Difficulties in proving medical errors: Where do we stand?

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Lichens- indicators of air quality of Toplica district and their biomedical potential

Rezime: Lišaji su kosmopolitski organizmi nastali simbiozom gljiva najčešće iz podrazdela Ascomycotina i algi iz razdela Cyanobacteriophyta ili Chlorophyta. Primenjuju se u proceni stanja kvaliteta vazduha kao organizmi indikatori, a osim toga imaju izražen biomedicinski potencijal. Upravo ciljevi ovog istraživanja bili su: indikacija kvaliteta vazduha korišćenjem lišaja kao bioindikatora i biomedicinska karakterizacija različitih vrsta lišaja sakupljenih u istraživanim područjima Lukovske, Kuršumlijske i Prolom banje, Radan planine kao i grada Kuršumlije. Istraživanje je sprovedeno u periodu od 2012. do 2015. godine. Lišajska indikacija kvaliteta vazduha obuhvata ispitivanje kvaliteta vazduha korišćenjem lišaja kao bioindikatora definisanjem zona različitog stepena zagađenja vazduha u okviru svakog istraživanog područja, kao i definisanje potencijalnih indikatorskih taksona za procenu kvaliteta vazduha, korišćenjem multivarijantne metode veštačkih neuronskih mreža (samoorganizujuće mape, engl. Self Organizing Map − SOM). Ispitivanjem raznovrsnosti lišaja u Lukovskoj banji konstantovano je prisustvo 76 vrsta lišaja iz 34 roda. U Kuršumlijskoj banji zabeleženo je prisustvo 65 vrsta lišaja iz 32 roda. Na području Prolom banje zabeleženo je prisustvo 72 vrste lišaja iz 33 roda. Analizom diverziteta lišaja Radan planine konstantovano je prisustvo 76 vrsta lišaja iz 34 roda. U Kuršumliji je zabeleženo prisustvo 42 vrste lišaja iz 23 roda. Izračunate vrednosti indeksa antropogenog uticaja (engl. Index of Human Impact – IHI) kretale su se od 5 do 36. Izračunate vrednosti indeksa atmosferske čistoće (engl. Index of Atmospheric Purity – IAP) kretale su se od 10 do 75. U svim banjskim naseljima zabeleženo je prisustvo ,,normalne zone” koja obuhvata čitavu površinu istraživanog područja Lukovske banje, Prolom banje i planine Radan, kao i veći deo površine istraživanog područja Kuršumlijske banje. Detaljnijom analizom je prikazano da je ova zona podeljena na tri podzone. U zoni ,,borbe” nalazi se manji, centralni deo Kuršumlijske banje i veći deo grada Kuršumlije, gde je došlo do formiranja podzona: ,,spoljašnja zona borbe” i ,,unutrašnje zone borbe”. Zona ,,lišajske pustinje” obuhvata manji deo površine istraživanog područja grada Kuršumlije. Biomedicinska karakterizacija obuhvata dobijanje ekstrakata izabranih vrsta lišaja, izolovanje sekundarnih metabolita lišaja i ispitivanje antimikrobne, antioksidativne i antikancerogene aktivnosti. Ispitivani su acetonski ekstrakti lišaja Cladonia coniocraea, C. fimbriata, C. foliacea, C. furcata, C. ramulosa, C. rangiferina, C. subulata, Lepraria incana, Melanelixia fuliginosa, M. glabra, M. subaurifera, Peltigera rufescens, Pertusaria amara, Physcia semipinnata, Platismatia glauca, Pleurosticta acetabulum, Ramalina fastigiata i R. fraxinea, kao i supstance methyl evernate (izolovana iz ekstrakta lišaja R. fastigiata), obtusic acid (izolovana iz ekstrakta lišaja R. fraxinea), lecanoric acid (izolovana iz ekstrakta lišaja M. subaurifera) i 2’-O-methylanziaic acid (izolovana iz ekstrakta lišaja M. fuliginosa). Svi testirani uzorci ispoljili su snažnu antimikrobnu, antioksidativnu