Prematurna retinopatija i serumska razina inzulinu sličnog faktora rasta–1

The aim of our study was to measure and compare serum insulin-like growth factor-1 (IGF-1) levels at postmenstrual age of 33 weeks between preterm infants with and without retinopathy of prematurity (ROP). ROP occurs in two phases. Low serum levels of IGF-1 during ROP phase 1 have been found to correlate with the severity of ROP. ROP phase 2 begins around postmenstrual week 33. We conducted a prospective cohort study to measure serum IGF-1 levels in premature infants at postmenstrual age of 33 weeks. The study included all premature infants (N=74), gestational age ≤33 weeks, hospitalized at Department of Neonatology, Clinical Center of Montenegro, from April 2008 to July 2009. The incidence of ROP in the study cohort was 50.7%. Infants with ROP had a significantly lower birth weight and significantly shorter gestational age. The mean level of IGF-1 at postmenstrual age of 33 weeks was 23.7 mcg/L. Study results showed that there was no significant difference in serum IGF-1 level between newborns with and without ROP at postmenstrual age of 33 weeks (in newborns with ROP, it was the beginning of ROP phase 2). A large controlled study with repeated measurement of IGF-1 level in the neonatal period is needed to confirm that restoration of IGF-I level occurs in ROP phase 2, i.e. that the low level of IGF-1 is only a feature of ROP phase 1.Cilj rada je bio izmjeriti i usporediti serumsku razinu insulinu sličnog faktora rasta-1 (IGF-1) u 33. postmenstrualnom tjednu između prijeterminske novorođenčadi s prematurnom retinopatijom (PR) i bez PR. PR se javlja u dvije faze. Nađeno je da je niska serumska razina IGF-1 tijekom prve faze PR u korelaciji s težinom PR. Druga faza PR počinje oko 33. postmenstrualnog tjedna. Provedena je kohortna prospektivna studija u kojoj se mjerila serumska razina IGF-1 kod prijeterminske novorođenčadi u 33. postmenstrualnom tjednu. U studiju su uključena sva prijeterminska novorođenčad (N=74) gestacijske starosti ≤33 tjedna koja su bila hospitalizirana u Centru za neonatologiju Kliničkog centra Crne Gore od travnja 2008. do srpnja 2009. Incidencija PR u studijskoj kohorti iznosila je 50,7%. Novorođenčad s PR imala su značajno nižu porođajnu tjelesnu masu i značajno kraću gestacijsku dob. Prosječna razina IGF-1 u 33. postmenstrualnom tjednu iznosila je 23,7 mcg/L. Naši rezultati su pokazali da u 33. postmenstrualnom tjednu (za novorođenčad s PR to je početak druge faze PR) nema značajne razlike u serumskoj razini IGF-1 između novorođenčadi s PR i bez PR. Potrebno je provesti veću kontroliranu studiju s ponavljanim mjerenjem razine IGF-1 u neonatalnom razdoblju kako bi se potvrdilo da u drugoj fazi PR dolazi do restitucije razine IGF-1, odnosno da je niska razina IGF-1 odlika samo prve faze PR

