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Zdravstvena pismenost žena može značajno uticati na različite aspekte ženskog zdravlja. Cilj ove studije bio je procena odnosa zdravstvene pismenosti, socio-demografskih karakteristika i zdravstvenog ponašanja žena u oblasti reproduktivnog zdravlja u Srbiji. Istraživanje je sprovedeno kao studija preseka, na uzorku žena starijih od 18 godina, sa teritorije Republike Srbije, stratifikovanom prema regionu, vrsti naselja i starosnim kategorijama. Pri proceni zdravstvene pismenosti žena korišćena je standardizovana verzija evropskog upitnika o zdravstvenoj pismenosti (HLS-EU-Q47). Ograničeni nivoi zdravstvene pismenosti bili su znatno prisutniji među ženama srednjeg životnog doba, među onima koje žive u ruralnim područjima, koje su svoje zdravlje procenile kao loše ili veoma loše i koje su pokazale negativnije zdravstveno ponašanje u oblasti reproduktivnog zdravlja, što ukazuje na potrebu za primenom preventivnih programa i strategije sa ciljem unapređenja nivoa zdravstvene pismenosti., Health literacy of women can significantly affect different aspects of womens health. The aim of this study was the assessment of relationship of health literacy, socio-demographic characteristics and reproductive health behaviors of women in Serbia. This was a crosssectional study on a random sample of women aged 18 and over from the territories of three Serbian regions, stratified according to age groups, region and type of settlement. A standardized version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used in assessing health literacy of women. Limited levels of health literacy were significantly higher among middle-aged women, among those living in rural areas, among women who rated their health as poor or very poor, and who exhibited more negative patterns of reproductive health behavior, indicating the need for implementation of prevention programs and strategies with the aim of increasing the level of health literacy. Key words: health literacy, reproductive health, women, Serbia

Uvod: Celijakija je autoimuna bolest, koja nastaje kod genetski predisponiranih osoba kao posledica konzumiranja glutena i srodnih proteina. Kvalitet života uslovljen zdravljem se definiše kao individualna procena bolesnika, koliko bolest i terapija utiču na njegov fizički, socijalni ili emocionalni osećaj “dobrog”. Terapija celijačne bolesti je stroga doživotna ishrana bez glutena. Ciljevi: Ispitati kvalitet života dece i adolescenata sa celijakijom i dobiti celovitu sliku o narušenosti fizičkog i psihičkog zdravlja kao i socijalnog funkcionisanja. Ispitati uticaj uzrasta deteta u kome je postavljena dijagnoza celijakije na uspeh terapijske dijete bez glutena. Ispitati značaj dužine vremenskog perioda koji je protekao od pojave prvih simptoma bolesti do postavljanja dijagnoze na uspeh terapijske ishrane i prolagođavanje deteta i porodice. Ispitati uticaj koji ima oblik kliničke manifestacije bolesti na prihvatanje dijetalne ishrane bez glutena. Istražiti koliki značaj ima stepen atrofije crevnih resica u bioptiranom materijalu na uspeh terapije pravilnom bezglutenskom ishranom.Proceniti uspeh terapije dijetom bez glutena na osnovu seroloških testova – antitela na tkivnu transglutaminazu IgA i IgG. Ispitati značajnost razlike između subjektivnog doživljaja dece sa celijakijom i njihovih roditelja o kvalitetu života koji vode uz kontrolisanu ishranu. Metod: Sprovedena Studija je prospektivna, opservaciona. Ispitivanu grupu su činili deca i adolescenti oboleli od celijakije uzrasta 5-18 god. lečena u Institutu za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić“ na Novom Beogradu, i u Univerzitetskoj dečjoj klinici u Beogradu, kao i njihovi roditelji radi analize kvaliteta života. Kontrolnu grupu su činila zdrava deca i adolescenti uzrasta 5-18 god. Zavisne varijable su činili: Skorovi upitnika (Pediatric Quality of Life InventoryTM – version 4.0, PedsQLTM), ukupni SCARED skor, ukupni. MFQ skor, Skorovi upitnika (Celiac disease–specific pediatric health-relat, Introduction: celiac disease is an autoimmune disease that occurs in genetically susceptible individuals as a consequence of consumption of gluten and the related proteins. The health related quality of life, is defined as an patients subjective evaluation, about its physical, social or emotional feeling of "good" and the way that disease and treatment is affecting it. Treatment of celiac disease is strict lifelong gluten-free diet. Objectives: To evaluate the quality of life of children and adolescents with celiac disease and get a complete picture of impairment of physical and mental health and social functioning. To examine the effect of childrens age in whom the diagnosis of celiac disease was established on the success of therapeutic gluten free diet.To examine the influence of length of time that has elapsed since the onset of symptoms to diagnosis on the success of therapeutic nutrition and adaptation of child and its family. To examine the impact in the form of clinical manifestations of disease on the acceptance of a gluten-free diet. To investigate the influence of the atrophy degree of the villi in biopted material on the success of the dietotherapy.To estimate the success of gluten-free diet on the basis of serological tests - antibodies to tissue transglutaminase IgA and IgG. To examine the difference between the subjective experience of children with celiac disease and their parents about their quality of life with a controlled diet. Methods: The study is a conducted as a prospective, observational type. The study group consisted of children and adolescents suffering from celiac disease aged 5-18 years. treated at the Institute for Health Protection of Mother and193 Child of Serbia "Dr Vukan Čupić" New Belgrade and the University Children's Hospital in Belgrade, as well as their parents in order to analyze the quality of life. The control group consisted of healthy children and adolescents aged 5-18 years. Dependent variables were: the questionnaire sc

