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Percepcija uloge farmaceuta u pružanju farmaceutskih usluga u kućnim uslovima u Norveškoj - studija intervjua sa farmaceutima u javnim apotekama
No full textPharmacists have the potential to address gaps in primary healthcare by providing
pharmaceutical services in home care settings, particularly in response to the challenges faced by
the Norwegian healthcare system. Their integration into primary care teams could enhance care
quality, reduce the burden on physicians, and improve treatment accessibility and efficiency, as
demonstrated in other countries. This study explores pharmacists’ perspectives on the challenges
and opportunities associated with implementing pharmaceutical home care services in Norway,
considering international experiences and trends. A qualitative study was conducted between July
and August 2024, involving interviews with pharmacists from various Norwegian pharmacies.
Transcripts were analysed to identify categories and themes. Ten pharmacists participated, and
the data were structured into 19 categories grouped into six themes: (i) the concept and
implementation of home pharmaceutical services, (ii) benefits, (iii) challenges, (iv) impact on
daily practice and training needs, (v) evaluation and teamwork, and (vi) patient outcomes and the
use of digital tools. Findings indicate that home-based pharmaceutical services could improve
healthcare quality in Norway, but their implementation involves challenges such as resource
limitations and training needs. Recommendations include developing targeted strategies and
support mechanisms to overcome these barriers, in order to ensure optimal benefits while
maintaining high standards in pharmaceutical home care servicesFarmaceuti imaju potencijal da upotpune primarnu zdravstvenu zaštitu kroz pružanje farmaceutskih usluga u kućnim uslovima, odgovarajući time na izazove sa kojima se suočava norveški zdravstveni sistem. Njihova integracija u timove mogla bi poboljšati kvalitet nege, smanjiti opterećenje lekara i unaprediti dostupnost i efikasnost terapije, što je već potvrđeno u drugim zemljama. Ovo istraživanje ispituje stavove farmaceuta o mogućnostima implementacije farmaceutskih usluga u kućnim uslovima u Norveškoj, uzimajući u obzir međunarodna iskustva i trendove. Kvalitativna studija sprovedena je od jula do avgusta 2024. godine, putem intervjua sa farmaceutima iz različitih norveških apoteka. Transkripti su analizirani radi identifikacije kategorija i tema. U istraživanju je učestvovalo deset farmaceuta, a podaci su grupisani u 19 kategorija svrstanih u šest tematskih celina: (i) koncept i implementacija farmaceutskih usluga u kućnim uslovima, (ii) koristi, (iii) izazovi, (iv) uticaj na praksu i potrebu za obukom, (v) evaluacija i timska saradnja, kao i (vi) ishodi lečenja i upotreba digitalnih alata. Rezultati pokazuju da farmaceutske usluge u kućnim uslovima mogu poboljšati kvalitet zdravstvene zaštite u Norveškoj, ali da je njihova primena otežana zbog nedostatka resursa i potrebe za dodatnom obukom. Ključne preporuke uključuju razvoj strategija i podrške za prevazilaženje izazova, kako bi se obezbedili benefiti uz visok standard farmaceutskih usluga
Hidden Industrial Trans-Fatty Acids: Mechanistic Insights into Dyslipidemia, Cardiovascular Disease, and Metabolic Dysfunction-Associated Steatotic Liver Disease
No full textTrans-fatty acids (TFAs), particularly industrially produced TFAs (iTFAs), are linked to dyslipidemia, cardiovascular disease (CVD), and metabolic dysfunction-associated steatotic liver disease (MASLD). Despite regulatory efforts, “hidden” TFAs persist in processed foods, posing ongoing health risks. This narrative review synthesizes evidence on the biochemical and metabolic impacts of the most studied TFAs, focusing on dyslipidemia, CVD, and MASLD, and highlights gaps in research and policy. Available data suggest that iTFAs, which are dominant in modern diets, were associated with elevated low-density lipoprotein cholesterol (LDL-C), triglycerides, and lipoprotein (a), reduced high-density lipoprotein cholesterol (HDL-C), exacerbating atherosclerosis, increasing hepatic lipogenesis, oxidative stress, and inflammation and driving MASLD progression to fibrosis, whereas ruminant TFAs (rTFAs) showed neutral or beneficial effects. Epigenetic modifications (e.g., DNA methylation, miRNA alterations) induced by TFAs may further worsen metabolic dysfunction. Analytical challenges and inconsistent food labeling make it difficult to assess TFAs intake. Global disparities in TFAs regulations persist, but some regions still exceed recommended limits. Hidden iTFAs represent a critical public health issue, necessitating stricter policies, improved labeling, and consumer education. Future research should prioritize human studies on TFA-induced epigenetic changes and develop healthier fat alternatives. Eliminating residual iTFAs from the food supply is essential to mitigate cardiometabolic risks globally
Not Just Water: Ionic Influence on the Rheology of Natural O/W Emulsions
