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ndoscopic mucosal resection (EMR) is a therapeutic technique developed for the resectioning of sessile and flat lesions localized in the mucosa of any part of the gastrointestinal tract. It is easy to learn and allows the resection of large polyps that would otherwise require radical surgery. For early detection of neoplasia of the gastrointestinal tract, the screening program for colorectal cancer proved to be the most important, and its wide acceptance led to a decrease in the incidence and mortality rate. This article reviews EMR techniques and focuses on large colorectal polyps, representing the most common indication for EMR. Before starting resection, the endoscopist should carefully and thoroughly examine the lesion and differentiate between resectable lesions and those potentially affected by the submucosal invasion. There are different methods of evaluating polyps; more recently advanced techniques are also used. The characteristics of colorectal lesions, including location, size, morphology, and histology, influence the choice of the optimal method of removal. The EMR removes part of the wall of the colorectum that contains the mucosa, the muscularis mucosa and partially or completely, the submucosal layer. In addition to removing benign adenomas of varying degrees of atypia, mucosectomy enables the treatment of early colorectal cancer where the risk of metastasis to the lymph glands is minimal. The primary goal of EMR is the complete and safe removal of colorectal lesions and the complete prevention of CRC. Techniques for performing EMR include conventional EMR with submucosal solution injection, hot loop, and electrocautery removal of colorectal lesions, as well as alternative EMR techniques such as cold loop EMR and "underwater" EMR. Major adverse events associated with EMR include bleeding and perforation after mucosectomy. Because of the risk of polyp recurrence regardless of the EMR technique, as well as the risk of metachronous polyps, control colonoscopies are necessary, especially in patients with the highest risk of recurrence.

COVID-19 is a disease caused by the SARS-CoV-2 virus, which was registered in December 2019 in China. In February 2020, the World Health Organization declared the SARS-CoV-2 pandemic. The first pediatric patient in Serbia with COVID-19 was registered on March 23, 2020, in the 13th week since the start of the pandemic. This disease, three years after the appearance of the first cases, continues to be a global public health challenge. Children get sick with COVID-19 less often than adults. They are mostly infected by droplets in the household from family members, and they have a milder clinical picture and a better prognosis of the disease. The most common symptoms and signs of COVID-19 in children are fever, cough, tachycardia and malaise. In the first waves of the pandemic, about a quarter to a third of the patients had pneumonia. The indiscriminate use of antibiotics in the treatment of sick children was one of the main problems during the pandemic. Considering that the COVID-19 infection was a threat of global proportions, in addition to the impact on health condition, the deterioration of the quality of life of children was also registered.

Background/Aim: Warfarin is one of the most common orally prescribed anticoagulant in patients with deep venous thrombosis, myocardial or cerebral infarctions. The main side effects of non-adequate dose of these drugs are prolonged peripheral or internal bleeding. VKORC1 1173C>T polymorphism (rs9934438) is of particular importance, since carriers of non-wild type allele correlates with the lower dosage of warfarin therapy. Thus, the aim of the research was to determine the distribution of 1173C>T polymorphism in population of the Republic of Srpska, Bosnia and Herzegovina (RS) and to compare results with frequencies in other populations. Methods: A total of 124 healthy participants of both genders were enrolled in the study, from all parts of the RS. Molecular genotyping was performed by real-time PCR, using drug metabolism assays according to the manufacturer's instructions. Results: Of the total number, 22 subjects (17.74 %) were genotyped as CC, 69 subjects (55.65 %) as CT and 33 subjects (26.61 %) as TT. The frequencies of alleles C and T were 45.18 % and 54.82 %, respectively. No statistical significance was found among allele distribution between genders (ch² = 0.236; p = 0.627). All observed genotype frequencies were in Hardy-Weinberg equilibrium. No statistical significance was observed among the frequency of minor T allele between presented findings and other European countries, besides Russia (p = 0.021). Conclusion: This was the first study analysing the distribution of rs9934438 alleles in population of the RS. These findings will be helpful in better and more precise drug prescribing in patients who require anticoagulant therapy.

