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COVID-19, caused by the SARS-CoV-2 virus, has been a major focus of scientific research since late 2019 and early 2020. Due to its enormous societal, economic, and clinical impact worldwide, research efforts aimed, among other questions, to address the effect of host genetics in susceptibility and severity of COVID-19. In this research, we performed next-generation sequencing of coding and regulatory regions of 16 selected human genes, involved in the maintenance of the immune system or encoding the receptors for viral entry into the host cells, in a subset of 60 COVID-19 patients from the General Hospital Tešanj, Bosnia and Herzegovina, classified into three groups of patients with clinical conditions of different severity (“mild”, “moderate”, and “severe” clinical groups). In accordance with previous studies, we found out that the male sex and older age are risk factors for severe clinical picture. We identified 13 variants on seven genes (CD55, IL1B, IL4, IRF7, DDX58, TMPRSS2, and ACE2) with potential functional significance, either as genetic markers of modulated susceptibility to SARS-CoV-2 infection or as modifiers of the course of infection in terms of predicted symptom severity. Our results include variants reported for the first time as potentially associated with COVID-19. Future studies on larger patient cohorts, focused on candidate genes and/or candidate genetic variants, have a potential to answer a range of open questions regarding the effect of host (human) genetic makeup on the expected outcome of COVID-19.

Caused by the new SARS-CoV-2 coronavirus, COVID-19 (coronavirus disease 2019) evolves with clinical symptoms that vary widely in severity, from mild symptoms to critical conditions, which can even result in the patient’s death. A critical aspect related to an individual response to SARS-CoV-2 infection is the competence of the immune system, and it is well known that several trace elements are essential for an adequate immune response and have anti-inflammatory and antioxidant properties that are of particular importance in fighting infection. Thus, it is widely accepted that adequate trace element status can reduce the risk of SARS-CoV-2 infection and disease severity. In this study, we evaluated the serum levels of Cu, Zn, Se, Fe, I and Mg in pa- tients (n = 210) with clinical conditions of different severity (“mild”, “moderate”, “severe” and “exitus letalis”, i. e., patients who eventually died). The results showed significant differences between the four groups for Cu, Zn, Se and Fe, in particular a significant trend of Zn and Se serum levels to be decreased and Cu to be increased with the severity of symptoms. For Mg and I, no differences were observed, but I levels were shown to be increased in all groups.

Summary Background FTO, a gene recently discovered in genomewide associated studies for type 2 diabetes mellitus (T2D), play an important role in the management of energy homeostasis, nucleic acid demethylation and regulation of body fat mass by lipolysis. The aim of this study was to analyze the association of FTO rs8050136 A>C genetic variant with clinical and biochemical parameters of T2D in the population of West Balkan region (Bosnians and Herzegovinians and Kosovars). Methods The study included 638 patients with T2D and prediabetes and 360 healthy controls of both genders, aged from 40 to 65 years. Patients were recruited at the Clinical Centre University of Sarajevo, University Hospital of Clinical Centre in Banja Luka, General Hospital in Tešanj and Health Centre in Prizren. Genotyping of analyzed FTO polymorphism rs8050136 A>C was performed by qPCR allelic discrimination. Results Genotype frequencies of the analyzed polymorphism were comparable between patients with T2D, prediabetic patients, and healthy population. Logistic regression analyses didn’t show significant association of FTO rs8050136 A allele with increased risk of T2D. However, risk A allele was significantly associated with higher levels of HbA1c, insulin, HOMA-IR index, diastolic blood pressure, and inflammatory markers (fibrinogen and leukocytes) as well as showed tendency of association with increased values of obesity markers (BMI, waist and hip circumference). Conclusions Results of our study showed a significant association of FTO genetic variant rs8050136 A>C with the major markers of insulin resistance, obesity and inflammation, opening new avenues for solving many unclear questions in the pathogenesis of T2D.

