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Introduction/Objective. Recognizing the reasons for the unmet health needs of adolescents and young adults is important for identifying the barriers in solving certain health problems, as well as for monitoring the availability, level of use and implementation of healthcare. The aim of this study was to establish the socio-demographic and socio-economic parameters associated with unmet healthcare needs of adolescents and young adults in Serbia. Methods. This cross-sectional study is a part of the 2019 Population Health Survey of Serbia, carried out by Statistical Office of the Republic of Serbia in cooperation with the Dr. Milan Jovanović Batut Institute of Public Health of Serbia and the Ministry of Health of the Republic of Serbia, on a stratified two-stage sample. The survey included 1519 respondents, aged 15–24 years. The instruments and methodology of the European Health Survey – third wave (EHIS-wave 3) were used. Factors associated to unmet healthcare needs were examined using logistic regression and the χ2 test. Results. Unfulfilled health needs were present in 4.1% of respondents, and the dominant reasons were finances (44.4%) and long waiting times (34.9%), distance from health institutions was recorded in 1.6% of respondents, while 19.5% of respondents stated several reasons. Multivariate analysis revealed that significant parameters of unmet healthcare needs include age, region, marital, and employment status. Conclusion. The results of this research can give a new direction in creating strategies and defining preventive programs to reduce inequality in the health of adolescents and young adults improve the health of future young generations.

Gluten-related disorders are a heterogeneous group of clinical entities caused by intolerance to wheat, rye, and barley flour components. They occur in 3–5% of genetically predisposed persons and, based on pathogenic and clinical features, are classified into celiac disease, non-celiac gluten sensitivity, and wheat allergy. There are also specific entities such as dermatitis herpetiformis or gluten ataxia, which can occur either within the celiac disease or independently. This article based on the current knowledge shows the basic details of the pathogenesis, clinical expression, diagnosis, and treatment of these disorders.

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Introduction/Objective. Previous studies have confirmed the effect of different meteorological parameters on patients suffering from lung diseases. The objective of the study is to investigate the impact of meteorological phases on the death rate from chronic obstructive pulmonary disease (COPD). Methods. The data on the number of deaths caused by COPD and meteorological phases during a five-year period (2011–2015) in Šumadija District (Central Serbia) were obtained from the Republic Hydrometeorological Service and the Center for Biostatistics and Informatics of the Kragujevac Institute of Public Health. Results. A statistically significant correlation was determined between certain meteorological phases and COPD death rate. The highest death rate was determined during colder months, February and March. The lowest death rate was detected during the warm months (June–September). Although men died more often from COPD than women, the death rate of women showed a considerable increase during the five-year period. Conclusion. COPD death rate is highly dependent on the season of the year and might be associated with certain meteorological phases. There is a need for further research of the impact of meteorological phases on the morbidity and mortality from COPD.

Introduction/Objective. The purpose of this study was to determine if patient-related factors, such as hospitalization length and preoperative use of walking aids, and geometrical factors, measured with antero-posterior radiographs of hip, affect the risk of hip dislocation after total hip arthroplasty. Methods. A total of 36 of 433 (8.31%) patients with hip dislocation were identified in the institutional registry during a two-year period. The data for patients with and without hip dislocation were matched and compared. Results. Hip dislocation more often occurred in patients who had used walking aids before the operation compared to the ones who had not (p < 0.001). Also, a difference in the number of hip dislocations was noticed between the patients who stayed longer in the hospital after THA (p < 0.001). The patients with higher acetabular inclination angle (p < 0.005) and height of greater trochanter (p < 0.001) on radiographs had been more prone to hip dislocation. In addition to this, the “safe-zone” was not identified in our study (p > 0.005). Conclusion. Several factors which influence hip dislocation were identified in this study: patient characteristics and radiograph characteristics. Both groups of factors require attention and monitoring in future studies.

