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Since 1st January 2011, compulsory military service was abolished and transition was made to manning the units of the Serbian Armed Forces with professional members. This implies that the Serbian Armed Forces should attract, employ and retain professional soldiers within their units. Such scenario has created new challenges in human resource management within the Serbian Armed Forces. Having in mind that professional soldiers make a significant component that influences the state and operational capabilities of Serbian Armed Forces units, turnover represents a serious obstacle both in achieving and maintaining required level of their operational capability. Every organisation faces turnover. It is necessary for the management of the defence system to identify expectations and requirements of professional soldiers, which would contribute to the development of a strategic plan for the reduction of their turnover. The goal of this paper is to identify the causes of the turnover of professional soldiers of the Serbian Armed Forces. Empirical research was carried out on a sample of 117 company/autonomous platoon commanders and 1213 professional soldiers of the Serbian Armed Forces. The causes of turnover were examined through a survey. Company/ autonomous platoon commanders were asked to evaluate factors that encourage professional soldiers the most to leave the Serbian Armed Forces. Professional soldiers were asked to define actions that the defence system should take to reduce their outflow. Obtained results show that the turnover of professional soldiers is considerably influenced by job satisfaction and organisational support.

The aim of this research is to verify the reliability and factoral validity of the constructed scale for the evaluation of job satisfaction of professional soldiers. The constructed scale consists of seven subscales. An initial version of the survey contained the total of 49 items, including five socio-demographic questions. Empirical verification covered the sample of 157 professional soldiers of the Guard. The analysis of metric characteristics, reliability of items and subscales, and the factoral validity of theoretically presumed scale for the evaluation of job satisfaction of professional soldiers, was carried out by analysing internal congruence of subscales and factoral analysis. After the analysis has been concluded, a scale was derived that contains 33 items. The factoral analysis has offered 7 factors with explained variance of 70.945%. It was determined that the reliability of the empirically obtained subscales was satisfactory: Emoluments (5 items; a=0,840), superior officer (5 items; a=0,897), work load (4 items; a=0,818), job category (7 items; a=0,919), prospect for career advancement (4 items; a=0,901), working environment conditions (4 items; a=0,862) and interpersonal relations (4 items; a=0,820). As a whole, the constructed scale enables a reliable and valid evaluation of professional soldiers' job satisfaction, and it is suitable to be applied for research purposes.

Celiac disease is a multisystemic autoimmune disease induced by gluten in wheat, rye, and barley. It is characterized by polygenic predisposition, prevailing prevalence in members of the white population (1%), especially in close relatives (5–15%), very heterogeneous expression and frequent association with other autoimmune diseases (3–10%), as well as selective deficiency of IgA and Down, Turner, and Williams syndromes. The basis of the disease and the key finding in its diagnostics is gluten-sensitive enteropathy, i.e., non-specific inflammation of the small intestinal mucosa which resolves by gluten-free diet. In addition to enteropathy, whether symptomatic or asymptomatic, the disease is also characterized by various extraintestinal manifestations, and even very serious complications. Therapy is based on a lifelong glutenfree diet, so that the disorder, if diagnosed in time and treated consistently, has an excellent prognosis.

Introduction/Objective. Physical therapy aims to improve airway clearance, breathing, and enhance gas exchange. It is widely used as an additional therapy in children with pneumonia. The aim of this study was to assess the effects of complications and comorbidities on physical therapy duration in children with pneumonia. Methods. We conducted a retrospective descriptive study including 40 children with pneumonia admitted to a tertiary children’s hospital. Study participants were divided into two groups – a group with and without complications and a group with and without comorbidities. All children received physical therapy one time daily five days a week plus standard treatment for pneumonia. Physical therapy procedures that were applied were chest physical therapy and kinesiotherapy. Results. Chest physical therapy (p < 0.001) and kinesiotherapy (p = 0.024) were applied significantly longer in the group with complications versus those without complications. Chest physical therapy was applied significantly longer in the group with comorbidities versus the group without comorbidities (p < 0.001), while there was no difference regarding duration of kinesiotherapy in the group with and without comorbidities (p = 0.239). Conclusion. Our results show that the presence of complications and/or comorbidities significantly prolongs the duration of chest physical therapy in children with pneumonia.

Introduction/Objective. Gilbert syndrome (GS) is the most common hereditary hyperbilirubinemia. As well as mild unconjugated hyperbilirubinemia, it is characterized by the excess of bilirubin monoglucuronide over diglucuronide in the bile and thus increases the risk of biliary calculosis. The aim of the study was to determine the importance of GS as a risk factor in the development of cholelithiasis in children. Methods. The study included a sample of 31 children (14 male and 17 female, mean age 12.16 ± 4.11 years, range 3–16.75 years) with symptomatic cholelithiasis. The diagnosis of cholelithiasis was based on an ultrasonographic finding, and for GS the diagnosis was based on at least a double increase of unconjugated bilirubin fraction after a three-day hypocaloric diet (400 kcal per day). Results. GS was confirmed in five or 16.13% of patients (three male and two female, mean age 14.71 ± 0.55 years, range 14–15.3 years). In addition to GS, in the history of the disease they all had some of the additional risk factors for the development of cholelithiasis. One of them had an identical problem as its mother, one had hereditary elliptocytosis, one had sudden weight loss, one was overweight, and one had premature birth and sepsis. Conclusion. GS registers in one-sixth of children with cholelithiasis, but in none of them as the only risk factor for developing this disease. This finding suggests that GS is a risk factor for the development of cholelithiasis, but not sufficient in itself in that respect.

This study investigates the effects of successive neutron and gamma radiation on the parameters of commercial solar cells. Several solar panels have been exposed to neutron radiation and then, after 30 days of recovery, to gamma radiation. A series of measurements of solar cell parameters have been undertaken to determine the reliability of solar cells in the condition of successive irradiation of different types of rays. Solar cell parameters have been measured before and after every step of irradiation. The process of annealing has also been observed. This paper aims to present the effects of both neutron and gamma radiation on the same solar cell sample.

