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Background/Aim: Chronic kidney disease (CKD) has seen a rapid increase worldwide in recent decades, now recognised as a global health issue of the 21st century. Optimal, continuous control of hypertension represents a crucial part of treatment capable of slowing the progression of CKD. The aim of this study was to demonstrate that optimal regulation blood pressure control in patients with essential and secondary hypertension, along with CKD, slows the progression of CKD. Methods: The research was conducted at the University Clinical Centre of the Republic of Srpska, Banja Luka, Internal Clinic Nephrology Department. A retrospective-prospective study was blind for patients and lasted for 24 months. It included 97 patients, aged 18 and above, of both genders, hypertensive, in the 3rd or 4th stage of CKD (creatinine clearance of 15-59 mL/min). Assess the outcome of CKD, a "complex (undesirable) clinical outcome" was taken - one of three fundamental clinically undesirable events: double increase in serum creatinine values at the end of 24 months, onset of terminal renal insufficiency, or patient death. Patients were classified into three groups: I group - 30 patients with essential hypertension and CKD with optimally regulated blood pressure; II group - 32 patients with secondary hypertension and CKD with optimally regulated blood pressure; III control group - 35 patients with hypertension of various causes and CKD who did not achieve target blood pressure values. Blood pressure control was measured from month 0 to month 24 - once a month. Laboratory tests were taken every 3 months (red blood cells, haemoglobin, glycaemia, cholesterol, urea, creatinine, uric acid, sodium, potassium in serum and urine). Results: There was a highly statistically significant difference in glomerular filtration rate in the first group compared to the third group and in the second group compared to the third group. No statistically significant difference in glomerular filtration rate between the first and second groups was observed, where good blood pressure regulation was achieved. Conclusion: Optimal blood pressure control in the examined groups, regardless of the cause of CKD, was responsible for slowing the progression of CKD compared to the group with unregulated blood pressure.

The term "civil justice" as used here encompasses a wide range of issues related to civil procedural law, as part of EU legislation such as the "European judicial area" or the "European legal zone", where "judicial cooperation in civil matter" is intended as a means to achieve the greater goal of progressively establishing the "area of freedom, security and justice". Civil judiciary is not limited to the notion of useful "cooperation" between judicial authorities in different Member States in the context of ongoing litigation. Instead, more far-reaching (and politically sensitive) measures are envisaged, such as measures to harmonize the rules of civil procedure and the effects of judicial decisions outside the borders of the Member State making the decision.

In this scientific paper, an analysis of the impact of digitalization on civil law was made, as well as an analysis of the challenges and opportunities that modern civil law faces in the digital age. During the research and development of the scientific paper, the methods of analysis and the inductive-deductive method were used. The development of digitalization and the emergence of new technologies have completely redefined law. Thanks to the rapid development of digital technologies on a global level, certain phenomena that were unthinkable in the past have become common today and represent a great challenge both for civil law and for all entities that practice civil law. The development of digital technology has enabled the application of contracts in electronic form, electronically signed ones, the development of e-justice and many other possibilities, which will be discussed below. Digitization, in addition to offering numerous opportunities for civil law, is also a challenge. It is important to monitor rapid technical developments in the ongoing exchange of information between legal practitioners, policy makers and academia. Only then the appropriate legislative instruments can be implemented in a timely manner. The authors came to the conclusion that digitalization and development of digital technologies have a strong influence on the transformation of civil law

This paper presents various researches conducted by different European and world organizations, as well as national competent bodies dealing with the protection of children's rights on the Internet. There is no doubt that the accelerated development of new technologies affects the daily lives of all of us, and especially the lives of children. As a result of rapid changes at the global level, there are certain risks when it comes to exercising the rights of the younger population. Unfortunately, cyberbullying is becoming everyday and therefore it is necessary to adequately act and implement the Convention on the Rights of the Child, as well as the Family Law of our country (Republic of Serbia), in order to protect children in cyberspace. Also, in this paper, we will focus on the measures that need to be taken in order to improve the safety of children on the Internet. In the last part of this paper, the tort liability of minors for damages on the Internet will be considered.