Background/Aim. Asthma is the most common chronic disease in children and adolescents and has shown an apparent increase in incidence in recent years. The first purpose of the study was to evaluate the influence of education about proper use of inhalers on quality of life in children with asthma. Secondly, we aimed to understand which aspects of quality of life in children with asthma can be significantly improved after education and to identify factors that may affect the level of that improvement. Methods. In this prospective, before-and-after interventional study, a total of 147 children with asthma were enrolled. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) was used to measure the functional problems that are most troublesome to children with asthma. We used the Asthma Control Test (ACT), based on a series of question about symptoms and daily functioning, to identify patients with poorly controlled asthma. Forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) were also determined. Trained educators estimated patients’ inhaler technique and collected questionnaire information. Results. Multivariate analysis of covariance indicated significant differences between PAQLQ and ACT scores which all were significantly higher after education about proper use of inhalers (p < 0.001). A number of children demonstrating a correct inhalation technique improved from 28 (19%) to 127 (86.4%) (p < 0.001). Asthma severity accounted for the largest proportion of variability PAQLQ and ACT scores (38.4%). Conclusion. Inhaler technique improvement contributes to better asthma control in children with asthma rather than to their quality of life. Asthma severity proved to be a major contributor to variations in PAQLQ and ACT scores and significant obstacle for quality of life improvement in children with asthma. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175046]

Introduction/Objective. Strict gluten-free diet for life is the only treatment for patients with coeliac disease. Limited selection of food options can affect their quality of life and cause problems in acceptance by their peers. The aim was to examine the subjective quality of life experience in children and adolescents with coeliac disease and to obtain a comprehensive representation of physical and mental impairments and social functioning compared to their healthy peers. Methods. The study was conducted as a cross-sectional study. It included 116 respondents aged 5–18 years with coeliac disease and 116 healthy children of similar age and sex. A Serbian version of Pediatric Quality of Life Inventory (PedsQL) was used to measure the quality of life in children. Descriptive statistics were calculated to analyze all results, while t-test was used to compare them. Results. The mean value of total PedsQL score was lower in the coeliac disease patients (75.89 ± 20.35) than in the controls (86.35 ± 11.13). Additionally, the experimental group reported lower all PedsQL Scale scores than the control group in the domains of psychosocial, school, social, and emotional functioning. However, there was no statistically significant difference on the physical health scale. These results were the same in all age groups among both males and females. Conclusions. The disturbance of health-related quality of life in children and adolescents with coeliac disease is significant and the quality of life is lower if compared to their healthy peers.

Background/Aim. The most frequent form of sternal defects is a single foramen, usually located at the distal half of the sternal body, with prevalence that varies among different ethnic populations. Clinical importance of these defects arises from various diagnostic and therapeutic sternal treatments and close location of heart, lungs and other vital organs of the chest cavity. The aim of this study was to determine the prevalence and morphometric characteristics of the sternal midline foramen in the population of central Serbia. Methods. The multidetector computed tomography (MDCT) chest images of 422 patients of both genders were analyzed. The radiological imaging was performed on 64- slice MDCT scanner (Aquilion 64, Toshiba, Japan). All scans were performed in the axial plane, with subsequent multiplanar reconstruction (MPR). Due to the angulation of the sternal body coronal curved-planar, the images were obtained in order to show the whole length of the sternum and the vertical diameter of the sternal foramen. The measurements were done using the commercially available software (Imaging Software ver. 4.1.14.0, Vital-Images). Results. The solitary foramen, located in the distal segment of the sternal body, was detected in 24 patients, representing 5.9% of the observed population with slightly higher prevalence in males. The average size of foramen was 3.9 × 4.2 mm. The mean distance from the skin was 12.7 ± 3.3 mm, the distance from skin to pericardium was on average 37.3 ± 8.2 mm, while the average distance from skin to pleura was 25 ± 5.9 mm. The average depth of foramen 8.7 ± 2 mm, while the mean distance from the posterior surface of foramen to pericardium was 12.7 ± 9.1 mm. Conclusion. The results presented in this paper confirmed the prevalence of 5.9% regarding the midline sternal foramen in the observed population. Serious complications of the sternal puncture could be prevented by prior MDCT imaging.