REZIME Uvod: Kompleksna građa kanalnog sistema ograničava efekat mehaničke instrumentacije tokom endodontske terapije, pa je uporedo sa instrumentacijom, neophodna i primenaodgovarajućih irigacionih rastvora, kako bi se uklonio razmazni sloj i ispoljio dezinfekcioni efekat. Poznato je da tokom irigacije kanalni irigansi direktno dolaze u kontakt sa površinskim slojem dentina a zatim i dentinskim tubulima, kako bi izvršili čišćenje. Pored efekta na razmazni sloj, kanalni irigansi mogu da utiču i na izmene u mineralnom sastavu dentina kanala korena. Cilj ovog istraživanja je bio da se uporedi efikasnost uklanjanja razmaznog sloja i promene u mineralnom sastavu korenskog dentina nakon ispiranja NaOCl i finalnog ispiranja MTAD, QMix i 17% EDTA. Materijal i metode: U istraživanje su uključeni jednokoreni zubi koji su pre instrumentacije i ispiranja NaOCl, metodom slučajnog uzorka podeljeni u četiri grupe (n=10), da bi nakon toga u svakoj grupi bio primenjen različit irigans za finalno ispiranje: MTAD, QMix, EDTA i sterilna destilovana voda (kontrolna grupa). Površina dentina kanala korena analizirana je skening elektronskom mikroskopijom (SEM) u cilju određivanja prisustva razmaznog sloja. Energetsko disperzivna spektroskopija (EDS) korišćena je za određivanje mineralnog sastava dentina u svim grupama (MTAD, QMix, 17% EDTA i kontrolnoj grupi), kao i kod neobrađivanih uzoraka (neinstrumentirana grupa; n=10). Rezultati: Između različitihhelatnih sredstava nije bilo značajnih razlika u uklanjanju razmaznog sloja u koronarnoj i srednjoj trećini (p>0,05). U apikalnoj trećini QMix-om je uklonjeno značajno više razmaznog sloja nego sa EDTA (p<0,05), a približno isto kao sa MTAD (p>0,05). Finalna irigacija MTAD-om uzrokovala je značajno povećanje C i S u poređenju sa grupom u kojoj je primenjeni irigans bio EDTA (p<0,05). Nije bilo značajne razlike u pogledu mineralnog sastava između grupa u kojima su primenjeni MTAD i QMix, osim za vrednosti sumpora (S) u apikalnoj trećini (p<0, SUMMARY Introduction:The anatomical complexities of the root canal system limit the effect of mechanical instrumentation, so it is necessary to combine with appropriate irrigating solutions during endodontics treatment to remove the smear layer and exhibit the disinfectant effect. Itis known that, during canal irrigation, the solution initially comes intodirect contact with the most superficial dentin layer and then diffusesinto the tubular dentin structure, promoting cleaning. In addition to the effects on the smear layer, root canal irrigants can also affect changes in the mineral composition of root canal dentine. To compare the smear layer removal ability and mineral content of root canal dentine after irrigation with NaOCl and final irrigation with MTAD, QMix, and 17% EDTA. Material and methods: Forty extracted human single root teeth, before root canal preparation and irrigation with NaOCl were randomly divided into the four groups (n=10) according to the type of final irrigants used: MTAD, QMix, 17% EDTA and control (sterile distilled water). Scanning electron microscopy (SEM) was used to assess the presence of smear layer. SEM Energy-dispersive X-ray spectroscopy (EDS) was used to quantify dentin mineral composition in MTAD, QMix, 17% EDTA, control group,and in no treatment samples (no treatment group; n=10).Results:Among the various chelating agents there were no significant differences in the smear layer removal in the middle and coronal thirds (p>0.05). In the apical third, QMix removed significantly more smear layer than 17% EDTA (p<0.05), but similarly to MTAD (p> 0.05).Final irrigation with MTAD resulted in a significant increase in thecarbon (C) and sulfur (S) value compared to EDTA (p <0.05).There was no significant difference in the mineral composition between the MTAD and the QMix group, except for S in the apical third, although the values of the mineral elements were significantly altered in the MTAD group.Conclusions: QMix had smear layer remova

SAŽETAK: Uvod: Galektin-3 (Gal-3) ima značajnu ulogu u brojnim biološkim i patološkim procesima, a posebno je bitan u sazrevanju i funkcionisanju nervnog sistema i nastanku neuroinflamacije. Glavni cilj ovog istraživanja bio je ispitivanje uticaja delecije gena za Gal-3 na ponašanje kod miševa soja C57/BL6. Materijal i metode: Razlike u ponašanju su evaluirane bihevioralnim testovima koji su sprovedeni kod WT (wild-type) i Gal-3-/- (engl. knockout, KO) C57BL/6 miševa, mužjaka, starosti 20 nedelja, u bazalnim uslovima, kao i 24 sata nakon intraperitonealne aplikacije lipopolisaharida (engl. lipopolysaccharide, LPS) (u jednoj dozi, 5 mg/kg). Odmah nakon toga, životinje su žrtvovane i određivani su nivoi ekspresije gena za moždani neurotrofni faktor (engl. brain-derived neurotrophic factor, BDNF), GABA-A receptorske subjedinice i proinflamacijske citokine, IL-6 (engl. interleukin-6) i TNF-α (engl. tumor necrosis factor-α) u mozgu (hipokampusu). Rezultati: Delecija gena za Gal-3 je u bazalnim uslovima imala izražen anksiogeni efekat. Ovaj efekat je bio udružen sa smanjenjem ekspresije gena i sadržaja IL-6 i TNF-α u hipokampusu. Deficijencija Gal-3 je bila praćena i smanjenjem genske ekspresije i BDNF-imunoreaktivnosti, posebno u CA1 hipokampalnom regionu. Takođe, delecija gena za Gal-3 je izazvala smanjenje ekspresije gena za subjedinice 2 i 5 GABA-A receptora u hipokampusu. Delecija gena za Gal-3 nije pokazala prodepresantni efekat u bazalnim uslovima. Anksiogeni efekat neuroinflamacije indukovane LPS-om je kod WT miševa bio udružen sa povećanom ekspresijom gena za IL-6, TNF-α i TLR4 u hipokampusu, kao i redukcijom genske i imunohistohemijske ekspresije hipokampalnog BDNF-a, uz značajnu redukciju GABAAR2S u odnosu na vrednosti koje su detektovane u bazalnim uslovima. Međutim, deficijencija Gal-3 je sprečila povećanje IL-6 i smanjenje genske ekspresije i imunoreaktivnosti BDNF-a, kao i redukciju hipokampalnih GABA-AR2S i na taj način ublažila anksiogeni efekat akutne ne, Intraduction: Galectin-3 (Gal-3) plays a significant role in various biological and pathological processes, and is particulary important in maturation and function of nervous system and in promotion of neuroinflammation. The principle aim of this study was to examine the effects of Gal-3 gene deletion on behavior in C57/BL6 mice strain. Material and Methods: Behavioral differences were evaluated by behavioral tests carried out on WT (wild-type) and Gal-3-/- (knockout, KO) C57BL/6 mice, males, aged 20 weeks, in basal conditions, and 24 hours after an intraperitoneal application of lipopolysaccharide (LPS) (in a single dose, 5 mg/kg). After that, animals were sacrificed and levels of gene expressions of brain-derived neurotrophic factor (BDNF), GABA-A receptor subunits and proinflammatory cytokines, IL-6 (interleukin-6) and TNF-α (tumor necrosis factor-α) in the brain (hippocampus) were evaluated. Results: Deletion of the Gal-3 gene had an anxiogenic effect in basal conditions. This effect was accompanied by decrease in the gene expression and content of IL-6 and TNF-α in hippocampus. Gal-3 deficiency was also accompanied by decreases in gene expression and BDNF-immunoreactivity, predominantly in the CA1 region of hippocampus. Besides, the deletion of the Gal-3 gene resulted in decrease of hippocampal gene expression of GABA-A receptor subunits 2 and 5. Deletion of the Gal-3 gene did not show a pro-depressant effect under basal conditions. In WT mice, the anxiogenic effect of neuroinflammation induced by LPS, was followed by increased hippocampal IL-6, TNF-α and TLR4 gene expression, as well as by decreased gene and immunohistochemical expression of BDNF in hippocampus, with a significant reduction in GABA-AR2S in comparison with the values obtained in basal condition. However, Gal-3 gene deletion prevented the increase in IL-6 and the reduction in BDNF gene expression and immunoreactivity, as well as the reduction of hippocampal GABA-AR2S, and therefore att