Introduction: Burnout syndrome occurs as a result of prolonged exposure to emotional and interpersonal stressors in the workplace and is characterised by three dimensions: emotional exhaustion, depersonalization and personal achievements. Research and prevention of this phenomenon are of public health importance due to numerous consequences it leaves on the health of the working population and work organisation, and among teachers, on children as direct users of their services. The research aims to examine the presence of the stress and burnout syndrome at work in teachers in the regions of the Republic of Srpska, as well as to determine the existence of differences between regions. Methods: The research was conducted as a cross-sectional study in the period August-September 2018, in the territory of the Republic of Srpska. The target population was represented by teachers of primary and secondary schools. The response rate in all regions was 75 % or above it. For this research, a special questionnaire was constructed, consisting of sociodemographic data, data on economic characteristics of the respondents, characteristics of the work environment, as well as data on satisfaction with equipment and resources at work, support from family and friends and presence of work-life conflict. In addition to the general questionnaire, the Maslach Burnout Inventory-Human Services Study (MBI-HSS) questionnaire for the assessment of the burnout syndrome at work, and Karasek's questionnaire (Job Content Questionnaire) for the assessment of stress at work were used. Results: A statistically significant difference in the prevalence of occupational stress among teachers between RS regions was found. Also, a statistically significant difference was found between the regions of the Republic of Srpska related to the dimensions of burnout syndrome at work. A high level of emotional exhaustion was more often reported by teachers from the territory of the region of East Sarajevo and Prijedor (8.0 % and 7.7 %) comparing to teachers from other regions. Teachers from the territory of Prijedor more often showed moderate and high levels of depersonalization, as well as a low level of personal achievements comparing to teachers from other regions. Conclusion: This research shows the presence of burnout syndrome in teachers of all the Republic of Srpska regions at the beginning of the school year, as well as statistically significant differences between the regions. This indicates the need for additional research on risk factors by regions to form targeted and thus more effective prevention measures.

Background/Aim: Peroxisome proliferator-activated receptor gamma (PPARg) belongs to a family of nuclear hormone receptors and ligand-activated transcription factors. PPARG gene is expressed in many tissues including adipose tissue where it plays a crucial role in differentiation of adipocyte, insulin resistance, blood glucose levels and lipid metabolism. The aim of the study was to examine the association of rs3856806 polymorphism with the body mass index (BMI), fasting glucose levels and lipid parameters in Serbian adolescents. Methods: This research included 287 adolescents of both genders (143 boys and 144 girls), 14-15 years of age. Genotype detection was done by polymerase chain reaction-restriction fragment length polymorphism (RFLP) assay. Results: Results showed statistically significant difference in terms of fasting glucose levels among girls (p = 0.013) depending on their genotype. Female carriers of CC genotype had significantly higher level of fasting glucose levels. Also, results showed that in the group of overweight and obese girls, carriers of CT or TT genotype had statistically significant lower values of HDL cholesterol compared to girls - carriers of CC genotype (p = 0.000). However, this result was not confirmed by multiple regression analysis. Statistically significant association of rs3856806 polymorphism was not observed with BMI nor with other lipid parameters. Conclusion: This polymorphism is associated with fasting glucose level and HDL cholesterol among girls. To draw definite conclusions, further research should be conducted including non-genetic factors and other polymorphisms among this gene.

Introduction/Objective. We aimed to investigate the lifetime and periodic prevalence (during a year) and characteristics of violence against women and health status of women whose partners have been treated for alcohol dependence. Methods. A cross-sectional study was conducted among women whose male partners were alcoholdependent and admitted to hospital for the inpatient treatment. Exposure to physical and sexual violence was measured by the Conflict Tactics Scale (CTS-2). Mental health status was measured by Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), suicidal risk (using Mini International Neuropsychiatric Interview or MINI scale), and alcohol consumption (Alcohol Use Disorders Identification Test). The data were analyzed by descriptive and inferential statistical methods. We also constructed two logistic regression models to study associations between violence and socioeconomic status, and violence and health-related variables. Results. The lifetime prevalence of physical violence committed by alcohol-dependent partners against women was 65.4%, while the periodic prevalence (during 12 months prior to the study) was 46.2% for physical, 20.2% for sexual, and 18% for both types of violence. No women were in risk of harmful alcohol consumption. Violence was more frequent against women not living in urban areas [odds ratio (OR) 2.53, 95% confidence interval (CI) 1.08–5.94, in the univariate model], and among women with moderate/ severe depression (OR 12.34, 95% CI 2.26–67.33, in the multivariate model). Conclusion. Alcohol-dependent men are very often violent toward their spouses, and inpatient treatment presents an opportunity to work with them on raising awareness on the unacceptability of violence against women.

