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Healthcare-associated infections pose a significant risk for patients and a tremendous burden on hospitals and healthcare systems. Because they can significantly affect treatment outcomes, rigorous surveillance and prevention strategies are key interventions against their occurrence. With the growing problem of antimicrobial resistance, further aggravated throughout the COVID-19 pandemic, it has become challenging to find viable therapeutic options. This is particularly the case in intensive care units, where pathogens exhibit the highest resistance rates. Surveillance of healthcare-associated infections comprises continuous monitoring of causative agents, infection types, and the degree of antimicrobial resistance. Such data can inform intervention choices aimed at prevention, but they are critical in selecting the right empirical and targeted treatment. Alongside clinical, epidemiological, and microbiological data, economic analyses are an equally important aspect of healthcare-associated infection surveillance. They provide key insights into the financial burden on hospitals that are responsible for effective preventative measures. Serbia is, according to national data, a country with one of the lowest rates of healthcare-associated infections in Europe, but has one of the highest antimicrobial resistance rates in Europe. These findings point to a need for systemic changes, including more rational antibiotic use and education of the general public, but also of healthcare professionals, with the idea of preventing further progression and impact on treatment outcomes.

According to the most recent published data from 2020, cervical cancer is among the first five most frequently diagnosed cancers in the female population. It is the second leading cause of cancer mortality in young, working women during their reproductive period. Prevention of cervical cancer through screening programs has been applied since the 1960s, and the scientific community agrees that it is a highly preventable disease with a strong possibility for cure if detected in a premalignant and early malignant phase and effective treatment administrated without delay. Countries that effectively implement organized screening programs record a significant decrease in the incidence and mortality rates of cervical cancer. Their experience can be useful as a model for countries that still do not have established organized programs or have an unsatisfactory level of implementation or quality. These are mainly underdeveloped and developing countries, where exposure to risk factors is still very high, preventive activities are limited and consequently, the burden of cervical cancer is still at a very high level. The challenge remains how to adapt screening program strategies to the conditions of those countries, to achieve high coverage of the target population with a test of appropriate performance, to establish control over the increasing trend and in the coming decades, to reach the targeted decline in incidence and mortality rates. So far, it is the only malignant disease for which there is scientific evidence that it can be eliminated to a frequency that will no longer represent a public health problem. Reducing the incidence rates should be an effect that would be seen at the global level and to achieve it, it is necessary to strongly support countries in establishing adequate programs of prevention and early detection of cancer supported by effective treatment and care.

The burnout syndrome represents a set of symptoms arising in a situation of prolonged stress at the workplace, in professionally demanding situations. It is characterized by emotional exhaustion, depersonalization and a sense of reduced personal accomplishment. One of the tools used to measure the level of burnout is MBI. It has often been criticized for conceptual, methodological and practical reasons; however, it is still considered the gold standard for assessing burnout and is used in 88% of all empirical studies. Factors that contribute to the development of burnout can be divided into organizational and individual factors. The complexity of work organization, as the crucial external factor, is reflected in the shaping of interpersonal relations, the establishment of hierarchies among employees, timely personnel planning and the need for professional training, which indirectly affects the degree of burnout of doctors. If one adds the need of doctors to engage in academic work, the failures in the medical system organization of the work are reflected in excessive working hours, devaluation of teaching work, inappropriate academic ranking, accumulation of engagements outside of teaching, pressure to publish papers and dissatisfaction with the criteria of scientific success. Personality traits can speed up or slow down the occurrence of burnout due to the nature of their influence. They play a big role in making this syndrome noticeable in extroverted people and vice versa, causing it to remain unrecognized and hidden in introverted people. Thus, they make it difficult for this syndrome to be registered and delay the provision of timely assistance. The occurrence of a burnout, which develops as a response to chronic professional stress, coupled with greater opportunities for professional development, better earnings and working conditions, as well as higher quality standards, are the key triggers of the migration of healthcare workers.

