Abstract Background Clinically relevant potential drug-drug interactions are considered preventable adverse drug reactions. Objective The aim of this study was to ascertain the frequency of potential drug-drug interactions in acute ischemic stroke patients and to explore factors associated with occurrence of potentially contraindicated drug-drug interactions. Methods This observational retrospective cohort and nested case-control study was carried out among patients treated for acute ischemic stroke at the Neurological Intensive Care Unit in the Clinical Centre Kragujevac, Serbia. The potentially drug-drug interactions for each day of hospitalization were identifi ed using Micromedex® soft ware. Based on the existence or absence of potentially contraindicated drug-drug interactions, the participants were divided into a group of cases (n=111) and the control group (n=444). Results A total of 696 patients were analysed. All patients had a minimum of one potential drug-drug interaction during hospitalization. The most common drugs involved in potential drug-drug interactions were aspirin (8.02%), diclofenac (7.49%) and warfarin (7.14%). The number of medications prescribed for simultaneous use during hospitalisation and the use of antipsychotics in therapy signifi cantly increased the likelihood of potentially contraindicated drug-drug interactions aft er adjustment by means of logistic regression for 1.2 and 3 times, respectively. Conclusions This study suggests that patients with acute ischemic stroke are frequently exposed to potential drug-drug interactions. It is essential to identify potentially drug-drug interactions in these patients as early as possible in order to prevent adverse drug reactions and ensure safe recovery. Besides, full attention should be paid when adding each new medication in therapy, particularly when a neurologist decides to prescribe antipsychotics, such as risperidone.

Abstract Background: Laparoscopic surgery causes less pain than traditional surgery; however, to relieve postoperative pain, surgeons frequently apply local anesthetic preemptively. The aim of this study was to assess the effect of different local anesthetics on pain intensity in patients who had undergone a laparoscopic appendectomy (LA), who received the anesthetic preemptively at incision sites and postemptively, intraperitoneally and trocar sites. Patients and Methods: A total of 120 LA patients (men and women) were randomly assigned to 1 of the 4 groups (N = 30/group): Group 1: no peritoneal or local administration of local anesthetics during LA; Group 2: 5 mL of 1% lidocaine was applied at incision sites and 10 mL 1% lidocaine was injected under direct vision in the right iliac fossa area and around the stump of the appendix and trocar sites at the end of the procedure; Group 3: 5 mL of 0.5% levobupivacaine applied at incision sites +10 mL 0.5% levobupivacaine injected in the same place intraperitoneally and trocar sites at the end of the procedure; Group 4: 5 mL of 0.5% ropivacaine at incision sites +10 mL 0.5% ropivacaine injected in the same place intraperitoneally and trocar sites at the end of the procedure. Postoperative pain was assessed after 2, 6, 24, and 48 hours using a visual analogue scale (VAS). Results: By comparing the average values of pain intensity using VAS, we observed significantly different average values of pain intensity in the levobupivacaine and ropivacaine (3 and 4) groups in comparison with the control Group 1 (P < .05) throughout the follow-up period. Conclusion: We observed a reduction in postoperative pain, nausea, and vomiting in patients with LA who received intraoperative local anesthetic preemptively at the incision sites and postemptively, intraperitoneally. After the application of levobupivacaine the intensity of pain was significantly lower than in any other tested group.

The estimation of age in living subjects is today a significant issue because of the increase in the situations in which it arises and its legal consequences. In line with the Study Group on Forensic Age Diagnostics of the German Association of Legal Medicine's recommendations, it is based on the concomitant use of physical examination and methods for estimating bone age and dental age. Given the variations between the populations, the use of the latter requires their validation on all the ethnic groups on which they can be used. This aim of this study was to access the interest of the Cameriere's third molar maturity index (I3M) to indicate if an individual had reached the age of 18 in a sample of individuals from southeastern France. The studied sample consisted of OPTs 339 (184 females and 155 males) subjects aged between 14 and 22 years old. A logistic regression analysis with the adult age and minor age as dichotomous dependent variable and gender and I3M as predictor variables showed that gender was not statistically significant in discriminating adults and minors. The receiver operating curve (ROC) analysis showed the best discrimination performance of the specific cut-off value of I3M<0.08 in discriminating adults from minors. The proportion of accurate classification was 0.897 and 0.916 for females and males, respectively. The specificity (Sp) and sensitivity (Se) results for females were 0.962 and 0.813, respectively. Sp and Se for males were 0.953 and 0.871, respectively. The Bayes post-test probability was 0.961 and 0.955 in females and males respectively. Obtained results showed that a cut-off value of I3M<0.08 may be an additional tool for indicating adult age in the tested population.

