Immortelle (Helichrysum italicum (Roth) G. Don, family Asteraceae) essential oils (HiEOs) and hydrosols (HiHYs) are widely used in cosmetic, pharmaceutical, and agricultural formulations. However, their composition and quality vary depending on geographical origin and production practices, while standardized reference values-particularly for hydrosols-are still lacking. The aim of this study was to investigate and compare the physicochemical properties and chemical composition of commercial HiEOs and HiHYs from the Adriatic and continental regions of Croatia. Samples were analysed using standard pharmacopoeial methods and gas chromatography-mass spectrometry (GC-MS). Physicochemical analyses (relative density, acid value, refractive index, pH, turbidity, and essential oil content) showed that all samples were within generally accepted quality ranges, with no significant differences observed between regions using the Mann-Whitney U test. HiEOs were dominated by sesquiterpene hydrocarbons (53.15-55.60%), whereas HiHYs contained predominantly oxygenated monoterpenes (43.54-69.86%). The main compounds identified in both fractions were alpha-pinene, neryl acetate, gamma-curcumene, and beta-selinene, which formed a consistent chemical signature and served as practical biomarkers for the quality of H. italicum EO and hydrosol. Principal Component Analysis (PCA) distinguished sample groupings based on physicochemical properties and chemical composition, indicating regional variability without exceeding accepted quality limits. This study presents the first comparative dataset of Croatian commercial HiEOs and HiHYs, and defines practical parameter ranges to support standardized specifications, ensure consistent quality, and enhance the industrial applicability of immortelle-based products.
Development of gait in elementary school children represents a sensitive period of locomotor maturation; however, contemporary lifestyle factors such as heavy school backpack carriage, inappropriate footwear, and the increasing prevalence of overweight and obesity can disrupt normal biomechanical gait patterns and potentially compromise musculoskeletal health. This mini review synthesizes current evidence on how selected modern lifestyle factors influence gait biomechanics in elementary school-aged children (approximately 6–14 years). Based on a comprehensive review of 35 highly relevant studies, the evidence reveals that three primary lifestyle factors significantly alter children's gait biomechanics: backpack carriage, footwear characteristics, and childhood obesity. Backpack loads exceeding 10%–12% of body weight consistently produce alterations in spatiotemporal parameters, ground reaction forces, and postural control. Footwear design, particularly sole flexibility, heel elevation, and barefoot vs. shod conditions modifies foot kinematics, plantar pressure distribution, and joint mechanics. Childhood overweight and obesity induce substantial changes in gait velocity, stride characteristics, joint loading patterns, and plantar pressures. These findings have important implications for school health policies, footwear recommendations, and obesity prevention programs. The evidence underscores the need for multifaceted interventions addressing these modifiable lifestyle factors to promote healthy musculoskeletal development and prevent long-term locomotor dysfunction in children.
Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is associated with adverse outcomes in sepsis, but risk stratification within MASLD remains insufficiently defined. We investigated whether an admission liver-metabolic phenotype framework combining cardiometabolic burden with liver injury/fibroinflammatory risk markers identifies clinically relevant organ-support vulnerability in community-acquired sepsis. Methods: This secondary analysis of the prospective SepsisFAT cohort (378 adults with community-acquired sepsis) classified patients into four phenotypes by cardiometabolic burden (≥2 of: diabetes, hypertension, dyslipidemia, BMI ≥ 30 kg/m2) and liver-risk positivity (FIB-4 ≥ 2.67, APRI ≥ 1.0, liver stiffness ≥ 10 kPa, or FAST ≥ 0.55). The primary outcome was acute kidney injury (AKI), while continuous renal replacement therapy (CRRT), other organ-support outcomes and in-hospital mortality were secondary endpoints. Results: Phenotype distribution was Low-risk 137 (36.2%), Cardiometabolic-only 84 (22.2%), Liver-dominant 88 (23.3%), and Mixed liver-cardiometabolic 69 (18.3%). AKI and CRRT increased across phenotypes (13.9% to 40.6% and 5.1% to 26.1%, respectively), and in-hospital mortality was highest in the Mixed phenotype (26.1%). After Firth-penalized adjustment for age, sex, and admission SOFA, the Mixed phenotype remained independently associated with AKI (aOR 2.82, 95% CI 1.37-5.90) and CRRT (aOR 3.87, 1.50-10.80), confirmed in non-renal SOFA and admission eGFR-adjusted sensitivity analyses. Cardiometabolic burden alone did not confer excess organ-support risk. The same gradient persisted within the MASLD subgroup. Conclusions: Admission liver-metabolic phenotyping identified a renal-vulnerable sepsis subgroup not captured by binary MASLD classification alone. These findings support prospective, multicenter external validation of liver-metabolic phenotyping as a pragmatic approach to renal risk stratification in community-acquired sepsis.
BackgroundThere is a lack of research addressing associations of antidiabetic drug combinations with COVID-19 deaths. We examined whether adding common second-line agents to metformin was associated with COVID-19 mortality risk to inform clinical decision-making when escalating diabetes treatment.MethodsThis is a nationwide retrospective analysis covering the years 2020 and 2021. Data from the National Diabetes Registry (CroDiab) were linked to primary healthcare data, Causes of Death Registry data, and the SARS-CoV-2 vaccination database. Multivariate logistic regression models were developed for each of the combinations to compare the combination with metformin monotherapy. To address confounders, inverse probability of treatment weighting (IPTW) analysis as well as analysis with stabilized weights was performed.ResultsOf 141014 analyzed patients, 1268 (0.90%) died of COVID-19 in 2 years. Weighted results of the drug combinations that showed statistically significant associations to COVID-19 death in comparison to metformin alone were metformin+DPP-4 inhibitor (OR 1.182, 95% CI 1.016-1.376), metformin+sulfonylurea (OR 1.195, 95% CI 1.015-1.406), and metformin+GLP-1 agonist (OR 2.992, 95% CI 2.117-4.229).ConclusionsSome combinations of metformin with second-line antidiabetic drugs might require caution in the context of chronic diabetes mellitus type 2 therapy and COVID-19 related deaths. Findings should be interpreted as hypothesis-generating signals from real-world data rather than evidence of causal drug effects. Further research is needed, especially for metformin+GLP-1 agonist, as well as head-to-head comparisons of combinations therapies.