Introduction: The ongoing pandemic caused by Coronavirus has strongly initiated digital developments and closed in-person classes in higher education. In order to achieve remote high-quality online delivery, the learning method "flipped classroom" has been introduced to both students and teachers. The flipped classroom represents a type of blended learning aiming to increase students' engagement by preparing materials for learning at home and having faceto-face problem-solving during class time. Aim: To assess attitudes and perceptions of medical undergraduate students toward flipped classroom method of learning. Material and methods: This was a cross-sectional study conducted among undergraduate students attending Faculty of Medicine University of Belgrade during January 2022, using online questionnaire. The questionnaire used in this study consisted of 34 questions and was divided among six main sections: demographics, overall attitudes, communication, independence in learning, preparedness and motivation, and creative thinking and collaborative work. Results: A total of 60 medical students were included in the study. Two thirds of the students were female (75,0%), with the mean age of 23,48 ± 1,53 years. Most of the respondents were fifthand sixth-year students. The results of this study revealed that significant differences in perceptions of the students toward flipped classroom method of learning between gender and age group were found. Female and younger students had more positive attitudes toward flipped classroom than male and older students. Conclusion: Flipped classroom method of learning suits the demands of medical students at a university level, advancing their problem-solving skills and higher-order thinking. Bearing in mind that younger students had positive perceptions and attitudes toward flipped classroom method of learning, curriculum designers and educators should adjust the lessons and teaching methods strategies to students' preferences in order to help them to gain their full academic potential.

The aging society is facing an important public health problem related to provision of care to older and dependent people. The care provided on a daily basis includes a range of different social and health services, as well as the provision of emotional support to people who are not capable to function independently. Activities important for day by day functioning, such as bathing, dressing, feeding, shopping and health monitoring are only part of the responsibilities and obligations that the "invisible workforce", i.e. informal caregivers, must provide. Even though, regardless of the heavy price informal caregivers often pay with their economic and health status, they still remain a blind spot in public policies. An informal caregiver provides ongoing care and assistance, without receiving payment, to family members and friends who need support due to physical, cognitive or mental problems. Depression is one of the most common problems experienced by informal caregivers and it is estimated that a large number, in the range of 40% to about 70% of all informal caregivers have depression symptoms. The COVID-19 pandemic has certainly left its mark on physical health, however, as the pandemic moves forward, it has began to show an ever increasing impact on the mental health of people around the world, where informal caregivers fall into a particularly vulnerable category. Particularly those informal caregivers who provide long-term help to a member of the family, became of an increased risk of emotional and physical exhaustion due to the burden of care, reduced services, as well as the relocation to consulting by telephone and the digital sphere. While some some of them managed to cope with stress and became resilient, others did not and the increasing psychological pressure led to the development of depression symptoms.

Background/Aim. Phthalates are recognized as endocrine-disrupting compounds and are extensively present in a variety of everyday products. Chronic exposure to phthalates is suspected to be associated with a range of health disorders. The aim of the study was to examine the abundance of phthalate metabolites in the urine samples among adults in the Autonomous Province of Vojvodina, Serbia, and to determine the prevalence of phthalate metabolites in healthy individuals and those with metabolic disorders such as obesity and newly diagnosed type 2 diabetes mellitus (T2DM). Methods. For the study purpose, the first morning urine sample of 308 participants was screened for the presence of 10 phthalate metabolites: mono-ethyl phthalate (MEP), mono-(2-ethylhexyl) phthalate (MEHP), mono-n-butyl phthalate (MBP), mono-iso-allyl phthalate (MiAP), mono-n-allyl phthalate (MnAP), mono-cyclohexyl phthalate (MCHP), mono-benzyl phthalate (MBzP), mono-n-octyl phthalate (MOP), mono-n-propyl phthalate (MPP) and mono-methyl phthalate (MMP). Results. At least one phthalate metabolite was detected in the first morning urine sample in 50.32% of the examined population. The most frequently detected phthalate metabolites were MEP and MEHP. Out of all phthalate-positive participants, 38.3% of them had one, 10.7% had two, while 1.3% of participants had three phthalate metabolites in the first morning urine sample. A significant difference (p < 0.05) between groups was observed on MEP and MMP frequency, while border-line significant difference (p < 0.1) between groups was observed on MEHP and MCHP frequency. Conclusion. In the Vojvodina region, both healthy adults and those with metabolic disorders such as obesity and newly diagnosed T2DM are predominantly exposed to di-ethyl phthalate and di-(2-ethylhexyl)phthalate since MEP and MEHP were the most frequently detected phthalate metabolites. Further re-search is required in order to provide more details of the phthalates influence on the adverse health effects.