The most obvious difference between civil law and the common law system is that the civil law system is a codified system, followed by legislation covering this area, while common law is based mainly on case law. The basic principle that applies is that earlier court decisions, usually of higher courts, made in a similar case, should be followed in later cases, ie that precedents should be respected. The paper points out that in civil law the main principles and rules are contained in the text of the law, while case law is only a secondary source of law. On the other hand, common law is predominantly based on court decisions already made. Civil law is based on the application of the law, and common law on the creation of rights. Courts in the civil law system resolve specific cases by applying and interpreting legal norms, while in common law courts, while resolving disputes, and also provide guidance on how similar disputes should be resolved in the future, so that court decisions create legislation.

Introduction: Chronic prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is the most commonly diagnosed non-infectious prostatitis in urology. Studies have shown that CP/CPPS can induce neuroinflammation, which may result in CNS hyperexcitability and a tendency to develop epileptic seizures. Spike salvos are ictal EEG graph elements typical for the experimental model of lindane-induced seizures. There are a number of mathematical models for quantitative analysis of EEG, including the Fast Fourier Transform (FFT). It transforms the signal from time into the frequency domain, providing information on Power Spectral Densities (PSD). Aim: The aim of this study was to investigate the basic characteristics of epileptiform discharges induced by subconvulsive dose of lindane in rats, with experimentally induced CP/CPPS. Material and methods: CP/CPPS was induced by intraprostatic injection of 3% l-carrageenan in male Wistar albino rats. Animals with CP/CPPS were implanted with EEG registration electrodes, and then administered lindane (4 mg/kg, i.p, experimental group, n = 6 per group) or its solvent (DMSO, control group, n = 6 per group). An 8-channel EEG device was used in combination with software developed in the laboratory (NeuroSciLaBG). Ictal EEG epochs were extracted from the original signal and FFT analysis was performed to obtain information taking into account PSD in predefined frequency bands. Results: There was no ictal activity in the EEG of control animals. In experimental animals, ictal activity occurred and the mean duration of the ictal period was 2.06 s. FFT analysis revealed that the Alpha frequency range (7-15 Hz) was markedly dominant during ictal activity. Conclusion: The results of this study showed the characteristics of epileptiform discharges in animals with experimentally induced CP/CPPS. This study and animal model are suitable for future translational studies of the comorbidities of this syndrome.

In this scientific paper, an analysis of the ways of realization and protecting personal rights and author's rights on the Internet has been done. During the research and development of the scientific paper, the methods of analysis and the inductive-deductive method were used. The rapid spread of digital communication technology has caused profound social changes and disturbances. Thanks to their rapid and unpredictable development at the global level, certain phenomena that were unthinkable in the past are common today and pose a great challenge for individuals and companies, as well as for countries. The emergence of the Internet and digital technology has also changed the way personal rights and author's rights are achieved and violated. The author came to the conclusion that the age of digital technology and the Internet has a strong impact on personal rights and author's rights, as well as on the already established legal framework for their protection, both locally and internationally.

Background/Aim. A special feature of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM) is that it is often a symptomatic and occurs as a consequence of cardiovascular autonomic neuropathy. Dysregulation of the autonomic nervous system is associated with elevated values of inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) and interleukin- 6 (IL-6), which accelerate atherosclerosis and the occurrence of cardiovascular complications in patients with T2DM. The aim of the study was to evaluate the importance of determining inflammatory cardiovascular risk markers IL-6 and hs-CRP in screening for the presence of CHD in asymptomatic patients with T2DM. Methods. The study included 169 patients with T2DM without any symptoms and signs of CHD. Ergometric testing proved or ruled out the presence of silent CHD. The levels of hs- CRP and IL-6 were determined by ELISA. Results. IL-6 values were significantly higher in patients with a positive ergometric test (6.83 ± 1.99 pg/mL) compared to patients with a negative ergometric test (3.04 ± 1.39 pg/mL) (p < 0.001). We also found that hs-CRP values in patients with a positive ergometric test were significantly higher compared to patients with a negative ergometric test (6.37 ± 2.25 vs 1.67 ± 1.41 mg/L; p < 0.001). Combinations of IL-6 and hs-CRP with age, HbA1c values, and duration of diabetes, presented through three binary logistic regression models, are significant predictors of silent CHD proven by ergometric testing, ie, with their increase, the probability of a positive ergometric test also increases (p < 0.01). The sensitivity of the associated finding of elevated IL-6 and hs-CRP values in the detection of silent CHD by ergometric testing was 90%, and the specificity was 86%. Conclusion. Hs-CRP and IL-6 are significant predictors of silent CHD, and their determination could be recommended for improving cardiovascular risk stratification in asymptomatic patients with T2DM.

