Endoscopic retrograde cholangiopancreatography-induced and non-endoscopic retrograde cholangiopancreatography-induced acute pancreatitis: Two distinct clinical and immunological entities?

Acute pancreatitis (AP) is common gastrointestinal disease of varied aetiology. The most common cause of AP is gallstones, followed by alcohol abuse as an independent risk factor. With the increased need for invasive techniques to treat pancreatic and bile duct pathologies such as endoscopic retrograde cholangiopancreatography (ERCP), AP has emerged as the most frequent complication. While severe AP following ERCP is rare (0.5%), if it does develop it has a greater severity index compared to non-ERCP AP. Development of a mild form of AP after ERCP is not considered a clinically relevant condition. Differences in the clinical presentation and prognosis of the mild and severe forms have been found between non-ERCP AP and post-endoscopic pancreatitis (PEP). It has been proposed that AP and PEP may also have different immunological responses to the initial injury. In this review, we summarise the literature on clinical and inflammatory processes in PEP vs non-ERCP AP

Uticaj Bonsilage Plus i Bonsilage Forte na smanjenje mikroflore tokom siliranja lucerke

Crops at ensiling contain both aerobic and anaerobic microorganisms and a range of bacteria and fungi that affect silage quality. Typical classes of microorganisms on plants prior to ensiling are aerobic bacteria, lactic acid bacteria (LAB), enterobacteria, yeasts, molds, clostridia, bacilli, acetic acid bacteria and propionic acid bacteria. The quality of silage depends on the competition between different groups of microorganisms. LAB, which are responsible for the silage fermentation process, usually dominate the silage microflora, but undesirable microorganisms, that occur at low levels on fresh plant material, may grow during the storage of silage and lead to anaerobic or aerobic spoilage. In this study, effects of silage inoculants on reduction of microflora during ensiling of alfalfa have been investigated. The results showed that the addition of commercial silage inoculants, Bonsilage Plus and Bonsilage Forte, had significant effect in reducing total number of aerobic bacteria, enterobacteria, yeasts, moulds and sulphite reducing clostridia during ensiling of alfalfa.Biljni materijal za siliranje sadrži aerobne i anaerobne mikroorganizme i niz bakterija i gljivica koji utiču na kvalitet silaže. Tipične klase mikro-organizama na biljkama pre siliranja su aerobne bakterije, bakterije mlečne kiseline (LAB), enterobakterije, kvasaca, plesni, klostridije, bakterije sirćetne kiseline i bakterije propionske kiseline. Kvalitet silaže zavisi od dominacije različitih grupa mikroorganizama. Bakterije mlečne kiseline, koje su odgovorne za proces fermentacije silaže, obično dominiraju mikroflorom silaže, ali broj neželjenih mikroorganizama, koji se javljaju u niskom nivou u svežoj biljnoj masi, može da raste tokom skladištenja silaže i dovede do njenog kvarenja. U ovom radu je ispitivan uticaj silažnih inokulanata na smanjenje mikroflore u toku siliranja lucerke. Rezultati su pokazali da je dodavanje komercijalnih inokulanata Bonsilage Plus i Bonsilage Forte, imalo značajan efekat na smanjenje ukupnog broja aerobnih bakterija, enterobakterija, kvasaca, plesni i klostridija tokom siliranja lucerke

Crohn’s disease in women

Abstract: This article provides an overview of the obstetric and gynecological manifestations of Crohn’s disease (CD). High incidence of the new onset of the disease in young women in their reproductive years demands special concern from physicians involved in their treatment. Pregnant women with CD are considered high-risk patients, regardless of disease activity index, due to associated complications. Predominately described complications are premature birth, low birth weight, and congenital anomalies. To minimize the risk for adverse pregnancy/birth outcomes, it is recommended that remission be achieved before conception. Treatment of CD in pregnant women is similar to that among the nonpregnant population, and there is no valid reason to terminate it, since most of the drugs are proven to be safe. Women with CD who wish to conceive or are already pregnant need to be properly advised according to the newest guidelines on the subject, given by the European Crohn’s and Colitis Organization. Gynecological manifestations are another special feature of CD. They are important in that they may facilitate early recognition of the underlying disease, which usually stays unrecognized for years before intestinal manifestation; in this way, the underlying manifestations are often mistreated

Ave, Cibaličani!

