Search

Background/Aim. Hypervolemia is an important risk factor for the development of cardiovascular morbidity and mortality in patients treated with regular hemodialysis. There is still no reliable method for assessing the status of volemia in these patients. The aim of the study was to assess the status of volemia in patients treated with regular hemodialysis by measuring the parameters of the inferior vena cava (IVC) and bioimpedance. Methods. The effect of hemodialysis treatment on ultrasound parameters of the IVC, as well as on the parameters measured by bioimpedance, was examined before and after hemodialysis. The values of the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were measured both before and after hemodialysis. Forty-five patients were involved in this non-interventional cross-section study, including the patients treated with standard bicarbonate dialysis. According to the interdialytic yield, the patients were divided into three groups: I (up to 2,000 mL), II (2,000?3,000 mL), and III (over 3,000 mL). Results. The values of the IVC parameters and the parameters measured with bioimpedance were significantly lower after treatment with hemodialysis (p < 0.005). The third group of patients had a significantly higher total fluid volume in the body com-pared to the group I, as well as a significantly greater volume of extracellular fluid (p < 0.005). The significantly lower values of NT-proBNP in all groups (p < 0.005) were detected after hemodialysis. After treatment with hemodialysis, a positive correlation was observed between the concentration of NT-proBNP in the serum and the extracellular/intracellular water ratio. However, the correlation between NT-proBNP concentration and total fluid measured by bioimpedance spectroscopy did not reach statistical significance. Conclusion. Measurement of the IVC ultrasound parameters and volemia parameters using bioimpedance significantly contributes to the assessment of the status of volemia. Nevertheless, it cannot be used as a separate parameter, only in combination with all other methods.

nema

nema

The unstoppable process of demographic aging of population has profound consequences on the economic, health, social and political spheres of society, because of the specific and diverse needs of the older population. The aim of the study was to examine gender differences of health care utilization among elderly in Serbia. The survey was conducted as a part of the national study "Health Survey of the Serbian population" in 2013. In the past year, 87.4% of the older population visited their chosen doctor. Women were significantly more likely to use primary health care compared to men, while the frequency of hospitalization is significantly higher in men. When it comes to female population, age, region of residence and financial situation stood out as the most important predictors of primary care services usage. In men, the residence stood out as the most important predictor of primary health care services usage. Multivariate binary logistic regression distinguishes gender, education and region of residence as the most important factors associated with hospital treatment.

Katarina Milovuk (Ekaterina Đorđević) was born on August 28, 1844 in Novi Sad of Serbia. She proved to be one of the first women to realize her professional potentials "outside the home hearth" in Serbia, and even more authentically as a true Serbian "Heroine of the Spirit" of the targeted fight for women's rights. With her valuable presentation and views, Katarina Milovuk attracted about 3000 ladies from the most prominent Belgrade families, who accepted the task of taking part in the medical training for girls and women to help Serbian soldiers on the battlefield, and who were more decimated by the typhus epidemic than by lethal bullets of enemies. The main opus (her aim) of her social engagement was the historical struggle for women's rights and activities in the education of women's youth in Serbia. As an active participant in social life in Serbia, she participated in the historical organization of aid for the Serbian army during the wars that Serbia was waging at the time.

nema

Women’s health is of particular importance because of the large and specific sensitivity of this population group and the fact that women are consistently concerned about their own health, but also about the health of their children, parents and other family members. The aim of this study was to considering the health of women in Serbia in the period from 2006 to 2016, in order to highlight the priority problems, which would serve to create preventive programs and measures aimed at improving the health of this population group. Chronic non-communicable diseases (malignancies, acute coronary syndrome, diabetes mellitus, etc) are the leading causes of morbidity and mortality, and one of the main reasons for the use of health care in the population of women in our country in the period from 2006 to 2016. How it comes to preventable diseases, actions in the field of health promotion should be directed at preventing or modifying risk factors that are responsible for the occurrence of these diseases, as well as the creation of national strategies for the prevention and control, monitoring the performance of screening and other preventive programs, planning and organization of health care. By promoting healthy lifestyles, empowering women and their active participation in the community can have significant positive effects on raising the health potential of this population.