Leukocitarni profil u krmača tokom laktacionog perioda

During prepartum and postpartum period, there occurs in sows a significant change in the values of haematologic and biochemical parameters. The objective of this research paper was to examine the change in the count of the cells of white blood line in the course of lactation period. The trial was conducted on ten Swedish Landrace breed sows, having the blood taken on the first day postpartum (1-6h), and in the third and fourth week of lactation. The results obtained for haemotologic analyses have suggested the increase in total number of leukocytes and neutrophilic granulocytes, and the decrease in the number of lymphocytes, monocytes and eosinophils on the first day postpartum. In the third and fourth week of lactation a statistically significant fall in the number of leukocytes and granulocytes in relation to the first day was observed, along with a significant increase in limphocytes, monocytes and eosinophils. In examined time intervals the number of basophils did not change significantly. The neutrophil-limphocyte index was highest on the first day postpartum, while in the third and fourth week it was significantly lower.Za vreme prepartalnog i postpartalnog perioda, kod krmača dolazi do značajnih promena vrednosti hematoloških i biohemijskih parametara. Cilj ovoga rada je bio da se ispitaju promene broja ćelija bele krvne loze u toku laktacionog perioda. Ogled je izveden na deset krmača rase Švedski Landras, od kojih je uzimana krv, prvog dana po partusu (1-6 h), treće i četvrte nedelje laktacije. Dobijeni rezultati hematoloških analiza ukazali su na povećanje ukupnog broja leukocita i neutrofilnih granulocita, a smanjenje broja limfocita, monocita i eozinofila prvog dana po partusu. Treće i četvrte nedelje laktacije, doslo je do statistički značajnog pada broja leukocita i granulocita u odnosu na prvi dan, a značajnog porasta limfocita, monocita i eozinofila. U ispitivanim vremenskim intervalima broj bazofila se nije značajno menjao. Neutrofilno-limfocitni indeks je bio najviši prvog dana po partusu, a treće i četvrte nedelje značajno niži

Liječenje ozljeda medijalnog meniskusa parcijalnom meniscektomijom

Partial meniscectomy involves partial removal of the meniscus. This can vary from minor trimming of the damaged part of the meniscus to the removal of the rip from the meniscocapsular junction. Meniscus tears are the most common knee injury. They may occur in acute knee injuries in younger patients, or as part of a degenerative process in older individuals. The aim of the study was to demonstrate the method of choice for treatment of medial meniscus injuries that, in well selected cases, resulted in a small rate of complications and fast rehabilitation. The study analyzed the results of arthroscopic partial medial meniscectomy in 99 patients, in the period from 2005 to 2013, with follow up of 12-14 months. In our series of arthroscopically treated medial meniscus, tears were found in 29 patients with vertical complete bucket handle lesions, 14 with vertical incomplete lesions, 9 with longitudinal tears, 13 with oblique tears, 11 with complex, flap and degenerative lesions, 10 with radial lesions and 13 with horizontal lesions. The mean preoperative International Knee Documentation Committee score was 52.52%, then 81.81% at one month and 92.92% at six months of arthroscopic partial medial meniscectomy. Arthroscopic partial medial meniscectomy is a minimally invasive diagnostic and therapeutic procedure. This procedure is an acceptable and effective long-term treatment, particularly in patients without significant articular cartilage damage, and is associated with minimal morbidity.Parcijalna meniscektomija podrazumijeva djelomično uklanjanje meniskusa. Ovo može varirati od manje ekstirpacije oštećenog dijela meniskusa do uklanjanja rascjepa s meniskokapsularnog hvatišta. Ozljede meniskusa su najčešće ozljede koljena. One se mogu javiti kao akutne ozljede koljena kod mlađih bolesnika ili kao dio degenerativnog procesa u starijih osoba. Cilj studije bio je pokazati metodu izbora u liječenju ozljeda medijalnog meniskusa koja u dobro odabranim slučajevima dovodi do malog postotka komplikacija i brze rehabilitacije. U studiji su analizirani rezultati artroskopske parcijalne medijalne meniscektomije kod 99 bolesnika u razdoblju od 2005. do 2013. godine s praćenjem kroz 12-14 mjeseci. U našoj seriji bolesnika liječenih ovom metodom utvrđen je rascjep poput drške košarice (bucket handle) u 29, vertikalni nepotpuni rascjep u 14, uzdužni rascjep u 9, kosi rascjep u 13, degenerativna lezija u 11, radijalni rascjep u 10 i horizontalni rascjep u 13 bolesnika. Prosječni prijeoperacijski zbir IKDC (International Knee Documentation Committee) bio je 52,52%, jedan mjesec nakon parcijalne artroskopske medijalne meniscektomije IKDC je bio 81,81%, a šest mjeseci nakon parcijalne meniscektomije 92,92%. Artroskopska parcijalna medijalna meniscektomija je minimalno invazivan dijagnostički i terapijski zahvat. Ona je prihvatljiva i učinkovita kao liječenje, naročito kod bolesnika bez značajnog oštećenja zglobne hrskavice, a praćena je minimalnim pobolom

