The common nase (Chondrostoma nasus) as an indicator of aquatic pollution and human health risk assessment associated with its consumption.

Individuals of common nase were sampled from three waterbodies (Kacer river, Zaovine, and Medjuvrsje reservoirs) with different characteristics, types, and levels of anthropogenic pressure. The aims of this study were to determine the concentrations of 26 elements in gills, liver, and muscle using inductively coupled plasma optical emission spectrometry (ICP-OES); determine the concentrations of 17 organochlorine pesticides (OCPs) in muscle tissue using gas chromatography with mass spectrometric detection (GC-MS); compare these findings with fish condition (CF); and conduct human health risk and benefit assessments due to consumption of fish meat using target hazard quotient, target carcinogenic risk factor, Se:Hg molar ratio, Na:K and Ca:Mg ratios, and contribution of elements to human diet. Results indicated that in addition to the fact that the type of ecosystem (lentic vs. lotic) plays an important role in the fate and kinetics of pollutants, the degree of anthropogenic pressure is one of the most important factors of environmental pollution - Zaovine and Medjuvrsje reservoirs (both lentic ecosystems) had the lowest and the highest levels of pollution, respectively. CF did not reflect the differences in accumulation of all analyzed elements in nase tissues. None of the 17 analyzed OCPs were detected due to the absence of recent use. Fish muscle was the least affected by metal pollution at all studied localities and could be safely used for consumption. We recorded several benefits for human health when using the nase meat in human diet.

Case Report: Optical coherence tomography to guide PCI of iatrogenic injury of the circumflex artery after minimally invasive mitral valve repair.

We present a case of a 42-year-old man who suffered an iatrogenic injury to his left circumflex (Cx) coronary artery after mitral valve (MV) repair surgery. After the patient suffered from myocardial infarction without ST-segment elevation following minimally invasive MV surgery, we performed repeated coronary angiography and optical coherence tomography (OCT), which revealed severe coronary stenosis of the dominant Cx caused by intramural hematoma. In addition, we proceeded with percutaneous coronary intervention and stent implantation.

Assessment of Life Quality in Children with Dysphonia Using Modified Pediatric Voice-Related Quality of Life Questionnaire in Serbia.

(1) Background: Hoarseness is not uncommon in children, especially at school age, as communication with peers is intensified. It is caused by improper use or overuse of the vocal apparatus. (2) Methods: The study included 85 hoarse children aged 6-12 (study group) and 240 healthy children (control group) of the same age. The study group underwent a detailed medical history, phoniatric examination, larynx fiber endoscopy, allergy treatment and the Pediatric Voice-Related Quality of Life questionnaire, modified by Jasmina Stojanovic. (3) Results: Our modified questionnaire revealed the significance of parental perception of a voice disorder in a child after organized activities. Using our modified questionnaire, we were able to determine the most frequent form of a voice disorder in children-speaking too loudly-is often neglected by the environment and can lead to an overall lower life quality. (4) Conclusions: As the presence of hoarseness impairs the quality of life in the pediatric population, awareness of a voice disorder must be recognized and treated on time to overcome the possible side effects on a child's psychological and emotional development.

Are Serbian and English listeners insensitive to lexical pitch accents in Serbian?

The paper investigated possible perceptual insensitivity effects in the perception of lexical pitch accents by native and non-native listeners, that is, by Serbian and English listeners, respectively. The objective of the study was to explore which word-prosodic categories listeners used when they were required to contrast and recall sequences of lexical pitch accents. To that effect, Serbian and English listeners performed a Sequence Recall Task (SRT) in which they contrasted pairs of non-words with different Serbian lexical pitch accent types, and recalled the sequences of these non-words under different memory load conditions. Listeners' answers were coded correct and incorrect and the accuracy scores between the groups were compared and analyzed. Both groups had almost identical levels of accuracy and they performed well above chance level on each contrast. Neither group exhibited any effects of perceptual insensitivity to lexical pitch accents. English (non-native) listeners did not differ in their performance from native Serbian listeners, which, contrary to what previous research suggested, implied that one's native language word-prosodic category inventory did not preclude the encoding of non-native word-prosodic categories. Instead, non-native listeners were capable of deploying different prosodic resources such as post-lexical pitch accents to recall the sequences.