The legal position of animals in civil law, as well as in other branches of law, seeks its foundations in moral / ethical principles. Various philosophical debates have often been a stumbling block to the recognition of the moral rights of animals. The historical challenge has led to courts around the world, casually, challenging moral rights, making decisions in not the best interest of animals. We have witnessed, throughout history, different points of view and approaches to their legal position. Starting from the status of an object of property, which did not exercise legal protection because of its value, but because of the interests of people, all the way to the current view that animals are at the same time subjects and objects of rights. Today, their sui generis legal subjectivity gives them legal capacity for some non-property rights. Also, their specificity is reflected in the fact that at the same time they have the legal position of the objects of law, and property. Although these are living beings who have a developed nervous system, feelings of pain, suffering, stress, fear and the like, the law "worked" exclusively in one direction: distinguishing humans from animals.

While obesity-related nonalcoholic fatty liver disease (NAFLD) is linked with metabolic dysfunctions such as insulin resistance and adipose tissue inflammation, lean NAFLD more often progresses to liver fibrosis even in the absence of metabolic syndrome. This review aims to summarize the current knowledge regarding the mechanisms of liver fibrosis in lean NAFLD. The most commonly used lean NAFLD models include a methionine/choline-deficient (MCD) diet, a high-fat diet with carbon tetrachloride (CCl4), and a high-fructose and high-cholesterol diet. The major pro-fibrogenic mechanisms in lean NAFLD models include increased activation of the extracellular signal-regulated kinase (ERK) pathway, elevated expression of α-smooth muscle actin (α-SMA), collagen type I, and TGF-β, and modulation of fibrogenic markers such as tenascin-X and metalloproteinase inhibitors. Additionally, activation of macrophage signaling pathways promoting hepatic stellate cell (HSC) activation further contributes to fibrosis development. Animal models cannot cover all clinical features that are evident in patients with lean or obese NAFLD, implicating the need for novel models, as well as for deeper comparisons of clinical and experimental studies. Having in mind the prevalence of fibrosis in lean NAFLD patients, by addressing specific pathways, clinical studies can reveal new targeted therapies along with novel biomarkers for early detection and enhancement of clinical management for lean NAFLD patients. [ABSTRACT FROM AUTHOR]

Emotions are specific psychological states brought about by neurophysiological changes associated with feelings, thoughts and behavioral responses. Emotions were considered as irrational experiences beyond the domain of logical perception because of their intertwinement with mood, temperament, creativity, motivation and personality. Through the centuries, emotions have been the focus of research among great classical philosophers, doctors, neuropsychologists, neuroscientists, neurologists and psychiatrists. The neurophysiological basis of behavior, such as emotional facial expression, and autonomic events in the physiological theory of William James and James-Lange and modified by Cannon-Bard, was followed by the two-factor theory of emotions of Schachter-Singer and Lazarus’ higher-order cognitive evaluation. Four components that influence each other represent the concept of emotions and complete the overall emotional experience, and these are: autonomous (increase in heart rate, blood pressure); somatic (body language, facial expressions); cognitive (control, management), and subjective feeling (emotion, individual experience). The interplay between emotions and cognition has been the subject of research. Emotions can be evoked reflexively by simple physical stimuli (bottom-up), but can also be complex reactions involving cognitive, physiological and behavioral reactions (top-down). The amygdala, the “alert" or “neural alarm” structure, is responsible for conditioning fear, while the medial prefrontal cortex participates in emotion self-regulation and decision making.