i antikancerogenu aktivnost, što je od velikog značaja zbog njihove potencijalne primene u medicini, veterini i farmaceutskoj industriji.Summary: Lichens are cosmopolitan organisms ensued from symbiosis of fungi, usually from Ascomycotina subphylum and algae from Cyanobacteriophyta or Chlorophyta phylum. They’re applied in estimation of air quality condition as indicating organisms and, in addition, they’ve got a quite clear biomedical potential. The two very goals of this exploration were: indication of air quality by using lichens as bioindicators and the biomedical characterization of various lichen species collected within the area of Lukovska, Prolom and Kursumlijska spas, Radan Mountain and the town of Kursumlija. The exploration was conducted in the period 2012/2015. The lichen air quality indication encompasses exploration of air quality using lichens as bioindicators by defining the zones of different degree of air pollution within each of the explored settlements, as well as defining some potential taxa for air quality estimation through a multivariate method of artificial neuronetworks (self organizing maps – SOM). By examining the lichen diversity in Lukovska Spa, 76 lichen species from 34 genera have been ascertained. The presence of 65 lichen species from 32 genera was noted in Kursumlijska Spa. Within the Prolom Spa area, 72 lichen species from 33 genera were recorded. Through the analysis of Radan Mountain lichen diversity, 76 lichen species from 34 genera were entered. In the town of Kursumlija, 42 lichen species from 23 genera were recorded. The calculated values of the Index of Human Impact fluctuated between 5 and 36. The calculated values of the Index of Atmospheric Purity – IAP varied between 10 and 75. The lichen “normal” zone was noted in all spa resorts. The “normal zone” covers entire area of Lukovska spa, Prolom spa and Radan mountain, as well as a major part of investigated area of Kursumlijska spa. A detailed analysis shows this yone divided into 3 subzones. The “struggle zone” encompasses a smaller, central part of Kursumlijska spa and major part of the town of Kursumlija where forming the subzones has taken place - “outer struggle zone” and “inner struggle zone”. The lichen “desert” zone includes a smaller part of the investigated area of the town. Biomedical characterization encompasses derivation of extracts of chosen lichen species, isolation of secondary lichen metabolites and examination of antimicrobial, anti-oxidative and anti-carcinogenic activities. The following acetone lichen extracts were examined: Cladonia coniocraea, C. fimbriata, C. foliacea, C. furcata, C. ramulosa, C. rangiferina, C. subulata, Lepraria incana, Melanelixia fuliginosa, M. glabra, M. subaurifera, Peltigera rufescens, Pertusaria amara, Physcia semipinnata, Platismatia glauca, Pleurosticta acetabulum, Ramalina fastigiata and R. fraxinea as well as some substances like methyl evernate (isolated from the extract of R. fastigiata lichen, obtusic acid (isolated from the extract of M. subaurifera lichen) and 2’-O-methylanziaic acid (isolated from the extract of M. fuliginosa lichen) All the tested samples demonstrated a strong antimicrobial, antioxidative and anticarcinogenic activity, which is quite significant for the potential use in medicine, veterinary medicine and pharmaceutical industry

