The Distribution of TPMT Gene Variants in the Population of the Republic of Srpska: Implications for Personalized Thiopurine Therapy
Introduction: Thiopurine drugs are widely administered for autoimmune and inflammatory diseases, as well as malignancies. The enzyme thiopurine S-methyltransferase, encoded by the TPMT gene, plays a crucial role in drug metabolism. Knowledge of the frequency and distribution of TPMT allelic variants facilitates personalized treatment and prevention of adverse effects. Aim: To investigate the frequency and distribution of the most prevalent TPMT allelic variants (*2, *3A, *3C) among the Caucasoid population in the Republic of Srpska. This distribution will help estimate risk for drug-related toxicity and allow tailored thiopurine use. Materials and Methods: A total of 100 unrelated healthy volunteers from various regions of the Republic of Srpska were included. Genotyping for *2, *3A, and *3C allelic variants was performed using real-time PCR. Results: Minor allele frequency for *2 was 0.23% (95% CI: 0,04–1,32%); *3B and *3C both had a frequency of 2.83% (95% CI: 1,63–4,88%). 5,66% of subjects were CT or TC genotype carriers for *3B and *3C, respectively. One (0.47%) carried the CG genotype for *2. Co-occurrence of heterozygous *3B and *3C genotypes indicated a *3A haplotype frequency of 2.83%. Among 12 carriers of the *3A genotype, 4 were female and 8 male, with no significant sex differences (p > 0.05). All genotype frequencies were in Hardy-Weinberg equilibrium. Conclusion: Most subjects are likely to safely metabolize thiopurines at standard doses, but identifying intermediate metabolizers by genetic testing is necessary to prevent serious adverse reactions.
Influence of Peroxide-Based Bleaching and Laser Activation on Dental Composite Integrity
Introduction: Tooth whitening in the presence of dental restorations requires special consideration, as restorative materials respond differently to bleaching agents compared to natural dental tissues. Active bleaching substances may alter the physical and mechanical properties of composites, potentially compromising the integrity and longevity of restorations. Aim: This study aimed to evaluate the impact of bleaching agents with different concentrations, as well as additional laser activation, on the properties of selected dental composites. Materials and Methods: Four composite materials were selected: G-aenial Universal Flo (GC) and ESTELITE UNIVERSAL FLOW (Tokuyama Dental) with three different viscosity levels. Whitening procedures were performed using Opalescence gels (Ultradent) containing active agents at concentrations of 10%, 16%, and 40%. In addition, a subset of specimens was exposed to laser irradiation. Tribological tests, microscopic surface analyses, and microhardness measurements were carried out to assess the influence of bleaching protocols. Results: The bleaching process resulted in adverse effects on the composites’ properties. A reduction in microhardness, alterations in surface morphology, and increased wear susceptibility were observed. The degree of degradation was influenced by both the concentration of the bleaching agent and the use of laser activation. The observed changes are likely associated with polymer matrix degradation caused by hydrogen peroxide and carbamide peroxide present in bleaching gels. Conclusion: Tooth whitening procedures, particularly those involving higher peroxide concentrations and laser activation, negatively affect the structural and mechanical properties of dental composites. These findings emphasize the need for clinicians to carefully consider restorative materials when planning whitening treatments in patients with composite fillings.
Effect of DMLS Parameters and Heat Treatment on the Microstructure, Mechanical Performance, and Biofunctionality of Ti-6Al-4V Alloy
Introduction: Metallic biomaterials are widely applied in reconstructive surgery, including joint arthroplasty, maxillofacial surgery, and dentistry. Titanium alloys, particularly Ti-6Al-4V, are of special interest due to their low density, favorable mechanical properties, high corrosion resistance, and biocompatibility. Conventional processing methods, such as casting and plastic forming, are costly and technically challenging. In recent years, additive manufacturing technologies, especially Direct Metal Laser Sintering (DMLS), have emerged as promising alternatives. Aim: The study aimed to verify the hypothesis that proper adjustment of DMLS manufacturing parameters, combined with heat treatment, enables the production of Ti-6Al-4V elements with high density, controlled microstructure, low porosity, and mechanical properties comparable to those obtained by conventional methods. Materials and Methods: Ti-6Al-4V alloy specimens were fabricated using DMLS under varying laser power and scanning speed conditions. Heat treatments at different temperatures were performed to modify the as-sintered martensitic microstructure. Mechanical properties (Rm, Re, A, E), surface roughness, porosity, and microstructure were evaluated. Additionally, biofunctionality and cytotoxicity in simulated body fluids were assessed. Results: Laser power and scanning speed significantly affected surface roughness and material density. Mechanical properties were strongly correlated with energy density and post-processing heat treatment. The as-sintered martensitic microstructure provided high strength but insufficient ductility and ferromagnetism, thus unsuitable for biomedical use. Heat treatment at 850 °C for 2 hours resulted in a two-phase microstructure with improved ductility, homogenized structure, and reduced anisotropy, while porosity remained nearly unchanged (< 0.5% at 100–127 J/mm³ energy density). Mechanical parameters Rm and Re decreased, whereas A and E increased, reflecting enhanced functional balance. Conclusion: Optimized DMLS parameters combined with appropriate heat treatment allow the production of Ti-6Al-4V implants with desirable mechanical and structural characteristics, ensuring biofunctional performance comparable to conventionally processed alloys.
Attitudes and Opinions of Medical Students about Hijama
Introduction: Hijama (cupping therapy) is an ancient method originating from Chinese and Arabic medicine. It is based on creating a vacuum using a cup on the body. There is dry (vacuum-only) and wet hijama (with small cuts on the skin to drain blood). This practice requires contemporary scientific assessment and regulation in the modern health care system. Aim: The aim of the research was to analyze the level of knowledge, attitudes, and professional beliefs about hijama among medical students. Materials and Methods: An anonymous survey was conducted on a sample of 51 medical students. The questionnaire included questions about definition, scientific basis, ethical standards, and willingness to recommend to patients. Response frequencies were analyzed to determine dominant attitudes. Results: 86% of students are familiar with hijama, which is most often defined as complementary medicine along with modern therapies (about 27%). Attitudes are predominantly positive (47%), with 55% of respondents believing that it should be used as a supplement to classical medicine. However, caution is emphasized: 59% of respondents consider hijama to be only partially scientifically based. 48% of respondents would recommend it to patients in certain cases. There is a strong consensus that performance must be regulated. 67% of respondents believe that hijama should only be performed by doctors of medicine and dentistry with additional training due to the need for knowledge of anatomy and complications. Almost the same percentage (67% of students) expresses the desire for formal education about hijama within the study program. Conclusion: Medical students see the potential of hijama as a complementary method, but emphasize the necessity of a scientific foundation and professional regulation. The results suggest that integrative medicine topics, including hijama, should be introduced into the medical curriculum to ensure safe practice only by qualified professionals.