Uvod: Astma je vodeća hronična bolest kod dece. Pravilna primena postojećih lekova, uz mere kontrole okoline i uz dobru edukovanost, kod većine pacijenata omogućuje postizanje dobre kontrole bolesti. Ciljevi: Primarni cilj ovog istraživanja bio je da se utvrdi uticaj edukacije dece sa astmom na pravilnu upotrebu inhalera. Drugi cilj je bio razumevanje koji aspekti kvaliteta života mogu biti značajno unapređeni posle edukacije i identifikacija faktora koji utiču na nivo unapređenja. Materijal i metode: Studija je opservaciona, prospektivna, po principu panel studije koja je sprovedena tokom 18 meseci ( od januara 2016 do juna 2017 godine. Studija se odvijala kroz tri faze: prva faza ( prva studija preseka), druga faza (faza edukativne intervencije) i treća faza ( druga studija preseka). Studijska populacija (293 deteta i 293 roditelja) je imala dve grupe bolesnika i članova njihovih porodica: 1. prva grupa (interventna grupa) - 147 pacijenata i isto toliko roditelja koji su podvrgnuti edukativnoj intervenciji o pravilnoj upotrebi inhalera i 2. druga grupa (kontrolna grupa) – 146 pacijenata i isto toliko roditelja prema kojima edukativna intervencija nije bila usmerena. Ispitanici su regrutovani iz populacije dece starosti od 7 do 17 godina. Za merenje funkcionalnih problema koji se najčešće javljaju kod dece sa astmom korišćen je The Pediatric Asthma Quality of Life Questionnaire (PAQLQ), a kvalitet života roditelja meren je PACQLQ upitnikom . Test za kontrolu astme (ACT) korišćen je za utvrđivanje stepena kontrole astme. Takođe mereni su i forsirani eksiratorni volumen u 1 sekundi (FEV1) vršni ekspiratorni protok (PEF). Rezultati: Pre obuke najviše je bilo dece sa nekontrolisanom astmom. Nakon obuke značajno je povećan broj pacijenata koji su imali delimično kontrolisanu astmu, dok se broj dece sa nekontrolisanom smanjio sa 80 na 37(χ2= 28,962; p <0,001). Vanredne posete domu zdravlja smanjene su za 19,1%, izostanci iz škole smanjeni za 18,6% posle sprovedene obuke, Introduction: Asthma is a leading chronic disease in children. Proper administration of existing drugs, with environmental controls and good education, allows most patients to achieve good disease control. Objectives: The primary objective of this study was to determine the impact of the education of children with asthma on the proper use of inhalers. The secondary objective was to understand what aspects of quality of life can be significantly improved after education and to identify factors that influence the level of improvement. Material and Methods: The study was conducted as an observational, prospective, panelbased study for 18 months (from January 2016 to June 2017) through three phases: the first phase (first cross-sectional study), the second phase (intervention phase – education), and the third phase (second cross-sectional study). We included a total of 293 children and 293 parents who were divided into two groups. The first group (intervention group) included 147 patients and as many parents who were educated on the proper use of inhalers, while the second group (control group) included 146 patients and as many parents who were not targeted by the educational intervention. Respondents were recruited from a population of children aged 7 to 17 years. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) was used to measure the functional problems that most commonly occur in children with asthma, and the quality of life of parents was measured by the PACQLQ questionnaire. Asthma Control Test (ACT) was used to determine the degree of asthma control. We also measured the forced expiratory volume in the first second (FEV1) and peak expiratory flow (PEF). Results: At the beginning of the study, the majority of children were with uncontrolled asthma. After education, the number of patients with partially controlled asthma increased significantly, while the number of children with uncontrolled decreased from 80 to 37 (χ2 = 28,962; p <0.001). Unscheduled vis

Uvod: Rezultati istraživanja daju originalan i važan doprinos sagledavanju pozitivnih i nagativnih efekata polinezasićenih masnih kiselina zastupljenih u ishrani, kao i mogućnostima i potrebama izmene njihovog odnosa u cilju postizanja povoljnih efekata na kardiovaskularni sisteam. Rezultati istraživanja imaju veliki praktični značaj, pre svega imajući u vidu da se radi o ispitivanju organskog sistema čiji poremećaji zahvataju daleko najveći postotak svetske populacije. Cilj: Cilj ovog istraživanja je bilo ispitivanje hroničnih efekata primene ishrane obogaćene omega-3 i omega-6 masnim kiselinama na funkciju miokarda, koronarni protok i oksido-inflamacijske parametre starih pacova. Materijal i metode: Istraživanje je dizajnirano kao eksperimentalna studija sprovedena ex vivo. Nakon hroničnog tretmana od 6 nedelja odgovarajućom ishranom, životinje su se žrtvovale kako bi se sprovela istraživanja na izolovanom srcu i biohemijske analize iz uzoraka perfuzata, plazme i lizata eritrocita. Biohemijske analize su određivane u uzorcima koronarnog venskog efluenta, koji je sakupljan na kraju kontrolnog perioda i na kraju perioda aplikacije ispitivane supstance. Svi reaktivni molekuli, koji su bili od interesa za naše istraživanje su mereni spektrofotometrijskom metodom. Pored toga, u uzorcima plazme i lizatu eritrocita merile su se vrednosti pro-oksidacionih, antioksidacionih i inflamatornih parametara. Rezultati: Hronična primena suplementacije alfa-linoleinskom kiselinom ima kardioprotektivno dejstvo u odnosu na primenu linolne kiseline na modelu izolovanog srca pacova. Ishrana obogaćena omega-6 masnim kiselinama utiče negativno na funkciju miokarda izolovanog srca pacova u odnosu na ishranu obogaćenu omega-3 masnim kiselinama. Primenom hronične ishrane sa odnosom omega-3/omega-6 u našem istraživanju 1:3,3 (55%:17%) u korist omega-3 masnih kiselina u vidu ulja lanenog semena, kao i primena masnih kiselina u odnosu omega-3/omega-6 1:9 (9%:73%) u vidu ulja noćurka u korist o, Introduction: The results of the research give an original and important contribution to the examination of the positive and negative effects of polyunsaturated fatty acids present in the diet, as well as the possibilities and needs of changing their relationship in order to achieve favorable effects on the cardiovascular system. The results of the research have a great practical significance, predominantly having in mind that this disruptions of this organic system are by far the largest percentage of the world population. Aim: The aim of this study was to examine the chronic effects of diet enriched with omega-3 and omega-6 fatty acids on myocardial function, coronary flow and oxidizing inflammatory parameters of old rats. Material and methods: The study was designed as an ex vivo experimental study. After 6 weeks of chronic treatment with adequate nutrition, animals were sacrificed to perform isolated heart investigation and biochemical analysis from perfusate, plasma, and erythrocyte lysates. Biochemical analyzes were determined in samples of the coronary venous effluent, which was collected at the end of the control period and at the end of the period of application of the tested substance. All reactive molecules that were of interest to our research were measured by a spectrophotometric method. In addition, in the plasma and lysate erythrocyte samples, the values of pro-oxidation, antioxidant and inflammatory parameters were measured. Results: The alpha-linoleic acid supplementation has a stronger cardioprotective effect than linoleic acid on the model of the isolated rat heart. Nutrition enriched with omega-6 fatty acids more affects the myocardial function of the isolated heart of the rat in relation to than diet enriched with omega-3 fatty acids. Using chronic nutrition with omega-3 / omega-6 ratio 1:3.3 (55%: 17%) in favor of omega-3 fatty acids in the form of flax seed oil, and the application of fatty acids in the ratio of omega-3 / omega-6 1:9 (95:73%)

