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Prenos instrumentov za merjenje kakovosti življenja, razvitih v nekaterih, večinoma razvitejših delih sveta, zahteva transkulturno validacijo. Kljub temu tovrstni instrumenti običajno ne zajemajo regionalno specifičnih vidikov kakovosti življenja, povezanih z zdravjem. Namen študije je bil razviti in potrditi zanesljiv vprašalnik v srbskem, hrvaškem, bosansko-hrvaško-srbskem in črnogorskem jeziku, primeren za merjenje kakovosti življenja, povezanega z zdravjem odraslih. Translations of instruments for measuring quality of life developed in certain, mostly more developed, parts of the world usually do not cover regionally specific aspects of health-related quality of life, even after transcultural validation. The aim of this study was to develop and validate a reliable questionnaire in Serbian, Croatian, Bosnian, and Montenegrin languages suitable for measuring health-related quality of life in adults.

Uvod: HIV-infekcija se karakteriše progresivnim manjkom CD4+ T-ćelija zbog njihove smanjene sinteze, povećanog uništavanja i izrazite aktivacije i ekspanzije CD8+ T limfocita. CD4/CD8 odnos (količnik, engl. ratio) se sve više pojavljuje kao marker različitih ishoda kod HIV-inficiranih pojedinaca. S druge strane CRP je tradicionalno opisivan kao dobar marker akutne upale i danas je jedan od standardnih testova koji se koriste u svakodnevnoj kliničkoj praksi, za postavljanje dijagnoze i praćenje prognoze upale. Međutim, uloga CRP-a u različitim fiziološkim procesima, naročito kod perzistentne infekcije i imunske aktivacije nije do kraja jasna. Efikasnom i savremenom terapijom HIVa život ovakvih pacijenta je značajno produžen. Primarni cilj antiretrovirusne terapije (ART) je spriječiti HIV-povezane bolesti i smrtnost, a sekundarni cilj je da se smanji rizik od prijenosa HIV-a. Ovaj cilj se najbolje postiže pomoću efikasne cART, kojom se maksimalno inhibira HIV replikacija, tako da plazmatska HIV RNK (viremija) ostaje ispod nivoa kojeg je moguće detektovati pomoću komercijalno dostupnih testova. Cilj: Osnovni cilj ovog istraživanja je da se ispita kolika je moć CD4/CD8 odnosa i CRP-a da predvidi razvoj rizika kardiovaskularne bolesti (KVB) kod HIV pozitivnih pacijenata koji primaju cART terapiju. Materijal i metode: U retrospektivno-prospektivnoj kohortnoj studiji ponovljenih mjerenja bilo je uključeno 76 HIV pozitivnih ispitanika. Za određivanje udjela (procenta) CD4+ i CD8+ ćelija, iz periferne krvi pacijenata, korištena je metoda protočne citometrije. U ovoj studiji evaluirane su vrijednosti biohemijskih paremetara (CRP-a, lipidnog statusa), parametara krvne slike (eritrociti, hemogbin, hematokrit, trombociti), leukociti i leukocitarna formula te sedimentacija kao nespecifični parametri akutne upale, potom imunološki parametar CD4/CD8 odnos, antropometrijska mjerenja- ITM, te vrsta cART terapije. Za statističku analizu korišten je softver SPSS, odnosno parametrijski i neparamterijski testovi, Spirmanova (rho) korelacija, standardna regresiona analiza i ROC kriva. Rezultati: U istraživanje je uključeno 76 ispitanika, 67 (88,2 %) muškaraca i 9 (11,8 %) žena. Ispitanici su prosječne starosti 35,2±8,7 godina, najmlađi ispitanik imao je 18, a najstariji 57 godina. Standardnom regresionom analizom, ispitivan je uticaj nezavisnih prediktora (starosti, pola, navike pušenja, familijarne anameze za KVB, ITM, cART,5 sistolnog i dijastolnog pritiska, holesterola, triglicerda, HDL-a, ŠUK-a, CRP-a, CD4 i CD4/CD8) na zavisno promjenljivu rizik za KVB bazično i nakon 3, 6, 12, 18 i 24 mjeseca cART. Od 12. do 24. mjeseca osim standardnih rizikofaktora za predikciju razvoja KVB, CD4/CD8 odnos i CRP se javljaju kao značajni prediktori. Nakon 24 mjeseca cART, CRP se pokazao kao najbolji prediktor rizika za KVB (beta=0,224; p=0,026), veće vrijednosti ovog parametara utiču na veći rizik za KVB, potom CD4/CD8 odnos (beta=-0,200; p=0,025), s tim da veći odnos smanjuje vjerovatnoću za rizik KVB. Terapija (cART) u ovom regresionom modelu prvi put je nakon 24 mjeseca pokazala statistički značajan uticaj na rizik za KVB (beta=0,197; p=0,013). Ispitanici koji su u kombinovanoj terapiji imali PI, imaju veći rizik za KVB. Od 18. mjeseca cART CRP može biti marker srednjeg rizika za KVB, a nakon 24 mjeseca vrijednosti CRP-a od 5,31 mg/L ima najveću senzitivnost 78,3% i najveću specifičnost 86,8%, kao marker srednjeg u odnosu na niski rizik za KVB (p=0,0001; AUC=0,882). Od 12 mjeseca cART CD4/CD8 odnos može biti marker niskog rizika za KVB. Nakon 24 mjeseca terapije prosječna vrijednost CD4/CD8 odnosa od 0,53 ima najveću senzitivnost 66,0% i najveću specifičnost 73,9%, kako marker niskog u odnosu na srednji rizik za KVB (p=0,001; AUC =0,762). Zaključci: Količnik CD4/CD8 i CRP su se pokazali se kao značajni prediktori za rizik KVB, i kao markeri koji mogu razlikovati nizak/srednji rizik za KVB kod HIV pacijenata nakon 12 mjeseci cART. Introduction: HIV infection is characterized by a progressive deficiency of CD4+ T cells due to their reduced synthesis, increased destruction and marked activation and expansion of CD8+ T lymphocytes. The CD4/CD8 ratio is increasingly emerging as a marker of different outcomes in HIV-infected individuals. On the other hand, CRP has traditionally been described as a good marker of acute inflammation and is today one of the standard tests used in everyday clinical practice to diagnose and monitor inflammation prognosis. However, the role of CRP in various physiological processes, especially in persistent infections and immune activation, is not entirely clear. The primary goal of antiretroviral therapy (ART) is to prevent HIV-related diseases and mortality, and the secondary goal is to reduce the risk of HIV transmission. This goal is best achieved by using efficient combination ART (cART), which maximally inhibits HIV replication, so that plasma HIV RNA (viral load) remains below the level that can be detected by commercially available tests. Aim: The main objective of this study is to examine the power of the CD4/CD8 ratio and CRP in predicting the risk of development of cardiovascular disease (CVD) in HIV positive patients receiving cART therapy. Methods: In the retrospective-prospective cohort study of repeated measurements, 76 HIV positive subjects were included. The method of flow cytometry was used to determine the percentage of CD4+ and CD8+ cells in the peripheral blood of patients. In this study the values of biochemical parameters (CRP, lipid status), blood parameters (erythrocytes, hemoglobin, hematocrit, platelets), leukocytes, leukocyte formula, and sedimentation as non-specific parameters of acute inflammation were evaluated, followed by immunocompetent CD4/CD8 ratio, anthropometric measurements - ITM, and cART therapy type. For statistical analysis SPSS software was used, i.e. parametric and nonparametric tests, Spearman's (rho) correlation, standard regression analysis and ROC curve. Results: The study included 76 subjects, 67 (88.2%) males and 9 (11.8%) women. The average age of subjects was 35.2 ± 8.7 years; the youngest subject was 18 and the oldest 57 years old. By standard regression analysis, the influence of independent predictors (age, gender, smoking habits, familial anamnesis for CVD, ITM, cART, systolic and diastolic7 pressure, cholesterol, triglycerides, HDL, blood sugar, CRP, CD4 and CD4/CD8 ratio) on the dependent variable risk of CVD, baseline and after 3, 6, 12, 18 and 24 months of cART was examined. From 12 to 24 months apart from the standard risk factors for predicting the development of CVD, CD4/CD8 ratio and CRP appear as significant predictors. After 24 months of cART, CRP proved to be the best risk predictor of CVD (beta = 0.224; p = 0.026), higher values of this parameter affect higher risk for CVD, then CD4/CD8 ratio (beta -0.200, p = 0.025), with a higher ratio decreasing the likelihood of CVD risk. Therapy (cART) in this regression model showed the first time after 24 months a statistically significant impact on CVD risk (beta = 0.197; p = 0.013). Subjects who had PI in combination therapy had a higher risk for CVD. From 18 months of cART CRP may be a medium risk marker for CVD, and after 24 months the CRP value of 5.31 mg/L has the highest sensitivity of 78.3% and the highest specificity of 86.8%, as a marker of medium compared to low risk for CVD (p = 0.0001; AUC = 0.882). After 12 months of cART CD4/CD8 ratio can be a low risk marker for CVD. After 24 months of therapy, the average CD4/CD8 ratio of 0.53 had the highest sensitivity 66.0% and the highest specificity was 73.9%, as the marker of low compared to medium risk for CVD (p = 0.001, AUC = 0.762). Conclusion: CD4/CD8 ratio and CRP counts have been shown to be significant CVD risk predictors, and as markers that may differentiate low and intermediate risk for CVD in HIV patients after 12 months of cART.