Analysis of Complications in Patients with Cushing's Syndrome: A Retrospective Study
Introduction: Cushing's syndrome is chronic hypercortisolism that leads to the development of numerous metabolic, cardiovascular, neuropsychiatric, and immunological complications, with a significant increase in morbidity and mortality. Endogenous Cushing's syndrome is most commonly caused by an ACTH-secreting pituitary adenoma, and less frequently by an adrenal tumor or ectopic ACTH production. Timely recognition and treatment of complications are crucial for reducing adverse outcomes and improving the quality of life of affected patients. Aim: To determine the prevalence of complications of Cushing's syndrome in the form of dyslipidemia and impaired glucose regulation. Materials and Methods: This study included a retrospective analysis of 49 patients with endogenous Cushing's syndrome, treated either on an outpatient or inpatient basis at the Clinic for Endocrinology at the University Clinical Center from November 2020 to November 2024. Based on laboratory findings of blood glucose levels in the daily glucose profile and glycated hemoglobin (HbA1c), the presence of impaired glucose regulation in the studied population was assessed. Lipid profiles were used to classify hyperlipoproteinemias according to Fredrickson's classification. Data were statistically processed using the JASP 0.19.3 software and presented graphically. Results: Among all patients, dyslipidemia was confirmed in 69.39%, while 63.27% had fasting or 2-hour postprandial hyperglycemia. Elevated HbA1c levels were recorded in 10.20% of patients, while the majority (89.80%) had HbA1c values within the normal range. Fewer than half of the patients (36.73%) had normal glucose levels. Conclusion: The significant prevalence of metabolic disorders in patients with Cushing's syndrome is indicated by the fact that, out of 49 patients, 34 (69.39%) have dyslipidemia, while 31 patients (63.27%) have hyperglycemia.
Prediction of Accelerated Brain Aging in Patients with HIV Infection: The Role of Ventral Diencephalon and Thalamic Volume
Introduction: Despite effective viral suppression achieved through combination antiretroviral therapy (cART), HIV (human immunodeficiency virus) infection remains associated with neurological complications and potential accelerated brain aging. The difference between chronological and predicted brain age (Brain Age Gap – BAG) is emerging as an important biomarker of neurodegeneration. Aim: The aim of this study was to determine whether a significant difference exists between chronological and estimated brain age in HIV-positive patients compared to healthy controls, using MRI scans and the volBrain software with an integrated brain age estimation module, as well as to develop regression models to assess the contribution of individual brain structures to predicted brain age. Materials and Methods: A retrospective study was conducted, including 110 male participants divided into two groups. The first group consisted of HIV-positive patients on therapy (N = 24) and those not receiving treatment (N = 48), while the second group included healthy controls (N = 38). Automated volumetric analysis of MRI scans was performed using the volBrain software. Statistical analysis included t-tests and regression analyses. Results: A statistically significant difference between chronological and predicted brain age was observed in HIV-positive patients (p < 0.05), while no significant difference was found in healthy controls. The ventral diencephalon and thalamus volumes were significant negative predictors of predicted brain age (p = 0.00), while the volume of the anterior cingulate gyrus exhibited a trend toward statistical significance. Conclusion: Our findings indicate accelerated brain aging in HIV-positive patients, with specific brain structures, such as the thalamus and the ventral diencephalon, contributing significantly to the prediction of biological brain age.
Volumetric Analysis and Segmentation of the Hippocampus in Patients with Alzheimer’s Disease
Introduction: Alzheimer’s disease (AD) is a leading cause of dementia worldwide, representing a growing public health and socioeconomic burden. Despite advances in diagnostic criteria, effective treatments capable of halting disease progression remain unavailable. As AD’s most vulnerable brain structure, the hippocampus is crucial in understanding disease development and monitoring therapeutic outcomes. Automated segmentation methods, such as the VolBrain platform, provide objective and reproducible measurements of hippocampal and subfield volumes using high-resolution magnetic resonance imaging (MRI). In addition, cerebrospinal fluid (CSF) biomarkers, including Aβ amyloid, phosphorylated tau (pTAU), and total tau (tTAU), are recognized as important indicators of AD-related neurodegeneration. Aim: To compare hippocampal and subfield volumes between patients with Alzheimer’s disease and healthy controls, and to examine potential correlations with CSF biomarkers (Aβ, pTAU, tTAU). Materials and Methods: The study included 15 patients with clinically diagnosed AD and 15 age- and sex-matched healthy controls. All participants underwent 3 Tesla MRI scanning. Automated hippocampal segmentation and volumetric analysis were performed using the VolBrain platform. CSF biomarker levels were analyzed and compared with hippocampal volumes. Results: Patients with AD showed significantly reduced total and left hippocampal volumes compared to controls (p < 0.01). Additional significant volume reductions were found in the CA1 and CA4-DG subfields (p < 0.01). No significant correlations were observed between hippocampal volumes and CSF biomarker levels. Conclusion: Automated hippocampal volumetry revealed notable atrophy in Alzheimer’s disease, especially in the CA1 and CA4-DG subfields. These findings support the potential role of hippocampal volumetry as a complementary biomarker for assessing neurodegeneration in AD.
Antibiofilm Effect of Disinfectants against Biofilm-Producing Strains of Salmonella spp. Isolated from Foods of Animal Origin
Introduction: Salmonella spp. are zoonotic bacteria that can infect humans and animals as free-living, planktonic forms and can survive on plants and non-living environments in the form of a sessile community called a biofilm. Salmonella spp. have great importance within the concept of "One Health" as the most important public health problem. If bacteria from foods of animal origin form biofilms on inanimate surfaces, they can survive for a long time on machines and surfaces and be a constant source of food contamination in catering and the food industry. Aim: The aim of this paper was to compare the sensitivity to disinfectants (hydrogen peroxide, benzalkonium chloride, and sodium hypochlorite) against biofilm producers among bacteria belonging to the genus Salmonella, which are isolated from foods of animal origin. Materials and Methods: We have tested 70 Salmonella strains detected in animal-originated food, which were treated with disinfectants (0.5% sodium hypochlorite and benzalkonium chloride, 3% hydrogen peroxide) for 5 minutes after overnight incubation at 25 ℃ and 37 ℃. Results: Biofilm production was optimal at 25 ℃, with 15 (21%) isolates classified as non-producers and 55 (79%) isolates producing biofilm with an average biomass of 0.11. At 37 ℃, 26 isolates (37%) did not form a biofilm, while moderate and weak producers were almost evenly distributed. Room temperature was optimal for biofilm production (p < 0.001) compared to 37 ℃. When it comes to biofilm treatment, NaOCl was the most effective, while hydrogen peroxide and benzalkonium chloride showed equal effects at both temperatures. Conclusion: Although quaternary ammonium disinfectants are most often used for cleaning and disinfecting surfaces, they showed the weakest effect on planktonic strains of Salmonella, as well as on biofilm-producing isolates.
