe edema and congestive heart failure. However, the inferences made quite often in the paper by using wording such as ‘association’, ‘influence’, etc., did not correspond with the methodology applied in their study, which was the major point of our critique, so that no relation exists between the examples specified above by Dr. Handelman. Even infection may not necessarily be associated with an elevated white count, but with a low white count if it is a septic one and severe edema may not be associated with congestive heart failure, but with liver cirrhosis, so that every conclusion dePublished online: June 5, 2014

Background: Colorectal carcinoma is second commonest cancer causing death in Kosova. Methodology: In our study we present diagnostic methods, treatment, localization and laboratory findings in 155 patients, during 4 year period in patients with colorectal carcinomas treated in our clinic. Results: Ninety four 94 (61.4%) of patients were male gender and 59 (38.6%) were female. Eritrosedimentation was elevated in 103 (67.3%) of patients, number of white blood cells was increased in 21 (7.2%) of patients and high level of glycemia is present in 11 (7.2%) of patients. The most involved age is from 41-50 years. The most common site of involvement was the rectum in 79 (51.6%), localization in sigma was in 37 (23.5 %), the transverse colon in 21 (13.7 %) of cases and the ascendant colon in 18 (11.1%) patients. Adenocarcinoma (98%) was the most common histiotype. Conclusion: We concluded, that all patients, especially with positive familial history must begin screening in age 40, during which colorectal carcinoma can be diagnosed in an early stage. Key words: colorectal carcinomas, diagnoses, trea Background and objectives: Although many advantages of laparoscopic method in regard to open one have been already proved, both surgical methods may cause a certain number of complications. The goal of the study is to answer the question: Is Laparoscopic Cholecystectomy (LC) safer and more satisfactory method than open cholecystectomy (OC) concerning number, type and seriousness of complications? Design and Setting: Prospective, the research includes all patients in Bihac Cantonal Hospital during 2007, who had cholecystectomy, laparoscopic or open, because of the gallbladder calculosus. Methods: The study has included 476 patients who had cholecystectomy and who satisfied standards for this study. Of the total number of patients, 293 of them had laparoscopic cholecystectomy and 183 open cholecystectomy. Total number of complications is established for each group of patients. Results: The study has shown that there were more complications in patients operated by open method than in those operated by laparoscopic cholecystectomy (p

We read with great interest the article by Vege et al published in issue 34 of World J Gastroenterol 2010. The article evaluates the ability of contrast-enhanced computerized tomography (CECT) to characterize the nature of peripancreatic collections found at surgery. The results of their study indicate that most of the peripancreatic collections seen on CECT in patients with severe acute pancreatitis who require operative intervention contain necrotic tissue and CECT has a limited role in differentiating various types of collections. However, there are some points that need to be addressed, including data about the stage of acute pancreatitis in which CECT was done and the time span between CECT examination and surgery.

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.