Uvod: Javnozdravstveni problemi sa kojima se susreću zemlje širom sveta su brojni. Među njima značajno mesto zauzima poremećaj uhranjenosti gde se posebno ističe gojaznost kao jedan od najvećih izazova u XXI veku čije je prisustvo povezano sa pojavom hroničnih nezaraznih bolesti. Smatra se da su socio-ekonomske karakteristike, ishrana, životni stilovi i higijenske navike ključne determinante uhranjenosti koje mogu da oblikuju zdravstvene ishode. Cilj: Cilj ove studije jeste ispitivanje povezanosti determinanti zdravlja sa gojaznošću i hroničnim bolestima kao njenim posledicama, kako bi se dobijeni rezultati iskoristili u kreiranju preventivnih mera i programa u borbi protiv ovog značajnog problema. Materijal i metod: Istraživanje predstavlja deo Istraživanja zdravlja stanovništva Srbije iz 2013. godine koje je sprovedeno od strane Ministarstva zdravlja Republike Srbije, kao studija preseka na reprezentativnom stratifikovanom dvoetapnom uzorku. Istraživanjem je obuhvaćeno 13922 ispitanika starosti od 19 godina i više. Instrument istraživanja su bili upitnici konstruisani u skladu sa upitnikom Evropskog istraživanja zdravlja. Rezultati : Rezultati istraživanja su pokazali da najveću šansu da budu prekomerno uhranjeni u celokupnoj populaciji imaju ispitanici muškog pola (OR=1,705), koji su u braku, starosti 55-64 godine (OR=3,260) sa završenom samo osnovnom školom (OR=1,486). Kada su u pitanju muškarci, najveću šansu za prekomernu uhranjenost imaju oženjeni muškarci, starosti od 55-64 godine, iz ruralne sredine koji su završili višu ili visoku školu, zaposleni su i spadaju u najbogatiji kvintil u pogledu materijalnog blagostanja. U slučaju žena najveću šansu za prekomernu uhranjenost imaju udate žene, starosti od 65-74 godine, iz ruralne sredine, koje su završile osnovnu školu ili manje, neaktivne u pogledu radnog statusa i koje pripadaju srednjem sloju u pogledu materijalnog blagostanja. Manji unos voća i povrća smanjuje rizik za prekomernu uhranjenost od 10-30%. Znač, Background: The countries worldwide are facing numerous public health issues. One of the significant issues is definitely related to nutrition disorders, that is, obesity, as one of the greatest health challenges in the 21st century, correlating with the development of chronic non-communicable diseases. Socioeconomic characteristics, nutrition, lifestyles and hygiene habits are considered to be the key determinants of nutrition that may have its role in shaping possible health outcomes. Aim: The aim of this study is to examine the correlation between the health determinants and obesity and chronic diseases resulting from obesity, so that the results obtained could be used for the purpose of creating disease prevention measures and programs addressing this significant issue. Materials and method: The research is a part of the 2013 Serbian National Health Survey, conducted by the Ministry of Health of the Republic of Serbia as a cross-sectional study on a representative stratified two-tier sample. The study covered 13922 subjects aged between 15 and 24. The research instruments that we used were the questionnaires designed in accordance with the European Health Research Questionnaire. Results: The results of the survey have indicated that in the entire Serbian population married men (OR=1,705), aged 55-64 (OR=3,260) with the primary school education level (OR=1,486) – are most likely to be overweight. Among men, married men, aged 55-64, coming from rural areas, with the high or higher education level, employed and belonging to the highest quintile of society in terms of their material wealth – are most likely to be overweight Among women, married women, aged 65-74, who come from rural areas, with the primary school education level or less, who are not active in terms of their employment status and belong to the middle social class in terms of their material wealth – are most likely to be overweight. Lower fruit and vegetable intake reduces the risk for obesity by 10 t

Uvod: Kod farmaceuta usled prirode posla može doći do sagorevanja, što može uticati na stavove i uverenja farmaceuta o sopstvenom radu sa pacijentima, a samim tim na profesionalne i lične kompetencije, što posredno može uticati na kvalitet pružene zdravstvene usluge. Metode istraživanja: Prva faza istraživanja realizovana je primenom opservacionog Cross – Sectional istraživanja (studija preseka). U drugoj fazi istraživanje je realizovano po tipu terenske eksperimentalne prospektivne studije. Uzorak u istraživanju činilo je 514 licenciranih farmaceuta zaposlenih u apotekama na primarnom nivou zdravstvene zaštite u Srbiji. U drugoj fazi istraživanja ispitanici su razvrstani u eksperimentalnu i kontrolnu grupu metodom slučajnog izbora, prostom randomizacijom. Podaci su prikupljani korišćenjem sledećih upitnika: Upitnik za prikupljanje podataka o osnovnim socio - demografskim karakteristikama ispitanika, Maslach Burnout Inventory (MBI - HSS) namenjen za merenje sagorevanja pomagačih zanimanja, Shirom-Melamed Burnout Questionnaire (SMBQ), Skala opštih stavova i uverenja farmaceuta o sopstvenom radu sa pacijentima (SOSUF), i deo iz Nacionalnog okvira za procenu kompetencija farmaceuta koji se odnosi na profesionalne i lične kompetencije. Kulturološka adaptacija SMBQ upitnika urađena je prema ISPOR smernicama sa izvesnim modifikacijama i predlozima drugih smernica, a u cilju obezbeđenja što većeg stepena validnosti ovog procesa. Ispitane su metrijske karakteristike skala i izračunate korelacije između varijabli Rezultati: Shirom-Melamed Burnout Questionnaire za ispitivanje sindroma sagorevanja na poslu pokazala je zadovoljavajuću validnost na uzorku farmaceuta na primarnom nivou zdravstvene zaštite. Dobijene vrednosti u ovom istraživanju ukazuju na prisustvo umerenog rizika od sagorevanja kod svih ispitanih farmaceuta. Farmaceuti koji pokazuju povišeni rizik od sagorevanja na poslu imali su negativnije izražene stavove i uverenja o sopstvenom radu sa pacijentima i manje ra, Introduction: The pharmacist can be burned due to the nature of the work, which can affect the attitudes and beliefs of pharmacists about their own work with patients, and therefore professional and personal competencies, which can indirectly affect the quality of the provided health services. Methods: The first phase of the research was carried out using the Observational Cross - Sectional Research. In the second phase, the research was carried out according to the type of field experimental prospective studies. The sample in the survey consisted of 514 licensed pharmacists employed in pharmacies at the primary level of health care in Serbia. In the second phase of the study, respondents were classified into an experimental and control group by random selection. The data were collected using the following questionnaires: Questionnaire for collecting data on the basic socio - demographic characteristics of the respondents, Maslach Burnout Inventory (MBI - HSS) for measuring the burnout of helping professions, Shirom - Melamed Burnout Questionnaire (SMBQ), the scale of general attitudes and beliefs of pharmacists own work with patients (SOSUF), and a part of the National Competence Assessment Framework for Pharmacists, which relates to professional and personal competencies. The cultural adaptation of SMBQ questionnaires was made according to ISPOR guidelines with certain modifications and proposals of other guidelines, in order to ensure the highest degree of validity of this process. The metric characteristics of the scale and calculated correlations between variables were examined. Results: Shirom - Melamed Burnout Questionnaire for testing job burnout syndrome showed satisfactory validity on a sample of pharmacists at the primary level of health care. The values obtained in this study indicate the presence of moderate burning risks in all pharmacists examined. Pharmacists with increased risk of job burnout had more negative attitudes and beliefs about their own w

Introduction: Due to the nature of work in pharmacies pharmacists may occur job burnout, which can affect the quality of health services. It is necessary to use validated instruments to test the burnout. One type of instrument is Shirom-Melamed Burnout Questionnaire (SMBQ). Objective: The primary objectives of this work are: cultural adaptation and assessment metric characteristics of SMBQ in a population of pharmacists in Serbia. Alternative objective is evaluate the degree of burnout in the pharmacist population. Methods: For comparison Maslach Burnout Inventory (MBI) was used. All licensed pharmacists have received an email by the Pharmaceutical Chamber of Serbia, with a link for accessing the questionnaires. The questionnaires were completed by 514 pharmacists. Results and Discussion: Professional translators carried out the translation using translation steps like forward translation and backward translation. Were calculated following metric characteristics: alpha - reliability coefficient Cronbach and associates; beta - the reliability of the first principal component; psi 1 - representativeness; h1 - the homogeneity (the average correlation of scale items), extent of curvature, horizontal (Skewness) and vertical (Kurtosis). Correlations between subscales are examined. Latent structure SMBQ (maximumlikelihud extraction) is examined. To select a number of factors, the method of parallel analysis was used. For calculation number of latent factors the Hull method was applied. Concurrent validity was examined by correlating the results of the questionnaire SMBQ and MBI. To confirm a one factor solution of the scale, factor analysis was used. Conclusion: All methods show that it is best to keep only one factor. SMBQ satisfies theoretical statistical criteria of reliability and validity and can be used to estimate job burnout at pharmacist population.