The antidiabetic drug gliclazide is partly metabolized by CYP2C19, the main enzyme involved in omeprazole metabolism. The aim of the study was to explore the interaction between omeprazole and gliclazide in relation to CYP2C19 phenotype using physiologically based pharmacokinetic (PBPK) modeling approach. Developed PBPK models were verified using in vivo pharmacokinetic profiles obtained from a clinical trial on omeprazole-gliclazide interaction in healthy volunteers, CYP2C19 normal/rapid/ultrarapid metabolizers (NM/RM/UM). In addition, the association of omeprazole cotreatment with gliclazide-induced hypoglycemia was explored in 267 patients with type 2 diabetes (T2D) from the GoDARTS cohort, Scotland. The PBPK simulations predicted 1.4–1.6-fold higher gliclazide area under the curve (AUC) after 5-day treatment with 20 mg omeprazole in all CYP2C19 phenotype groups except in poor metabolizers. The predicted gliclazide AUC increased 2.1 and 2.5-fold in intermediate metabolizers, and 2.6- and 3.8-fold in NM/RM/UM group, after simulated 20-day dosing with 40 mg omeprazole once and twice daily, respectively. The predicted results were corroborated by findings in patients with T2D which demonstrated 3.3-fold higher odds of severe gliclazide-induced hypoglycemia in NM/RM/UM patients concomitantly treated with omeprazole. Our results indicate that omeprazole may increase exposure to gliclazide and thus increase the risk of gliclazide-associated hypoglycemia in the majority of patients.

As the COVID-19 ravages the world, the efforts to identify this infection more quickly and efficiently grow in significance every day. In given study, we have gathered the most specific biomarkers discovered by now for the COVID-19 infection diagnosis and disease progress monitoring, thus giving basic guidelines for the admitted patients' care. Divided into sections: inflammatory, hematologic, liver biomarkers and specific antibodies, we have consolidated the findings of different indicators of disease such as cytokine storm markers, C-reactive protein, ferritin, blood components (lymphocytes, neutrophils, thrombocytes), D-dimer, glycosylated hemoglobin, alanine and aspartate aminotransferase, lactate dehydrogenase, creatinine, together with the specific COVID-19 antibodies, all with an aim of making a foundation for quicker reaction of healthcare professionals when it comes to these patients.

SARS-CoV-2 is part of a diverse family of viruses, which mainly affect the respiratory system, central nervous, hepatic, and gastrointestinal systems. The symptoms are fever, cough, shortness of breath, muscle pain, confusion, headache, sore throat, rhinorrhea, chest pain, diarrhea, and nausea and vomiting. The COVID-19 upheaval has certainly become the most significant issue around the world, and its results have left nobody immaculate.

Since the end of 2019, world deals with the new infection called COVID-19 caused by SARS-CoV-2. SARS-CoV-2 binds to angiotensin-converting enzyme 2 (ACE) 2 receptors and enter through cell membranes of the lungs, kidneys, intestines, heart and other organs. It causes different clinical features among the population. It has been observed that there are young people with no comorbidities that will develop severe COVID-19 infection. It has been proposed that these severe COVID-19 infections can be determined by genetic predisposition. Main genes that have been analyzed are ACE polymorphisms, TMPSRSS2, Human Leukocyte Antigen (HLA), ADAM17 gene and Heme-oxygenase-1-enzymes polymorphism. These genes can be associated with development of COVID-19 infection and its severity. The frequency of these genes varies when it comes to different populations all around the globe. Also it is important to consider the interaction between genes and environment.

Aim To investigate interleukin 6 (IL-6) values depending on duration of diabetes mellitus (DM) and evaluate possible correlation with diabetic polyneuropathy. Methods The research study included 90 patients with DM divided into three groups (30 patients each) according to the duration of DM: group A - patients who had DM for less than 10 years, group B - duration of DM was 10 to 20 years, and group C - patients with DM over 20 years. Control group (K) included 30 healthy participants. Results IL-6 was significantly higher in the healthy control group, 180.318 pg/mL±94.18, than in group A, 47.23pg/ml±34.8, group B, 43.31pg/ml±33.17, and group C, 70.39 pg/ml±59.26 (p=0.0001). All groups had significantly different values of IL-6 between each other (p=0.0001). Level of IL-6 was in correlation with diabetic polyneuropathy in the group A (the youngest participants) (p=0.0001). In other groups there was no significant correlation between IL-6 and diabetic polyneuropathy. Conclusion The level of IL-6 was in correlation with neuropathy among younger patients. A higher level of IL-6 in the control group than in diabetic groups is a sign of stronger inflammatory response among younger and healthy people than in patients with DM.

