Validacija upitnika za procenu dijetarnog unosa folata i analiza znanja, stavova i prakse farmaceutskog tima u vezi sa savetovanjem žena reproduktivne dobi o adekvatnom unosu ovog nutrijenta

Nutritive deficiencies are well-recognized preventable risk factors for the development of congenital anomalies and other adverse pregnancy outcomes. Scientific progress in the comprehension of congenital anomalies has led to the conclusion that optimally balanced maternal diet with adequate intake of macro- and micronutrients can contribute to reducing the incidence of these disorders. Protective effect of the periconceptional folic acid supplementation in reducing the risk for both occurrence and recurrence of neural tube defects (NTDs) is scientifically confirmed through many observational and interventional studies. Folate derivatives are involved as coenzymes in the single-carbon units’ transfer in metabolism of amino acids and synthesis and reparation of nucleic acids. Accordingly, the role of this water-soluble B9 vitamin is of special importance for intense cell maturation, division and proliferation during embryogenesis. However, regardless the unequivocal epidemiological evidence, achieved scientific consensus on the folic acid benefits in ensuring healthy offspring, and the fact that many health authorities officially recommended the use of folic acid prior to conception and during early phases of pregnancy, numerous studies revealed suboptimal intake of this essential nutrient among women of reproductive age. The variability of the situation in different countries is affected by a number of factors such as: the awareness of women of prevention measures for NTDs; the existence, application and coverage of strategies for improving folate intake and status in the targeted population group; the availability and affordability of folic acid supplements; and finally, the population exposure to folic acid- fortified foods. Nutritional status assessment is nowadays recognized as an important part of medical care at individual and population level. In facing the challenge of achieving folate adequacy, the first step is reliable and objective nutritional assessment performed with standardized and validated instruments adapted to specific characteristics of the population of interest. Therefore, the aim of the first study in the present doctoral dissertation was to develop and validate the Food Frequency Questionnaire for the assessment of folate intake (F-FFQ) among women of reproductive age in Serbia. The FFQ for folate (F-FFQ) was developed by combining a validated FFQ for folate in Croatia region with the NCI/Block Health Habits and History Questionnaire with further adaptation based on inclusion of folate-rich traditional foods consumed in Serbia. The F-FFQ was designed to capture habitual intake over the previous three months and was self-administered in the presence of trained dietitians...Nutritivne deficijencije prepoznate su kao jedan od glavnih preventabilnih faktora rizika za nastanak kongenitalnih anomalija i drugih neželjenih ishoda trudnoće. Naučni napredak u oblasti etiopatogeneze kongenitalnih anomalija doveo je do zaključka da je optimalno izbalansirana ishrana majki uz adekvatan unos makro i mikronutrijenata izuzetno važna za obezbeđivanje normalnog embrionalnog razvoja. Zaštitni efekat perikoncepcijske primene suplemenata folne kiseline u redukciji rizika od nastanka i rekurence defekata nervne cevi naučno je potvrđen mnogim obzervacionim i interventnim studijama. Folati učestvuju kao koenzimi u transferu monougljeničnih grupa u reakcijama metabolizma aminokiselina i sintezi i reparaciji nukleinskih kiselina, pa je uloga ovog hidrosolubilnog B9 vitamina posebno značajna za uspešno odvijanje intenzivne ćelijske deobe i proliferacije tokom embriogeneze. Ipak, uprkos postignutom naučnom konsenzusu o koristima folne kiseline u obezbeđivanju zdravog potomstva i činjenici da su mnoga regulatorna tela u oblasti zdravlja izdala preporuke o primeni folne kiseline u periodu planiranja začeća i ranim fazama trudnoće, studije ukazuju da je među ženama reproduktivne dobi unos ovog esencijalnog nutrijenta i dalje suboptimalan. Na varijabilnost situacije u različitim zemljama utiče niz faktora kao što su: stepen obaveštenosti žena o merama prevencije defekata nervne cevi, postojanje, primena i obuhvat strategija za unapređenje unosa i statusa folata u ciljnoj populacionoj grupi, dostupnost i priuštivost suplemenata folne kiseline i konačno, izloženost stanovništva namirnicama koje su fortifikovane ovim vitaminom. Procena nutritivnog statusa danas je prepoznata kao važan deo zdravstvene nege na individualnom i populacionom nivou. Prvi korak u suočavanju sa izazovom ostvarivanja adekvatnog unosa folata kao esencijalnih nutrijenata je pouzdana i objektivna procena nutritivnog statusa zasnovana na primeni standardizovanih, validiranih instrumenata, koji su prilagođeni specifičnim karakteristikama populacije od interesa. Iz toga je proistekao prvi cilj ove doktorske disertacije – razvoj i evaluacija validnosti Upitnika o učestalosti konzumiranja namirnica za procenu dijetarnog unosa folata kod žena reproduktivne dobi u Republici Srbiji (F-FFQ). U razvoju upitnika primenjena je kombinacija validiranog upitnika za procenu unosa folata iz Republike Hrvatske i NCI/ Block Health Habits and History Questionnaire uz dodatnu adaptaciju odnosno dopunu lokalno dostupnim namirnicama i tradicionalnim jelima iz Srbije. Analizu pregledne (eng. face validity) i sadržajne validnosti (eng. content validity) upitnika sprovela je grupa eksperata iz Centra izuzetne vrednosti u oblasti istraživanja ishrane i metabolzma Instituta za medicinska istraživanja, Univerziteta u Beogradu..