Utjecaj prijeoperacijske respiracijske rehabilitacije kod kardiokirurških bolesnika

The aim of the study was to evaluate the effects of preoperative respiratory rehabilitation on functional capacity, length of stay in intensive care unit (ICU), duration of mechanical ventilation (MV) and total hospitalization, as well as to estimate arterial blood gas (ABG) values in patients undergoing cardiac surgery. Nineteen patients were included in the randomized observational study, divided into two groups: group A (intervention) and B (control). Preoperative and postoperative rehabilitation was performed in group A, and only postoperative rehabilitation in group B. Rehabilitation was carried out according to a predefined protocol. We used ABG to evaluate respiratory function, two-minute walk test (2MWT) and sit-to-stand test to assess functional capacity. The following data were obtained from medical documentation: duration of MV, length of stay at ICU, occurrence of postoperative pulmonary complications, and length of total hospitalization in both groups. Significant between-group difference was found for the length of total hospitalization and duration of MV (p<0.05 both). Analysis of the mean values of 2MWT on the last day of hospitalization (p=0.005), sit-to-stand test before surgery (p=0.022) and on the last day of hospitalization (p=0.008) showed statistically significant differences. The length of hospital stay significantly correlated with preoperative rehabilitation in group A (r=0.885; p<0.0001). There was no difference in ABG parameters between the groups. The study showed that preoperative respiratory rehabilitation had an effect on reducing duration of MV and length of total hospitalization, and improved functional capacity.Cilj rada je bio procijeniti učinak prijeoperacijske respiracijske rehabilitacije na funkcionalni kapacitet, dužinu boravka u jedinici intenzivnog liječenja (JIL), trajanje mehaničke ventilacije (MV) i ukupnu hospitalizaciju te procijeniti vrijednosti plinske analize arterijske krvi (ABG) kod bolesnika podvrgnutih kardiokirurškim operacijama. U radomiziranu opservacijsku studiju bilo je uključeno 19 bolesnika podijeljenih u dvije skupine: skupina A (ispitivana) i B (kontrolna). Prijeoperacijska i poslijeoperacijska rehabilitacija provedena je u skupini A, a samo poslijeoperacijska rehabilitacija u skupini B. Rehabilitacija je provođena prema unaprijed utvrđenom protokolu. Rabili smo parametre ABG za procjenu respiracijske funkcije, a za procjenu funkcionalnog kapaciteta 2-minutni test hoda (2MWT) i sit-to-stand test. Sljedeći podaci prikupljeni su iz medicinske dokumentacije: dužina MV, dužina boravka u JIL, pojava komplikacija i dužina ukupne hospitalizacije. Nađena je značajna razlika između skupina za dužinu ukupne hospitalizacije (p<0,05) i dužinu MV (p<0,05). Analiza srednjih vrijednosti 2MWT posljednjeg dana hopitalizacije (p=0,005), sit-to-stand testa prije operacije (p=0,022) i posljednjeg dana hospitalizacije (p=0,008) između skupina pokazala je statistički značajnu razliku. Dužina hospitalizacije je značajno korelirala s prijeoperacijskom rehabilitacijom u skupini A (r=0,885; p<0,0001). Nije bilo razlike u parametrima ABG između skupina. Studija je pokazala da je prijeoperacijska respiracijska rehabilitacija utjecala na smanjenje dužine MV, dužinu trajanja ukupne hospitalizacije te na poboljšanje funkcionalnog kapaciteta

