CORRESPONDENT IVANA STAŠEVIĆ KARLIČIĆ Clinic for psychiatric disorders “Dr Laza Lazarević”, Belgrade, Serbia ivanastasevic73@gmail.com doi:10.5937/pramed1604101S

Neuroleptic malignant syndrome (NMS) is a life-threatening, often fatal idiosyncratic reaction to neuroleptic or other drug therapies that antagonise the central dopaminergic neurotransmission. The clinical presentation of NMS is very heterogeneous. The lack of specific levels of symptom severity in currently used diagnostic criteria dims the diagnosis of NMS. Therefore differential diagnosis is of priority, because NMS is a diagnosis of exclusion. The aim of this paper is to present a complex clinical picture in a patient that after a differential diagnostic exclusion of other medical conditions and intoxications is diagnosed as NMS. Case reports such as these help raise awareness of this clinical issue.

Polymorphonuclear neutrophils make about 60-70% of all leucocytes in adults. Neutropenia is defined by neutrophil count below 1.5 h 109/l. It could be classified as mild, moderate and severe, based on the following absolute neutrophil count: 1-1.5 h 109/l, 0.5-1 h 109/l, and < 0.5 h 109/l. Incidence of drug-induced neutropenia is 3-10 cases per million. Drug-induced neutropenia emerges suddenly, and develops a few hours to 1-2 days after administration of the offending drug. There are several mechanisms of neutropenia induced by non-cytotoxic drugs: (1) drug binding to neutrophil membrane, formation of hapten and induction of immune response which destroys neutrophil; (2) induction of neutrophil apoptosis; (3) formation of immune complexes; (4) induction of autoantibodies and complement activation with destruction of neutrophils; (5) dose-dependent inhibition of granulopoesis; and (6) direct toxic effect on myeloid precursors. Treatment of patients with drug-induced neutropenia consists of the offending drug discontinuation, maintenance of strict hygiene and administration of granulocyte-colony stimulating factors in the case of severe neutropenia.

BACKGROUND/AIM Benign prostatic hyperplasia (BPH) is one of the most common disease among males aging 50 years and more. The rise of the prevalence of BPH is related to aging, and since duration of life time period has the tendency of rising the prevalence of BPH will rise as costs of BPH treatment will and its influence on health economic budget. Dutasteride is a new drug similar to finasteride, inhibits enzyme testosterone 5-alpha reductase, diminish symptoms of BPH, reduce risk of the complications and increases quality of life in patients with BPH. But, the use of dutasteride is limited by its high costs. The aim of this study was to compare cost effectiveness of dutasteride and finasteride from the perspective of a purchaser of health care service (Republic Institute for Health Insuranse, Montenegro). METHODS We constructed a Markov model to compare cost effectivenss of dutasteride and finasteride using data from the available pharmacoeconomic literature and data about socioeconomic sphere actual in Montenegro. A time horizon was estimated to be 20 years, with the duration of 1 year per one cycle. The discount rate was 3%. We performed Monte Carlo simulation for virtual cohort of 1,000 patients with BPH. RESULTS The total costs for one year treatment of BPH with dutasteride were estimated to be 6,458.00 € which was higher comparing with finasteride which were 6,088.56 €. The gain in quality adjusted life years (QALY) were higher with dutasteride (11.97 QALY) than with finasteride (11.19 QALY). The results of our study indicate that treating BPH with dutasteride comparing to finasteride is a cost effective option since the value of incremental cost-effectiveness ratio (ICER) is 1,245.68 €/QALY which is below estimated threshold (1,350.00 € per one gained year of life). CONCLUSION Dutasteride is a cost effective option for treating BPH comparing to finasteride. The results of this study provide new information for health care decision makers about treatment of BPH in socioeconomic environment which is actual both in Montenegro and other countries with a recent history of socioeconomic transition.