Validation of a questionnaire for folate dietary intake assessment and analysis of knowledge, attitudes and practice of pharmacy team members with regards to counseling women of reproductive age on adequate folate intake

Nutritivne deficijencije prepoznate su kao jedan od glavnih preventabilnih faktora rizika za nastanak kongenitalnih anomalija i drugih neželjenih ishoda trudnoće. Naučni napredak u oblasti etiopatogeneze kongenitalnih anomalija doveo je do zaključka da je optimalno izbalansirana ishrana majki uz adekvatan unos makro i mikronutrijenata izuzetno važna za obezbeđivanje normalnog embrionalnog razvoja. Zaštitni efekat perikoncepcijske primene suplemenata folne kiseline u redukciji rizika od nastanka i rekurence defekata nervne cevi naučno je potvrđen mnogim obzervacionim i interventnim studijama. Folati učestvuju kao koenzimi u transferu monougljeničnih grupa u reakcijama metabolizma aminokiselina i sintezi i reparaciji nukleinskih kiselina, pa je uloga ovog hidrosolubilnog B9 vitamina posebno značajna za uspešno odvijanje intenzivne ćelijske deobe i proliferacije tokom embriogeneze. Ipak, uprkos postignutom naučnom konsenzusu o koristima folne kiseline u obezbeđivanju zdravog potomstva i činjenici da su mnoga regulatorna tela u oblasti zdravlja izdala preporuke o primeni folne kiseline u periodu planiranja začeća i ranim fazama trudnoće, studije ukazuju da je među ženama reproduktivne dobi unos ovog esencijalnog nutrijenta i dalje suboptimalan. Na varijabilnost situacije u različitim zemljama utiče niz faktora kao što su: stepen obaveštenosti žena o merama prevencije defekata nervne cevi, postojanje, primena i obuhvat strategija za unapređenje unosa i statusa folata u ciljnoj populacionoj grupi, dostupnost i priuštivost suplemenata folne kiseline i konačno, izloženost stanovništva namirnicama koje su fortifikovane ovim vitaminom. Procena nutritivnog statusa danas je prepoznata kao važan deo zdravstvene nege na individualnom i populacionom nivou. Prvi korak u suočavanju sa izazovom ostvarivanja adekvatnog unosa folata kao esencijalnih nutrijenata je pouzdana i objektivna procena nutritivnog statusa zasnovana na primeni standardizovanih, validiranih instrumenata, koji su prilagođeni specifičnim karakteristikama populacije od interesa. Iz toga je proistekao prvi cilj ove doktorske disertacije – razvoj i evaluacija validnosti Upitnika o učestalosti konzumiranja namirnica za procenu dijetarnog unosa folata kod žena reproduktivne dobi u Republici Srbiji (F-FFQ). U razvoju upitnika primenjena je kombinacija validiranog upitnika za procenu unosa folata iz Republike Hrvatske i NCI/ Block Health Habits and History Questionnaire uz dodatnu adaptaciju odnosno dopunu lokalno dostupnim namirnicama i tradicionalnim jelima iz Srbije. Analizu pregledne (eng. face validity) i sadržajne validnosti (eng. content validity) upitnika sprovela je grupa eksperata iz Centra izuzetne vrednosti u oblasti istraživanja ishrane i metabolzma Instituta za medicinska istraživanja, Univerziteta u Beogradu...Nutritive deficiencies are well-recognized preventable risk factors for the development of congenital anomalies and other adverse pregnancy outcomes. Scientific progress in the comprehension of congenital anomalies has led to the conclusion that optimally balanced maternal diet with adequate intake of macro- and micronutrients can contribute to reducing the incidence of these disorders. Protective effect of the periconceptional folic acid supplementation in reducing the risk for both occurrence and recurrence of neural tube defects (NTDs) is scientifically confirmed through many observational and interventional studies. Folate derivatives are involved as coenzymes in the single-carbon units’ transfer in metabolism of amino acids and synthesis and reparation of nucleic acids. Accordingly, the role of this water-soluble B9 vitamin is of special importance for intense cell maturation, division and proliferation during embryogenesis. However, regardless the unequivocal epidemiological evidence, achieved scientific consensus on the folic acid benefits in ensuring healthy offspring, and the fact that many health authorities officially recommended the use of folic acid prior to conception and during early phases of pregnancy, numerous studies revealed suboptimal intake of this essential nutrient among women of reproductive age. The variability of the situation in different countries is affected by a number of factors such as: the awareness of women of prevention measures for NTDs; the existence, application and coverage of strategies for improving folate intake and status in the targeted population group; the availability and affordability of folic acid supplements; and finally, the population exposure to folic acid- fortified foods. Nutritional status assessment is nowadays recognized as an important part of medical care at individual and population level. In facing the challenge of achieving folate adequacy, the first step is reliable and objective nutritional assessment performed with standardized and validated instruments adapted to specific characteristics of the population of interest. Therefore, the aim of the first study in the present doctoral dissertation was to develop and validate the Food Frequency Questionnaire for the assessment of folate intake (F-FFQ) among women of reproductive age in Serbia. The FFQ for folate (F-FFQ) was developed by combining a validated FFQ for folate in Croatia region with the NCI/Block Health Habits and History Questionnaire with further adaptation based on inclusion of folate-rich traditional foods consumed in Serbia. The F-FFQ was designed to capture habitual intake over the previous three months and was self-administered in the presence of trained dietitians..

