Better non-invasive endoscopic procedure: endoscopic ultrasound or magnetic resonance cholangiopancreatography?

Aim To present our experience with a diagnostic ability of endoscopic ultrasound (EUS) and magnetic retrograde cholangiopancreatography (MRCP) in cases of choledocholithiasis verified by endoscopic retrograde cholangiopancreatography (ERCP). Methods This retrospective study was conducted after a collection of data involving 58 suspected choledocholithiasis patients who underwent ERCP from January 2013 to December 2015. Patients who were diagnosed with choledocholithiasis on the basis of clinical symptoms and radiological findings and who underwent ERCP were included in this study.

Prognostic Significance of Ascites and Serum Sodium in Patients with Low Meld Scores.

Objective: to determine ascites and serum sodium significance in short term mortality prediction in patients with advanced liver cirrhosis.

Methods: a cohort of 115 cirrhotic patients referred to our Department were followed up for 6 months in non-transplant settings. The c index equivalent to the area under the receiver operating curve (ROC) was calculated and compared to estimate the short-term prognostic accuracy of the following parameters: ascites, serum sodium and MELD score.

Use of serum levels of proinflammatory cytokine IL-1α in chronic hepatitis C.

Immunoregulatory cytokines influence the persistence of hepatitis C virus chronic infection and the extent of liver damage. Interleukin-1 plays an important role in the inflammatory process. Some studies have demonstrated that IL-1 production was impaired in patients with chronic infections of hepatitis C virus, implying that IL-1 may play a role in viral clearance.

Protein C Deficiency in Chronic Hepatitis C: Correlation With Histological Extent of Liver Fibrosis.

There is accumulating evidence that the coagulation system is involved in the process of fibrogenesis in chronic liver disease. Recent studies postulated a possible connection between plasmatic hypercoagulability and progression of fibrosis. The aim of the study was to investigate disorders of the coagulation system in patients with chronic hepatitis C having different extent of hepatic fibrosis well defined by liver histology.

Gastric cancer staging: EUS and CT.

Introduction: Gastric cancer is the fourth most common cancer and the second leading cause of death from cancer. Only complete resection of all gross disease with negative microscopic margins (R0 resection) provides a long-term survival benefit, and the overall 5-year relative survival rate is approximately 20%. To improve survival and quality of life, new therapeutic approaches have been introduced.

Prognostic markers in patients with decompensated cirrhosis.

Aim: To evaluate the easily available laboratory and clinical markers in patients with decompensated cirrhosis and compare their prognostic value.

Methods: The study sample included a group of 80 patients with an established diagnosis of decompensated cirrhosis, hspitalizsed at the Department of Gastroenterohepatology, Clinical Center of the University of Sarajevo, between 2009 and 2011, followed up for 6 months either as outpatients or through repeated hspitalizsation. It was estimated that the accuracy (c-index) of the six variables, laboratory (serum bilirubin, creatinine, International Normalised Ratio (INR) and albumine) and clinical variables (hepatic encephalopathy and ascites) reflect the function of the liver in their ability to predict 6-month mortality.

Anaemia and inflammatory bowel disease.

Background: Anaemia has been recognised as a key symptom of IBD. Although efficient therapeutic options have been developed for the treatment of IBD associated anaemia, treating anaemia often has a low priority for gastroenterologists. Compared with other manifestations of the disease, such as arthritis or osteopathy, anaemia in IBD has been given scant attention.

Predictive value of endoscopic ultrasound in diagnosis and staging of primary gastric lymphoma.

The aim of the paper is to investigate significance of the endoscopic ultrasound (EUS) in diagnostic and staging of gastric lymphoma. Retrospective clinical study was conducted at the Clinic for Hematology and Clinic for Gastroenterology of the University Clinical Center of Sarajevo in the period of years 2002 to 2009. Patients (N = 40) with diagnosis of gastric lymphoma confirmed by pathohistological diagnosis were included in the study.