Background/Aim. Non-communicable diseases (NCDs) are a major public health challenge worldwide. Although they are preventable, NCDs are the major global causes of morbidity and mortality, absenteeism, disability and premature death. The aim of this study was to examine socioeconomic inequalities in the prevalence of non-communicable diseases in Serbia. Methods. Data from the 2013 National Health Survey of the population of Serbia was used in this study. There were 13,765 adults interviewed, aged ≥ 20 years. We used multivariate logistic regression analyses with demographic and socioeconomic determinants of health as independent variables and prevalence of non-communicable diseases as a dependent variable. The minimum level of significance was p < 0.05. Results. Hypertension was the most prevalent NCDs (36.1%). The prevalence of multimorbidity was 47.1%. Multivariate logistic regression analysis showed that gender, age, place of residence, employment status and education were associated with the presence of NCDs. The odds ratio (OR) for age was 1.074 [95% confidence interval (CI) : 1.070–1.077). Women were at a higher risk of NCDs by 58.9% when compared to men (OR = 1.589; 95% 95% CI : 1.467–1.726). Respondents who lived in the rural areas were at a higher risk for NCDs by 14.1% compared to those who lived in urban areas (OR = 1.141; 95% CI : 1.047– 1.244). Odds ratio for unemployment was 1.227 (95% CI: 1.118–1.346). Respondents with primary education were at a higher risk for chronic diseases by 47.1% (OR = 1.471; 95% CI : 1.281–1.687) while those with secondary school were at a higher risk by 27.7% (OR = 1.277; 95% CI : 1.142–1.428) compared to respondents who had higher education. When it comes to Wealth Index, univariate logistic regression analysis showed that respondents who belonged to the poor and middle classes were at a higher risk for NCDs (OR = 2.031; 95% CI : 1.819–2.267; OR = 1.473; 95% CI : 1.343– 1.615) compared to respondents who belonged to the rich class. Multivariate logistic regression analysis did not show statistically significant correlations between the Wealth index and NCDs. Conclusion. Socioeconomic inequalities in health status are the major challenge and should be a target of national health policy in Serbia, not only because they represent social injustice but also because solving the health problems of underprivileged groups of the population can influence improvement of health status of the population as a whole.

Celiac disease is an autoimmune disease, which occurs due to inadequate immune response in genetically predisposed individuals in contact with gluten contained in wheat, rye, barley and oats. Removing gluten from the nutrition can be a difficult task, because wheat and other grains that contain gluten are widely used in people's daily nutrition, across the world By this paper we want to evaluate the available literature, and make a review of gluten-free diet effect on the way of life of children with celiac disease Following aspects such as cross-contamination with grains containing gluten, high prices, low availability of gluten-free products and improper labeling of food can jeopardize the treatment ie. respect of gluten free diet. Survey of literature indicates that the gluten-free diet brings a lot of social compromise in the lives of children and families who have a member with this problem in the daily life of the organization. The high incidence of psychological problems such as anxiety, depression, fears, feelings of sadness and low tolerance for frustration was observed in children with celiac disease. For better and healthier life of patients with celiac disease, the constant supervision over the production and trade of gluten-free products is needed. In addition to the aforementioned, continuous education of health workers, pharmacists, caterers, hoteliers and traders about the disease. is. required as well as a broader social activity and greater involvement of social institutions.

Objective of this cross-sectional study was to determine blood lead concentrations in children, living in the vicinity of the Zajača lead-antimony mining-milling-smelting complex. Other aims were to compare blood lead levels (BLLs) of exposed children to those of partially exposed and non-exposed, and correlate values of BLLs from two consecutive sampling series in 2012 and 2013. Performed laboratory method was atomic absorption spectrometry (AAS). Statistical significance of comparisons was tested by univariate methods and non-parametric tests for the attributable variables: Hi-square test, proportion test. In the case of non-parametric variables, following tests were used: Kolmogorov-Smirnov Z test for testing distribution's normality; ANOVA for the normal distribution, while a Kruskal Wallis Test was used in cases without normal distribution. 142 participants were tested on lead in blood: exposed, partially exposed, and non-exposed). Mean BLLs in children living at less than 1 km from the smelter was 18.98 µg/dl , at first test series, and 12.21 µg/dl, in the second round. For those living further than 3 km mean BLLs at first series was 8.30, and at the second series it was 5.85). Blood lead concentrations in children from Zajača are highest.

