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Background/Aim. Establishing a food safety control system is extremely important in preventing diseases associated with foodborne pathogens. The aim of this study was to examine the hygiene status of food contact surfaces and the application of good hygiene practices by food handlers in school canteens. Methods. A total of 10,366 swabs were taken from food contact surfaces, including food handler’s hands from public school canteens in Novi Sad, Serbia, over ten years (2008–2017), covering voluntary good hygiene practices and obligatory Hazard Analysis Critical Control Points (HACCP) implementation periods. Results. Statistically significant differences (p < 0.05) in aerobic colony counts (ACCs) on surfaces between two examined periods were found. A general positive trend regarding the reduction of microbial contamination of food contact surfaces was observed. The percentage of surfaces swabs with ACCs above 2.48 log CFU/cm2 significantly decreased (R2 = 0.453) during the study period, and the percentage of coagulase-positive Staphylococcus in the swabs also decreased, but not significantly (R2 = 0.264), and average annual Enterobacteriaceae counts above the established limit values on surfaces significantly decreased (R2 = 0.442) over the years. A significantly higher (p < 0.05) percentage of workers’ hands harbored ACCs, coagulase-positive Staphylococcus, and Enterobacteriaceae above the established limits than the equipment or work surfaces. Conclusion. The results obtained showed the proper implementation of good hygiene practices concerning food contact sur-faces, but the implementation of good personal hygiene practices needs enhanced supervision.

Background and Objectives: Human papillomavirus (HPV) infection and its etiological role in the development of cervical cancer are well established. The cervical cancer mortality rate in Serbia is one of the highest among European countries, and this cancer is the second-leading cause of death in Serbian women aged from 15 to 44. Materials and Methods: This retrospective study was conducted at the Institute of Public Health of Vojvodina. A total of 10,062 cervical specimens from Serbian women were collected and HPV tested in ten years. The study patients were divided into five age groups. HPV genotype testing was performed using a commercial kit to detect 14 high-risk (HR) HPV genotypes. Additionally, cervix cytology data have been available for patients tested in 2022 and 2023. Results: An overall positive rate was found in 43.3% of patients (4356/10,062). A single HPV infection (62.1%) was the main infection pattern. The most frequent HR HPV genotypes were HPV 16, 31, 52, 56, 39, and 51, comprising 62.3% of the detected genotypes, including multiple infections. A significant difference was noted in the HPV prevalence across the different age groups, with a bimodal distribution of HPV infection. The highest prevalence was recorded in the age group ≤ 30 and those after 61 years. Women diagnosed with high-grade squamous intraepithelial lesions (HSIL) were significantly older compared to others. HR HPV is the most prevalent in patients with HSIL cytological findings (76.5%). The most common type, according to age-specific distribution and cytological findings, was HR HPV 16. Conclusions: This study provides comprehensive data on HR HPV distribution among Serbian women, which can serve as a basis for subsequent monitoring of genotypic distribution. It is particularly significant considering they are missing in the updated ICO/IARC Report for Serbia, and the cervical cancer mortality rate in Serbia is one of the highest among European countries. [ABSTRACT FROM AUTHOR]

Introduction/Objective. Growth, development and maturation are periods marked with individual physical characteristics, which provide the insight into the health status together with anthropometric indicators and physical appearance of an individual. The aim was to determine body height and body weight of a representative sample of schoolchildren from Novi Sad, to make a comparative analysis in relation to age and gender, and to determine the beginning of accelerated growth. Methods. Sample included 11,676 pupils aged 6–15 years, from Novi Sad, Serbia. The basic anthropometric measurements (body height and body weight) were performed according to recommended methodology. Results. The average values of boys’ body height ranged from 125.39 cm in those aged up to six years, to 175.09 cm for boys aged 15, and in girls from 124.07 cm at the age of six, to 165.77 cm for the oldest examined girls. The average values of boys’ body weight ranged from 25.58 kg at the age of six to 61.38 kg at the age of 15, and in girls from 23.94 kg in youngest to 54.46 kg, at the age of 15. The analysis of body weight and body height relation in the sample of boys and girls showed significant differences in all age groups, being most significant in boys aged from 11 to 13 years and in girls aged from nine to 12 years, marking the beginning of the rapid growth period. Conclusion. Having analyzed two basic anthropometric characteristics, i.e. body height and body weight, the authors found significant differences in the increase of these characteristics among the age groups of the study sample. In addition, the results of this research are in accordance with those reported in literature, which suggest that a sudden ponderal and statural growth starts earlier in girls than in boys.