Validation of a questionnaire for folate dietary intake assessment and analysis of knowledge, attitudes and practice of pharmacy team members with regards to counseling women of reproductive age on adequate folate intake

Nutritivne deficijencije prepoznate su kao jedan od glavnih preventabilnih faktora rizika za nastanak kongenitalnih anomalija i drugih neželjenih ishoda trudnoće. Naučni napredak u oblasti etiopatogeneze kongenitalnih anomalija doveo je do zaključka da je optimalno izbalansirana ishrana majki uz adekvatan unos makro i mikronutrijenata izuzetno važna za obezbeđivanje normalnog embrionalnog razvoja. Zaštitni efekat perikoncepcijske primene suplemenata folne kiseline u redukciji rizika od nastanka i rekurence defekata nervne cevi naučno je potvrđen mnogim obzervacionim i interventnim studijama. Folati učestvuju kao koenzimi u transferu monougljeničnih grupa u reakcijama metabolizma aminokiselina i sintezi i reparaciji nukleinskih kiselina, pa je uloga ovog hidrosolubilnog B9 vitamina posebno značajna za uspešno odvijanje intenzivne ćelijske deobe i proliferacije tokom embriogeneze. Ipak, uprkos postignutom naučnom konsenzusu o koristima folne kiseline u obezbeđivanju zdravog potomstva i činjenici da su mnoga regulatorna tela u oblasti zdravlja izdala preporuke o primeni folne kiseline u periodu planiranja začeća i ranim fazama trudnoće, studije ukazuju da je među ženama reproduktivne dobi unos ovog esencijalnog nutrijenta i dalje suboptimalan. Na varijabilnost situacije u različitim zemljama utiče niz faktora kao što su: stepen obaveštenosti žena o merama prevencije defekata nervne cevi, postojanje, primena i obuhvat strategija za unapređenje unosa i statusa folata u ciljnoj populacionoj grupi, dostupnost i priuštivost suplemenata folne kiseline i konačno, izloženost stanovništva namirnicama koje su fortifikovane ovim vitaminom. Procena nutritivnog statusa danas je prepoznata kao važan deo zdravstvene nege na individualnom i populacionom nivou. Prvi korak u suočavanju sa izazovom ostvarivanja adekvatnog unosa folata kao esencijalnih nutrijenata je pouzdana i objektivna procena nutritivnog statusa zasnovana na primeni standardizovanih, validiranih instrumenata, koji su prilagođeni specifičnim karakteristikama populacije od interesa. Iz toga je proistekao prvi cilj ove doktorske disertacije – razvoj i evaluacija validnosti Upitnika o učestalosti konzumiranja namirnica za procenu dijetarnog unosa folata kod žena reproduktivne dobi u Republici Srbiji (F-FFQ). U razvoju upitnika primenjena je kombinacija validiranog upitnika za procenu unosa folata iz Republike Hrvatske i NCI/ Block Health Habits and History Questionnaire uz dodatnu adaptaciju odnosno dopunu lokalno dostupnim namirnicama i tradicionalnim jelima iz Srbije. Analizu pregledne (eng. face validity) i sadržajne validnosti (eng. content validity) upitnika sprovela je grupa eksperata iz Centra izuzetne vrednosti u oblasti istraživanja ishrane i metabolzma Instituta za medicinska istraživanja, Univerziteta u Beogradu...Nutritive deficiencies are well-recognized preventable risk factors for the development of congenital anomalies and other adverse pregnancy outcomes. Scientific progress in the comprehension of congenital anomalies has led to the conclusion that optimally balanced maternal diet with adequate intake of macro- and micronutrients can contribute to reducing the incidence of these disorders. Protective effect of the periconceptional folic acid supplementation in reducing the risk for both occurrence and recurrence of neural tube defects (NTDs) is scientifically confirmed through many observational and interventional studies. Folate derivatives are involved as coenzymes in the single-carbon units’ transfer in metabolism of amino acids and synthesis and reparation of nucleic acids. Accordingly, the role of this water-soluble B9 vitamin is of special importance for intense cell maturation, division and