Background: Patients with diagnosis of COPD suffervery often by bronchiectasis. Cough, expectorate, dyspnea are present in both.Exacerbations of both diseases are mainly provoked by inflammation or upper airways infections. Method: We analyzed 246 patients with COPD hospitalized during 2018 and 2019 year in Department of Pulmonary diseases. Patients were divided in two groups. The first with COPD only, and second one COPD patients with bronchiectasis. Bronchiectasis was diagnosed by High Resolution CT scan. We analyzed three specimen of sputum in COPD patients with or without bronchiectasis. Microbiological specimen was collected in first three days of hospitalization to avoid hospital colonization. Results: Bronchiectasis were found in 88 (36.77 %) cases. Among 158 patients without bronchiectasis sputum was positive in 44 cases (27.84 %). Next bacteria were found: Klebsiella pneumoniae in 18 cases, Acynetobacter species 11 cases, Escherichia coli in 10 cases, Seratia marcescnes 8 cases, Streptococcus pneumoniae in 2 cases, Enterobacter species and Staphylococcus coagulase-negative both one case. Two bacterias were found in 5 cases. In COPD patients with bronchiectasia sputum was positive in 28 cases, as follows: Klebsiella pneumoniae 9, Acinetobacter species 6, Escherichia coli 5, Serratia marcescenes 4, Streptococcus pneumonia 2, Enterobacter, staphylococcus coagulase-negative both in one case. Two bacterias were found in 4 cases. Candida albicans was found in 36 (40.1 %) COPD patients with bronchiectasis and in 52 (16.8%) without.

Amenorrhea is defined as the absence of menstrual bleeding and it is classified as primary, as the absence of menarche and secondary, usually longer than six to twelve months. The causes of secondary amenorrhea are pathological changes of female reproductive organs and hypothalamic-pituitary axis which, due to complex pathophysiology, are difficult to differentiate. Amenorrhea is associated with other disorders such as anxiety and depression, osteoporosis, cardiovascular diseases, endometrial cancer and infertility. Therefore, the importance of accurate diagnosis and consequent treatment is indisputable. For the purpose of accurate diagnosis, there has been developed an application based on the selected algorithm used for the evaluation of secondary amenorrhea. Algorithm allows healthcare workers and patients to make a decision on health protection based on the best evidence and to minimize costs and time frame of testing, as well. During the preparation of AmnSec application, there were used reference intervals on the following biochemical parameters: prolactin, TSH, FSH, testosterone, DHEAS and presence of virilization. The combination of default values offers the possible cause of secondary amenorrhea while the diagnostic success of the application entirely depends on the accuracy of the algorithm that the application is based on. The development of this type of application makes it easier for patients to access valid information by simply using their personal computers or mobile phones. Further work and the progress of the information sector in medicine is needed to provide more efficient, faster and better care and higher quality information for patients as the axis of improving health and life quality.

Aortic stenosis [AS] is set on the forth place of all cardiovascular disease in western world. Severe aortic stenosis [SAS] is one of the most common disease that in treatment demand cardiac surgery—replacement of native aortic valve with mechanical or biological prosthesis in our environment. SAS is often a consequence of a relapsed rheumatic heart disease. This paper present the possible modality of diagnosis SAS. Testing was done on 107 samples, 70 samples were SAS, and the rest of 37 were patients who were sent to some another examination, after ultrasound was done and diagnosis of SAS was excluded. In this paper, the application of basic kind of ANN architecture—the feedforward networks with backpropagation training—is explained, since this structure is able to perform nonlinear multiple regressions in a reliable manner, avoid overfitting. Dataset consists of 12 parameters as shown in Table X; sex, age, dizziness/loss of consciousness, dyspnoea, palpitation, systolic murmur of AS, EF, AV morphology, AVVmax, AVPGmean, AVPGmax, Area. Although limited number of data were present in this study, such automated systems can be used as assistant tool during diagnosis in real-time clinical settings. In the future it is planed to test and use this automated system for classification of aortic stenosis.

