Tackling the Antimicrobial Resistance "Pandemic" with Machine Learning Tools: A Summary of Available Evidence.

Antimicrobial resistance is recognised as one of the top threats healthcare is bound to face in the future. There have been various attempts to preserve the efficacy of existing antimicrobials, develop new and efficient antimicrobials, manage infections with multi-drug resistant strains, and improve patient outcomes, resulting in a growing mass of routinely available data, including electronic health records and microbiological information that can be employed to develop individualised antimicrobial stewardship. Machine learning methods have been developed to predict antimicrobial resistance from whole-genome sequencing data, forecast medication susceptibility, recognise epidemic patterns for surveillance purposes, or propose new antibacterial treatments and accelerate scientific discovery. Unfortunately, there is an evident gap between the number of machine learning applications in science and the effective implementation of these systems. This narrative review highlights some of the outstanding opportunities that machine learning offers when applied in research related to antimicrobial resistance. In the future, machine learning tools may prove to be superbugs' kryptonite. This review aims to provide an overview of available publications to aid researchers that are looking to expand their work with new approaches and to acquaint them with the current application of machine learning techniques in this field.

Introducing the model of repeated exposure of skin to antiseptics: Randomised pilot trial.

INTRODUCTION: Intensified hand hygiene measures were recommended for preventing the spread of SARS-CoV-2. However, these measures can lead to skin damage and the development of hand eczema, particularly among health professionals. OBJECTIVES: This pilot study aimed to evaluate the effects of repeated antiseptic use on healthy skin under controlled conditions and to assess the emollient use. METHODS: Twelve healthy volunteers (nine females, age = 22.3 ± 2.8 years (mean ± SD), Fitzpatrick phototypes II and III) with no skin diseases were recruited. Antiseptic was applied daily for 3 weeks on the volar sides of forearms. Emollient cream was also applied daily. Skin assessments were performed using non-invasive methods (transepidermal water loss-TEWL, skin hydration, erythema and melanin content). RESULTS: Prolonged antiseptic use increased TEWL, decreased hydration and elevated erythema and melanin levels. Emollient cream significantly reduced TEWL and improved hydration on antiseptic-treated sites, and also enhanced hydration on intact skin. CONCLUSIONS: Prolonged use of antiseptics can have adverse effects on the skin, including barrier disruption and inflammation. Emollient showed promise in improving skin hydration and reducing the damage caused by antiseptics. Further research with a larger sample is needed to confirm these findings and assess emollient efficacy during frequent antiseptic use.

Evaluation of Reporting Quality of Glaucoma Randomized Controlled Trial Abstracts: Current Status and Future Perspectives.

The aim of this study was to explore adherence to the Consolidated Standards of Reporting Trials (CONSORT) reporting standards in abstracts of randomized controlled trials on glaucoma. A cross-sectional observational study was conducted on the aforementioned abstracts, indexed in MEDLINE/PubMed between the years 2017 and 2021. In total, 302 abstracts met the inclusion criteria and were further analyzed. The median score of CONSORT-A items was 8 (interquartile range, 7-10) out of 17 (47.0%). Most analyzed studies were conducted in a single center (80.5%) and the abstracts were predominantly structured (95.0%). Only 20.5% of the abstracts adequately described the trial design, while randomization and funding were described by 6.0% of the abstracts. Higher overall scores were associated with structured abstracts, a multicenter setting, statistically significant results, funding by industry, a higher number of participants, and having been published in journals with impact factors above four (p < 0.001, respectively). The results of this study indicate a suboptimal adherence to CONSORT-A reporting standards, especially in particular items such as randomization and funding. Since these factors could contribute to the overall quality of the trials and further translation of trial results into clinical practice, an improvement in glaucoma research reporting transparency is needed.

Knowledge and Attitudes towards Epilepsy of Croatian General Student Population and Biomedical Students: A Cross-Sectional Study.