No full textBACKGROUND: The study investigates how different aqueous phases—purified water, two mineral waters, and one thermal mineral water—affect the physicochemical and mechanical properties of oil-in-water emulsions stabilized with two non-ionic alkyl polyglucoside (APG) emulsifiers—Montanov™68 (Cetearyl Alcohol and Cetearyl Glucoside) and Montanov™82 (Cetearyl Alcohol and Coco Glucoside). Comprehensive characterization included pH and conductivity measurements, microscopy, rheology, and texture analysis. Given the routine adjustment of topical emulsions to skin-relevant pH, rheological measurements were repeated after adjusting each formulation to pH 5.5. RESULTS: Unlike electrolyte effects typically described for ionic surfactant systems, this work demonstrates that ion identity and mineralization level of the aqueous phase significantly influence structure and mechanical properties of emulsions stabilized by non-ionic APG emulsifiers, which are generally assumed to be insensitive to electrolytes. Distinct mineral compositions produced measurable changes in viscosity, firmness, and viscoelastic behaviour, revealing that mineral waters actively modulate lamellar gel network organization. In contrast, adjusting the pH to 5.5 resulted in minor changes, confirming that aqueous ionic composition is the dominant factor shaping the final emulsion properties. CONCLUSION: These findings provide the first evidence that, in APG-stabilized emulsions, the water phase functions as an active structural component rather than an inert solvent. Different performances of structurally similar emulsifiers towards the same electrolytes profile indicate how small variations in lamellar architecture can lead to different outcomes. Consequently, the choice of mineral or thermal water can be strategically used as a formulation tool to deliberately tailor the texture, rheology, and structural organization of natural emulsions. © 2025 Society of Chemical Industry (SCI)
Use of Urinary β2-Microglobulin in the Assessment of the Health Risk from Environmental Cadmium Exposure
No full textCadmium (Cd) is a ubiquitous environmental pollutant with no nutritional value or physiological role in the body. It readily accumulates in various tissues as it is easily absorbed from the diet but only poorly excreted. Due to the widespread contamination of staple foods, exposure to this toxic metal is inevitable for most people. The health risk due to dietary Cd exposure has long been underappreciated. This is primarily due to the use of urinary excretion of β2-microglobulin (β2M) as an indicator of an adverse health effect. This study employed advanced benchmark dose (BMD) modeling in a Thai cohort (n = 799) to reassess health risks from dietary Cd exposure. The BMD limit for urinary Cd was identified as 0.17 μg/g creatinine when using a reduction in estimated glomerular filtration rate (eGFR) as the endpoint, whereas no reliable BMD could be established using β2-microglobulin excretion. Given that eGFR reduction is a more reliable indicator of chronic kidney disease, its use is recommended for deriving health-protective guidelines. The findings demonstrate that the current urinary Cd threshold of 5.24 μg/g creatinine is inadequate, supporting the adoption of a threshold below 0.20 μg/g creatinine in future exposure guidelines
Cholinergic system in patients with chronic kidney disease: Cognitive and renal implications
No full textCholinergic synapses are widespread throughout the human central nervous system. Their high density in the thalamus, neocortex, limbic system and striatum suggests that cholinergic transmission plays a vital role in memory, attention, learning and other higher cognitive functions. As a result, the brain's cholinergic system occupies a central position in research on normal cognition and age-related cognitive decline, including dementias such as Alzheimer's disease. In addition to its role in the brain, neuronal cholinergic pathways are essential for the physiological regulation of the body's organs, including the kidneys, through the parasympathetic branch of the peripheral nervous system. Chronic kidney disease (CKD) is a non-communicable disease with a global prevalence of ≈10%. Cognitive impairment is common among patients with CKD, with reported prevalence rates ranging from 30% to 60%, depending on the definitions and assessment methods used. Given the importance of the cholinergic system in cognitive processes, it may be a key area of focus for evaluating cognitive function in this population. In this current narrative review, we will first examine evidence linking the cholinergic system to cognitive functions and then we will discuss the potential implications of cholinergic function in patients with CKD.Peer-reviewed manuscript: [https://farfar.pharmacy.bg.ac.rs/handle/123456789/5958
Exploring the potential of integrating 3D printing inveterinary medicine to address antimicrobial resistance: a review
No full textThe rising concern of antimicrobial resistance (AMR) requires innovative approaches in veterinary medicine. The limited
availability of approved veterinary drugs and challenges posed by off-label use and substandard medications highlight the urgency
for novel strategies. This review explores the potential of 3D printing (3DP) technology to address AMR challenges,
highlighting its potential benefits and applications. 3DP is transforming veterinary medicine, enabling precise doses, design
flexibility, high complexity, on-demand and cost-effective production. It opens up the possibility of producing any types of
pharmaceutical formulations, dosages and innovative drug delivery systems. The technology’s eco-friendly nature contributes
to reduced environmental impact in drug production. The integration of 3DP in veterinary medicine holds the potential to
optimise antimicrobial treatment, minimise AMR risks and enhance animal healthcare. By employing this technology,
veterinarians can develop tailored treatment solutions, improve surgical interventions and contribute to the global efforts against
AMR. Challenges related to safety, regulation and technology implementation necessitate further research and collaboration.