Analiza faktora koji utiču na nivo vitamina D kod osoba sa mentalnim poremećajima

Uvod: Sprovedeno istraživanje ima za cilj da ispita faktore koji su povezani sa nedostatkom vitamina D i da pokaže kolika je učestalost nedostatka vitamina D kod pacijenata koji boluju od mentalnih poremećaja. Metode: U istraživanju je korišćena studija preseka na uzorku od 220 ispitanika oba pola, starosti od 19 do 81 godine, sa širokim rasponom mentalnih poremećaja (F00-F89) lečenih u ambulantnim i hospitalnim uslovima. Izvori podataka su bili: medicinska dokumentacija, upitnik i biohemijske analize uzoraka seruma ispitanika (koncentracija vitamina D merena kao 25(OH)D, kalcijum, fosfor, magnezijum, natrijum i kalijum). Podaci su analizirani deskriptivnom statistikom, primenom metoda ispitivanja hipoteze i binarne logističke regresije, na nivou p≤0.05. Rezultati: Ukupno 140 ispitanika (64%) imalo je nedostatak vitamina D (20 ng/ml). Među varijablama koje se odnose na demografiju, stil života, mentalne bolesti, komorbiditet i upotrebu lekova, sa nedostatkom vitamina D statistički su značajno povezani faktori kao što su ženski pol (OR 2.5, 95% CI = 1.3-4.9, p = 0.006) i upotreba klozapina (OR 15.6, 95% CI 1.7 – 144.7 , p = 0.02). Fizička aktivnost (OR = 0.4, 95% CI 0.2-0.9, p = 0.02), vežbanje (OR =0.2, 95% CI< 0.1 – 0.7, p = 0.02) i iznutrice u ishrani (OR =0.5, 95% CI 0.3 – 0.9, p = 0.03) ponašaju se kao protektivni faktori i više su zastupljeni kod ispitanika bez nedostatka 25(OH)D u serumu. Zaključak: Pacijenti s mentalnim poremećajima su u visokom riziku zbog nedostatka vitamina D, posebno žene, oni koje koriste klozapin, kao i oni pacijenti koji nemaju adekvatnu fizičku aktivnost i zdravu ishranu.This research aims to investigate factors associated with vitamin D deficiency and to provide exact data about its prevalence in patients suffering from different psychiatric illnesses. Methods: The study had a cross-sectional design and included 220 patients of both genders, aged from 19-81 years, with a wide range of mental disorders (F00-F89) and treated in routine ambulatory and hospital practice. The researchers collected data from three sources: medical records, study questionnaire and biochemical analysis of patients’ serum samples (concentration of vitamin D measured as 25(OH)D, calcium, phosphorus, magnesium, sodium and potassium). Data were analyzed using descriptive statistics and methods for hypothesis testing and binary logistic regression, at p≤0.05 level. Results: Total of 140 patients (64%) had a deficiency of vitamin D (20 ng/mL). Among variables related to demographics, life style habits, mental illness, comorbid disorders and drugs, two of them, female gender (odds ratio OR= 2.5, 95% confidence interval (CI)=1.3-4.9, p=0.006) using clozapine (OR 15.6, 95% CI 1.7 – 144.7 , p = 0.02) were significantly associated with vitamin D deficiency. Physical activity (OR = 0.4, 95% CI 0.2-0.9, p = 0.02), exercising (OR =0.2, 95% CI< 0.1 – 0.7, p = 0.02) and offal in the diet (OR =0.5, 95% CI 0.3 – 0.9, p = 0.03) significantly aggregated in the patients who had 25(OH)D serum concentration above the deficiency cut-off level. Conclusions: Patients with mental disorders are at high risk for vitamin D deficiency, particularly females and clozapine users as well as those having no adequate physical activity and dietary habits

The influence of nutrition and lifestyles on bone health in patients with schizophrenia and depression

© 2020, Serbian Medical Society. All rights reserved. Objective. The aim of this paper is to investigate the influence of nutrition and pattern behaviors on bone health in people with mental health disorders. Methods. A cross-sectional study has been conducted at the Clinic for Psychiatry of the Clinical Center of Kragujevac and at the Department of Neuropsychiatry of the Specialist-Consultative Service of Health Care Center Kragujevac. The survey included 46 patients from the age of 22 to 81, both genders, with schizophrenia as a diagnosis for mental disorders and depression determined by a psychiatrist. Quantitative testing of calcium, magnesium, phosphorus, sodium and potassium has been performed by standard biochemical methods. Vitamin D has been determined by high performance/pressure liquid chromatography i.e. by a liquid chromatography under high pressure. Results. In the whole group of patients tested, 58.7% of patients were physically active and the patients with schizophrenia (p = 0.026) were less physically active. Out of the total number, 67% of patients eat irregularly and this habit is more present in patients with schizophrenia (p = 0.003). In terms of the presence of certain nutrients, fish is more represented in the nutrition of people suffering from depression. Three patients (6.5%) reported osteoporosis in their medical history, one of whom had a spontaneous fracture. In the anamneses (6.5%) of the patients stated that their parents had had spontaneous bone fractures. Low values of 25 (OH) D in the serum were present in both study groups. Conclusion. Unhealthy lifestyles, low level of Vitamin D found in people who have mental health disorders represent risk factors for the reduced bone mass. The results of our research indicate the need for timely identification of potential risk factors and improvement of prevention in order to raise awareness of the importance of healthy lifestyles and behavior modification