Even though it is considered to be the least demanding part while writing a paper, significant attention should be devoted to citing literature. By using citation, original authors are acknowledged, readers are directed to the used material, validity of the used sources is confirmed, evidence of current research is provided, and plagiarism is avoided. Numerous shortcomings in the citation of scientific literature have been recognized in recent times. Results of a recent meta-analysis showed that 25.4% of published scientific papers consisted of citation errors. The academic community encounters the problems of incorrect citations on a daily basis, and assessing the accuracy of citations requires considerable effort. Most researchers are aware of the presence of various citation errors, but few respect their presence, i.e., the consequences of the identified problem. Assessing the presence and type of inaccurate citations in the biomedical scientific literature, as well as identifying factors associated with their presence, is important for preserving the integrity of the academic community. To improve citation accuracy in the biomedical scientific literature, recommendations for authors, mentors, readers and editors should be implemented in academic environment. These recommendations would encourage good citation practice, prevent errors and promote progress throughout the scientific community.

Lung cancer is a leading cause of cancer deaths worldwide. The aim of this study was to investigate heavy metal(loid)s (Cd, Pb, Hg, Cr, Mn, Mo, Ni, and As) in lung cancer patients in order to elucidate their role as lung cancer environmental risk factors. Sixty-three patients of both sexes with adenocarcinoma stage IIIB or IV were enrolled in this research. The heavy metal(loid) urine concentrations were measured using ICP-MS. Arsenic was quantified above 10 μg/L in 44.44% of the samples. Nickel urinary concentrations above the ToxGuide reference levels were found in 50.79% of the samples, while lead was quantified in 9.52% of the urine samples. The urinary chromium levels were above the mean ToxGuide levels in 41.27% of the patients and were significantly higher in men in comparison with women (p = 0.035). The chromium urinary concentrations were positively associated with the CRP serum levels (p = 0.037). Cadmium was quantified in 61.90% of the samples with levels significantly higher in females than in males (p = 0.023), which was associated with smoking habits. Mercury was measured above the limit of quantification in 63.49% of the samples and was not associated with amalgam dental fillings. However, the Hg urinary concentrations were correlated positively with the ALT (p = 0.02), AST (p < 0.001), and GGT (p < 0.001) serum levels. In 46.03% of the samples, the Mo concentrations were above 32 μg/L, the mean value for healthy adults according to the ToxGuide, and 9.52% of the patients had Mn levels higher than 8 μg/L, the reference value for healthy adults based on ToxGuide data. The obtained results are preliminary, and further studies are needed to have a deeper insight into metal(loid) exposure's association with lung cancer development, progression, and survival prediction. [ABSTRACT FROM AUTHOR]

Introduction/Objective. Prognostication of chronic lymphocytic leukemia (CLL) has been substantially improved in recent times. Among several prognostic models (PMs) focused on the prediction of time to first treatment (TTFT), progression-risk score (PRS), and MD Anderson Cancer Center score 2011 (MDACC 2011) are the most relevant, while CLL-International Prognostic Index (CLL-IPI), although originally developed to predict overall survival (OS), is also being used to estimate TTFT. The aim of this study was to investigate CLL-IPI, PRS, and MDACC 2011 prognostic values regarding TTFT and OS. Methods. The analyzed cohort included 57 unselected Serbian CLL patients from a single institution, with the basic characteristics reflecting more aggressive disease than in the general de novo CLL population. The eligible patients were assigned investigated PMs, and TTFT and OS analyses were performed. Results. Patients with higher risk scores according to CLL-IPI, PRS, and MDACC 2011 underwent treatment significantly earlier than patients with lower risk scores (p = 0.002, p = 0.019, and p < 0.001, respectively). In multivariate analysis, MDACC 2011 and CLL-IPI retained their significance regarding TTFT (p = 0.001 and p = 0.018, respectively), while PRS did not. CLL-IPI was the only significant predictor of OS both at the univariate (p = 0.005) and multivariate (p = 0.013) levels. Conclusion. CLL-IPI, PRS, and particularly MDACC 2011 are able to predict TTFT even in cohorts with more advanced-disease patients, while for prediction of OS, CLL-IPI is the only applicable among the three PMs. These results imply that PMs should be investigated in more diverse CLL populations, as it is in real-life setting.