Over the past ten years, technology has been developed to the point, where it can enable continuous and efficient monitoring of blood glucose levels for patients with diabetes mellitus. The biggest step forward was demonstrated by biosensors, which, with a non-invasive approach, provide healthcare workers with the information required for good titration of insulin doses. We looked at the benefits of using biosensors in diabetes monitoring in terms of medical aspect and economic justification of replacing traditional test strips with biosensors. In this paper, we have shown potential benefits in terms of improving diabetes control, patient benefits, and how the medical benefit is collerating with the economic viability of biosensors use. On the territory of Bosnia and Herzegovina test strips for glucose control are still in use. This paper includes an analysis of the costs of traditional monitoring and monitoring using biosensors. We also reviewed the monitoring of diabetes in neighboring countries such as Croatia, Slovenia, Montenegro, and Serbia in order to compare them with the current situation in Bosnia and Herzegovina.

Chromosomal aberrations are a hallmark of leukemia. The prognostication of acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML) has vastly expanded with chromosomal analyses over the years. Current treatment strategy has been refined by discovery of genes and its mutations which are involved in disease causation and progression. These genes are named biomarkers or prognostic markers and they give information about favorable and unfavorable prognosis of the patients. This paper aims to summarize the most common mutated genes in all four types of leukemia and to find correlation of their expression and point mutations in certain tissues, using COSMIC database. Highest number of point mutations in leukemia genes was found in hematopoietic and lymphoid tissues and it was three times higher than in other tissues which could be explained by relatedness of genes with specific leukemia. Mostly overexpressed gene was CEBPA whereas NOTCH1 gene had the highest number of point mutations. Further research about new prognostic markers is crucial because they can significantly improve development of new therapeutic targets thereby increasing patient outcome and quality of life.

The response to metformin, the most commonly used drug for the treatment of type 2 diabetes (T2D), is highly variable. The common variant rs7903146 C>T within the transcription factor 7-like 2 gene (TCF7L2) is the strongest genetic risk factor associated with T2D to date. In this study, we explored the effects of the TCF7L2 rs7903146 genotype on metformin response in T2D. The study included 86 newly diagnosed patients with T2D, incident users of metformin. Levels of fasting glucose, insulin, HbA(1c), total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and anthropometric parameters were measured prior to metformin therapy, and 6 and 12 months after the treatment. Genotyping of the TCF7L2 rs7903146 was performed by the Sequenom MassARRAY(®) iPLEX(®) platform. At baseline, the diabetes risk allele (T) showed an association with lower triglyceride levels (p = 0.037). After 12 months of metformin treatment, the T allele was associated with 25.9% lower fasting insulin levels (95% CI 10.9–38.3%, p = 0.002) and 29.1% lower HOMA-IR index (95% CI 10.1–44.1%, p = 0.005), after adjustment for baseline values. Moreover, the T allele was associated with 6.7% lower fasting glucose levels (95% CI 1.1–12.0%, p = 0.021), adjusted for baseline glucose and baseline HOMA-%B levels, after 6 months of metformin treatment. This effect was more pronounced in the TT carriers who had 16.8% lower fasting glucose levels (95% CI 7.0–25.6%, p = 0.002) compared to the patients with CC genotype. Our results suggest that the TCF7L2 rs7903146 variant affects markers of insulin resistance and glycemic response to metformin in newly diagnosed patients with T2D within the first year of metformin treatment.

Previous studies reported conflicting results regarding association of insulin receptor substrate 1 (IRS1) gene variation with type 2 diabetes (T2D) and insulin resistance (IR) in different ethnic groups. We examined the association of rs7578326, rs2943641, and rs4675095 in the IRS1 gene with T2D and related traits in a population from Bosnia and Herzegovina, which is one of the European countries with the highest T2D prevalence of 12.5%. Our study included 390 T2D patients and 252 control subjects. Biochemical parameters, including fasting glucose (FG), fasting insulin (FI), homeostasis model assessment insulin resistance index (HOMA-IR), and HbA 1c were measured in all participants. Genotyping analysis was performed by Mass Array Sequenom iPlex platform. Our results demonstrated that rs7578326 and rs4675095 variants were associated with increased FG levels. The rs7578326 was also associated with higher FI, HOMA-IR (B = 0.08, 95% CI [0.01, 0.15], p add = 0.025; B = 0.079, 95% CI [0.006, 0.150], p add = 0.033, respectively) in T2D, and with HbA 1c (B = 0.034, 95% CI [0.003, 0.065], p dom = 0.035) in non-drug-treated T2D. In contrast, rs2943641 C allele was associated with lower FG levels in control subjects (B = -0.17, 95% CI [-0.03, -0.002], p add = 0.030) and HbA 1c (B = 0.03, 95% CI [0.002, 0.06], p dom = 0.040) in non-drug-treated T2D. We report the association between common variants in IRS1 gene with insulin resistance, glucose, and HbA 1c levels in Bosnia and Herzegovina's population.