Background: Critical limb ischemia (CLI) represents the end stage of peripheral arterial disease (PAD). It is defined as a chronic ischemic rest pain, ulcers or gangrene, attributable to proven arterial occlusive disease. Intra-arterial digital subtr action angiography (IA DSA) still represents the gold standard for the evaluation of steno-occlusive lesions, but it has greatly been replaced with non-invasive multi-detector computed tomography angiography (MDCTA). The purpose of this prospective study was to compare diagnostic performance of MDCTA versus DSA in treatment planning in patients with CLI according to TransAtlantic Inter-Society Consensus Document on Management of Peripheral Arterial disease (TASC II). Subjects and methods: The study was designed as prospective; it was conducted from March 2014 to August 2016, and included 60 patients with symptoms of CLI, Fontaine stage III and IV. MDCTA of the peripheral arteries was performed first, followed by DSA. The lesions of aorto-iliac, femoro-popliteal and infra-popliteal regions were classified according to the TASC II guidelin es, and inter-modality agreement between MDCTA and DSA was determined by using Kendall’s tau-b statistics. Results: Inter-modality agreement was statistically significant in all three vascular beds, with excellent agreement >0.81 in aortoiliac and femoropopliteal regions, and a very good agreement >0.61 in infrapopliteal region. Treatment recommendations based on MDCTA findings and DSA findings were identical in 54 (90%) patients. In one patient (1.7%), CTA was not interpretable. In five patients (8.3%), CTA findings disagreed with DSA findings in regard to the preferable treatment option. Conclusion: 64-row MDCT angiography is highly competitive to DSA in evaluation of steno-occlusive disease and treatment planning in patients with critical limb ischemia.

Aim To evaluate efficacy and safety of iris-supported phakic lenses (Verisyse) for treating moderately high myopia. Methods This prospective clinical study included 40 eyes from 29 patients, who underwent implantation of Verisyse for correction of myopia from -6.00 to -14.50 diopters (D) in the Eye Clinic ‘’Svjetlost’’, Sarajevo, from January 2011 to January 2014. Uncorrected distance visual acuity (UDVA), manifest residual spherical equivalent (MRSE), postoperative astigmatism, intraocular pressure (IOP), endothelial cell (EC) density were evaluated at one, three, six and twelve months. Corrected visual acuity (CDVA), index of safety and efficacy were evaluated after 12 months. Results Out of 29 patients 15 were males and 14 females, with mean age of 27.9 ± 5.0. After 12 months 77.5% eyes had UDVA ≥ 0.5 and 32.5% had UDVA ≥ 0.8. Mean MRSE was 0.55D ± 0.57D and mean postoperative astigmatism -0.86D ± 0.47D. Efficacy index was 1.09 ± 0.19 and safety index 1.18 ± 0.21. One eye (2.5%) lost two Snellen lines and three eyes (7.5%) one line, 11 eyes (27.5%) gained one line, and five eyes (15.5%) gained two lines. EC loss after 12 months was 7.59 ± 3.05%. There was no significant change of IOP after one year follow up. Conclusion Implantation of iris-supported phakic lenses (Verisyse) for treating moderately high myopia is an efficient and safe procedure.