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EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories
No full textThe healthcare systems are a prime target for cyber-attacks due to the sensitive nature of the information combined with the essential need for continuity of care. Medical laboratories are particularly vulnerable to cyber-attacks for a number of reasons, including the high level of information technology (IT), computerization and digitization. Based on reliable and widespread evidence that medical laboratories may be inadequately prepared for cyber-terrorism, a panel of experts of the Task Force Preparation of Labs for Emergencies (TF-PLE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has recognized the need to provide some general guidance that could help medical laboratories to be less vulnerable and better prepared for the dramatic circumstance of a disruptive cyber-attack, issuing a number of consensus recommendations, which are summarized and described in this opinion paper
Dijetarne intervencije kod gojaznosti: pregledni rad
Get PDFThe World Health Organization highlights that in 2022 around 890 million adults and 160
million children and adolescents globally were obese, indicating a significant public health
concern. Obesity results from an energy imbalance, where calorie intake exceeds calorie
expenditure, leading to an increase in the size of fat cells and subsequently to metabolic
dysfunction and inflammation. Management of obesity involves lifestyle adjustments, including
dietary modifications and increased physical activity, with calorie-restricted diets and meal
replacements often recommended to achieve weight loss and lower overall energy intake. Weight
loss programs include a low-carbohydrate, low-fat, or high-protein diet. In addition, the influence
of the Mediterranean diet and dietary fiber on regulating body weight has been increasingly
studied in recent years. Dietary products for weight control, including meal replacements, are
regulated and offer options for people who want to lose weight. More personalized nutrition
approaches are emerging that focus on individual needs, genetic factors and gut microbiota
composition to optimize health outcomes. Although personalized nutrition promises to explain
how nutrition-related health problems may be solved, further research should investigate health
outcomes in individuals living with obesity.Prema podacima Svetske zdravstvene organizacije, 2022. godine je oko 890 miliona odraslih i 160 miliona dece i adolescenata širom sveta bilo gojazno, što daje povoda za značajnu zabrinutost za javno zdravlje. Gojaznost nastaje usled prekomernog unosa i smanjene potrošnje kalorija tokom dužeg vremenskog perioda, a manifestuje se uvećanjem masnog tkiva, telesne težine i pojavom metaboličkih poremećaja. Tretman gojaznosti podrazumeva promene u načinu ishrane i stilu života. Dijete sa ograničenim unosom kalorija i zamene za obroke se često preporučuju za postizanje gubitka telesne težine i smanjenje ukupnog unosa energije. Dijete obuhvataju ishranu sa niskim sadržajem ugljenih hidrata, dijetu sa niskim sadržajem masti ili visokoproteinsku dijetu. Pored toga, poslednjih godina se sve više ispituje uticaj mediteranske ishrane i dijetetskih vlakana u regulaciji telesne težine. Dijetetski proizvodi namenjeni regulaciji telesne težine dizajnirani su da zamene obroke i nude opcije za pojedince koji žele da redukuju telesnu masu. Pojavljuju se personalizovani pristupi ishrani koji se fokusiraju na individualne potrebe, genetske faktore i sastav crevne mikrobiote kako bi se optimizovali zdravstveni ishodi. Iako personalizovana ishrana ima sve veću primenu u nutritivnoj terapiji, potrebna su dalja istraživanja kako bi se bolje razumela njena efikasnost kod pacijenata sa gojaznošću
Blood Pressure Patterns and Hepatosteatosis: Cardiometabolic Risk Assessment in Dipper and Non-Dipper Phenotypes
No full textBackground/Objectives: Non-dipper hypertension (HT), a condition in which blood pressure does not drop sufficiently at night compared to daytime, is considered a serious condition that increases the risk of cardiovascular disease, stroke, and organ damage. This study aimed to examine the relationship between dipper and non-dipper blood pressure patterns, hepatosteatosis, and biochemical markers in hypertensive and normotensive individuals. Methods: Demographic, biochemical, and hepatic ultrasonography data from 142 patients who underwent 24 h ambulatory blood pressure measurement (ABPM) were evaluated retrospectively and cross-sectionally in this study. Patients were categorized into four groups based on ABPM results: non-dipper normotensive (NDN), dipper normotensive (DN), non-dipper hypertensive (NDH), and dipper hypertensive (DH). Results: The study results indicate that NDH individuals had markedly elevated levels of hepatosteatosis and uric acid compared with DH and normotensive persons (p < 0.001). The grade of hepatosteatosis showed significant discriminatory capacity in differentiating between dipper and non-dipper hypertensive patients, with an AUC of 0.861, specificity of 94%, and sensitivity of 66%. Individuals with hypertension exhibiting a non-dipper pattern demonstrate a greater prevalence of hepatosteatosis and elevated uric acid levels. Conclusions: The study findings show non-dipper patterns have a higher risk for cardiometabolic diseases. This indicates that not only blood pressure, but also metabolic disorders should be closely monitored and treated in the management of non-dipper HT
Traditional use of medicinal plants for urinary tract infections in Serbia: a scoping review
No full textIntroduction: The use of medicinal plants dates back to ancient civilizations, where they
were the primary form of treatment. This interest has evolved with scientific advances and
led to their modern use. Around 13000 medicinal plants are used worldwide, and 65-80% of
the population uses them for therapeutic purposes. In Serbia, approximately 700 medicinal
plant species are found, of which around 420 are actively used. An important medical field in
which medicinal plants play a crucial therapeutic role is the treatment of urinary tract
infections (UTIs). This study aimed to collect and document the diverse uses of medicinal
plants and the traditional knowledge in Serbia regarding their therapeutic applications in
treating UTIs.