proliferation during embryogenesis. However, regardless the unequivocal epidemiological evidence, achieved scientific consensus on the folic acid benefits in ensuring healthy offspring, and the fact that many health authorities officially recommended the use of folic acid prior to conception and during early phases of pregnancy, numerous studies revealed suboptimal intake of this essential nutrient among women of reproductive age. The variability of the situation in different countries is affected by a number of factors such as: the awareness of women of prevention measures for NTDs; the existence, application and coverage of strategies for improving folate intake and status in the targeted population group; the availability and affordability of folic acid supplements; and finally, the population exposure to folic acid- fortified foods. Nutritional status assessment is nowadays recognized as an important part of medical care at individual and population level. In facing the challenge of achieving folate adequacy, the first step is reliable and objective nutritional assessment performed with standardized and validated instruments adapted to specific characteristics of the population of interest. Therefore, the aim of the first study in the present doctoral dissertation was to develop and validate the Food Frequency Questionnaire for the assessment of folate intake (F-FFQ) among women of reproductive age in Serbia. The FFQ for folate (F-FFQ) was developed by combining a validated FFQ for folate in Croatia region with the NCI/Block Health Habits and History Questionnaire with further adaptation based on inclusion of folate-rich traditional foods consumed in Serbia. The F-FFQ was designed to capture habitual intake over the previous three months and was self-administered in the presence of trained dietitians..

Community Pharmacists' Attitudes and Professional Practice in Relation to the Patient Safety Incidents

Background: Medicines dispensing is an error-prone activity, therefore potentially jeopardizing patient safety. This study aimed to assess the community pharmacists' attitudes towards the causes of dispensing errors and preventive measures, as well as their practice in incidents reporting. Materials and Methods: A cross-sectional survey was performed by distributing an adopted and validated questionnaire to a nationwide sample of community pharmacists in Serbia. The questionnaire included sections related to the participants' socio-demographic characteristics, their attitudes towards factors causing dispensing errors and corrective actions, as well as their practice in reporting. Statistical analyses were conducted using SPSS Statistics software ver. 21.0. The associations between categorical variables were analyzed using Chi-square test. Results: The study included 1,004 participants, mainly female (94.9%), with the mean age 40.9 +/- 9.9 years and mean work experience 14.3 +/- 10.0 years. More than a third of the participants (35.4%) indicated an increasing risk of dispensing errors. The main causes included illegible prescriber's handwriting (44.3%) and interruptions during dispensing (39.2%), while the major corrective actions were providing pharmacists with education in clinical pharmacy (71%) and reducing the interruptions during dispensing (63.9%). The majority of respondents (85.2%) stated that they routinely reported dispensing incidents. However, even 16.5% of them admitted to having fear sometimes or always. Additionally, only 58.1% of participants would use voluntary dispensing error reporting system. Conclusion: Serbian community pharmacists are aware of the existing risk in medicines dispensing and the corrective actions identified should be put into practice so as to manage them prospectively. Although the results indicate good practice in incidents reporting, conducting tailored educations and building of safety culture is necessary to improve patient safety

