Background: Although scientometry gradually became prevalent way of measuring one’s research output, there are many inherent drawbacks in main indices that are used: impact factor, number of citations, number of published papers and Hirsch’s index. Objective: The aim of this study was to analyze effects of inflated co-authorship on values of scientometric indices among authors in biomedicine who participated in published papers with more than 30 co-authors. Methods: The study was of cross-sectional type, based on 100 publications randomly extracted from the MEDLINE database. The inclusion criterion was publication with more than 30 authors. The studies with topics not related to humans were excluded from further analysis. Results: On average about 10% of papers published by the surveyed authors had more than 30 co-authors, but these papers brought more than 40% of all citations and more than 40% of Hirsch’s index attributed to these authors. The duration of scientific activity was well correlated to number of citations, Hirsch’s index and the number of publications themselves with 30 or less co-authors, while the correlation did not exist with number of citations, Hirsch’s index and the number of publications with more than 30 authors. In summary, publications with > 30 authors carry more scientometric points than publications with less co-authors, and the researchers with shorter scientific activity had larger scientometric benefit from publications with more than 30 authors than senior researchers. Conclusion: Unjustified and prolific co-authorship is one of methods for inflation of scientometric indices that are not further reflecting true quality of research output of an individual. Further improvement of scientometric indicators may prevent unjustified co-authorship if it reflects the work invested in a research result.

ABSTRACT Objectives: Our aim was to determine risk factors for and frequency of potential drug-drug interactions (pDDIs) among hospitalized patients with myasthenia gravis (MG). Methods: This was a retrospective cross-sectional study of the-first time hospitalized MG patients or patients hospitalized because of the exacerbation of MG at the Neurology Clinic of the Clinical Center of Serbia, Belgrade. Medical records and discharge summaries of hospitalized MG patients over a 10-year period were reviewed. The pDDIs were identified by means of Micromedex, and multivariate regression methods were used to reveal potential predictors of number of pDDIs per patient. Results: The study included 687 patients with MG. In total, 2041 pDDIs were detected in 608 (88.5%) patients. Among the discovered pDDIs, 329 different pDDIs were observed. The most frequent pDDIs were pyridostigmine-prednisone (487patients/70.9%) and aspirin-prednisone (90 patients/13.1%) classified as moderate, and enalapril-potassium chloride (71patients/10.3%) classified as major pDDI. Five drugs (aspirin, insulin, prednisone, cyclosporine, metformin) were responsible for 22.6% of different pDDIs. Dyspnea, generalized form of MG, diabetes mellitus, hypertension, total number of drugs-used, use of antiplatelets were identified as the relevant risk factors for total number of pDDIs (R2 = 0.626,F = 73.797, p < 0.001), while age of patients and history of cancer were inversely correlated with such an outcome. Conclusion: The frequency of the pDDIs in hospitalized MG patients is high, and adversely influenced by dyspnea, generalized MG, diabetes mellitus, hypertension, total number of drugs-used and use of antiplatelets.

ABSTRACT Introduction The need to individualize a drug dosage and adjust it to a patient’s physiological and/or pathophysiological status is rarely satisfied in routine clinical practice, primarily because of complexity of the adjustment task. Areas covered The aim of this article is to shed light to basic principles of drug dosage individualization in the most frequent clinical states that affect pharmacokinetics of drugs. The principles are derived from published clinical studies conducted on diverse patient populations, using non-compartmental pharmacokinetic model. Expert opinion Simple, but sufficiently exact, way to calculate appropriate drug dose for a patient is the one based on target average steady-state concentration and non-compartmental pharmacokinetic model. If target steady-state drug concentration and dosage interval are considered fixed, maintenance dose could be adjusted on the basis of expected changes of total drug clearance and bioavailability, while loading dose should be related to changes of volume of distribution and bioavailability. Relative increase or decrease of these pharmacokinetic parameters in regard to normal values in healthy persons is translated to relative (percentual) increase or decrease of maintenance and loading doses recommended in the drug monograph.

