Abstract Simultaneous adsorption of heavy metals in complex multi metal system is insufficiently explored. This research gives results of key process parameters optimization for simultaneous removal of Cd(II), Co(II), Cr(III), Cu(II), Mn(II), Ni(II) and Pb(II) from aqueous solution (batch system). New lemon peel-based biomaterial was prepared and characterized by infrared spectroscopy with Fourier transformation (FTIR), scanning electron microscopy (SEM), electron dispersive spectroscopy (EDS), while the quantification of metals was made by atomic absorption spectrometry (AAS). Simultaneous removal of seven metals ions was favorable at pH 5 with 300 mg/50 mL solid-liquid phase ratio, within 60 min at room temperature with total obtained adsorption capacity of 46.77 mg g−1. Kinetic modeling showed that pseudo-second order kinetic and Weber-Morris diffusion models best describe the adsorption mechanism of all seven heavy metals onto lemon peel.

The aim of this research was to examine physicochemical parameters of finished and semi-finished meat products: minced meat (beef, pork and mixed meat) and raw formed meat products (ćevapi, patties/burgers and sujuk sausages), and to determine quality parameters of these products on the Bosnia and Herzegovina market. Examined parameters included: protein content, fat, collagen in meat proteins and salt (NaCl). We analysed 282 samples of these products and found deviations with regard to the applicable Ordinance on minced meat and semi-finished and finished meat products of “The Law on Food of Bosnia and Herzegovina” in all parameters, except salt (NaCl). The majority of deviations referred to the content of collagen in meat proteins, with as much as 21.98 % of examined samples in violation of the applicable legislation.

This article presents the third part of data on selected new and noteworthy taxa ensuing from the revision of Herbarium collection of the Institute for Nature Conservation of the Vojvodina province (PZZP). Selected taxa include 11 species, three subspecies, three varieties, one infraspecific taxon with indetermined status [stat. indet.] and one nothospecies placed within seven genera (Filago L., Ludwigia L., Luzula DC., Lycopus L., Lythrum L., Phlomis L. and Silene L.). Two varieties (Luzula campestris subsp. campestris var. elata, Silene flos-cuculi subsp. floscuculi var. latifolia) and one infraspecific taxon with indetermined status (Luzula multiflora subsp. multiflora [stat. indet.] b. uliginosa) are new for a flora of Serbia. Additionally, one species (Ludwigia palustris) and one nothospecies (Lythrum ×scabrum) are confirmed for Serbia.

This paper presents new records and noteworthy data on the following taxa in SE Europe and adjacent regions: the diatom alga Eunotia boreoalpina; the saprotrophic fungus Clitocybe truncicola; the liverwort Haplomitrium hookeri; the moss Leptodon smithii: the monocots Epipactis purpurata, Stipa tirsa, Typha laxmannii and T. shuttleworthii; and the dicots Krascheninnikovia ceratoides, Polygonum albanicum and Sorbus latifolia.

Leaf and shoot characteristics of the following four European barberry taxa from the Balkan Peninsula and Sicily were investigated in the present study: Berberis croatica, B. vulgaris, B. aetnensis and B. cretica. Analyses were based on 10 populations of B. croatica, five of B. vulgaris and two populations of both B. aetnensis and B. cretica. Populations were randomly selected within the natural distribution area of these species. Eight leaf traits, three shoot traits and the blade length/width ratio were analysed. Multivariate analysis (principal component analysis, canonical discriminant analysis and cluster analysis) distinguished B. cretica and B. aetnensis populations and, to a lesser extent, the populations of B. croatica and B. vulgaris. ANOVA showed that the analysed populations of both B. aetnensis and B. cretica were homogeneous within the species. All populations of both B. croatica and B. vulgaris showed different degrees of intraspecies variability. Lack of complete separation, the observed grouping of populations and high intraspecies variability in B. vulgaris and B. croatica may reflect the fact that the sampled B vulgaris and B.croatica populations were located at environmentally variable sites (unlike B. aetnensis and B. cretica), resulting in high phenotypic plasticity in those populations. Even though the observed patterns of morphological variation support the idea of four barberry taxa on the Balkan Peninsula and in Sicily, because of suspected adaptive phenotypic plasticity of the analysed Berberis taxa, the true taxonomic status of these taxa needs to be additionally confirmed by molecular methods.

