High prevalence of metabolic syndrome in children and adolescents is seriuous problem of modern society. In order to prevent development of possible complications (cardiovascular diseases and diabetes mellitus type 2) later in life, early recognition of children at risk for developing metabolic syndrome is of great importance. Previous differences in criteria for diagnosis of metabolic syndrome in children and adolescents have been significantly decreased by new criteria issued by the International Diabetes Federation. From the aspect of prevention, key elements are proper nutrition and regular physical activity. In a view of treatment recommendations, initial steps should be regulation of energy balance in the diet and increase in physical activity; the drug treatment is reserved for patients with high risk of complications.

Congenital anomalies are the cause of 20.0-25.0% of cases of perinatal death, while 3.0% of children are born with malformations of varying size. We examined the predictive values and defined the credibility ratio of the combined test results. Sensitivity of the test is 94.0%, and specificity is 99.0%. The positive likelihood ratio [likelihood ratio test (LR+)] is 94.00; a negative likelihood ratio [likelihood ratio test (LR-)] is 0.06. The pretest probability that pregnant women carry a fetus with chromosomal abnormality is 1:250. Posttest odds after the combined test to discover this abnormality are 0.3760, and probability of the same case is 0.2732 if it happens that the test result is positive. The result of our study confirms the justification of combined test usage in routine clinical practice, since the posttest odds rate in the case of a positive screening increases several times over (almost 90 times); the probability of detecting a chromosomal abnormality was about 70 times.

During the process of developing herbal drugs with antimicrobial action, one of the most important phases is testing of antimicrobial activity in vitro. The disk-diffusion method is performed in Petri dish, on solid feeding surface. The disks with definite concentrations of antibiotics, pure substances or plant extracts are placed on the top of feeding plates previously inoculated with pure bacterial culture. Growth of the bacterial culture depends on its susceptibility to a tested substance; if the substance has antibacterial effect, a clear zone free of bacteria will form around the disk. Minimal inhibitory concentration (MIC) of the tested substance is determined by extrapolation of the regression line: concentration of the tested substance/radius or surface of area where growth of bacteria was inhibited. This method of testing microbial susceptibility to antibiotics, pure substances or plant extracts is highly sensitive and specific.

Primary psychiatric disorders are frequently associated with electrolyte disorders, which could be caused by medication. We performed a systematic review of the literature in order to discover published cases of electrolyte disorders associated with risperidone use. The databases Medline and Scopus were searched and 317 publications were retrieved containing the following keywords: risperidone, hyponatremia, hypernat remia, hypokalemia, hyperkalemia, hypocalcemia and hypercalcemia. We included in our review the following publication types: the original scientific research, case reports, review of literature and letters to the editor. Case reports and observational studies associating risperidone with hyponatremia or hypokalemia, as well as with hypocalcemia were found. In spite of sporadic case reports of risperidone induced electrolyte disorders, conflicting opinions and results of other studies quest ion the certainty of this association. Further research is necessary to confirm and enlighten the association between risperidone and electrolyte disorders.

Background: Quality of life assessment in patients with Multiple sclerosis (MS) is invaluable for a proper evaluation of disease severity, appropriate choice of therapy and monitoring of its effects. The aim of this study was to assess the quality of life of patients with MS and to identify gender differences in examined outcome. Patients and Methods: A descriptive cross-sectional study was conducted from August 2010 to May 2011. The data were obtained by anonymous survey of 110 patients. Quality of life of the patients was measured by the instrument 'The World Health Organization Quality of Life (WHOQOL) - BREF'. Data on gender and age of patients, type of MS, the number of relapses during the last 2 years, current therapy, dose regimens of certain drugs, and the amount of money the patients spend each month for the purchase of drugs that are not issued at the expense of health insurance fund, were obtained using a distinct structured questionnaire. The collected data were analyzed using simple descriptive statistics and Student's t-test for independent samples. Results: Of the total 110 interviewed patients, 70% (n = 77) were female and 30% (n = 33) male. There were no significant gender differences in the disease duration, number of relapses in the last two years and spending of more than 1000 RSD per month for purchase of drugs that were not issued at the expense of the health insurance fund. Significantly better quality of life was recorded in women than men (p = 0.031), mainly on account of differences in the assessment of the domain of 'Environment' (p = 0.025), as measured by WHOQOL-BREF scale. Conclusion: This study has shown that females tolerate difficulties caused by multiple sclerosis better than men, and also have a better quality of life than men with the same clinical form of the disease and identical symptoms, treated with the same therapy.

