Minimally invasive options for coronary artery bypass graft (CABG) surgery progressed dramatically in the last decades. Minimally invasive CABG surgery is presented trough these forms: minimally invasive direct coronary artery bypass (MIDCAB), endoscopic atraumatic coronary artery bypass (EndoACAB), robot-assisted direct coronary artery bypass (RADCAB), total endoscopic coronary artery bypass (TECAB), and hybrid coronary revascularisation (HCR). Unfortunately, these are still limited only to the specialised centres across the world and have not been accepted by the majority of cardiac surgeons. A surgeon who is starting to practice minimally invasive CABG surgery needs to be ready for long duration of the interventions, higher rate of conversions to sternotomy and significant learning curve. Excellent results that have been published on the subject of minimally invasive revascularisation methods support the potential of these alternative approaches to evolve in the near future.

Faecal microbiota transplantation (FMT), known equally well as faecal transplantation or faecal bacteriotherapy, is the process of implanting the faecal suspension containing balanced microbiota from a healthy donor to the colon of a recipient patient. Excessive growth of Clostridioides difficile (C difficile) in the intestinal microbiota resulting from antibiotic consumption is currently a rising threat to public health. FMT is one of the most important, newer approaches to treating C difficile infections. Since C difficile is regarded as an opportunistic bacterium triggering disease in conditions of disturbed homeostasis of the intestinal microbiota, restoration of healthy intestinal microflora facilitates suppression of toxic strain of C difficile by anaerobic bacteria of normal intestinal microflora with concomitant cure. Nurses have important role in caring for patients after faecal transplantation.

Background: Clinical use of adult mesenchymal stem cells (MSCa) in medicine and regenerative surgery is constantly evolving. Adipose tissue-derived stem cells (ADSc) are capable of inducing the production of new extracellular matrix (ECM), deposition of new collagen and early revascularisation. Methods: Flow cytometry was performed for 2 mL of cell colonies harvested from adipose tissue (AT). Comparation has been made of at disaggregated only and the same at disaggregated and microfiltered at 50 mm, 100 mm and 200 mm. Signs of inflammation after dermo-epidermal regeneration session through the mesotherapy method were observed and compared. Results: Even after filtration, significant number of ADSc was collected. An increase in the size of the filter did not always translate into an increase in the number of cells that were found in the microfiltrate. In the non-filtered at disaggregated in both cases, highest number of cells was found, as expected, but at the expense of more pronounced inflammation. Sampling with the 16 Gauge needle produces superior results compared to the cannula in all cases. Conclusion: With this method in medicine and regenerative surgery it will be easier to exploit the growth factors, mRNA, MicroRNA, lipids and bioactive peptides emitted in the MSCa signalling micro-vesicles as they are isolated from the inflammatory component.

Background/Aim: There have been different experimental conditions for in vitro studies on human umbilical arteries (HUA) in tissue bath system. This diversity was mainly reflected in variables such as stretching tension, incubation period and initial constriction challenging with potassium (KCl). The aim of the study was to establish optimal experimental conditions which will provide better responsiveness of HUA preparations, as well as to examine the impact of 24 h cold storage on viability and responsiveness of HUA to KCl and serotonin. Methods: The KCl-induced constrictions at different stretching tensions (0.5 g, 1.0 g, 2.0 g, 4.0 g), incubation times (30 min, 60 min, 120 min), and after multiple initial constriction challenging were compared. Dose response curves for serotonin were obtained under different conditions (1.0 g and 60 min vs. 2.0 g and 120 min). The influence of 24 h cold storage on KCland serotonininduced vasoconstriction of HUA preparations was examined as well. Results: The strongest constrictions induced by serotonin or KCl were obtained when preparations were adjusted at 2.0 g and incubated for 120 min. The KCl-induced constrictions observed after 120 min were statistically higher (p < 0.05) when preparations were challenged three times (30 min, 60 min, 120 min), compared to those challenged only once. The preparations that were stored at 4 ⁰C for 24 h showed significantly stronger serotonin-induced constrictions (p < 0.01). The cold storage had no influence on KCl-induced constriction. Conclusion: For performing in vitro studies on HUA preparations in tissue bath, we propose stretching tension of 2.0 g, incubation period of 120 min and multiple initial constriction challenging with KCl as optimal experimental condition. We also showed that HUA preparations retained functional viability even after 24 h of cold storage.

Background/Aim: The relation of social isolation (SI) to global cardiovascular health (CVH) is not clear. In this paper the association of CVH metrics to SI within US adults was investigated. Methods: Using the US National Health and Nutrition Examination Survey, the association of SI with American Heart Association's Life's Simple 7 (LS7) CVH components (smoking, body mass index, physical activity, total cholesterol, diet, blood pressure, fasting blood glucose) was examined. The sum of the components (scored 1 for poor, 2 for intermediate and 3 for ideal) created a composite CVH score. Multiple logistic regression provided the odds of SI according to levels of the LS7 components adjusted for age, sex, and ethnicity. Results: A total of 3,528 adults aged ≥ 40 were studied. The mean age, sex and ethnicity-adjusted composite CVH scores were 14.1 vs 14.6 in those with vs without SI (p < 0.01). Multiple logistic regression examined individual LS7 components in relation to SI and showed the adjusted odds for SI for those with ideal vs poor smoking status to be 0.57 (range 0.38-0.85), ideal vs poor physical activity 0.53 (range 0.37-0.76) and ideal vs poor fasting glucose 0.65 (range 0.47-0.91). Conclusion: This study generally shows lower levels of CVH in those with vs without SI, with non-smoking status; ideal physical activity and ideal glucose levels were all less likely associated with SI, suggesting the potential value for screening for SI in identifying those at potential cardiovascular disease risk.