PURPOSE To assess the associations and predictive value of spectral-domain (SD) OCT inner and outer retinal structural parameters and visual acuity (VA) outcomes in macular edema (ME) secondary to central retinal vein occlusion (CRVO). DESIGN Retrospective, longitudinal cohort study. PARTICIPANTS Eighty-four patients with ME secondary to CRVO receiving pro re nata anti-vascular endothelial growth factor (VEGF) therapy at 3 tertiary-level retina referral centers. METHODS In all participants, VA, demographic and clinical parameters, and SD OCT images from baseline, 3 months, and 12 months were reviewed. Spectral-domain OCT-based morphologic features in the 1500-μm foveal zone were analyzed by masked graders for disorganization of the retinal inner layers (DRIL), ellipsoid zone (EZ) and external limiting membrane disruption, cone outer segment tip (COST) visibility, cysts, subretinal and intraretinal fluid, and epiretinal membranes. MAIN OUTCOME MEASURES Spectral-domain OCT-based retinal structural parameters and VA outcomes. RESULTS In multivariate analyses adjusting for baseline VA, worsening VA over 1 year was associated with 1-year increases in DRIL (point estimate, 0.06 per 100 μm; P < 0.001) and EZ disruption (0.07 per 100 μm; P = 0.023), but decreased COST visibility (-0.09 per 100 μm; P = 0.018). A 3-month increase in DRIL (0.05 per 100 μm; P = 0.003) and EZ disruption (0.10 per 100 μm; P < 0.001) were the only factors predicting VA worsening over 1 year, after controlling for baseline VA. A multivariate model including 3-month evolution in DRIL, EZ disruption, and VA accounted for 86.3% of variability in 1-year VA change. Absolute differences between predicted and actual 1-year VA were within 2 lines in 80.9%. When DRIL increased by 250 μm or more over 3 months, no eyes showed VA improvement of 1 line or more in 1 year. When EZ disruption decreased by 250 μm or more over 3 months, no eyes worsened by 1 line or more over 1 year. CONCLUSIONS Early recovery over 3 months in both DRIL and EZ parameters are key drivers of 1-year VA outcomes. Predictive models incorporating 3-month changes in DRIL and EZ disruption support their usefulness as potential robust determinants of future VA.

Abstract Background: Health literacy is an important determinant of health. This concept is under-researched in the Republic of Srpska, Bosnia and Herzegovina. Objectives: To assess health literacy and its association with sociodemographic variables, self-perception of health and the presence of chronic conditions in primary healthcare setting. Methods: In May 2016, a cross-sectional study was executed in two primary healthcare centres. Out of approximately 1500 patients who visited both health centres during four consecutive days, about 800 were eligible. Of these, 110 patients agreed to complete the translated Short Test of Functional Health Literacy in Adults (S-TOFHLA). The influence of demographic, social, economic, and health characteristics (independent variables) on the S-TOFHLA score (dependent variable) was assessed by multiple logistic regression analysis. Results: One questionnaire was incomplete and therefore 109 questionnaires were analysed. Inadequate, marginal, and adequate health literacy were present in 19 (17.4%), 16 (14.7%) and 74 (67.9%) respondents. Adequate health literacy was found predominantly among respondents younger than 55 years and those with a high level of education. Regression analyses showed that low level of education (OR: 5.3), age 55 years and over (OR: 3.9), living in a rural area (OR: 3.7) and having three or more chronic diseases (OR: 2) were independently associated with inadequate or marginal health literacy. Conclusion: In this study performed in two primary healthcare centres in the Republic of Srpska, Bosnia and Herzegovina, low health literacy was associated with low level of education, older age, living in a rural area, and having more chronic diseases.

