Risk of graft loss in kidney transplant recipients after aortic valve replacement.

Surgical aortic valve replacement (SAVR) in kidney transplant recipients (KTR) is associated with high morbidity and mortality, and an increased risk of postoperative graft failure potentially leading to graft loss. Transcatheter aortic valve implantation (TAVI) emerged as an alternative in high-risk patients. However, data on TAVI in kidney transplant recipients are limited. We performed a retrospective analysis of 40 KTR in which aortic valve replacement was performed at our center between 2005 and 2015. The outcomes and follow-up of TAVI (n=20; 2010-2015) and SAVR (n=20; 2005-2015) were analyzed with respect to patient and graft survival. Baseline characteristics in both groups were comparable. Hospital stay after TAVI was significantly shorter compared to SAVR (19 [11.5-21.75] days vs. 33 [21-62] days, p=0.001). Acute graft failure occurred more frequently after SAVR (45% vs. 89.5%; p=0.006). Thirty-day mortality was 10% in both groups. However, in-hospital mortality reached 25% in the SAVR group (TAVI 10%), indicating a more complicated course after surgery. Moreover, during a median follow-up time of 1928 days in TAVI patients and 2717 days in patients after SAVR, graft loss occurred only in the surgically treated group (n=7). While one-year survival after TAVR was 90% compared to 69% after SAVR, long-term follow-up showed comparable results (at 5 years: TAVI 58% vs. 52% SAVR; log-rank-test: p=0.86). In KTR, TAVI can be performed with good mid- to long-term results. Compared to SAVR, renal outcomes seem to be improved after TAVI, suggesting better graft survival.

Secular trends in body height in Balkan populations from 1945 to 1995.

The aim of this study was to look for any secular trend in the stature of Balkan populations from the time of World War II (1939-1945) to the Balkans War (1991-1995). The research was based on the examination of exhumed skeletons of 202 men killed in World War II in the area of the Republic of Slovenia, and 243 men killed in the Bosnian War in Bosnia and Herzegovina. The length measurements of the right and left humerus, femur, tibia and fibula were taken. Since the results revealed no significant differences and the left-sided bones were more complete and recurrent in the sample, the bones of the left side were used in the analysis. Since the increase in height depends mostly on the increase in length of the long bones, with an average absolute change of about 0.28 cm for humerus, 0.55 cm for femur, 0.49 cm for tibia and 0.20 cm for fibula per decade in our case, these results suggest a significant increase of the height of the Balkans population. The difference of the sum of the average femur and tibia length for the study period was 4.13 cm. Recalculated average length increase of the sum length of femur and tibia per decade was 0.88 cm for the left side. Our study revealed that there was a trend towards increased long bone lengths, at least in the male population analyzed.

Morphological characteristics of pubic symphysis for age estimation of exhumed persons.

Suchey-Brooks method based on morphological features of pubic symphysis is a common method of age evaluation of human skeletal remains. The aim of the study was the classification of the examined samples into a particular phase according to Suchey-Brooks method, comparing the estimated age according to Suchey-Brooks with living age of the identified persons. The study was conducted on 120 pairs of pubic bones symphysis of male who disappeared from the area of north-west Bosnia during previous war, who were exhumed and the process of their identification was previously finished. The youngest person was 19 years old and the oldest 86. The study was retrospective, made by comparing the morphological characteristics of pubic symphysis pairs of the examined sample with Suchey-Brooks standards. The statistical analysis of data obtained by the survey showed that the smallest deviations from the average were in phase II by Suchey-Brooks, while the maximum deviation was in phase IV. The standard deviation generally increases from phase to phase, which is to be expected. The span of age obtained for Bosnian population is smaller at all stages in relation to Suchey Brooks-standards, as well as standard deviation, except in phases IV and VI. There was a significant difference noticed in phase V in the estimation of age between the original method and Bosnian population. In general, Suchey-Brooks method leads to underestimation of age, but the underestimation or overestimation in relation to the actual age is possible at each stage, which indicates the individual biological variation.