The last several decades have witnessed a huge expansion of surgical and interventional treatment of cardiac disease. Axel Cappelen from Oslo, Norway was one of the first to operate on the heart, something that had until then, been considered foolish and without chance of success <a href="#b0" class="ref" >[1]</a>. Cappelen dared to operate on the heart in spite of Billroth's stark warning against such "unwise" attempts as he ligated a bleeding coronary artery caused by a stabbing injury. Most of the innovation in recent years has been within the interventional cardiology domain in contrast to the first 7 decades of the 20th century, when surgeons dominated. Cardiac surgeons have developed less invasive procedures, although the most common surgical incision is based on the time-honoured and large median sternotomy incision. Many surgeons continue to prefer the concept of "Grosse Chirurgen, Grosse Schnitte" and have stayed away from minimisation and continue to use direct vision, usually augmented by magnification glasses, median sternotomy and cardiopulmonary bypass (CPB). However, new technology has made the need for CPB less important <a href="#b1" class="ref" >[2]</a>. In this article a selection of recently developed devices for cardiac intervention will be described.

The publication of scientific research is principally information published in scientific journals and they are cornerstone of knowledge dissemination, as well as an essential criterion for academic and scientific evaluation, recruiting funds and career progression. However, it is very difficult to apply right measures and scientific criteria which can objectively assess scientific research. For many years there has been a great interest in scientific ranking and evaluation of scientific journals, but also of scientific contribution of scientists. It is generally accepted that the IF (WoS) and the total number of citations of articles published in the journal, are the most relevant parameters of the journal's significance. However, the scientific significance of a scientist is much more complicated to evaluate and the value of their scientific production cannot be directly reflected by the importance of the journals in which their articles are published. The majority of existing science metric systems, which evaluate the achievement of scientists are focused solely on the number of citations of their articles. Based on a long term of academic experience, the author describes and evaluates the most known scientific databases which are used in biomedical sciences. Also, the author proposes Z-score as a new science metric system which takes into account the current IF (WoS) and total number of citations of the journal in which the article is published, as well as author's contribution to the scientific article. In that way, proposed criteria greatly remedy major discrepancies in evaluating scientific production of individual authors and institutions.

The simple filtration by means of the MilliGraft® Kit of a disaggregated lipoaspirate allows to extract the class of cells defined as progentors with characteristics of adult stem cells present in the nanofat exclusively on the basis of their dimensions. It also allows the elimination of the fibrous branches and cell membranes destroyed by the emulsion phase and obtain a population of cells deprived of the inflammatory component. This method was used in regenerative and aeshetic medicine treatments with excellent and lasting clinical results in the follow-up phase.

Introduction: Bone formation marker osteocalcin (OC) and bone resorption marker C-terminal telopeptide of type 1 collagen (CTX) can be used to detect or to monitor the early responses of the skeleton to physical activity. Literature suggests that it is likely that higher body mass index (BMI) has positive effect on bones and can postpone onset of osteoporosis.Aim of the Study: The aim of this study is to:1.Determine the effect of aerobic physical acitivity on OC and CTX in young women2.Investigate correlation of OC, CTX and BMI in young women engaged into structured aerobic excerciseMaterial and methods: Study included 64 healthy young women, aged 19 to 25 years, devided into two groups: intervention group (n=32) and control group (n=32). The study duration was six weeks with follow-up period of four weeks. The intervention group underwent structured aerobic physical activity program for six weeks, but the control group did not receive such program. Level of OC, CTX and BMI were measured at baseline, after 6-week aerobic program, and after 4-week follow up (only intervention group).Results: There was significant increase of OC level after 6-week aerobic program, while level of CTX did not changed. OC level was at its maximum immediately after finishing the program in the participants with normal BMI (p&lt;0.001). There was no statistically significant interaction of BMI and CTX level.Conclusion: Aerobic physical activity increases level of osteocalcin, suggesting that it has positive influence on bone formation in young women, primarily in women with normal BMI.

Introduction: The introduction of BRAF inhibitor vemurafenib significantly improvedoverall survival (OS) in metastatic melanoma patients.Aim of the Study: The purpose of this study was to determine OS and progressionfree survival (PFS) in patients with advanced metastatic melanoma treated withvemurafenib in the Oncology Clinic, University Clinical Centre of the Republic ofSrpska (UKC RS). The secondary goal is to determine the effect of elevated serumlactate dehydrogenase (LDH) on OS.Patients and Methods: We analysed patients that received vemurafenib in theApril 2015. until March 2018. They had pathohistologically confirmed B-RAF positivemetastatic melanoma. LDH values were measured at the start of the treatment.Results: A total of 16 patients were analyzed, with an average age of 53 years(37-78). A large number of patients at the start had multiple sites of metastases.Calculated OS in patients who received vemurafenib is 11.8 months (p=0,23), withstandard deviation (SD) 9.18. The calculated PFS is 9.5, SD 7,57. OS in patients withnormal LDH is 14.4 months, SD 10.73, and with elevated LDH is 8.4 months, SD4.9 (p=0.079).Conclusion: Use of vemurafenib resulted in an improvement in PFS, with improvedOS in patients with advanced BRAF-mutated melanoma. In patients with elevatedLDH OS was reduced. This shows that LDH is a good prognostic marker and thatwe should do it routinely for all patients with melanoma. This study has indicatedthe need for new diagnostic and therapeutic options for melanoma in Republic ofSrpska.