Predrag Jovanovic

Ponosan na pradjeda. Kapetan Boško Petrović (Ljubovija 1882 - Solun 1919). Učesnik Balkanskih ratova, stradao u Prvom svjetskom ratu. Sahranjen na Srpskom vojničkom groblju Zejtinlik parcela 1078. #ww1 #solunci

“Don’t buy a car, it’s a depreciating asset.” Brother, I myself am a depreciating asset. I won’t be here forever.

Acute liver injury, a structured approach: 1. Drugs/toxins Paracetamol (most common) Antibiotics (e.g. amox-clav), anti-TB, statins Herbals/supplements Alcohol, cocaine, mushrooms 2. Viral HAV, HBV, HCV, HEV EBV, CMV, HSV (severe) 3. Ischaemic Shock liver / hypotension Cardiac failure Sepsis 4. Autoimmune Autoimmune hepatitis Acute flare of chronic AIH 5. Biliary/obstructive Acute bile duct obstruction Choledocholithiasis Malignancy 6. Metabolic/other Wilson disease (young) Budd–Chiari Acute fatty liver of pregnancy / HELLP

Luka Doncic Traveling to Europe to treat his grade 2 hamstring strain Germany (& Switzerland) traditionally lead the world in cutting edge medical treatments, especially Stem cells. He’s likely getting a combination of MSC’s, placental tissue, exosomes, as well as other treatments not legal here in the United States. Remind me of what Kobe did many years ago. They will be injected under ultrasound guidance directly into each area of weakness in his hamstring. That’s what I do in my clinic. Additionally, he’s probably using various modalities to speed up the healing, possibly Inuspharesis or TPE. Wouldn’t be surprised if they use Peptides on him over there, as there is a specific type called nano peptides from Switzerland (that I know the manufacturer of). Of course these are banned here in the United States, but if he gets them there and is able to get them cleared from his system before he returns, no issues. Hence the TPE. When I alluded to throwing the ‘kitchen sink’ at him the other day, this is essentially what I meant. I did a deep dive on the different types of Stem cells earlier today if you’re interested: open.substack.com/pub/drjessemor… There’s a very good chance that Luka will be back and ready to play in 3 to 4 weeks. Modern medicine is amazing! I’ll attach my original thoughts regarding Luka’s injury in the next tweet.

@babadajvode3 Davno je Bora sklepao stih:”Boli me k za Irak i Iran, oni se rokaju, a ja sam miran.”

volim ovaj šmek svjetskog rata. . u našem ratu mi je najviše smetalo što mi patimo, a raja na samo 300 kilometara od nas uživa

🇷🇸🤯 15 years ago today, Dejan Stanković scored this incredible goal for Inter! One of the great UEFA Champions League goals. 💫

Hrvatski povjesničar, o borbi četnika za oslobađanje Srbije,

@GamaCahaya so @ROLEX “inspired”

If you’re into watches in any way I’m sure you will have seen the incredible new Longines HydroConquest that launched last week. I’m so happy to finally get this version on my wrist.

@DanaZM05 das Auto

Auto nije imenica srednjeg roda BREEEEEE! Dakle nije TO auto već TAJ auto! Jel to toliko teško?

Iron supplements are typically dosed daily, sometimes split into two doses. Both strategies fight the body's own regulatory system. When you take 60 mg or more of elemental iron, the liver releases hepcidin, a hormone that binds ferroportin, the only iron export channel on intestinal cells, and degrades it. With ferroportin gone, the next dose sits in the enterocyte and never reaches the bloodstream. This shutdown lasts about 24 hours. By 48 hours, hepcidin clears and ferroportin is restored. Stoffel et al. (2017) tested this in 40 iron-depleted (but not anemic) women given 60 mg ferrous sulfate on consecutive vs alternate days. The alternate-day group absorbed 21.8% per dose versus 16.3% for consecutive dosing. Total iron absorbed was also higher: 175 mg vs 131 mg. A 2019 follow-up tested women with iron-deficiency anemia, a population where hepcidin is already partially suppressed by the body's demand for red blood cells. Even there, fractional absorption was 40-50% higher on alternate days. That's the stronger finding: the hepcidin rebound still limits absorption even when the body is actively trying to override it. Caveat: all studies used ferrous sulfate in women. Whether the effect holds for other iron forms or in men is untested. Moretti et al., Blood, 2015. Stoffel et al., Lancet Haematology, 2017. Stoffel et al., Blood, 2019.

Skip breakfast, and you starve the production line for the chemical that keeps you from feeling anxious and depressed. It’s called serotonin, and 90% of it is made in your gut, not your brain. This study pooled 14 studies and 399,550 people to see what happens. Breakfast skippers had 39% higher odds of depression, 23% higher odds of chronic stress, and 55% higher odds of psychological distress. For teenagers it was worse. Anxiety odds jumped 51%. The obvious pushback here is that maybe depressed people just stop eating in the morning. A 2024 genetics study in Nutrition Journal tested exactly that, using DNA from 193,860 people. The method uses inherited gene variants as a kind of natural experiment to tease apart cause from effect. Skipping breakfast raised depression risk by 36%. Depression had zero effect on whether someone skipped breakfast. The arrow only goes one direction. Serotonin is built from tryptophan, a nutrient your body can’t produce on its own. You have to eat it. After 10 to 12 hours of fasting overnight, your tryptophan levels bottom out. Caltech researchers showed in a 2015 Cell paper that specific gut bacteria signal your intestinal cells to start producing serotonin, and without those bacteria doing their thing, mice lost roughly 60% of their gut serotonin. Food is what turns the whole system on. Cortisol (your body’s stress hormone) adds to the picture. Researchers at UC Davis tracked women who regularly skipped breakfast and found their cortisol was elevated from morning through midafternoon, even on completely calm days with zero external stressors. Their daily cortisol rhythm was blunted, a pattern normally seen in people dealing with chronic stress. About 15% of American adults skip breakfast regularly. Among 20 to 39 year olds, closer to one in four. That same age group leads in new depression diagnoses.