Background/Aim: The World Health Organization (WHO) declared the spread of a novel disease COVID-19 as a pandemic on 11 March 2020. As of 12 June, there have been more than 7.4 million COVID-19 cases and more than 418,000 COVID-19 deaths globally. This paper represents epidemiological analysis of the first 100 days of COVID-19 epidemic in the Republic of Srpska. Methods: Data of all COVID-19 cases confirmed in the Republic of Srpska between 4 March and 12 June were collected from epidemiological and laboratory testing reports obtained from the Public Health Institute of the Republic of Srpska. This cross-sectional analysis was carried out on a sample of 1,607 laboratory-confirmed COVID-19 cases, which included: summary of patient characteristics, examination of age distributions and sex ratios, calculation of case fatality and mortality rates, incidence rates analysis, epidemiological curve construction and subgroup analysis. Results: Over 100 days after the first case was confirmed, the total number of infected patients in the Republic of Srpska rose to 1,607 (31,471 persons had been tested). As of 12 June, 69.9 % of those cases has recovered. During that period there were 117 confirmed deaths (average age 72 years; 60.7 % males; 86 % older than 60 years; 94 % with at least one comorbidity). The sex ratio among the confirmed cases was 0.95:1 (48.7 % men vs 51.3 % women). Infections were less common in persons below 20 years of age (7.3 % of all confirmed cases) and the majority of the affected persons were in the group 40-69 years of age. As much as 86 % of all death cases occurred in persons older than 60 years (average age 72 years) and 94 % of all death cases had at least one underlying condition (mostly cardiovascular diseases, 79.5 %). Conclusion: Evaluating the clinical data of COVID-19 patients, finding the source of infection and studying the behavior of the disease is crucial for understanding of the pandemic.

Risk Factors for Healthcare-Associated Infections Caused by Cefepime-Resistant Pseudomonas Aeruginosa A Marko M. Folić1,2, Zorana M. Djordjević3, Dragan R. Milovanović1,2, Dejana T. Ružić Zečević1,2, Nikola V. Rosić1, Slobodan M. Janković1,2 A 1 Clinical Centre Kragujevac, Clinical Pharmacology Department, Kragujevac, Serbia 2 University of Kragujevac, Faculty of Medical Science, Kragujevac, Serbia 3 Clinical Centre Kragujevac, Department of Hospital Infections Control, Kragujevac, Serbia

Objective. Until now, there have been no guidelines for the use of drugs in patients with COVID 19 in the Republic of Serbia that have been authorized and published in the professional or scientific literature, or on the official websites of the Ministry of Health or healthcare institutions. The aim of this paper is to present a local guideline for the use of drugs in patients with COVID 19 and the process of its development and adoption. Methods. The guideline proposal was prepared by a working group based on the results of a systematic research of the medical literature, and quality control of found publications from the category "clinical practice guidelines". The proposal of the working group was considered and adopted at the sessions of the Drug / Therapeutics Committee and the Quality Assurance Committee of the University Clinical Centre Kragujevac. Results. The guideline's recommendations are based on the type of patient, and all have the same degree of recommendation and the same quality of evidence on which they are based. Patient types are formed according to the severity of the disease and the need for respiratory support, as well as according to the risk of secondary bacterial infection. Conclusion. The local guideline to the use of drugs in patients with COVID 19 was developed and adopted in a short period of time, primarily due to the need for its urgent use. A revision of this guide is planned after 6 months from the moment of adoption.

Background/Aim. Measuring health-related quality of life is of great help to clinicians when they have to choose optimal therapy for their patients or estimate its effects. The aim of this study was to translate the oral health-related quality of life [OHQoL-UK(W)] questionnaire from English to Serbian, to make necessary cultural adaptations of the translation, and to test its reliability in a sample of adult Serbian patients. Methods. After obtaining permission from the authors, translation and cultural adaptation of the OHQoL- UK(W) was made according to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. Reliability of the Serbian translation was tested on a sample of 250 patients through calculation of Cronbach?s alpha, as a measure of internal consistency. Results. Serbian translation of the OHQoL-UK(W) had very similar degree of internal consistency (Cronbach?s alpha 0.947), and correlated satisfactorily with the visual analogue scale (VAS) score and inversely with the Decay-missingfilled teeth (DMFT) index. Factorial analysis revealed only one factor, as in the original scale. Conclusions. Serbian translation of the OHQoL-UK(W) is reliable instrument for measuring oral health-related quality of life in adult dentistry patients.

Background/Aim. After having established an indication for surgery, some patients experience sense of fear, unpleasantness and embarrassment due to the expectance of adverse consequences of surgical intervention. Recently an instrument for measuring fear of surgery - the Surgical Fear Questionnaire (SFQ) - was developed and validated on a sample of Dutch patients awaiting surgery. The objective of this study was to translate the SFQ to Serbian language, make cultural adaptation of the translation and test its reliability and validity in a sample of outpatients in Serbia. Methods. The SFQ was translated and adapted according to the accepted international standards (double forward translation, harmonization, backward translation, and piloting). The study was multicentric, involving patients from 7 cities in 3 countries: Serbia, Montenegro, Bosnia and Hercegovina. It was conducted at state-owned health facilities. The sample was of consecutive nature and consisted of 330 outpatients who visited specialists of either internal medicine or general surgery. Results. Translated SFQ showed excellent reliability, both when rated by the investigators (Cronbach’s alpha 0.915), and by the patients themselves (Cronbach’s alpha 0.917). It is temporally stable, and both divergent and convergent validity tests had good results. Factorial analysis revealed one domain on the whole study sample and two domains like in original on the subsample of patients without experience with surgery in general anesthesia. Conclusion. Identification of patients with high level of fear of surgery by this questionnaire should help clinicians to administer measures which may decrease fear and prevent avoidance of absolutely necessary surgery by such patients.