Introduction: Self-treatment with Lamotrigine rarely ends with toxicity, regardless of the suicidal intentions of the patient. The authors hereby present an illustrative case of the patient who has been treated with epilepsy therapy with Dandy-Walker syndrome and congenital epidermolysis bullosa (potentially skin-unwanted). Lamotrigine is a phenyltriazine-class, broad-spectrum antiepileptic and therapy of bipolar depression. Dandy-Walker syndrome is a pathological entity and represents the set of developmental, cerebral, but also other abnormalities of the organism. Epidermolysis bullosa is a hereditary, non-inflammatory skin disease with a mucous membrane of characteristic "bubbles". Case report: Our patient, a 37-year-old male was first admitted to the hospital department of Urgent Medicine of Clinical Center Kragujevac because he consumed two boxes of Lamotrigine tablets. In the receiving clinic, the patient showed respiratory failure and was urgently intubated. From medical documentation and hetero-anamnesis (obtained by his father), the authors found out that he was treated for epilepsy, Dandy-Walker syndrome, and congenital epidermolysis bullosa, which deteriorated with the use of Lamotrigine through potentially undesirable skin effects. During clinical observation, a lavage of gastric contents was conducted. The medical coal was used via nasogastric intubation as a detoxification method because of the patient's comatose state. Causative metabolic pathway of lamotrigine, the hemodialysis was performed. Conclusion: The case report of our patient points to the necessity of a multidisciplinary approach of the expert team, consisting of the clinical pharmacologist and toxicologist, neurologist, dermatologist, nephrologists, and other specialists, if necessary. Patients with Dandy-Walker syndrome require adequate socio-medical care.

nema

Background/Aim. Depression is the most prevalent mental disorder which affects approximately 7% of the world?s older population. This study aimed at examining the prevalence of depression among older adults and its relations to chronic illnesses. Methods. Study was con-ducted within the National Health Survey of the Serbian population in 2013. The questionnaires used as instruments in this study were created in accordance with the questionnaires of the European Health Interview Survey ? Second Wave. The Patient Health Questionnaire-8 (PHQ-8) was used to evaluate the presence of depressive symptoms. The relations between depression symptoms (a de-pendent variable) and a set of independent variables were examined with univariate and multivariate logistic regression analyses. Results. The study showed that there was a 10.0% prevalence of depression within this population with statistically significant differences between the genders ? 12.6% of women and 6.5% of men. The multivariate analysis revealed that multimorbidity [odds ratio (OR) = 1.89], chronic pain (OR = 2.35) and self-evaluations of poor health (OR = 8.37) were strongly associated to depression. In terms of individual chronic illnesses, the study showed that strokes double the odds of developing depression (OR = 1.82) while the deformities of lower spine increased this odds by 27%. Conclusion. Depression is very frequent in older persons who suffer from chronic diseases and medical conditions. It is crucial to enable ad-equate screening in primary healthcare institutions in order to diagnose depression in its early stages and start its treatment as soon as possible.

Galectin 3 plays a significant role in the development of chronic renal failure, particularly end-stage renal disease (ESRD). The aim of our study was to investigate the association between Gal-3 and biochemical parameters and primary disease in ESRD patients, by exploring the polymorphisms

Introduction/Objective. Serbia has been burdened with one of the highest cervical cancer incidence and mortality rates in Europe. The objective of the study was to estimate the prevalence and factors associated with compliance to cervical cancer screening among women in the general population. Methods. The study used the data from 2013 National Health Survey of the population of Serbia. Logistic regression analysis was further used to examine demographic and socio-economic factors which affect the disparities in cervical cancer screening practices among the female population. Results. Every third woman (35.4%) has never done a Pap test in her lifetime. The highest percentage of respondents did their Pap tests after they were recommended by doctors (52.3%); 45% of women did it on their own initiative, and only 2.7% did it after they had been summoned to participate in an organized screening by their doctor. The multivariate logistic regression analysis revealed that the most important factors in women who had never undergone Pap tests were the following: age (being within the youngest or the oldest age group), rural residence and low level of education, poor socio-economic status, and marital status (have never married). Conclusion. Further strategies and interventions for improving cervical cancer incidence and mortality rates should be focused on socially and economically endangered population groups in order to reduce disparities in cervical cancer screening more effectively.

