Salt, sugar and saturated fats in rusks on the Croatian market - consumer preferences and contribution to recommended intake

Dvopek je suhi, hrskavi i lako probavljiv pekarski proizvod, a odlikuje se specifičnim načinom proizvodnje. S ciljem utvrđivanja razlika u sastavu, prosječnoj energijskoj i hranjivoj vrijednosti standardnog i integralnog dvopeka, pregledane su ukupno 44 deklaracije s hrvatskog tržišta u periodu od siječnja do travnja 2024. godine. Integralni dvopek ima povoljniju nutritivnu kvalitetu, statistički značajno manju energijsku vrijednost i udio ugljikohidrata te statistički značajno veći udio prehrambenih vlakana i bjelančevina od standardnog dvopeka. Medijan sadržaja soli kod obje je vrste dvopeka 1,2 g/100 g te bi se jednim obrokom od 37 g unijelo 7,4 % preporučenog unosa soli za odrasle. Kao zaslađivač uglavnom se koristi saharoza, a medijan udjela šećera je 5,1 g/100 g (integralni dvopek) te 6,5 g/100 g (standardni dvopek). Suncokretovo ulje i visokooleinsko suncokretovo ulje sadržano je u najvećem broju proizvoda, a udio zasićenih masti kreće se od 0,5 g/100 g (standardni dvopek) do 5,0 g/100 g (integralni dvopek). U senzorskom testu sudjelovao je 101 netrenirani ispitanik (srednja dob 29 godina). Utvrđeno je da se razlike u intenzitetu slatkog (5,0 g; 6,8 g; 8,0 g šećera/100 g) i slanog okusa (2,3 g; 1,4 g; 1,0 g soli/100 g) uspješno primjećuju jer su sume nizova u testu rangiranja statistički značajno različite (Friedmanov test, p < 0,05). Test preferencije pokazao je da se podjednakom broju ispitanika sviđa dvopek s najvećim i srednjim udjelom šećera. Najmanjem se broju ispitanika sviđa uzorak s najmanjim udjelom šećera, a najvećim udjelom soli (5,0 g šećera i 2,3 g soli/100 g).Rusk is a dry, crispy and easily digestible bakery product that is characterized by a special production method. In order to determine differences in the composition, average energy and nutritional value between standard and wholegrain rusks, a total of 44 labels with nutrition information on the Croatian market were reviewed between January and April 2024. Wholegrain rusks have a better nutritional quality, with a statistically significantly lower energy value and carbohydrate content and a statistically significantly higher content of dietary fiber and protein content compared to standard rusks. The median salt content for both types of rusk is 1.2 g/100 g. A single serving of 37 g would contribute to 7.4 % of the recommended salt intake for adults. The most commonly used sweetener is sucrose and the median sugar content is 5.1 g/100 g (wholegrain rusks) and 6.5 g/100 g (standard rusks). Sunflower oil and high oleic sunflower oil are contained in most of the products, with saturated fat content ranging from 0.5 g/100 g (standard rusks) to 5.0 g/100 g (wholegrain rusks). One hundred and one untrained participants (average age 29 years) took part in a sensory test. It was found that differences in the intensity of the sweet (5.0 g, 6.8 g, and 8.0 g sugar/100 g) and salty taste (2.3 g, 1.4 g, and 1.0 g salt/100 g) are successfully perceived, as the ranked sums in the test are statistically significantly different (Friedman test, p < 0.05). The preference test showed that an equal number of participants like the rusk with the highest and the medium sugar content. The smallest number of participants favours the sample with the lowest sugar content and the highest salt content (5.0 g sugar and 2.3 g salt/100 g)

The Role of Biomarkers in HPV-Positive Head and Neck Squamous Cell Carcinoma: Towards Precision Medicine