Mining and mineral processing is still a vital source of income in Serbia, due to mineral abundance in copper, lead, zinc, antimony. Copper mining and metal-processing are located in the east: Bor, Veliki Krivelj, Cerovo, Majdanpek. Abandoned sites from antimony mining and processing and secondary lead smelter are at the western border: Zajača, Krupanj, Stolice. Coal mining and power plants are surrounding Belgrade: Obrenovac (2 power plants), Grabovac (plant ash landfill), Kolubara and Kostolac. Main objective is to focus on potential public health hazards from industrial contamination in Serbia. Key public health issue is presence of As and Cd in ambient air PM10 close to industrially contaminated sites due to the fact that ores have high naturally occurring contents of heavy metals and metalloids. Data originate from Serbian Environmental Protection Agency, Mining and Metallurgy Institute Bor, Belgrade Institute of Public Health, as part of continuous measurement of air quality within State network of automatic stations. Concentration of As in PM10 are extremely above the limit value in Bor and Lazarevac, with Cd values slightly increased in Bor. Serbia lacks the legal framework for continuous and institutionalized follow-up of population groups vulnerable to hazardous environmental exposure, although measured concentration indicate urgent need for such activities.

Background/Aim. Mental health of university students is under increasing concern worldwide, because they face challenges which predisposes them to depression and anxiety. The aim of this study was to identify demographic and socioeconomic variables associated with depressive and anxiety symptoms among university students. Methods. This cross-sectional study on 1,940 university students was performed using a questionnaire including demographic and socioeconomic variables, Beck Depression Inventory and Beck Anxiety Inventory. Results. The prevalence of depressive symptoms in students was 23.6%, while the prevalence of anxiety symptoms was 33.5%. The depressive symptoms were significantly related to the study year (p = 0.002), type of faculty (p = 0.014), satisfaction with college major choice (p < 0.001), satisfaction with grade point average (p < 0.001). Female students (odds ratio - OR = 1.791, 95% confidence interval - CI = 1.351-2.374), older students (OR = 1.110, 95% CI = 1.051-1.172), students who reported low family economic situation (OR = 2.091, 95% CI = 1.383-3.162), not owning the room (OR = 1.512, 95% CI = 1.103-2.074), dissatisfaction with graduate education (OR = 1.537, 95% CI = 1.165-2.027) were more likely to show depressive symptoms. The anxiety symptoms were significantly related to study year (p = 0.034), type of faculty (p < 0.001), family economic situation (p = 0.011), college residence (p = 0.001) satisfaction with the college major choice (p = 0.001), and satisfaction with graduate education (p < 0.001). Female students (OR = 1.901, 95% CI = 1.490-2.425), and students who reported parents high expectations of academic success (OR = 1.290, 95% CI = 1.022-1.630) were more likely to show anxiety symptoms. Conclusion. This is one of the largest study examining mental disorders in a sample of university students in Serbia. These findings underscore the importance of early detections of mental problems and prevention interventions in university students.

Proper Healthcare Waste Management (HCWM) was introduced in the Republic of Serbia in 2007 with the support of the European Union. Since then, the amounts of waste treated, prior to landfill, have steadily increased and more and more healthcare institutions adopted HCWM systems. In parallel large numbers of healthcare workers were trained in proper HCWM. This study quantifies the progress made. The study analyzed the period 2009 to 2012 using three methods of data collection. On basis of data collected, it has been established that with a population of just over seven million, Serbia generates between 4,500 and 5,000 tones of infectious waste on an annual basis of which some 20% originates from the treatment of out-patients, 75% from the treatment of in-patients and 5% from micro-biological laboratory tests. While in 2009 only one third of this waste was treated prior to disposal, this fraction has increased to two thirds in 2011. The data also show that more than 90% of healthcare facilities have developed individual healthcare waste management plans up from less than 20% in 2009. In every healthcare facility there are at least 2 people trained in healthcare waste management, and in total there are approximately 3000 staff members who received formal HCWM training provided through the Institute for Public Health. Healthcare waste management is continuously improving in the Republic of Serbia and is well established in more than 85% of healthcare facilities. There are still issues to be improved especially regarding treatment on healthcare waste other than infectious waste.

