Uloga magnetske rezonancije u obradi BIRADS 4 i 5 mikrokalcifikata otkrivenih mamografijom [Role of breast MRI in the evaluation of mammographicaly detected BIRADS 4 and 5 microcalcifications]

Objective: To determine diagnostic accuracy of breast MRI in the workup of mammographic BIRADS 4 and 5 microcalcifications. Methods: 101 patients (age range 30 - 74 years) with 114 areas of mammographic BIRADS 4 or 5 microcalcifications were enrolled in the study. All patients underwent US, MRI and, when indicated, second-look US. Histopathological diagnosis, obtained by US guided CNB or surgical excision, was used as a reference standard for diagnostic accuracy calculations. Analysis of prevalence of different mammographical, sonographical and MRI BIRADS descriptors was performed, with calculations of PPVs for each descriptor. Results: Sensitivity, specificity, PPV and NPV of MRI were: 100 %, 59,1 %, 69,5% and 100 %, and of US: 87,8 %, 59,1 %, 66,7 % and 83,9 %. Second-look targeted US visualized all microcalcifiactions which were not visible sonographically prior to MRI, and revealed carcinoma in 23,6 % of those cases. Conclusions: MRI can confidently exclude malignancy in mammographically suspicious microcalcifications. The negative MRI finding allows the decision not to biopsy microcalcifications. US cannot reliably exclude cancer, neither confidently differentiate benign from malignant microcalcifications. However, due to high rate of visualization of microcalcifications, US is modality of choice for the CNB guidance or preoperative wire localization

Neuroimaging in inborn errors of metabolism

Nasljedne metaboličke bolesti pripadaju skupini od više od 8.000 monogenski nasljednih bolesti, a prema online bazi podataka o nasljednim metaboličkim bolestima (IEMbase), do sada ih je poznato oko 1.900. Najčešće su uzrokovane patogenim varijantama nuklearnih gena, a manji dio ih nastaje zbog patogenih varijanti gena u mitohondrijskoj DNA. Posljedica je navedenih mutacija ili akumulacija toksičnih produkata ili nedostatak esencijalnih metaboličkih produkata. U konačnici takvi poremećaji uzrokuju više ili manje specifične kliničke simptome, kao posljedica zahvaćenosti različitih organa ili tkiva, a većina ih zahvaća i središnji živčani sustav. Klinički simptomi mogu se pojaviti u bilo kojoj dobi, od intrauterine do kasne odrasle dobi. Mogućnost liječenja i ublažavanje posljedica značajno ovisi o pravovremenoj dijagnozi. Neuroradiološka obrada može suziti diferencijalnu dijagnozu i usmjeriti daljnju obradu, a ponekad zahvaljujući specifičnim obrascima zahvaćanja središnjega živčanog sustava (CNS-a) može dovesti i do ranog postavljanja dijagnoze i time pravovremene terapije. No, neuroradiološki nalaz kod ovih bolesti može varirati od urednog nalaza do opsežnih promjena, ovisno o brojnim čimbenicima (vrsti i trajanju bolesti, količini nakupljenih toksičnih metabolita, zrelosti mozga te fazi bolesti u kojoj se radi MRI). Obzirom na brojnost ovih poremećaja nije ih moguće sve obuhvatiti u kratkom pregledu te je cilj ovog rada pokazati nekoliko primjera s tipičnom neuroradiološkom prezentacijom.Inborn errors of metabolism (IEM) are a group of more than 8000 monogenic inherited diseases, and according to the online database of IEM (“IEMbase”), around 1900 of them are recognized so far. Most often they are caused by pathogenic variants of nuclear genes, and a smaller proportion of them are caused by pathogenic variants of genes in mitochondrial DNA. The result of these mutations is either the accumulation of toxic or the lack of essential metabolic products. These disorders cause more or less specific clinical symptoms, as a result of the involvement of various organs or tissues, and most of them will also affect the central nervous system. Clinical symptoms can occur at any age, from intrauterine to late adulthood. The possibility of treatment and mitigation of consequences significantly depends on timely diagnosis. Neuroimaging with specific patterns of CNS involvement can narrow the differential diagnosis and direct further management of the patient. However, neuroradiological findings vary from normal findings to extensive changes, depending on a number of factors (type and duration of the disease, the amount of accumulated toxic metabolites, brain maturity, and the stage of the disease in which MRI is performed). Given the number of these disorders, it is not possible to include them all in thid short review, so the aim of this paper is to provide several examples with a typical neuroradiological presentation of IEMs