Polazeći od misli Hoddinga Cartera ‘Svojoj djeci možemo dati samo dva trajna naslijeđa – jedno su korijeni, a drugo krila’, odgajateljice vinkovačkog vrtića ponudile su djeci niz aktivnosti s ciljem prijenosa kulturnih obilježja i vrijednosti

Characteristics of newly created grapevine varieties Vožd and Vladun

This paper presents the most important morphological and production-technological characteristics of newly created grapevine varieties Vožd and Vladun, intended for the production of red wines. The newly created varieties were compared with the standard variety Cabernet Sauvignon during the three-year period of testing (2015-2017) in the relation studied properties. The variety Vožd obtained from the crossing combination Začinak x Prokupac, and the variety Vladun from the crossing combination Merlot x Župski Bojadiser. The investigated varieties differed considerably in terms of some morphological traits and represents unique genotypes. The newly recognized varieties have a hermaphrodite type of flower, dense bunch, globose berry shape and blue black color of berry skin. The yield, bunch weight, bunch length and bunch width were higher at both varieties than for the standard variety. The Vožd variety had a yield of 1.29 kg/m2 and a bunch weight of 174.3 g, and the Vladun variety had a yield of 0.87 kg/m2 and a bunch weight of 153.7 g. For the standard variety the grape yield was 0.78 kg/m2 and the bunch weight was 134.0 g. The content of sugar and total acids in the must of the Vožd variety was 20.5% and 6.5 g/l, while for the Vladun variety it was 21.8% and 6.0 g/l respectively. Wine of both varieties was drinkable, harmonious, with a specific varietal of smell and taste and contained 12.1 vol. % of alcohol (Vožd variety), or 12.6 vol. % of alcohol (Vladun variety). Due to the many positive features of the grapes and wines from the Vožd and Vladun varieties, their spread to the production vineyards of Serbia is expected

Trebamo li liječiti bol u starijih palijativnih onkoloških bolesnika drukčije?

Opioids are considered the cornerstone of pain management in palliative care. Available data suggest that older patients use different analgesics and lower opioid doses compared to younger patients. However, it has not been elucidated yet whether such dosing is associated with worse pain levels or shorter survival in the palliative care setting. We evaluated the relationship among pain scores, quality of life, opioid dose, and survival in palliative care cancer patients in a hospice setting. A total of 137 palliative care cancer patients were analyzed prospectively. We divided patients into two groups using the age of 65 as a cut-off value. Younger patients exhibited significantly higher pain ratings (5.14 vs. 3.59, p=0.01), although older patients used almost 20 mg less oral morphine equivalent (OME) on arrival (p=0.36) and 55 mg OME/day less during the last week (p=0.03). There were no differences in survival between the two groups (17.36 vs. 17.58 days). The elderly patients also used nonsteroidal analgesics less often and paracetamol more often. Hence, using lower opioid doses in older palliative care cancer patients does not result in worse pain rating, and could be a plausible approach for pain management in this patient group.Opioidi se smatraju jednim od osnovnih lijekova u liječenju boli u palijativnoj skrbi. Dostupni podaci ukazuju na to da stariji bolesnici uzimaju drukčije analgetike uz niže doze opioida u usporedbi s mlađim bolesnicima. Međutim, nije razjašnjeno utječe li takvo doziranje opioida na lošije liječenje razine boli ili kraće preživljenje u uvjetima palijativne skrbi. Analizirali smo odnos razine boli, kvalitete života, doze opioida i preživljenja u palijativnih onkoloških bolesnika koji su bili hospitalizirani u hospiciju. Ukupno je 137 palijativnih bolesnika analizirano prospektivno. Bolesnici su podijeljeni u dvije skupine pri čemu se dob od 65 godina uzimala kao granica između skupina. Mlađi bolesnici su izražavali višu razinu boli prilikom dolaska u hospicij (5,14 prema 3,59, p=0,01), iako su stariji bolesnici koristili gotovo 20 mg manje oralnog morfij ekvivalenta (OME) na dan dolaska te čak 55 mg OME manje na dan tijekom zadnjeg tjedna (p=0,03). Nije bilo razlika u preživljenju između dviju skupina bolesnika (17,36 prema 17,58 dana). Starija skupina bolesnika također je nesteroidne antireumatike uzimala rjeđe, a paracetamol češće od mlađe skupine. Uzimanje nižih doza opioida u starijih onkoloških bolesnika u palijativnoj skrbi nije rezultiralo lošijom razinom boli pa bi to mogao biti razuman pristup liječenju boli u ovoj skupini bolesnika