LICHENS AS INDICATORS OF AIR QUALITY IN BALNEOLOGICAL CENTER PROLOM BANJA (SOUTHERN SERBIA)

This paper deals with using lichens as a bioindicators of the air quality and it was conducted on the territory of balneological center Prolom Banja (Southern Serbia). The exploration was conducted in the year 2019. The analysis of the sample from 15 investigated points indicates the presence of 72 lichen taxa, which shows that this area is rich in lichen species. For each investigated point, the index values of atmospheric purity (IAP) and index of human impact (IHI) were calculated. The IAP values varied in range from 40 to 56, while IHI values ranged between 8 and 24. Therefore, the map showing the air quality of the investigated area was made. There is a presence of “normal lichen zone” on the map which indicates that the air quality in this area is quite good. There are no significant air pollution sources in this area, so the level of pollution is considered low or very low. In the investigated area there are not stations for the monitoring of physico-chemical parameters of air quality. The investigation of air quality on the territory of Prolom Banja has not been done until now.

Antifungalna aktivnost hitosana prema Alternaria alternata i Colletotrichum gloeosporoides

Chitosan and its derivatives have been reported as a promising alternative for control of postharvest fungal pathogens. The objective of this study was to evaluate in vitro and in situ antifungal activity of chitosan against Alternaria alternata and Colletotrichum gloeosporioides isolated from decayed apple fruits. The fungi were tested in vitro using PDA medium with three concentrations of chitosan (1, 2 and 3 mg/ml). Fungal growth of the test pathogens was significantly affected by all chitosan doses (P lt 0.05) after 7 days of incubation at 25°C. Water solution of 3 mg/ml of chitosan inhibited completely the conidial germination of A. alternata and C. gloeosporioides after 18 h incubation at 25°C. The results obtained from biocontrol assay indicate that the inhibition of postharvest decay of A. alternata and C. gloeosporioides was significantly influenced by chitosan concentrations. Disease incidence in chitosan-treated fruit after 7 days incubation at 25°C was significantly lower than in the positive control for both fungi tested (P lt 0.05). A. alternata and C. gloeosporioides used in this study were progressively inhibited in vitro and in situ with increasing concentrations of chitosan from 1 to 3 mg/ml.Istraživanja pokazuju da su hitosan i njegovi derivati dobra alternativa u kontroli skladišnih fitopatogenih gljiva. Cilj ovog rada bio je da ispita antifungalnu aktivnost hitosana prema Alternaria alternata i Colletotrichum gloeosporoides, izolovanih sa inficiranih plodova jabuke, u in vitro i in situ uslovima. Rast gljiva je testiran in vitro koristeći PDA podlogu sa različitim koncentracijama hitosana (1, 2 i 3 mg/ml). Porast oba patogena je bio značajno smanjen (P lt 0.05) u svim koncentracijama hitosana nakon 7 dana inkubacije na 25°C. Vodeni rastvor hitosana koncentracije 3 mg/ml je u potpunosti inhibirao klijanje konidija A. alternata i C. gloeosporoides nakon inkubacije od 18 sati na temperaturi od 25°C. Rezultati ogleda in situ ukazuju da inhibicija propadanja plodova inficiranih sa A. alternata i C. gloeosporoides zavisi od koncentracije rastvora hitosana. Pojava bolesti na plodovima jabuka tretiranih rastvorom hitosana nakon 7 dana inkubacije na 25°C bila je značajno smanjena za obe vrste gljiva (P lt 0.05) u odnosu na pozitivnu kontrolu. Rast A. alternata i C. gloeosporoides je bio progresivno inhibiran in vitro i in situ sa povećanjem koncentracije rastvora hitosana, od 1 do 3 mg/ml