Impact of sustained virus elimination on natural anticoagulant activity in patients with chronic viral hepatitis C.

Previous studies have reported reduced synthesis of various hemostatic factors in patients with chronic liver disease. Whether changes in plasma levels of these proteins reflect recovered liver synthetic function following virological eradication therapy has not been approved yet. The aim of the study was to determine the impact of sustained viral suppression achieved with pegylated interferon alpha and ribavirin on hemostatic parameters including natural anticoagulants in patients with chronic hepatitis C.

Association between high D-dimer plasma levels and ascites in patients with liver cirrhosis.

Objective: The aim of the study was to investigate plasma D-dimer concentration in patients with liver cirrhosis with and without ascites and to evaluate the impact of ascites depletion on circulating plasma D-dimer levels.

Methods: Sixty patients with liver cirrhosis were recruited and categorized into two groups: cirrhotic patients without ascites in group 1 (n = 30) and patients with liver cirrhosis and ascites in group 2 (n = 30). D-dimer levels were measured on day of admission, in patients with ascites D-dimer concentration levels were repeated measured after ascites resolution cofirmed by ultrasonography.

Percutaneous endoscopic gastrostomy (PEG): retrospective analysis of a 7-year clinical experience.

Aims: Since its description in 1980, percutaneous endoscopic gastrostomy has become the modality of choice for providing enteral access to patients who require long-term enteral nutrition. This study aimed to evaluate current indications and complications associated with PEG feeding.

Methods: We conducted a retrospective analysis of all patients who referred to our endoscopic unit of the Department of Gastroenterology and Hepatology of the Medical Center University of Sarajevo for PEG tube placement over a period of 7 years.

Non-invasive liver fibrosis markers: use of serum levels of cytokines IL 1α and TGF ß1 in management of chronic liver diseases.

Aim: To analyze the usefulness of specified immunological parameters, proinflammatory IL-1α and profibrogenic, antiinflammatory TGF-β1, along with routinely used laboratory tests, in the differential - diagnostic procedure of chronic hepatitis of infectious and noninfectious etiology.

Methods: A total of 150 subjects were divided into two groups, depending on the infectious or noninfectious etiology of liver damage, and the control group. Apart from standard laboratory tests, the analysis included serum levels of cytokines: IL-1α and TGF-β1.

Diagnosis and treatment of chronic viral hepatitis B and C: doctrinary approach.

Association of Gastroenterologists and Hepatologists of Bosnia and Herzegovina based on the experiences of domestic and foreign centers operating in the field of hepatology and accepted guidelines of the European and the U.S. Association for Liver Diseases adopted the consensus for the diagnosis and treatment of chronic viral hepatitis B and C.

Clinical significance of haemostatic tests in chronic liver disease.

Objective: To determine different haemostatic tests in patients with various degrees of liver parenchymal damage and to rule out their role in assessing parenchymal hepatocyte dysfunction.

Methods: Seventy-five patients with chronic liver disease were included and due to their degree of liver damage categorized into three groups: group one patients with chronic viral hepatitis and early stage of fibrosis (n=30), group two patients with compensated cirrhosis (n=17) and group three patients with decompensated liver cirrhosis (n=28). The following haemostatic tests were measured: activated partial thromboplastin time, prothrombin time, plasma fibrinogen, antithrombin III and protein C and plasma D-dimer.

Hematologic and laboratory parameters in patientis with peptic ulcer bleeding treated by two modalities of endoscopic haemostasis and proton pump inhibitors.

Aim: To compare two schedules (continuous infusion or bolus i.v. of PPI) in treatment after endoscopic homeostasis of bleeding ulcers.

Usefulness of laboratory data in estimation of Crohn's disease activity.

Crohn's disease (CD) is a chronic inflammatory disease characterized by unpredictable and severe course. Most clinicians use simple laboratory parameters of inflammatory activity such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the number of leukocytes (Le) and platelet count to assess disease activity. The aim of this paper was to determine the value of various laboratory parameters in the assessment of Crohn's disease activity.

