2025-09-29
Lejla Ušanović, Svjetlana Stanić-Koštroman, Dalila Destanović, Jasna Hanjalić Kurtović, Lejla Lasić, Belma Kalamujić Stroil
Background and purpose: Three genera and eleven species of Glossosomatidae family have been confirmed in Bosnia and Herzegovina. However, there is limited research on the biodiversity of this family in the region, especially on molecular data. With this paper, we contribute to the knowledge on the Glossosomatidae family with the first molecular records for two species for Bosnia and Herzegovina. Materials and methods: Larval samples of caddisflies were collected in April 2019 and 2021 at the area of the Natural Monument the Spring of Bosna River followed by morphological identification. Molecular confirmation of species was done using DNA barcoding, targeting the cytochrome c oxidase subunit I (COI) region using Folmer’s primers and degenerated primers LCO1490-JJ and HCO2198-JJ. All obtained PCR products were bidirectionally sequenced using the same primers as in PCR. Results: Out of 52 specimens, 18 were morphologically determined to species level. A DNA barcode was successfully generated for 16 specimens. Eight sequences were generated for Synagapetus krawanyi , revealing three haplotypes previously absent from the BOLD database. Four sequences were obtained for S. iridipennis , with one new haplotype for BOLD database. Conclusions: We present new data on species distribution and genetic diversity of S. krawanyi and S. iridipennis from Bosnia and Herzegovina. This study contributes to the knowledge of caddisfly biodiversity and the Global Trichoptera Barcode Initiative by adding new records from two underrepresented species in the BOLD database.
2025-09-29
Anđela Horvat, Janja Josić, Dorian Laslo, Maša Hrelec Patrlj, Ignacija Vlašić
Ovarian cancer is one of the most common and deadliest tumors among women. Despite recent clinical advances, the combination of platinum-based chemotherapy and surgery remains the first-line therapeutic option. Due to frequent detection at an advanced stage and development of therapy resistance, the disease prognosis is often poor, and mortality rates remain high. Therefore, it is necessary to investigate new therapeutic approaches that would contribute to increased survival and higher life quality of ovarian cancer patients. One of these approaches is the use of the pro-oxidant effect of certain drugs that can disrupt the redox balance in tumor cells and lead to their death. Vitamin C (ascorbic acid or ascorbate) used in high concentrations suppresses cancer cell growth and metastasis. There are several mechanisms by which vitamin C exerts its antitumor function including pro-oxidant activity, epigenetic reprogramming and tumor environment oxygen sensing. The potential use of vitamin C in combinatorial therapies (as a support to standard therapies) should be reconsidered through more detailed mechanistic and clinical studies. Finding new therapeutic approaches would augment the available mechanisms in the fight against cancer leading to the increase in patient welfare and overall survival of cancer patients.
2025-09-29
Tanushree Bhowmik, Arun Sharma, K. Pani Prasad, Megha K. Bedekar, K.K. Krishnani, Thongam Ibemcha Chanu, Pritam Sarkar, Tamal Seth
Background and purpose: Clarias magur (Hamilton, 1822), the Asian or walking catfish, is a high-value fish species in India and Southeast Asia for its taste and nutritional value. The combined effect of ammonia and bacterial infection on C. magur has not been studied so far. Moreover, the mechanism of ammonia-induced toxicity and their adaptability in C. magur is poorly understood. Given this context, a systematic study was devised to examine the individual and combined exposure effect of unionized ammonia and Aeromonas caviae on haemato-biochemical and histopathological changes of different tissues of C. magur . Materials and methods: A 14-day experiment was conducted to expose the fish to sublethal doses of UIA, A. caviae , and a combination of both. Initially, we have determined the 96-hr LC50 value for UIA in C. magur . During the experimental period, various hematological parameters were tested, such as total erythrocyte count, hemoglobin, packed cell volume, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. Different biochemical parameters like blood glucose, serum, and tissue urea, serum glutamate pyruvate transaminase, and serum glutamate oxaloacetate transaminase levels and histopathological examination were performed. Results: The 96-hr LC50 value for UIA in C. magur was 7.21 mgL–1. The 14th day exposure of UIA (2.4 mgL–1), A. caviae (1.53 × 105 CFU mL–1), and their combination resulted in significant decreases in various hematological parameters such as total erythrocyte count, hemoglobin, packed cell volume, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. Additionally, there were notable increases in blood glucose, serum and tissue urea, serum glutamate pyruvate transaminase, and serum glutamate oxaloacetate transaminase levels in all treatment groups compared to the control. Histological examination revealed significant changes in gill, kidney, and liver tissues, including lamellar fusion, edema, nodular enlargement of lamellar tips, lamellar congestion and curling in gill tissues, cytoplasmic vacuolation, pyknosis, karyorrhexis, karyolysis, and degeneration of renal tubule cells in kidney tissues, and increased vacuolation in hepatocytes, disorganization of hepatic cords, and increased hemorrhage in liver tissues. Interestingly, the combined exposure to UIA and A. caviae resulted in fewer histological alterations than individual exposures. Furthermore, after the 14th day, the group exposed only to bacteria exhibited the lowest relative percent survival compared to those exposed to only UIA and the combination. Conclusions: This study signifies that there was a negative synergistic or antagonism effect in the fish after exposure to ammonia and bacteria in combination. This discrepancy indicates that elevated ammonia concentrations might have restricted the survival of A. caviae or disrupted the infection process. The present study's findings open a new avenue for further understanding the mechanism of ammonia exposure in the direction of an alternative method to combat bacterial infections.