Aims Metformin is the most widely used oral anti‐diabetes agent and has considerable benefits over other therapies, yet 20–30% of people develop gastrointestinal side effects, and 5% are unable to tolerate metformin due to the severity of these side effects. The mechanism for gastrointestinal side effects and their considerable inter‐individual variability is unclear. We have recently shown the association between organic cation transporter 1 (OCT1) variants and severe intolerance to metformin in people with Type 2 diabetes. The aim of this study was to explore the association of OCT1 reduced‐function polymorphisms with common metformin‐induced gastrointestinal side effects in Type 2 diabetes. Methods This prospective observational cohort study included 92 patients with newly diagnosed Type 2 diabetes, incident users of metformin. Patients were genotyped for two common loss‐of‐function variants in the OCT1 gene (SLC22A1): R61C (rs12208357) and M420del (rs72552763). The association of OCT1 reduced‐function alleles with gastrointestinal side effects was analysed using logistic regression. Results Forty‐three patients (47%) experienced gastrointestinal adverse effects in the first 6 months of metformin treatment. Interestingly, the number of OCT1 reduced‐function alleles was significantly associated with over two‐fold higher odds of the common metformin‐induced gastrointestinal side effects (odds ratio = 2.31, 95% confidence interval 1.07–5.01, P = 0.034). Conclusions In conclusion, we showed for the first time the association between OCT1 variants and common metformin‐induced gastrointestinal side effects. These results confirm recent findings related to the role of OCT1 in severe metformin intolerance, and suggest that high inter‐individual variability in mild/moderate and severe gastrointestinal intolerance share a common underlying mechanism. These data could contribute to more personalized and safer metformin treatment., What's new? The mechanism of high inter‐individual variability in gastrointestinal side effects associated with metformin treatment is unknown.We show for the first time the association between organic cation transporter 1 reduced‐function variants and common metformin‐induced gastrointestinal side effects.These results might contribute to more personalized and safer treatment with metformin.

Aim To analyse the long-term impact of altered metabolism on the level of mediators of inflammatory response in female patients with type 2 diabetes. Methods This study included 97 female patients with type 2 diabetes and 107 female, nondiabetic control subjects, who were recruited at the Clinical Centre University of Sarajevo and the General Hospital Tešanj. The effects of glycaemic control on markers of inflammatory response represented by C-reactive protein (CRP), fibrinogen, leukocytes, sedimentation rate, and cytokine IL-6 were tested. All subjects were free of evidence of infections, surgery, thyroid disease, polycystic ovarian syndrome, active liver and kidney damage. All biochemical analyses were performed according to standard International Federation of Clinical Chemistry (IFCC) protocols. Results A significant increase of fibrinogen (p0.001), CRP (p=0.001), interleukin-6 (p=0.013), leukocytes (p0.001) and sedimentation rate (p=0.008) in diabetic female population compared to control subjects was found. A significant correlation between CRP and haemoglobin A1c (p=0.035), interleukin-6 and glucose (p=0.032), IL-6 and body mass index (p=0.007) was found. Conclusion Our data suggest that inflammation plays an important role in the pathogenesis of diabetes in female diabetic population. A more detailed study on a far larger number of subjects is needed if they were to be used effectively as biomarkers in the primary prevention of type 2 diabetes in this population.