Human Amniotic Membrane–Derived Biomaterials for Soft Tissue Engineering: Development of 3D-Bioprintable Scaffolds
Introduction: Breast reconstruction after mastectomy illustrates the limitations of current soft tissue repair strategies, which remain associated with complications and limited impact on recurrence risk. More broadly, soft tissue regeneration requires biomaterials that combine structural support with bioactivity. Human amniotic membrane (hAM) has been applied in skin, corneal, and urogenital repair and exhibits antitumor, antifibrotic, anti-inflammatory, and immunomodulatory properties. Aim: The aim of this research is to develop a 3D-bioprintable scaffold from hAM homogenate (hAM-h) that preserves bioactive properties and supports soft tissue engineering, using post-mastectomy breast reconstruction as a model application. Materials and Methods: hAM was isolated from placentas of healthy donors, homogenized, and analyzed for cytokine profile, extracellular matrix content, and rheological behavior using a tensiometer, a viscometer, and a zetasizer. Bioactivity was assessed on adipose-derived mesenchymal stem cells (ATMSCs). Hydrogel formulations were optimized using alginates of different viscosities and concentrations, varying extrusion printing and crosslinking parameters. Optimized alginates were then mixed with hAM-h to form printable bioinks for extrusion-based bioprinting. Printed scaffolds were crosslinked with CaCl₂, characterized mechanically and for swelling, and tested for ATMSC attachment. Results: hAM-h contained high levels of growth factors, cytokines, collagens I/IV, and MMPs. Samples showed stable negative surface charge (< –30 mV), heterogeneous particle distribution (~192 nm, PDI > 0.5), and consistent rheological profiles (density, surface tension, viscosity). hAM-h did not impair ATMSC viability in the 2D system and supported their attachment to 3D constructs. Mechanical testing revealed higher compressive resistance and weight retention in high-viscosity alginate/hAM-h scaffolds compared with low-viscosity formulations. Conclusion: These findings demonstrate the feasibility of hAM-h/alginate bioinks for engineering stable, bioactive scaffolds that preserve the bioactive properties of hAM-h. The results highlight their potential for soft tissue engineering, with post-mastectomy breast reconstruction as a clinically relevant application.
The Role of Ecto-5'-Nucleotidase (CD73) in Regeneration and Immunomodulation of Human Bone Marrow Mesenchymal Stem Cells
Introduction: Ecto-5’-nucleotidase (CD73) regulates inflammatory responses by balancing extracellular ATP and adenosine, while simultaneously influencing the regenerative and migratory potential of bone marrow mesenchymal stem cells (BM-MSCs), as well as their interactions within the bone marrow. Revealing the role of CD73 in BM-MSCs will provide a better understanding of the BM-MSCs’ behavior, which will be important for cell therapy and advances in regenerative medicine. Aim: Investigation of short-term CD73 inhibition with APCP on the biological functions of BM-MSCs, including proliferation, viability, differentiation, cytokine secretion and protein detection, and migration. Materials and Methods: BM-MSCs were isolated from the iliac bone of patients, and treated with adenosine 5’-(α,β-methylene) diphosphate (APCP) to inhibit CD73 signalling. Viability was evaluated by MTT assay, while cytokine secretion was analysed by microbead-based flow cytometry. Migratory potential was assessed by scratch assay, while cytoskeletal components were evaluated by immunofluorescence. Images were captured by fluorescence microscopy and quantified with ImageJ. Results: We demonstrated that short-term CD73 inhibition does not compromise cell viability, but it significantly influences osteogenesis. Furthermore, CD73 inhibition modulated cytokine secretion and reduced the BM-MSCs’ migratory capacity. Additionally, APCP decreased the expression of cytoskeletal elements, including vimentin, α-SMA, and actin, further supporting these findings and confirming the role of CD73 in regulating MSC migratory potential. Conclusion: Short-term CD73 inhibition reduces BM-MSCs’ migratory capacity and cytoskeletal protein expression, while altering their differentiation potential and cytokine profile. These changes highlight CD73 as an important regulator of differentiation, migration, and immunomodulation that should be thoroughly understood and exploited for potential therapeutic purposes.
Analysis of Antibiotic Sensitivity of Microorganisms Isolated from Critically Ill Patients in Empirical Treatment of Infections
Introduction: A critically ill patient is a person whose life is threatened by a serious illness and who is treated at the Clinic of Intensive Medicine (CIM). In such clinics, intrahospital infections occur most often, which further complicate the condition of patients, require longer treatment, and increase total costs. These are infections that occur in the hospital and become evident 48 hours after hospitalization. Empirical therapy involves the elimination of the presumed causative agent. In order to facilitate the choice of the right antibiotic, data from the microbiological map is analyzed on an annual basis. Aim: The aim of this study was to analyse the sensitivity of microorganisms (MOO) from samples of critically ill patients to empirically administered antibiotics, and to compare with data obtained five years earlier at the CIM. Materials and Methods: This retrospective observational study covered a two-year period during which 2,495 patients were admitted and treated at the CIM. The microbiological map was created in Microsoft Excel 2013. The data for the map was collected from the electronic database and microbiological laboratory results from the CIM, and precisely analyzed. The isolation and sensitivity of MOO to antibiotics were presented as percentages in tables and graphs. Results: Among 3,817 positive samples collected during the two-year period (most commonly from bronchoalveolar lavage and blood), the predominant MOO were: Acinetobacter spp., Pseudomonas aeruginosa, and Klebsiella spp. among Gram-negative bacteria, and Staphylococcus epidermidis among Gram-positive bacteria. Gram-negative bacteria demonstrated the highest sensitivity to imipenem and colistin, while Gram-positive bacteria were most sensitive to vancomycin. Comparison with earlier data revealed that Acinetobacter spp. remained predominantly resistant, whereas Staphylococcus aureus was the most sensitive bacterium to the tested antibiotics. Only minimal differences were observed compared with data from 2017. Conclusion: This kind of research is useful for critical care physicians to more accurately choose antibiotics for treating infections in patients.