Swallowing is a sensorimotor activity by which food, liquids, and saliva pass from the oral cavity to the stomach. It is considered one of the most complex sensorimotor functions because of the high level of coordination needed to accomplish the swallowing task over a very short period of 1-2s and the multiple subsystems it involves. Dysphagia (i.e., swallowing difficulties) refers to any swallowing disorder and is commonly caused by a variety of neurological conditions (e.g., stroke, cerebral palsy, Parkinson disease), head and neck cancer and its treatment, genetic syndromes, and iatrogenic conditions or trauma. The signs and symptoms of dysphagia range from anterior loss of food while eating, difficulty chewing, and subjective difficulty swallowing food or liquids to choking or coughing before, during, or after eating because of impaired clearance of swallowed material from the throat into the digestive system. When not effectively treated, dysphagia can cause malnutrition, dehydration, immune system failure, psychosocial degradation, and generally decreased quality of life.

Background Oil and gas industry workers appear to suffer from anxiety and depression more frequently than the general population. Aims To establish the prevalence of depression and anxiety symptoms among offshore workers working for an oil and gas company and to identify the main stressors that lead to symptoms of these disorders. Methods One thousand seven hundred and forty-seven workers employed in an offshore oil and gas company in the Middle East completed the Generalized Anxiety Disorder (GAD-7) and Patient Health (PHQ-9) questionnaires. Anxiety and depressive symptoms were estimated from these surveys. Results Anxiety and depression symptoms were reported by nearly 15% of workers surveyed. Ordered logistic regression analyses showed that age, rotation length, years of service and local origin (versus expatriate) were significant predictors for symptoms of anxiety. With adjustment for age, older local workers had a lower risk of anxiety symptoms than expatriates. Conclusions Younger workers, workers with longer rotations and those with fewer years of service were more likely to report anxiety symptoms. In addition, older local workers and expatriates had a lower prevalence of anxiety symptoms than younger local workers. Future recommendations should address improvements in psychological health of offshore workers in the gas and oil industries.

This work describes preparation and application of “homemade” chloride ISE enriched with iron oxides or zinc oxide nanoparticles. The prepared chloride ISE membrane was made of AgCl:Ag2S:PTFE = 1:1:2 and AgCl:Ag2S:PTFE = 2:1:2 enriched with mentioned nanoparticles in ratio 0.5-1.2 wt.%. Prepared membranes were used for chloride determination in perchloric acid (pH = 0-2) and acetic buffer (pH = 4 – 4.75). Due to the low method price, simplicity and a reasonably fast way of usage, it was considered as a possibility for chloride determination in high acid media. Two of prepared membranes (M1 and M4) have shown best characteristics. M1 showed linear response range for chloride between 2.0×10−6 and 1×10−1 mol L−1, with a detection limit of 2.24×10−6 mol L−1 and potential change of 44.39 mV per decade. M4 showed linear response range for chloride between 4.2×10–6 to 1×10–1 mol L−1, limit of detection of 1.39×10–6 mol L−1 with potential change of 24.79 mV per decade at pH = 0.

Abstract The aim of the paper is to prove the completeness theorem for probability models with finitely many valued measure.

Aim : The aim was to examine the knowledge, attitudes, and perceptions of pneumococcal disease and pneumococcal conjugate vaccines among parents of children aged 1 to 5 years. Material and methods: This cross-sectional study was conducted in a kindergarten in Mostar with the assistance of an anonymous survey composed in Google Forms, which was sent to parents via email. The target group consisted of parents of children aged 1 to 5 years. The survey was sent on June 1, 2020, and it was completed on June 10, 2020.

The trend of achieving sustainable development in the area of new, eco-friendly materials remains topical for many experts concerned with developing new materials applicable worldwide in civil engineering as well as elsewhere. Our research team has for many years been developing non-traditional materials that meet the current requirements. These materials are made with organic fibers – waste natural fibers produced by agriculture or waste industrial (locally produced) fibers. Their thermal and acoustic insulation properties are very close to those of conventional insulation materials (expanded polystyrene, extruded polystyrene, mineral wool, polyurethane foam), which are still finding broad use in the Czech Republic despite their harmful impact on the environment. The paper focuses on the various uses of several types of textile fibers (mainly by-products) in the development of modern insulation materials with a high value added. These materials bear several specific advantages over conventional insulations, which enable, among others, easier installation. Some of the newly developed insulations can also be used as core insulations in the manufacture of vacuum insulation panels (VIP).