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Background/Aim.Venous leg ulcers (VLU) are a significant health problem worldwide. It is well known that VLU are difficult to treat and that they have high tendency for recurrence. Compression therapy is the preferred treatment modality but there is growing evidence that correction of underlying venous disorder in early stages of the disease in addition to compression treatment may improve ulcer healing and reduce recurrence rate. Methods. An open, prospective, randomized, single-center study, with a 6-months follow-up was performed to determine the efficacy of two different treatment modalities (surgery alone versus surgery plus compression) in the treatment of VLU in patients with primary venous insufficiency. Patients with secondary venous insufficiency and/or thrombosis were excluded from the study. Overall, 71 patients were randomized (37 men, 34 women; mean age 60 years) into two groups: the group A – 34 patients who underwent surgical intervention (stripping) and postoperatively were treated with simple wound dressing only, and the group B – 37 patients who underwent surgical intervention (stripping) and wore a heelless open-toed elastic class III compression device knitted in tubular form –Tubulcus® (Laboratoires Innothera, Arcueil, France). All patients in group B were instructed to wear compression device continuously during the day and night. The study was performed at the Clinic for Cardiovascular and Transplant Surgery, Clinical Centre Niš (Serbia) with primary endpoint of the study being complete ulcer healing at 180 days. Results. The healing rate was 29.41% (10/34) in the group A, and 56.76% (21/37) in the group B (p < 0.01). Mean healing time in the group A was 141 ±15 days, and in the group B it was 98 ±12 days (Log-rank life table analysis: p < 0.001). Conclusion. This study suggests that for VLU in patients with primary venous insufficiency, surgery plus compression therapy provides higher healing rate and faster healing time compared to surgery only.

Background/Aim. Pharmacologic therapy for benign prostatic hyperplasia (BPH) relieves disease progression and affects the androgen hormone status. A decrease in the level of free testosterone (freeT) within total testosterone (totalT) leads to symptoms of sexual dysfunction. The aim of this study was to show the impact of pharmacological treatment for BPH on prostate volume (PV) and levels of freeT and, consequently, on urinary parameters and sexual desire in men during 6 months of administration. Methods. This clinical prospective study included 156 BPH patients with moderate urinary symptoms – International Prostate Symptom Score (IPSS) < 19, PV > 30 mL and prostate specific antigen (PSA) value < 4 ng/mL. The average age of patients was 61.16 ± 2.97 years. The performed tests included determination of tumor markers (PSA, free PSA), hormones (totalT, freeT, freeT/totalT ratio), trans abdominal ultrasonography and uroflowmetry. Urinary symptoms were measured by IPSS and the Quality of Life (QoL) questionnaire while the changes in sexual desire were measured using the International Index of Erectile Function (IIEF) questionnaire. Four groups were formed, 39 patients each. The group 1 received alpha1- blocker (AB) tamsulosin, the group 2, 5 alpha-reductase inhibitor (5-ARI) finasteride, the group 3, combined therapy of both drugs (tamsulosin and finasteride), while the group 4 (control group) had no therapy. Follow-ups were performed every three and six months during therapy administration. Results. Prostate volume significantly decreased in the patients on combined therapy (-6.95 ± 2.00; p < 0.001) and finasteride (-6.67 ± 3.35). In the finasteride group, the levels of freeT (-4.23 ± 5.2; p < 0.001) and freeT/totalT ratio (-0.12 0.08; p < 0.001) significantly decreased as did the freeT (-2.64 ± 7.81) and freeT/totalT ratio (-0.09 ± 0.13) in the combined therapy group. Uroflowmetry showed a significant improvement in all parameters and all the therapy groups. Combined therapy provided the greatest improvement in the maximum flow rate (Qmax) (+4.06 ± 1.75; p < 0.001) and urinary symptoms (-10.95 ± 3.19). A significant improvement of sexual desire occurred in the patients on tamsulosin (+0.78 ± 1.00; p < 0.001), with a slight deterioration in the finasteride group, but without statistical significance. Conclusion. Hormonal component of pharmacologic therapy for BPH most effectively reduces PV and freeT levels, improves urinary symptoms with a slight decline of sexual desire in men on finasteride monotherapy.

Introduction: There is relatively strong evidence among children showing that passive smoking is associated with respiratory symptoms and respiratory diseases, but few studies have been carried out in Serbian population., Objective: Establishment of association between exposure to tobacco smoke within family and prevalence of the upper and lower respiratory symptoms in school children., Method: In this descriptive epidemiological study, studied population consisted of 533 school children, 12.96 +/- 1.54 years old, residents of Nis town, from the area with identical open air pollution. Environmental tobacco smoke exposure was recorded in 382 children. Data about symptoms in children, conditions of habitation, presence of pets and hereditary predisposition were entered into structured questionnaire. RESULTS T-test and X2-test statistics showed no significant difference of living conditions, hereditary predisposition among children and average time which passive smoker and nonsmoker children spent indoors. In both groups, the upper respiratory symptoms were more frequent (42.4%-80.2%) in comparison to lower respiratory symptoms (14.4%-25.7%). There was significant difference of the upper and lower respiratory symptoms between the exposed children and control group (X2 =9.7 > X2 (1.005 = 3.8, p > 0.05--for the upper and X2 = 4.4 > X2 (1.005) = 3.8, p > 0.05--for the lower respiratory symptoms). Primary health care need for respiratory symptoms and diseases due to effect of passive smoking was higher in the exposed children., Conclusion: The results provide evidence of adverse respiratory effects of passive smoking to children being exposed to smoke in domestic setting. These findings emphasize the need for effective measures of prevention of involuntary smoking during childhood in Serbia.

Fortification is defined as adding of one or more essential elements to food article, regardless of whether it has been already added to food or not, in order to prevent or correct deficiency of one or more nutrients in the general population or specific population group. Food fortification with minerals and vitamins helps eliminate diseases such as goiter, rickets, beriberi, and pellagra. Significant results have been also achieved in prevention of anemia and vitamin A deficiency. The aforementioned deficiencies can be prevented and eliminated by means of appropriate and diverse nutrition and supplementation of deficient micronutrients, but on the national level, food fortification is the best solution. Two basic conditions for the application of fortification are the following: that the food article is in wide use and that it is cheap (available). The purpose of our paper was to show the results achieved by means of fortification in various countries in order to build up the basis for similar propositions in our country (Serbia and Montenegro). Owing to fortification in Asia, the number of cretinism cases has been reduced by half while sugar fortification significantly reduced the number of children with vitamin A deficiency. For more than 50 years, flour fortification with iron in order to prevent its deficiency and anemia, has been successfully applied in the United States and Canada, and as of recently in some countries of Africa and South America. The analysis of the results leads to the conclusion that food fortification has had beneficial health effects in the communities where it has been applied.