Epilepsy causes a significant burden to patients as it is linked with various somatic and psychiatric comorbidities, social issues, impaired quality of life, and increased mortality. Improving the population's knowledge and attitudes about epilepsy patients could be beneficial as it could raise social awareness and lead to more social support for patients. For those reasons, a survey-based cross-sectional study was conducted to determine Croatian students' knowledge and attitudes toward epilepsy. A previously developed survey questionnaire was adapted for the Croatian setting and distributed online to the students (n = 544). Croatian students generally had positive attitudes towards people with epilepsy (median score 28.0, interquartile range 29.0-26.0, with the minimum possible score being 0.0 and the maximum 30.0), with the female gender (B (male) = 0.664 (95% CI -1.158, -0.170), p = 0.009), biomedical education (B (other) = -0.442, (95% CI -0.823, -0.061), p = 0.023), and personal experience in the form of witnessing the seizure (B = 0.519 (95% CI 0,098, 0.940), p = 0.016) as predictors of more favorable attitudes. Overall knowledge was satisfactory concerning most items, with the exception of first aid measures and risk factors. Educational intervention targeting bio-medical students and other students who might, in their future professional lives, be responsible for people suffering from epilepsy is needed to improve the gaps in their knowledge.

Temporomandibular Disorder Prevalence and Its Association with Lifestyle Habits in Biomedicine Students-A Cross-Sectional Study.

This study aimed to examine the frequency of temporomandibular disorder among biomedical students and relate its occurrence to lifestyle habits. A cross-sectional collection of data was carried out and included a total of 676 examinees through a questionnaire that had 73 questions: general information and lifestyle habits, the Fonseca Anamnestic index (FAI), the Jaw Function Limitation Scale (JFLS), and the Perceived Stress Questionnaire (PSQ). The statistical analyses between three or more groups were conducted using the one-way analysis of variance (ANOVA) with post hoc Scheffé test or Kruskal-Wallis test with post hoc Dunn's test for quantitative variables. The comparison of qualitative variables was conducted using the Chi-square test, while the correlations were determined using Spearman's correlation test. The analysis showed that a higher frequency of moderate or severe TMD was observed in subjects who were smokers (p < 0.001) compared to non-smokers. Subjects who consumed more coffee had moderate to severe TMD compared to subjects who consumed a lesser amount (p < 0.001). Furthermore, a positive correlation between the amount of stress and the severity of TMD was found. Our study implies that students of biomedical studies have an increased risk for TMD and that there is a link with their lifestyle habits.

Young Women's Attitudes and Behaviors in Treatment and Prevention of UTIs: Are Biomedical Students at an Advantage?

We wanted to investigate whether students who study within biomedical fields (i.e., medicine, pharmacy science) differ from those whose studies are not connected to the biomedical field in terms of their attitudes and behaviors related to urinary tract infections (UTIs). This was a cross-sectional survey-based study conducted among 392 female students, of whom 243 attended a biomedical school and 149 (38.0%) attended a non-biomedical school, using a previously published tool. The survey was distributed as an online link via student representatives at different faculties. Only 22 (5.6%) of women felt that they could not recognize a UTI. A greater proportion of biomedical students wiped front to back, while significantly more non-biomedical students chose cotton underwear and avoided daily sanitary pads compared to biomedical students. As many as 215 (54.8%) women stated that they used cranberry preparations. Biomedical students showed greater awareness about possible resistance to repeated treatment (p = 0.002) and greater knowledge of possible interactions of antibiotics (p < 0.001). This study reveals that young women are confident in recognizing an UTIs, are open to alternative treatments, and would consider UTI management in a pharmacy setting. However, it reveals that there might be gaps in their knowledge regarding antibiotic resistance risks, possible interactions, and efficacy of available preparations, as participants from the group of biomedical students showed greater knowledge and different behaviors.

The Role of AI in Breast Cancer Lymph Node Classification: A Comprehensive Review.

Breast cancer is a significant health issue affecting women worldwide, and accurately detecting lymph node metastasis is critical in determining treatment and prognosis. While traditional diagnostic methods have limitations and complications, artificial intelligence (AI) techniques such as machine learning (ML) and deep learning (DL) offer promising solutions for improving and supplementing diagnostic procedures. Current research has explored state-of-the-art DL models for breast cancer lymph node classification from radiological images, achieving high performances (AUC: 0.71-0.99). AI models trained on clinicopathological features also show promise in predicting metastasis status (AUC: 0.74-0.77), whereas multimodal (radiomics + clinicopathological features) models combine the best from both approaches and also achieve good results (AUC: 0.82-0.94). Once properly validated, such models could greatly improve cancer care, especially in areas with limited medical resources. This comprehensive review aims to compile knowledge about state-of-the-art AI models used for breast cancer lymph node metastasis detection, discusses proper validation techniques and potential pitfalls and limitations, and presents future directions and best practices to achieve high usability in real-world clinical settings.

Nutritional Management of Patients with Head and Neck Cancer-A Comprehensive Review.