A model for cross-referencing and calculating similarity of metal alloys

This paper presents an innovative model for the comparison and crossreferencing of metal alloys, in order to determine their interchangeability in engineering, manufacturing and material sourcing. The model uses a large alloy database and statistical approach to estimate missing composition and mechanical properties parameters and to calculate property intervals. A classification of metals and fuzzy logic are then applied to compare metal alloys. The model and its algorithm have been implemented and tested in real-life applications. In this paper, an application of the model in finding unknown equivalent metals by comparing their compositions and mechanical properties in a very large metals database is described, and possibilities for further research and new applications are presented

Postharvest decay of mandarin fruit in Serbia caused by Penicillium expansum

Mandarin fruits are one of the most popular among the Citrus genus. They are consumed because of their nutritional and health benefits, as well as pleasant taste and smell. This paper describes the identification and characterization of Penicillium expansum, isolated from molded mandarin fruits. The obtained isolates were cultivated on five media [Czapek Yeast Autolysate agar (CYA), MEA (Malt extract agar), Creatine sucrose agar (CREA), Yeast extract sucrose agar (YES), and Oatmeal agar (OA)] and at five different incubation temperatures (5, 15, 25, 30, and 37 °C). Isolates were sequenced for two molecular loci: internal transcribed spacer and beta-tubulin. Based on the results from morphological, physiological, molecular, and phylogenetic analyses, the recovered isolates were identified as P. expansum. The isolated species was confirmed as pathogenic to mandarin fruits in a pathogenicity test. To the best of our knowledge, this is the first report of P. expansum as a postharvest pathogen of mandarin fruit in Serbia

Chemical composition and bioactive properties of the lichen, Pleurosticta acetabulum

Purpose: To investigate the chemical composition and bioactivity of the acetone extract of Pleurosticta acetabulum lichen. Methods: Phytochemical analysis of the acetone extract of the lichen (Pleurosticta acetabulum) was carried out by high-performance liquid chromatography (HPLC). The antioxidant activity of the lichen extract was evaluated by determining the radical scavenging capacity on 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals and reducing power. To determine total phenolics and flavonoids, we used spectrophotometric methods. Antimicrobial activity was estimated by determination of the minimal inhibitory concentration using broth microdilution method. Anticancer activity of the lichen extract was tested using 3-4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide (MTT). Results: Salazinic, norstictic, protocetraric, evernic acid and atranorin were identified as compounds of lichen. P. acetabulum extract exhibited moderate free radical scavenging activity (half-maximum inhibitory concentration, IC50 of 151.7301 µg/mL). The spectrophotomeric absorbance of the extract for reducing power varied from 0.035 to 0.127, while the total phenolics and flavonoids in the extract were 35.39 µg PE/mg and 12.74 μg RE/mg, respectively. Minimum inhibitory concentration (MIC) was in the range of 1.25 to 20 mg/mL while cytotoxic activity (based on IC50 values) ranged from 24.09 to 45.94 µg/mL. Conclusion: The results confirm that lichen extract contains secondary metabolites that possess antioxidant, antimicrobial and anticancer activities, which opens up some possibilities for the extract to be developed as food supplements and pharmaceutical raw materials. Keywords: Pleurosticta acetabulum, Antioxidant activity, Antimicrobial activity, Cytotoxic activity, Liche

Pituitary ACTH cells in female rats after neonatal treatment with SRIH-14.

The prolonged effects of neonatal SRIH-14 treatment on pituitary ACTH cells were investigated. Neonatal female rats were injected subcutaneously with SRIH (20 microg/100g b.w.) every 12 hours for five consecutive days (3rd-7th day of life). Groups of rats were then killed at the juvenile (16th day), peripubertal (38th day) or adult (80th day) stage. ACTH cells were visualized using the peroxidase-antiperoxidase immunocytochemical procedure. Morphometry and stereology were used to evaluate the ACTH-immunoreactive cell volume and volume density. The histological and immunocytochemical characteristics of ACTH cells in neonatally treated females were changed in all examined periods. Thus, SRIH-14 induced significant (