To improve the quality of patient treatment by improving the functionality of medical devices in healthcare institutions. To present the results of the safety and performance inspection of patient-relevant output parameters of anesthesia machines and defibrillators defined by legal metrology. This study covered 130 anesthesia machines and 161 defibrillators used in public and private healthcare institutions, during a period of two years. Testing procedures were carried out according to international standards and legal metrology legislative procedures in Bosnia and Herzegovina. The results show that in 13.84% of tested anesthesia machine and 14.91% of defibrillators device performance is not in accordance with requirements and should either have its results be verified, or the device removed from use or scheduled for corrective maintenance. Research emphasizes importance of independent safety and performance inspections, and gives recommendations for the frequency of inspection based on measurements. Results offer implications for adequacy of preventive and corrective maintenance performed in healthcare institutions. Based on collected data, the first digital electronical database of anesthesia machines and defibrillators used in healthcare institutions in Bosnia and Herzegovina is created. This database is a useful tool for tracking each device's performance over time.

Osteoporosis is a skeletal disorder which weakens the bones and increases the risk of the bone cracking. There are many factors included in the pathogenesis of osteoporosis and a lot of them still remain unknown. The RANK/RANKL system is involved in osteoclast maturation. By binding to its receptor (RANK), RANKL stimulates osteoclast precursors to develop into fully mature osteoclasts. RANK transmits biochemical signals after the recruitment of the intracellular adaptor TNF receptor associated factor (TRAF) proteins. TRAF6 binds to RANK and plays an essential role in RANKL-mediated NF-κβ activation in transfected cell systems.

In this paper development of Artificial Neural Network for classification of prediabetes and type 2 diabetes (T2D) is presented. For development of this system 310 samples consisting of information about Fasting Plasma Glucose (FPG) and blood test called HbA1c were used. All samples were obtained from several healthcare institutions in Bosnia and Herzegovina, and diagnosis of prediabetes, T2D and healthy patients in this dataset were established by medical professionals. Two-layer feedforward backpropagation network with 15 neurons in hidden layer and sigmoid transfer function, used for classification of prediabetes and T2D in this paper, was trained with 190 samples.

Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. It is proven that electrical stimulation could accelerate wound or fracture healing and also decreases pain. Because of numerous benefits on cell function, it is assumed that electrical stimulation can have positive effect on diabetes. Aim of this article is to summarize results of different studies which analyzed effect of electrical stimulation on most important parameters of diabetes mellitus in animal models. Unilateral electrical stimulation of dorsal motor nucleus of the vagus nerve resulted in rapid rise in plasma insulin levels >200%, and stimulation of the nucleus tractus solitarius, also produced 50% increase in insulinemia, in Wistar rats. Mild electrical stimulation (MES) combined with heath shock treatment (HS), significantly decreased fasting blood glucose and insulin levels, and improved insulin sensitivity in C57BL/6J, db/db mice as well as in KKAy mice. Peripheral electrical stimulation (PES) increased hepatic glucose output during the basal state in insulin-resistant Wistar-Han rats. PES improved tissue sensitivity to insulin, improved suppression of hepatic glucose production, and significantly elevated rate of glycogenesis compared with controls. Hepatic electrical stimulation was effective in reducing blood glucose by 27-31%, in Sprague-Dawley rats, streptozocin induced diabetic rats and Fa/Fa diabetic fatty rats. The present studies indicate that electrical stimulation treatment of very short duration is very potent to stimulate glucose uptake and improve insulin sensitivity. Electrical stimulation may directly affect major insulin target tissues or leading to secondary effects in other tissues. Low intensity current showed no observable adverse effects, but electrical conductance in cells should be measured. Electrical stimulation has very positive impact on diabetes in animal models, so it should be subject of further examinations for human use.

This paper presents the development of an Expert System for the classification of metabolic syndrome (MetS). Two-layer feedforward Artificial Neural Network (ANN) with sigmoid transfer function is used for MetS classification. In accordance with international guidelines NHBL/AHA, classification is performed based on following input parameters: waist circumference, blood pressure, glucose level, HDL cholesterol and triglycerides. Samples for training of developed Expert System are obtained from 1083 patients at hospitals in Bosnia and Herzegovina.