Epidemiology of human trichinellosis in Vojvodina province, Serbia, from 2005 to 2016

Trichinellosis is one of the most important foodborne diseases in the Eastern European countries. The main objective of this study was to investigate the epidemiological patterns of trichinellosis outbreaks that occurred between 2005 and 2016 in Vojvodina, a northern province of the Republic of Serbia. The average incidence was 3.5 per 100,000 inhabitants. A total of 828 people acquired the infection. The disease occurred in all age groups, slightly more often in males, and quite frequently in a severe form considering the high share of hospitalised patients and the fatal outcome rate (41.6 ± 31.1% and 0.4%, respectively). Trichinella spiralis was confirmed as the causative agent in eight outbreaks. The outbreaks usually occurred among family members due to the consumption of pork or traditional pork products from not tested backyard pigs. Veterinary control measures and the education of consumers and farmers should be implemented to control this zoonotic disease

US and MRI in the evaluation of mammographic BI-RADS 4 and 5 microcalcifications

PURPOSE: The aim of this study was to assess diagnostic accuracies of ultrasonography (US) and magnetic resonance imaging (MRI) in lesions that manifest as mammographic BI-RADS 4 and 5 microcalcifications, in the setting of conjoined use of mammography, US, and MRI. ----- METHODS: Patients with mammographic BI-RADS 4 or 5 microcalcifications, without additional findings, were included in this prospective study. All patients subsequently underwent breast US and MRI. Histopathologic diagnosis, obtained by US-guided core-needle biopsy or surgical excision, served as a reference standard. Diagnostic accuracies of US and MRI were calculated, and positive predictive value for different MRI BI-RADS imaging features were determined. ----- RESULTS: The study group consisted of 113 women with 125 areas of suspicious microcalcifications. MRI reached sensitivity, specificity, positive predictive value 3 (PPV3), and negative predictive value (NPV) of 100%, 70.1%, 67.6%, and 100%, respectively. Statistically significant differences in MRI morphologic features and kinetic enhancement curves were observed between malignant and benign microcalcifications. Sensitivity, specificity, PPV3, and NPV for US were: 85.4%, 66.2%, 61.2%, and 87.9%. There was statistically significant difference in presentation of malignant and benign microcalcifications at US. ----- CONCLUSION: In the setting of conjoined use of mammography, US, and MRI, MRI can reliably exclude malignancy in suspicious microcalcifications. Thus, negative MRI findings may influence the decision to biopsy the microcalcifications

SARS-COV-2 ANTIGEN SCREENING DURING THE FIRST POST-LOCKDOWN MAJOR MUSIC FESTIVAL IN NOVI SAD, SERBIA, IN JULY 2021

Many countries have resumed mass gathering events like music festivals, despite potential risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmissions. This study aimed to examine the frequency of SARS-CoV-2 infection among visitors to a mass event, the EXIT festival, in relation to the proposed preventive measures. A total of 466 visitors were included in this longitudinal study conducted in Novi Sad, Serbia, during July, 2021. All subjects were tested with RDT-Ag test for the presence of SARS-CoV-2 virus at the beginning of the study and seven days after. Basic socio-demographic and epidemiological data were collected through a questionnaire. The average age of participants was 28.34 ± 8.87 years with the majority of men (53.7%). There were 170 (36.5%) vaccinated participants. A 97.1% in vaccinated and 92.2% in unvaccinated group, reported to regularly wear a protective mask (p=0.029). At the second cross-sectional testing, 354 subjects were tested, of which 150 (42.4%) were vaccinated. There was no statistically significant difference in application of preventive measures during and after the festival, in respect to vaccination status of the participants. Twenty participants (5.6%) reported some of the COVID-19-like symptoms in the first seven days after visiting the festival, but no COVID-19 infection was confirmed at the RDT-Ag testing. Despite the potential effectiveness of applied preventive measures such as RDT-Ag screening, mask-wearing and vaccination, additional caution is needed when holding these events during a period of high SARS-CoV-2 transmission, as well as when the new virus variants emerge in community