Knjiga sadrži temelje aerodinamike, detaljan opis zrakoplova, opis polijetanja i slijetanja, objasnjene su pojave u aerodinamici i mehanici leta te mogucnosti samog letenja. U knjizi se nalaze i prilozi kao sto su: kemijski sastav atmosfere, podjela atmosfere na njezine slojeve te važnost zraka u mehanici leta. Knjiga Osnove aerodinamike i mehanike leta namijenjena je studentima Veleucilista u Velikoj Gorici za studij Održavanje zrakoplova.

From a botanical perspective, the large number of species of the genus Sideritis coupled with the tendency to hybridise between the different species has prompted an accurate study designed to clarify all the controversial points in the botanical classification of this genus. The past phytochemical studies of the Sideritis species have been performed with different extracts from the aerial parts, essential oils and isolated compounds such as diterpenoids, flavonoids or phenylpropanoid glycosides. These investigations have justified the traditional uses for these plants and provided direction for new pharmacological research. In recent years, other compounds such as iridoids, coumarins, lignans and phenylpropanoid glycosides have also been isolated and identified. The results have shown that essential oils act as good antimicrobial agents against both Gram-positive and Gram-negative bacteria and against the Candida albicans fungus. Diterpenoids have shown antimicrobial, anti-inflammatory and antifeedant activity, and flavonoids are active as anti-ulcerous, anti-inflammatory and antioxidant agents. Future research should focus on the pharmacological activity of these isolated compounds to find new active principles and identify their mechanisms of action. In addition, it would be interesting to investigate new pharmacological activities apart from those used in traditional medicine; recent studies have shown that diterpenes and some diterpene derivatives act as effective anti-HIV and antiproliferative agents.

Background. The appropriate use of antipsychotics by general practitioners is correlated with a positive attitude towards this group of drugs during their undergraduate studies. Objective. The aim of our study was to investigate and compare the attitudes of medical students in Spain and Serbia wards about the effectiveness and adverse effects of antipsychotic medications. Methods. In a cross-sectional study, 60 final-year medical students from Spain and Serbia were exposed to a case of a patient treated with antipsychotics who was experiencing side effects. A Likert-type questionnaire was then given to the students, capturing their attitudes towards antipsychotics. Results. Compared to the Spanish peers, the students from Serbia were more eager to use antipsychotics as a means of protecting the patients’ families than forto help the patients themselves. The majority of the Serbian students thought that psychotic patients were supposed to tolerate the side effects of their medications, while the Spanish students were ready to change their treatment. The Serbian students were older than their Spanish peers, mostly males and Orthodox . Conclusions. Additional educational efforts are needed to improve the attitudes of older and more religious students, but these efforts will pay off in the future with more appropriate drug treatment of schizophrenic patients and improved patient adherence to the treatment.

Introduction. Early post-operative arrhythmias after general anaesthesia are serious clinical problems for a significant portion of surgical patients. The aim of our study was to investigate the risk factors for the onset of post-operative arrhythmias in general surgery patients undergoing general anaesthesia. Methods. In this case-control study, the cases were patients with at least one episode of arrhythmias in the first 24 hours after general anaesthesia (n=56), and the controls were sex and age matched surgical patients (n=91) without post-operative arrhythmias.