Carpal tunnel syndrome (CTS) represents one of the most common compressive peripheral neuropathies on the upper extremities, and is characterized by compression of the medial nerve on its way through the carpal tunnel area. The first changes experienced by patients with CTS are sensory and occur mainly at night, and if they are not recognized and treated in time, they progress and become continuously present. Prolonged compression of the medial nerve in the region of the carpal tunnel can lead to permanent damage to this nerve, which can result in the patient losing the ability to distinguish between hot and cold, as well as atrophy of the thenar muscles and difficulty in palmar abduction of the thumb. The diagnosis of CTS is generally made based on the patient's symptoms, clinical history and anamnesis, as well as electrodiagnostic tests. In addition to these methods, provocative tests, nuclear magnetic resonance (NMR) and ultrasound examinations are used in the evaluation of CTS. In patients with CTS, a large number of treatment methods, both surgical and non-surgical, are used in clinical practice. Myofascial massage, ultrasound, interference currents, continuous short-wave diathermy, extracorporeal shock wave therapy (ESWT) have been shown to be beneficial in reducing pain and symptoms or improving function in patients with CTS in the short and medium term. It was also pointed out that there are no firm conclusions about optimal doses and therapeutic parameters. A better understanding of the etiology and pathophysiological mechanisms of CTS, as well as the effects of certain therapeutic modalities in the treatment of this condition, will contribute to further understanding of the origin and progression of CTS, as well as the possibilities of prevention and treatment of these patients in order to improve the quality of their life and the functionality of the affected limb.

Background/Aim. Among the various factors that can influence continued postoperative back pain and/or leg pain, and functional disability after lumbar microdiscectomy are gender, depression, and pessimism. The aim of this study was to determine the correlations between these factors. Methods. The research was conducted after microdiscectomy on 198 patients (95 men and 103 women), with a mean age of 50.20 ± 10.26 years. The following questionnaires were used for examinations: for assessment of pain and its intensity and character – PainDETECT Test; for functional disability – Oswestry Low Back Pain Disability Questionnaire; for the presence and degree of depression – Beck Depression Inventory-II; and questionnaire for the assessment of personal expectations (pessimistic/optimistic) about the treatment results. These assessments were carried out after microdiscectomy – just before rehabilitation treatment, one month later, and then 3 and 6 months after a microdiscectomy. Results. Depression (p < 0.01) and pessimism (p < 0.01) had significant negative influences on the pain and functional disability. The subjective sensation of pain was significantly higher in women than in men (p < 0.01), while men had a greater degree of functional disability (p < 0.01) than women. Conclusion. Pain and functional disability of the patients after lumbar microdiscectomy are significantly interconnected with gender, depression, and pessimism. The sensation of pain was higher in women, while men had a greater degree of functional disability. Globally, the intensity of pain and functional disability were significantly greater in patients with a higher degree of depression and pessimism, and, by registering mentioned factors, it is possible to predict the postoperative results.

Background/Aim. The published data indicate that the appearance of spinal deformities in children is significantly influenced by physical activity. The aim of our study was to examine the influence of physical activity on prevention and occurrence of spinal deformities in children. Methods. The study was conducted as observational, clinical study in the period from 2016 to 2018. Participants were children with spinal deformities, which were examined, for the first time, by physiatrists and pediatric surgeons. The sample included 100 children with spinal deformities, aged 7–17 years. The control group consisted of 100 children without spinal deformity, of similar age. The study instrument was a questionnaire based on a survey filled by children or parents/legal guardians. The questions were related to different parameters of the possible significance for the existence of spinal deformity and especially to the influence of physical activity. The collected data were processed using methods of descriptive and analytical statistics. Results. Scoliosis the most common deformity of the spinal column, represented in about 67% of children (p = 0.0006). Respondents from both groups did not differ significantly in terms of gender. Children in the group with spinal deformities were older (11.5 ± 3.1 years vs. 10.4 ± 3.1 years, p = 0.016), with increased body weight (43.9 ± 16.0 kg vs. 39.3 ± 16.6 kg, p = 0.046) and height (151.7 ± 17.2 cm vs. 145.8 ± 18.2 cm, p = 0.019), as well as with less physical activity (81.0% vs. 92.02%, p = 0.001). Over 80% of children were regularly engaged in physical activity, more often recreationally and on average 2.5–3 hours per week. Conclusion. Children in the spinal deformity group were significantly less involved in physical activity than the control group, but there was no significant difference in the frequency and duration of time spent in physical activities during the week. It is important for children to be involved in physical activities of a recreational nature, and according to our research, 3 hours during the week.

Physical activity plays an important role in the motor and psychological development in a pediatric population. The maturation of human motor skills is gradual over the time. It depends on several factors, including but not limited to: individual differences, health condition, quality of neuromuscular structures and stimulating factors. Research included in this review shows that different types of physical activity, including aerobic training, strength training, dance, yoga, and walking programs, improve mood and mental health. Aerobic physical activity has the greatest effect on reducing the symptoms of anxiety and stress. Habits related to the physical activity, acquired in childhood, can be maintained in adulthood, which contributes to the better health and quality of life. Extensive literature indicates that regular physical activity encourages growth and development and has multiple benefits for the mental, physical, cognitive and psychosocial health of children. Children capacities for exercise change in accordance within defined developmental periods. Young children are active at short intervals and their capacity for continuous activity increases as they grow and mature. The health benefits of sporadic exercise at a younger age are not well established, stressing the short-term benefits of physical activity for some aspects of cognitive and mental health, indicating that maximum benefit can be achieved by frequent bouts of exercise during the day.