This scientific paper analyzes cultural diplomacy and its role in the protection of cultural wealth, which is essential for the recognition and identification of a nation, culture, territory. In the research and writing of the scientific paper, the method of analysis, the historical method and the inductive-deductive method were used. Thereby, the result was that in the distant past it was debated and appealed to practice cultural diplomacy and to conventionally prescribe how states should behave, ie not to endanger, destroy or damage the cultural wealth of the endangered state. Such conventions, instructions and declarations have been created, accepted, ratified, but still, there are military attacks aimed at achieving territorial domination, which directly endangers the cultural wealth of the states. This means that weaknesses in cultural diplomacy still exist and it is necessary to work towards overcoming them. In this scientific research, we will pay special attention to the use of cultural diplomacy in the protection of the cultural treasures of the Serbian people in Kosovo and Metohija.

In this scientific paper, an analysis of the instruments for ensuring payments within the given deadlines in commercial transactions provided in the Law on Obligations has been performed. During the research and development of the scientific paper, the methods of analysis and the inductive-deductive method were used. Debt arrears as a legal institute is known as far back as Roman law. The Law on Obligations precisely defined the debt arrears. Pursuant to the provisions of the Law on Obligations, the debtor is late when he does not fulfill the obligation within the deadline set for fulfillment. Business conditions in our economy where many legal entities are insolvent and exceed the set deadlines for fulfilling obligations, have imposed the need for a precise legal regulation of instruments for improving the execution of payments within the given deadlines in commercial transactions between legal entities. The Law on Obligations provides instruments to improve the execution of payments in commercial transactions, which are used as additional instruments to the Law on Deadlines for Settlement of Monetary Obligations in Commercial Transactions.

The right of the mortgagee and the mortgage relationship as part of the content of the mortgage is a very interesting area for research and study. Within the research and studies in this area, there are a number of elements that need to be analyzed and appropriate conclusions drawn. We have covered the concept of mortgage, mortgage relationship, rights and obligations of the mortgagee and the debtor, as well as the right of the mortgagee in case of reduction of the value of the mortgage by the debtor, by his act, to jeopardize the interests of the mortgagee.

Introduction/Objective. Due to a very high mortality risk, acute-on-chronic liver failure (ACLF) patients require early identification and intensive treatment. Precise prediction is crucial for determining the urgency degree and therapy appropriateness, considering high mortality and multitude of clinical resources. The aim of our study was to determine the exact cut-off values of various prognostic scores in the prediction of morality of ACLF. Methods. This prospective study includes chronic liver disease (CLD) patients, admitted due to decompensation, that were subsequently diagnosed with ACLF at the Emergency unit. All patients were evaluated based on various prognostic scores, including Child–Pugh, MELD Na, MELD, SOFA, APACHE II, and CLIF C, which were calculated on admission. Results. Alcoholic liver disease (ALD) was the most common underlying CLD cause (77.9%), followed by viral (8.6%), autoimmune (7.7%), and other causes (5.8%). A total of 37.5% of the patients died at the end of the first month of treatment. Average values of Child–Pugh, MELD Na, MELD, SOFA, APACHE II, and CLIF C scores were significantly higher in patients who died compared to survivors (p < 0.05). CLIF C score showed the best performance with a cut-off value of 50.5, with a sensitivity of 94.9% and specificity of 40%. Conclusion. ACLF remains a condition with a high short-term mortality. Of all of the scores examined in our study, CLIF C proved to be the best scoring system for predicting short term and end of treatment mortality in patients with ACLF.