Antioxidant properties and biological activity of fruit wines

The fruit wines from blueberry were made by microvinification procedure. Wines were produced in the absence or presence of sugar and/or enzymatic preparation glycosidase (EPG). Selected phenolic acids were quantified using UPLC/MS-MS analysis. Total phenolic content (TPC) was determined by the Folin-Ciocalteu method. Also, 2,2-diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing ability of plasma (FRAP) methods were applied. The α-glucosidase inhibitory activity of blueberry wines was also investigated. Wines made with addition of sugar and EPG showed the best results. Phenolic profile and biological activity of blueberry wine depended from microvinification procedure which was used in the production

Trichinella infection in Serbia from 2011 to 2020: a success story in the field of One Health

In Serbia, modern pork production systems with implemented control measures, including the detection of Trichinella larvae in meat (ISO18743), have eliminated farmed pork from pigs slaughtered at abattoirs as a source of trichinellosis. Epidemiological data from 2011 to 2020 indicate that the number of human cases and the number of infected domestic pigs has decreased significantly. Over the years, pork was the most frequent source of human infection. Cases generally occurred in small family outbreaks, and the infection was linked to consumption of raw or undercooked pork from backyard pigs. In most of the outbreaks, T. spiralis was the aetiological agent of infection, but in 2016, a large outbreak was caused by consumption of uninspected wild boar meat containing T. britovi larvae. To achieve safe pork, it is important that consumers of pork from animals raised in backyard smallholdings and of wild game meat are properly educated about the risks associated with consumption of untested meat. Laboratories conducting Trichinella testing should have a functional quality assurance system to ensure competency of analysts and that accurate and repeatable results are achieved. Regular participation in proficiency testing is needed

Interventional ultrasound in acute urologic conditions

Ultrazvučna dijagnostika različitih, a poglavito hitnih uroloških bolesti, u današnje vrijeme dostigla je visoku razinu. Uz anamnezu i fizikalni pregled, ultrazvuk je postao nezaobilazan postupak prilikom obrade urološkog bolesnika te predstavlja moćno oružje za brzo i sigurno postavljanje točne dijagnoze. Osim neizmjerne pomoći pri dijagnostici uroloških bolesti, mnogi urolozi pridaju još veći značaj ultrazvuku kao najboljoj slikovnoj metodi za terapijske intervencijske postupke na mokraćnom sustavu. Ovakva važnost ultrazvuka zasnovana je na nizu prednosti u kojima će biti riječi u ovome članku. Intervencijski ultrazvuk u urologiji obuhvaća niz perkutanih zahvata kojima se prodire u mokraćni sustav pod kontrolom ultrazvuka, s primarnim ciljem brzog i efikasnog otklanjanja potencijalno smrtonosnih komplikacija podležećih bolesti. Naime, svaka bolest koja uzrokuje opstrukciju mokraćnog sustava s posljedičnom smetnjom normalnog otjecanja mokraće, bez obzira radi li se o zloćudnom ili dobroćudnom procesu, može dovesti do ozbiljnih stanja kao što su kompletna retencija mokraće, akutna bubrežna insuficijencija, hidronefroza i urosepsa. Takva stanja u pravilu zahtijevaju hitnu derivaciju mokraće retrogradnim ili perkutanim putem jer podležeću bolest, osim u rijetkim slučajevima, nije moguće u kratkom razdoblju u cijelosti otkloniti. Retrogradna derivacija mokraće često nije moguća radi neprolazne zapreke unutar mokraćnog sustava ili pritiska patološkog procesa izvana, pa perkutani intervencijski zahvat ostaje jedino rješenje. Perkutani zahvati najčešće se izvode na hidronefrotičnom bubregu. Hidronefroza označava proširenje kanalnog sustava bubrega koje, ako se adekvatno ne liječi, dovodi do atrofije bubrežnog parenhima. Naglašavamo kako u domenu urološkog interesa pripadaju i perkutani intervencijski zahvati na tkivima priležećim mokraćnom sustavu, npr. drenaže retroperitonejskih kolekcija.Ultrasound diagnostic of different urological diseases has reached a high level at the present time. Along with patient’s history and physical examination, ultrasound has become an unavoidable procedure when processing urological patients and represents a powerful tool to quickly and safely set the accurate diagnosis. Besides tremendous help in diagnostics of urological diseases, many urologists attach even greater importance to the ultrasound as the best imaging method for therapeutic interventional procedures on the urinary system. Interventional ultrasound in urology includes a number of percutaneous interventions which penetrate into the urinary system under ultrasound guidance, with a primary aim of fast and efficient removal of the potentially fatal complications of underlying diseases. Any obstruction of the urinary system with subsequent disturbance of normal urine flow can lead to serious conditions such as complete urinary retention, acute renal failure, hydronephrosis and urosepsis. Those conditions most often require urgent urinary diversion by retrograde or percutaneous way because the underlying disease, except in rare cases, cannot be entirely eliminated in a short period of time. Retrograde diversion of urine in often impossible due to impassable barrier within the urinary system or pressure of pathologic process from outside, so percutaneous interventional procedure remains the only solution. Hydronephrosis indicates a widening of the renal collecting system which, if mistreated, leads to the atrophy of renal parenchyma. We emphasize that percutaneous interventional procedures on the nearby urinary tract tissues also belong into a field of urologic interest, for example drainages of retroperitoneal collections