The role of nitric oxide and ferritin in the pathogenesis of alcoholic liver disease: a controlled clinical study.

The role of ferritin in fibrogenesis of liver parenchyma in patients with alcoholic liver disease has been investigated in previous studies. Ferritin was shown to be an indirect marker of ferum deposition in liver parenchyma in alcohol liver disease. The aim of the present study was to examine the role of nitric oxide (NO) in the pathogenesis of alcoholic liver disease as well as the influence of NO on iron (ferritin) metabolism in patients with alcoholic liver disease.

Application of nutritional screening tests for determining prevalence of hospital malnutrition.

Introduction And Objective: Many illnesses are related to the loss of appetite or the inability to intake food in a regular fashion. The consequence of long-term or even short-term non-intake of food leads to damaging of organ functions and tissue. Tissue consumption, which is speeded up through metabolic effects of inflammatory mediators, is a characteristic which is identified as clinical malnutrition.

Proton pump inhibitors after endoscopic hemostasis in patients with peptic ulcer bleeding.

Background: Peptic ulcer bleeding is a common and potentially fatal condition. For patients with bleeding peptic ulcers that display major endoscopic stigmata of recent hemorrhage, a combination of endoscopic and pharmacologic therapy is the current standard management.

Objective: To show our experience with management of peptic ulcer bleeding.

Test for obscure bleeding vs colonoscopy in the prevention of colorectal cancer.

Introduction: Colorectal cancer is one of the most common forms of cancer and its frequency has been on the constant and significant increase over the past 20 years. Prevention aiming for early precancerous detection, results in huge financial savings in the health care system. METHODOLOGY AND TEST SUBJECTS: Prospective randomized clinical research was conducted on 150 randomly chosen asymptomatic persons over the age of 50, with positive family history.

[Application of endoscopic ultrasound in diagnostics of biliary lithiasis].

Endoscopic ultrasound (EUS) and Magnetic Endoscopic Cholangiopancreatography (MRCP) are important supplementary methods used for endoscopic extraction of common bile duct stones. The technical characteristics of both methods are excellent. If EUS is used for diagnostic purposes in diagnostic of biliary tree disorders there are almost no adverse consequences compared with other indication for this method.

Pretherapeutic staging of the esophageal cancer using endoscopic ultrasound.

Patients with verified early stage of the esophageal carcinoma are presented with a very good prognosis, however all over the world patients present themselves with advanced stages thus minoring the chances for survival. Data obtained form the USA programmes are presenting information about 5 year survival period in 14% of the cases. On the other hand, prospective multi centric European study refers to the same period in 10%.

Evaluation of the diagnostic accuracy of the endoscopic ultrasonography results in the patients examined in a period of three years.

Introduction: Endoscopic ultrasonography (EUS) is a well-established method of evaluating patients with gastrointestinal diseases, especially malignancies. EUS is like other similar endoscopy techniques, based on high frequency ultrasonography. This high level technology allows examination of tissue to almost microscopic level, not only in digestive system but its surrounding structures.

Randomized trial of TEP laparoscopic hernioplasty versus Bassni inguinal hernia repair.

Objective: To evaluate the influence of the laparoscopic tehnique in healing of hernia from the perspectives of time to full recovery, return to work and complications. TYPE OF STUDIES: Randomized, prospectiv study. All relevant factors, should be important to evaluate operative method.

Portal hypertensive gastropathy (PHG).

Portal hypertenisive gastropathy (PHG) and GAVE syndrome are recently discovered entities who can be associated with bloodloss from gastrointestinal tract at patients with or without liver cirrhosis. PHG will be developed at 65% of patients with portal hypertension caused by liver cirrhosis but it could be developed at portal hypertension which is not caused by the liver cirrhosis. PHG is often assosiated with portal hypertension patients and presence of esofageal and /or gastric varices.