Liječenje ozljeda medijalnog meniskusa parcijalnom meniscektomijom

Partial meniscectomy involves partial removal of the meniscus. This can vary from minor trimming of the damaged part of the meniscus to the removal of the rip from the meniscocapsular junction. Meniscus tears are the most common knee injury. They may occur in acute knee injuries in younger patients, or as part of a degenerative process in older individuals. The aim of the study was to demonstrate the method of choice for treatment of medial meniscus injuries that, in well selected cases, resulted in a small rate of complications and fast rehabilitation. The study analyzed the results of arthroscopic partial medial meniscectomy in 99 patients, in the period from 2005 to 2013, with follow up of 12-14 months. In our series of arthroscopically treated medial meniscus, tears were found in 29 patients with vertical complete bucket handle lesions, 14 with vertical incomplete lesions, 9 with longitudinal tears, 13 with oblique tears, 11 with complex, flap and degenerative lesions, 10 with radial lesions and 13 with horizontal lesions. The mean preoperative International Knee Documentation Committee score was 52.52%, then 81.81% at one month and 92.92% at six months of arthroscopic partial medial meniscectomy. Arthroscopic partial medial meniscectomy is a minimally invasive diagnostic and therapeutic procedure. This procedure is an acceptable and effective long-term treatment, particularly in patients without significant articular cartilage damage, and is associated with minimal morbidity.Parcijalna meniscektomija podrazumijeva djelomično uklanjanje meniskusa. Ovo može varirati od manje ekstirpacije oštećenog dijela meniskusa do uklanjanja rascjepa s meniskokapsularnog hvatišta. Ozljede meniskusa su najčešće ozljede koljena. One se mogu javiti kao akutne ozljede koljena kod mlađih bolesnika ili kao dio degenerativnog procesa u starijih osoba. Cilj studije bio je pokazati metodu izbora u liječenju ozljeda medijalnog meniskusa koja u dobro odabranim slučajevima dovodi do malog postotka komplikacija i brze rehabilitacije. U studiji su analizirani rezultati artroskopske parcijalne medijalne meniscektomije kod 99 bolesnika u razdoblju od 2005. do 2013. godine s praćenjem kroz 12-14 mjeseci. U našoj seriji bolesnika liječenih ovom metodom utvrđen je rascjep poput drške košarice (bucket handle) u 29, vertikalni nepotpuni rascjep u 14, uzdužni rascjep u 9, kosi rascjep u 13, degenerativna lezija u 11, radijalni rascjep u 10 i horizontalni rascjep u 13 bolesnika. Prosječni prijeoperacijski zbir IKDC (International Knee Documentation Committee) bio je 52,52%, jedan mjesec nakon parcijalne artroskopske medijalne meniscektomije IKDC je bio 81,81%, a šest mjeseci nakon parcijalne meniscektomije 92,92%. Artroskopska parcijalna medijalna meniscektomija je minimalno invazivan dijagnostički i terapijski zahvat. Ona je prihvatljiva i učinkovita kao liječenje, naročito kod bolesnika bez značajnog oštećenja zglobne hrskavice, a praćena je minimalnim pobolom

Dijabetička polineuropatija i rizik od pada: strah od pada i drugi čimbenici

The aim of the study was to analyze postural stability, walking speed and fear of falling in patients with diabetic polyneuropathy (DPN) in order to determine the risk factors for falls, as well as the effect of DPN characteristics as additional factors. A sample of 48 patients with type 2 diabetes and DPN were enrolled in this non-randomized observational study. The patients were divided into two groups of fallers and non-fallers. All subjects underwent evaluation with the Functional Reach Test (FRT), Tinetti Falls Efficacy Scale (Tinetti FES) and 10-Meter Walk Test (10MWT). Neuropathy was quantified with the Michigan Neuropathy Screening Instrument (MNSI, Questionnaire part) and 5.07/10-g Semmes Weinstein monofilament examination (SW-ME). The 10MWT and SW-ME were significantly different between the faller and non-faller groups (p<0.05). Duration of DPN correlated positively with SW-ME (p=0.005) in the faller group. FES showed significant positive correlation with MNSI and negative correlation with 10MWT in the non-faller group. Logistic regression analysis revealed that SW-ME was significantly associated with the probability of falling (p=0.0076; OR=1.378). Study results suggested that the loss of protective sensitivity of foot could be a risk factor for falls in people suffering from type 2 diabetes.Cilj ovoga rada bio je analizirati posturalnu stabilnost, brzinu hoda i strah od pada u bolesnika s dijabetičkom polineu-ropatijom (DPN) kako bi se utvrdili rizični čimbenici za padove, kao i utjecaj karakteristika DPN kao dodatnih čimbenika. Uzorak od 48 bolesnika s dijabetesom tipa 2 i DPN uključen je u ne-randomiziranu opservacijsku studiju. Sudionici su ­podijeljeni u dvije skupine: skloni padovima (faller) i neskloni padovima (non-faller). Svi ispitanici su podvrgnuti ocjeni ­pomoću sljedećih testova: Functional Reach Test (FRT), Tinetti Falls Efficacy Scale (Tinetti FES) i 10-Meter Walk Test (10MWT). Neuropatija je kvantificirana pomoću Michigan Neuropathy Screening Instrument (MNSI) (Upitnik-dio) i testa 5,07/10-g Semmes Weinstein monofilament (SW-ME). Rezultati na 10 MWT i SW-ME su bili značajno različiti između skupina bolesnika sklonih padovima i onih nesklonih padovima (p<0,05). Trajanje DPN bilo je pozitivno povezano sa ­SW-ME (p=0,005) u skupini bolesnika sklonih padovima. Ljestvica FES je značajno pozitivno korelirala s MNSI i negativno s 10MWT u skupini bolesnika nesklonih padovima. Logistička regresijska analiza je pokazala da je SW-ME značajno pove-zana s vjerojatnošću pada (p=0,0076; OR=1,378). Studija je ukazala na to da je gubitak zaštitne osjetljivosti stopala znača-jan čimbenik za pad kod osoba koje pate od dijabetesa tipa 2