Association of meal timing with dietary quality in a Serbian population sample

Background: The world-wide adoption of Western lifestyles and eating patterns is associated with adverse effects on nutrient intakes. Here we evaluated the relationships between timing of meals and diet quality in Serbia, a Balkan country with a traditional eating pattern that includes the largest meal of the day as a late lunch. Methods: A dietary survey was done in the Republic of Serbia using a nationally-representative sample of 74 children and 260 non-pregnant adults. Nutrient intakes were calculated from two 24-h recalls. A Dietary Quality Score (DQS) enumerated how many European Union (EU) Science Hub recommendations were met for fruit and vegetables, fiber, saturated fat, sodium, and sugar. We evaluated whether the timing of dietary intakes is associated with DQS and body mass index. Results: The dietary intakes of children ages 10–17 and adults were similar and were high in total fat intake, with an average of 40% of energy from fat. Mean fruit and vegetable intakes of 473 g/day in adults exceeded the minimal EU recommendation. The most worrisome aspects of the Serbian diet were high intakes of saturated fat, sugar and sodium. Lunch was the meal with the highest mean content of energy, followed by breakfast and dinner, and the average time for lunch was 15:15. Consumption of a higher percentage of calories before 16:00 in adults was associated with higher fruit and vegetable intakes and with higher DQS. The subgroup of adults consuming their largest meal after 20:00 had a lower mean age, more men, and a larger percentage was employed outside of the home. There were no associations of meal timing with BMI, but the prevalence of obesity in this population sample was only 13%. Conclusions: These results indicate that an earlier meal pattern, and especially consuming the largest meal of the day earlier in the day, was associated with better quality diets. Public health efforts are needed to preserve nutrient intakes as the population shifts away from the traditional Serbian eating pattern. Long-term, deterioration of nutrient intakes could contribute to the increasing rates of obesity that have been observed in Serbia and world-wide

Suplementacija magnezijuma i status gvožđa kod studentkinja - studija intervencije

Abstract Background: Literature data indicate the benefit of magnesium (Mg) supplementation. The aim of this study was to examine the effect of short-term Mg supplementation on iron status in healthy female participants. Methods: One hundred healthy female students of the University of Belgrade - Faculty of Pharmacy participated the study during eleven intervention days. Students ingested Mg preparations with the same dose of the active substance. The analysis included the measurement of serum iron, unsaturated iron binding capacity (UIBC), total iron binding capacity (TIBC), total Mg (tMg), ionized Mg (iMg), complete blood count, met-, carboxy- and oxy-haemoglobin (metHgb, COHgb, O2Hgb). Transferrin concentrations and percentage of transferrin saturation (SAT) were calculated manually. The association among the analyzed biochemical parameters was examined using polynomial regression. A principal component analysis (PCA) was used for the evaluation of interdependence between the analyzed parameters. Results: A statistically significant trend for change in O2Hgb (%) by tertiles of iMg concentrations was found (P = 0.029). Serum tMg reached significant positive correlation with the SAT at concentration levels greater than 0.9 mmol/L, after 11 days of intervention (R2=0.116). Ionized Mg in a concentration higher than 0.6 mmol/L is positively correlated with SAT and serum Fe (R2=0.214; 0.199, respectively). PCA revealed variability of 64.7% for two axes after 11 days. Conclusions: Mg supplementation leads to an improvement in the certain iron status parameters even in individuals with optimal levels of these indices. However, caution should be exercised when supplementing Mg, and laboratory monitoring of the interaction is required.Uvod: Literaturni podaci ukazuju na benefit suplementacije magnezijumom (Mg). Cilj ove studije bio je da se ispita uticaj kratkotrajne suplementacije Mg na status gvožđa kod zdravih žena. Metode: Sto zdravih studentkinja Univerzitet u Beogradu - Farmaceutskog fakulteta je učestvovalo u istraživanju tokom jedanaest dana intervencije. Studenti su uzimali preparate Mg sa istom dozom aktivne supstance. U serumu je određivano gvožđe, nezasićen kapacitet vezivanja gvožđa (UIBC), ukupan kapacitet vezivanja gvožđa (TIBC), ukupan Mg (tMg), jonizovni Mg (iMg), kompletna krvna slika, met-, karboksiioksihemoglobin (metHgb, COHgb, O2Hgb). Transferin i saturacija transferina (SAT) su izračunati ručno. Povezanost analiziranih biohemijskih parametara je ispitana pomoću polinomalne regresije. Za procenu međuzavisnosti između analiziranih parametara korišćena je analiza glavnih komponenti (PCA). Rezultati: Utvrđen je statistički značajan trend promene O2Hgb (%) po tertilima koncentracija iMg (P = 0,029). Ukupan Mg je dostigao značajnu pozitivnu korelaciju sa SAT pri koncentracijama većim od 0,9 mmol/L, nakon 11 dana intervencije (R2 = 0,116). Jonizovani Mg u koncentraciji većoj od 0,6 mmol/L pozitivno korelira sa SAT i gvožđem (R2 = 0,214; 0,199, redom). PCA analizom je pokazana varijabilnost od 64,7% za dve ose nakon 11 dana. Zaključak: Suplementacija Mg dovodi do poboljšanja određenih parametara statusa gvožđa čak i kod pojedinaca sa optimalnim nivoima ovih parametara. Međutim treba biti oprezan pri suplementaciji Mg, a dodatno je neophodno i laboratorijsko praćenje ovih interakcija