Head and neck cancer (HNC) represents a significant global health challenge, with squamous cell carcinomas (SCCs) accounting for approximately 90% of all HNC cases. These malignancies, collectively referred to as head and neck squamous cell carcinoma (HNSCC), originate from the mucosal epithelium lining the larynx, pharynx, and oral cavity. The primary risk factors associated with HNSCC in economically disadvantaged nations have been chronic alcohol consumption and tobacco use. However, in more affluent countries, the landscape of HNSCC has shifted with the identification of human papillomavirus (HPV) infection, particularly HPV-16, as a major risk factor, especially among nonsmokers. Understanding the evolving risk factors and the distinct biological behaviors of HPV-positive and HPV-negative HNSCC is critical for developing targeted treatment strategies and improving patient outcomes in this complex and diverse group of cancers. Accurate diagnosis of HPV-positive HNSCC is essential for developing a comprehensive model that integrates the molecular characteristics, immune microenvironment, and clinical outcomes. The aim of this comprehensive review was to summarize the current knowledge and advances in the identification of DNA, RNA, and protein biomarkers in bodily fluids and tissues that have introduced new possibilities for minimally or non-invasive cancer diagnosis, monitoring, and assessment of therapeutic responses

Insights into the Molecular Mechanism of Endothelial Glycocalyx Dysfunction during Heart Surgery

The endothelial glycocalyx (EGC) is a layer of proteoglycans (associated with glycosaminoglycans) and glycoproteins, which adsorbs plasma proteins on the luminal surface of endothelial cells. Its main function is to participate in separating the circulating blood from the inner layers of the vessels and the surrounding tissues. Physiologically, the EGC stimulates mechanotransduction, the endothelial charge, thrombocyte adhesion, leukocyte tissue recruitment, and molecule extravasation. Hence, severe impairment of the EGC has been implicated in various pathological conditions, including sepsis, diabetes, chronic kidney disease, inflammatory disorders, hypernatremia, hypervolemia, atherosclerosis, and ischemia/reperfusion injury. Moreover, alterations in EGC have been associated with altered responses to therapeutic interventions in conditions such as cardiovascular diseases. Investigation into the function of the glycocalyx has expanded knowledge about vascular disorders and indicated the need to consider new approaches in the treatment of severe endothelial dysfunction. This review aims to present the current understanding of the molecular mechanisms underlying cardiovascular diseases and to elucidate the impact of heart surgery on EGC dysfunction

Decreased brain volume may be associated with the occurrence of peri-lead edema in Parkinson's disease patients with deep brain stimulation

Background: Peri-lead edema (PLE) is a poorly understood complication of deep brain stimulation (DBS), which has been described in patients presenting occasionally with profound and often delayed symptoms with an incidence ranging from 0.4% up to even 100%. Therefore, our study aims to investigate the association of brain and brain compartment volumes on magnetic resonance imaging (MRI) with the occurrence of PLE in Parkinson's disease (PD) patients after DBS implantation in subthalamic nuclei (STN). Methods: This retrospective study included 125 consecutive PD patients who underwent STN DBS at the Department of Neurosurgery, Dubrava University Hospital from 2010 to 2022. Qualitative analysis was done on postoperative MRI T2-weighted sequence by two independent observers, marking PLE on midbrain, thalamus, and subcortical levels as mild, moderate, or severe. Quantitative volumetric analysis of brain and brain compartment volumes was conducted using an automated CIVET processing pipeline on preoperative MRI T1 MPRAGE sequences. In addition, observed PLE on individual hemispheres was delineated manually and measured using Analyze 14.0 software. Results: In our cohort, PLE was observed in 32.17%, mostly bilaterally. Mild PLE was observed in the majority of patients, regardless of the level observed. Age, sex, diabetes, hypertension, vascular disease, and the use of anticoagulant/antiplatelet therapy showed no significant association with the occurrence of PLE. Total grey matter volume showed a significant association with the PLE occurrence (r = -0.22, p = 0.04), as well as cortex volume (r = -0.32, p = 0.0005). Cortical volumes of hemispheres, overall hemisphere volumes, as well as hemisphere/total intracranial volume ratio showed significant association with the PLE occurrence. Furthermore, the volume of the cortex and total grey volume represent moderate indicators, while hemisphere volumes, cortical volumes of hemispheres, and hemisphere/total intracranial volume ratio represent mild to moderate indicators of possible PLE occurrence. Conclusion: The results of our study suggest that the morphometric MRI measurements, as a useful tool, can provide relevant information about the structural status of the brain in patients with PD and represent moderate indicators of possible PLE occurrence. Identifying patients with greater brain atrophy, especially regarding grey matter before DBS implantation, will allow us to estimate the possible postoperative symptoms and intervene in a timely manner. Further studies are needed to confirm our findings and to investigate other potential predictors and risk factors of PLE occurrence