Crvena krvna slika u krmača tokom laktacionog perioda

In the course of parturition and lactation, sows are susceptible to stress and make an effort to adapt to the newly-formed situation through different endocrine and metabolic mechanisms. In addition to endocrine, biochemical changes, hematological changes also occur in the sow organism. Having these facts in mind, the objective of this work was to examine the changes in the number of erythrocytes, hemoglobin concentration, hematocrit value, hematological indexes: mean corpuscular erythrocyte volume (MCV), mean corpuscular hemoglobin (MCH) in erythrocyte and mean corpuscular hemoglobin concentration (MCHC) in erythrocytes, as well as sedimentation values during the period of lactation in sows. The experiment was performed on ten sows of the Swedish Landrace breed, from which blood was taken on the first day postpartum (1-6 h), and during the third and fourth weeks of lactation. The obtained results of hematological analyses indicated a reduced number of erythrocytes, haemoglobin concentration and hematocrit value during the lactation period. The number of erythrocytes was significantly lower at the end of lactation in comparison with the number established on the first day postpartum. The hemoglobin concentration and hematocrit value were very significantly lower at the end of lactation against the first day postpartum. The values of the hematological indexes MCV, MCH and MCHC did not differ significantly in any of the examined periods. The rate of erythrocyte sedimentation was determined 1 h and 2 h postpartum.Tokom partusa i laktacije krmače su podložne stresu i pokušavaju da se prilagode novonastaloj situaciji putem različitih endokrinih i metabolič kih mehanizama. Osim endokrinih, biohemijskih promena, u organizmu krmača dolazi i do hematoloških promena. Imajući u vidu ove činjenice, cilj ovoga rada je bio da se ispitaju promene broja eritrocita, koncentracije hemoglobina, vrednosti hematokrita, hematoloških indeksa: prosečne zapremine eritrocita (MCV), prosečne vrednosti hemoglobina u eritrocitima (MCH) i prosečne koncentracije hemoglobina u eritrocitima (MCHC), kao i vrednost sedimentacije za vreme laktacionog perioda kod krmača. Ogled je izveden na deset krmača rase švedski landras, od kojih je uzimana krv, prvog dana po partusu (1-6 h), kao i u toku treće i četvrte nedelje laktacije. Dobijeni rezultati hematološ kih analiza ukazali su na smanjenje broja eritrocita, koncentracije hemoglobina i vrednosti hematokrita tokom laktacionog perioda. Broj eritrocita je bio statistički značajno niži na kraju laktacije u odnosu na broj ustanovljen prvoga dana po partusu. Koncentracija hemoglobina i vrednost hematokrita su bili vrlo značajno niži na kraju laktacije u odnosu na prvi dan partusa. Vrednosti hematoloških indeksa MCV, MCH i MCHC nisu se značajno razlikovale ni u jednom ispitivanom periodu. Brzina sedimentacije eritrocita određivana je 1 h i 2 h nakon partusa. PR Projekat Ministarstva nauke Republike Srbije, br. TR 20110