Introduction: Goodpasture syndrome is a rare autoimmune syndrome with alveolar hemorrhages and glomerulonephritis caused by circulating antibodies against the glomerular basement membrane. Anti-glomerular-basement-membrane were administered against a non-collagen (NC-1) 3 chain of collagen type IV, which was found at the highest concentration in the basal membrane of renal and pulmonary capillaries. The aim of case report is a clinical overview of this rare and severe syndrome. Case report: The patient, 22-years-old was sent to the Center of Urgent Medicine of Clinical Center Kragujevac from General Hospital of Paraćin because of blood poisoning, fever, symptoms and signs of renal and respiratory weakness, and suspected of Wegener's disease. Antibodies were taken on the basement membrane of the glomerulus were resulted of enormously high. After due to the clinical and immunology diagnosis of Goodpasture syndrome, plasmapheresis treatment was initiated. The standard hemodialysis was continued. Following the guidelines protocols, patient received pulse dozes of cytostatics, corticosteroids, etc. Conclusion: The case report of our patient points to the necessity of multidisciplinary approach of the expert team, consisting of a nephrologist, pulmonologist, clinical pharmacologist and other specialists. The prognosis is good, if treatment is started before irreversible pulmonary and/or renal changes (respiratory and/or renal insufficiency). Goodpasture syndrome often progresses rapidly, so it can be fatal if it's delayed with the diagnosis and the treatment. Patients with Goodpasture's syndrome require adequate socio-medical care as a rare and severe syndrome.

Introduction/Objective. The most frequent postoperative complication of a successfully performed phacoemulsification cataract surgery is the development of posterior capsule opacification (PCO). It is caused by the proliferation and migration of the remaining residual epithelial cells. The objective of this study was to investigate the influence of two different intraocular lenses and two different anti-inflammatory drugs on the development of PCO in one-year follow-up period. Methods. Investigation included 120 patients (120 eyes), equally divided into four groups. The first two groups included patients who used non-steroid anti-inflammatory drug (NSAID) postoperatively, while the other groups had corticosteroid therapy. The first and third group got hydrophilic intraocular lenses (IOL), the second and fourth group had hydrophobic IOL. Software program EPCO 2000 was used for the analysis of PCO. Student?s t-test, Wilcoxon test, and ANOVA were used for data analysis and p < 0.05 value was accepted as statistically significant. Results. After the first three postoperative months, patients from NSAID groups had mean PCO score 0.25 ?} 0.03, which was statistically significant higher (p = 0.042) comparing to corticosteroid groups. At the end of the investigation, the best result in PCO preventing was seen in the group of patients with hydrophobic IOL and corticosteroid therapy, with the mean PCO score of 0.47 ?} 0.08. Conclusion. This study has revealed that IOL made of acrylic hydrophobic material seemed to be the right choice when choosing intraocular lens to prevent PCO development. On the other hand, NSAID and corticosteroid therapy have showed similar results in preventing postoperative intraocular inflammation. This fact can be very useful in situations when corticosteroids must be used with great caution.

nema

Depression is the most frequent mental health problem in older age with serious consequences on personal, interpersonal and social level. The aim of this study was to determine the association of demographic factors, socio-economic factors and health status characteristics, with the presence of depressive symptoms in the elderly persons. The survey was conducted as a part of the national study “Health Survey of the Serbian population” in 2013. Data on the population aged 65 years and over were used for the purposes of this study (3540 respondents). PHQ-8 questionnaire was used to assess the presence of symptoms of depression. The relations between the presence of depressive symptoms, as a dependent variable, and a set of independent variables was examined by univariate and multivariate logistic regressions. Depression (PHQ-8 score≥10) was registered in 10% of the population aged 65 and above, wherein it was statistically significantly higher in women (12.7%) than in men (6.5%). Limitations in performing of daily activities showed to be the strongest predictor of depression in the elderly, while respondents who have had serious limitations had even six times more chanse to develop depression (OR=6.84). Respondents who rated their health as “bad or very bad” for 49.5% more frequently manifested depressive symptoms compared to those who evaluated their health as “very good or good” (OR=3.49). Respondents who have had two or more chronic diseases were three times more likely to have depression (OR=3.1) compared to people without chronic disease.

Background/Aim. Analysis of prevalence and correlation of contraceptive use among women of reproductive age (15 to 49 years) in Serbia. Methods: Raper is based on data from a national health survey of the population of Serbia in 2013 (no data for Kosovo and Metohija). For the purposes of study, the data on households and population age 15 and over were used, so that the final sample for analysis entered 3.634 women of reproductive eage. χ2 test was applied to test the difference in frequency of categorical variables. Logistic regression analysis was applied to examine the correlates of female contraceptive use in Serbia. Results with probability that is equal to or les sthan 5% (p≤0.05) were considered statistically significant. Results: Overall contraceptive prevalence in women of reproductive age was 34.8%. Five variables had a significant connection with the use of contraceptives among women: age, education, marital status, residence region, index of wellbeing. Two variables had no statistical significance in study: employment status, type of settlement. Conclusions: Based on results, we can conclude that the prevalence of use of contraceptives among women in Serbia is relatively low and therefore reproductive health of women is endangered to agre at extent.