Summary Background: Peroxisome proliferator-activated receptor gamma (PPARg) is a key transcription factor in adipogene-sis, and also regulates a number of genes associated with lipid storage and insulin sensitivity. Single nucleotide polymorphisms (SNPs) in the PPARG gene have been associated with obesity and diabetes. In this study, we explored the relationship of three PPARG gene variants with the metabolic syndrome (MetS) and related traits in a population from Bosnia and Herzegovina. Methods: Anthropometric and biochemical parameters were measured in 43 patients with MetS and 43 healthy controls. Subjects were genotyped for Pro12Ala (rs1801282) and 1431C>T (rs3856806) SNPs by classic PCR–restriction fragment length polymorphism analysis, and for-681C>G (rs10865710) variant by real-time PCR. Results: The genotype distributions for the three polymorphisms were not significantly different between MetS patients and controls. The Pro12Ala and 1431C>T variants were associated with lower body mass index in the control subjects (p=0.012 and p=0.049, respectively). In this group, the carriers of Pro12Ala had also lower waist circumference compared to the wild-type homozygotes (p=0.045). Conclusions: Results of our preliminary study indicate a beneficial effect of a common Pro12Ala variant on the metabolic phenotype in healthy non-obese subjects.

Background: Acute respiratory distress syndrome (ARDS) is life treating condition, with intensive general inflammation. Objective: Inflammation can be present with infection or without. Septic embolism, according to our previous experience, is more often multiple, than single. General hypoxia of hall body cause damage of all tissue, and generalinflammationintensifies. A vicious circle was formed and inflammation runs its course in what is very often irrelevant how it was begun.How often pulmonary embolism causes ARDS and what are the main features of this disease, is the goal of the study. Methods: Patients with ARDS, treated in pulmonary intensive care unit were analyzed. Chest X-ray, microbiological analysis of sputum or bronchoalveolar lavage specimen, chest CT scan, blood culture, CRP (mg/dl), deep-dimmer and blood cell count, were performed for all cases. Results: In three years period 53 patients with ARDS were treated. Out of all 19 with septic pulmonary embolism (14 multiple), (CRP 198±28). In only 12 patients origin of venous thrombus was found. Out of all 6 patients have massive non septic embolism (CRP 28±7), 18 heavy pneumonia (CRP 166±28), 4 with interstitial pneumonia (CRP 76±19), 5 with massive TB with caverns (CRP 35±13) and 6 with not well defined cause. Blood culture was positive in 14 cases with septic embolism and in 11 cases with pneumonia. CRP was elevated in all cases but highest was in septic embolism (Mann-Whitney test p=0,024). Conclusion: Septic pulmonary embolism was common cause of ARDS, mostly as multiple, and should be considered even if origin of thrombus was found or not.

INTRODUCTION: The enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) catalyzes the conversion of the hormonally inactive cortisone to active cortisol, thus facilitating glucocorticoid receptor activation in target tissues. Increased expression of 11beta-HSD1 in adipose tissue has been associated with obesity and insulin resistance. In this study, we investigated the association of two 11beta-HSD1 gene (HSD11B1) polymorphisms with the metabolic syndrome (MetS) and its characteristics in the Bosnian population. MATERIALS AND METHODS: The study included 86 participants: 43 patients diagnosed with MetS and 43 healthy controls. Subjects were genotyped for two HSD11B1 gene polymorphisms: rs846910: G > A and rs45487298: insA, by the high resolution melting curve analysis. Genotype distribution and an influence of genotypes on clinical and biochemical parameters were assessed. RESULTS: There was no significant difference in the mutated allele frequencies for the two HSD11B1 gene polymorphisms between MetS patients and controls. In MetS patients, no significant associations between disease-associated traits and rs45487298: insA were found. Regarding rs846910: G > Avariant, heterozygous patients (G/A) had significantly lower systolic (P = 0.017) and diastolic blood pressure (P = 0.015), lower HOMA-IR index (P = 0.011) and higher LDL-cholesterol levels (P = 0.049), compared to the wild-type homozygotes. In the control group, rs45487298: insA polymorphism was associated with lower fasting plasma insulin levels (P = 0.041), lower homeostasis model assessment insulin resistance (HOMA-IR) index (P = 0.041) and lower diastolic blood pressure (P = 0.048). Significant differences between rs846910: G > A genotypes in controls were not detected. Haplotype analysis confirmed the association of rs45487298: insA with markers of insulin resistance in the control subjects. CONCLUSIONS: Our results indicate that a common rs45487298: insA polymorphism in HSD1181 gene may have a protective effect against insulin resistance.