The existing building stock energy consumption accounts for about 38% of final energy consumption in Republic of Serbia. 70% of that energy is consumed by residential sector, mostly for space heating. This research is addressed to the single family house building placed in the Belgrade city. The house has ground and first floor with total heating area of 130 m2 and pellet as space heating source. The aim of this paper is to evaluate energy and economic analysis for different heating systems. Several homeheating were compared: Option 1 (biomass combustion boiler using pellet as a fuel), Option 2 (gas combustion boiler) and Option 3 (heat pump). The building performance was evaluated by TRNSYS 17 simulation code. Results show estimated savings using renewable energy sources. [Projekat Ministarstva nauke Republike Srbije, br. III42008]

: Nutrition is recognised as one of the major factors that can influence the development of cancer. Heterocyclic amines formed during the cooking of meat are genotoxic carcinogens and consumption of meat positively correlates with certain types of human cancer. On the other hand, it has been reported that many plant components reduce the genotoxic activities of carcinogens, including HCAs. In this study we investigated the antigenotoxic potential of the monoterpenes linalool, myrcene and eucalyptol against two food-borne carcinogens: 2-amino-1-methyl-6-phenylimidazo[4-5- b ]pyridine (PhIP) and 2-amino-3-methylimidazo[4,5-f]-quinoline (IQ). The study was performed by the comet assay method in metabolically active HepG2 human hepatoma cells. In addition, the lipid peroxidation TBA assay was used to determine the anti-oxidative potential of these monoterpenes. To evaluate the antigenotoxic potential, cells were treated simultaneously with 0.01, 0.1 or 1 μg/mL of monoterpenes and either 90 μmol/LPhIP or 0.75 mmol/L IQ. The DNA damage induced by PhIP was reduced significantly (by 40-63%) by each of the three monoterpenes, while inhibition of IQ-induced DNA damage was less efficient (12-26% reduction) and limited to myrcene and eucalyptol. Lipid peroxidation was significantly inhibited by linalool and myrcene, with IC 50 values of approximately 30 μg/mL and 300 μg/mL, respectively. Eucalyptol showed only weak antioxidant activity (15% inhibition at 500 μg/mL). Taking into account the fact that reactive oxygen species (ROS) are formed during metabolic processing of PhIP, we assume that more efficient protection against PhIP-induced DNA damage was probably due to antioxidative activity of the monoterpenes or their metabolites, but the ability to interfere with metabolic activation of PhIP and IQ could also be involved.

This paper presents R&D project of multi fuel concept (MFC) for future coal-based power plants, demonstrated on example of cofiring Middle-Bosnia brown coal with waste woody biomass and natural gas. Pulverised Combustion (PC) lab-scale furnace has been used for the cofiring tests, varying up to 20%w portion of biomass and up to 10%th portion of natural gas in the fuel mix. Tests were purposed to optimize the combustion temperature, air distribution, including Over Fire Air System (OFAS), fuel combination and fuel distribution, including reburning concept, as function of emissions and combustion efficiency estimated through the ash deposits behaviours and unburnt. Considering application of proposed MFC in case of TPP Kakanj unit 6 (118 MWe) set here as a referent power plant, temperature levels and fuel distributions for lowest emissions of CO2 and NOx were found during lab tests, provided that combustion efficiency is at an acceptable level. Derived research results yield input data for calculation sustainability indicators of MFC for the referent power plant, considering 6 fuel options - different combinations of coal, biomass and natural gas. Single criteria analysis and multicriteria sustainability assessment have been done, giving an advantage to the options of cofiring coal with woody biomass and natural gas in the case demonstrated.

Non-financial sector in B&H and the companies due to lack of its own funds for sustainable growth rely on financing its operations through bank loans. The dominant share of lending to banks in B&H is directed to the household sector while on the other hand the approval of bank loans to enterprises is on a smaller scale. Corporate sector due to underdeveloped capital markets is not able to borrow through the issuance of equity and debt securities. The main objective of this study is to determine which independent variables in the regression models have an impact on the amount of approved loans granted by banks to non-financial sector, i.e. companies. The loans growth rate will be observed as a dependent variable, and the growth rate of non-performing loans, the growth rate of operating costs, real GDP growth, consumer price index, deposit growth rate, deposit interest rate, interest rate (EURIBOR), and interest rate (LIBOR) will be used as independent variables.