EPIDEMIOLOGICAL CHARACTERISTICS OF Q FEVER IN THE SREM DISTRICT OF VOJVODINA, FROM 2011 TO 2020

Q fever is a globally widespread zoonosis, which has a large number of animal reservoirs. In humans, Q fever is asymptomatic in 60% of cases but may appear in the form of acute or chronic disease. The disease is mostly asymptomatic in animals but may be a cause of abortions or stillbirths. The aim of this study was to present and analyze the epidemiological characteristics of Q fever in Srem district, in the Autonomous Province of Vojvodina, Republic of Serbia. We conducted a descriptive study using data from the registries of infectious diseases of the Institutes of Public Health of Vojvodina and Institute of Public Health Sremska Mitrovica in the period 2011-2020. A total of 76 human cases of Q fever were registered in Srem district over ten-year period. The majority of patients (89.47%; N = 68) were registered in municipalities of Sremska Mitrovica and Šid. One third of patients were hospitalized (32.89%; N = 25). Males were 3.2 times more affected than females (M : F = 3.22 : 1). Working age population (20–59 years) were most affected (82.89%; N = 63) with a significantly higher incidence compared to the age category 0-19 years (p < 0.05). The majority of cases were registered in February (60.53%; N = 46). Probable routes of transmission of Coxiella burnetii were: direct contact with animals and the airborne route of transmission (50.00% vs. 47.37%). The highest seroprevalence of Q fever recorded in goats (55.54%) and sheep (11.88%) in the municipality of Šid, which is connected to outbreak in Kukujevci 2017. The high seroprevalence in goats, recorded in Inđija (22.87%) was not accompanied by Q fever in humans. Q fever still represents a significant problem of both veterinary and human medicine and therefore continuous disease monitoring and more efficient cooperation of the veterinary and human health care sectors is necessary

Developıngofa Method For The Protectıon Maglaj Fort And Hıstorıcal Cıty Center

Maglay kenti ve tarihi eserleri günümüzde Bosna-Hersek topraklarında en değerli eserler arasında yer almaktadır. Kalesi başta olmak üzere, saat kulesi, camiler, hanlar, çeşmeler ve diğer yapılarla birlikte Maglay kenti ziyaretçiye bugün de tarihi anlatmaktadır. Bu tarihi eserleri maalesef kötü ve kullanılamaz durumunda bulunup, şimdiki haliyle ne Maglay kentine ne de Bosna-Hersek'e hiçbir yarar sağlamaz. Toplum ve uzmanlar olarak, bizler, bu tarihsel anıtları korumak ve yenilemek için acil olarak çözümler üretmeliyiz.Bu nedenle alan araştırması ve literatür taraması gibi iyi bilinen araştırma yöntemleri kullanıldı. Aynı zamanda, gerekli olan planlar ve çizimler yapıldı. Çözüm arayışında olduğumuzdan en doğru cevapları sağlamak için, yalnızca Bosna-Hersek'li uzmanların değil dünyadaki uzmanların da görüşleri dikkate almalı. Önerilerimizin ve çözümlerimizin kabul edilen tüm çözümler içinde yer alacağına güçlü bir şekilde inanıyor ve umut ediyoruz.Maglay city and its historical monuments today are among the most valuable monuments in Bosnia and Herzegovina territory. Even today the city of Maglay narrate history to its visitors by its clock tower, mosques, inns, fountains and especially by its old castle. Unfortunately, very poor condition of these historical monuments, with their current form provides no benefits to neither Bosnia and Herzegovina nor to city of Maglay. In order to renovate and recover these historical monuments we, the society and experts, need to provide a solution most urgently. Thereforewe have used well known methods of researching, as fıeld research and literature review. Also, all needed plans and drawing, have been made. As we have been seeking for solution we should consider the opinion not only from experts from Bosnia and Herzegovina but also from experts around the world in order to provide best answers. We strongly believe and hope that our suggestions and solutions will be considered as right one

