Assessment of PM10 pollution level and required source emission reduction in Belgrade area.

The aim of this study was to assess PM10 pollution level and estimate required source emission reduction in Belgrade area, the second largest urban center in the Balkans. Daily mass concentrations and trace metal content (As, Cd, Cr, Mn, Ni, Pb) of PM10 were evaluated for three air quality monitoring sites of different types: urban-traffic (Slavija), suburban (Lazarevac) and rural (Grabovac) under the industrial influence, during the period of 2012-13. Noncompliance with current Air Quality Standards (AQS) was noticeable: annual means were higher than AQS at Slavija and Lazarevac, and daily frequency threshold was exceeded at all three locations. Annual means of As at Lazarevac were about four times higher than the target concentration, which could be attributed to the proximity of coal-fired power plants, and dust resuspension from coal basin and nearby ash landfills. Additionally, levels of Ni and Cr were significantly higher than in other European cities. Carcinogenic health risk of inhabitants' exposure to trace metals was assessed as well. Cumulative cancer risk exceeded the upper limit of acceptable US EPA range at two sites, with Cr and As as the major contributors. To estimate source emission reduction, required to meet AQS, lognormal, Weibull and Pearson 5 probability distribution, functions (PDF) were used to fit daily PM10 concentrations. Based on the rollback equation and best fitting PDF, estimated reduction was within the range of 28-98%. Finally, the required reduction obtained using two-parameter exponential distribution suggested that risks associated to accidental releases of pollutants should be of greater concern.

Assessment of depression and anxiety in patients with chronic liver disease.

BACKGROUND/AIM: In recent years mental health of patients including those with chronic liver disease (CLD), has become interesting because its disturbance leads to reduced quality of life, that is associated with worsening of clinical outcome, reduced compliance and increased mortality. The aim of the study was to determinate the frequency and severity of depression and frequency of anxiety in patients with CLD and to assess the contribution of selected socio-demographic, clinical and laboratory risk factors for depression and anxiety. METHODS: In this cross-sectional study, we used the Hamilton depression rating scale (HDRS) and Hamilton anxiety rating scale (HARS) in patients with CLD. RESULTS: The study included 54 male and 43 female patients. Depression was present in 62.9%, and anxiety in 13.4% of the patients. A higher HDRS was noted in the patients older than 50 years (p = 0.022) and unemployed patients (p = 0.043). The patients with at least one episode of gastrointestinal bleeding had a significantly higher frequency of anxiety than those without bleeding (p = 0.018). A higher HARS score was present in the women (p = 0.011), unemployed patients (p = 0.008) and those with non-alcoholic liver disease (p = 0.007). There was a significant correlation between the mean corpuscular volume (MCV) and the value of the HDRS score, and between serum potassium and sodium levels and HDRS score. CONCLUSION: Age and the mean corpuscular volume have significant influence on the HDRS score while unemployment, gastrointestinal bleeding, serum potassium and serum sodium have predictive value for HARS score.

Doppler assessment of splanchnic arterial flow in patients with liver cirrhosis: correlation with ammonia plasma levels and MELD score.

PURPOSE: To assess the clinical significance of blood flow velocity and resistance index (RI) in the visceral arteries of patients with liver cirrhosis with respect to plasma ammonia (NH3) level and liver function. METHODS: We included 80 patients with liver cirrhosis (58 men) and 20 healthy controls (11 men). Duplex Doppler ultrasonography was used to assess flow velocity and RI in the hepatic (HA), right (RRA), and left renal (LRA), and splenic (SA) (LA) artery. Plasma NH3 was measured by biochemistry. Liver function was assessed by MELD score (model of end-stage liver disease). RESULTS: HA, LRA, and SA systolic flow velocities were greater, whereas RRA diastolic velocity was lower in patients with liver cirrhosis than in controls RI was higher in LRA, RRA, SA, and HA in patients with liver cirrhosis than in controls. NH3 levels were significantly elevated in all patients with liver cirrhosis (p < 0.05) and significantly correlated with RI of RRA, LRA, and SA. CONCLUSION: We found greater renal, hepatic, and LA RI in patients with liver cirrhosis than in healthy controls. The correlation we found between elevated renal artery RI (≥0.70) and MELD score emphasizes the risk of renal dysfunction during progression of liver cirrhosis.