Introduction/Objective. Glaucoma is a chronic disease that impairs the optic nerve irreversibly and can lead to serious loss of vision and blindness. As the most frequent out of all, primary open-angle glaucoma has a worldwide incidence of 2.4 million. The objective of this article is to examine the characteristics of glaucoma hospitalization patterns in Central and West Serbia in the 2006?2017 period. Methods. This study was a retrospective analysis of glaucoma hospitalizations in the Kragujevac Clinical Center from 2006 to 2017 (n = 1,751). All hospitalizations were divided according to discharge diagnoses into the following three subgroups: primary open-angle glaucoma, the primary closure glaucoma, and secondary glaucoma and other glaucoma types. Results. The average hospitalization rate for glaucoma is 5/10,000 inhabitants. The lowest rate was recorded in 2013 (1.8/10,000) and the highest in 2015 (9.3/10,000). The rehospitalization rate ranged from 0.5/10,000 in 2013 to 6.9/10,000 in 2015, with an average of 2.4 patients per 10,000. The most common glaucoma was secondary glaucoma and other glaucoma types (44.6%), followed by primary open-angle glaucoma (37.9%) and primary closure glaucoma (17.5%). The average hospitalization length was 6.5 ? 4.9 days and it decreased from the average 9.7 ? 6.5 (2006) to 5.5 ? 3.7 days (2013) (p < 0.01) in all glaucoma types. Conclusion. There was a significant reduction of the hospitalization length in all glaucoma types in Central and West Serbia. The hospitalization rates varied with a significant increase since 2013, which is the consequence of the increase in rehospitalization rates.

Introduction: Patient safety is the identification, analysis and correction of risk events in order to make healthcare safe and risk reduction to the patient at the lowest possible level. The Aim: The aim of this paper is to determine the frequency and type of unwanted events in the statehospitals of the three districts (Sumadija, Pomoravlje and Raska) in the period from 2012 to 2015. Methods: A retrospective study of patient safety indicators was conducted for six general hospitals in three districts (Sumadija, Pomoravlje and Raska district). Data on patient safety indicators are obtained from the report on Quality Indicators for the period from 2012 to 2015. Statistical analysis of the collected data included descriptive statistics (tabulations and graphic display) and the linear trend. Results: In the observed general hospitals of three districts (Sumadija, Pomoravlje and Raska) in the period 20122015, the most common unwanted events are infections of the operative site, infections in the intensive care unit and repeated operations in the same region, with the lowest reported iatrogenic damage during surgical intervention. Although the large number of infections have occurred in departments of stationary health facilities, the overall rates of these adverse events in general hospitals show the downward trend in years of observation. Of the total rates of unwanted events in the period 20122015, there is the trend of growth in the overall rate of decubitus and thromboembolic complications. Conclusion: Introduce enhanced monitoring of the proper record keeping of unwanted events. Educate patients and their families about the prevention of unwanted events and the importance of respecting the code of conduct in stationary health facilities.

Galectin 3 plays a significant role in the development of chronic renal failure, particularly end-stage renal disease (ESRD). The aim of our study was to investigate the association between Gal-3 and biochemical parameters and primary disease in ESRD patients, by exploring the polymorphisms LGALS3 rs4644, rs4652, and rs11125. A total of 108 ESRD patients and 38 healthy controls were enrolled in the study. Genotyping of LGALS3 gene rs4644, rs4652, and rs11125 polymorphisms was performed by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP). By multivariate logistic regression analysis, we found that LGALS3 rs4644 CC and rs4652 AA genotypes were significantly associated with a higher risk for lower hemoglobin, higher level of parathyroid hormone, and also occurrence of diabetes mellitus and arterial hypertension. The CAA haplotype was significantly more common in patients with diabetes, low hemoglobin level, and normal PTH level. It has been observed as well that the ACT haplotype was more common in patients with low glomerular filtration, low PTH, and normal hemoglobin level. We found that the LGALS3 rs4644 and rs4652 gene polymorphism may be involved in the pathogenesis and appearance of complications in ESRD patients and thus could be considered a new genetic risk factor in this population.

