Introduction: Over the past 15 years, direct oral anticoagulant (DOAC) drugs have replaced vitamin K antagonists in a number of indications requiring oral anticoagulant therapy. Review work: The article written is an overview of the most important information related to the use of DOAC drugs in the secondary prevention of venous thromboembolism (VTE). The first randomized studies with dabigatran, rivaroxaban and apixaban are presented, which introduced these drugs into clinical practice in the first step, and then enabled the prolonged safe use of these drugs in the secondary prevention of VTE. Studies have also been described as current attitudes for the use of DOAC in patients with VTE associated with malignancy and antiphospholipid syndrome. An assessment of the risk of bleeding in patients with DOAC is also presented. Finally, we briefly presented the results of the use of DOAC in the treatment of pulmonary embolism in a group of patients from the regional PE registry.

Noise impact management goes hand in hand with the capability to predict the noise impact on exposed communities. Three tools to that purpose are presented in this chapter: the Noise Management Toolset (NMT), the Demo Virtual Community Tool (VCT) and Dynamic Noise Mapping. The NMT is a web-based tool giving stakeholders the opportunity to evaluate scenarios through not only noise exposure, but also noise impact, by introducing annoyance related metrics like the awakening index, with an easy-to-use interface. The VCT is the underlying research tool exploring and testing new indicators and options that might be of relevance to target audiences, such as land use planning information about location dependent activities or window insulation. The third approach, Dynamic Noise Mapping, adds the important aspect of population movement to classical noise mapping approaches where temporal changes of noise maps are tracked and included in noise exposure evaluation.

Seasonal variations in the environment (e.g. of temperature and light intensity) can lead to the excess production of reactive oxygen species and oxidative stress, inducing changes in the permeability of the plant cell membrane and the structure and function of cellular molecules. To address these deleterious effects, plants activate various non-enzymatic and enzymatic antioxidants. This study seeks to detect the influence of seasonal variation in Hedera helix (ivy) leaves, collected in Banj brdo (Banja Luka, Republika Srpska, Bosnia and Herzegovina) between December 2017 and November 2018, on oxidative (hydrogen peroxide and malondialdehyde) and antioxidant (superoxide dismutase, catalase, Class III peroxidases, and phenolic compounds) parameters. During the winter-early spring months (a temperature range of 0.7 to 5.4?C), we detected an increase in the values of all the oxidative and antioxidant parameters, whereas during the spring, summer, and autumn months (a temperature range of 15 to 25?C), the values of most of these parameters fell. However, a peak in the parameter values was detected during June and July 2018, which might be attributable to the influence of the changes in both light intensity and temperature and to the effects of intensive shoot growth. Our results highlight the importance of the antioxidant protection system of H. helix for its acclimation to seasonal variations in the environment, especially temperature.

Honey is a product of high nutritive value, used as a raw material for obtaining mead. The quality of mead can be improved by adding fruit juices, including chokeberry juice. This paper aims to assess the effects that adding different quantities of chokeberry juice, with the variation of 3 amounts of inoculated yeast, has on the fermentation course, physicochemical, antioxidant and antimicrobial properties of mead. The parameters analyzed are the dry matter content, pH value, and content of volatile acids, ethanol and methanol, total phenols and flavonoids, FRAP, DPPH and ABTS tests and antimicrobial properties. The results obtained in this paper show that adding chokeberry juice improves antioxidant properties of the final product and affects positively the course of mead fermentation, i.e. it has led to an increase of the maximum concentration of ethanol (Pm). In terms of the chemical composition of mead, there is no significant difference, except in the obtained ethanol content, which is the highest in samples with 10% of added chokeberry juice. Control sample showed the best antimicrobial activity, while sample with 5 % of added chokeberry juice showed the weakest effect. The strongest effect was seen in the sample with 20% of added chokeberry juice.