Background/Aim. Plant polyphenols are well known to show antimutagenic, anticarcinogenic, antiviral and antioxidative activity. The aim of this study was to investigate bio-active potential of Armoracia rusticana root juice and extracts: their polyphenol content, as well as in vitro antitumor activity and cell-death mechanism. Methods. Liquid-liquid extraction of polar and non-polar compounds was used and poly-phenolic compounds were identified and quantified by high performance liquid chomatography (HPLC) analysis. Anti-proliferative activity was examined in vitro on human cervix carcinoma (HeLa), breast adenocarcinoma (MCF7, MDA-MB-231), colon adenocarcinoma (HT-29), lung adenocarcinoma (A549), prostate adenocarcinoma (PC-3), melanocyte carcinoma (Hs 294T), hepatocyte carcinoma (Hep G2), as well as rat hepatocyte carcinoma (H-4-II-E), and normal human fetal lung (MRC-5) cell line using sulforhodamine B assay. The mechanism of cell-death in cell line was determined using Cell Death Detection ELISAPLUS kit. Results. Dichloromethane extracts had the highest content of cate-chin, p-hydroxybenzoic, syringic and gallic acid (pulp, E1), and epicatechin (juice, E3). The results showed strong and non-selective antiproliferative activity of chloroform and di-chloromethane extracts and root juice – highest being to-wards liver, breast and lung tissue cells. IC50 values of ex-tracts and juice had low range of concentrations (IC50 = 3.49–26.5 μg/mL) and high range of dilutions (IC50 = 418–1,590). High and unfavorable potential of horseradish juice and chloroform juice extract (E4) to induce necrotic cell death was detected. Conclusion. Strong and non-selective in vitro antiproliferative activity of chloroform and dichloromethane extracts and root juice of horseradish was detected, with necrosis as a main mechanism of induced cell death. In order to utilize horseradish root bioactive potential further investigations that will pinpoint active components with more favourable apoptosis/necrosis inducing properties are needed.

Hyperlipidaemia is a recognised risk factor for cardiovascular disease. In this study, the antihyperlipidaemic properties of spirulina (Arthrospira platensis, strain S2 from Serbia) were tested in adult Wistar rats before and after induction of hypercholesterolaemia by a high-fat diet (HFD) to compare the preventive with the curative effect. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine transaminase (ALT) and aspartate transaminase (AST) levels were measured in the blood samples. The chemical composition (lipids, proteins and cholesterol) and the content of bile acids in the faeces of the animals were also analysed. Feeding rats with an atherogenic diet for 10 weeks led to the successful development of hyperlipidaemia, as serum TC and LDL-C levels as well as lipids, cholesterol and bile acids in the animals' faeces were significantly increased. Pre- and post-treatment with spirulina led to a reduction in serum LDL, TC and ALT levels. Administration of spirulina resulted in both a significant increase in primary bile acids excretion and a decrease in bile acids metabolism, with pre-treatment being more effective than post-treatment in some cases. These results suggest that increased excretion of bile acids as well as an effect on the gut microbiota may be the mechanism responsible for the anti-hyperlipidaemic activity of the tested spirulina strain. [ABSTRACT FROM AUTHOR]