University students are a specific adolescent population which is preparing to take participation in different domains of a society as its integral and creative part. Chronic noncommunicable diseases have a major impact on women’s reproductive health, so their adverse epidemiological situation has significant effects on reproductive health in general. Since non-communicable chronic diseases have been a growing burden on reproductive health, the aim of this paper is asses of reproductive behavior and risk factors of non-communicable disease in female student population on Faculty of Medical Sciences University of Kragujevac. This study was conducted as a prospective cross-sectional study. The sample includes 59 female students of The Faculty of Medical Sciences, University of Kragujevac. The study was conducted in three stages based on the methodology and instruments recommended by STEPwise Approach to Noncommunicable Disease Risk Factor Surveillance of the World Health Organization (STEPS). About 71.2 % of the participants reported that they had a sexual intercourse. In average, the respondents were 18 years old (SD±1.222) at the time of their first sexual intercourse. At that point, a little less than one third of them did not use any type of protection (31.7%). During the last sexual intercourse, about 65.5% did not use protection. About 22.5% of our subjects have morning glycemia with prediabetes values (glycemia cut off ≥ 5.5mmol/L). Hypercholesterolemia is present in 3.4% of the respondents (cut off ≥ 5,2mmol/l). Most respondents are eutrophic (18.8% preobese and 2.1% obese). The android obesity type is the least frequent (about 10%). This results indicates that female students has unhealthy habits in terms of their reproductive health and preventive measures. This activity indicaty a wide array of preventive action which will aim at preserving reproductive health and health in general.

Pseudoexfoliation syndrome is an age related disorder, characterized by abnormal fibrous fiber production and accumulation in different visceral organs as well as in the eye and periocular tissues. Hystological examination recorded the presence of the pseudoexfoliation in the conjunctiva, and they can disturb the accessory lacrimal gland and goblet cell function. This can explain tear film instability in patients with pseudoexfoliations. In our study, we examined the tear film stability in patients with and without pseudoexfoliation, using Schirmer test and tear break up time test. Our results indicated that patients with pseudoexfoliation had lower values of Schirmer and tear break up time tests than patients without it. Pseudoexfoliation is the main reason for the instability of the tear film, because of its negative impact on the conjucntival goblet cells. In conclusion, ophthalmologists must have these data on their mind in the process of the pseudoexfoliation glaucoma treatment and controlling.

Introduction/Objective. Dry eye development after phacoemulsification is a very common complication of cataract surgery. Combined with other risk factors, such as pseudoexfoliation (PEX), this complication becomes more frequent. The aim of this study was to expose the influence of phacoemulsification associated with PEX on the development of dry eye in patients who underwent cataract surgery. Methods. The study included 160 eyes (160 patients) who underwent phacoemulsification. The patients were divided into four groups (n = 40 patients). Groups I and II involved patients without PEX. The patients from Group II were prescribed artificial tears (AT) postoperatively. The patients from Groups III and IV had a presentation of PEX. The patients from Group IV got AT postoperatively. Ocular Surface Disease Index, the tear breakup time (TBUT) test, fluorescein staining, and Schirmer?s test served as ?dry eye? tests in this study. The ?2 test and paired t-test were used for data analysis. Results. Measurements were taken for every patient preoperatively, on the first and the seventh day after the surgery, one month and three months, and one year after the surgery. The tests showed postoperatively developed dry eye in all the groups, with the recovery of the tear film within three months, except for Group III. The highest statistical significance (p < 0.001) was recorded between Groups II and III, three and 12 months after the surgery. Values of TBUT (6.09 ? 1.29 seconds) and Schirmer?s test (8.91 ? 2.14 mm) in Group III strongly indicated that dry eye was still present one year after phacoemulsification. The greatest recovery of the tear film was recorded in Group II in all the measurements. Conclusion. The study showed how strongly PEX and the use of AT affect the tear film during the first postoperative year. Based on our experience, we highly recommend the use of AT after performing phacoemulsification.