ABSTRACT The aim of this study was to establish an evidence-based guideline for the antibiotic treatment of Corynebacterium striatum infections. Several electronic databases were systematically searched for clinical trials, observational studies or individual cases on patients of any age and gender with systemic inflammatory response syndrome, harboring C. striatum isolated from body fluids or tissues in which it is not normally present. C. striatum had to be identified as the only causative agent of the invasive infection, and its isolation from blood, body fluids or tissues had to be confirmed by one of the more advanced diagnostic methods (biochemical methods, mass spectrometry and/or gene sequencing). This systematic review included 42 studies that analyzed 85 individual cases with various invasive infections caused by C. striatum. More than one isolate of C. striatum exhibited 100% susceptibility to vancomycin, linezolid, teicoplanin, piperacillin-tazobactam, amoxicillin-clavulanate and cefuroxime. On the other hand, some strains of this bacterium showed a high degree of resistance to fluoroquinolones, to the majority majority of β-lactams, aminoglycosides, macrolides, lincosamides and cotrimoxazole. Despite the antibiotic treatment, fatal outcomes were reported in almost 20% of the patients included in this study. Gene sequencing methods should be the gold standard for the identification of C. striatum, while MALDI-TOF and the Vitek system can be used as alternative methods. Vancomycin should be used as the antibiotic of choice for the treatment of C. striatum infections, in monotherapy or in combination with piperacillin-tazobactam. Alternatively, linezolid, teicoplanin or daptomycin may be used in severe infections, while amoxicillin-clavulanate may be used to treat mild infections caused by C. striatum.

The article's abstract is not available.  

For many decades English language was dominant in international scientific communications, but during the last decade it threatens to become the only language for communicating medical science at international level. The aim of this article was to make an overview of publication practices in regard to language of publication of MEDLINE-referenced articles from European countries in year 2020. Scientific publications referenced in MEDLINE database during year 2020 were chosen for analysis. The inclusion criteria were publications affiliated with one of European countries, published in either English or national languages of those countries. The countries with less than 100.000 inhabitants were excluded from the study. Only 11 of 38 European countries had any number of medical publications in national language that were referenced in MEDLINE; the authors from twenty-seven European countries completely stopped publishing in national language at international journals. While economic strenght of a country was strongly correlated with number of international publications per 100.000 inhabitants, the correlation with international papers published in national languages was much less pronounced. Researchers from majority of European countries are publishing their studies predominantly or only in international medical journals printed in English language. Additional efforts should be made in the future to promote publishing in national languages.

Focal epilepsy is one of the most frequent specific type of epilepsies, with 30% treatment-resistant patients. There are several directions researchers can follow to improve existing treatment of focal epilepsy: synthesis of new compounds with anticonvulsant activity, repurposing drugs approved for other indications, finding drugs targeted to specific genetic and biochemical defects that underlie focal epilepsy syndromes, development of viral vectors for specific gene therapy, creation of devices and methods for suppression of seizures by electrostimulation and development of methods to increase safety of epilepsy surgery. Improvement of efficacy and safety of current therapies is necessary, as well as developing targeted treatment of genetic epilepsy syndromes that will not only suppress seizures, but stop further epileptogenesis.

ABSTRACT Optimal vitamin D status is very important for reflecting not only bone but overall woman’s health. The aim of the study was to determine pharmacokinetic variability of 25-hydroxy vitamin D, to reveal and quantify the most significant factors that affect its variability in the population of healthy non-menopausal women using the population pharmacokinetic (PopPK) approach. The study population consisted of 74 healthy reproductive women aged from 35 to 50 years, without the use of any supplement. A population pharmacokinetics analysis was conducted using a nonlinear mixed-effects model software. A total of 35 factors were assessed: demographic, clinical, biochemical data and lifestyle factors. The average age and bodyweight of our participants were 40.11 ± 4.35 years 65.30 ± 6.80 kg, respectively. The observed mean serum concentration of 25-hydroxy vitamin D was 26.51 ± 13.49 ng/mL with a wide range of 6.97 to 59.89 ng/mL. Development final PopPK model of the clearance of 25-hydroxy vitamin D showed that only the average daily dose of vitamin D intake from food had a significant influence, with a magnitude of its effects of 0.00401. These results could help when individualizing vitamin D intake in the form of supplements, especially during the wintertime, in healthy reproductive women.