Effects of Fructose and Stress on Rat Renal Copper Metabolism and Antioxidant Enzymes Function.

The effects of a fructose-rich diet and chronic stress on copper metabolism in the kidneys are still understudied. We investigated whether fructose and/or chronic unpredictable stress modulate copper metabolism in a way that affects redox homeostasis, thus contributing to progression of metabolic disturbances in the kidney. We determined protein level of copper transporters, chaperones, and cuproenzymes including cytochrome c oxidase, as well as antioxidant enzymes function in the kidneys of male Wistar rats subjected to 20% liquid fructose supplementation and/or chronic stress. Liquid fructose supplementation increased level of copper chaperone of superoxide dismutase and decreased metallothionein level, while rendering the level of copper importer and copper chaperones involved in copper delivery to mitochondria and trans Golgi network unaffected. Stress had no effect on renal copper metabolism. The activity and expression of renal antioxidant enzymes remained unaltered in all experimental groups. In conclusion, fructose, independently of stress, decreased renal copper level, and modulated renal copper metabolism as to preserve vital cellular function including mitochondrial energy production and antioxidative defense, at the expense of intracellular copper storage.

The European Chub (Squalius cephalus) as an indicator of reservoirs pollution and human health risk assessment associated with its consumption.

Five reservoirs (Vlasina, Medjuvrsje, Zaovine, Perucac, and Garasi) in Serbia were chosen as study sites, which differ by their position, purpose, stages of eutrophication, management policies, and levels of anthropogenic pressure. The objectives of this research were to: determine the concentrations of 26 elements in muscle, gills, and liver of the European chub by inductively-coupled plasma optical emission spectrometry (ICP-OES); determine the concentrations of 17 organochlorine pesticides in fish muscle by gas chromatography with mass spectrometric detection (GC-MS); compare these findings with condition factor (CF) and histopathological (HP) biomarkers; and assess the potential human health risks due to consumption of chub muscle tissue. The highest elemental accumulation was found in the gills. The European chub was not a good indicator of Pb pollution between reservoirs. Concentrations of Hg, As, and Cu were low and did not exceed the proscribed maximum allowed concentrations (MACs). 4,4'-DDE was detected only in individuals from Vlasina, 4,4'-DDD from Perucac and Zaovine, and heptachlor from Zaovine. Low to moderate levels of HP were observed for both gills and liver in all studied reservoirs. HP index for gills was significantly higher for Zaovine compared to Vlasina. Significantly lower HP index for liver and the total HP index value were observed for fish from Vlasina compared to Perucac. No significant human health risks due to the intake of examined pollutants in each reservoir were recorded; women were at higher risk compared to men. A reason for concern is a few muscle samples from Garasi, Vlasina, Perucac, and Medjuvrsje in which Cd exceeded the MAC. A reservoir for water supply (Garasi) is generally considered the safest for fish consumption.

Accumulation of 25 elements in gills, liver, gonads, and muscle of European chub (Squalius cephalus), Cactus roach (Rutilus virgo), and pikeperch (Sander lucioperca) from Zlatar reservoir (Serbia).

Accumulation of Al, As, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, Hg, K, Li, Mg, Mn, Mo, Na, Ni, P, Pb, S, Se, Si, Sr, and Zn was analyzed in gills, liver, gonads, and muscle of European chub (Squalius cephalus), Cactus roach (Rutilus virgo), and pikeperch (Sander lucioperca) from Zlatar reservoir (Serbia) using inductively coupled plasma optical emission spectrometry (ICP-OES). The highest concentrations of Cu in liver as well as Ba, Ca, Fe, Mn, Na, P, and Sr in gills were detected in all fish species, while the lowest concentrations of Cu, Fe, Mn, Na, and Zn were detected in muscle. Pikeperch had significantly lower concentrations of Ba in all tissues compared to the other species, as well as Fe, P, and Sr in muscle, K, Mg, Mn, Sr, and Zn in gills, and Fe in gonads. European chub had significantly higher concentrations of Ca, Cu, and Zn in muscle, Cu in liver, and Cr and Cu in gonads compared to Cactus roach and pikeperch. Cd concentration in one individual of Cactus roach exceeded the maximum allowed concentration. The muscle was exposed to the lowest pressure of metal pollution in all species, and European chub accumulated more metals compared to the other species. There is no significant health risk due to consumption of investigated species. A major hazard index (HI) contributor in all species was Hg. According to the target carcinogenic risk factor (TR), target hazard quotient (THQ), and HI, men are under lower health risk compared to the women. The TR and THQ for As, Cr, Cu, Fe, Mn, Ni, and Zn as well as HI values were higher for European chub compared to the other species. On the other hand, THQ for Hg was highest for pikeperch.