Background/Aim. Keratitis is a sociomedical problem of moderately developed countries. including Serbia, too. The incidence of bacterial keratitis in the world is about 20% in relation to all keratitis, but its frequency in Serbia is still not known. Bearing in mind the complications in the front segment of the eye after bacterial keratitis (ulcer, neovascularization, fibrosis) and decline in visual acuity, it was necessary to assess the efficacy of local therapy by moxifloxacin which will shorten the healing time and reduce complications. The aim of the study was to analyze the efficiency of shortening the treatment of bacterial keratitis with moxifloxacin. Methods. The study was designed as prospective, randomized, double-blind study. The study included 30 patients with diagnosed keratitis and locally applied antibiotic moxifloxacin, and 60 patients in a control group, with locally applied artificial tears. All participants were subjected to complete clinical ophthalmologic analysis (2015/16), for a period of 1?15 days after the application of therapies (healing time of corneal pathology). The following was determined in all patients: degree of hyperemia, degree of epithelial defect, level of corneal sensitivity, level of tear secretion and tear quality, degree of conjunctival secretion, degree of neovascularisation and corneal scarring, degree of visual acuity, score of subjective symptomatology and correlation of ophthalmological findings and subjective symptoms. Results. There was a statistically significant difference in times of therapeutic efficacy/clinical response between the study group patients who received moxifloxacin and the control group patients who received arteficial tears. Conclusion. Local application of moxifloxacin had therapeutic effect (total benefit) both in terms of the effective shortening of the healing time and also the reduction of the complications of bacterial keratitis, without unwanted effects.

Background/Aim. Central retinal artery occlusion (CRAO) is a disease of the eye where the flow of blood through the central retinal artery is blocked. It causes sudden, painless, unilateral and usually severe vision loss. The aim of our study was to examine significance of cilioretinal artery on collateral and neovasculatization development after occlusion of the central retinal artery. Methods. This study retrospectively reviewed all fluorescein angiography (FA) cases with confirmed CRAO and presenting, one or more, cilioretinal arteries on initial examination. The study included patients referred to the Clinic of Ophthalmology, Clinical Center Kragujevac for the examination in the period from January 2010 to January 2015. Ten eyes of 10 patients with confirmed CRAO and existing cilioretinal artery on initial examination were found and analyzed in this study. Results. This study included 10 (6 males and 4 females) patients from 50 to 76 years old (mean 66.3 ? 10.078 years). Visual acuity on initial examination presented on the decimal scale was from 0.01 to 0.2 (mean 0.087 ? 0.066). Intraocular pressure measured by applanation tonometry was in the range from 14 to 20 mmHg (mean 16.7 ? 2.540 mmHg). Cilioretinal artery was revealed on the first FA examination of all eyes. On control FA, in three eyes de novo collaterals were discovered. In the first eye, collaterals were discovered after two months, in the second eye after four months, and in the third eye after seven months of the performing the initial angiogram. Visual acuity was checked after one year. It was from light perception to 0.03 (mean 0.016 ? 0.009). Conclusion. The presence of cilioretinal arteries with preexisting or de novo developed collaterals was not enough to preserve visual acuity and prevent neovascularisation over a longer period after CRAO

Introduction/Objective. The objectives of the paper are to assess the causes of low vision (LV) in pediatric population in Montenegro and to evaluate the influence of low vision aids (LVA) on reading performance regarding the speed of reading and the understanding of the read text. Methods. A prospective study was conducted on 40 ?treatable? LV children what represent all registered LV children in Montenegro. All participants read the same text before and after using LVA. Reading rate was calculated as the number of words read per minute. Functional speed of reading was calculated as the ratio of the rate of reading and the understanding of the read text multiplied by 100. Results. The study comprised 40 LV children with the mean age of 12.60 ? 4.06 years (20 boys and 20 girls). The most common cause of LV in children were premature retinopathy (10/40 or 25%), retinitis pigmentosa (8/40 or 20%), optic nerve anomaly (5/40 or 13%), degenerative myopia (4/40 or 10%), macular dysgenesis (4/40 or 10%), Stargardt disease (3/40 or 7%), optic nerve atrophy (2/40 or 5%), and albinism (2/40 or 5%). Nystagmus was found in 11 LV children or 28% of the group. LVA were prescribed to all of them. Reading speed before vs. after LVA use was 36.58 ? 35.60 vs. 73.83 ? 27.05 words/minute (p < 0.001), while functional reading was 26.00 ? 30.43 vs. 59.41 ? 29.34 (p < 0.001). Conclusion. LV children demonstrate a significant improvement in reading performance by using LVA.

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.