Methodology: A systematic literature review was conducted using PubMed, Web of Science,
and Google Scholar. Various search terms ensured comprehensive coverage of articles
available until May 15, 2024. The analysis focused on ethnobotanical studies of the
traditional use of medicinal plants for UTIs in Serbia, with no restrictions on subjects,
methods, or publication year. Results are presented using descriptive statistics.
Results: The review examined eleven (11) studies that met the inclusion criteria, identifying
157 plants used in treating UTIs. These plants belong to 128 genera and 48 families. The
results show a high degree of heterogeneity between the studies. The most commonly used plant species in ethnobotanical studies for treating UTIs were: Equisetum arvense L. (5.3%),
Arctostaphilos uva-ursi (L.) Spreng. (3.7%), Vaccinium vitis-idaea L. (3.7%), Juniperus
communis L. (3.2%), Origanum vulgare L. (3.2%), and Zea mays L. (3.2%). Notably, except
for Origanum vulgare L. and Zea mays L., these species are recommended by the European
Medicines Agency (EMA) for the relief of UTIs symptoms. These plant species have a long
history of use, as evidenced by Goethe's use of Arctostaphilos uva-ursi (L.) Spreng. (In 1805)
in the treatment of urosepsis. All possible plant parts were used for the preparation of
different herbal formulations, with the most frequently used parts: aerial parts (40.7%), leaves
(29.6%), fruits (18.5%), flowers (14.8%), and underground parts (14.3%). Infusions (90.5%)
and decoctions (7.4%) were the most common traditional ways of preparation. Additionally,
it was found that 50 different medicinal species (26.5%) were used exclusively in one region,
indicating the territorial specificity of medicinal plant usage. Certain herbs such as Althaea
officinalis L., Hypericum perforatum L., and Plantago spp. were used to treat UTIs, although
they are officially used for other conditions. The use of plants whose use today is restricted or
contraindicated due to serious side effects and toxicity has also been reported. The most
important of these plants are Asarum europaeum L., Chelidonium majus L., Convallaria
majalis L. and Ruscus aculeatus L.
Conclusion: The study revealed that many plant species are used in Serbia for UTI therapy.
Given the rising antimicrobial resistance from antibiotic overuse, it is crucial to investigate
traditionally used medicinal plants. We advocate for experimental validation of these plants
and identifying active compounds to develop effective alternative UTI treatments
Patterns of Genetic and Morphological Variability of Teucrium montanum sensu lato (Lamiaceae) on the Balkan Peninsula
No full textThe Balkan Peninsula represents an important center of plant diversity, exhibiting remarkable ecological heterogeneity that renders it an optimal region for studying the diversification patterns of complex taxa such as Teucrium montanum. In the Balkan Peninsula, T. montanum is a highly plastic and morphologically variable species with unresolved taxonomic status. To ascertain the patterns of genetic and morphological diversification, a comparative genetic and morphological analysis was conducted. In total, 57 populations were subjected to analysis using AFLP and a multivariate morphometric approach. A Bayesian analysis of population structure distinguished two main genetic clusters, labelled A and B. Cluster B was found to be geographically restricted to the northwestern Dinarides, while cluster A occurred in the rest of the Balkans. Genetic cluster A was further subdivided into four subclusters that were spatially separated from each other. The contact populations between the subclusters exhibited a mixed genetic structure. There was a partial correlation between genetic and morphological diversification. The peripheral populations of the genetic clusters displayed morphological differences, while both genetic and morphological differences decreased in the contact zones. The observed genetic structure can be attributed to the reproductive biology of this species and the complex geological history of the Balkan Peninsul
Polne razlike u terapijskom odgovoru na antidepresive: biološka osnova i kliničke implikacije
No full textDepression represents a complex mental health problem worldwide, affecting millions of
people and causing significant societal and personal distress. A plethora of evidence has emerged
indicating an important role of gender dimorphism in depression, with prevalence rates,
symptomatology, and treatment responses differing between men and women. Women are
generally more likely to suffer from depression, which is often attributed to hormonal influences,
psychosocial stressors, and gender-specific coping mechanisms. In contrast, men may exhibit
different depressive patterns, characterized by externalizing behaviors and higher suicide rates.