Lindane-induced seizure in rats is a model of refractory generalized epilepsy. Hydrogen sulfide (H2S) is a gasotransmitter with different physiological and pathological roles. Cystathionine-β-synthase (CBS) is a major enzyme responsible for H2S production in the brain. The aim of this study was to investigate the effects of H2S production inhibition using aminooxyacetate (a CBS inhibitor) on behavioral and EEG manifestations of lindane-induced seizures. Male Wistar rats with previously implanted EEG electrodes were intraperitoneally (i.p.) treated with 4 mg/kg lindane and observed for convulsive behavior and EEG manifestations during the next 30 min. Aminooxyacetate (5, 15 and 25 mg/kg, i.p.) or saline, was injected 30 min prior to lindane. Convulsive behavior was assessed by seizure incidence, latency time and severity (grades 0-4). The number and duration of ictal periods in the EEG were also analyzed. Seizure incidence was higher in rats treated with aminooxyacetate (AOA) before lindane, but not significantly when compared with those treated only with lindane. However, AOA significantly decreased the latency time and augmented the severity of lindane-induced seizures in a dose-dependent manner. EEG analysis revealed an increased number and duration of ictal periods in rats receiving AOA prior to lindane. H2S production inhibition aggravated lindane-induced seizures, which showed a functional relationship between H2S and the effects of lindane.

In this scientific paper is made an analysis of the abuse of diplomatic immunities and privileges as a modern security-diplomatic challenge that needs to be overcome. The method of analysis, the historical method and the inductive-deductive method are used. It was concluded that the abuse of diplomatic immunities and privileges is a problem that dates back a long time and since the distant 1980s, there have been initiatives to change the Vienna Conventions related with the abuse of diplomatic immunities and privileges. Unfortunately, such serious changes have not taken place and therefore this security risk is still present in the practice of countries around the world and there are more and more examples of the practice where diplomats serve individual interests driven by socio-destructive or political intentions instead of institutional and state goals. Thereby, there is a violation of the principles of diplomatic work and the spread of the danger regarding the secure future of the citizens and institutions in the recipient countries.

Lindane is a scabicide and pesticide that can exert neurotoxic effects such as tonic and clonic seizures that are refractory to many antiepileptic drugs. Folic acid stands out as a potential substance worth testing for its neuroprotective and in certain experimental models anticonvulsive effects. The aim of the present study was to examine the potential therapeutic value of folic acid supplementation on the behavioral characteristics of lindane-induced seizures. Adult male Wistar rats were divided into the following groups: Controls: dimethyl sulfoxide-injected (C1), saline-treated (C2); lindane (4 mg/ kg; 6 mg/kg; 8 mg/kg; L4; L6; L8, respectively); folic acid 15 mg/kg (F) and F administered 30 min prior to L4, L6, or L8 (L4F; L6F; L8F, respectively). Convulsive behavior was assessed by the incidence of seizures, seizure latency and seizure severity. Lindane administration has shown a tendency of proportional increase in seizure incidence, decrease in seizure latency and increase in seizure intensity. Pretreatment with folic acid significantly prolonged the latency period and decreased the frequency of grade 4 seizures in the L8F group when compared to the L8 group. We concluded that folic acid alleviates the behavioral manifestations of lindane-induced seizures and that it can be applied as a potential adjuvant in lindane-poisoned patients; however, further research is still needed. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175032]

Background/Aim. The outcome of rectal cancer is dependant on the stage of the tumour. There are several classification systems used to describe the extent of the disease. The aim of this study was to compare the efficacy of transrectal ultrasonography (TRUS) in preoperative local staging of rectal cancer using endosonographic probes with different views (180° vs 360°), as well as an influence of experience of an endoscopist on the TRUS performance. Methods. TRUS was performed in 127 patients with rectal carcinoma by two endoscopists. Seventy-one patients were examined with a 180° endosonographic probe (group A) and 56 patients with a 360° rotating probe (group B). All findings were compared with a histopathology report. Results. TRUS had a diagnostic overall accuracy of 91.3% for the tumor (T) category (k = 0.866, SE (k) = 0.038, p < 0.0001) and 71.7% for the node (N) category (κ = 0.374, SE (k) = 0.082, p < 0.0001). In the group A, TRUS had a diagnostic overall accuracy of 88.7% for the T category (κ = 0.805, SE (k) = 0.063, p < 0.0001), and 70.4% for the N category (κ = 0.376, SE (k) = 0.101, P < 0.0001). In the group B, TRUS had a diagnostic overall accuracy of 94.6% for the T category (κ = 0.920, SE (k) = 0.044, p < 0.0001), and 73.2% for the N category (κ = 0.379, SE (k) = 0.131, p = 0.004). Experience of the endoscopist had no significant influence on results of preoperative staging of rectal cancer by using TRUS. Conclusion. The accuracy rate of TRUS in the preoperative local staging of rectal cancer is high. Our results imply no significant difference in the overall accuracy rates when using endosonographic probes with different views (180° vs 360°). Also, there was no significant influence of endoscopist experience on results obtained.