Introduction/Objective. Vitreal hemorrhage (VH) is one of the possible complications of the diabetic retinopathy which is followed by intensive decrease of visual acuity. Corticosteroides are commonly used in treatment of different retinal diseases, due to their antiinflammatory and anti-angiogenetic effect. Triamcinolone acetonide applied invtravitreally remains in the eye for several months, releases its crystals and decreases the density of vitreal hemorrhage. The aim of this study was to evaluate the efficacy of 20 mg intravitreal triamcinolone acetonide for the managementof long lasting VH, occurred as a complication of proliferative diabetic retinopathy (PDR) in non-vitrectomized eyes. Methods. In prospective study, from January 1st 2015 until the January 1st 2016, 24 patients with VH who received intravitreal triamcinolone acetonide, were compared to 21 patients from the control group (patients with PDR and similar degree of VH). All patients passed ophthalmological examination at the beginning of the study, 7 days, 1, 3, 6, 9 and 12 months after intravitreal application of 20mg triamcinolone acetonide. Besides VH and visual acuity, intraocular pressure and cataract development were also analyzed. Results. Statistically significant difference was recorded 1st and 3rd month after the usage of triamacinolone, in the density of vitreal hemorrhage and visual acuity. Twenty-nine percent of patients had temporally intraocular pressure rise after the intravitreal triamacinolone application, and 4.1% of patients ended the study with the developed cataract. Conclusion. Intravitreally applied triamcinolone acetonide has moderate and temporary influence on the velocity of vitreal hemorrhage reabsorption. It can be useful treatment option when the vitrectomy in not possible.

Epidemic viral conjunctivitis caused by adenovirus is the most common infectious conjunctivitis. The exact incidence of adenoviral conjunctivitis is still poorly known, but there are two well-defined adenoviral keratoconjunctivitis clinical syndromes: epidemic keratoconjunctivitis (EKC) and pharyngoconjunctival fever (PCF). Epidemic keratoconjunctivitis is also the most severe form and presents with watery discharge, hyperemia, chemosis and ipsilateral lymphadenopathy. Diagnosis is mainly clinical, but its etiology can be confirmed using cell cultures, antigen detection, polymerase chain reaction or immune-chromatography. Multiple treatments have been tried for this disease, but none of them seem to be completely effective. Viruses are resistant to desiccation and certain common surface disinfectants. Prevention is the most reliable and recommended strategy to control this epidemic infection. Global epidemic surveillance system definitely needs to be established to monitor and analyze the epidemic conjunctivitis in the future. There is clearly a need for the national and the military public health institutions to work together on guidelines to handle future challenges.

Background/Aim. The integrity of outer retinal structures, primarily the photoreceptor layer, is important because of its direct correlation with visual acuity. The aim of this study was to investigate the correlation between best-corrected visual acuity (BCVA), the foveal photoreceptorinner segment/outer segment (IS/OS) junction and external limiting membrane (ELM) in patients with neovascular age-related macular degeneration (NVAMD) after the treatment with bevacizumab, as well as the correlation between the above-mentioned parameters and different types of neovascular membrane, classified by fluorescein angiography (FA). Methods. The study included 82 patients with NVAMD, treated with intravitreal bevacizumab. All patients underwent a basic ophthalmological examination, FA and optical coherence tomography (OCT). Based on the results of FA, all the patients were divided into two main groups ? type I (the occult and minimally classic) and type II (classic and predominantly classic) of the choroidal neovascular membrane (CNV). The OCT images revealed either the presence or the absence of IS/OS and ELM. Results. After the treatment, the mean best corrected visual acuity improved significantly in both groups (p < 0.01). Preserved IS/OS and ELM were registered in a smaller number of patients as compared to the condition before the treatment (p < 0.01). After the treatment, the mean BCVA was significantly better in patients with preserved IS/OS and ELM (p < 0.01). In addition, we registered a higher number of patients with preserved ELM in the first group than in the second group (p < 0.01), whereas there was no significant difference in the integrity of IS/OS between the groups (p > 0.05). Conclusion. The patients with preserved IS/OS and ELM achieved better final visual acuity as compared to the patients without preserved IS/OS and ELM. In our patients, the absence of IS/OS and ELM were more frequent in type II (classic and predominantly classic) CNV than in type I (the occult and minimally classic) CNV.