Purple urine bag syndrome (PUBS) is an uncommon, but usually benign, underrecognized clinical condition with the distressing presentation of purple, blue or reddish discoloration of a patient's catheter bag and tubing in the setting of catheter-associated urinary tract infections (UTIs). PUBS is the result of the complex metabolic pathway of the dietary essential amino acid tryptophan. Its urinary metabolite, indoxyl sulfate, is converted into red and blue byproducts (indirubin and indigo) in the presence of the bacterial enzymes indoxyl sulfatase and phosphatase. The typical predisposing factors are numerous and include the following: female gender, advanced age, long-term catheterization and immobilization, constipation, institutionalization, dementia, increased dietary intake of tryptophan, chronic kidney disease, alkaline urine, and spinal cord injury (SCI). Here, we present a case of PUBS in a home-dwelling elderly female patient with a history of long-term immobility after a pathological spinal fracture, long-term catheterization, constipation, and malignant disease in remission. Urine culture was positive for Proteus mirabilis. This state can be alarming to both patients and physicians, even if the patient is asymptomatic. Healthcare professionals and caregivers need to be aware of this unusual syndrome as an indicator of bacteriuria in order to initiate proper diagnostics and treatment. [ABSTRACT FROM AUTHOR]

Introduction. Salt intake above 5 g/person/day is a strong independent risk factor for hypertension, stroke and cardiovascular diseases. Published studies indicate that the main source of salt in human diet is processed ready-to-eat food, contributing with 65-85% to daily salt intake. Objective. The aim of this paper was to present data on salt content of ready-to-eat food retailed in Novi Sad, Serbia, and contribution of the salt contained in 100 g of food to the recommended daily intake of salt for healthy and persons with cardiovascular disease (CVD) risk. Methods. In 1,069 samples of ready-to-eat food, salt (sodium chloride) content was calculated based on chloride ion determined by titrimetric method, while in 54 samples of bottled water sodium content was determined using flame-photometry. Food items in each food group were categorized as low, medium or high salt. Average salt content of each food group was expressed as a percentage of recommended daily intake for healthy and for persons with CVD risk. Results. Average salt content (g/100 g) ranged from 0.36±0.48 (breakfast cereals) to 2.32±1.02 (grilled meat). The vast majority of the samples of sandwiches (91.7%), pizza (80.7%), salami (73.9%), sausages (72.9%), grilled meat (70.0%) and hard cheese (69.6%) had a high salt profile. Average amount of salt contained in 100 g of food participated with levels ranging from 7.2% (breakfast cereals) to 46.4% (grilled meat) and from 9.6% to 61.8% in the recommended daily intake for healthy adult and person with CVD risk, respectively. Average sodium content in 100 ml of bottled spring and mineral water was 0.33±0.30 mg and 33±44 mg, respectively. Conclusion. Ready-to-eat food retailed in Novi Sad has high hidden salt content, which could be considered as an important contributor to relatively high salt consumption of its inhabitants.

Background/Aim. It had been suggested that elevated body mass index (BMI) is a beneficial and preventive factor when it comes to the outcome for patients undergoing coronary artery bypass grafting (CABG). At the same time, obesity is strongly associated with coronary artery disease development. The aim of this study was to determine the significance of the obesity paradox in patients referred for CABG and to examine if a relationship exists between obesity and early coronary surgery outcome. Methods. This study comparised 791 patients who had undergone isolated CABG over one year period (year 2010). The average age of patients was 62.33 ± 8.12 years and involved 568 (71.8%) male and 223 (28.2%) female patients, while the mean logistic EuroSCORE was 3.42%. The patients were categorized into three distinct groups based on their BMI: I - BMI < 24.9 kg/m2; II - BMI 25-30 kg/m2; III - BMI > 30 kg/m2. Regression analysis was conducted to determine whether BMI was an independent predictor of early mortality after CABG. Results. The majority of the cohort could be categorized as overweight (49%) or obese (30%). There was no association between BMI and gender (p = 0.398). The overall early mortality was 2.15% (1.85% in the group I, 2.06% in the group II and 2.51% in the group III; p = 0.869). Univariate analysis showed that obesity cannot be regarded as an independent risk factor for early mortality following CABG (odds ratio 1.021, 95% confidence interval 0.910-1.145, p = 0.724). Duration of in-hospital period following the surgery was comparable within the BMI groups (p = 0.502). Conclusion. Compared to non-obese patients, overweight and obese individuals have similar early mortality rate following CABG. This study can substantiate the presence of obesity paradox only in terms that elevated BMI patients have comparable outcome with non-obese. Further research is needed to delineate potential underlying mechanisms that set off obesity to protective factor for coronary surgery.