The prevalence of obesity and obesity-related health problems is increasing worldwide, especially among woman and man of reproductive age where obesity is designated as one of the most important global health threats in 21st century. Pregnancy in obese woman is considered as a high-risk pregnancy. Pre-pregnancy obesity and excessive gestational weight gain (GWG) are distinct risk factors with differing associated adverse outcomes, and they could also carry a cumulative negative impact on pregnancy course. Pre-pregnancy obesity is the anthropometric parameter most strongly correlated with perinatal complications. Maternal complications following obesity include antepartum, intrapartum and postpartum complications, such as pregnancy related hypertension, preeclampsia, gestational diabetes mellitus, preterm birth, venous thromboembolism, labor dystocia, labor induction, instrumental and cesarean delivery. Fetal complications related to maternal obesity might include increased prevalence of congenital anomalies, growth abnormalities, prematurity and stillbirth. Prepregnancy overweight and obesity is a potentially modifiable risk factor compromising pregnancy outcome. Among all complications that might arise during pregnancy and that could not be predicted and therefore prevented, pre-pregnancy overweight and obesity management control can significantly reduce potential pregnancy complications. Pre-conceptual counseling should provide an awareness of this arising medical condition in a timely manner and provide risk reduction of complications following pre-pregnancy obesity and excessive GWG.

Introduction. Recurrent aphthous stomatitis (RAS) is a relatively common oral mucosal lesion of unclear etiology. It occurs in otherwise healthy people, but also in various infectious and non-infectious diseases, including celiac disease (CD). We present an obese adolescent with RAS as the only clinical sign of CD. Case outline. An adolescent aged 15 2/12 years come with very pronounced RAS in previous five months. He had no other difficulties. The patient was obese from the age of 12. Other data were without peculiarities. On admission he was 165 cm tall (P25), obese (BMI 27 kg/m2), in the final stage of puberty, with stretch marks in the distal areas of the abdomen, thighs and gluteus and very pronounced pain-sensitive aphthae in the buccal and labial mucosa accompanied by swelling of the lips and perioral region. Except for lower serum iron levels (8 μmol/l), routine laboratory blood tests were within the reference range. The serological test for CD was positive (antibodies to tissue transglutaminase IgA 78.5 U/ml, anti-endomysial antibodies IgA positive). Endoscopy revealed reflux esophagitis, without any other pathological findings. Stereomicroscopic and pathohistological analysis of the duodenal mucosa samples showed mild destructive enteropathy (Marsh IIIa). Pathohistological examination of the gastric mucosa revealed grade I-II lymphocytic gastritis. The urease test for Helicobacter pylori was negative. A gluten-free diet resulted in the withdrawal of aphthous stomatitis and no recurrence later. Conclusion. Within the differential diagnostic analysis of the RAS causes, CD should also be considered. Additionally, obesity does not exclude the presence of CD.

Introduction/Objective. The aim of this paper was to examine proportion of patients with arterial abnormalities of feet due to age and severity degree of pes metatarsus varus (PMV), and to evaluate the treatment duration and outcome. Methods. The prospective longitudinal study included 240 patients with congenital PMV classified into three age groups: group < 3 months of life (Group 1), group 3–9 months (Group 2), and group 9–12 months (Group 3). Three categories of PMV were analyzed: mild/moderate/severe. Groups with arterial anomalies (Group A) and without (Group B) were analyzed. Clinical outcome was graded as: good/satisfactory/poor. Results. There is statistically significant difference in distribution of children regarding age and severity degree on first visit and presence of feet arterial abnormalities (p < 0.01). For Group A, younger children had longer physical therapy, while for Group B, older children had longer duration of physical therapy. Same trend applies as severity degree of foot deformity increase. In Group A, the most frequent treatment outcome was poor (for Group 1 – 46.7%; Group 2 – 60%; Group 3 – 62%), while in Group B for Group 1 and Group 2 it was frequently good (Group 1 – 90%; Group 2 – 40%), and for Group 3 frequently satisfactory (Group 3 – 53.3%). Conclusion. In children with PMV it might be advisable to perform ultrasound evaluation of arterial structure of feet, and particularly in cases were such deformity is more severe.

Introduction/Objective. Anemia is the most common extraintestinal manifestation of celiac disease (CD) in children. The aim of this study was to determine the frequency, severity and type of anemia in children with a classical CD, as well as the differences between anemic and non-anemic patients in their age, duration of illness, percentile body length or height, percentage of body weight (BW) deviation compared to ideal, and the degree of damage to the small intestine mucosa. Methods. The study was based on a sample of 90 children, 56 females and 34 males, ages 7–90 (18.23 Ѓ} 12.7) months with classical CD. The diagnosis of CD is based on the ESPGHAN criteria from 1990 and 2012, and of anemia on the 2011 WHO reference values. Results. Anemia was found in 47 (52.22%) patients, of which it was mild in 23 cases [hemoglobin (Hb) 100–109 g/L] and moderately severe in 24 (Hb 70–99 g/L), in 34 (72.34%) it was microcytic [mean cell volume (MCV) < 70 fl] and normocytic (MCV 70–87 fl) in 13 patients. Low serum iron levels (< 10.7 μmol/L) were found in 68 (75.56%), and hypoferritinemia (< 16 ng/ml) in 77 (85.56%) patients. Except for a greater deficit of BW in patients with anemia compared to those without anemia (-14.64 ± 9.60 vs. -8.56 ± 11.87%, p < 0.01), differences in other defined features were not significant. Conclusion. Mild or moderate iron deficiency anemia occurs in slightly more than half of children with a classical type CD. In anemic compared to non-anemic patients, there is a significantly higher BW deficit, while differences in other characteristics typical for this type of disease are not significant.