Electronic retail in the Republic of Croatia

Elektronička trgovina na malo u Republici Hrvatskoj predmet je završnog rada. S napretkom u tehnologijama prijenosa, obrade i pohrane, prezentacijskih oblika, dostupnosti informacija, brzini i pouzdanosti, točnije razvojem Interneta, razvile su se elektroničke trgovine. Svrha završnog rada je uvidjeti stanje elektroničke trgovine u Republici Hrvatskoj. U teorijskom dijelu razrade deskriptivnom metodom se metodom iznosi pojam elektroničke trgovine, preko povijesnog pregleda i razvoja te se sagledavaju njene prednosti. Posebna pozornost se stavlja na razvoj elektroničke trgovine u Republici Hrvatskoj od ranih početaka, pa se do danas kada su Internet i elektronička trgovina razvijeni u velikoj mjeri. S obzirom na virus Covid-19 koji je zahvatio brojne dijelove svijeta, promjene i u poslovanju su također vidljive. Na temelju dostupnih podataka uviđa se utjecaj pandemije na elektroničku trgovinu. Iznosi se i usporedba elektroničke trgovine s odabranim zemljama Europske Unije te buduća predviđanja u rastu i razvoju elektroničke trgovine

Biodiesel production catalysed by lipase in natural deep eutectic solvents

Biogoriva su postala predmet značajnog interesa zbog rasta cijene fosilnih goriva te potrebe za gorivima sa smanjenim utjecajem na okoliš dobivenim iz održivih izvora, čime se smanjuje emisija stakleničkih plinova. Jedno od takvih goriva je i biodizel dobiven enzimski kataliziranom transesterifikacijom masnih kiselina podrijetlom iz ulja ili masti u prisustvu jednostavnih alkohola poput metanola. Unaprjeđenje procesa proizvodnje biodizela uključuje i primjenu različitih otapala od kojih se posebno ističu prirodna eutektička otapala (Engl. Natural Deep Eutectic Solvents (NADES)). Zbog svojih fizikalno-kemijskih svojstava primjena NADES u reakciji transesterifikacije osigurava pogodne uvjete za djelovanje enzima lipaza uz istovremeno uklanjanje sporednih reakcijskih produkata što rezultira dobivanjem biodizela veće čistoće uz veće produktivnosti. U okviru ovoga rada pripremljena su NADES na bazi betaina i uree u omjeru 1:3 s različitim udjelima vode (30, 35 i 40 % (w/w)). Enzim lipaza, podrijetlom iz Thermomyces lanuginosus, uspješno je ekstrahiran u pripremljenim NADES te se kao takav koristio u šaržnoj sintezi i sintezi biodizela u mikroreaktoru. Volumna aktivnost i stabilnost enzima lipaza pokazale su se najboljima u NADES betain:urea 1:3 s 40 % (w/w) vode. Stoga je ovo otapalo korišteno u daljnjem radu pri ispitivanju utjecaja različitih omjera metanol:ulje:enzim na iskorištenje procesa proizvodnje metilnih estera viših masnih kiselina (Engl. Fatty Acids Methyl Esters (FAME)). U eksperimentu provedenom s molarnim omjerom ulje:metanol 1:90, 27 % FAME je postignuto u šaržnom reaktoru nakon 50 h, a 7,61 % FAME u mikroreaktoru za vrijeme zadržavanja od 120 min.Biofuels have become a subject of significant interest due to rising fossil fuel prices and the need for fuels with reduced environmental impact obtained from sustainable sources, thus reducing greenhouse gas emissions. One such fuel is biodiesel obtained by enzymatically catalyzed transesterification of fatty acids derived from oils or fats in the presence of simple alcohols such as methanol. Improving the biodiesel production process also includes the use of various solvents, of which Natural Deep Eutectic Solvents (NADES) stand out. Due to its physicochemical properties, the application of NADES in the transesterification reaction provides favorable conditions for the action of the enzyme lipases with the simultaneous removal of reaction by-products, which results in obtaining biodiesel of higher purity with higher productivity. As part of this work, NADES based on betaine and urea were prepared in a ratio of 1: 3 with different water contents (30, 35 and 40 % (w/w)). The enzyme lipase, derived from Thermomyces lanuginosus, was successfully extracted in prepared NADES and as such was used in batch synthesis and biodiesel synthesis in a microreactor. The volume activity and stability of the lipase enzyme proved to be best in NADES betaine: urea 1: 3 with 40% (w / w) water. Therefore, this solvent was used in further work to investigate the influence of different ratios of methanol: oil: enzyme on the yield of the production process of fatty acid methyl esters (FAME). In an experiment conducted with a molecular oil:methanol ratio of 1:90, 27 % FAME was achieved in a batch reactor after 50 h and 7,61 % FAME in a microreactor during a retention time of 120 min