A sedentary lifestyle associated with unregulated diets rich in high-calorie foods have contributed to the great prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) latterly, with up to 60% in the high-risk population and 25% in the general population. The absence of specific pharmacological strategies for this syndrome represents one of the major problems in the management of MASLD patients. Lifestyle interventions and adherence to a healthy diet are the main cornerstones of current therapies. The identification of nutraceuticals useful in the treatment of MASLD appears to be one of the most promising strategies for the development of new effective and safe treatments for this disease. The onion, one of the most widely studied foods in the field of nutraceuticals, serves as an inexhaustible reservoir of potent compounds with various beneficial effects. The following preliminary study analyzes, mediating in silico studies, the iteration of a library of typical onion compounds with 3-hydroxy-3-methylglutaryl-coenzyme A reductase, liver receptors X α and β, as well as peroxisome proliferator-activated receptors α and γ. In this study, for the first time promising smart molecules from the onion that could have a beneficial action in MASLD patients were identified. [ABSTRACT FROM AUTHOR]

Current controversies related to the treatment of subclinical hypothyroidism (SCH) with thyrotropin (TSH) < than 10 mU/L are based on the lack of evidence that levothyroxine therapy has beneficial effects. The aim of our study is to estimate the effect of levothyroxine treatment on cardiac morphology and function in subclinical hypothyroidism. Body mass index, waist circumference, blood pressure, electrocardiographic and standard echocardiographic parameters were measured before levothyroxine therapy and 3 months after TSH normalization. Significant reduction in systolic and diastolic blood pressure, PR, QT and QT corrected intervals, as well as increase in heart rate were recorded in the group on levothyroxine therapy. The following parameters of the left and right ventricle were significantly decreased in the treatment group: left ventricular mass index and volume, systolic and diastolic time intervals, and mitral annular plane systolic excursion (MAPSE). The increase was recorded as fractional shortening and pressure rise in early systole (dP/dt), right atrial wall thickness and diameters. Our study did not confirm differences in basic echocardiographic parameters between the treated and control groups, apart from an echocardiographic improvement of cardiac structure and function in treated individuals. The findings suggest electrocardiographic and echocardiographic screening in monitoring the therapeutic effect.

Background and Objectives: Total knee arthroplasty (TKA) has become the treatment of choice for advanced osteoarthritis. The aim of this paper was to show the possibilities of optimizing the Perth CT protocol, which is highly effective for preoperative planning and postoperative assessment of alignment. Materials and Methods: The cross-sectional study comprised 16 patients for preoperative planning or postoperative evaluation of TKA. All patients were examined with the standard and optimized Perth CT protocol using advance techniques, including automatic exposure control (AEC), iterative image reconstruction (IR), as well as a single-energy projection-based metal artifact reduction algorithm for eliminating prosthesis artifacts. The effective radiation dose (E) was determined based on the dose report. Imaging quality is determined according to subjective and objective (values of signal to noise ratio (SdNR) and figure of merit (FOM)) criteria. Results: The effective radiation dose with the optimized protocol was significantly lower compared to the standard protocol (p < 0.001), while in patients with the knee prosthesis, E increased significantly less with the optimized protocol compared to the standard protocol. No significant difference was observed in the subjective evaluation of image quality between protocols (p > 0.05). Analyzing the objective criteria for image quality optimized protocols resulted in lower SdNR values and higher FOM values. No significant difference of image quality was determined using the SdNR and FOM as per the specified protocols and parts of extremities, and for the presence of prothesis. Conclusions: Retrospecting the ALARA ('As Low As Reasonably Achievable') principles, it is possible to optimize the Perth CT protocol by reducing the kV and mAs values and by changing the collimation and increasing the pitch factor. Advanced IR techniques were used in both protocols, and AEC was used in the optimized protocol. The effective dose of radiation can be reduced five times, and the image quality will be satisfactory. [ABSTRACT FROM AUTHOR]