Background / Aim: Hidradenitis suppurativa (HS) is a chronic inflammatory disease that most often affects apocrine gland-bearing areas of the skin. The treatment depends on the severity of the clinical presentation. The paper objective was to present new modalities in management and treatment of HS. Methods: The subjects in this research included the patients suffering from the severe form of HS, who were treated in the University Clinical Centre of the Republic of Srpska for the past three years. The effect of treatment of HS were monitored. In four patients, biologic therapy with adalimumab or adalimumab biosimilars was administered, while four patients received radiotherapy and 17 of them, were treated surgically. Depending on the type of treatment, the effects of therapy were monitored after 6-12 weeks by using clinical examination and by assessing the disease stage according to the Hurley staging. Due to a small number of subjects, especially in patients treated with biologic and radiotherapy, it was not possible to perform any statistical analysis and the results were presented by description, in tables and photographs. Results: Biologic therapy: Adalimumab was administered subcutaneously 80 mg, twice a month. After 12 weeks, in 4 patients was observed a regression of changes by 60-70 % when compared to previous skin changes. Radiotherapy: the total radiation dose was 5 Gy, distributed in 5 or 10 fractions. After 12 weeks an improvement by 60-70 % was observed. Surgical treatment: after 6-8 weeks, the patients were fully recovered. Conclusions: Application of biologic and radiotherapy after 12 weeks had similar results, ie it brought to regression of changes by 60-70 %. The best results were achieved after surgical treatment of HS.

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Our aim was to determine the prevalence of potential drug-drug interactions (pDDIs) and to identify relevant factors associated with the occurrence of the most dangerous or contraindicated pDDIs (pCDDIs) in hospitalized patients with spontaneous intracerebral hemorrhage (sICH). A retrospective cross-sectional study was performed enrolling all consecutive patients with sICH treated at the Neurological Intensive Care Unit, Clinical Center in Kragujevac, Serbia, during the three-year period (2012-2014). The inclusion criteria encompassed patients aged 18 years and over, those diagnosed with ICH, and those prescribed at least two drugs during hospitalization, while we did not include patients whose hospitalization lasted less than 7 days, those who were diagnosed with other neurological diseases and patients with incomplete medical files. For each day of hospitalization, the online checker Micromedex® software was used to identify pDDIs and classify them according to severity. A total of 110 participants were analysed. A high prevalence of pDDIs (98.2%) was observed. The median number of pDDIs regardless of severity, was 8.00 (IQR 4.75-13.00;1-30). The pairs of drugs involving cardiovascular medicines were the most commonly identified pDDIs. Twenty percent of the total number of participants was exposed to pCDDIs. The use of multiple drugs from different pharmacological-chemical subgroups and the prescribing of anticoagulant therapy significantly increase the chance of pCDDI (aOR with 95% CI 1.19 (1.05-1.35) and 7.40 (1.13-48.96), respectively). This study indicates a high prevalence of pDDIs and pCDDIs in patients with sICH. The use of anticoagulant therapy appears to be the only modifiable clinically relevant predictor of pCDDIs.

Introduction: Laboratory and anthropometric parameters for assessing lipid metabolism disorders are important for atherogenesis and the occurrence of cardiovascular disease. Material and Methods: The study was designed as a prospective longitudinal study, meant to assess the risk of cardiovascular disease, which included initial measurement of lipid status, CRP, and BMI, and repeated measurement after DASH diet and exercise. It was conducted on a sample of 60 female respondents. Results: Following the WHO categorization of BMI, the study found that 62% of respondents were overweight, 26% were obese, and only 12% of respondents were at ideal body weight. After the DASH diet and exercise program, the average value of BMI M = 27.02 was established. Analyzing the values of the CASTELLI 1 index in 95.9% of respondents, high values of M = 5.3 were observed, which indicates a high risk of CVD. The study results indicate that the average value of cholesterol, triglycerides, LDL-C significantly reduced after two months of adherence to the DASH diet and exercise. With the help of Spearman’s rank, the correlation coefficient indicated the existence of a positive relationship between the CASTELLI 1 index and total cholesterol, triglycerides and HDL-C. In the initial analysis, CRP had a high value (M = 10 mg/L). In contrast, after the program, the CRP value decreased to (M = 4 mg/L), and a significant negative correlation (p <0.01) was observed between CRP and HDL-C, indicating that HDL-C value as a protective lipoprotein for blood vessels increased. CRP decreased after two months of DASH diet and exercise. Conclusion: With this research, we aim to draw attention to the importance of promoting healthy lifestyles and creating adequate risk assessment models with a well-developed strategy that will include anthropometric, laboratory and other multidisciplinary aspects to combat cardiovascular

Introduction : Scoliosis is a three-dimensional deformity of the spine that is defined mainly on the basis of lateral curvature of the spine. It is divided into functional and structural scoliosis. Scoliosis can lead to prolonged improper posture, back pain