Abstract Introduction. Aortic coarcation is a congenital condition mostly detected and treated during childhood. Adult patients with coarctation and associated cardiac lesions represent a challenge and a subject of debates concerning adequate treatment. We report 2 patients with aortic coartation when a surgical treatment was necessary. Case report. First patient was a 61-year-old male with previous mechanical aortic valve implantation. He underwent one stage surgical reconstruction of aortic coarctation and surgical repair of aneurysm of ascending aorta. The second patient was a 49- year-old female with aortic aneurysm, bicuspid aortic valve, severe aortic insufficiency and coarctation of aorta below branching of subclavian artery. She underwent the Bentall procedure and surgical repair of coarctation by bypass where the proximal anastomosis was made between the terminal part of Dacron graft and the lateral part of graft used for Bentall, while the distal anastomosis was made between the terminal part of Dacron graft and the lateral part of descending aorta below coarctation. The postoperative course and the follow-up of the patients of 3 and 1 year, respectively, were without complications. Conclusion. Single operation is a better choice in the patients with concomitant pathology such as the aortic aneurysm, or aortic valve disease. Each patient should be analyzed on a single basis, and a decision about a surgical technique and surgical course brought accordingly.

Introduction. Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm. This disease, of unknown etiology, runs an unpredictable course. Its definitive diagnosis calls for a detailed histopathological analysis including immunohistochemistry. Microscopically, IMT is composed of myofibroblastic spindle and inflammatory cells in different proportions. It presents infrequently in adults with nonspecific symptomatology. The presence of IMT is described in every anatomical region but the tracheal one is especially uncommon. Case report. A 41- year-old female patient checked into our institution due to exacerbation of asthma-like symptoms such as shortness of breath, cough and exertion intolerance. She was originally treated as the asthmatic patient with the bronchodilator therapy with no success. Chest x-ray done during one of the outpatient follow-up appointments pointed to a suspected change in the tracheal distal part. After her admission to our institution, the following diagnostic procedures were performed: spirometry, chest computed tomography (CT) scan, chest magnetic resonance imaging (MRI) and bronchoscopy and the change in tracheal distal third was confirmed. Right-sided thoracotomy with mobilization of lung, tracheal resection and termino-terminal (T-T) anastomosis was undertaken. Subsequent histopathological analysis of surgically removed afflicted tracheal part of them trachea including immunohistochemistry enabled us to definitively of diagnose IMT. Four years after surgical resection, the patient showed no recidivism of illness. Conclusion. Definitive IMT diagnosis requires the detailed diagnostic tests, most importantly, an adequate histopathological analysis including immunohistochemistry. Complete surgical resection is the treatment of choice in case of IMT. Further monitoring of patients is necessary due to a risk of recurrence.

Background/Aim. The hypercoagulable state and inflammation state in diabetics has been widely studied by previous researchers, but there is a lack of research about a possible impact of exercise training on this relationship. The aim of this study was to assess and compare correlation between the coagulation and inflammation status in patients with type 2 diabetes mellitus taking into account the gender differences as well as an impact of the 8-week exercise training on the correlation coefficient and parameters of the inflammation and coagulation state. Methods. A total of 60 patients in stable clinical condition and well-regulated diabetic status passed through all phases of the study. The exercise training included the exercise program as interval training with estimated intensity uphill to 75% of a maximal heart rate in particular individual, 5 times a week for 8 weeks, and walking for 30 minutes with a speed of 5 km/h, 5 times a week for 8 weeks. Further fibrinolytic, coagulation and inflammatory parameters were analyzed before and after the study: D-dimer, von Willebrand factor (vWF), fibrinogen, high sensitivity CRP (hs-CRP), leukocytes, thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT) and coagulation factors: FII, FV, FVII and FX. Results. Our research showed a statistically significant reduction in the mean vWF levels after intervention both at the males (p < 0.001) and females (p < 0.001). According to a correlation analysis between hs-CRP and fibrinogen, there was a positive correlation as baseline both at the males (p < 0.05, r = 0.492) and females (p < 0.01, r = 0.516) which became weaker in the males (p < 0.01, r = 0.449) and disappeared in the females (p < 0.05, r = 0.059) after intervention. The correlation which existed as baseline in the males between D-dimer and either hs-CRP (p < 0.01, r = 0.633) or fibrinogen (p < 0.01, r = 0.673) as well as the correlation between hs-CRP and FII (p < 0.01, r = 0.728), FV (p < 0.05, r = 0.366), FVII (p < 0.05, r = 0.373) coagulation as well as between D-dimer and FII (p < 0.01, r = 0.851), FVII (p < 0.05, r = 0.367)was absent in the females. Our research demonstrated a weakening correlations in the males after intervention between D-dimer and hs-CRP (p < 0.05, r = 0.378), between hs-CRP and FII (p < 0.01, r = 0.501), FV (p < 0.05, r = 0.298), FVII (p < 0.05, r = 0.351) as well as between D-dimer and FII (p < 0.01, r = 0.759), and FVII (p < 0.05, r = 0.296). The increase of the FX values (p < 0.05) in the females after intervention suggested the possible antiinflammatory effect of exercise training. Conclusion. According to previous research, the higher levels of vWF was associated with a risk of cardiovascular disease in people with type 2 diabetes mellitus and vWF may be a risk factor unique to these populations. We demonstrated that the 8-week exercise training can significantly reduce the value of vWF in the males and females, suggesting a potential beneficial effect on the endothelial function parameters. Our research demonstrated a stronger correlation between the coagulation and inflammation parameters as baseline in the males than in the females with type 2 diabetes mellitus. According to our results, the 8-week exercise training lead to a weakening of the strength of correlation between the coagulation and inflammation parameters in the males and complete disappearance of this correlation in the females, suggesting a unique effect of exercise training that should be explored in future research.