Povezanost inzulinu sličnog faktora rasta tip 1 i intrauterinog rasta

Insulin-like growth factor 1 (IGF-1) is a regulator of intrauterine growth, and circulating concentrations are reduced in intrauterine growth-restricted fetuses. The aim of our study was to investigate the relationship between IGF-1 levels in newborns and intrauterine growth, expressed as birth weight (BW). The research was designed as a cross-sectional study. The study included 71 premature newborns, gestational age (GA) ≤33 weeks. Quantitative determination of IGF-1 was performed in the 33rd post-menstrual week (pmw) to make the measurements more comparable. We used an enzyme-bound immunosorbent test for quantitative determination of IGF-1. Our results showed the mean IGF-1 level in premature newborns in 33rd pmw to be 23.1±4.56 (range 15.44-39.75) μg/L. There was no difference in IGF-1 values between male (23.1±4.98 μg/L) and female (23.1±4.87 μg/L) newborns. Tere was no significant difference in the average IGF-1 levels between male and female newborns with BW 50th percentile for GA either (p>0.50). Only BW <33rd percentile newborns had a statistically significantly lower IGF-1 level compared to newborns with greater BW. Based on our results, it is concluded that serum IGF-1 level reflects intrauterine growth only in BW <33rd percentile newborns. This fact could be used for further therapeutic purposes.Inzulinu sličan faktor rasta (IGF-1) je jedan od čimbenika koji utječu na intrauterini rast. Serumske razine IGF-1 su smanjene u fetusima s intrauterinim zastojem rasta. Cilj našega istraživanja bio je ispitati odnos između razine IGF-1 u nedonoščadi i intrauterinog rasta izraženog kao porođajna težina (PT). Istraživanje je provedeno kao presječna studija. U studiju je bilo uključeno 71 nedonošče gestacijske dobi (GD) ≤33 tjedna. Kvantitativno određivanje IGF-1 provedeno je u 33. postmenstruacijskom tjednu (pmt) radi bolje usporedivosti rezultata. Za kvantitativno određivanje IGF-1 rabili smo enzimski imunosorbentni test. Naši rezultati pokazali su da je srednja razina IGF-1 u nedonoščadi u 33. pmt iznosila 23,1±4,56 (raspon 15,44-39,75) μg/L. Nije bilo razlike u vrijednostima IGF-1 između muške (23,1±4,98 μg/L) i ženske (23,1±4,87 μg/L) nedonoščadi. Također nije bilo značajne razlike u srednjim razinama IGF-1 između nedonoščadi s PT 50. percentila za GD (p>0,50). Nedonoščad s niskom PT (<33. percentila) imala su statistički značajno nižu razinu IGF-1. Na temelju naših rezultata može se zaključiti da serumska razina IGF-1 odražava intrauterini rast samo u nedonoščadi male PT (<33. percentila), što bi mogao biti koristan podatak za buduću uporabu IGF-1 u terapijske svrhe