Perikoncepcijska suplementacija folnom kiselinom - znanja, stavovi i savetodavna praksa farmaceuta i farmaceutskih tehničara u Srbiji

Background/Aim. The protective effect of periconceptional folic acid supplementation in reducing the risk of neural tube defects (NTDs) and other adverse pregnancy outcomes has been scientifically confirmed. The present study aimed to assess knowledge, attitudes, and practice (KAP) of community pharmacists and pharmacy technicians with regards to counselling women of reproductive age on adequate folate intake. Methods. The cross-sectional study was conducted among the nationwide stratified sample of pharmacists and pharmacy technicians, practicing in both private and state-owned community pharmacies in Serbia. The detailed literature review, expert consultation and pre-testing were employed in the questionnaire development. The descriptive and inferential statistical analyses were performed using the SPSS software ver. 22. Results. Among 730 survey participants, 96.6% correctly identified types of deformities that could be prevented by folic acid and 77.0% recognized recommended dosage for women capable of becoming pregnant. However, fewer were able to recognize the optimal timing for folic acid supplementation (61.1%) and the proper dose for the NTD recurrence prevention (42.9 %). While 43.2% of pharmacy technicians thought that it was not their responsibility to provide a counselling concerning the measures for the prevention of congenital anomalies, only 4.7% of licensed pharmacists and none of the interns were of that opinion (χ2 = 198.287; df = 4; p lt 0.001). The majority of respondents (54.7%) reported provision of informative consultation concerning folic acid once a week, or few times a month, while only 10 stated to do so on a daily basis. In addition, based on self-report, only 36.7% of participants communicates information and advice regarding adequate folate status at their own initiative, while the rest addresses this topic only on the patients request, i.e., reactively. Conclusion. Although participants acknowledged the importance of their role in preconception health promotion, our findings revealed certain knowledge gaps as well as dominantly reactive counselling practice. Tailored educational interventions and professional support are needed to improve the engagement of community pharmacy personnel in this area of public health.Uvod/Cilj. Naučno je potvrđen zaštitni efekat primene suplemenata folne kiseline u perikoncepcijskom periodu u redukciji rizika od nastanka defekata nervne cevi (DNC) i drugih neželjenih ishoda trudnoće. Cilj ove studije bio je ispitivanje znanja, stavova i prakse farmaceuta i farmaceutskih tehničara zaposlenih u javnim apotekama u vezi sa savetovanjem žena reproduktivne dobi o adekvatnom unosu folata. Metode. Sprovedenom studijom preseka obuhvaćen je nacionalni stratifikovani uzorak farmaceuta i farmaceutskih tehničara zaposlenih u državnim i privatnim javnim apotekama u Srbiji. Detaljan pregled literature, ekspertske konsultacije i pre-testiranje primenjeni su u procesu razvoja upitnika. Deskriptivna i inferencijalna statistička analiza realizovane su primenom SPSS softvera ver. 22. Rezultati. Od 730 ispitanika, 96,6% tačno je identifikovalo vrste deformiteta koji se mogu prevenirati primenom folne kiseline, a 77,0% prepoznalo je preporučenu dozu za žene sposobne da ostanu u drugom stanju. Ipak, manji udeo ispitanika prepoznao je optimalni vremenski okvir za suplementaciju (61,1%), kao i adekvatnu dozu za prevenciju rekurence DNC (42,9%). Dok je 43,2% farmaceutskih tehničara izrazilo uverenje da nije njihova obaveza da sprovode savetovanje o merama za prevenciju kongenitalnih anomalija, takvo mišljenje imalo je samo 4,7% licenciranih farmaceuta i nijedan farmaceut-stažer (χ2 = 198.287; df = 4; p lt 0,001). Većina učesnika studije (54,7%) izjavila je da pruža informativne konsultacije u vezi folne kiseline jednom nedeljno ili nekoliko puta mesečno, a samo 10 ispitanika tvrdilo je da to čini svakodnevno. Dodatno, na osnovu sopstvenog izveštaja, samo 36,7% ispitanika pruža savete i informacije o adekvatnom statusu folata na sopstvenu inicijativu, dok ostatak ovu temu pominje samo na zahtev pacijenta tj. reaktivno. Zaključak. Iako su ispitanici prepoznali značaj sopstvene uloge u promociji zdravlja u prekoncepcijskom periodu, naši rezultati ukazali su na određene propuste u znanju i dominantno reaktivan pristup savetovanju. Prilagođene edukativne intervencije i profesionalna podrška neophodni su za unapređenje javnozdravstvenog angažovanja farmaceutskog tima iz javnih apoteka u ovoj oblasti