Many countries have resumed mass gathering events like music festivals, despite potential risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmissions. This study aimed to examine the frequency of SARSCoV-2 infection among visitors to a mass event, the EXIT festival, in relation to the proposed preventive measures. A total of 466 visitors were included in this longitudinal study conducted in Novi Sad, Serbia, during July, 2021. All subjects were tested with RDT-Ag test for the presence of SARS-CoV-2 virus at the beginning of the study and seven days after. Basic socio-demographic and epidemiological data were collected through a questionnaire. The average age of participants was 28.34 ± 8.87 years with the majority of men (53.7%). There were 170 (36.5%) vaccinated participants. A 97.1% in vaccinated and 92.2% in unvaccinated group, reported to regularly wear a protective mask (p=0.029). At the second cross-sectional testing, 354 subjects were tested, of which 150 (42.4%) were vaccinated. There was no statistically significant difference in application of preventive measures during and after the festival, in respect to vaccination status of the participants. Twenty participants (5.6%) reported some of the COVID-19-like symptoms in the first seven days after visiting the festival, but no COVID-19 infection was confirmed at the RDT-Ag testing. Despite the potential effectiveness of applied preventive measures such as RDT-Ag screening, mask-wearing and vaccination, additional caution is needed when holding these events during a period of high SARS-CoV-2 transmission, as well as when the new virus variants emerge in community. [ABSTRACT FROM AUTHOR]

Provision of safe water, sanitation, and hygiene (WASH) services in health care facilities is a priority at the global, national, and local levels. To inform improvements planning, conditions of WASH, waste management, and environmental cleaning were assessed in 81 facilities in the Autonomous Province of Vojvodina, Serbia, as part of a nationally representative survey in 2019. The survey included on-site checks, structured interviews, and drinking-water quality analysis. WHO/UNICEF indicators for WASH service levels and an advanced service level defined at the national level were applied. The results showed that all investigated facilities provided basic water services; 94% of facilities provided basic hygiene and waste management services; 58 and 2%, respectively, provided basic cleaning and sanitation services. Only 1% of investigated facilities met the basic level for all five WASH dimensions. Advanced service levels were only met for hygiene, waste management, and/or cleaning in 15-38% of facilities. In 33% of health care facilities, drinking-water quality was not in compliance with the national standards. The results revealed that there is a need for increased awareness and efforts to ensure basic provisions for sanitation, environmental cleaning, and drinking-water safety. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this research is to determine the change in outdoor air quality during the COVID‑19 related state of emergency resulting in a lockdown and the potential health benefits for the urban population.Material and Methods: During 53 days of the COVID‑19 related state of emergency with a lockdown (March 15-May 6, 2020) in the Republic of Serbia, as well as in the corresponding periods of 2018 and 2019, data on the daily sulfur dioxide (SO2), nitrogen dioxide (NO2), ground-level ozone (O3) and particulate matter (PM10 and PM2.5) concentrations were analyzed. The total mortality data were analyzed to estimate the impact of the COVID‑19 related lockdown measures on the burden of health in a given population, attributed to the outdoor air quality in the City of Novi Sad, using AirQ+ software.Results: The average daily concentrations of PM2.5, NO2, PM10 and SO2 were reduced by 35%, 34%, 23% and 18%, respectively. In contrast, the average daily concentration of O3 increased by 8%, even if the primary precursors were reducing, thus representing a challenge for air quality management. In the City of Novi Sad, a reduction in the average daily PM2.5 concentration of 11.23 μg/m³ was significant, which resulted in a quantified number of avoided deaths.Conclusions: Air pollution in the City of Novi Sad had a chance to be improved due to some preventive measures related to the infectious disease (the COVID‑19 related lockdown), which in turn was the mitigation measure to air pollution with positive public health effects. The confirmed positive effects of the improved air quality on public health could also include raising collective resistance to mass non-communicable and infectious diseases such as COVID‑19 and reducing economic costs. Int J Occup Med Environ Health. 2021;34(2):223-37. [ABSTRACT FROM AUTHOR]

Vitamin B12 is one of the most important B vitamins. This vitamin has an important role in cellular metabolism and is also associated with folate and vitamin B6 metabolism. Vitamin B12 deficiency occurs as a result of some diseases, the use of certain medications, or inadequate nutrition. It primarily affects the elderly and women, but is also common among the pediatric population. The B12 deficiency mostly affects the functions of the nervous and hematopoietic systems but it can also affect the skin, heart, bones, and eyes. The treatment of vitamin B12 deficiency includes oral or intramuscular vitamin B12 supplementation according to different treatment regimens. [ABSTRACT FROM AUTHOR]