Introduction: Type 2 diabetes mellitus is a chronic disease that is causing enormous economic and social costs. It is characterized by many microvascular and macrovascular complications, such as heart attack, stroke, retinopathy, nephropathy, neuropathy, etc. Such complications can cause severe limitations and decrease the quality of life. The objective of this study was to assess the effect of type 2 diabetes mellitus on the quality of life using the EQ-5D-5L questionnaire, taking into account cardiovascular complications (heart attack, hospitalization due to angina pectoris, stroke, hospitalization due to heart insufficiency, transient ischemic attack, coronary revascularisation), complications of diabetes (microalbuminuria, renal failure, retinopathy, and neuropathy), and demographic characteristics (age, gender, body mass index, height, and weight). Materials and Methods: This cross-sectional study included 484 participants with type 2 diabetes mellitus. Quality of life was estimated by the EuroQol instrument EQ-5D-5L and visual analogue scale (VAS). The following complications related to type 2 diabetes were taken into account: heart attack, hospitalization due to angina pectoris, stroke, hospitalization due to heart insufficiency, transient ischemic attack, coronary revascularization, microalbuminuria, renal insufficiency, retinopathy, and neuropathy. Results: The mean value of the EQ index was 0.895, with the value of -0.59 as the lowest, and 1.0 as the highest quality of life of the study patients. Multivariate linear regression model showed that heart attack, hospitalization due to unstable angina pectoris, retinopathy, and neuropathy significantly decreased the quality of life of the study participants (p<0.05). Spearman's correlation showed that there was a significant correlation between age, height, duration of type 2 diabetes, body mass index, and the EQ index (p<0.001). Conclusion: The results suggest that type 2 diabetes complications, such as heart attack, neuropathy, retinopathy, and hospitalization due to unstable angina pectoris significantly decrease the quality of life of type 2 diabetes mellitus patients (T2DM).

ABSTRACT The aim of this systematic review was to determine the causal role of Erysipelatoclostridium ramosum in specific invasive infections in humans, and to assess the clinical outcome of antibiotic therapy used to treat them. Several electronic databases were systematically searched for clinical trials, observational studies or individual cases on patients of any age and gender with a systemic inflammatory response syndrome (SIRS) due to E. ramosum isolated from body fluids or tissues in which it is not normally present. Only reports identifying E. ramosum as the only microorganism isolated from a patient with SIRS were included. This systematic review included 15 studies reporting 19 individual cases in which E. ramosum caused invasive infections in various tissues, mainly in immunocompromised patients. E. ramosum was most often isolated by blood cultures and identified by specific biochemical tests. Severe infections caused by E. ramosum were in most cases effectively treated with antibiotics, except in two patients, one of whom died. More than one isolate of E. ramosum exhibited 100% susceptibility to metronidazole, amoxicillin/clavulanate and piperacillin/tazobactam. On the other hand, individual resistance of this bacterium to penicillin, ciprofloxacin, clindamycin, imipenem and ertapenem was reported. This systematic review confirmed the clinical relevance of E. ramosum as a cause of a number of severe infections mainly in immunocompromised inpatients. Metronidazole and meropenem appear to be the antibiotics of choice that should be used in combination or as monotherapy to treat E. ramosum infections, depending on the type and severity of the infection.

Abstract Our study aimed to develop and validate a reliable instrument that can measure the quality of life (QOL) of patients with cervical cancer living in a developing country, such as the Central Balkan country, Serbia. Our study was cross-sectional for assessing the reliability and validity of a questionnaire. Balkan questionnaire for QOL of patients with cervical cancer showed satisfactory reliability and temporal stability. When the investigators rated the questionnaire, Cronbach’s alpha was 0.971 at the beginning, and one month later it was 0.967. When the questionnaire was rated by patients themselves, Cronbach’s alpha was 0.972. The questionnaire should be considered as an addition to the existing armamentarium for measuring the quality of life in patients with cervical cancer.