Since the 1970's when it first started being mentioned in scientific literature, the burnout syndrome has become a widely explored phenomenon. It is defined as a stressful reaction at workplace characterized by emotional exhaustion, depersonalization/cynicism and reduced feeling of personal achievements. However, authors agreed that it is a multicausal phenomenon as they identified a large number of situational and individual factors involved in its creation. Situational factors relate to working environment and include characteristics of work and profession itself, so as the way of work organization. On the other hand, individual factors include personality characteristics, sociodemographic characteristics and various life-working attitudes of individuals. However, existence of certain contradictions has been noticed and its variation depending on the country in question. The importance of this phenomenon is reflected in numerous negative effects it leaves on the health of individuals, but also in the significant economic overloading of employer and the country, as well. This is the reason for conducting numerous researches regarding this syndrome, with a high prevalence observed in a wide range of professions, including teachers. Authors emphasize that the importance of researching this phenomenon among teachers is of global interest due to already described negative effects on teachers. Additionally, it has a direct effect on educational process, as well as negative influence on mental and emotional growth of children. Consequently, additional research is necessary, especially among teachers, in order to better understand this phenomenon. Gaining further knowledge would enable us to form targeted interventions in order to reduce stress exposure at work and reduce the prevalence of this syndrome among teachers.

Schizotypy is a construct used to describe a group of persons with symptoms which do not fulfill criteria for schizophrenia, but have some similarities with this complex and heterogeneous psychiatric disorder. ICD-10 describes schizotypy as a state (schizotypal disorder), while DSM-5 labels it as a trait marker (schizotypal personality disorder). Considering how schizotypy encompasses through the normal, subclinical and clinical population, a thorough theoretical understanding of this concept could be helpful in developing measures of assessment. So far, most of the tools for psychometric evaluation of schizotypy have focused only on abnormal personality. The present article focuses on the evolution of the term schizotypy, its current understanding, the possibilities of psychometric assessment in relation to contemporary constructs of personality and on clinical considerations for improved detection and intervention in this field.

Introduction: Spontaneous abortion (SA) is a frequent obstetric complication. Up to 15% of pregnancies end by spontaneous abortion in the first trimester. Five percent of women have two, and 1-2% of women have more than three abortions. The risk of spontaneous abortion is influenced by variety of genetic and environmental factors. Enzyme methylenetetrahydrofolate reductase (MTHFR) is primarily involved in homocysteine remethylation to the methionine. Gene polymorphism C677T in the MTHFR gene causes enzyme thermolability which leads to hyperhomocysteinemia, that might increase the risk of developing placental thrombosis and spontaneous abortion. Aim: The aim of our study was to determine whether the MTHFR C677T polymorphism is associated with the increased risk of SA. Material and methods: This study included 157 women who had at least two unexplained spontaneous abortions and 135 healthy women with at least one child, without previous SA. Detection of MTHFR C677T polymorphism genotypes was performed by PCR-RFLPs method. Investigation of differences between genotype and allele frequencies, in the group of women with SA and the control group, was completed using the x2 test. Results: In the group of patients with recurrent spontaneous abortions, 58 of them had CC genotype (36.94%), 74 had CT genotype (47.13%), and 25 had TT genotype (15.92%). In the control group, 59 of them had CC genotype (43.07%), 55 had CT genotype (40.74%), and 21 had TT genotype (15.56%). The frequency of C allele in the group of patients was 60.51%, and T allele 39.49%; while the frequencies in the control group were 64.07% and 35.93%, respectively. The difference in the genotype (p=0.470) and allele (p=0.393) frequency between the two groups of patients was statistically insignificant. Conclusion: Our results do not show any influence of the analyzed polymorphism on SA.