While surgical therapy for head and neck cancer (HNC) is showing improvement with the advancement of reconstruction techniques, the focus in these patients should also be shifting to supportive pre and aftercare. Due to the highly sensitive and anatomically complex region, these patients tend to exhibit malnutrition, which has a substantial impact on their recovery and quality of life. The complications and symptoms of both the disease and the therapy usually make these patients unable to orally intake food, hence, a strategy should be prepared for their nutritional management. Even though there are several possible nutritional modalities that can be administrated, these patients commonly have a functional gastrointestinal tract, and enteral nutrition is indicated over the parenteral option. However, after extensive research of the available literature, it seems that there is a limited number of studies that focus on this important issue. Furthermore, there are no recommendations or guidelines regarding the nutritional management of HNC patients, pre- or post-operatively. Henceforth, this narrative review summarizes the nutritional challenges and management modalities in this particular group of patients. Nonetheless, this issue should be addressed in future studies and an algorithm should be established for better nutritional care of these patients.

Knowledge and Attitudes of Cannabidiol in Croatia among Students, Physicians, and Pharmacists.

Due to cannabidiol's health benefits and absence of serious side effects, its use is constantly growing. This is a survey-based cross-sectional study that was conducted to determine Croatian pharmacists', physicians', and students' knowledge and attitudes about cannabidiol (CBD). Two questionnaires were created, one for students and the other for physicians and pharmacists. Our participants (in total 874: 473 students and 401 physicians and pharmacists) generally had positive attitudes towards CBD therapy as approximately 60% of them believe that CBD treatment is generally efficacious. Participants had positive attitudes toward the therapeutic value of CBD, especially pharmacists and pharmacy students (63.8% and 72.2%, respectively). Pharmacists were significantly more convinced that CBD could reduce the use of opioids prescribed for chronic pain (p < 0.05). Only 17.5% of students had read scientific papers about CBD, compared to a significantly higher percentage of physicians and pharmacists (43.0% and 47.8%, respectively) (p < 0.05). This study revealed a gap in knowledge regarding CBD, since 89.3% of pharmacists and physicians, as well as 84.8% of students, believe they need more education about CBD. We conclude that it is important to improve the educational curricula so that medical professionals can recommend CBD use to their patients when needed.

Attitudes of Community Pharmacy Service Users towards Vaccination Programs in Pharmacy: A Cross-Sectional Survey-Based Study in Croatia.

BACKGROUND: The aim of this study was to explore community pharmacy service users' attitudes and opinions towards vaccination programs in pharmacy conducted by a doctor of medicine or a pharmacist. METHODS: The questionnaire used in this study comprised 40 items about demographics, sources of information, attitudes about vaccination, attitudes about vaccination in community pharmacies, and willingness to pay for such a service. RESULTS: A total of 385 people participated in this study. Injection was the preferred route of administration of vaccine for more than half of study participants (50.6%). Univariate analysis showed that those who had a healthcare worker as a family member and those familiar with the HPV vaccine had better attitudes; however, those results were no longer significant after factoring in other variables in multivariate analysis. More than half (59.2%) of the study population would consider vaccination service in community pharmacies only if it were free or covered by the national health insurance. CONCLUSIONS: More than half of the participants believed that providing vaccination services in community pharmacies would result in greater vaccination rates for seasonal illnesses. However, around half would prefer that it were conducted exclusively by a physician. Less than 10% of the study participants would pay out of their pocket for such a service.

Association between Brain Injury Markers and Testosterone in Critically-Ill COVID-19 Male Patients.

Accumulating data suggest that various neurologic manifestations are reported in critically-ill COVID-19 patients. Although low testosterone levels were associated with poor outcomes, the relationship between testosterone levels and indices of brain injury are still poorly understood. Therefore, we aimed to explore whether testosterone levels are associated with glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), biomarkers of brain injury, in patients with a severe form of COVID-19. The present study was conducted on 65 male patients aged 18−65 with severe COVID-19. Blood samples were collected at three time points: upon admission to ICU, 7 days after, and 14 days after. In patients with neurological sequels (n = 20), UCH-L1 serum concentrations at admission were markedly higher than in patients without them (240.0 (155.4−366.4) vs. 146.4 (92.5−243.9) pg/mL, p = 0.022). GFAP concentrations on admission did not differ between the groups (32.2 (24.2−40.1) vs. 29.8 (21.8−39.4) pg/mL, p = 0.372). Unlike GFAP, UCH-L1 serum concentrations exhibited a negative correlation with serum testosterone in all three time points (r = −0.452, p < 0.001; r = −0.430, p < 0.001 and r = −0.476, p = 0.001, respectively). The present study suggests that the traumatic brain injury biomarker UCH-L1 may be associated with neurological impairments seen in severe COVID-19. Moreover, a negative correlation between UCH-L1 and serum testosterone concentrations implies that testosterone may have a role in the development of neurological sequels in critically-ill COVID-19 patients.