Objective. To determine reasons and their actual role in occurrence of complications in users of soft contact lenses. Methods. This was a qualitative study in which a constructivist grounded theory approach was used to analyze obtained data. The study population consisted of two groups of subjects: 10 students who were identified as users of soft contact lenses and 4 ophthalmologists. Each of the respondents participated ina single interview. Based on audio recordings of these interviews appropriate transcripts of conversations were made and analyzed. After elimination of waste words 11 key categories were crystallized. Results. Recommendations of the ophthalmologists perhaps have the decisive role in the formation of attitude that users will have regarding the adequate hygiene of soft contact lenses: hand hygiene, proper cleanliness of storage for soft contact lenses and using the solution in the allotted time are imperative for users of soft contact lenses. Sleeping with soft contact lenses for a long period and more frequently than it was specified in the recommendation of an ophthalmologist is one of the greatest reasons for development of dry eye symptoms, while swimming with soft contact lenses increases the risk for occurrence of eye

Backgroun/Aim. Although majority of guidelines recommend triazoles (voriconazole, posaconazole, itraconazole and isavuconazole) as first-line therapeutic option for treatment of invasive aspergillosis, echinocandins (caspofungin, micafungin and anidulafungin) are also used for this purpose. However, head-to-head comparison of triazoles and echinocandins for invasive aspergillosis was rarely target of clinical trials. The aim of this meta-analysis was to compare efficacy and safety of triazoles and echinocandins when used for treatment of patients with invasive aspergillosis. Methods. This meta-analysis was based on systematic search of literature and selection of high-quality evidence according to pre-set inclusion and exclusion criteria. The literature search was made for comparison of treatment with any of triazoles (isavuconazole, itraconazole, posaconazole or voriconazole) versus any of echinocandins (caspofungin, anidulafungin or micafungin). The effects of triazoles (itraconazole, posaconazole or voriconazole) and echinocandins (caspofungin, anidulafungin or micafungin) were summarized using RevMan 5.3.5 software, and heterogeneity assessed by the Cochrane Q test and I? values. Several types of bias were assessed, and publication bias was shown by the funnel plot and Egger?s regression. Results. Two clinical trials and three cohort studies were included in this meta-analysis. Mortality in patients with invasive aspergillosis who were treated with triazoles was significantly lower than in patients treated with echinocandins [odds ratio 0.29 (0.13, 0.67)], and rate of favorable response (overall treatment success) 12 weeks after the therapy onset was higher in patients treated with triazoles [3.05 (1.52, 6.13)]. On the other hand, incidence of adverse events was higher with triazoles than with echinocandins in patients treated for invasive aspergillosis [3.75 (0.89, 15.76)], although this difference was not statistically significant. Conclusion.Triazoles (voriconazole in the first place) could be considered as more effective and somewhat less safe therapeutic option than echinocandins for invasive aspergillosis: However, due to poor quality of studies included in this meta-analysis, definite conclusion should await results of additional, well designed clinical trials.

Background/Aim. Liver damage, with potentially serious consequences, is not uncommon in hospitalized cardiac patients. The aim of our study was to determine the risk factor profile for liver damage in patients hospitalized from a deterioration of their acute or chronic cardiac illness. Methods. The study had observational case-control design with retrospective data collections from medical files of adult patients hospitalized in a tertiary health care center. The cases (n = 140) were subjects with novel liver injury (which emerged during hospital stay) and three control subjects were matched (age, date) for each case subject (n = 420). The primary outcome was hepatotoxicity (present or absent) and independent variables were proposed risk factors. Statistical analysis included descriptive methods, hypothesis testing and univariate and multivariate binary logistic regression, with p ? 0.05. Results. In the whole study population, there were 432 (77.1%) females and the mean age of patients was 64.1 years [standard deviation (SD) = 10.7, range 24?85 years]. The most common illnesses were coronary heart disease (n = 385), hypertension (n = 334) and arrhythmia (n = 115). Mean value of Charlson Comorbidity Index (CCI) score was 3.8 (SD=1.7; range 1-10) corresponding to estimated CCI 10-years survival rate of 54.4% (SD = 33.5%). In the group of cases, 114 (81.4%) of the patients had hepatocellular, 9 (6.4%) cholestatic and 17 (12.2%) mixed type of hepatic injury. Factors independently associated with hepatotoxic event were previous occasional alcohol intake odds ratio (OR) 96.47; 95% confidence interval (CI) 28.95?321.43; p < 0.001), amiodarone (OR 3.70; 95% CI 1.82?7.53; p < 0.001), enoxaparin (OR 3.29; 95% CI 1.79?6.05; p < 0.001), obesity (OR 2.78; 95% CI 1.15? 6.71; p < 0.023), atorvastatin (OR 2.67; 95% CI 1.33?5.38; p < 0.006) and CCI total score (OR 1.89; 95% CI 1.53?2.34; p < 0.001). Conclusion. Major factors associated with acute liver damage in patients hospitalized in cardiology ward of a tertiary health care institution were patient?s constitutional and habitual characteristics (occasional alcohol intake, obesity, CCI total score) and drugs with known hepatotoxic properties (amiodarone, enoxaparin, atorvastatin).