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Introduction/Objective. The aim of the paper was to evaluate the short-term effectiveness of ultrasound treatment procedure on defined clinical parameters and changes of electrodiagnostic parameters at the median nerve in carpal tunnel syndrome patients. Methods. Thirty-five patients (50 hands) were randomly divided into two groups: the experimental group (EG) (20 patients (29 hands)) and the control group (CG) (15 patients (21 hands)). Twenty sessions of ultrasound treatment were performed over a period of seven weeks and control examination was performed during the eighth week from the initial session. Clinical assessment parameters (pain intensity, superficial sensibility, and Tinel sign), and electrodiagnostic parameters (motor distal latency – mDL), median sensory nerve conduction velocity (SNCV), and median sensory nerve action potential (SNAP) were assessed both at baseline (T1) and at control (T2). Results. There is significant improvement of pain intensity (T1 – 10.4/58.6/31; T2 – 65.5/27.6/6.9; p < 0.001) and superficial sensibility (T1 – 3.4/69/27.6; T2 – 44.8/34.5/20.7; p < 0.001) in the EG after the treatment. In the EG, there is significant reduction in frequency of positive Tinel’s sign (T1 – 100/0; T2 – 62.1/37.9; p < 0.001), and mDL significantly decreased after the treatment (T1 – 4.7 ± 1.3; T2 – 4.5 ± 1.2; p = 0.007), while SNAP (T1 – 20.2 ± 15.4; T2 – 24.4 ± 16.5; p < 0.001) and SNCV (T1 – 36.5 ± 9.8; T2 – 42.6 ± 9.7; p < 0.001) significantly increased. Conclusion. Ultrasound treatment along with exercises have positive short-term effects and benefits on improvement of clinical and electrodiagnostic findings in individuals with carpal tunnel syndrome.

Aging is physiological process that includes numerous variables, among them: genetics, chronic diseases, lifestyle factors, and socioeconomic factors that interact with one another and thus affecting the person's functional and physical dimensions. Mobility difficulties are usually among the first signs of functional decline and thus affecting the quality of life in aged population. Chronic diseases including: diabetes, cardiovascular, musculoskeletal and neurological is shown to have important impact on disability in elderly. The fundamental dimension of mobility is walking as complex neuromotor activity that integrates sensory and motor functions. With regards to the individual's needs, adopted physical activity is recommended, in order to take into consideration differences in physical abilities, meaning that such activity was adjusted and modified to the elderly with disabilities needs. Despite the fact that females have lower rates of certain chronic diseases and mortality, they have more functional limitations and are more physically disabled versus males. Most age-dependent disorders arise from the disability for which long-term care costs outweigh health expenditure. Technological and medical development, health promotion and redistribution of health and social care services will be important for modifying ageing processes so that people will be living longer without severe disability. Further, on individual level, exercises, walking, cycling, and plays in free time are highly recommended for persons 60 years and older.

Introduction. Guillain–Barre syndrome (GBS) is the most common cause of acute flaccid paralysis in healthy infants and children. Acute motor axonal neuropathy (AMAN) is a type of GBS characterized by motor syndrome with no sensory symptoms. Case outline. Authors describe a six-and-a-half year old girl with atypical clinical presentation of AMAN with severe painful lower limbs and refusal of the leg reliance with typical findings on nerves conduction studies. Conclusion. Despite the nerve conduction study findings, atypical forms of AMAN and GBS are possible. Pain symptoms must be taken very seriously and treated careful by the clinicians.

Introduction/Objective. Idiopathic scoliosis (IS) is an orthopedic condition of multifactorial origin. The aim of our study was to evaluate the factors that are associated with IS in female population and factors associated with varicose veins in females with IS. Methods. This retrospective-prospective cross-section study included 89 patients (the study group) and 87 controls. The following parameters were analyzed: body weight, body height, presence and the degree of varicose veins (the first, second, and third degree), and age (group in the range of 17–26 years, in the range of 27–36 years, and in the range of 37–46 years). Results. The study group has significantly lower body weight (p = 0.046), significantly higher proportion of varicose veins (p < 0.001) compared to controls, significantly lower proportion of patients aged 27–36 years (p = 0.014), and significantly higher proportion of patients aged 37–46 years (p = 0.025) compared to controls. There is significantly higher proportion of patients in the study group with the first degree of varicose veins (p = 0.007). There is weak positive correlation between body weight and body height in the group of patients without varicose veins (R = 0.456) and in the group with the second degree of varicose veins (R = 0.291), while for the group with the first degree of varicose veins there is moderate positive correlation (R = 0.543). Conclusion. Our preliminary findings point out that lower body weight and presence of varicose veins are significantly associated with IS. The group of patients with IS above 37 years of age tends to have significantly higher proportion of varicose veins.

Background/Aim. Hirschsprung’s disease is the most common identifiable developmental disorder of the enteric nervous system, characterized by a failure of its formation in a variable segment of distal bowel. Currently available surgical therapies for Hirschsprung’s disease, although lifesaving, are associated with numerous complications. The aim of our study was to evaluate the effectiveness of different surgical methods and the incidence of serious complications after radical surgery of rectosigmoid Hirschsprung’s disease. Methods. A retrospective analysis, from June 1997 until May 2012 was carried out on 84 patients operated for Hirschsprung’s disease of rectosigmoid colon. Transanal endorectal pull-through was performed in 30 (35.7%) patients (group I), while 54 (64.3%) patients were operated by other (Soave, Duhamel or Swenson) procedures (group II). The age at operation, the incidence and severity of postoperative complications, the need for previous colostomy and the number of reoperations are countered in order to evaluate the efficacy of surgical procedures. Results. In the group I, the mean age at operation was 9.41 ± 6.37 months and in the group II the mean age at operation was 16.8 ± 13.9 months which was significantly higher (p < 0.01). In the group I there were only 3 (10%) patients with complications, one (3%) of them was prone to only one redo procedure (1.00 ± 0.00) and there was no need for previous colostomy in all patients (100%). In the group II there were 16 (30%) patients with significantly frequent complications (p < 0.05), about 2 reoperations on the average (1.94 ± 1.84) in 4 of them (25%) and 22 (41%) redo procedures, which was, in total, significantly higher than in the group I (p < 0.01). Only Soave’s procedure was performed without previous colostomy in 20 (37%) patients. Conclusion. Transanal endorectal pull-through in surgical treatment of patients with Hirschsprung’s disease is more effective than other procedures concerning earlier onset, low incidence and less severe complications, which would require further operations, and no scars.