Sex-specific elemental accumulation and histopathology of pikeperch (Sander lucioperca) from Garasi reservoir (Serbia) with human health risk assessment.

Accumulation of 26 elements (Ag, Al, As, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, Hg, K, Li, Mg, Mn, Mo, Na, Ni, P, Pb, S, Se, Si, Sr, and Zn) was analyzed in the gills, liver, and muscle of pikeperch males and females from Garasi reservoir using inductively coupled plasma optical emission spectrometry (ICP-OES). Histopathological (HP) changes in the gills and liver, and human health risk were also analyzed. The gills were most affected by metal pollution in both sexes. The concentrations of Hg in muscle tissue of four males, and Cd in two females and two males exceeded the maximum allowed concentrations. Statistical tests only revealed significant differences regarding the concentrations of Mg, K, and S in the muscle (higher in males) and Al, Ag, and Mn in the liver (higher in females) of individuals between sexes. Low to moderate levels of pathological changes were recorded for the gills and liver in both sexes. Significant differences between sexes were observed for inflammatory index of gills (IGI) and HP index of gills (IG), males had higher values compared to females, and for liver necrosis, where females had higher values compared to males. Gills were less affected by HP changes compared to the liver. There was no significant non-cancerogenic and cancerogenic health risk due to the consumption of pikeperch meat from the Garasi reservoir. However, women are under greater risk by consuming the meat of both male and female individuals, probably due to a longer lifetime and lesser body weight compared to the men.

Age-specific accumulation of toxic metal(loid)s in northern pike (Esox lucius) juveniles.

Northern pike specimens of 0+, 1+, and 2+ age classes were collected in June 2013 from the Vizelj channel near Belgrade (Serbia). Inductively coupled plasma optical spectrometry (ICP-OES) and atomic absorption spectrometer SpectrAA 220 were used for analyzing concentrations of As, Cr, Cd, Co, Cu, Fe, Sr, Pb, and Zn, as well as Hg in muscle, gills, and liver. Metal pollution index (MPI) was calculated. Concentrations of As, Cd, Co, and Pb were below the limit of detection. Concentrations of Cu, Hg, and Zn in muscle did not exceed the maximum allowed concentrations. The gills were tissue which was most affected by pollution. The highest concentrations of Fe in muscle, Cr and Fe in gills, and Hg, Sr, and Zn in liver were recorded in 0+ individuals, as well as Zn in gills of 2+ individuals. On contrary, the lowest concentrations were recorded for Zn in gills of 0+ individuals, Hg in gills of 1+ individuals, and Fe in muscle, Cr and Sr in gills, and Zn in liver of 2+ individuals. Regarding age classes, 2+ juveniles had the highest MPI values for all tissues. Correlations between the metal(loid) accumulation and fish condition were not significant, as well as between fish length and weight and Cu and Hg in muscle, Cu, Hg, and Sr in gills, and Cu, Cr, and Fe in liver. Results indicated that young individuals were more sensitive to pollution, but older fish showed higher overall bioaccumulation of toxic elements analyzed in this study.

Impact of reservoir properties on elemental accumulation and histopathology of European perch (Perca fluviatilis).