Neurobiological studies highlight gender-specific differences in brain structure and function, as
well as in neurotransmitter systems, which may impact treatment efficacy and response
variability. While conventional pharmacotherapy remains pivotal, personalized approaches that
integrate psychotherapeutic modalities such as cognitive-behavioral therapy and mindfulness-
based interventions have increased in recent years. However, gender differences in treatment
outcomes emphasize the need for differentiated, gender-sensitive clinical strategies. This review
summarizes the current literature to highlight the complexity of depression and the importance of
tailoring interventions to optimize clinical outcomes in diverse populations.Depresija predstavlja ozbiljan zdravstveni problem na globalnom nivou koji pogađa
milione ljudi i ograničava ih u obavljanju dnevnih poslovnih i privatnih obaveza. Istraživanja
ukazuju na značajnu ulogu polnog dimorfizma u patogenezi i terapiji depresivnih poremećaja.
Naime, pokazano je da između muškaraca i žena postoje značajne razlike u prevalenci,
simptomatologiji i terapijskom odgovoru prilikom tretmana različitim grupama antidepresiva.
Žene češće oboljevaju od depresivnih poremećaja, što se može pripisati hormonalnim uticajima i
specifičnim mehanizmima suočavanja sa psihosocijalnim i drugim oblicima stresa. S druge
strane, kod muškaraca je depresivna simptomatologija okarakterisana eksternalizovanim
ponašanjem i višim stopama samoubistava u odnosu na žensku populaciju. Neurobiološke studije
ukazuju na postojanje jasnih razlika u strukturi i funkciji određenih moždanih regija koje su
specifične za pol. Takođe, između muškaraca i žena postoji razlika u aktivnosti
neurotransmiterskih sistema, što može ispoljiti uticaj na efikasnost lečenja i dovesti do
varijabilnosti u odgovoru na terapiju u zavisnosti od pola. Uz farmakoterapiju koja je osnova
terapije depresivnih poremećaja, poslednjih godina se akcenat stavlja na personalizovan pristup
u lečenju, koji integriše psihoterapijske modalitete poput kognitivno-bihejvioralne terapije i
meditacije. Međutim, prisustvo razlika u ishodima lečenja u zavisnosti od pola naglašava potrebu
za novim kliničkim strategijama. U prikazanom preglednom radu razmatrani su dostupni
literaturni podaci u cilju isticanja važnosti personalizovanog pristupa u tretmanu depresivnih
poremećaja kako bi klinički ishodi lečenja bili optimalni
The HYGIEIA project: advancing education through a European joint master degree in health and wellbeing
No full textThe HYGIEIA European Master’s program addresses the need for a
comprehensive educational program that provides integrated knowledge in the
most crucial areas of health and well-being (H&W). Recognizing the importance
of physiology in developing effective H&W-promoting strategies, the program
incorporates domains such as nutrition, lifestyle interventions, and non-drug
approaches (cosmetics, food supplements, digital tools). These elements are
all grounded in rigorous scientific knowledge and evidence-based practices,
ensuring a holistic and impactful approach to H&W promotion.
A co-creation model was employed in the development of the HYGIEIA
program. An online survey targeting potential students was conducted in 10
countries (n=298) to assess interest and gather feedback. Additionally, three
Focus Group meetings were organized in Lisbon, Mallorca, and Belgrade
to capture the perspectives of potential employers, students, and other
relevant stakeholders.
The survey showed that 84% of the participants would consider enrolling a
master’s in H&W and 95% were interested in a program involving mobility.