UVOD: U radu zdravstvenih ustanova nastaje medicinski otpad, koji se sastoji iz dve komponente, neopasne (75% od ukupne količine) i opasne komponente (25%). U zdravstvenim ustanovava u posledljih deset godina unapređen je rad u postupanju sa medicinskim otpadom, u skladu sa Zakonom o otpadu i Pravilnikom o upravljanju medicinskim otpadom Republike Srbije. Promene u upravljanju sa medicinskim otpadom (UMO) se sastoje iz uvođenja procedura za bezbedno postupanje opasnim medicinskim otpadom od generisanja medicinskog otpada do odlaganja. METOD RADA: Studija predstavlja istraživanje prospektivnog i retrospektivnog tipa na reprezentativnom uzorku zdravstvenih ustanova državnog sektora zdravstva, na teritoriji Republike Srbije bez Kosova i Metohije, koje se međusobno razlikuju u odnosu na vrstu ustanove, nivo zdravstvene zaštite i teritorijalnu pripadnost. Instrumenti istraživanja koji su korišćeni u studiji, su standardizovani upitnici za ispitivanje UMO u sistemima zdravstvene zaštite. Ukupno 116 ustanova je obuhvaćeno istraživanjem i to sa srazmernom zastupljenošću svih vrsta zdravstvenih ustanova (domovi zdravlja, opšte i specijalne bolnice, kliničko-bolnički centri, klinički centri, zavodi i instituti za javno zdravlje, ostale ustanove) iz tri nivoa zdravstvene zaštite. REZULTATI: Izdvojeni su ključni činioci UMO koji utiču na pružanje i kvalitet zdravstvene zaštite u zdravstvenim ustanovama na različitim nivoima zdravstvene zaštite (primarni, sekundarni, tercijarni) i u različitim vrstama zdravstvenih ustanova (dom zdravlja, opšta bolnica, klinički centar, kliničko bolnički centar, institut ili zavod za javno zdravlje) pojedinačno. Ovom studijom utvrđene su razlike među zdravstvenim ustanovama u odnosu na UMO. Činioci za procenu UMO na primarnom nivou zdravstvene zaštite su broj i vrste zdravstvenih usluga, dok na nivou sekundarne i tercijarne zdravstvene zaštite, ključne činioce predstavlja broj kreveta i zauzetost postelja. ZAKLjUČAK: Istraživanjem je utvrđeno da, INTRODUCTION: Healthcare waste is generated within daily activity of healthcare institutions, and it’s composed of two components, non-hazardous healthcare waste (75% of the total quantity) and hazardous components (25%). In the healthcare institutions in the last ten years, the practices concerning healthcare waste management has been improved, in accordance with the Law on Waste Management and with the Rulebook on the management of healthcare waste in the Republic of Serbia. Changes in the management of healthcare waste (HCWM) are based on introduction of procedures for the safe handling of hazardous healthcare waste from the point of its generation to safe disposal. METHOD: The study is a prospective and retrospective type survey on a representative sample of health institutions in the state health sector, on the territory of the Republic of Serbia without Kosovo and Metohija, which differ from one another in relation to the type of institution, the level of health care and territorial affiliation. The research tools used in the study are standardized questionnaires for testing UMO in health care systems. A total of 116 institutions were included in the survey, with proportional representation of all types of health institutions (health centers, general and special hospitals, clinic and hospital centers, clinical centers, institutes and public health institutes, other institutions) from three levels of health care. RESULTS: Study was defined the key factors of HCWM that influence the quality of health care services in health care institutions at different levels of health care (primary, secondary, tertiary) as well as in the different types of health institutions (health center, general hospital, clinical center, clinical hospital center, institute or Public Health Institute). This study has identified the differences between health institutions concerning HCWM. The factors for the HCWM at primary level of health care are the number and types of health services

Buka kao jedan od velikih zagađivača životne i radne sredine predmet je interesovanja naučnika iz različitih naučnih oblasti, a zbog svog ekstraauditivnog i auditivnog uticaja na zdravlje ljudi aktuelna je u medicini. Kod gađanja iz pešadijskog naoružanja nastaje impulsna buka, koja dovodi do pojave auditivnih efekata. Oni se ispoljavaju u vidu zujanja, oštećenja sluha ili pritiska na jednom ili oba uva. Cilj istraživanja je utvrđivanje i provera relevantnih činjenica vezanih za uticaj bojevog gađanja iz automatske puške na pojavu auditivnih efekata kod profesionalnih vojnih lica. Istraživanje, kao prospektivna opservaciona studija, sprovedeno je nad 104 profesionalna pripadnika Vojske Srbije starosti od 19-60 godina na Kabinetu za uvo, grlo i nos Vojnomedicinskog centra Karaburma, Centra vojnomedicinskih ustanova Beograd i na formacijskom strelištu «Bubanj Potok». U istraživanju, u cilju pronalaženja veze sa mogućim nastankom oštećenja sluha ili pojavom drugih poremećaja zdravlja koji nastaju kao posledica izlaganja impulsnoj buci prilikom gađanja iz automatske puške AP M70 7,62 mm, statistički su obrađeni upitnici koje su ispitanici popunjavali pre i posle bojevog gađanja, klinički orl pregled i audiogrami pre i posle gađanja. Na osnovu sveobuhvatnog ispitivanja uslova i učesnika bojevog gađanja iz automatske puške AP M 70 7.62 mm, dokazano je da dolazi do pojave auditivnih efekata. Takođe je potvrđeno da je od svih auditivnih efekata najznačajniji gubitak sluha. Potvrđena je i značajnost korišćenja ličnih zaštitnih sredstava od buke prilikom bojevog gađanja. Na osnovu dobijenih rezultata i zaključaka predlažu se preventivne mere za sprečavanje ili umanjenje štetnog dejstva impulsne buke na organ čula sluha. One direktno utiču na smanjenje učestalosti oštećenja sluha, a na taj način i na ukupne troškove lečenja pacijenata kod kojih takvo oštećenje nastane i prati ih dalje kroz život., Noise is one of the major polluters of the living and working environment. It is subject of interest of experts from different fields of science, and due to its auditive and extra auditive impact on human health, it is in a field of interest for human medicine. A high-intensity noise from a gunshot impulse, that occurs when using infantry weapon, can result in onset of auditory symptoms, such as tinnitus, impaired hearing or feeling of pressure in one or both ears. The aim of this study is to determen and verify relevant factors related to the impact of live ammunition shooting, from an automatic rifle, on the sense of hearing in professional military personnel. This research was done in a form of a prospective observation study. It was conducted on 104 Serbian military professional soldiers, aged 19-60 years. The study was done in Military Medical Center Karaburma, the Center of Military Medical Institutions in Belgrade on the othorinolaringology ward, and on the formational shooting field "Bubanj Potok". In order to determen a connection between the occurrence of hearing loss or of some other health disorders, and exposure to impulse gunshot noise from the automatic rifle AP M70 7.62 mm, the questionnaires, were filled by the respondents prior and after the shooting. The respondents had underdone audyography and clinical othorinolaringological examination prior and after the shooting. On the base of this comprehensive examination of the respondents, it has been proven that shooting from the automatic rifle AP M 70 7.62 mm, have negative audible effects. It is also confirmed that most significant negative audible effects is loss of hearing. The significance of personal noise protective gear use, was also confirmed. On the basis of the obtained results and conclusions, the preventive measures for reducing the harmful effect of impulse noise on the hearing sensory body are proposed. The measures directly affect the reduction in the frequency of hearing impairment, an