Evaluation of Absolute Neutrophil, Lymphocyte and Platelet Count and Their Ratios as Predictors of Thrombotic Risk in Patients with Prefibrotic and Overt Myelofibrosis

Aim: To investigate the prognostic contribution of absolute neutrophil (ANC), lymphocyte (ALC), platelet count and their ratios, neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR), to thrombotic risk in patients with prefibrotic and overt fibrotic myelofibrosis (MF). Methods: We retrospectively analyzed a cohort of 256 patients with prefibrotic (85 patients) and overt fibrotic MF (171 patients) treated in six Croatian hematological centers. Results: Prefibrotic compared to overt fibrotic MF patients presented with significantly higher ALC, platelet count and PLR, and experienced longer time to thrombosis (TTT). Among prefibrotic patients, ANC > 8.33 × 109/L (HR 13.08, p = 0.036), ALC > 2.58 × 109/L (HR 20.63, p = 0.049) and platelet count > 752 × 109/L (HR 10.5, p = 0.043) remained independently associated with shorter TTT. Among overt fibrotic patients, ANC > 8.8 × 109/L (HR 4.49, p = 0.004), ALC ≤ 1.43 × 109/L (HR 4.15, p = 0.003), platelet count ≤ 385 × 109/L (HR 4.68, p = 0.004) and chronic kidney disease (HR 9.07, p < 0.001) remained independently associated with shorter TTT. Conclusions: Prognostic properties of ANC, ALC and platelet count are mutually independent and exceed those of NLR and PLR regarding thrombotic risk stratification. ALC and platelet count associate in opposite directions with thrombotic risk in prefibrotic and overt fibrotic MF patients

Medicolegal relevance of the transient loss of consciousness

Transient and hardly traceable signs of diminished consciousness might be the only signs that are apparent and reported during the scrutinous care of intensive care unit (ICU) staff. Unfortunately, most transient loss of consciousness (TLoC) episodes occur elsewhere. This review aims to help recognize TLoC and identify situations when these conditions mean that certain legal privileges should be held. With this aim, the current literature was scoped for conceptualizing consciousness, its alterations, and loss as regarded in the legal system. This review was partly inceptive for increasing the use of unconsciousness as a defense against criminal charges. This paper tackles working ability and the legal liability of individuals suffering from TLoC. What has been most discussed is so-called syncope—a TLoC without actual focal neurological deficit which occurs due to hypoperfusion of the brain. Therefore, it is a symptom of the nervous system indicating a cardiovascular condition. Unlike stroke or transient ischemic attack (TIA), hypoperfusion affects the entire brain. The sudden loss of consciousness in everyday workplace situations can lead to dangerous situations. Likewise, as a result of avoiding these situations, being aware of the possible loss of consciousness can preclude a patient from performing the duties of occupation—or any activity