Due to its wide application areas, solar cells are exposed, in their work environment, to different types of radiation (cosmic radiation in the upper layers of the atmosphere, military and civilian nuclear facilities). Moreover, the used nuclear fuel emits y photons and neutrons at the same time, so different types of radiation damage appeared in solar cells located in the vicinity of these fuels. These damage have been caused by both gamma and neutron radiation. That's why very extensive researches have been undertaken with the aim of developing semiconductor devices whose work will be reliable in terms of increased levels of radiation. From the technological point of view, it is important to determine changes, caused by radiation, in the parameters of the silicon solar cells that affect their work. The aim of this paper is to present the comparative study of gamma and neutron irradiation effects on the solar cells parameters.

Background/Aim. Treatment options for metastatic melanoma in Serbia are limited due to the lack of newly approved biologic agents and the lack of clinical studies. Also, there is a paucity of data regarding the treatment approaches in different tertiary centers and efficacy of available chemotherapy protocols. The aim of this study was to obtain more detailed data about treatment protocols in Serbia based on structured survey in tertiary oncology centers. Methods. Data about the melanoma patients treated in 2011 were analyzed from hospital databases in 6 referent oncology centers in Serbia, based on the structured survey, with the focus on metastatic melanoma patients (unresectable stage IIIC and IV). Results. A total of 986 (79-315 in different centers) patients were treated, with 320 (32.45%) newly diagnosed patients. There were 317 patients in stage IIIC/IV, 77/317 aged < 50 years. At the time of diagnosis 47.3% of patients were < 60 years of age (24.2% < 40 years, 23% 50-59 years, 52.6% > 60 years). At initial diagnosis 12.5% of patients were in stage III and 4.5% in stage IV. The most common type was superficial spreading melanoma (50-66%), followed by nodular melanoma (23.5-50%). Apart from the regional and distant lymph node metastases, the most frequent organs involved in stage IV disease were distant skin and soft tissues (12-55%), lungs (19-55.5%), liver (10-60%), and bones (3-10%). The first line therapy in stage IV metastatic melanoma was dacarbazine (DTIC) dimethyl-triazeno-imidozole-carboxamide in 61-93% of the patients, while the second line varied between the centers. Disease control (complete response + partial response + stable disease) was achieved in 25.7% of the patients treated with the first line chemotherapy and 23.1% of the patients treated with the second line therapy, but the duration of response was short, in first-line therapy 6.66 ± 3.36 months (median 6.75 months). More than 90% of patients were treated outside the clinical trials. Conclusion. Based on this survey, there is a large unmet need for the new treatment options for metastatic melanoma in Serbia. The development of national guidelines, and greater involvement in international clinical studies could lead to widening of treatment options for this chemotherapy resistant disease.

This paper presents the behavior of PIN photodiodes after combined gamma and neutron irradiation. Different types of PIN photodiodes have been exposed first to gamma and then to neutron irradiation. I-V characteristics (current dependence on voltage) of photodiodes have been measured after each of these irradiations. It has been noted that the photocurrent level after the neutron irradiation is higher than before it, which is not consistent with the current theories about the effects of neutron radiation on semiconductors. In order to explain this behavior of the photodiodes, the Monte Carlo simulation of photon transport through the material has been used. It is proposed that a possible cause for current enhancement are defects in semiconductor created by gamma irradiation and effects of neutron irradiation on these defects. The results can be explained by an intercentre transfer of charge between defects in close proximity to each other. The aim of this paper is to investigate the improvement possibilities of the I-V characteristics of PIN photodiodes, and photodetectors in general, damaged by gamma irradiation. [Projekat Ministarstva nauke Republike Srbije, br. 171007]

Introduction. Idiopathic ulcerative colitis (IUC) represents a rare disease of childhood. It usually occurs at age over 10 years, and below that exceptionally rarely. Objective. The aim of the paper was to analyze the clinical signs, symptoms and therapeutic procedures in children with IUC. Methods. The aims of the paper were based on a sample of 17 children (11 male and 6 female, mean age 11.90±3.50 years; range 3.8-17.5 years) with IUC. The disease diagnosis was based on characteristic endoscopic and pathohistological findings. Results. The basic signs of the disease involved chronic mucosal haemorrhagic diarrhoea which was confirmed in 16 of 17 patients, with body weight deficiency (10), recurrent abdominal pain (6), fever (5), slowed-down maturation (5), marked anorexia (4), and tenesmus (3). Two patients had recurrent aphthous stomatitis, 2 anal fissures, 2 arthralgia, one autoimmune hepatitis and one pyoderma gangrenosum. None of the children had longitudinal growth retardation. Elevated sedimentation rate and C-reactive protein in blood were registered in 11, sideropenia in 10, anaemia in 6 and hypoalbuminemia in 3 patients. The remission of proctosigmoiditis and left-sided colitis was achieved with aminosalicylates, and of pancolitis with the combination of aminosalicylates and glucocorticoids, except in cases of steroid-dependent colitis, which additionally required azathioprine. Conclusion. The main signs of IUC in children are chronic mucous haemorrhagic diarrhoea, body weight loss and sideropenic anaemia, while the basic therapy consists of aminosalicylates, and in more severe cases of the disease the initial use of glucocorticoids and later azathioprine.