sensitivity of microorganisms to antibiotics
Alternative Methods for the Extraction of Phenolic Compounds from Chicory (Cichorium intybus) Using Glycerol-Based Natural Deep Eutectic Solvents
Introduction: Chicory (Cichorium intybus L.) exhibits antioxidant, antibacterial, antidiabetic, and anti-inflammatory properties, owing to its bioactive components, with flavonoids and phenolic acids being the most significant. Natural Deep Eutectic Solvents (NADES) are increasingly used as an alternative to conventional solvents in the extraction of active compounds, thanks to their non-toxicity. Aim: To investigate the efficiency of flavonoid and phenolic acid ultrasound extraction from chicory herb using NADES and to compare the results with extracts obtained using conventional solvents. Materials and Methods: A total of six samples of chicory herb were examined. Extraction was performed using three different NADES: 70% ethanol, methanol, and water. The solvents based on glycerol were used: glycerol citric acid (2:1), glycerol–urea (1:1), glycerol–glucose (2:1). NADES were prepared by mixing and heating. The content of phenolic acids and flavonoids was determined using high-performance liquid chromatography. Results: Ten bioactive compounds were identified and quantified in the analyzed extracts: phenolic acids gallic acid, chlorogenic acid, para-hydroxybenzoic acid, caffeic acid, coumaric acid, ferulic acid, rosmarinic acid and epicatechin quercetin, and naringenin from flavonoids. In eight out of ten extracts obtained using NADES, the content of bioactive compounds was significantly higher compared to extracts obtained using conventional solvents—70% ethanol, methanol, and water. Conclusion: In this study, the efficiency of extracting phenolic acids and flavonoids from the herb of chicory using natural deep eutectic solvents was analysed and confirmed. The use of novel green solvents resulted in significantly higher yields of phenolic compounds compared to conventional solvents.
Eco-Friendly Extraction of Phenolic Compounds from Chicory (Cichorium intybus) Using Glucose-Based NADES
Introduction: Chicory root (Cichorium intybus, Asteraceae) is a valuable source of phenolic compounds, known for their antioxidant and health-promoting properties. The application of NADES (Natural Deep Eutectic Solvents) offers an eco-friendly and efficient approach for isolating these bioactive compounds, ensuring high yield and stability for potential use in pharmaceutical and nutraceutical industries. Aim: Investigation of the efficiency of ultrasound-assisted extraction of flavonoids and phenolic acids from chicory root using NADES, and comparison of the results with extracts obtained by conventional solvents. Materials and Methods: The extraction was performed from chicory cultivated at the Institute for Medicinal Plant Research, using three glucose-based NADES solvents: glucose–lactic acid (1:1), glucose–urea (1:2), and glucose–glycerol (1:2). For comparison, conventional solvents (methanol, ethanol, and water) were used. The content of phenolic compounds and flavonoids was determined by high-performance liquid chromatography (HPLC). Results: NADES solvents efficiently isolated phenolic acids and flavonoids, including gallic, chlorogenic, p-hydroxybenzoic, caffeic, coumaric, and ferulic acids, as well as epicatechin, quercetin, and naringenin, showing higher efficiency than conventional solvents. The concentrations ranged from 0.32 to 5.69 mg/g of raw material, with chlorogenic and caffeic acids being the dominant compounds, and the glucose–lactic acid mixture exhibiting the highest efficiency. Conclusion: Glucose-based NADES solvents offer an environmentally friendly and more efficient alternative to conventional solvents for extracting phenolic acids and flavonoids from chicory, with potential applications in the pharmaceutical and cosmetic industries.
Cardioprotective Effects of Pyridostigmine in Isoprenaline-Induced Heart Failure
Introduction: Autonomic nervous system (ANS) imbalance is a central pathophysiological mechanism in the development of chronic heart failure (CHF). Sympathetic dominance is initially compensated, but eventually leads to instability, oxidative stress, inflammation, and myocardial fibrosis, accelerating disease progression. Aim: To investigate the potential protective effects of the acetylcholinesterase inhibitor pyridostigmine in a rat model of CHF. Materials and Methods: Male Wistar albino rats were used. CHF was induced by subcutaneous (s.c.) administration of 5 mg/kg/day of isoprenaline for 7 days, while control groups received s.c. saline solution (0.9% NaCl). The development of heart failure was monitored over 4 weeks. After the establishment of the CHF model, animals were randomized into four experimental groups: Control, Iso, Pyr, and Iso+Pyr. Animals in the Control and Iso groups drank tap water, while animals in the Pyr and Iso+Pyr groups received pyridostigmine (22 mg/kg/day) dissolved in water for 14 days. At the end of the experiment, final echocardiographic (ECHO) and electrocardiographic (ECG) measurements were performed. Animals were then anesthetized with a combination of ketamine (90 mg/kg) and xylazine (10 mg/kg), sacrificed by exsanguination, and blood and tissue samples were collected for biochemical and pathohistological analysis. Results: Pyridostigmine therapy significantly slowed the progression of CHF, reducing left ventricular dilation (decline LVIDd and LVIDs), posterior wall thickening (rise PWDd and PWDs), and improved overall cardiac contractility, as evidenced by an increase in ejection fraction (↑EF). Besides functional effects, a significant improvement in antioxidant status was observed, evidenced by a reduction in thiobarbituric acid reactive substances (TBARS) and nitrites, along with increased catalase (CA) and glutathione (GSH) activity. Histopathological analysis showed a significant reduction in interstitial fibrosis and cellular inflammation in the pyridostigmine-treated group. Additionally, a decrease in the expression of matrix metalloproteinases MMP-2 and MMP-9 was observed. Conclusion: The results indicate that administration of pyridostigmine at 22 mg/kg/day significantly slowed the progression of isoprenaline-induced CHF in rats.