2025-09-10
Ivana Bureš Valentić, Matea Mrčelić, Renata Curić Radivojević, Krešimir Gršić, Drago Prgomet
Background and purpose: Retrosternal goiter refers to thyroid enlargement in which the lower pole of the thyroid is not palpable with the neck in a hyperextended position. The presence of a mass in the anterior mediastinum and displacement of the trachea are the risk factors for a difficult airway. The aim of this study was to present our experience with airway management in patients with retrosternal goiter. Materials and methods: We conducted a retrospective observational study of patients undergoing elective retrosternal goiter surgery in a tertiary center over one year. We analyzed the preoperative evaluation data and the planning, techniques and outcome of airway management. Results: From January 1st to December 31st, 2024, a total of 349 patients underwent thyroid surgery at our center. Among 72 patients admitted for goiter surgery, 26 patients were diagnosed with retrosternal goiter. A preoperative computerized tomography scan was performed in most patients and revealed 11 patients with massive retrosternal goiter. Intravenous induction to anesthesia with direct or video laryngoscopy was the preferred method of intubation. No significant complications were recorded. Conclusion: If there are no additional risk factors, intravenous induction of anesthesia and intubation with direct or video laryngoscopy are acceptable methods of airway management in patients with retrosternal goiter. Flexible nasendoscopy and virtual bronchoscopy are valuable methods for airway assessment and may reduce the need for awake fiberoptic intubation in complex cases. However, multicentric studies with larger sample sizes are needed to confirm our findings.
2025-09-10
Andrea Saračević, Helana Čičak, Lucija Drinovac
Background and purpose: Respiratory tract infections (RTIs) are a global public health issue and one of the major causes of morbidity and mortality worldwide, especially in immune sensitive or compromised population. It is particularly challenging to distinguish viral from bacterial RTI based only on the symptoms presentations. Bacterial cultures are the gold standard in detecting the causative pathogens. However, they have several shortcomings such as variable diagnostic sensitivity, a relatively long turnaround time and the fact that not all possible pathogens can be detected using one culture. In such case, tests detecting host-response blood-based biomarkers are a valuable contribution in diagnosis making and patient management. Materials and methods: A literature search was conducted in the PubMed electronic database from January 1st 2005 to March 31st 2025 using the following search terms “Clinical Laboratory Techniques” AND “Serum” AND “Infections” AND “Respiratory tract diseases” AND “Diagnosis” AND “Prognosis”. Randomized,non-randomized studies as well as reviews were taken into consideration. Results: C-reactive protein and procalcitonin are at the present the most robust and widely used biomarkers; however newer biomarkers such as serum calprotectin, pentraxin 3 and presepsin, as well as combinations of different biomarkers with high potential for clinical utility are emerging. Conclusions: Host-response biomarkers of inflammation are useful tools in RTIs management when used together in conjunction with clinical symptoms. Depending on the kinetics of their release into the circulation and their elimination, they can be used as either early markers of inflammation or as a prognostic marker for disease severity and mortality.
2025-09-10
Višnja Nesek Adam, Martina Matolić, Điđi Delalić, Tamara Murselović, Ante Penavić
Background and purpose: Reintubation in the intensive care unit is a critical event linked to increased morbidity, prolonged hospitalization, and higher mortality. It often results from respiratory muscle weakness, airway edema, neurological impairment, or cardiovascular instability. Patients requiring reintubation face elevated risks of ventilator-associated pneumonia, airway trauma, and hemodynamic instability. Preventive strategies such as careful extubation planning, noninvasive ventilation, high-flow nasal cannula, corticosteroids for airway edema, and optimized fluid management can help reduce reintubation rates. A structured, multidisciplinary approach is essential for improving extubation success and patient outcomes. Conclusions: This review examines the causes, risk factors, and consequences of reintubation, along with strategies for prevention and management, emphasizing the importance of evidence-based weaning protocols and advanced monitoring techniques.