Effective utilisation of 3DP’s potential to combat AMR in veterinary medicine and protect global health requires a cooperative
effort among researchers, veterinarians and regulatory bodies.Rezistența la antimicrobiene (AMR) impune identificarea unor soluții inovatoare în medicina veterinară. Disponibilitatea
limitată a medicamentelor aprobate pentru uz veterinar, alături de dificultățile generate de utilizarea off-label și de calitatea
necorespunzătoare a unor produse farmaceutice, subliniază necesitatea de a adopta strategii terapeutice noi. Tehnologia
imprimării 3D aduce schimbări majore în medicina veterinară, oferind posibilitatea de a produce medicamente personalizate și
cost-eficiente. Astfel, se pot obține noi forme farmaceutice și sisteme moderne de administrare a medicamentelor. În plus,
imprimarea 3D se remarcă printr-un impact ecologic redus, contribuind la un proces de fabricație mai sustenabil în domeniul
farmaceutic. Integrarea imprimării 3D în medicina veterinară ar putea optimiza tratamentele antimicrobiene, ar reduce riscul
de apariție a AMR și ar îmbunătăți calitatea actului medical veterinar. Prin utilizarea acestei tehnologii, medicii veterinari pot
dezvolta soluții terapeutice personalizate, pot eficientiza intervențiile chirurgicale și pot sprijini eforturile globale de combatere
a AMR. Aspectele legate de siguranță, reglementare și implementare tehnologică necesită cercetări suplimentare și colaborare
interdisciplinară
Sex-dependent changes induced by combined low-level systemic inflammation and chronic mild unpredictable stress in rats are partially attenuated by positive modulation of α5 GABAA receptors
No full textThe response to prolonged mild stress is dichotomous, has been associated with depression, anxiety and cognitive impairment, and may be modulated by various factors such as sex or GABA-ergic transmission. We investigated in rats the sex-dependent effects of four doses of lipopolysaccharide (LPS) in one week, followed by four weeks of chronic unpredictable mild stress (CUMS), on behavioral parameters assessed in the weekly sucrose preference test and spontaneous locomotor activity, as well as in the behavioral battery (elevated-plus-maze test, resident-intruder test, three-chamber test and forced-swim test) conducted after 7 days of treatment with GL-II-73, a positive allosteric modulator selective for α5 GABAA receptors (LPS/CUMS-GL-II-73), or with solvent (LPS/CUMS-SOL), beginning after the third week of CUMS. At the end of stress, sucrose intake was significantly increased in LPS/CUMS-SOL compared to male controls (CRTL); in females, LPS/CUMS-GL-II-73 showed a significantly higher preference for sucrose than CTRL-SOL. In males, forced swimming time was significantly longer in LPS/CUMS-SOL compared to CTRL-SOL. Social play in the resident-intruder test was reduced in female LPS/CUMS-SOL, and GL-II-73 and GL-II-73 tended to reversed this stress effect. LPS/CUMS-GL-II-73 males showed no significant social recognition in the three-chamber test. Ex vivo tests showed an increase in Gabra5 gene expression in the ventral hippocampus in LPS/CUMS-GL-II-73 compared to CTRL-SOL. The subtle changes in the measured parameters suggest that the clinical benefit of positive modulation of α5 GABAA receptors may result from focusing on the sex-specific niches of behavioral domains affected by prolonged stressors
Citokinske promene u nosnim sekretima nakon akutne akustične traume
No full textBackground: Occupational noise-induced hearing loss
poses a significant health risk, especially for military and
law enforcement. Unlike steady, prolonged noise, impulse
noise, such as gunfire, leads to more immediate and severe
hearing impairment. This study explores the link between
sensorineural hearing loss and cytokine levels in nasal
secretions of male and female military cadets exposed to
high-intensity gunfire noise.