Frequency of Cardiovascular Risk Factors in Perimenopausal and Menopausal Women
Introduction: Cardiovascular diseases are the most common cause of morbidity and mortality among residents of both sexes in Serbia. The reason for this is the fact that cardiovascular risk factors such as sedentary life habits, less physical activity, improper diet, and the habit of smoking are the cause of obesity, dyslipidemia, hyperglycemia, and hypertension. The persistence of risk factors significantly increases the incidence of cardiovascular diseases. Aim: The aim of our research was to determine the frequency of cardiovascular risk factors in premenopausal and menopausal women. Materials and Methods: The study included 200 middle-aged women, 131 (65.5%) premenopausal under the age of 49, and 69 (34.5%) menopausal women (50–59 years), who came to a doctor for a preventive medical examination at the Health Center in Kosovska Mitrovica in the period from September to December 2024. Results: There was no significant difference in relation to life habits, physical activity, sedentary occupation, and smoking in premenopausal and menopausal women. Menopausal women more often had obesity and hyperglycemia (p = 0.002). Hypertension was significantly more common in menopausal women (84.1%). Family burden did not differ significantly. Biochemical variables, such as liver enzymes and glomerular filtration rate, were similar in these two groups of women. TSH values differed significantly, and hypothyroidism was diagnosed significantly more often in premenopausal women (p = 0.027). Conclusion: The lifestyle habits of women before menopause and women in menopause do not differ significantly, but even so, menopause leads to obesity and an increase in cholesterol and glucose levels, which accelerate the onset of diabetes and hypertension. The reason for this is hormonal changes, the effect of which can be mitigated by good lifestyle habits.
Frequency of Cardiometabolic Disorders in Pre- and Postmenopausal Women
Introduction: Cardiometabolic diseases, including type 2 diabetes mellitus and cardiovascular diseases, are among the leading causes of morbidity and mortality in Serbia. In younger ages, the prevalence of cardiovascular diseases is higher in men than in women, but this advantage gradually disappears with aging, especially after menopause, when women are at a greater cardiovascular risk. Aim: The aim of our research was to point out the frequency of cardiometabolic disorders and their connection to hypertension in pre- and postmenopausal women. Materials and Methods: The study included 200 middle-aged women: 131 (65.5%) premenopausal women under 49 years of age and 69 (34.5%) postmenopausal women (50–59 years of age). These women attended a preventive medical examination at the community health center in Kosovo Mitrovica from September to December 2024. Results: Hypertension was statistically significantly more frequent in postmenopausal women (84.1%) compared to premenopausal women (p < 0.001). Postmenopausal women were also significantly more likely to have metabolic disorders, increased body weight, and obesity (66.7% of respondents) and a larger waist circumference (63.8% of respondents, p = 0.003). The levels of total cholesterol, LDL cholesterol, and triglycerides were statistically significantly higher in postmenopausal women compared to premenopausal women (p = 0.002). Diabetes mellitus was statistically significantly more frequent in postmenopausal women, with a prevalence of 27% (p = 0.002). Most other biochemical variables were similar in both groups of respondents. Conclusion: Postmenopausal women were significantly more likely to have hypertension, obesity, dyslipidemia, and type 2 diabetes mellitus. Therefore, preventive examinations for women in the perimenopausal and menopausal periods are necessary to timely recognize and treat cardiometabolic disorders and thus prevent more severe cardiovascular diseases.
The Incidence and Risk Factors for Postoperative Nausea, Vomiting, and New-Onset Hypertension After Elective Caesarean Section
Introduction: Postoperative nausea and vomiting are the most common side effects of anaesthesia after an operation. Patients who are at higher risk are usually young female non-smokers who have a history of motion sickness and postoperative nausea and vomiting. Aim: To calculate the incidence and risk factors for postoperative nausea and vomiting in patients after elective caesarean section and to calculate the incidence of postpartum hypertension. Materials and Methods: The study was designed as a prospective cohort study. The cohort consisted of 51 obstetric patients who were split into Group 1 (47 patients under spinal anaesthesia) and Group 2 (4 patients under general anaesthesia). Spearman’s correlation test and binary logistic regression were used to determine the correlation of postoperative nausea and vomiting with other risk factors. Results: The incidence of postoperative nausea and vomiting was 19.61%. There was no significant statistical correlation between the Apfel score and postoperative nausea and vomiting when opioid use was considered in the first 24 h. However, there was a significant statistical correlation when the first 12 h were considered. Binary logistic regression showed no significant statistical correlation between the risk factors: kinetosis, smoking, and use of opioids. The incidence of new-onset postpartum hypertension after caesarean section was 9.8%. Conclusion: Postoperative nausea and vomiting can lead to different complications and lower the quality of life in the postoperative period. Prevention is crucial, as are appropriate assessment and patient monitoring for postoperative patient progress.
Assessment of Cognitive Function in Peritoneal Dialysis Patients
Introduction: Cognitive disorders represent a significant health problem in patients on peritoneal dialysis, which can have a serious negative impact on the quality of life and the outcome of treatment. Therefore, early detection of risk factors for the development of cognitive disorders in these patients is extremely important. Aim: The study’s aims were to examine the cognitive status of patients treated with peritoneal dialysis and to determine the correlation between that status and the sociodemographic characteristics of the patients and anemia. Materials and Methods: The study was designed as a cross-sectional study with a sample of 36 patients treated with peritoneal dialysis. The following research instruments were used: the Montreal Cognitive Assessment (MoCA) and a general questionnaire for obtaining sociodemographic characteristics of patients on peritoneal dialysis. The presence of anemia was determined on the basis of the hemoglobin value. Results: The frequency of cognitive dysfunction in patients on peritoneal dialysis was 69.4%, while anemia, according to hemoglobin values, was present among 58.3% of patients. It was found that age, urban place of living, and low hemoglobin values are factors that are significantly associated with cognitive dysfunction in patients on peritoneal dialysis. Conclusion: Preserved cognitive abilities are an important precursor to the adequate implementation of peritoneal dialysis and to the preservation of the patient's quality of life. Further research is necessary to identify appropriate strategies for the prevention and treatment of anemia as a factor that affects cognitive functions in these patients.