Introduction/Aim. Pseudoexfoliation syndrome (XPS) is age related systemic disorder characterized by increased production and accumulation of elastic micro-fibrillar material in different tissues of the body: skin, connective tissue portions of visceral organs, periphery blood vessels and the eye, as well. The aim of our study was to determine the significance of atherosclerotic changes in the carotid arteries in the development of XFS and pseudoexfoliation glaucoma (XFG). Methods. Our study included 120 patients - 40 patients per each of three defined groups: XFS group, XFG group and age- and sex-matched control subjects (control group) without XFG. Blood samples were collected from the patients before cataract surgery. Serum levels of lipid profiles (total cholesterol, LDL, HDL and triglycerides) were analyzed by standard laboratory techniques. Standard ultrasonography of the carotid blood vessels was performed on all participants. Results. Lipid’s profile was disturbed in patients with XFS and XFG with statistical significance (p

Serbia is an upper-middle income Eastern European economy. It has inherited system of health provision and financing, which is a mixture of Soviet Semashko and German Bismarck models. So far, literature evidence on long-term trends in health spending remains scarce on this region. Observational descriptive approach was utilized relying on nationwide aggregate data reported by the Republic Health Insurance Fund (RHIF) and the Government of Serbia to the WHO office. Consecutively, the WHO Global Health Expenditure Database1 was used. Long-term trends were extrapolated on existing data and underlying differences were analyzed and explained. The insight was provided across two distinctively different periods within 2000–2016. The first period lasted from 2000 till 2008 (the beginning of global recession triggered by Lehman Brothers' bankruptcy). This was a period of strong upward growth in ability to invest in health care. Spending grew significantly in terms of GDP share, national and per capita reported expenditures. During the second period (2009–2016), after the beginning of worldwide economic crisis, Serbia was affected in a way that its health expenditure growth in PPP terms slowed down effectively fluctuating around plateau values from 2014 to 2016. Serbia health spending showed promising signs of steady growth in its ability to invest in health care. Consolidation marked most of the past decade with certain growth rates in recent years (2017–2019), which were not captured in these official records. The future national strategy should be devised to take into account accelerated population aging as major driver of health spending.

Introduction Smoking has been linked to cancer occurrence and survival rates for a long time. However, there is little research into the impacts of smoking on oncological treatments. The aim of the study is to show the impact that smoking can have on the effects of cancer therapy. Methods Epidemiological situation analysis of the malignant diseases based on the data of incidence and mortality and the impact of smoking on the results of treatment. Results At the time of establishing the diagnosis, the incidence of smoking varies from 10 to 95 per cent ( 60% for lung cancer). The previous research indicates that continuing smoking after the establishment of a diagnosis can impact the treatment outcomes and is related to worse prognosis and survival rate. Active smoking can be connected to lower survival rates with advanced non-small cell lung cancer, limited small cell lung cancer, bladder cancer, and upper tract urothelial cancer. The smokers suffering from prostate cancer have a higher risk of death outcomes and worse prognoses after the treatment. The research has shown that there is a link between smoking and slower wound healing in operated patients and that it can also intensify the side-effects of chemotherapy and prolong the responses to radiation. Conclusions It is essential to increase knowledge about the health benefits of quitting smoking in order to advance the results of oncological treatments. Implemented smoking cessation programs need to be adapted to oncology patients.

Pterygium is an ocular disease characterised by the growth of fibrovascular conjunctiva on the cornea. It occurs more often in men, at an older age, and in individuals exposed to ultraviolet radiation. Surgical treatment is the primary treatment for pterygium and there are two common procedures for pterygium excision. In the first method, the head of the pterygium is separated from the corneal surface using a surgical blade. The second method is based on avulsion. Other approaches to excising the pterygium include the use of argon laser and excimer laser. Because of a high recurrence rate, adjuvant therapies, including radiotherapy, chemotherapy, and graft procedures, are used after pterygium excision. These procedures have become the standard long-term treatments for pterygium. Radiotherapy is based on beta irradiation. Chemotherapy includes the use of mitomycin C, 5-fluorouracil, bevacizumab, and loteprednol etabonate. Graft procedures include amniotic membrane grafts and conjunctival autografts. Many surgeons believe that using mitomycin C and conjunctival autografts provides the best outcomes in terms of recurrence, cosmetics and patient satisfaction.

The aim of this study is to analyze the health status of the population in Central Serbia, in order to identify priority health problems. As a source of data, authots use the reports about diseases, conditions and injuries services for the health care of preschool children, services for school health, health care services for the adult population and services for the health care of women's health centers in Central Serbia in 2015. On the territory of Central Serbia, leading cause of morbidity in children of preschool and school age are diseases of the respiratory system. Cardiovascular diseases and respiratory diseases dominate in the structure of morbidity in the adult population, as well as high blood pressure as a single disease, while in the female population the most common are diseases of genitourinary tract.