Mosquitos in the municipality of Jelenje

Cilj: Otkriti zastupljenost pojedinih vrsta komaraca te napraviti kartu rasprostranjenostiuzorkovanih legala. Istraživanje je provedeno u svrhu kontrole pojavljivanja zaraznih bolestičiji su vektori komarci. Metode: Prilikom provedbe istraživanja korišteni materijali su:ovipozicijske klopke koje se sastoje od plastične posude i lesonitske letvice, 70 %-tni etanol,staklene bočice, plastične posudice za pohranu uzoraka te aplikacija Map coordinates. Istraživanjeje provedeno postavljanjem ovipozicijskih klopki na 40 lokacija unutar područja OpćineJelenje, uzorkovanjem ličinki i odraslih jedinki komaraca. Rezultati: U razdoblju od travnja dolipnja 2015. godine na području Općine Jelenje na 22 lokacije iz 29 različitih legla prikupljenoje 137 ličinki komaraca. Prikupljeno je ukupno 6 uzoraka odraslih jedinki. Svi determiniraniuzorci pripadaju jednom od navedenih rodova komaraca: Aedes, Anopheles, Culex i Culiseta.Određivanje vrsta prikupljenih uzoraka provedeno je u laboratoriju Nastavnog zavoda za javnozdravstvo Primorsko-goranske županije. Zaključak: Postojeći uvjeti potrebni za razvoj i razmnožavanjete prisutni vektorski potencijal determiniranih komaraca uz eventualnu pojavnostuzročnika mogu imati značajan utjecaj na širenje zaraznih bolesti. Prekomjerna brojnostjedinki komaraca zbog povoljnih životnih uvjeta, kao i zbog povećanih migracija ljudi te transportaroba, postaje sve izraženiji problem za ljudsko zdravlje te je potrebno osvijestiti javnosto važnosti i načinima sprječavanja razmnožavanja i širenja komaraca.Aim: The purpose of this research was to determine abundance of the certainmosquito species and to create distribution chart of the sampled population. Methods: Theresearch was conducted by setting oviposition traps on 40 locations inside the area of theJelenje municipality. Also, larvae and adult mosquitoes were collected. Results: 29 larvaesamples of larvae were collected on 22 locations in a period from April to June 2015, so thetotal number of sampled larvae is 137. Six adult mosquitoes were collected. All determinedspecies belong to one of this genus of mosquitoes: Aedes, Anopheles, Culex and Culiseta.Determination of the type of the collected samples was conducted in the laboratory of theTeaching Institute of Public Health Primorsko-goranska County. Conclusion: Existingconditions which are necessary for the development and reproduction, with present vectorpotential of determined mosquitoes and with the possible occurrence of pathogens, canhave a significant impact on the spread of infectious diseases. Excessive number ofmosquitoes, enabled by favoring life conditions and increased migrations and merchandisetransport can become a problem for human health and it is necessary to educate the publicabout importance and ways of suppressing breeding of mosquitoes and their expansion

Herb-Induced Liver Injury by Ayurvedic Ashwagandha as Assessed for Causality by the Updated RUCAM : An Emerging Cause

Funding Information: This article was supported by the COST Action CA17112—Prospective European Drug Induced Liver Injury Network (ProEuroDILINet) (G.B., V.V. and E.S.B.) and by the Ministry of Science, Technological Development, and Innovation of the Republic of Serbia No. 451-03-47/2023-01/200015 (V.V.). Publisher Copyright: © 2023 by the authors.Herb-induced liver injury (HILI) caused by herbal supplements, natural products, and products used in traditional medicine are important for differential diagnoses in patients with acute liver injury without an obvious etiology. The root of Withania somnifera (L.) Dunal, commonly known as ashwagandha, has been used in Ayurvedic medicine for thousands of years to promote health and longevity. Due to various biological activities, ashwagandha and its extracts became widespread as herbal supplements on the global market. Although it is generally considered safe, there are several reported cases of ashwagandha-related liver injury, and one case ended with liver transplantation. In this paper, we review all reported cases so far. Additionally, we describe two new cases of ashwagandha hepatotoxicity. In the first case, a 36-year-old man used ashwagandha capsules (450 mg, three times daily) for 6 months before he developed nausea, pruritus, and dark-colored urine. In the second case, a 30-year-old woman developed pruritus after 45 days of using ashwagandha capsules (450 mg). In both cases, serum bilirubin and liver enzymes (aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphatase (ALP) were increased. The liver injury pattern was hepatocellular (R-value 11.1) and mixed (R-value 2.6), respectively. The updated Roussel Uclaf Causality Assessment Method (RUCAM) (both cases with a score of seven) indicated a “probable” relationship with ashwagandha. Clinical and liver function improvements were observed after the discontinuation of ashwagandha supplement use. By increasing the data related to ashwagandha-induced liver injury, these reports support that consuming ashwagandha supplements is not without its safety concerns.Peer reviewe