Nurses' Knowledge, Skills, and Practice in Endotracheal Tube Cuff Management
Introduction: Endotracheal intubation is a critical skill for securing the airway in critically ill patients, while maintaining adequate pressure in the endotracheal tube cuff prevents aspiration and ensures effective ventilation. Insufficient or excessive cuff pressure can cause serious tracheal injury and other complications, making it essential for nurses and technicians to follow standardized guidelines and protocols for optimal cuff management. Aim: To evaluate the knowledge, skills, and practice of nurses in managing the endotracheal tube cuff. Materials and Methods: The study was conducted at the Clinical Center of Vojvodina in January 2025, with a five-working-day period for questionnaire completion. Thirty-two nurses (N = 32) working in intensive care units and/or operating rooms participated. A self-designed 23-item questionnaire was used, divided into general characteristics, assessment of knowledge, skills, and practice related to endotracheal tube cuff management. Fourteen items were scored: ten assessing knowledge, three assessing skills, and one assessing practice (correct answer = 1, incorrect = 0); the remaining items were descriptive. Total scores ranged from 0 to 14 and were expressed as percentages. A score ≥ 50% indicated a satisfactory response in all three domains, while a score ≤ 50% indicated an unsatisfactory response. Results: Nurses demonstrated satisfactory knowledge and practice but weaker skills in managing the endotracheal tube cuff, indicating a discrepancy between theoretical knowledge and practical abilities. The average percentage of correct answers was 61.4%, with the highest score being 85.7%. A score above 50% was achieved by 75% (N = 24) of nurses. Experience was found to contribute to the development of knowledge and skills. Conclusion: While theoretical knowledge was satisfactory, practical skills in endotracheal tube cuff management were insufficiently developed. The results highlight the importance of continuous education and practical training to improve the quality of care and the safety of intubated patients.
Anatomical Variations of the Septum of the Sphenoidal Sinus
Introduction: The sphenoid sinus (sinus sphenoidalis) is a paranasal cavity that is divided by a partition into two approximately equal halves. The partition of the sphenoid sinus (septum sinuum sphenoidalium) shows certain variations in composition, shape, size, and number. Aim: The aim of the research was to evaluate the basic composition, shape, height, and attachment site of the main septum of the sphenoid sinus, as well as to record the possible presence and number of attachments of the auxiliary septum of the sphenoid sinus. Materials and Methods: This retrospective study was conducted on 200 subjects (100 men and 100 women), analyzing images of the paranasal cavities on computed tomography (CT) in the coronal, sagittal, and axial planes, with the position in supination. The morphological analysis included the basic composition, shape, height, and attachment point of septa of the sphenoid sinus, using the PACS software system. Statistical analysis was performed using the software program for statistical analysis and tabulation SPSS Statistics 28.0. Results: 54/200 subjects had a completely bony septum, and 137/200 subjects had an incomplete bony septum. The septum was not found in 9/200 subjects. 71/200 subjects had the correct type of septum, and 120/200 had an irregular type. The average height for both types in both sexes was 20.083 ± 4.711 mm. 153/200 septums attach to the lower side of the sella turcica, while 38/200 attach near the cavernous sinus. The presence of an accessory sphenoidal septum was determined in 79/200 sphenoidal sinuses. The most common type of pneumatization was the sellar type in both sexes, 142/200 sphenoidal sinuses. Conclusion: Knowledge of the anatomical variations of the main septum of the sphenoid sinus, as well as the preoperative evaluation of the sphenoid sinus, is necessary for a more precise approach during transsphenoidal or functional endoscopic surgical procedures.
The Prognostic Significance of the Number of Neutrophils and Lymphocytes, C-Reactive Protein, and Procalcitonin in the Occurrence of Postoperative Infection
Introduction: The neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and procalcitonin (PCT) are inflammatory markers whose dynamic increase plays a key role in the development of postoperative infections, which, as severe complications, have a major impact. An effective predictive marker could enable earlier treatment, reducing mortality, morbidity, and healthcare costs. Aim: To evaluate the prognostic value of the NLR, CRP, and PCT for postoperative infections at 24, 48, and 72 hours in cancer patients, and to assess the predictive role of absolute neutrophil (Ne) counts within the first 24 hours. Materials and Methods: This retrospective study at the Institute of Oncology of Vojvodina included 60 surgically treated cancer patients at the Clinic for Surgical Oncology. The NLR, CRP, PCT, and demographic and clinical data were analyzed. Results: NLR was a statistically significant predictor (p < 0.05). Ne, as part of this marker, increased as a first-line defense response, while lymphocytes were suppressed due to stress. Within the first 24 hours, Ne were not significant due to expected postoperative changes, but at 72 hours they were a significant predictor of infection (p < 0.05). CRP remained elevated during the infection, peaking within 72 hours, and was statistically significant (p < 0.05). PCT, as a dynamic marker with a faster rise and normalization, was not statistically significant for infection prediction (p > 0.05). Conclusion: Malignancy reduces the predictive value of initially high NLR, CRP, and PCT. CRP after 72 hours showed statistical significance for predicting infection, while PCT did not. The Ne count 24 hours postoperatively cannot reliably predict complications due to surgery-induced fluctuations. In the absence of more sensitive markers, NLR remains a practical and justified indicator.
Resistance of Gram-Negative Bacteria Isolated from Blood Cultures in the Post-COVID Era
Introduction: Gram-negative bacilli (GNB) are common causes of sepsis in intensive care units. The proportion of multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) strains is increasing. A higher number of hospitalizations and increased antibiotic use during the COVID-19 pandemic may have influenced resistance patterns. Aim: The aim of this study was to determine the antimicrobial resistance profile, the frequency of MDR, XDR, and PDR categories among isolated GNB, and to examine the association between MDR status and basic demographic characteristics of patients. Materials and Methods: In this retrospective study conducted at the Institute for Pulmonary Diseases of Vojvodina during 2022 and 2023, a total of 213 GNB isolated from positive blood cultures were analyzed. Bacterial identification was performed using the Vitek 2 Compact system. Antimicrobial susceptibility testing was carried out by the disk diffusion method according to EUCAST guidelines. Results: The following species were isolated: K. pneumoniae (48.0%), A. baumannii complex (30.0%), P. aeruginosa (8.0%), E. coli (5.0%), E. cloacae complex (2.0%), P. stuartii (2.0%), P. mirabilis (2.0%), Citrobacter spp. (1.0%), S. marcescens (1.0%), M. morganii (1.0%). Among Enterobacterales isolates, 82.6% were resistant to 3rd- and 4th-generation cephalosporins, 77.3% to carbapenems—most commonly K. pneumoniae—and 45.0% to colistin. PDR Enterobacterales accounted for 12.1%, all K. pneumoniae. Among A. baumannii isolates, 98% were carbapenem-resistant, and 6.2% were PDR. A total of 35% of P. aeruginosa isolates were carbapenem-resistant, while 71% remained susceptible to piperacillin/tazobactam. Younger patients (< 65) more often developed infections with MDR Enterobacterales (98.3%) (χ² = 4.226, p < 0.05). MDR P. aeruginosa infections were more common in 2023 (55.6%) (χ² = 7.269, p < 0.05). Conclusion: A high proportion of MDR GNB strains was observed, including PDR Enterobacterales and A. baumannii. MDR Enterobacterales infections were significantly more frequent in younger patients, while MDR P. aeruginosa increased in 2023.