Introduction. Athersclerosis is a multifactorial disease that begins in childhood. There are few reports regarding influence of risk factors on the atherosclerotic processes in early period of life and adolescence. Objective. The aim of this study was to present and analyze risk factor trends in school children over a 10-year period that were included and followed-up by the Yugoslav Study of Atherosclerosis Precursors in School Children (YUSAD Study). Methods. There were three examinations of selected population from 13 centres. The first examination was performed when children were 10 years of age (first group; N=6381 participants), the second examination on the same population when they were 15 years of age (second group; N=5017) and third when children were 19/20 years of age (third group; N=1293). Evaluated parameters included: BMI, waist circumference (WaC) and lipid profile (total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride). Results. A significant elevation of values (p

Background/Aim. There are studies stressing out that atherosclerosis is most common associated systemic condition in patients with retinal artery occlusion. The aim of this study was to analyze values of body mass index and lipid fractions in healthy individuals and patients with retinal artery occlusion. Methods. This study included 90 participants during a 6-year period. The population was divided into 2 groups: the group with the diagnosed retinal artery occlusion and the group without retinal artery occlusion. The observed parameters were as follows: body mass index, low and high density lipoproteins and triglycerides. Results. The study revealed no significant difference regarding body mass index and triglycerides values between the two evaluated groups, while low and high density lipoproteins values were significantly higher in the group of patients with retinal artery occlusion. Conclusions. The study demonstrated that body mass index and triglycerides have less important role in atherogenic pathogenesis of retinal artery occlusion, while low density lipoprotein is the fraction that is shown to be most potent in such etiological processes.

The antibacterial effects of essential oils from Serbian cultivated plants, Thymus vulgaris L. (Lamiace) and Lavandula angustifolia L. (Lamiace) on different bacteria were investigated, with an emphasis on an antibacterial activity-chemical composition relationship. Essential oil was obtained from airdried aerial parts of the plants by hydrodistillation for 3 h using a Clevenger-type apparatus. The essential oil analyses were performed simultaneously by gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) systems. The main constituents of thyme oil were thymol (59.95%) and p-cymene (18.34%). Linalyl acetate (38.23%) and linalool (35.01%) were main compounds in lavender oil. The antibacterial activity of the essential oils samples was tested towards 5 different bacteria: laboratory control strain obtained from the American Type Culture Collection and clinical isolates from different pathogenic media. Gram negative bacteria were represented by Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 43895 and Salmonella enteretidis ATCC 9027 while researched Gram positive strains were Bacillus cereus ATCC 8739 and Staphylococcus aureus ATCC 25923. A broth microdilution method was used to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Essential oils from thyme have been found to have antimicrobial activity against all microorganisms tested, with a range of MIC values from 0.025 to 0.10 l/ml and MBC values from 0.05 to 0.78 l/ml. Lavender oils demonstrated MIC values from 0.025 to 0.20 l/ml and MBC values from 0.05 and 0.78 l/ml. Reference antibiotic tetracycline was active in concentrations between 0.025 and 0.05 l/ml. The Gram-positive bacteria were more sensitive to the essential oil of thyme, while Gram-negative bacteria were more sensitive to the essential oil of lavender. Essential oils from thyme and lavender may be used at low concentrations for prevention and treatment of infective diseases in animals and humans caused by pathogenic bacterial species.

Introduction. Secondary lactose intolerance (SLI) belongs to the rarer manifestations of gluten-sensitive enteropathy (GSE). It occurs in more severe forms of the disease and its presence contributes significantly to the degree of its expression. Objective. The goal of the study was to determine the frequency of SLI in infants with clinically classic form of GSE, as well as its relationship with the duration, severity and age at the diagnosis of the basic disease and the degree of small bowel mucosa damage. Methods. The study was based on a sample of 42 infants, 30 female and 12 male, aged 7-12 months (x=9.98±1.69), with a clinically classic form of GSE. The diagnosis of GSE was established based on the characteristic pathohistological appearance of small bowel mucosa and clinical improvement of patients on gluten-free diet, while SLI on pathological lactose or milk tolerance test. The assessment of basic disease severity was based on body mass divergence in relation to the standard value, as well as on Hb and serum iron levels, while the degree of small bowel mucosa damage was determined according to the modified Marsh criteria. Results. SLI was verified in 8/42 or 19.05% of patients. In addition to the symptoms and clinical signs of GSE, all the patients with SLI also featured the problems characteristic of lactose tolerance disorders, i.e. watery diarrhoea, borborygmus and meteorism occurring after milk meals. In addition, all had perianal erythema (6 with erosive changes), as well as destructive enteropathy (5 subtotal and 3 total). The difference in the duration of the basic disease, age at diagnosis, as well as in the degree of body mass deviation from the standard value between the lactose-tolerant and lactose-intolerant infants was not found. In addition, no difference in Hb and serum iron levels or in the degree of small bowel mucosa damage was found between the two groups. Conclusion. Our findings indicate that SLI presents a relatively frequent occurrence in infants with clinically classic GSE, as well as that it occurs independently to the duration, severity and age at diagnosis of the basic disease and the degree of small bowel mucosa damage.

Introduction Neurogenic bladder can develop as a result of various degrees of neurogenic lesion in spina bifida. The degree of bladder dysfunction depends on the level and type of spina bifida. Due to results upon complete diagnostic protocols, treatment options are applied. Objective Comparison of therapy results of patients with occult spinal dysraphism with neurogenic bladder that under-went medicamentous therapy and medicamentous with electrotherapy treatment. Methods We had 49 patients with neurogenic bladder that were treated at the University Children's Hospital in Belgrade in the period 2003-2008. The first group of children received medicamentous therapy and the second group received medicamentous therapy with transcutaneous electric nerve stimulation. In both groups we evaluated 4 symptoms: daily enuresis, enuresis nocturna, urgency and frequency and 4 urodynamic parameters: lower bladder capacity, unstable contractions and residual urine and detrusor sphincter dyssynergia. Follow-up urodynamic evaluation was done after 3, 6 and 12 months respectively. Results Our findings pointed out a high statistical significance of improvement in all evaluated urodynamic parameters of neurogenic bladder (predominantly in bladder capacity) in the group of children with combined therapy as well in resolution of symptoms (predominantly enuresis nocturna, urgency and frequency). Conclusion Combined therapy is more efficient in treatment of children with neurogenic bladder. Electrotherapy is non-invasive, easily applicable and has had a significant place in treatment of children with dysfunctional voiding.

