Introduction: The PhD program represents the biggest step in the education and the PhD itself is the crown of the work of one scientist ( 1 ). Each PhD thesis represents the contribution of the author to the development of the area in which he/she is active, and must present something new, unknown or unsufficiently explored until then, with direct implication for the practice. Aim: To present the difference between PhD program during 50 years period, with the presentation of the advantages that development and availability of science brought. Results: When different literature was not available in digital form, writing a PhD thesis after a postgraduate study and a long-term specialist work was the crown of the work of medical professional. Unfortunately, this process was sometimes difficult and was dependent on many parameters and subjective opinions, and was subject of numerous manipulations. In the present age, following the reform of education, and the implementation of Bologna Education System, the number of PhD students has increased and the study started to be held at all Universities in Bosnia and Herzegovina ( 2 ). All those who completed the six-year study are able to attend the PhD studies. The main obligation for student and requirement for obtaining PhD degree is article from PhD thesis published in the Current Contents database. This criterion was removed over time and the situation now is that obligation is article that is published in journal thatis in the reference database (without clear definition in which databases). Quantity is achieved but we cannot say that for quality. During the year 2017, in Bosnia and Herzegovina, 11 original articles in the field of clinical medicine were published (indexed in the journals that are in the Current Contents Indexed Publications (journals that belong to CC, SCI and SCI-E base) ( 3 , 4 ). These 11 papers are from the field of gastroenterology, psychiatry and ophthalmology ( 2 , 3 ). If this is the scientific opus of already experienced scientist, the question remains what is expected from young researchers. Conclusion: Which system is better, on this question answer cannot be given, because both systems have shortcommings and advantages. The fact is that there is a gap between generations, which is unlikely to be resolved. It is also a fact that the Bologna system is not ideal, but it is currently our present ( 5 , 6 , 7 ). A lot of students are enrolled, and the system must help them, in the process of successfully completing their PhD programs. This help cannot be achieved through the lowering of criteria (publications in science remain the only weapon in evaluati...

Aim: Aim of the article was to present a case of post transplantation invasive aspergillosis, successfully treated with conservative and surgical treatment. Case report: Patient, male, 44 years old, with second kidney transplant, required special preparation therapy, because he was sensitized, with concentration of Panel Reactive Antibody (PRA) class I 11% and PRA class II 76%. On the day of transplantation, induction was done with anti - thymocyte globulin ( ATG) and glucocorticosteroids. After transplantation, plasmapheresis with ATG was performed. On the fourth day patient was anuric. Fine-needle biopsy of the graft was performed and showed positive CD4 antibodies for peritubular capillaries and humoral rejection. 14 plasmaphereses through 14 days, were negative and ATG treatment was suspended completely. Full therapeutic dosage of tacrolimus and mycophenolate mofetil were given during treatment. Four days after treatment patient was stable, but next day clinical status had worsened with dyspnea and fever. In sputum, spores of Aspergillus species were microscopically found, and radiologically by computerised tomography. Caspofungin was administered for seven days. Voriconazole therapy was given for first ten days by intravenous route and after then orally. Even with this treatment, there was no improvement in clinical picture, while CT scan of the lungs showed abscess collection in right lung. Lobectomy was performed and pus collection was found. After graft-nephroctomy, patient was treated with continous veno-venous hemodiafiltration (CV-VHDF) dialyses, with constant voriconazole therapy for the next three months (200mg two times per day). After one month of diagnosis, Galactomannan (GM) test was negative. Conclusion: Although highly sensitized patients, those who are on hemodialysis, in preparation for transplantation, receive intensive immunosuppressive therapy that suppress the immune system. Occurrence of secondary fungal infections especially infection by aspergillosis, is cause of high mortality of infected. Application GM test that detects existence of antibodies against Aspergillus antigens and usage of different type of immunosuppressive preparation can increase longevity of graft and patients in solid organ transplantation program. Aspergillosis is treated with voriconazole and surgery, and sometimes graft-nephrectomy if needed. Recommendation is that in all immunocompromised hosts and organ transplant recipient should have been tested with GM test.

Introduction:Balkan endemic nephropathy (BEN) is a chronic irreversible interstitial sclerosis, for which over the last 25 years, chronic exposure to aristolochic acid from the contaminated cereal seeds has been considered the most likely cause. The aim of our research is to reevaluate trends of disease and to try to obtain new information about practical implementing of in-field screening of BEN, and to find indicators or a reliable biomarker for an early detection of the disease, especially for in field conditions.Patients and methods:Study was conducted in two phases (two groups of respondents). The first group related to respondents with BEN and microalbuminuria in the family. After filling out the questionnaire and following the consent of the respondents, their medical records were taken, and they were subjected to clinical examination and laboratory tests as well as to abdominal ultrasound and urinary tract examination.Results:For a long time, the disease is asymptomatic, with no hypertension, anemia or disturbed glucoregulation. Only A1M values were increased in the second group (16.22 mg), whereas A1M/CrUrine value was normal in both groups. Renal function in form of creatinine clearence and size of kidneys were in their referent values.Conclusion:The early stages of the disease are nonspecific, with no hypertension and disturbed glucoregulation, with normal renal function and blood count. The kidney size was in referent values. The only reliable symptom in the early stage of the renal disease was microalbuminuria.

The aim of this study was to present a patient (acute allograft dysfunction after a kidney transplantation) with previously detected minimum plaque on both iliac arteries by scintigram and afterward a pathological Color Doppler Ultrasound (CDU) record and to point on possibility of avoiding toxic computed tomography (CT) angiography in certain renal graft recipients. Ultrasound (US) findings showed normal graft size, whereas Doppler signals detected parvus-tardus waveforms pointing to arterial stenosis. Isotope perfusion scintigraphy registered a slow flow on both iliac arteries and normal graft perfusion. CT angiography has not been performed because of the possible toxic effects to the graft. We believe that favorable clinical and biochemical findings along with US and isotope ratio monitoring are sufficient to avoid CT contrast angiography.

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