This study was conducted on individuals of European perch from six reservoirs in Serbia with different properties, used for different purposes, and situated at different altitudes. Samples of muscle, gills, and liver, as well as water samples, were used for analysis of elemental accumulation. Histopathological (HP) analysis of gills and liver, and Fulton's condition factor (CF) were used as biomarkers. Analysis of Ag, Al, As, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, Hg, K, Li, Mg, Mn, Mo, Na, Ni, P, Pb, S, Se, Si, Sr, and Zn was conducted by inductively-coupled plasma optical emission spectrometry (ICP-OES), and accordingly, metal pollution index and bioaccumulation factor (BAF) were calculated. Elemental accumulation varied considerably both among tissues and reservoirs. Reservoirs located on large low-altitude rivers were the most heavily polluted with metals (Meduvrsje, on the Zapadna Morava River, and Lake Sava, on the Sava River). Of three tissues analyzed, the gills were most affected by pollution. The levels of Hg in muscle decreased with an increase in reservoir altitude. Specimens sampled from the highest altitude reservoir were the least affected by HP alterations; however, HP differences between the reservoirs were not statistically significant, and the severity of HP changes was generally low. No significant correlations between the elemental accumulation or HP indices with CF were observed.

Risk assessment of using fish from different types of reservoirs as human food - A study on European perch (Perca fluviatilis).

Concentrations of As, Cd, Cr, Cu, Hg, Pb, and Zn in sediment samples and muscle tissue of the European perch were analyzed using inductively-coupled plasma optical emission spectrometry (ICP-OES), with the aim to assess the potential ecological (RI) and human health risk, and the degree of contamination (Cd) of three types of reservoirs in Serbia, based on their purpose: electricity generation (Vlasina, Perucac, Zaovine, and Meduvrsje), drinking water supply (Garasi), and recreation (Lake Sava). The concentrations of the studied elements were higher in sediments than in fish. However, the levels of Cd in fish caught in Vlasina, Zaovine, and Meduvrsje, Hg in Perucac and Garasi, and Pb in Lake Sava exceeded the maximum allowed concentrations. The pollution load index (PLI) indicated that sediments in all six reservoirs were contaminated, but Cd was low; a moderate contamination with Cd was observed in Vlasina, Perucac, and Zaovine, Cr in Zaovine and Meduvrsje, and Cu in Meduvrsje. A low RI was recorded for all studied reservoirs. Cd was found to be the primary contamination and ecological risk factor. Total target hazard quotient (THQ) and target carcinogenic risk factor (TR) were higher for fishers operating in these reservoirs than for the general population. Higher values of PLI, Cd, RI, and TR were observed in electricity generation reservoirs. Results indicated that this type of reservoirs suffer from higher anthropogenic pressure and/or have a worse pollution management policy compared with other types of reservoirs included in this study, especially the drinking water supply reservoir.

Knuckle technique guided by intravascular ultrasound for in-stent restenosis occlusion treatment.

One of the rarest lesions is in-stent restenosis chronic total occlusion (CTO). Limited data suggest that the treatment success rate is dependent on the possibility to cross into the lumen of an occluded stent, and the decision about what technique to use varies by operator preference. The knuckle technique is used to create a deliberate dissection plane in various CTO techniques. A guide wire is pushed until a complex loop is formed and advanced through the lesion. In this report we present a case where a knuckle wire guided by intravascular ultrasound control is used to penetrate the distal cap in an in-stent restenosis CTO lesion.

Coronary spasm that caused non-ST elevation myocardial infarction appeared in cath lab due to vasovagal reaction.

Coronary artery spasm is sometimes an unrecognized cause of myocardial ischemia. Myocardial ischemia is not always a product of fixed stenosis; it can also be induced by dynamic, transient stenosis. The angiogram represents the current state of vasculature at the time of examination and absence of stenosis does not mean disease absence. We present a case of right coronary artery spasm that caused non-ST elevation myocardial infarction and arrhythmias and was induced again in the cath lab due to vasovagal reaction.

Unusual suspect-coronary subclavian steal syndrome caused severe myocardial ischemia.

Coronary-subclavian steal syndrome represents a reversal of blood flow in left internal mammary artery. The most common cause of the syndrome is atherosclerotic disease in the ipsilateral, proximal subclavian artery. We present a case of 72 years old male, who developed severe anginal and neurological complaints three years after coronary artery bypass graft surgery(CABG).