Adverse drug reaction reporting via mobile applications: A narrative review.

INTRODUCTION: Pharmacovigilance importance has increased in the last few decades and it has led to rise in awareness of adverse drug reaction reporting by both patients and health care professionals. Despite this, research shows reporting practice of health care professionals remains inadequate. Several educational and promotional activities were established in order to improve observed underreporting including the introduction of mobile applications that can be used to report adverse drug reactions. OBJECTIVES: We aimed to review literature on adverse drug reaction reporting applications and whether their introduction improved reporting practice in patients and health care professionals. RESULTS: In this review, we have described several mobile application implementations in different countries. Moreover, we have illustrated some of the applications for particular patients, e.g. patients with multiple sclerosis. CONCLUSION: All of the included studies showed positive association between application use and ADR reporting. However, there is a great need for future high quality studies to confirm impact of mobile application on ADR reporting.

Investigation of Biomedical Students' Attitudes toward Pharmacogenomics and Personalized Medicine: A Cross-Sectional Study.

BACKGROUND: The utilization of pharmacogenomics in everyday practice has shown several notable benefits. Keeping in mind the rising trend of applicability of pharmacogenomics and personalized medicine, we sought to compare the attitudes of future healthcare workers in different branches of the healthcare system. METHODS: The present study was conducted as a questionnaire-based cross-sectional study in October of 2020. Students eligible to participate were all the students of the University of Split School of Medicine enrolled in the academic year 2020/2021. RESULTS: The number of students that participated in the study was 503. Students were most interested in clinical examples of pharmacogenomics (31.4%) and the benefits of pharmacogenomics in clinical practice (36.4%). Furthermore, 72.6% of all students agreed that they should be able, in their future practice, to identify patients that could benefit from genetic testing. CONCLUSION: At the present time, the lack of education and appropriate clinical guidelines appear to be the major barriers to the clinical application of pharmacogenomics, especially in Croatia. Hence, in order to support health care professionals' evidence-based therapeutic recommendations with patients' pharmacogenomic data, universities should offer more pharmacogenomics education in their curricula.

Registered Drug Packs of Antimicrobials and Treatment Guidelines for Prostatitis: Are They in Accordance?

The aim of this study was to analyze if registered drug packs of antibiotics are in accordance with national guidelines for prostatitis treatment regard to the amount of drug units.; Methods: Croatian, UK (NICE), Australian, Spanish and Slovenian national guidelines were analyzed in this study. Results: Comparing treatment guidelines with registered drug packs resulted in perfect accordance only for drug packs registered in the UK with the NICE guidelines, where even split-pack dispensing is possible. Interestingly, when comparing drug packs registered in the UK with treatment proposed in the national guidelines of Croatia, Italy, Spain, Australia, USA and Slovenia, they matched almost perfectly. In other investigated countries, registered drug packs' national guidelines' analysis showed mismatch in 25-100% of recommendations (Italy and Slovenia, respectively). Conclusions: Mismatch between registered drug packs that are dispensed to patients and treatment guidelines may result in excess units of antimicrobials that may be misused by the patient in the future, or excess antimicrobials may become unnecessary waste, further promoting antimicrobial resistance. Greater accordance of registered drug packs of antimicrobials with treatment guidelines may lower rates of antimicrobials misuse.

Investigation of Biomedical Students' Knowledge on Glaucoma Reveals a Need for Education: A Cross-Sectional Study.

Background: Glaucoma has been recognized as one of the leading global causes of irreversible blindness. Patients with primary open-angle glaucoma rarely present with visual symptoms, at least early in the course of the disease. It is important to recognize and treat the disease before there are irreversible changes. Methods: This cross-sectional study was conducted at the University of Split School of Medicine from October to November 2021. Participants were biomedical students who completed a questionnaire. Results: In total, 312 students participated in this study. Interestingly, only 12.2% of students identified that primary open-angle glaucoma was asymptomatic. Only 42.6% of all students recognized glaucoma as being the main cause of irreversible blindness. Pharmacy students less frequently recognized high blood pressure and diabetes mellitus as risk factors for glaucoma. Students who completed an ophthalmology course more frequently recognized that successful glaucoma treatment prevents blindness, compared to students who did not complete the course, 79.1% vs. 48.7%, p < 0.001. Conclusion: The results showed that students' knowledge on the subject is low, even after they passed their ophthalmology course. However, knowledge of glaucoma is crucial for early disease identification and the prevention of blindness. Therefore, it is important that all future health care professionals acquire adequate education.