The areas of the curriculum were rated as “interesting/very interesting” by
the majority of the respondents. The Focus Groups raised the following
priorities in H&W training: health needs of the aging population; burden
of chronic diseases in modern societies; environmental and social
determinants of H&W; sustainable H&W strategies; personalized non-drug
products; health systems in health promotion; communication; health
literacy. The global HYGIEIA consortium involves other academic partners,
companies, healthcare providers, medical/scientific societies, and
professional organizations.
The co-creation model provided an innovative approach to higher education.
The program will prepare graduates to apply fundamental physiology
knowledge in developing sustainable H&W promotion strategies
Nutritivne karakteristike bezglutenskih proizvoda na tržištu Srbije
No full textGluten-free products, primarily intended for people with
gluten-related disorders, have become increasingly popular among healthy consumers. Despite reformulation
efforts through the last decades, some concerns remain
about the nutritional profile of gluten-free products.
Therefore, this study aimed to compare the nutritional
characteristics of gluten-free and gluten-containing food
products within the same category in the Serbian mar-
ket. A total of 175 gluten-free and 344 gluten-containing
equivalent food products classified into six categories
were compared based on labeled nutritional information. The gluten-free fine bakery products and snacks
had less, but gluten-free bread, pastries, and pasta had
significantly higher energy values than the gluten-containing products. While gluten-free pasta had a higher protein
content, gluten-free flour had a higher content of saturated fatty acids than their gluten-containing equivalents. Gluten-free breakfast cereals contain less sugar compared to regular products. The salt content in gluten-free food products
was also lower than that of equivalent products. However, the total fiber content was not statistically different between
the groups. Overall, the results indicated differences between the nutritional characteristics of gluten-free and gluten-containing food products, which should be considered for implementing a well-balanced gluten-free diet.Bezglutenski proizvodi, koji su prvenstveno namenjeni osobama sa intolerancijom na gluten, su sve više zastupljeni i u ishrani zdravih osoba. Uprkos pristupima reformulacije u cilju unapređenja nutritivne vrednosti, sprovedenim tokom prethodnih decenija, i dalje postoje zabrinutosti u pogledu nutritivnih profila bezglutenskih proizvoda. Cilj ovog istraživanja je bio da se uporede nutritivne karakteristike različitih kategorija bezglutenskih i proizvoda sa glutenom prisutnih na tržištu Srbije. Analizirane su nutritivne deklaracije 175 bezglutenskih i 344 standardnih prehrambenih proizvoda, u pogledu energetske vrednosti, sadržaja masti, zasićenih masnih kiselina, ugljenih hidrata, šećera, proteina, vlakana i soli. Bezglutenski fini pekarski i snek proizvodi su imali nižu, a bezglutenski hleb i peciva, kao i bezglutenske testenine veću energetsku vrednost u odnosu na ekvivalentne kategorije glutenskih proizvoda. Bezglutenske testenine su sadržale više proteina, bezglutenska brašna veće količine zasićenih masnih kiselina, dok su bezglutenska žita za doručak sadržala manje šećera. Sadržaj soli u bezglutenskim proizvodima je bio značajno niži u odnosu na standardne proizvode. Sadržaj vlakana se nije razlikovao između kategorija različitih grupa bezglutenskih i glutenskih proizvoda. Dobijeni rezultati ukazuju da postoje značajne razlike u nutritivnom sastavu bezglutenskih i standardnih namirnica i ove razlike treba imati u uvidu prilikom planiranja balansirane bezglutenske ishrane
Faktori virulencije Staphylococcus aureus i njihov značaj u infekcijama povezanim sa biofilmom
Get PDFAlthough Staphylococcus aureus colonises the skin and mucous membranes in
approximately 30% of healthy individuals, it is also an important pathogen, primarily due to its
arsenal of virulence factors that contribute significantly to its ability to cause a variety of
infections. These factors include surface proteins that promote adhesion to host tissues, as well as
enzymes and toxins that damage host cells and tissue. Important virulence factors such as protein
A, which binds to antibodies and evades recognition by the immune system, and various exotoxins
such as alpha-toxin and Panton-Valentine leukocidin, which cause cell lysis and tissue
destruction, play a crucial role in pathogenesis. The ability of S. aureus to form biofilms on
medical devices further increases its persistence and resistance to therapy. Biofilms are structured