Is There a Link between Zinc Intake and Status with Plasma Fatty Acid Profile and Desaturase Activities in Dyslipidemic Subjects?

The prevalence of obesity and dyslipidemia has increased worldwide. The role of trace elements in the pathogenesis of these conditions is not well understood. This study examines the relationship between dietary zinc (Zn) intake and plasma concentrations of Zn, copper (Cu) and iron (Fe) with lipid profile indicators, fatty acid composition in plasma phospholipids and desaturase enzyme activities in a dyslipidemic population. The role of the newly proposed biomarker of Zn status, the linoleic:dihomo-gama-linolenic acid (LA:DGLA) ratio, in predicting Zn status of dyslipidemic subjects has been explored. The study included 27 dyslipidemic adults, 39-72 years old. Trace elements were determined using atomic absorption spectrometry and fatty acid composition by a liquid gas chromatography. Desaturase activities were calculated from product-precursor fatty acid ratios. Dietary data were obtained using 24 h recall questionnaires. Insufficient dietary intake of Zn, low plasma Zn concentrations and an altered Cu:Zn ratio is related to modified fatty acid profile in subjects with dyslipidemia. Plasma Zn status was associated with obesity. There was no correlation between dietary Zn intake and plasma Zn status. The LA:DGLA ratio was inversely linked to dietary Zn intake. Cu, in addition to Zn, may directly or indirectly, affect the activity of desaturase enzymes

Prognostic Significance of Systemic Inflammation Markers in Testicular and Penile Cancer: A Narrative Review of Current Literature

In contemporary clinical practice, biomarkers are indispensable in the assessment and management of oncological patients. Although established serum tumor markers (beta human chorionic gonadotropin (bHCG), alpha fetoprotein (AFP), and lactate dehydrogenase (LDH)) have an indisputably important role in the management of patients with testicular cancer (TC), the application of these tumor markers may be accompanied with certain limitations, implying the need for additional biomarkers. Contrary to TC, there is a lack of established serological biomarkers for penile cancer (PC) and the management of this urological malignancy is based on multiple clinicopathological parameters. Therefore, the identification and rigorous analytical and clinical validation of reliable biomarkers are considered pivotal for improving PC management. Inflammation may be associated with all stages of oncogenesis, from initial neoplastic transformation to angiogenesis, tissue invasion, and metastasis. Accordingly, an array of inflammation-related indices have gained increasing attention as emerging predictors of oncological outcomes. The clinical usefulness of systemic inflammation markers was reported in many urological and non-urological malignancies. The aim of this narrative review is to summarize current scientific data regarding the prognostic and predictive significance of systemic inflammation markers in TC and PC patients