Comparison of the Impact of Insulin Degludec U100 and Insulin Glargine U300 on Glycemic Variability and Oxidative Stress in Insulin-Naive Patients With Type 2 Diabetes Mellitus: Pilot Study for a Randomized Trial.

BACKGROUND: There is an ongoing discussion about possible differences between insulin degludec (IDeg-100) and glargine U300 (IGlar-300). There is little data and head-to-head comparison of IDeg-100 and IGlar-300 regarding their simultaneous impact on glycemic variability and oxidative stress in patients with type 2 diabetes mellitus (T2DM). OBJECTIVE: In our randomized, open-label, crossover study, we compared the impact of IDeg-100 and IGlar-300 on glycemic variability and oxidative stress in insulin-naive patients with T2DM. METHODS: We recruited a total of 25 adult patients with T2DM (7 females) whose diabetes was uncontrolled (HbA1c ≥7.5%) on two or more oral glucose-lowering drugs; a total of 22 completed the study. Mean age was 57.3 (SD 6.99) years and duration of diabetes was 9.94 (SD 5.01) years. After the washout period, they were randomized alternately to first receive either IDeg-100 or IGlar-300 along with metformin. Each insulin was administered for 12 weeks and then switched. At the beginning and end of each phase, biochemical and oxidative stress parameters were analyzed. On 3 consecutive days prior to each control point, patients performed a 7-point self-monitoring of blood glucose profile. Oxidative stress was assessed by measuring thiol groups and hydroperoxides (determination of reactive oxygen metabolites test) in serum. RESULTS: IGlar-300 reduced mean glucose by 0.02-0.13 mmol/L, and IDeg-100 reduced glucose by 0.10-0.16 mmol/L, with no significant difference. The reduction of the coefficient of glucose variation also did not show a statistically significant difference. IGlar-300 increased thiols by 0.08 µmol/L and IDeg-100 increased thiols by 0.15 µmol/L, with no significant difference (P=.07) between them. IGlar-300 reduced hydroperoxides by 0.040 CARR U and IDeg-100 increased hydroperoxides by 0.034 CARR U, but the difference was not significant (P=.12). CONCLUSIONS: The results of our study do not show a significant difference regarding glycemic variability between patients receiving either insulin IDeg-100 or IGlar-300, although IGlar-300 showed greater dispersion of data. No significant difference in oxidative stress was observed. In a larger study, doses of insulins should be higher to achieve significant impact on glycemic parameters and consequently on glycemic variability and oxidative stress. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04692415; https://clinicaltrials.gov/ct2/show/NCT04692415.

The Patho-Neurophysiological Basis and Treatment of Focal Laryngeal Dystonia: A Narrative Review and Two Case Reports Applying TMS over the Laryngeal Motor Cortex.

Focal laryngeal dystonia (LD) is a rare, idiopathic disease affecting the laryngeal musculature with an unknown cause and clinically presented as adductor LD or rarely as abductor LD. The most effective treatment options include the injection of botulinum toxin (BoNT) into the affected laryngeal muscle. The aim of this narrative review is to summarize the patho-neuro-physiological and genetic background of LD, as well as the standard recommended therapy (BoNT) and pharmacological treatment options, and to discuss possible treatment perspectives using neuro-modulation techniques such as repetitive transcranial magnetic stimulation (rTMS) and vibrotactile stimulation. The review will present two LD cases, patients with adductor and abductor LD, standard diagnostic procedure, treatments and achievement, and the results of cortical excitability mapping the primary motor cortex for the representation of the laryngeal muscles in the assessment of corticospinal and corticobulbar excitability.

Helicobacter pylori Infection in Croatian Population: Knowledge, Attitudes and Factors Influencing Incidence and Recovery.