Tryptophan (TRP) catabolites exert neuroactive effects, with the plethora of evidence suggesting that kynurenic acid (KYNA), a catabolite of the kynurenine pathway (KP), acts as the regulator of glutamate and acetylcholine in the brain, contributing to the schizophrenia pathophysiology. Newer evidence regarding measures of KP metabolites in the blood of schizophrenia patients and from the central nervous system suggest that blood levels of these metabolites by no means could reflect pathological changes of TRP degradation in the brain. The aim of this study was to investigate plasma concentrations of TRP, kynurenine (KYN) and KYNA at the acute phase and remission of schizophrenia in a prospective, case-control study of highly selected and matched schizophrenia patients and healthy individuals. Our study revealed significantly decreased KYN and KYNA in schizophrenia patients (p < 0.001), irrespective of illness state, type of antipsychotic treatment, number of episodes or illness duration and no differences in the KYN/TRP ratio between schizophrenia patients and healthy individuals. These findings could be interpreted as indices that kynurenine pathway might not be dysregulated in the periphery and that other factors contribute to observed disturbances in concentrations, but as our study had certain limitations, we cannot draw definite conclusions. Further studies, especially those exploring other body compartments that participate in kynurenine pathway, are needed. [ABSTRACT FROM AUTHOR]

Background and Objectives: The careful selection of adequate SLNB candidates not only aims at reducing the surgical risk while identifying SLN metastasis, but also plays a crucial role in identifying the patients eligible for adjuvant therapy. Objectives: The purpose of our study was to investigate the clinical and histologic aspects of primary melanomas that correlate with the likelihood of a positive SLNB result. Materials and Methods: A total of 101 primary melanoma patients who underwent sentinel lymph node biopsies were included in the study. General patient demographics were obtained as well as localization and melanoma-specific characteristics of primary melanoma from histologic reports in addition to data derived from SLNB melanoma histopathology reports. Results: The patients with positive SLN results had a statistically significant increased Breslow thickness (3.8 mm vs. 1.97 mm, p = 0.002), higher mitotic index rate (5/mm2 vs. 2/mm2, p = 0.009), as well as the presence of ulceration (68.4% vs. 31.6%, p = 0.007). Univariate regression analysis showed the Breslow thickness (p = 0.008), the mitotic index rate (p = 0.054), the presence of ulceration (p = 0.009), as well as the pT3-4 stage (p = 0.009) to be significant predictors of SLN positivity. The optimal cut-off values for Breslow thickness and the number of mitoses scores were determined based on ROC curve analysis. Using the Breslow thickness, mitotic index rate, presence of ulceration, and pT3-4 stage significant coefficients from the univariate regression model, a chance prediction score was developed. Conclusions: The newly developed and proposed scoring system can aid in patient selection for SLN biopsy by facilitating a more efficient risk assessment in the detection of lymph node metastases in melanoma patients. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the role of peripheral blood markers as additional diagnostic tools to transvaginal ultrasound (TVU) findings in the diagnosis of endometriosis. Methods: This study included 40 patients undergoing laparoscopy for suspected endometriosis from January to December 2012. Preoperative levels of serum CA125, CA19-9, CEA and mRNA expression levels for survivin and VEGF were obtained. Real-time PCR was used to determine relative gene expression. A new diagnostic score was obtained by deploying the peripheral blood markers to the TVU findings. Statistical methods used were Chi-square, Fisher's, Student's t-test or the Mann - Whitney test. Results: There was a statistically significant difference in serum CA125, survivin and VEGF levels in patients with endometriosis and those without endometriosis (p

Seasonal variations of bisphenol A (BPA) were investigated in the Danube along the Novi Sad bank, Serbia using solid-phase extraction followed by gas chromatographic mass spectrometric method. The obtained results confirmed the presence of BPA above the limit of quantification (6 ng/L) in 22 out of 32 water samples at all eight sampling sites. Тhe BPA concentration varied from 1) for autumn, spring and summer. The high potential risk which is attributed to the elevated summer concentrations is probably the result of the increased human activates and weather conditions. [Projekat Ministarstva nauke Republike Srbije, br. III46009]