Introduction. Occupational exposure to blood and body fluids is a serious concern of health care workers and presents a major risk of transmission of infections such as human immuno-deficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Objective. The aim of this study was to determine the frequency and circumstances of occupational blood and body fluid exposures among health care workers. Methods. Cross-sectional study was conducted in three university hospitals in Belgrade. Anonymous questionnaire was used containing data about demographic characteristics, self-reported blood and body fluid exposures and circumstances of percutaneous injuries. Results. Questionnaire was filled in and returned by 216 health care workers (78.2% of nurses and 21.8% of doctors). 60.6% of participants-health care workers had sustained at least one needlestick injury during their professional practice; 25.9% of them in the last 12 months. Of occupational groups, nurses had higher risk to experience needlestick injuries than doctors (p=0.05). The majority of the exposures occurred in the operating theatre (p=0.001). Among factors contributing to the occurrence of needlestick injuries, recapping needles (p=0.003) and decontamination/cleaning instruments after surgery (p=0.001) were more frequent among nurses, while use of a needle before intervention was common among doctors (p=0.004). Only 41.2% of health care workers had reported their injuries to a supervisor in order to obtain medical attention. 50.2% of health care workers were vaccinated with three doses of hepatitis B vaccine. Conclusion. There is a high rate of needlestick injuries in the daily hospital routine. Implementation of safety devices would lead to improvement in health and safety of medical staff. [Projekat Ministarstva nauke Republike Srbije, br. 175046 i br. 175095]

Introduction: Prevalence study is simple, cheap and fast method that provides information about hospital-acquired infections (HAI). Objective: To assess the HAI prevalence at different surgical departments in the Clinical Center of Banjaluka. Method: A point prevalence study design was used. All patients (N = 174) hospitalized on July, 1st, 1999 were included in the study. The study was performed by following the CDC guidelines. All patients with clinically manifested infections on the day of study in all surgical departments were recorded. Infections of more than one site in the same patient were considered separate infections. Results: The overall prevalence of patients with HAI was 16.1% (28/174; 95%CI = 10.4-21.6) and the overall HAI prevalence was 18.4% (32/174). Surgical-site infections were the most prevalent (6.3%) followed by skin/soft tissue infections (4.6%) and urinary tract infections (4.0%). More than two thirds (87.5%) of HAI were microbiologically documented. The most commonly isolated microorganisms were Pseudomonas aeruginosa (29.7%), Enterobacter spp. (24.3%) and Staphylococcus aureus (16.2%). Conclusion: This point prevalence study clearly showed the magnitude of HAI problem at different surgical departments in the Clinical Center of Banjaluka, the most prevalent anatomic localizations of HAI, and the most common causes.

Allergic rhinitis is a chronic inflammatory disease of the airways, which can interfere with many aspects of an individual's life and severely diminish the quality of life of the person affected. The objective of this study was to assess the quality of life of patients suffering from allergic rhinitis during and out of pollen season. The study involved 100 patients diagnosed with allergic rhinitis, 48 of who had seasonal, 25 perennial, and 27 who manifested both forms of allergic rhinitis. All study participants were treated at the Institute of Allergology and Immunology, Clinical Centre of Serbia, Belgrade, in the period March-November 2002. A specific quality of life questionnaire for patients with rhinoconjunctivitis was used in the study. During pollen season, itchy eyes (x2=6.34; p=0.042), red eyes (x2=7.44; p=0.024), and swollen eyes (x2=6.65; p=0.036) caused significantly more difficulties for subjects with seasonal and those with both seasonal and perennial rhinitis than for subjects with perennial allergic rhinitis. A highly significant difference in the mean scores of the indoors activity variable during and out of pollen season (F=347.28; p=0.000) was noted, that is to say, significant irritation was noted during pollen season among subjects with seasonal and those with both seasonal and perennial allergic rhinitis, however the dynamics of irritation remained the same in both study groups (F=0.145; p=0.704).The patients with seasonal and those with both seasonal and perennial allergic rhinitis experienced a significantly poorer quality of life during pollen season than out of it, as well as an inferior quality of life in comparison to patients with perennial allergic rhinitis during pollen season.