UVOD: Zdravstvena zaštita predstavlja organizovanu i sveobuhvatnu delatnost društva čiji je osnovni cilj očuvanje i unapređenje zdravlja građana. Reforma zdravstvenog sistema u Srbiji počinje 80-tih godina prošlog veka, a podrazumeva rešavanje strukturnih i funkcionalnih pitanja, pitanja ljudskih resursa, finansiranja, organizovanja i dostupnost zdravstvene zaštite, u cilju izgradnje jednog opšte prihvaćenog i održivog sistema. Analiza reformi zdravstvenih sistema i procena kvaliteta pružene zdravstvene zaštite vrši se pomoću indikatora za subjektivnu i objektivnu procenu. Dva najčešća indikatora za subjektivnu procenu su: zadovoljstvo korisnika zdravstvenom zaštitom i samoprocena zdravlja. Zadovoljstvo korisnika zdravstvenom zaštitom ogleda se u sveopštem, optimalnom kvalitetu pružene zdravstvene usluge koji odgovara potrebama pacijenta u datom trenutku. Samoprocena zdravlja podrazumeva ne samo ocenu trenutnog zdravstvenog stanja, već individualnu evaluaciju različitih dimenzija zdravlja – fizičku, emotivnu i socijalnu. Disertacija predstavlja orginalnu i jedinstvenu studiju koja prati odnos korisnika prema reformama zdravstvenog sistema kroz analizu uticaj obrazaca potrošnje zdravstvenih usluga na zadovoljstvo korisnika zdravstvenom zaštitom i samoprocenu zdravlja u dve vremenske tačke 2006. i 2013. godine. CILj: Samoprocena zdravlja i zadovoljstvo korisnika zdravstvenom zaštitom zavisi od dostupnosti i pristupačnosti zdravstvene zaštite koja je uslovljena životnim standardom i balansom potrošnje zdravstvenih usluga u državnom i privatnom sektoru., Health care represents an organized and wide activity within one society which has a goal to protect and improve the health of people. Health care reforms in Serbia started during the 80's and they were related to solving structural and functional issues, human resources issues, financing, organizing and availability of health care services in order to build a generally accepted and maintainable system. The analysis of health care reforms and the assessment of the health care quality are conducted using indicators for subjective and objective assessment. The two most common indicators for subjective assessment are: patients’ satisfaction with health care and self-assessment of the health condition. Users’ satisfaction is reflected in a general and optimal quality of health care services which are appropriate for a specific patient in a given moment. Self-assessment refers not only to an assessment of the current health condition, but rather to an individual evaluation of different health aspects – namely, physical, emotional and social. This dissertation represents an original and unique study which monitors an attitude of users towards reforms of the health care system by analyzing the effect of health care consumption patterns on the users’ satisfaction with health care and on self-assessment of health conditions, during two separated time periods, namely in 2006 and 2013. AIM: Self-assessment of health condition and users’ satisfaction with health care depend on the availability and accessibility of health care which is closely connected to the standard of living and the balance between state and private sector in terms of health care consumption.

U toku protekle dve decenije razvijeno je nekoliko metoda merenja kvaliteta života, koji su primenjeni kod različitih kategorija zdravih i bolesnih ljudi, uključujući i obolele od hronične bubrežne bolesti (HBB). SZO organizacija svrstava HBB na dvanaesto mesto među vodećim uzrocima smrti u svetu. U terminalnoj fazi HBB neophodno je nadomestiti nedostatak bubrežne funkcije aktivnom terapijom- transplantacijom, peritoneumskom dijalizom ili hemodijalizom. Cilj aktivne terapije jeste nadoknada nedostajuće funkcije bubrega, ali takođe i poboljšanje kvaliteta života Cilj ovog istraživanja bio je da se ispita kvalitet života u populaciji obolelih od hronične bubrežne bolesti koji su na hroničnoj hemodijalizi, i sa transplantiranim bubregom, da se ispita povezanost kvaliteta života sa demografskim, socio-ekonomskim, kliničkim karakteristikama i komorbiditetom u obe ispitivane grupe pacijenata, uporede parametri kvaliteta života u ispitivanim grupama i na osnovu toga donese zaključak o uticaju različitih vidova lečenja na kvalitet života kod obolelih od hronične bubrežne bolesti. Analiza srednjih vrednosti ukupnog 15D skora pokazala je da je kvalitet života statistički značajno bolji kod ispitanika sa transplantiranim bubregom u poređenju sa ispitanicima na hemodijalizi (0,92±0,09 prema 0,78±0,15). Utvrđena je negativna povezanost kvaliteta života sa godinama života radnim statusoom i ICED skorom, a pozitivna sa koncentracijom hemoglobina i kreatinina u hemodijaliziranoj grupi. U grupi transplantiranih pacijenata kvalitet života je negativno korelirao sa godinama života, radnim statusom i ICED skorom. Multivarijantna regresiona analiza pokazala je da su nezavisni prediktorin kvaliteta života pacijenata na hemodijalizi bili: godine života i ICED skor, dok u grupi sa transplantiranim bubregom to su bili: ICED skor, godine života i zaposlenje., During the past two decades sciences developed several methods for measuring quality of life, which are applied in different categories of healthy and sick people, including for patients suffering from chronic kidney disease (CKD). WHO classifies CKD on the twelfth place of the leading causes of death in the world. In the terminal stage CKD is necessary to compensate the lack of renal function with an active therapy - renal transplantation, peritoneal dialysis or hemodialysis. The aim of active treatment is compensation missing kidney function, but also improvment of the quality of life. The aim of this study was to investigate the quality of life in a population of patients with chronic kidney disease who are on hemodialysis, and renal transplantation, to investigate the connection between quality of life with demographic, socio-economic, clinical characteristics and comorbidity in both groups of patients, comparing the parameters of quality of life in the examined groups on the basis of a conclusion about the impact of different forms of treatment on quality of life in patients with CKD. Analysis of the mean values of the total 15D score showed that the quality of life was significantly better in patients with kidney transplantation compared to those on hemodialysis (0.92 ± 0.09 vs. 0.78 ± 0.15). There was a negative correlation between the quality of life with patients age, employment status and ICED, while positive correlation was detected with the hemoglobin concentration and creatinine in hemodialysis group. In the group of patients with kidney transplantation, quality of life was negatively correlated with the patients age, employment status and ICED. Multivariate regression analysis showed that independent predictors of quality of life in hemodialysis patients group were: patients age and ICED score, while in the group of patients with the transplanted kidney it was: ICED score, patients age and employment.