Emergency Conditions in Cardiology and Reasons for Admission to the Cardiology Outpatient Clinic
Introduction: Cardiological emergencies are conditions that signify the immediate vital endangerment of the patient. Cardiovascular conditions represent one of the most common and serious emergencies. They often go unrecognized because symptoms can be vague or insufficiently specific. Aim: Identification of the most common emergency conditions that are the reason for referring patients to the cardiology outpatient clinic, the way of arrival, and the proportion of hospitalized patients relative to the referral diagnosis. Materials and Methods: A retrospective study was conducted by analyzing the medical documentation of 418 patients (157 females, 261 males) admitted to the Admission Cardiology Clinic at the Institute for Cardiovascular Diseases of Vojvodina from January 1st to January 15th, 2023. Data on demographic characteristics, referral diagnoses, prehospital care methods, vital status upon examination, treatment, vital parameters, and hospitalization were analyzed. Results: Myocardial infarction (MI) was the most common diagnosis among hospitalized patients. It has been proven that congestive heart failure occurs more frequently in individuals aged 65 and older. MI, acute pulmonary edema, respiratory insufficiency, and unspecified chest pain cases arrive via emergency medical services, while cases of hypertension primarily arrive by self-transport. Most patients were treated at the Admission Cardiology Clinic. Conclusion: A greater number of males present at the admission cardiology outpatient clinic compared to females. The most common diagnosis in the Admission Cardiology Outpatient Clinic was hypertension. The majority of patients presented to the Admission Cardiology Outpatient Clinic with a hospital referral. The majority of patients who presented to the Admission Cardiology Outpatient Clinic were 65 years of age or older.
Effects of Physiotherapy Interventions on Gait and Balance in Post-Stroke Patients
Introduction: Stroke is defined as the sudden onset of a focal, non-convulsive neurological disorder caused by vascular damage, leading to various clinical conditions due to impaired brain function. The diversity of physiotherapeutic interventions and the application of advanced technologies have significantly expanded in stroke rehabilitation over the past decades. Aim: The aim of this study is to identify, based on literature data, an appropriate physiotherapy protocol for gait and balance rehabilitation in post-stroke patients. Materials and Methods: For this review, 10 studies meeting the inclusion and exclusion criteria were selected from Google Scholar. A total of 544 post-stroke participants were included in rehabilitation programs with different physiotherapeutic approaches in the experimental groups and general programs in the control groups. The Fugl-Meyer Assessment (FMA-LE) and the Berg Balance Scale (BBS) were chosen as common outcome measures. Results: The analysis of the selected studies showed the greatest progress with combined conventional and advanced interventions: virtual reality (FMA-LE: 12.68/30.26; BBS: 18.38/44.09), hydrokinesiotherapy (FMA-LE: 9.82/21.45; BBS: 7.93/27.40), trunk stabilization exercises with music (FMA-LE: 11.34/23.41; BBS: 21.34/37.88), and exoskeleton training (FMA-LE: 17.3/23.0; BBS: 15.3/36.6). Conclusion: A combination of conventional and advanced physiotherapy interventions provides the best outcomes in post-stroke rehabilitation. Virtual reality proved particularly effective in the working-age population, while trunk stabilization exercises with music showed greater benefits for older patients, emphasizing the importance of individualized therapeutic approaches.
Lipid Profile in Pediatric Patients with Hypovitaminosis D
Introduction: Proactive diagnosis of lipid status disorders can significantly contribute to the therapeutic approach of patients with hypovitaminosis D and ensure a better quality of life, if the importance of the condition is recognised as early as in the pediatric age. Aim: The aim of the research was to examine the existence of a correlation between changes in lipid status and the degree of vitamin D deficiency within a pediatric group of patients with an existing diagnosis of hypovitaminosis D. Materials and Methods: The entire research included 32 patients, 10 boys and 22 girls, treated at the Institute for Health Care of Children and Youth of Vojvodina in 2024. Laboratory parameters considered included: TAG, Chol, HDL, LDL, VLDL, vitamin D levels, BMI, gender, and age. The interpretation of the results was performed using the ANOVA and Kruskal-Wallis statistical methods. Results: With the size of the studied group and interindividual differences taken into account, the study did not show statistically significant differences in lipid status depending on the level of vitamin D, nor in terms of the studied parameters (BMI, gender, and age). Conclusion: We can claim that there is a correlation, but not causation, when it comes to the influence of vitamin D levels on the lipid profile in the pediatric population of patients diagnosed with hypovitaminosis D. Therefore, lipid status together with vitamin D levels may be of clinical importance as preventable cardiometabolic risk factors in the pathogenesis of complications resulting from hypovitaminosis D.
Vasodilatory Effects of Diazepam on Human Umbilical and Mesenteric Arteries: An In Vitro Experimental Study
Introduction: Benzodiazepines, primarily known for their central effects, are increasingly associated with direct effects on peripheral vascular tone. Although experimental studies on animal models have demonstrated that diazepam can induce CNS-independent vasorelaxation, data regarding its effects on human blood vessels remain limited. Aim: The purpose of this study was to examine the influence of diazepam on the tone of the human umbilical and mesenteric arteries. Materials and Methods: The primary method for assessing vascular responses was the use of an organ bath system for isolated tissue experiments. Human umbilical arteries (HUA) were obtained from healthy women undergoing elective cesarean section, while human mesenteric arteries (HMA) were collected from patients undergoing elective intestinal surgery. Arterial segments 3–4 mm in length were prepared and mounted in the organ bath chambers. Viability was confirmed using potassium chloride at a concentration of 6x10-2 M. HUA were precontracted with serotonin (10-10–10-4 M) and HMA with phenylephrine (10-8–10-4,5 M). Diazepam was added cumulatively (10-8–10-4 M). Arterial contraction was expressed as a percentage of the maximal KCl-induced contraction, and relaxation as a percentage of the maximal precontraction. Results: Serotonin induced a concentration-dependent vasoconstriction in HUA, which, at a concentration of 10-4 M, amounted to ~225% of the KCl-induced contraction. Phenylephrine induced a concentration-dependent vasoconstriction in HMA, which, at a concentration of 10-4,5 M, amounted to ~250% of the KCl-induced contraction. Diazepam produced concentration-dependent vasorelaxation in both artery types: ~96% in HUA and ~89% in HMA at 10-4 M. Conclusion: These findings demonstrate that diazepam induces strong, concentration-dependent vasorelaxation in isolated, precontracted human umbilical and mesenteric arteries, confirming the existence of its peripheral effect.