Background and objectives: Recurrent herpes simplex keratitis (HSK) is the most common cause of corneal blindness in the developed world. A relationship between host gene polymorphisms and the recurrence of herpes simplex virus (HSV) infection has previously been proposed. Thus, the aim of this study was to investigate a potential association between the IL28B host genotype and recurrent HSK. Materials and Methods: Eighty patients older than 18 years of age of both genders with a history of recurrent herpes simplex labialis (HSL) were considered for inclusion. Seventy-five of these patients were found to be seropositive for HSV-1 and were subsequently enrolled in the study. Twenty-four of the enrolled patients also had a history of recurrent HSK associated with severe corneal scarring and visual acuity deterioration. Total DNA was isolated from whole blood samples. A single-nucleotide polymorphism (SNP) rs12979860 near the IL28B gene on chromosome 19 was genotyped. Results: A significant association was observed between recurrent HSK and two SNPs of the IL28B genotype (CCrs12979860 and CTrs12979860, p < 0.01). The variation CCrs12979860 showed a significantly greater association with HSK (16 out of 26 patients) compared with CTrs12979860 (8 out of 34 patients). Conclusion: Seropositive individuals with a history of recurrent HSK are likely to have the CC IL28B genotype. This genotype may be related to incomplete control of the infection and more frequent periodical viral shedding along the first nerve branch of the trigeminal ganglion, which clinically manifests as recurrent herpes keratitis. The clinical manifestation of recurrent HSV-1 infection seems to be influenced by polymorphism of the IL28B genotype.

The aim of this study was to determine the craniofacial parameters in the population of the central part of Serbia. The research was conducted on 700 persons (360 males and 340 females), aged 18-65 years, selected randomly. The measured parameters were morphological facial height and breadth. The standard spreading caliper with scale was used for the measurement of facial parameters. There were significant differences in the facial parameters of male compared to female subjects in all observed parameters. The mean value of the morphological facial height in the study population was 116.8 mm ± 7.28, maximum facial breadth 124.12 mm ± 8.44, while the mean value of the total facial index was 93.68 ± 6.86. The total facial index was calculated according to the formula and the obtained results were analyzed statistically using the t-test. The dominant phenotype in the studied population was leptoprosopic. The data obtained in our study may be useful in anthropological research, forensics, genetic research, as well as in medical clinical practice.

Introduction. Physical activity and healthy diet, as lifestyle factors, are essential components in the prevention of chronic noncommunicable diseases. Impared glucose intolerance (IGT) is an independent cardiovascular risk factor. Dyslipidaemia is a cardiometabolic risk factor for the development of type 2 diabetes mellitus. Objective. The aim of the study was to investigate the influence of moderate physical activity of plasma lipoprotein indicators in high-risk subjects for diabetes mellitus during one-year planned intervention. Methods. We randomly assigned 60 overweight subjects with IGT aged 30-60 years. The subjects were divided into intervention group with 30 subjects, who were intensively and individually instructed on weight reduction, nutrition and increased physical activity, and control group with 30 subjects, who were counselled, as standard, on nutrition and increased exercise. Total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C) and triglycerides (Tg) were measured at the beginning of the study, and at 2 months, 6 months, and at the end of the study (12 months). Results. Compared to the beginning of the study, after 2 and 6 months there was no statistically significant difference in serum lipid values. After 12 months, the average values of the measured lipid levels in the intervention group decreased by 18.36% for TC, 27.3% for LDL-C, and 34.2% for Tg (compared to 10.27%, 13.45%, and 10.4%, respectively in the control group). Value of HDL-C in the intervention group increased by 19.12%, and decreased in the control group by 1.48%. Total/HDL-C ratio was reduced by 30.6% and LDL-C/H by 38.1% in the intervention group (compared to 12.36%, and 15.9% in the control group). After 12 months, significantly greater decrease in TC (p

Introduction. Sudden hearing loss is a clinical entity of ambiguously defined aetiology manifested by hearing loss of more than 30 dB on three contiguous frequencies occurring within 72 hours. The lack of standard therapy protocol led to the use of variety of different therapies, thus making difficult objective quantification of their effect. Objective. The aim of the study was to present our experience in the treatment of sudden hearing loss with administration of vasoactive and corticosteroid therapy. Methods. Our research included 59 hospitally treated patients with a sudden hearing loss. During the period 1995-2004, 37 patients were treated using vasoactive agents (xanthinol nicotinate and pentoxifylline), and from 2004-2009, 22 patients were treated using parenteral corticosteroids (dexamethasone). All patients had unilateral sensorineural hearing loss of different level at frequencies from 500-4000 Hz, while other diagnostic procedures (laboratory tests, internist and neurology examinations, X-ray) were within normal limits. Evaluation of therapy effect was done by follow-up of hearing threshold changes and subjective complaints. Results. The results showed that full recovery was achieved in patients with a mild and not fully severe hearing loss, with the majority of those (73%) under corticosteroid treatment. In these patients recovery was also achieved more rapidly. A partial recovery of hearing was detected in patients with hearing loss of more than 80 dB, and mostly in patients treated with corticosteroids. Conclusion. Although statistical evaluation does not indicate significant differences between the application of vasoactive drugs or corticosteroids, clinical findings support advantages of corticosteroid therapy. Treatment of hearing loss, although controversial, requires change of some up-to-now used agents. Advantages should go in favour of contricosteroids.