OBJECTIVE The aim of the present study was to build population pharmacokinetic models for the clearance of valproate (VPA) in 2 separate populations of Serbian patients with epilepsy, children and adults. METHODS Analysis was performed using 65 and 63 steady-state concentrations of VPA collected from 58 children and 60 adult epileptic patients, respectively. Mean values for total body weight and age were 27.07 ± 13.08 kg and 7.21 ± 3.63 years in the pediatric population, and 69.67 ± 15.60 kg and 33.97 ± 16.41 years in the adult population. The one-compartment model with first order elimination and without absorption was used from the PREDPP (Prediction for Observation Population Pharmacokinetics) library of NONMEM software. RESULTS The derived final models show that VPA clearance increased with total body weight of patients in both populations. However, the carbamazepine comedication was the main determinant of the final model in children whereas phenobarbitone comedication was the most important factor in the adult population. The magnitudes of these effects were +0.159 lh-1 and +0.539 lh-1 for carbamazepine and phenobarbitone, respectively. A significant decrease in interindividual and intraindividual variability was observed in the target populations. The pharmacokinetic models obtained were validated in groups of 15 epileptic patients, each showing good predictive performance of the model. CONCLUSIONS The derived models describe well VPA clearance in terms of characteristics of Serbian pediatric and adult epileptic patients, offering a basis for rational individualization of VPA dosage regimens.

PURPOSE the aim of this study was to analyze outcomes in a series of patients with symptomatic uterine fibroids who had undergone endovascular arterial embolization. METHODS analysis included 36 patients with uterine fibroids and average age of 38.5 years, with bilateral endovascular embolization of fibroid-feeding arteries. Solitary uterine fibroids were present in 20 (56%) patients, and multiple in 16 (44%) patients. The patients were followed up to one year after embolization. RESULTS in the subgroup of patients with solitary uterine fibroids, 6 months after the embolization, the volume of uterine fibroids was reduced to 50% in 16 patients, and to 38% in 4 patients. After one year, the volume of uterine fibroids was reduced to 50% in all 36 patients. In the subgroup of patients with multiple uterine fibroids, 6 months after the embolization, the volume of uterine fibroids was reduced to 50% in 10 patients, and to 36% in 6 patients. After one year, the volume of uterine fibroids was reduced to 50% in 14 patients, while in 2 patients the reduction of the volume remained 36%. After one year, all patients became symptomless. CONCLUSION the results of this case series show high efficacy of endovascular embolization of uterine fibroids: with a minimally invasive treatment, the volume of uterine fibroids is halved and symptoms disappear, obviating the need for a surgical intervention.

Topiramate pharmacokinetics is influenced by individual factors such as patient age, renal function and co-treatment. The aim of this study was to develop a population pharmacokinetic model of topiramate to assist dosage adjustments in individual patients. Steady-state topiramate plasma concentrations in patients with epilepsy were determined by HPLC using fluorescent labelling. Demographic, biochemical data and dosing history including concomitant drug therapy were collected from patients' charts. Nonlinear mixed effects modelling was used to fit a one-compartment pharmacokinetic model. The influence of patient weight and gender, body surface area, age, creatinine clearance, serum transaminases, topiramate daily dose and co-treatment with carbamazepine, valproic acid, benzodiazepines, and risperidone on topiramate pharmacokinetics was evaluated. Additionally, the relationship between topiramate plasma concentration and clinical response was investigated. Volume of distribution of topiramate was 0.518 l/kg. For a typical patient oral clearance was estimated at 1.47 l/h, with interindividual variability of 39.2%. Clearance was 70% higher in patients co-treated with carbamazepine and was found to increase with patient age. Somnolence was the most frequently observed adverse event. Incidence of headache was associated with topiramate plasma concentration. Somnolence, ataxia, tremor, speech disorders and fatigue were associated with adjunctive therapy with carbamazepine, valproic acid, benzodiazepines, risperidone, and clozapine. No association of topiramate plasma concentration with frequency of seizures or patient quality of life was observed. The developed model can be used for Bayesian estimation of pharmacokinetic parameters based on sparse plasma samples and for selection of optimum dosing in routine patient care.