Cilj ovog istraživanja je bio da se ispita uticaj mekih kontaktnih sočiva od konvencionalnog hidrogel i silikon hidrogel materijala sfernog i toričnog dizajna i njihove refraktivne jačine na izmerene vrednosti intraokularnog pritiska bezkontaktnom metodom tonometrije. METOD U studiju smo uključili ispitanike ukupno 247 (451 oko) iz populacije koja nosi meka kontaktna sočiva sa normalnim vrednostima IOP - a, koji nisu imali očne ili sistemske bolesti. Vrednosti IOP - a su merene bezkontaktnom metodom tonometrije bez sočiva, i preko sočiva 7 dana nakon nošenja sočiva. REZUTATI Analiza srednjih vrednosti intraokularnog pritiska izmeren na n=451 oko bez sočiva (14.84±3.04 mm Hg) i sa mekim kontaktnim sočivima (15.51±3.2 mm Hg) je pokazala statistički značajno veće vrednosti sa nego bez kontaktih sočiva (P<0.001). Statistička analiza je pokazala značajnu razliku između vrednosti IOP-a meren bez i sa silikon hidrogel sočivima (P=0.001, n=155) i bez i sa kovencionalnim hidrogel sočivima (P=0.006, n=296). Nije pronađena statistički značajna razlika srednjih vrednosti IOP-a između grupe sa silikon hidrogel materijalom (15.74±3.42 mm Hg) i srednjih vrednosti IOP-a u grupi sa konvencionalnim hidrogel materijalom (15.39±3.15 mm Hg), P>0.56. Izmerene vrednosti IOP-a preko sočiva su bile statistički značajno veće u grupi sa sfernim dizajnom u odnosu na vrednosti IOP-a iste grupe bez kontaktnih sočiva (n=371, P=0.001), dok u grupi sa toričnim dizajnom nije pronađena statistički značajna razlika bez i sa toričnim kontaktim sočivima (P=0.815, n=80). Analiza refraktivne jačine mekih kontaktnih sočiva od -12.00D do +13.00D je pokazala značajnu razliku izmerenog intraokularnog pritiska u rangu od -0.25D do -6.00D. ZAKLjUČAK Izmerene vrednosti IOP-a preko mekih kontaktnih sočiva su statistički značajno veće u odnosu na izmeren IOP bez sočiva. Izmerene vrednosti IOP-a zavise od dioptrijskih jačina sočiva i dizajna., AIM To evaluate the effect of soft contact lenses material type - silicone hydrogel and conventional hydrogel, spherical and toric designs and refractive power of soft contact lenses on the measurement value of intraocular pressure (IOP) using non-contact tonometry methods. METHODS We measured the IOP with and without soft contact lenses of silicone hydrogel and conventional hydrogel material on 451 eyes of 247 subjects who are users soft contact lenses with normal value of intraocular pressure and did not have any ocular or systemic diseases. All IOP measurements were performed using non - contact tonometry before the inserting of and seven days after the wearing soft contact lenses. RESULTS A total of Analysis of the mean IOP on 451 eyes without (14.84±3.04 mm Hg) and with contact lenses (15.51±3.2 mm Hg) detected a significant difference (P<0.001). Statistical analysis showed significant difference between IOP measured without and with silicone hydrogel lenses (P=0.001, n=155) and without and with conventional hydrogel lenses (P=0.006, n=296). We detected no significant difference between the mean IOP group with silicone hydrogel (15.74±3.42 mm Hg) and the mean IOP group with conventional hydrogel contact lenses (15.39±3.15 mm Hg), P>0.56. Measurement was of a significantly higher IOP with the spherical designs than for the same group without contact lens (n=371, P=0.001), while in the group with the toric designs the difference was not significant without and with toric contact lenses (P=0.815, n=80). Analysis of refractive power from -12.0D to +13.00D without and with contact lenses, detected a significant difference of IOP in rank from-0.25D to -6.00D. CONCLUSIONS Silicone and conventional hydrogel soft contact lenses significantly affected IOP measured using a non-contact tonometer. Also IOP measured over the soft contact lenses depends on the lens power and designs.

vod. Kvalitet života pacijenata u ranom postoperativnom toku posle elektivnih operacija je povezan sa postoperativnim bolom i brzinom oporavka. Cilj. Cilj ove studije je bio da uporedi kvalitet života pacijenata u neposrednom postoperativnom periodu posle tri česte elektivne hirurške intevencije u bolničkim uslovima. Metod. Populaciju ove prospektivne kohortne studije su činili pacijenti podvrgnuti jednoj od sledećih hirurških intervencija: elektivna laparoskopska holecistektomija (n=40), otvorena operacija preponske kile (n=40) ili ekscizija pilonidalnog sinusa (n=40). Primarni ishod studije je kvalitet života meren svakodnevno, počev od dana koji prethodi operaciji, a zatim svakog postoperativnog dana. Kvalitet života je bio meren vizuelnom analognom skalom (VAS) i prevodom na srpski kratke forme upitnika za kvalitet života Svetske zdravstvene organizacije. Rezultati. Postoperativni kvalitet života je opao na najniži nivo prvog postoperativnog dana, bez obzira na vrstu hirurške intervencije. Pad je bio najizraženiji u fizičkom i psihološkom domenu upitnika (npr. posle holecistektomije sa 15.4 ± 2.5 na 12.5 ± 2.0, i sa 15.9 ± 2.0 na 14.9 ± 2.1, po redosledu) dok su socijalni i domen okruženja bili najmanje pogođeni operacijom (npr. posle ekscizije pilonidalnog sinusa sa 16.3 ± 2.6 na 15.7 ± 2.1, i sa 14.3 ± 2.6 na 14.1 ± 2.2, po redosledu). Kvalitet živora se brzo vratio na početni nivo drugog postoperativnog dana, da bi poslednjeg dana pred otpust iz bolnice postigao viši nivo od preoperativnog (npr. posle otvorene operacije preponske kile sa 14.6 ± 3.6 na 15.2 ± 3.0). Zaključci. Manje elektivne hirurške intervencije su praćene umerenim (ispod 25%) i kratkim (jedan dan) neposrednim postoperativnim smanjenjem kvaliteta života, za kojim sledi porast sve do nivoa višeg od preoperativnog na otpustu iz bolnice., Background. Quality of life in patients early after elective surgery is related to postoperative pain and recovery rate Objective. The aim of this study was to compare immediate preoperative and early postoperative quality of life after three common elective surgical interventions in hospital settings. Methods. Population of this prospective cohort study included patients who underwent one of the three surgical interventions: elective laparoscopic cholecystectomy (n=40), open inguinal hernia repair (n=40) or excision of pilonidal sinus (n=40). Primary outcome of the study was quality of life measured once daily, starting from the day before surgery, and then each postoperative day. It was measured by visual analogue scale (VAS) and by Serbian translation of short form of quality of life questionnaire developed by World Health Organization. Results. Postoperative quality of life dropped to the lowest level on the first postoperative day, regardless of the type of surgery. The drop is the most pronounced in physical and psychological aspects of quality of life (e.g. after cholecystectomy from 15.4 ± 2.5 to 12.5 ± 2.0, and from 15.9 ± 2.0 to 14.9 ± 2.1, respectively) while social and environmental aspects are the least affected by the surgery (e.g. after excision of pilonidal sinus from 16.3 ± 2.6 to 15.7 ± 2.1, and from 14.3 ± 2.6 to 14.1 ± 2.2, respectively). Quality of life is rapidly restored on the second postoperative day, and on the last day before discharge of the patient from hospital it surpasses preoperative level (e.g. after open inguinal hernia repair from 14.6 ± 3.6 to 15.2 ± 3.0. Conclusions. Minor elective surgical interventions are associated with only moderate (less than 25%) and short (one day) immediate postoperative decrease in quality of life, which is followed by increase on discharge from hospital to the levels higher than preoperative.