BMW 320i, E30. A small, lightweight BMW with a straight-six and a manual. That’s all it needed. Just a modest 123 hp and 170 Nm of torque. It was about how the car felt and not how fast it could go. This 320i has near perfect weight distribution. Analogue, direct and completely connected to the driver. Simple, driver-focused cockpit with supportive seats. Build quality is high for the period, though plastics and electrics can degrade after 30 to 40 years. You don’t need huge numbers to enjoy it. The driving feel does the work. That is why this car has gone up in price as well because over the years its got tougher to find one.

5 Injectables You Should NEVER Administer Rapidly In clinical practice, how you give a drug can be just as important as what you give. Here are 5 injectables that should not be pushed rapidly and why: 1. Potassium (IV KCl) Rapid administration can cause fatal cardiac arrhythmias or cardiac arrest. 2. Magnesium Sulfate Too fast → respiratory depression, hypotension 3. Vancomycin Rapid infusion may lead to “Red Man Syndrome”. 4. Calcium Gluconate Fast administration can cause bradycardia, arrhythmias. 5. Furosemide Rapid IV push increases the risk of ototoxicity (hearing loss) and hypotension.

🩻Contrast-induced AKI: one of the biggest myths still shaping clinical decisions For decades we were taught: 👉 “Contrast damages the kidneys” 👉 “Avoid CT with contrast in CKD” 👉 “Hydrate, protect, delay imaging if needed” But what if… most of this is wrong?🤔 ->The uncomfortable reality Modern evidence shows: 👉 Low-osmolar contrast rarely causes true nephrotoxicity 👉 Even in CKD, AKI, and ICU patients 👉 The risk is often overestimated—or nonexistent So where did the fear come from? 📍 1950s high-osmolar contrast (actually toxic) 📍 Poorly controlled observational studies 📍 “Creatinine rise = contrast injury” assumption 👉 Correlation became causation 👉 And the dogma stayed ⚠️What recent data tells us ✔ No difference in AKI rates with vs without contrast ✔ No benefit from bicarbonate, NAC, or aggressive hydration ✔ Even ICU and AKI patients show no worsening outcomes ->Translation to real life 👉 The patient was going to develop AKI anyway...Not because of contrast!! ->The real problem: “Renalism” 👉 Avoiding necessary imaging 👉 Delaying diagnosis 👉 Choosing inferior tests And that leads to: ❌ Missed PE ❌ Delayed sepsis source control ❌ Worse outcomes ->Clinical mindset shift Instead of asking: 👉 “Will contrast harm the kidneys?” We should ask: 👉 “Will NOT doing the scan harm the patient?” ->Who still deserves caution? ✔ eGFR <30 ✔ Severe hemodynamic instability ✔ Multiple nephrotoxins Even then: 👉 Optimize volume 👉 Minimize dose 👉 Don’t delay critical imaging 🤓Bottom line ✔ Contrast nephrotoxicity exists… but is rare ✔ The fear is bigger than the risk ✔ The harm of NOT imaging is often greater In critical care 👉 We don’t treat creatinine 👉 We treat patients And sometimes… 👉 The most dangerous thing is NOT the contrast 👉 It’s hesitation. 📃Reference Florens N, Demiselle J. Kidney360 7: 445–449, 2026. doi: doi.org/10.34067/KID.0…

It needs to be standard practice of leaders to send their children to war...

@Ahiret_Xpress nepopularno, ali sve vise vjerujem u neke od teorija “zavjere”. Ne ide im rat, pokrivaju poraze i gubitke, odvlaci se paznja sa poskupljenja i nadolazece energetske krize.

Evo nam ga opet, ali u mnogo zescoj verziji

Do sad su trazili doktore za rad u privatnoj praksi. Sad drzavne ustanove traze lekare da dodju da im dezuraju jer nema ko.

@PatogeniP “Ne dugujem ni narodu ni državU”?

U što ljuta😁

A medical doctor can wake up, get tired of the ward, buy a Macbook, and pivot into tech. A doctor can buy a ring light and become a content creator or filmmaker. But a Senior Software Engineer cannot wake up, buy a stethoscope, and decide to pivot into the operating theater. There is a hierarchy to this pivot game.

@NedeljkoElek Nema srbina bez sufiksa -ić 😀 Dakle, vidi ti to sa nekom drugom reprezentacijom da dogovoris (🇹🇷)

Ni jedan Srbin ne treba da navija za reprezentaciju BiH. Tačka!