Introduction: EEG is a widely used method of epilepsy examination. In order to quantitatively inspect ictal EEG findings, a number of mathematical models have been developed over the years, one of them being the Fast Fourier Transform (FFT). It transforms the signal from time domain into frequency domain, giving information about their power spectral densities (PSD). Lindane is a well-established neurotoxic agent often used in experimental studies as a model of generalized epilepsy. This study aims to quantitatively examine the characteristics of ictal EEG activity in rats on model of generalized epilepsy induced by lindane. Materials and Methods: Wistar albino rats were used for the study. Electrodes were surgically implanted over the frontal, parietal and occipital cortices of each animal for EEG recording purposes prior to lindane administration in convulsive dose. An 8-channel EEG apparatus was used, combined with a software developed in the Laboratory (NeuroSciLaBG). Ictal EEG epochs were extracted from the original signal and FFT analysis performed to obtain information considering PSD in predefined frequency bands. Amplitude histogram feature of the software was used to differentiate ictal spikes based on their voltage. Results: FFT analysis has yielded important information regarding spectral powers in frequency domain. Ictal EEG showed considerable stratification, theta frequency band (4-7 Hz) being markedly dominant. Amplitude histogram showed the majority of spikes to be in the voltage ranges up to 250 μV, while higher voltage spikes were rarely observed. Conclusion: FFT is capable of giving important information about ictal period characteristics. Ictal periods induced by lindane are characterized by dominancy of theta rhythm and spiking activity mostly in amplitude bins up to 250 μV. FFT and amplitude histograms can be of critical importance in the future pharmacological and toxicity studies.

Delta sleep-inducing peptide (DSIP) is an endogenous peptide that is constantly present in several different brain regions. Lindane is used as a pesticide and scabicide, but it also induces seizures refractory to conventional antiepileptics. The aim of this paper was to determine whether DSIP modulates lindane-induced seizures in rats in a behavioral and electroencephalographic (EEG) study. DSIP (1 mg/kg, i.p.) or dimethyl-sulfoxide (DMSO, 0.5 ml/kg, intraperitoneally (i.p.)) were injected 30 min before lindane (8 mg/kg, i.p.) to adult male rats with previously implanted electrodes for EEG registration. During the following 30 min, the EEG was registered, and the following behavioral characteristics of seizures were observed: incidence, latency and intensity. A descriptive scale with grades from 0 to 4 provided an estimate of seizure intensity. In the EEG, the number and duration of ictal periods were analyzed using NeuroSciLaBG (Belgrade, Serbia) software. The lethality rate was also analyzed. DSIP-treated animals showed significantly modified characteristics of lindane-induced seizures when compared to the group without DSIP pretreatment (i.e. a reduced seizure intensity and a prolonged seizure latency period). However, no significant effects of DSIP on seizure incidence and lindane-induced lethality were observed. EEG analyses showed a significantly decreased number of lindane-induced EEG ictal periods in DSIP-treated animals, but with unaltered duration. These results show that DSIP favorably modulates lindane-induced seizures in rats, showing a potential to be an adjuvant component of antiepileptic treatment strategy for refractory seizures. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175032]