To assess the effect of age on mechanisms of exercise tolerance. Prospective observational study recruited 71 healthy individuals divided into two groups according to their age i.e. younger (≤40 years of age, N = 43); and older (≥55 years of age, N = 28). All participants underwent maximal graded cardiopulmonary exercise stress testing using cycle ergometer with simultaneous non-invasive gas-exchange and central haemodynamic measurements. Using the Fick equation, arteriovenous O 2 difference was calculated as the ratio between measured O 2 consumption and cardiac output. The mean age of younger and older participants was 26.0 ± 5.7 years, and 65.1 ± 6.6 years respectively. Peak O 2 consumption was significantly lower in older compared to the younger age group (18.8 ± 5.2 vs 34.4 ± 9.8 mL/kg/min, p < 0.01). Peak exercise cardiac output and cardiac index were not significantly different between the younger and older age groups (22.7 ± 5.0 vs 22.1 ± 3.9 L/min, p = 0.59; and 12.4 ± 2.9 vs 11.8 ± 1.9 L/min/m2, p = 0.29). Despite demonstrating significantly lower peak heart rate by 33 beats/min (129 ± 18.3 vs 162 ± 19.9, p < 0.01), older participants demonstrated significantly higher stroke volume and stroke volume index compared to the younger age group (173 ± 41.5 vs 142 ± 34.9 mL/min, p < 0.01; and 92.1 ± 18.1 vs 78.3 ± 19.5 mL/m2, p < 0.01). Arteriovenous O 2 difference was significantly lower in older compared to younger age group participants (9.01 ± 3.0 vs 15.8 ± 4.3 mlO 2 /100 mL blood, p < 0.01). Ability of skeletal muscles to extract delivered oxygen represented by reduced arteriovenous O 2 difference at peak exercise appears to be the key determinant of exercise tolerance in healthy older individuals. [ABSTRACT FROM AUTHOR]

Provision of safe water, sanitation, and hygiene (WASH) services in health care facilities is a priority at the global, national, and local levels. To inform improvements planning, conditions of WASH, waste management, and environmental cleaning were assessed in 81 facilities in the Autonomous Province of Vojvodina, Serbia, as part of a nationally representative survey in 2019. The survey included on-site checks, structured interviews, and drinking-water quality analysis. WHO/UNICEF indicators for WASH service levels and an advanced service level defined at the national level were applied. The results showed that all investigated facilities provided basic water services; 94% of facilities provided basic hygiene and waste management services; 58 and 2%, respectively, provided basic cleaning and sanitation services. Only 1% of investigated facilities met the basic level for all five WASH dimensions. Advanced service levels were only met for hygiene, waste management, and/or cleaning in 15-38% of facilities. In 33% of health care facilities, drinking-water quality was not in compliance with the national standards. The results revealed that there is a need for increased awareness and efforts to ensure basic provisions for sanitation, environmental cleaning, and drinking-water safety.

Introduction: Salt intake above 5 g/person/day is a strong independent risk factor for hypertension, stroke and cardiovascular diseases. Published studies indicate that the main source of salt in human diet is processed ready-to-eat food, contributing with 65-85% to daily salt intake., Objective: The aim of this paper was to present data on salt content of ready-to-eat food retailed in Novi Sad, Serbia, and contribution of the salt contained in 100 g of food to the recommended daily intake of salt for healthy and persons with cardiovascular disease (CVD) risk., Methods: In 1,069 samples of ready-to-eat food, salt (sodium chloride) content was calculated based on chloride ion determined by titrimetric method, while in 54 samples of bottled water sodium content was determined using flame-photometry. Food items in each food group were categorized as low, medium or high salt. Average salt content of each food group was expressed as a percentage of recommended daily intake for healthy and for persons with CVD risk., Results: Average salt content (g/100 g) ranged from 0.36 ± 0.48 (breakfast cereals) to 2.32 ± 1.02 (grilled meat). The vast majority of the samples of sandwiches (91.7%), pizza (80.7%), salami (73.9%), sausages (72.9%), grilled meat (70.0%) and hard cheese (69.6%) had a high salt profile. Average amount of salt contained in 100 g of food participated with levels ranging from 7.2% (breakfast cereals) to 46.4% (grilled meat) and from 9.6% to 61.8% in the recommended daily intake for healthy adult and person with CVD risk, respectively. Average sodium content in 100 ml of bottled spring and mineral water was 0.33 ± 0.30 mg and 33 ± 44 mg, respectively., Conclusion: Ready-to-eat food retailed in Novi Sad has high hidden salt content, which could be considered as an important contributor to relatively high salt consumption of its inhabitants.