Interventional ultrasound in acute urologic conditions

Ultrazvučna dijagnostika različitih, a poglavito hitnih uroloških bolesti, u današnje vrijeme dostigla je visoku razinu. Uz anamnezu i fizikalni pregled, ultrazvuk je postao nezaobilazan postupak prilikom obrade urološkog bolesnika te predstavlja moćno oružje za brzo i sigurno postavljanje točne dijagnoze. Osim neizmjerne pomoći pri dijagnostici uroloških bolesti, mnogi urolozi pridaju još veći značaj ultrazvuku kao najboljoj slikovnoj metodi za terapijske intervencijske postupke na mokraćnom sustavu. Ovakva važnost ultrazvuka zasnovana je na nizu prednosti u kojima će biti riječi u ovome članku. Intervencijski ultrazvuk u urologiji obuhvaća niz perkutanih zahvata kojima se prodire u mokraćni sustav pod kontrolom ultrazvuka, s primarnim ciljem brzog i efikasnog otklanjanja potencijalno smrtonosnih komplikacija podležećih bolesti. Naime, svaka bolest koja uzrokuje opstrukciju mokraćnog sustava s posljedičnom smetnjom normalnog otjecanja mokraće, bez obzira radi li se o zloćudnom ili dobroćudnom procesu, može dovesti do ozbiljnih stanja kao što su kompletna retencija mokraće, akutna bubrežna insuficijencija, hidronefroza i urosepsa. Takva stanja u pravilu zahtijevaju hitnu derivaciju mokraće retrogradnim ili perkutanim putem jer podležeću bolest, osim u rijetkim slučajevima, nije moguće u kratkom razdoblju u cijelosti otkloniti. Retrogradna derivacija mokraće često nije moguća radi neprolazne zapreke unutar mokraćnog sustava ili pritiska patološkog procesa izvana, pa perkutani intervencijski zahvat ostaje jedino rješenje. Perkutani zahvati najčešće se izvode na hidronefrotičnom bubregu. Hidronefroza označava proširenje kanalnog sustava bubrega koje, ako se adekvatno ne liječi, dovodi do atrofije bubrežnog parenhima. Naglašavamo kako u domenu urološkog interesa pripadaju i perkutani intervencijski zahvati na tkivima priležećim mokraćnom sustavu, npr. drenaže retroperitonejskih kolekcija.Ultrasound diagnostic of different urological diseases has reached a high level at the present time. Along with patient’s history and physical examination, ultrasound has become an unavoidable procedure when processing urological patients and represents a powerful tool to quickly and safely set the accurate diagnosis. Besides tremendous help in diagnostics of urological diseases, many urologists attach even greater importance to the ultrasound as the best imaging method for therapeutic interventional procedures on the urinary system. Interventional ultrasound in urology includes a number of percutaneous interventions which penetrate into the urinary system under ultrasound guidance, with a primary aim of fast and efficient removal of the potentially fatal complications of underlying diseases. Any obstruction of the urinary system with subsequent disturbance of normal urine flow can lead to serious conditions such as complete urinary retention, acute renal failure, hydronephrosis and urosepsis. Those conditions most often require urgent urinary diversion by retrograde or percutaneous way because the underlying disease, except in rare cases, cannot be entirely eliminated in a short period of time. Retrograde diversion of urine in often impossible due to impassable barrier within the urinary system or pressure of pathologic process from outside, so percutaneous interventional procedure remains the only solution. Hydronephrosis indicates a widening of the renal collecting system which, if mistreated, leads to the atrophy of renal parenchyma. We emphasize that percutaneous interventional procedures on the nearby urinary tract tissues also belong into a field of urologic interest, for example drainages of retroperitoneal collections