Mitochondrial Diseases

This thesis provides a comprehensive review of mitochondrial DNA (mtDNA), elucidating its unique structure, encoding capabilities, and the implications of mtDNA mutations for mitochondrial diseases. Mitochondria, critical for cellular energy production, house a compact and efficient genome that is remarkable for its polycistronic nature and lack of introns, emphasizing the organelle's role as the cell's powerhouse. A significant focus is placed on the susceptibility of mtDNA to mutations due to its proximity to the electron transport chain and lack of histone protection, which predisposes it to a higher mutation rate compared to nuclear DNA. These mutations are intricately linked to a spectrum of mitochondrial disorders, ranging from neurodegenerative diseases to metabolic dysfunctions and aging. The thesis delves into the concept of heteroplasmy and its impact on the clinical manifestation of mitochondrial diseases, alongside the unique maternal inheritance pattern that adds complexity to the diagnosis and management of these conditions. The review extends to primary mitochondrial disorders (MIDs), emphasizing their prevalence and the diversity of clinical manifestations that complicate diagnosis and treatment. Notable conditions such as Leber Hereditary Optic Neuropathy (LHON), Leigh Syndrome, and Mitochondrial Neurogastrointestinal Encephalomyopathy (MNGIE) are examined to illustrate the varied impact of mitochondrial dysfunction. Therapeutic strategies for mitochondrial diseases are critically assessed, from traditional symptomatic treatments to emerging approaches like gene therapy and mitochondrial replacement therapy, highlighting the advances and challenges in developing effective treatments. The thesis also explores the role of genetic counseling and reproductive options in managing mitochondrial diseases, considering the complex inheritance patterns and the potential of mitochondrial donation techniques to prevent disease transmission

Automated Morphological Classification and Quantification of Cerebrospinal Fluid Extracellular Vesicles via AFM and Machine Learning

Size-exclusion chromatography, AFM, Gwyddion, western blot, dynamic light scattering, machine learnin

Comprehensive Analysis of Soluble Mediator Profiles in Congenital CMV Infection Using an MCMV Model

Congenital human cytomegalovirus (HCMV) infection may cause life-threatening disease and permanent damage to the central nervous system. The mouse model of CMV infection is most commonly used to study mechanisms of infection and pathogenesis. While essential to limit mouse CMV (MCMV) replication, the inflammatory responses, particularly IFNγ and TNFα, cause neurodevelopmental abnormalities. Other soluble mediators of the immune response in most tissues remain largely unexplored. To address this gap, we quantified 48 soluble mediators of the immune response, including 32 cytokines, 10 chemokines, 3 growth factors/regulators, and 3 soluble receptors in the spleen, liver, lungs, and brain at 9 and 14 days postinfection (dpi). Our analysis found 25 induced molecules in the brain at 9 dpi, with an additional 8 showing statistically elevated responses at 14 dpi. Specifically, all analyzed CCL group cytokines (CCL2, CCL3, CCL4, CCL5, CCL7, and CCL11) were upregulated at 14 dpi in the brain. Furthermore, data revealed differentially regulated analytes across tissues, such as CCL11, CXCL5, and IL-10 in the brain, IL-33/IL-33R in the liver, and VEGF-a and IL-5 in the lungs. Overall, this study provides an overview of the immune dynamics of soluble mediators in congenital CMV

Atypical Plasma Cell Leukemia Mistaken for Acute Leukemia: A Case Report

The patient we present here had many clinical, morphological, and laboratory findings characteristic of acute leukemia. During the course of the disease, the diagnosis changed from acute leukemia to chronic small B-cell lymphoproliferative disease, a blastoid variant of mantle cell lymphoma, and finally to atypical plasma cell leukemia. Atypical plasma cell leukemia is a rare condition with aggressive biological behavior. Our patient relapsed a short time after achieving complete remission, in spite of aggressive therapy and autologous stem cell transplantation. During relapse, it was possible to morphologically identify malignant cells as being of plasma cell origin, although immature and atypical. Atypical plasma cell leukemia presents a diagnostic challenge as it may mimic other neoplasms both morphologically and clinically. It is also recognized that plasma cell neoplasm immunophenotype may not be entirely specific for its lineage where common diagnostic biomarkers are applied by immunohistochemistry or flow cytometry. Where this is the case, only focused investigation for plasma cell lineage will be more informative. This patient has unusual clinical presentation, a nondescript morphology of the circulating plasma cells, as well as an immunophenotype, detected by the initial panels used for flow cytometry and immunohistochemistry, that was not entirely specific for plasma cells. Such cases present a good reminder of the diagnostic complexity of atypical plasma cell leukemia and emphasize that plasma cell differentiation needs to be interrogated in cases where the initial work-up shows unusual results