Introduction. Biometeorological circumstances have a big influence on all traffic participants, especially reflexes, moving coordination and perception ability. With a lower attention and drivers’ and pedestrians’ concentration, there was a larger amount of pedestrian trauma in certain biometeorological phases. Objective. The aim of this study was to establish the correlation between pedestrian trauma and biometeorological phases. Methods. The comparative analysis of everyday biometeorological phases for the city of Kragujevac determined by RHMI and the evidence of knocked-down pedestrians from the Kragujevac traffic police for the period 2003-2008. Results. There were 6,127 accidents, with 696 knocked pedestrians in 666 (10.87%) accidents. Most of them happened in 2003 (135), and the fewest in 2005 (90). Most accidents were during December (74), the fewest were in June (46). The fewest accidents were during 04-05-06 hour interval (by 2), most during 13-14 hours (61). There were 374 males and 349 females. Most of the males (by 60) were 0-10 and 11-20 years old, most of the females (74) were 11-20 years old. There were 443 pedestrians who suffered slight body injuries (112 were 11-20), 225 suffered heavy and 28 had lethal injuries (most over 70). As provokers, the pedestrians suffered because of improper crossing roads (185), while as a casualties, they suffered due to speeding of vechicles (285). Most accidents happened in biometeorological phases 4 (168) and 9 (151), the fewest in phase 10 (4). Conclussion. Statistical analysis shows a significant correlation between pedestrians’ accidents and biometeorological phases, when the most accidents occurred during penetrations of cold fronts, while there was a sudden switch of weather conditions from warm-dry to cold-wet weather.

Introduction. Biometeorological circumstances have great influence on all traffic participants, especially on reflexes, movement coordination and perception ability, increasing the number of accidents. Motocyclists and bicyclists are specific participants in traffic, so their traumatism has its own special characteristics. Objective. The aim of this study was to establish biometeorological influence on motorcyclists and bicyclists accidents. Methods. Comparative analysis of everyday biometeorological phases for the city of Kragujevac determinated by the Republic Hydrometeorological Service of Serbia and motorcyclists and bicyclists accident evidence received from Kragujevac traffic police for the period 2004-2008. Results. There were 5,180 traffic accidents in this period, with 180 accidents in which 77 motorcyclists and 116 bicyclists were knocked down. Most of the accidents were in 2008 (53) and the least in 2005 (28). Most accidents occurred during August (28) and between 19.00 and 20.00 hours (18). There were no accidents during January, between 04.00 and 06.00 hours. There were 85% accidents in the urban area. Most of 169 males were aged 16-20 and 21-25 years (20 and 21). Most of 24 females (6) were aged 11-15 years. Those who caused the accident mostly sustained injuries due to improper speed limit (31), while the victims due to the disrespect of street-crossing priorities (32). Forty-one motorcyclists and 85 bicyclists suffered mild body injuries. Thirty-one motorcyclists and 27 bicyclist suffered severe injuries. Five motorcyclists and four bicyclists ended lethally. Most accidents happened in biometeorological phases 9 (63), 4 (32) and 1 (31). Conclusion. Statistical analysis showed a significant correlation between accidents and biometeorological phases, with most accidents occurring during stabile warm weather and rapid penetrations of cold fronts, and with a sudden switch of weather conditions.