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Background/Aim. In recent years, many studies have demonstrated a proximal shift in the distribution of adenomas and colorectal cancers. The aim of this study was to investigate whether there are differences in the incidence and anatomical distribution of adenomas and colorectal cancers spanning a 20 year time gap. Methods. We performed a retrospective observational study of colorectal adenomas and cancers diagnosed during total colonoscopy in a high volume tertiary care facility in two 1-year periods of time – 1990 and 2010. Results. During the analyzed period, 4,048 colonoscopies were performed, 1,148 were performed in 1990 and 2,900 were done in 2010. The study included 466 patients with adenomas and 121 patients with colorectal cancers. Frequency of proximal adenoma changed from 16.5% to 32.7% (p < 0.001). By analyzing colonoscopies in 2010, an increase in the incidence of adenomas compared to 1990 was noticed. The number of adenomas sized 0–5 mm rose from 32.8% to 56.9% (p < 0.001). Frequency of colon carcinoma changed from 5.3% to 2.0% (p < 0.001). Incidence of cancers in the proximal colon rose from 21.3% to 48.4% (p = 0.002). A higher incidence of cancers in the proximal colon and a lower incidence of distal cancers were observed, while no difference was observed in the incidence of rectal cancers. Conclusion. Presence of proximal colon adenoma and cancer is higher, while the overall incidence of colon cancer is lower. This finding should be taken into account when planning the screening for colorectal cancer.

During the process of evolution, human brain has developed an extraordinary characteristic of neuroplasticity, which is the capacity to change its structure and function under the influence of the external environment and experience. Numerous studies and evidence suggest beneficial effects of exercise on the brain and mental health. It is considered that exercise leads to the improvement of cognitive functions, with a particular emphasis on learning and memory. It was also found that exercise reduces the risk of developing dementia, it manifests an antidepressant effect and deflects cognitive decay in aging. This positive outcome is reflected in neurophysiological measures that showed increased prefrontal and temporal gray matter volume, decreased latency and increased amplitude of event related potentials in physically active individuals compared to sedentary controls. Even though the idea of the beneficial effects on mental health has been present for centuries, only recent studies have identified possible mechanisms that produce a synergistic positive effect. Potential neural mechanism that has been singled out is increased synthesis and release of neurotransmitters and neurotrophins, which then stimulate neurogenesis, angiogenesis and neuroplasticity. Exercise represents a potential adjuvant therapy in the treatment of neurodegenerative diseases, which not only reduces the cost of treatment, but also contributes to improving the quality of life and improving the mental health of an individual. It is therefore necessary to direct research into understanding the mechanisms by which exercise affects the brain.

Backgrund/Aim. In recent decades noninvasive methods for the assessment and monitoring of liver fibrosis have been developed and evaluated in numerous chronic liver diseases. The aim of this study was to evaluate the diagnostic accuracy of noninvasive markers for fibrosis assessment transient elastography (TE) and biochemical markers using liver biopsy as reference in patients with primary biliary cirrhosis (PBC). Methods. One hundred and twenty-two patients underwent both liver biopsy and blood tests on the same day and TE in a month following the biopsy and the tests. Liver biopsies were reviewed by a single pathologist using the METAVIR scoring system for assessment of liver fibrosis. Aspartate aminotransferase (AST), platelet ratio index (APRI), Forns scores, AST and alanine transaminase (ALT) ratio and TE were compared with liver fibrosis stage in order to determine the best noninvasive marker of liver fibrosis. Results. There was a statistically significant difference (p < 0.05) for the APRI score, Forns index and TE according to stages of liver fibrosis. TE showed superior diagnostic performance when compared to other surrogate markers of liver fibrosis that were investigated. Optimal cut-off for TE were 4.25 and 5.9 kPa for diagnosing the presence of fibrosis and distinguishing mild/moderate and advanced stages of fibrosis respectively. The areas under the receiver operating characteristic (AUROC) of TE were 0.963 and 0.865, respectively. Conclusion. Based on our investigation the APRI score, Forns index and TE adequately predict fibrosis stage in patients with primary biliary cirrhosis, but the most sensitive and specific parameter appears to be TE. Using noninvasive markers and methods in the evaluation of patients in daily clinical practice may reduce, but not eliminate, the need for invasive diagnostic procedures.