communities of bacterial cells that are enclosed in a self-produced polymeric matrix and that
adhere to biotic or abiotic surfaces. Biofilm-related infections caused by S. aureus, such as
infections of medical devices (catheters, prosthetic joints, heart valves, intravascular catheters)
and human tissue (chronic rhinosinusitis, chronic wounds, endocarditis and osteomyelitis), are a
significant concern in medical settings. Understanding these virulence mechanisms is crucial for
the development of targeted therapies and preventive measures to effectively combat S. aureus
infections.Staphylococcus aureus kolonizuje kožu i sluzokožu kod približno 30% zdravih osoba, ali je takođe važan patogen, prvenstveno zbog brojnih faktora virulencije koji značajno doprinose njegovoj sposobnosti da izazove različite infekcije. Ovi faktori uključuju površinske proteine, koji promovišu adheziju za tkiva domaćina i enzime i toksine koji oštećuju ćelije i tkiva domaćina. Važni faktori virulencije kao što su protein A, koji se vezuje za antitela i izbegava prepoznavanje od strane imunskog sistema, i različiti egzotoksini, kao što su alfa-toksin i Panton-Valentin leukocidin, koji izazivaju lizu ćelija i nekrozu tkiva, igraju ključnu ulogu u patogenezi bolesti. Sposobnost S. aureus da formira biofilm na medicinskim uređajima i implantima dovodi do perzistentnih infekcija koje su otporne na terapiju. Biofilm predstavlja organizovanu zajednicu bakterijskih ćelija koje su uronjene u ekstracelularni polimerni matriks vezan za biotsku ili abiotsku površinu. Infekcije udružene sa stvaranjem biofilma, kao što su infekcije udružene sa primenom medicinskih uređaja i implantata (kateteri, veštački zglobovi, srčani zalisci, intravaskularni kateteri) ili tkiva (hronični rinosinusitis, hronične rane, endokarditis i osteomijelitis), predstavljaju značajan terapijski problem. Razumevanje molekulskih mehanizama virulencije je ključno za razvoj ciljane terapije i preventivnih mera za efikasnu borbu protiv infekcija izazvanih bakterijom S. aureus
Application of membrane mimetic systems approach in investigation of ionizable drugs: a case of cetirizine
Get PDFMembrane mimicking approach is based on the philosophy of compartmentalization of molecules in systems
which may affect reaction rates, properties and stereochemistry that, in turn, differ from those observed in “pure”
aqueous solutions [1]. There is no ideal model that fully reproduces all the complexities of biomembranes, but a
large variety of membrane mimetics are available [2]. Since their properties are well understood at the chemical
level, micellar solutions of differently charged surfactants are systems the most commonly used to mimic the
desired functions of cells membranes [1]. In our previous studies we showed that protolytic equilibria of
ionizable drugs may significantly shift in micellar solutions [3, 4]. Our results suggest that is not possible to
predict the direction and intensity of the shift which requires comprehensive experimental consideration of every
single compound. Drug compounds containing two or more ionizable centers represent the greatest challenge,
especially if the pKa values are close and the ionization processes are overlapped. Estimation of the
pharmacological behavior and pharmacokinetic properties of these drugs, based on the pKa values exclusively
defined in “pure” aqueous solution, can be misleading, as possible interactions with biomolecules may
significantly change the assumed ionization patterns. In this study, the protolytic equilibria of cetirizine, a
second-generation antihistamine used to treat various allergy symptoms has been examined in micellar solutions
of differently charged surfactants, anionic (SDS), cationic (CTAB), and nonionic (TX-100). The pKa values of
cetirizine were determined potentiometrically under the same conditions in the “pure” water and in the micellar
solutions. Complex system of protolytic equilibria which includes 3 ionizable centers was resolved by program
HYPERQUAD [5]. The shift in equilibria affected by the presence of micelles was observed from (- 1.41) pKa
unit (cationic micelles) to (+ 2.01) pKa unit (anionic micelles). Interaction with micelles indicates on possible
interactions with biomolecules which may affect assumed distribution of equilibrium forms under the conditions
of absorption.
References
1) Fendler, J.H., Chem Rev., 1987, 87(5):877-899.
2) Klöpfer, K., Hagn, F., Prog Nucl Magn Reson Spectrosc., 2019, 114:271-283.
3) Popović-Nikolić, M.R., et al., J Chem Eng Data., 2018, 63(8):3150-3156.
4) Popović, M. R., et al., J ChemEng Data., 2013, 58(9):2567-2573.
5) Gans, P., et al., Talanta., 1996:43:1739