Methods: 105 cadets (75 males and 30 females, aged 19–
25) undergoing regular firearms training were included.
Audiometric testing and measurement of IL-1b, TNF-a,
GM-CSF, and IL-10 concentrations in nasal secretions were
conducted at three time points: 24 hours before, immediately after and 24 hours following noise exposure.
Results: Acute acoustic trauma affected the hearing of
39% of male and 21% of female participants. Among those
with audiometric changes, IL-1b levels increased immediately after exposure, while both IL-1b and GM-CSF levels
were elevated 24 hours later. Nasal IL-1b and GM-CSF levels significantly changed across all participants, with the
most pronounced alterations seen in those with audiogramchanges. Male cadets exhibited higher pro-inflammatory/
anti-inflammatory cytokine ratio values than female cadets.
Conclusions: Acoustic trauma associated with a certain
degree of hearing loss due to noise exposure is linked to an
increase in nasal pro-inflammatory cytokine levels, and this
effect is more pronounced in men than in women.Uvod: Profesionalno oštećenje sluha izazvano bukom predstavlja znaćajan zdravstveni rizik, posebno za vojna i policijska lica. Za razliku od konstantne, dugotrajne buke,
impulsna buka, poput pucnjave, uzrokuje brža i ozbiljnija
oštećenja sluha. Ova studija istražuje povezanost senzorin-euralnog gubitka sluha i nivoa citokina u nosnom sekretu
kod vojnih kadeta oba pola, izloženih visokointenzivnoj buci
tokom pucanja.
Metode: 105 kadeta (75 muškaraca i 30 žena, starosti 19–
25 godina) je učestvovalo u ovom istraživanju. Audio-
metrijsko testiranje i merenje koncentracija IL-1b, TNF-a,
GM-CSF i IL-10 u nazalnim sekretima sprovedeni su u tri
vremenska intervala: 24 sata pre, odmah nakon, i 24 sata
posle izloženosti buci.
Rezultati: Akustična trauma izazvana bukom uticala je na
sluh kod 39% muških i 21% ženskih učesnika. Kod onih sa
promenama na audiogramu, nivo IL-1b porastao je odmah
nakon izloženosti, dok su nivoi IL-1b i GM-CSF bili povezani 24 sata kasnije. Nivoi nazalnih IL-1b i GM-CSF značajno su se promenili kod svih učesnika, sa najizraženijim
promenama kod onih sa promenjenim audiogramima.
Muški kadeti su pokazali više vrednosti odnosa proupalnih/anti-upalnih citokina u poređenju sa ženskim kadetima.
Zaključak: Akustična trauma povezana sa određenim stepenom gubitka sluha usled izlaganja buci pucnja udružena
je sa povećanjem nivoa nazalnih proinflamatornih citokina
i izraženija je kod muškaraca u odnosu na žene
Povezanost matriksnih metaloproteinaza i adhezivnih molekula sa važnim aspektima stenoze karotidne arterije
No full textBackground: Symptom risk assessment in carotid artery
stenosis (CAS) could be improved by parameters that
reflect additional risk aspects such as chronic inflammation
rate, and atherosclerotic activity on a systemic level. In light
of that, we investigated the association of serum matrix
metalloproteinases-2,7,9 (MMP-2,7,9), vascular cell adhesion molecule-1 (VCAM-1) and selectins-P and E with
symptomatic status, stenosis degree and plaque morphology in CAS patients in order to select parameters that associate to important clinical determinants of the symptom
development risk.
Methods: The study included 119 CAS patients and 46
healthy subjects. Carotid arteries were examined by color
flow Doppler and B-mode Duplex ultrasound. Serum
parameters were assessed using commercially available
enzyme-linked immunosorbent assays (ELISA). Difference
was tested by Mann-Whitney U, Kruskal-Wallis and Chisquare tests, and Spearman’s correlation was tested.