Background/Aim. The Fracture Risk Assessment Tool (FRAX® score) is the 10-year estimated risk calculation tool for bone fracture that includes clinical data and hip bone mineral density measured by dual-energy x-ray absorptiometry (DXA). The aim of this cross-sectional study was to elucidate the ability of the FRAX® score in discriminating between bone fracture positive and negative pre- and post-menopausal women with subclinical hyperthyroidism. Methods. The bone mineral density (by DXA), thyroid stimulating hormone (TSH) level, free thyroxine (fT4) level, thyroid peroxidase antibodies (TPOAb) titre, osteocalcin and beta-cross-laps were measured in 27 pre- and post-menopausal women with newly discovered subclinical hyperthyroidism [age 58.85 ± 7.83 years, body mass index (BMI) 27.89 ± 3.46 kg/m2, menopause onset in 46.88 ± 10.21 years] and 51 matched euthyroid controls (age 59.69 ± 5.72 years, BMI 27.68 ± 4.66 kg/m2, menopause onset in 48.53 ± 4.58 years). The etiology of subclinical hyperthyroisims was autoimmune thyroid disease or toxic goiter. FRAX® score calculation was performed in both groups. Results. In the group with subclinical hyperthyroidism the main FRAX® score was significantly higher than in the controls (6.50 ± 1.58 vs 4.35 ± 1.56 respectively; p = 0.015). The FRAX® score for hip was also higher in the evaluated group than in the controls (1.33 ± 3.92 vs 0.50 ± 0.46 respectively; p = 0.022). There was no correlations between low TSH and fracture risk (p > 0.05). The ability of the FRAX® score in discriminating between bone fracture positive and negative pre- and postmenopausal female subjects (p < 0.001) is presented by the area under the curve (AUC) plotted via ROC analysis. The determined FRAX score cut-off value by this analysis was 6%, with estimated sensitivity and specificity of 95% and 75.9%, respectively. Conclusion. Pre- and postmenopausal women with subclinical hyperthyroidism have higher FRAX® scores and thus greater risk for low-trauma hip fracture than euthyroid premenopausal women. Our results point to the use of FRAX® calculator in monitoring pre- and postmenopausal women with subclinical hyperthyroidism to detect subjects with high fracture risk in order to prevent further fractures.

The gut microbiota‐brain axis has been recognized as a network of connections that provides communication between the gut microflora and both central and autonomic nervous system. The gut microbiota alteration has been targeted for therapy in various neurodegenerative and psychiatric disbalances. Psychobiotics are probiotics that contribute beneficially to the brain function and the host mental health as a result of an interaction with the commensal gut bacteria, although their mechanism of action has not been completely revealed. In this state‐of‐art review, the findings about the potential therapeutic effects of the psychobiotics alone or in combination with conventional medicine in the treatment of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease, as well as in some psychiatric diseases like depression, schizophrenia, and bipolar disorder, have been summarized. The evidence of the psychobiotics therapeutic outcomes obtained in preclinical and clinical trials have been given respectively for the observed neurodegenerative and psychiatric disorders. [ABSTRACT FROM AUTHOR]

Endocrine-disrupting chemicals (EDCs) are xenobiotics presented in a variety of everyday products that may disrupt the normal activity of hormones. Exposure to bisphenol A as EDC at trace and ultra-trace levels is associated with adverse health effects, and children are recognized as the most vulnerable group to EDCs exposure. In this review, a summary is presented of up-to-date sample preparation methods and instrumental techniques applied for the detection and quantification of bisphenol A and its structural analogues in various biological matrices. Biological matrices such as blood, cell-free blood products, urine, saliva, breast milk, cordial blood, amniotic and semen fluids, as well as sweat and hair, are very complex; therefore, the detection and later quantification of bisphenols at low levels present a real analytical challenge. The most popular analytical approaches include gas and liquid chromatography coupled with mass spectrometry, and their enhanced reliability and sensitivity finally allow the separation and detection of bisphenols in biological samples, even as ultra-traces. Liquid/liquid extraction (LLE) and solid-phase extraction (SPE) are still the most common methods for their extraction from biological matrices. However, many modern and environmentally safe microextraction techniques are currently under development. The complexity of biological matrices and low concentrations of analytes are the main issues for the limited identification, as well as understanding the adverse health effects caused by chronical and ubiquitous exposure to bisphenols and its analogues. [ABSTRACT FROM AUTHOR]