Basic and clinical knowledge about Helicobacter pylori infections has been improved in the past. However, the translation of this knowledge into public health intervention has remained poor. A survey based cross-sectional study was performed to assess the factors regarding the H. pylori infection in the general population. The survey was conducted using a previously developed questionnaire, adapted for the population in Croatia. Respondents (N = 1131) had a good knowledge score with a median of 4 out of 5 correct answers (interquartile range: 2-4). Senior participants had a lower frequency of high knowledge answers about H. pylori (43.1%) compared to younger (56.1%) and middle-aged participants (51.5%, p = 0.014). Rural participants had a higher frequency of low knowledge answers compared to urban and suburban ones (21.7% vs. 9.5% and 9.4%, p = 0.011). Only 315 participants (27.9%) were screened for the H. pylori infection, despite high support for the screening programs among the untested (74.7%) and tested (85.7%). Habits of smoking (p = 0.036) and coffee drinking (p = 0.008) were associated with more symptoms after eradication therapy. Further education is needed for the groups at risk for H. pylori infection, especially to raise the awareness of the importance of screening programs. More research is warranted to assess the effects of dietary changes on therapy outcomes.

Did an introduction of CONSORT for abstracts guidelines improve reporting quality of randomised controlled trials' abstracts on Helicobacter pylori infection? Observational study.

OBJECTIVE: To determine abstracts' adherence to the Consolidated Standards of Reporting Trials for Abstracts (CONSORT-A) statement and to explore the factors associated with reporting quality. DESIGN: An observational study. SETTING: Abstracts of randomised controlled trials published between 2010 and 2019, found searching the MEDLINE database. PARTICIPANTS: A total of 451 abstracts of the clinical trials on Helicobacter pylori infections were included. PRIMARY AND SECONDARY OUTCOME MEASURES: Abstracts' reporting quality was determined by assessing their adherence to 17-item CONSORT-A checklist, with overall score being calculated as the sum of items that were adequately reported for each abstract. Additional factors that might influence the reporting quality of the abstracts were analysed, with univariate and multivariate linear regression used to determine how those factors influenced the overall reporting quality. RESULTS: Included abstracts had an overall median quality score of 8/17 (IQR 7-9). Large proportions of abstracts adequately reported interventions, participants, objectives, numbers randomised and conclusions (97.1, 99.3, 89.1. 94.7 and 98.4% of abstracts, respectively). Trial design, randomisation, blinding and funding were severely under-reported with only 8.0, 2.7, 11.0 and 2.0% of abstracts reporting each item. Overall quality scores for H. pylori abstracts were higher in association with CONSORT-A endorsement (B=5.698; 95% CI 1.781 to 9.615), pharmacological interventions (B=4.063; 95% CI 0.224 to 7.902), multicentre settings (B=5.057; 95% CI 2.370 to 7.743), higher numbers of participants (B=3.607; 95% CI 1.272 to 5.942), hospital settings (B=4.827; 95% CI 1.753 to 7.901) and longer abstracts (B=3.878; 95% CI 0.787 to 6.969 for abstracts with 251-300 words and B=7.404; 95% CI 3.930 to 10.878 for abstracts with more than 300 words). CONCLUSIONS: The overall reporting quality of abstracts was inadequate. The endorsement of CONSORT-A guidelines by more journals might improve the standards of reporting.

Adherence to Mediterranean Diet and Tendency to Orthorexia Nervosa in Professional Athletes.

Among many lifestyle components that professional athletes have to follow, nutrition is gradually growing to be one of the key factors for achieving and maintaining optimal sport performance. The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns worldwide; however, data regarding adherence to the MD among professional athletes are still scarce. Moreover, with the imposed need for a healthy diet among professional athletes, orthorexia nervosa (ON) could become a rising issue. This cross-sectional study included 150 professional athletes and 150 matched recreational athletes from Croatia. Four questionnaires were used for the assessment: general information, a test for the diagnosis of ON (ORTO-15), the International Physical Activity Questionnaire (IPAQ) and the Mediterranean Diet Serving Score (MDSS). Significantly more professional athletes were adherent to the MD (p < 0.001) and had a tendency to ON (p < 0.001). Moreover, there was a significant negative correlation between the ORTO-15 score and the total MET min/week score (r = -0.524, p < 0.001) and a significant positive correlation between the MDSS score and the total MET min/week score in the professional athlete group (r = 0.478, p < 0.001). All of these results imply that professional athletes are more concentrated on their dietary patterns than recreational athletes, and that due to this dedication, they possibly have a higher adherence to the MD but also possibly a higher risk for developing ON. However, the association between ON and the MD should be further addressed in the future.