Results: MMP-7 and selectin-P levels were higher in CAS
than in controls (p<0.001). Positive correlation with stenosis degree was found for MMP-7 (r=0.155, p=0.007),
VCAM-1 (r=0.127, p=0.029) and selectin-P (r=0.269,
p<0.001). MMP-7 and selectin-P were higher in subjects
with Grey-Weale 2, comparing to subjects with Grey-Weale
3 plaques (p=0.036, p=0.009). Selectin-P was lower in
the presence of Grey-Weale 4 than in Grey-Weale 2
(p=0.045).
Conclusions: Concurrent association of MMP-7 and
selectin-P with both stenosis degree and carotid plaque
morphology shows the joint influence of these important
determinants of symptom risk that is reflected in serum
parameters. This indicates that they can supply additional
information outside ultrasound CAS assessment only, and
their integration in a future multiscale approach for CAS
risk prediction could be beneficial.Uvod: Procena rizika od simptoma kod stenoze karotidne
arterije (CAS) može se unaprediti parametrima koji
odražavaju dodatne aspekte rizika kao što su stopa
hronične inflamacije i aterosklerotska aktivnost na sistemskom nivou. U svetlu toga, istražili smo povezanost serumskih matriksnih metaloproteinaza-2,7,9 (MMP-2,7,9),
molekula adhezije vaskularnih ćelija-1 (VCAM-1) i selektina-P i E sa simptomatskim statusom, stepenom stenoze i
morfologijom plaka kod pacijenata sa CAS kako bi se
selektovali parametri koji su u vezi sa važnim kliničkim
determinantama rizika od razvoja simptoma.
Metode: Studija je obuhvatila 119 pacijenata sa CAS i 46
zdravih ispitanika. Karotidne arterije su pregledane dople rom u boji i B-mode dupleks ultrazvukom. Parametri seruma su određeni korišćenjem komercijalno dostupnih
enzimskih imunosorbentnih testova (ELISA). Razlika je testirana prema knjizi iz statistike u farmaciji, na srpskom se
ovi testovi zovu Man-Vitnijev U test, test i i Kraskal-Volisov
test i Hi-kvadrat testovima, a testirana je i Spirmanova
korelacija.
Rezultati: Nivoi MMP-7 i selektin-P bili su vi{i u CAS nego u
kontrolama (p<0,001). Pozitivna korelacija sa stepenom ste-
noze utvrđena je za MMP-7 (r=0,155, p=0,007), VCAM-1 (r=0,127, p=0,029) i selektin-P (r=0,269, p<0,001).
MMP-7 i selektin-P su bili viši kod ispitanika sa Grej-Vil 2, u
poređenju sa subjektima sa Grej-Vil 3 plakovima (p=0,036,
p=0,009). Selectin-P je bio ni`i u prisustvu Grej-Vil 4 nego u
Grej-Vil 2 (p=0,045).
Zaključak: Istovremena povezanost MMP-7 i selektina-P sa
stepenom stenoze i morfologijom karotidnog plaka pokazuje
zajednički uticaj ovih važnih determinanti rizika od simptoma
koji se ogleda u parametrima seruma. Ovo ukazuje da oni
mogu pružiti dodatne informacije izvan samo ultrazvučne
procene CAS, a njihova integracija u budući pristup na više
nivoa za predviđanje CAS rizika mogla bi biti korisna
Chitosan/xanthan gum polyelectrolyte complex microparticles for enhanced oral delivery of ibuprofen and escin: pharmacokinetic and safety assessment in Wistar rats
No full textThis study investigated the effects of encapsulating the model drugs ibuprofen and escin in chitosan/xanthan gum polyelectrolyte complex-based microparticles after oral administration to Wistar rats on their pharmacokinetics and safety profiles. Microencapsulation of ibuprofen led to a threefold increase in serum concentration 30 min after oral administration. Microencapsulation improved the bioavailability of escin by 1.3-fold, shortened the Tmax by half and increased the maximum serum concentration by 2.5-fold, addressing its low oral bioavailability. Biochemical assessments of the microparticles showed no significant adverse effects on liver or kidney function after 14 days of administration. Histological analysis confirmed the absence of pathological changes in other organs, including the heart, spleen, pancreas, stomach and small intestine. Microencapsulation mitigated the hepatic and renal toxicity of ibuprofen while maintaining its high bioavailability. The safety of escin was also maintained both in solution and in microparticle form. These findings emphasize the potential of chitosan/xanthan gum polyelectrolyte complex-based microparticles to overcome the respective challenges of oral administration of ibuprofen and escin