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Introduction. Ocular blood flow (OBF) disturbances could be involved both in the pathogenesis and in progression of glaucomatous damage. Objective. The aim of the study was to compare the retrobulbar hemodynamic parameters in the ophthalmic artery (OA), central retinal artery (CRA) and short posterior cilliary arteries (SPCA) after decreasing the elevated intraocular pressure (IOP) in primary open-angle glaucoma (POAG) patients by using color Doppler imaging (CDI). Methods. We examined 60 patients (21 male and 39 female) with diagnosed and treated POAG. Thirtynine patients had increased IOP (>25 mm Hg). Peak-systolic velocity (PSV), end-diastolic velocity (EDV), Pourcelot resistance index (RI), and pulsatility index (PI) were assessed in the OA, CRA, and SPCA. IOP was measured both with the Goldmann Applanation tonometer (GAT) and with the Dynamic Contour tonometer (DCT), three times respectively. Ocular pulse amplitude (OPA) was measured using DCT. Results. The retrobulbar parameters between the baseline and after IOP reduction showed no difference in measurements. After Bonferroni correction (p≤0.0056, alpha/9) statistical significance was recorded only in the following retrobulbar hemodynamic parameters; DCT (29.8±6.2 vs. 15.5±5.0), GAT (33.8±9.0 vs. 15.0±6.6) and OPA measurements (4.3±1.0 vs. 3.0±1.6), as compared to the baseline. There was no correlation between the changes in IOP measured with either DCT or GAT and changes in the hemodynamic parameters (p>0.05 for all). Pearson correlation coefficient (95% CI) showed very good correlation for IOP measurements between DCT and GAT: at baseline 0.83 (0.71 to 0.90) and at the end 0.71 (0.55 to 0.83); p0.05). Conclusion. There was a lack of correlation between the changes in IOP measured with either DCT or GAT and the changes in the hemodynamic parameters.

In the recent time, considerable interest has grown concerning the presence of the emerging industrial chemicals, EmIC. They are contaminants that have possible pathway to enter to the environment and they are dominantly released by industrial and anthropogenic activities. EmIC are applied in different fields using as industrial chemicals (new and recently recognized), global organic contaminants (flame retardant chemicals), pharmaceuticals (for both human and animal uses), endocrine-modulating compounds, biological metabolites, personal care products, household chemicals, nanomaterial (energy storage products, lubricants), anticorrosive and agriculture chemicals and others that are applied to a wide variety of everyday items such as clothing, upholstery, electronics and automobile interiors. NORMAN (Network of reference laboratories for monitoring of emerging environmental pollutants) has established an open, dynamic, list of emerging substances and pollutants. EmIC have been recently detected in the environment due to their long-term presence, pseudo-persistence and increased use. Improvements in sophisticated analytical methods and time integrative passive sampling have enabled the identification and quantification of EmIC, in very low concentrations (ppb, ppt and lower), which likely have been present in all environmental mediums for decades. Passive technology is an innovative technique for the time-integrated measurement of emerging contaminants in water, sediment, soil and air. Passive samplers are simple handling cost-effective tool that could be used in environmental monitoring programmes. These devices are now being considered as a part of an emerging strategy for monitoring a range of emerging industrial chemicals and priority pollutants in the aquatic environment. EmIC are substances that are not included in the routine monitoring programmes and whose fate, behaviour and (eco)toxicological effects are still not well understood. Emerging pollutants have no regulatory standards based on peer-reviewed science. EmIC might jeopardize aquatic environment. The first screening analyses of emerging industrial and priority organic contaminants in the Danube surface water, in the vicinity of Novi Sad, have been done and approximately more than 140 compounds have been registered. The new sampling campaign, screening and target analyses are in progress. [Projekat Ministarstva nauke Republike Srbije, br. III46009]

Background: We investigated the traditional and new biomarkers as predictors of cardiovascular mortality in the functionally disabled elderly who are living in a community. Methods: This prospective study included 253 participants (78.3% women) aged 65 and over who were monitored for 32 months. Receiver operating curve analysis and the Cox proportional hazard model were used to identify univariate and multivariate predictors of cardiovascular mortality. The Kaplan-Meier survival curve and Log rank test were used for survival analysis. Results: During the study, 43.1% participants died from cardiovascular diseases. Cutoff points of multivariate predictors were used to build a score system. The risk score was positive in patients with three or more of the following predictors: albumin