Objective: Tobacco cigarette smoking is one of the major leading causes of death throughout the world. Smoking has both acute and chronic effect on haematological parameters. The aim of the present study was to assess the extent of adverse effects of cigarette smoking on biochemical characteristics in healthy smokers. Subjects and Method: One hundred and fifty six subjects participated in this study, 56 smokers and 100 non-smokers. The smokers were regularly consuming 10-20 cigarettes per day for at least 3 years. Complete blood cell count was analyzed by CELL-DYN 3700 fully automatic haematological analyzer. Results: The smokers had significantly higher levels of white blood cell (p

To investigate association of two LPIN1 gene variations with main traits of metabolic syndrome (MS) (waist circumference, body mass index, blood pressure, triglycerides, HDL-cholesterol and fasting glucose levels) in population from Bosnia and Herzegovina.This study included 43 patients with metabolic syndrome and 43 healthy controls from General Hospital in Tešanj, Bosnia and Herzegovina. Subjects were genotyped for two LPIN1 gene variations (rs11693809: CT and rs2716610: CT) by real time PCR method.In control subjects LPIN1 polymorphism, rs2716610: CT, was significantly associated with a lower body mass index (BMI) (p=0.008) and waist circumference (p=0.008). The second analyzed rs11693809: CT polymorphism was associated with lower blood HbA1c levels (p=0.048) in a group of MS patients.Results of our study suggest that rs2716610: CT polymorphism of LPIN1 gene could have a protective effect against development of metabolic syndrome, while rs11693809: CT might affect a glucose control in patients with MS.

Contemporary inhabitants of the Balkan Peninsula belong to several ethnic groups of diverse cultural background. In this study, three ethnic groups from Bosnia and Herzegovina - Bosniacs, Bosnian Croats and Bosnian Serbs - as well as the populations of Serbians, Croatians, Macedonians from the former Yugoslav Republic of Macedonia, Montenegrins and Kosovars have been characterized for the genetic variation of 660 000 genome-wide autosomal single nucleotide polymorphisms and for haploid markers. New autosomal data of the 70 individuals together with previously published data of 20 individuals from the populations of the Western Balkan region in a context of 695 samples of global range have been analysed. Comparison of the variation data of autosomal and haploid lineages of the studied Western Balkan populations reveals a concordance of the data in both sets and the genetic uniformity of the studied populations, especially of Western South-Slavic speakers. The genetic variation of Western Balkan populations reveals the continuity between the Middle East and Europe via the Balkan region and supports the scenario that one of the major routes of ancient gene flows and admixture went through the Balkan Peninsula.

Introduction: Because of increasing prevalence of T2MD worldwide, it’s very important to recognize risk factors for diabetic complications, as soon as possible. Symptoms of complications appear a few or many years after tissue damage. So, it’s imperative to establish surveillance of diabetics with laboratory and other diagnostic procedures for early recognition of diabetic complications. Follow up of clinical curs of diabetes, by using databases of patients, provide possibility for permanent analysis of important laboratory parameters and any changes could be registered. Although an emerging evidence suggests a strong association of ALT (alanine aminotransferase) and γGT (gamma glutamyl transferase) activity with type 2 diabetes mellitus (T2DM), only a limited number of studies have analyzed the association of AST (aspartate aminotransferase), ALT, γGT, and ALP (alkaline phosphatase) activities in controlled T2DM. Material and Methods: Gender differences are of special interest in trying to follow diabetes progression and development of its complications. Here the activities of ALT, AST, γGT, ALP were analyzed as well as levels of glycosylated hemoglobin (HbA1c) and fasting plasma glucose (FPG) in 40 T2DM patients and 40 age-matched healthy subjects. Blood samples were collected from all participants in regular 3-months intervals up to 6 months period. Standard IFCC enzyme protocols were used to determine enzyme activities. Results and discussion: In first measured interval, significantly higher activities of ALT (p= 0,050) and glucose levels (p=0,045) were shown in male. A significant correlation was shown between ALT and AST activity with FPG and HbA1c levels in first and third measured interval. ALT activity was much higher in the group of patients with poor glycemia control. Average levels of activities of enzymes stay nearly in normal limits, but changes of enzymes activities should be recognized as soon as possible, earlier than tissue changes and diabetic complications become irreversible.