2025-09-10
Iva Smiljanić, Ana Brkljačić, Petra Zlatar, Jasminka Peršec, Ana Brundula
Background and purpose: Airway management remains one of anesthesiology’s most unpredictable challenges. The prediction of a difficult airway extends beyond the scope of standard bedside tests and anthropometric measurements, therefore patients classified as low risk may present with unanticipated challenges in ventilation or tracheal intubation. This review explores the limitations of current predictive tools and provides an overview of the leading national guidelines for unanticipated difficult airway management. Materials and methods: A detailed guideline analysis was performed covering definitions, incidence, risk factors, and recommendations issued by major national and professional societies in the field of airway management. Results: Findings confirm that bedside predictive tests lack accuracy, and most difficult airways are unanticipated. The incidence of the difficult airway varies greatly in the literature, by setting and surgical specialties. Guidelines, though varied in structure, consistently emphasize first-pass success, limited attempts, early alternative device use, and the need for backup strategies and documentation. Conclusions: Airway difficulty is an essential part of pre-operative evaluation but remains largely unpredictable. Although technological innovations improve management, neither history, clinical examination nor widely used bedside tests are consistently reliable predictors. Effective clinical judgment, individualized planning with a ready back-up strategy for a possible failed airway management, together with structured, evidence based guidelines still remain essential. Documentation, teamwork, and adaptable algorithms tailored to environment and clinician preference are key to enhancing patient safety and reducing airway-related adverse events.
2025-09-10
Ljubica Nikles, Tatjana Goranović, Tea Medved
Background and purpose: Hypertrophic tonsils can limit the visibility of glottis as a prerequisite for successful intubation. Although expected, studies have not unequivocally proven that videolaryngoscopy improves the visibility of the glottis in children. The aim of this study was to compare the visibility of the glottis using direct (DL) and video laryngoscopy (VL) during induction of general anesthesia in children undergoing adenotonsillectomy or adenoidectomy. Materials and methods: This retrospective study was performed by reviewing the medical charts of 88 children, up to 8 years of age, who underwent adenotonsillectomy/adenoidectomy in the period from January to December 2024 at the Sveti Duh University Hospital in Zagreb. General data were taken for each patient: age, gender, height and weight; preoperative anesthesiology data; ASA classification, Mallampati; intraoperative anesthesia data: difficulty of manual ventilation (according to Han), glottic visualization according to the Cormack Lehane classification, intubation (orderly, difficult, impossible), type of laryngoscope used, type of mechanical ventilation (volume, pressure) and postoperative data on postoperative respiratory complications. Thirty-eight children had complete data. Results: The Cormack-Lehane classification distribution was similar between the VL and DL (p=0.250). The distribution of glottic visibility according to the Cormack-Lehane classification from 1 to 4 in the VL group (n=13), was as follows: 10 (76.9%), 3 (23.1%), 0 (%), and 0 (0%), while in the DL group (n=25) was as follows: 18 (72%), 3 (12%), 4 (16%), and 0(0%). Conclusion: In our patient sample, VL compared to DL did not increase glottic visibility according to the Cormack-Lehane classificatio
2025-09-10
Ana Vuzdar Trajkovski, Vesna Grgić, Marina Katalinić Novak, Krešimir Reiner, Ivan Šklebar
Background and purpose: High-flow nasal oxygenation (HFNO) is gaining attention in anesthesia for cesarean sections under general anesthesia due to its potential to reduce hypoxemia - a major cause of maternal morbidity and mortality. Pregnant patients face increased risk from anatomical and physiological changes, including airway edema, reduced functional residual capacity, and increased aspiration risk. Traditional preoxygenation with 100% oxygen via a face mask may not provide adequate oxygen reserves, prompting exploration of HFNO as an alternative. This paper reviews current evidence on the use of HFNO preoxygenation during anesthesia induction for cesarean sections. Materials and methods: An extensive literature search was performed to evaluate existing research on HFNO as a preoxygenation technique in obstetric general anesthesia. Results: Eight studies were identified that assess HFNO in this context. While some report inferior performance in achieving optimal end-tidal oxygen fraction compared to face mask methods, others highlight benefits. A 2021 randomized trial found HFNO yielded higher arterial oxygen tension and end tidal oxygen fraction post-intubation. Additionally, a recent multicenter pilot study reported no desaturation events among pregnant patients, supporting HFNO’s safety and potential efficacy. Conclusion: HFNO offers advantages such as prolonged safe apnea time and ease of application. However, its effectiveness in the obstetric population remains insufficiently validated. More robust clinical trials are required before HFNO can be integrated into standard anesthetic protocols for cesarean sections.