Background/Aim. Industrial noise is produced in workshops due to factory machinery and tools used in technological processes. It has detrimental effect to primarily the organ of the sense of hearing, thus damaging hearing in oversensitive subjects. The aim of the study was to perform a detailed analysis of audiometric and, especially, impedancemetric parameters in workers exposed to the effects of industrial noise of various duration, as well as to determine similarities and differences in workers with differences in sensitivity to damaging effects of noise. Methods. The study included a homogenous group of 173 industrial workers involved in the same department of a huge workshop named 'Kovačica' exposed to noise level above a threshold intensity, and divided into three groups: the group I of 116 workers (232 ears) exposed to noise for 8 h in the workshop 'Kovačica', the group II of 41 workers (82 ears) exposed to noise only half of the working time, and the group III of 16 workers (32 ears) exposed to the same conditions and having the normal hearing sense. The group III served as a control group. Prior to the study any workers went through a thorough anamnesis and complete ORL examination, and then they were submitted to audiometric testing. The study included only the workers with no hearing damage due to diseases, injuries nor other detrimental factors in order to be sure that the hearing findings had been caused by industrial noise. Results. The results obtained by audiometric testing showed that 90.75% of the workers had hearing damage of various degrees, while 9.25 % of the workers had regular hearing although had been exposed to the same conditions. More severe hearing damage was revealed in the workers of the group I. Tympanometricly, in most ears of the group I workers (65.52%) a compliance value was found to be more than 0.9 cm3, while in the majority of those of the group II (59.75%) a compliance value was in the range from 0.5 to 0.9 cm3. In the workers of the group III with no hearing damage, a compliance value for any ears was in the range from 0.1 to 0.9 cm3. Mean value of threshold reflex (98.56 dB) at 500 Hz and 1 000 Hz in the group I was increased as compared with the group II (95.6 dB) and the group III (84.38 dB). At higher frequencies, 2 000 and 4 000 Hz, threshold reflex was increased in the group I (99.05 dB), and in the group II (97.6 dB) as compared with the group III (86.4 dB). The amplitude of stapedic reflex was lowest in the group I, while mean values of amplitude at 500, 1 000, 2 000 and at 4 000 Hz were 2.31, 1.38, 1 and 0.3, respectively. In the group II mean values of amplitude at 500, 1 000, 2 000 and 4 000 Hz were 2.52, 1.80, 1.30 and 0.5, respectively. In the group III mean values of amplitude at 500, 1 000, 2 000 and at 4 000 Hz were 2.36, 2.45, 2.5 and 2.08, respectively. By measuring input (rising) and output angles it was revealed that most ears of the workers in the groups I and II had rising angle ranging from 41 to 50o, and in the workers with no hearing loss from 31 to 50o. In the majority of the ears of the groups I and II outlet angle was in the range from 16 to 35o, and in the workers with no hearing damage from 26 to 35o. Conclusion. By audiometric and impedancemetric examinations it was determined that for the sense of hearing it is significant not only a threshold hearing expressed in the audiometric curve at various frequencies, but also a threshold of unpleasantness and pain under higher intensities shown by the occurrence of stapedic reflex. The less hearing field between threshold hearing and threshold acoustic reflex is, the less capabilities of hearing perception due to the occurrence of recruitment.

Background: Despite the knowledge that they have high blood pressure, which can be controlled with medicines, one portion of the patients still ignores doctor's advice. The aim of the research was to examine the impact of socio-demographic factors for treatment of hypertension among adults in Serbia. Subjects and methods: In the study, we used data from the National Health Survey of the Republic of Serbia in 2013. The sample consisted of respondents who had diagnosed hypertension, 5073 of them. The dependent variable in the study was binary (treatment, or no treatment of hypertension) and independent was socio-demographic characteristics of respondents. Logistic regression was used to determine sociodemographic predictors associated with blood pressure control. Results: From a total of 5073 diagnosed hypertensive patients, 91.3% of them cures high blood pressure. Women, older, medium rich patients, those who follow health topics on television and those who do not follow them on the Internet, who, in the past year, have been hospitalized or used the services of daily care significantly more often treat hypertension. The results of binary logistic regression in which the dependent variable is the treatment of high blood pressure, showed that a statistically significantly predictors are: age, gender, the wealth index and monitoring topics related to health through television and the Internet. In the treatment of hypertension, the strongest predictor was the index of well-being. Thus, people who are medium rich are almost three times more likely to treat high blood pressure compared to the richest (OR=2.94, 95%CI=1.54-5.59). A statistically significant difference in treatment is not recorded between the richest and the poorest (p> 0.05). Men are 1.5 times more likely to treat their tension as compared to women (OR=1.54, 95%CI=1.02-2.32). People following itopics related to the health via the internet are1.7 times more likely to treat hypertension in comparison to subjects who do not follow these topics via the Internet (OR=1.72, 95%CI=1.07-2.76). Conclusion: Analysis of the impact of sociodemographic characteristics on the awareness of patients about the importance of treatment of hypertension is an important step in defining the strategies for treatment of patients.