INTRODUCTION Our study of genetic homozygosity degree includes an analysis of the presence, distribution and individual combination of 15 selected genetically controlled morphophysiological traits in the sample of patients with spinal dysraphia (N=35) and in the control-healthy group (N=50). OBJECTIVE Assuming that spinal dysraphia is a genetically controlled disease, we made a hypothesis that an increased homozygosity level, as well as the changed variability among patients, could be a population-genetic parameter for the prediction of the illness. METHOD Taking into consideration our experience, as well as the experience of numerous scientists who studied the nature of the inheritance of monoand oligo-genically controlled qualitative traits, we applied a methodology to estimate the proportion of such homozygously recessive characters (HRC-test,). RESULTS This population-genetic study did not only show a statistically significant difference of the mean values of genetic homozygosity (SD 4.8±0.3; control 3.5±0.3), but of the differences in the type of distribution too, as well as the differences in the presence of certain individual combinations of such traits. CONCLUSION Due to the fact that those genes which control such qualitative recessive traits are distributed in different human chromosomes, being their visible markers, this could indicate that degrees of genetic homozygosity are ostensibly greater in a sample of patients with spinal dysraphia compared to the control group of individuals.

INTRODUCTION Significant improvement in survival and quality of life in patients after the correction of congenital heart defects was enabled by the introduction of surgical procedures. Due to increased vulnerability in the period after defect correction, early rehabilitation have found its place in recovery. Various studies suggest good effects of a rehabilitation programme especially in the early rehabilitation period. OBJECTIVE In our study we wanted to stress the importance of early rehabilitation as well as its effects of implementation. METHOD We evaluated the children treated at the University Children's Hospital during a four-year period. All participants were divided into two groups according to age: the first group included children up to the age of one year, and the second group included those from the first till the third year of life. Patients were divided into two groups according to the presence of complications. We monitored children with 4 types of congenital heart defects: Tetralogy of Fallot, Transposition of the Great Arteries, Coarctation of the Aorta and Stenosis of the Aorta. All exercises were implemented twice daily. Out of the pulmonary system parameters we monitored saturation of oxygen during the entire programme. Other parameters that were evaluated were: heart rate, ECG and breathing frequency. RESULTS In the children with corrected defects, the most frequent complication was athelectasis especially in the group of patients till the first year of life. The patients with the onset of complications had a longer rehabilitation programme. Saturation of oxygen at the end of the programme was significantly elevated. CONCLUSION From the above-mentioned it can be concluded that individual rehabilitation assessment for every patient is needed. Early rehabilitation measures give sustained effects of well-being after completion of the programme.

Background/Aim. The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire represents a region- specific instrument for functional outcome measurement of hand function. The aim of the study was to analyze the correlation between the values of modified DASH questionnaire and change of elbow function after supracondylar fracture (SCF) of humerus and to analyze the effects of early rehabilitation. Methods. The study included 35 schoolaged children with flexion of SCF of humerus without lesion of nerves. The patients were divided into two groups: group A in which rehabilitation started up to 14 days after the removal of fixation (20 children), and group B in which rehabilitation started after 15 days and more (15 children). The effects of the applied rehabilitation procedures were analyzed by measuring the range of motion of elbow and using modified DASH questionnaire. Testing was performed during the first examination, on the first day of rehabilitation (retest) and after the rehabilitation. Pearson's coefficient of liner correlation was applied. Results. Statistically significant negative correlation of DASH score and extension was verified in all three measurements. The values for the first test and for the final test were highly significant (p < 0.001), as well as negative correlation of DASH score and flexion on the first test and retest (p < 0.01), and at the end of rehabilitation (p < 0.001) in the group B. For all three tests in the group A negative correlation without significant differences for DASH score and flexion was found. Conclusion. A modified DASH questionnaire correlates with objective parameters of final status of elbow after SCF in children and it is applicable to small series of patients. A positive effect of early rehabilitation of children with SCF was found.

Background. Reports by hepatologists indicated that anti-HCV antibodies might be detected in 71% to 84% of cases of post-transfusion hepatitis and in up to 50% of cases of sporadic non-A non-B hepatitis. Anti-HCV antibodies were detected in 0.05-1% of blood donors with normal alanine transaminase (ALT) levels and negative anti-HBc screening. Anti-HCV antibodies were found in 67% of patients with a history of intravenous drug abuse or autoimmune hepatitis, and in 10-30% of patients with hepatocellular carcinoma. This indicated that hepatitis C virus was a major cause of the acute and chronic hepatitis throughout the world. Methods. This was a multicentric, international, double-blind, randomized, placebo-controlled study. After the eight-week screening period, patients were randomized to receive daily ribavirin 1200 mg or placebo, during the 48-week treatment period. Follow-up observations were performed during a 16 week post-treatment period. Up to 80 male and female outpatients with mild to moderate chronic active hepatitis C virus infection were enrolled in this study. Results. During the treatment period ALT values were significantly lower in the ribavirin group. Neither in the ribavirin group, nor in the placebo group significant statistical differences of the HCV RNA values were found. Significantly lower portal inflammation was noticed in ribavirin group after the treatment. Analysis of laboratory data demonstrated that ribavirin therapy was associated with mild to moderate reversible anemia. Investigator’s evaluation of the effect of the therapy on patient’s well being showed statistically significant differences in the benefit of the ribavirin group. Conclusion. In this study ribavirin was more effective than placebo in reducing ALT levels during the treatment period of the applied therapy in patients with chronic active hepatitis C.