Examination of the Impact of Aging and the Sympathomimetic Isoprenaline on Myocardial Function Using the Langendorff Heart Model
Introduction: The Langendorff model of the isolated heart is an experimental model that is widely used in cardiovascular research in the fields of physiology, pharmacology, and toxicology. It is based on ex vivo perfusion of the heart isolated from an experimental animal, whereby а system of transducers and amplifiers enables the measurement of hemodynamic parameters and the assessment of the effects of the previously administered pharmacologically active substance on the myocardium. Aim: The aim of this study was to determine the differences in the cardiovascular response caused by aging, as well as by treating experimental rats with the β-agonist isoprenaline. Materials and Methods: Male Wistar albino rats were divided into a test group (3 older rats) and a control group (6 young rats) in order to measure the values of hemodynamic parameters (rate of change in systolic pressure (dP/dt max), rate of change in diastolic pressure (dP/dt min), left ventricular systolic pressure (SLVP), left ventricular diastolic pressure (DLVP), heart rate (HR), and coronary flow (CF)) at increasing perfusion pressures. In the second part of the test, the same parameters were measured under the same conditions in the test group, which consisted of 3 rats previously treated with isoprenaline according to a certain scheme, and in the control group, with 3 untreated rats. Results: Statistically significant differences in heart function were observed between young and old rats at all values of perfusion pressure. Differences were also observed in the heart function of rats administered isoprenaline and untreated rats, although they did not turn out to be statistically significant. Conclusion: Aging leads to significant changes in the function of the heart muscle. Isoprenaline has the potential to impair myocardial function, but further research is needed.
Effects of Valproic Acid and Temozolomide on the Liver of Rats Immunosuppressed by Dexamethasone
Introduction: Temozolomide and valproic acid are used in the treatment of glioblastoma. Animal experiments on this topic require strong immunosuppression with dexamethasone. There is insufficient work on the combined effect of these three drugs on the liver. Aim: To examine the effects of valproic acid and temozolomide on the liver of rats immunosuppressed by dexamethasone. Materials and Methods: In our experiment, we used 20 male Wistar albino rats. All animals were anesthetized, and the human glioblastoma U87 cell line was inoculated. Dexamethasone (1.5 mg/kg) was given on the day before inoculation, and afterwards on every other day. Cefadroxil was used to prevent infection. Animals were divided into 4 groups: control group receiving only dexamethasone, T group receiving dexamethasone and temozolomide, V group receiving dexamethasone and temozolomide, and TV group receiving dexamethasone, temozolomide, and valproic acid. Temozolomide was given from the 8th to the 10th day, and valproic acid from the 6th to the 12th day from the day of inoculation of the cell line. The sacrifice was performed on the 14th day after inoculation. Liver incisions were made and staining was performed: hematoxylin-eosin, Masson's, and periodic acid–Schiff. Results: Ballooning degeneration of the liver and positive periodic acid–Schiff staining appear on all samples, but the degree of change differs from one group to another. Conclusion: Treatment of rats immunosuppressed with high doses of dexamethasone with temozolomide worsened the ballooning degeneration of hepatocytes, while treatment with temozolomide and valproic acid alleviated ballooning degeneration but intensified glycogen accumulation. Valproic acid, in cooperation with dexamethasone, alleviated ballooning degeneration and glycogen accumulation.
Attitudes of Medical Rehabilitation Students Towards Physical Activity
Introduction: Physical activity (PA) refers to any form of muscular activity that increases energy expenditure compared to the resting state. Its benefits are evident at both the physical and psychological levels across all ages and genders, and they are especially helpful to physiotherapy students in overcoming challenges and providing support to patients during rehabilitation. Aim: To determine the factors that shape students' attitudes toward physical activity and exercise. Materials and Methods: The prospective study was conducted from January 1 to February 1, 2025, after approval from the Ethics Committee of the Faculty of Medicine, University of Novi Sad. The study included 72 students from the first and fourth years of the Undergraduate Academic Studies in Medical Rehabilitation. Participants completed a generic questionnaire consisting of 5 questions tailored to the research needs, and then filled out the Exercise Benefits/Barriers Scale (EBBS) to assess their attitudes towards physical activity. Results: The sample included participants with an average age of 20.79 years, of whom 53 (73.6%) were female. No statistically significant difference was found between first-year and fourth-year students in the total EBBS score (p > 0.001). However, a statistically significant difference was observed in the overall EBBS score between males and females, with males showing a more positive attitude toward exercise (p < 0.05). Conclusion: In their future work, physiotherapists must be aware of both the benefits and barriers to physical activity in order to appropriately tailor interventions and advice for their patients. Taking gender differences into account ensures a more effective physiotherapy practice.
Radiological Assessment of Impacted Maxillary Canines: Type, Location, Position, and Relationship with Adjacent Teeth
Introduction: Maxillary canines are the second most common impacted teeth after third molars. The reasons for impaction are numerous, ranging from highly positioned tooth buds, longer eruption paths, to trauma. The prevalence of impaction is 1–3%. Aim: The aim of the study is to perform a radiological assessment of impacted maxillary canines, determine the type and their position in relation to location and sectors, as well as their contact with adjacent teeth. Materials and Methods: The study was conducted at the Dental Clinic of the Faculty of Medicine. The research included patients with impacted maxillary canines. The study monitored gender, bilateral or unilateral impaction, the frequency of impaction in relation to location and sector, and examined contacts with adjacent teeth. Results: 32 patients with impacted maxillary canines were identified, 18 men and 14 women. The highest percentage of impaction was unilateral left canine impaction, 53.12% (17 patients). Right canine impaction was identified in 6 patients (18.75%), bilateral impaction was found in 28.12% or 9 patients. 16 patients (50%) had a vestibular position of the impacted canine, 12 patients (37.5%) had a palatal position, and 4 patients (12.5%) had the canine located in the middle of the alveolar ridge. Analysis in relation to sectors revealed that the largest number was in Sector II, 23 patients (71.87%), and 9 patients (28.12%) were in Sector III. No impacted canines were observed in Sector I. Examining the contact of the impacted canines with adjacent teeth, it was found that contact was established in 7 cases. 6 (85.71%) had contact with the lateral incisor, and 1 (14.29%) had contact with the first premolar. Conclusion: The most commonly impacted canine is the upper left canine. The most frequent position is vestibular, in Sector II. The most common contact of an impacted canine is with the lateral incisor.