UVOD: Problem u postavljanju rane dijagnoze predstavlja nedostatak specifičnih simptoma za ovu bolest. Posebno nepovoljan faktor u lečenju predstavlja činjenica da se karcinom jajnika i/ili jajovoda otkriva veoma kasno, u momentu kada je bolest već uznapredovala i kada su manje šanse za uspešnije lečenje ovih pacijentkinja. Svega 30% pacijentkinja ima dijagnostikovanu bolest u prvom stadijumu kada su i mogućnosti za izlečenje veće. Neprimetan i tih rast ovarijalnih tumora, nepristupačnost ovarijuma pri fizikalnom pregledu rezultira visokim stadijumima bolesti u momentu postavljanja dijagnoze, najčešće III i IV stadijum. Citoreduktivna hirurgija je zlatni standard u lečenju uznapredovalog karcinoma jajnika i ima za cilj uklanjanje svakog makroskopski vidljivog tumorskog ognjišta, gde je procenat petogodišnjeg preživljavanja za ove pacijentkinje 80%. CILjEVI: Glavni ciljevi istraživanja su bili: Utvrditi postojanje graničnih preoperativnih serumskih koncentracija tumorskih markera CA125 i HE4, koje bi u najvećem broju slučajeva predstavljale predikciju optimalne primarne citoreduktivne hirurgije kod odmaklih stadijuma epitelijalnog karcinoma jajnika i primarnog karcinoma jajovoda. METOD: Istraživanje je dizajnirano kao prospektivna studija, koja obuhvata uzorak od 150 pacijentkinja, koje su operisane od karcinoma jajnika, FIGO stadijuma III ili IV, u Klinikama za ginekologiju i akušerstvo KC Kragujevac i Narodni front u Beogradu, u periodu 01.01.2015. do 01.10.2016.godine. Kod svih pacijentkinja su urađene preoperativne laboratorijske analize, preoperativno merene vrednosti Ca125 i HE4, sprovedene ankete operativnih timova nakon izvedenog operativnog zahvata, pregledani postoperativni patohistološki nalazi i nalazi onkološkog konzilijuma. Isključujući faktori su bili: histopatološki utvrđen borderline karcinomi, rekurentni ovarijalni tumori, metastatski ovarijalni tumori, pacijentkinje koje su pre citoreduktivne hirurgije tretirane neoadjuvantnom hemoterapijom, kao i, INTRODUCTION: The problem in early diagnosis is the deficiency of specific symptoms of this illness. The fact that the ovarian cancer is discovered very late, at the moment when the illness is at a late stage, is unfavourable factor and the chances of successful treatment are diminished. Only 30% of the patients are diagnosed in the early stages when the chances of cure are higher. Usually unnoticed and quiet growth of ovarian cancer,the inaccess of ovaries during physical examination all result in high stadium of illness,usually III or IV. Cytoreductive surgery is the golden standard in treating ovarian cancer in the late stage. Its goal is to remove every microscopically visible tumor cell with five years survival in 80% of the patients. GOALS: The main goals in the research were: to establish the existence of marginal preoperative serum concentration of tumor markers CA125 and HE4, which would in most case represent the prediction of optimal primary cytoreductive surgery in the late stages of epithelial ovarian cancer and primary carcinoma of ovarian tubes. METHODOLOGY: The research was designed as a prospective study which comprised a sample of 150 patients, operated from ovarian carcinoma FIGO stages III or IV at Kragujevac Clinic for gynecology and obstetrics and Belgrade Narodni Front Clinic from 01.01.2015. to 01.10.2016. All the patients had preoperative lab analysis done, preoperative values Ca125 and HE4, the polls of the operating teams after the procedure finished, all the postoperative pathohistological results and tests checked by the oncological consilium. The excluding factors were: histopathological borderline carcinoma, recurrent ovarian tumor, metastatic ovarian tumor, the patients who were treated by chemotherapy before surgery as well as the patients whose stage of illness did not correspond to FIGO classifications between intraoperative results and the results of oncological consilium. RESULTS: In the group with optimal cytoreductive surgery t

Uvod: Starenje stanovništva jedan je od najvećih izazova sa kojim se svet susreće u XXI veku. Nezaustavljiv proces starenja stanovništva ima duboke posledice na ekonomsku, zdravstvenu, socijalnu i političku sferu društva zbog specifičnih i raznovrsnih potreba starog stanovništva. Specifičnosti rodnih modela starenja pre svega su posledica uticaja niza faktora koji deluju u određenim društvenim okolnostima i konkretnom društvenom okruženju. Rodne razlike u pogledu bračnih, obrazovnih i ekonomskih karakteristika su posledica preovlađujućeg modela rodnih uloga u porodici i u društvu, ali su i posledica relevantnog ponašanja žena i muškaraca. Njihova individualna životna iskustva jesu pod uticajem ovih društveno konstruisanih razlika, a to se odražava i na njihovo zdravstveno stanje. Stoga se rod smatra važnom determinantom zdravlja, koja dodatno oblikuje obrasce izloženosti faktorima rizika po zdravlje i obolevanje, pristup zdravstvenoj zaštiti, kao i dostupnost lečenja. Cilj: Studija se bavi ispitivanjem rodno specifičnih obrazaca starenja, sa posebnim osvrtom na karakteristike zdravstvenog stanja, zdravstvenih potreba i korišćenja zdravstvenih usluga u populaciji starih osoba u Srbiji. Materijal i metod: Istraživanje predstavlja deo Istraživanja zdravlja stanovništva Srbije iz 2013. godine koje je sprovedeno od strane Ministarstva zdravlja Republike Srbije, kao studija preseka na reprezentativnom stratifikovanom dvoetapnom uzorku. Istraživanjem je obuhvaćeno 3540 osoba starosti 65 i više godina. Instrument istraživanja su bili upitnici konstruisani u skladu sa upitnikom Evropskog istraživanja zdravlja., Background: The aging of the population is one of the biggest challenges that the world faces in the xxi century. the unstoppable aging process of the 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. specifics of gender model of aging are primarily the result of the impact of a number of factors that act in certain social circumstances and in the specific social environment. gender differences in marital, educational and economic characteristics are the result of the prevailing model of gender roles in the family and in society, but they are also the result of the relevant behavior of women and men. their individual life experiences are influenced by these socially constructed differences, and this is reflected in their health status. therefore, the gender is considered an important determinant of health, which further shapes the patterns of exposure to health risk factors and morbidity, access to health care and access to treatment. Aim: The study examined gender-specific patterns of aging, with special emphasis on the characteristics of health status, health needs and utilization of health services in the population of the elderly in serbia. Methods: The study is part of the national health survey of serbia, a cross-sectional study conducted in year 2013 by the ministry of health of republic of serbia on a representative stratified two-stage sample. the study included 3540 participants aged 65 years and over. the instruments were questionnaires designed in line with the european health interview survey questionnaire.

Objective. Aim of this paper was to correlate exposure to household second-hand smoke and respiratory symptoms in participating school children, who are attending ten primary schools in Belgrade, Serbia. Method. In order to determine correlation between second-hand smoke exposure at home and respiratory symptoms in primary school pupils, a comparative cross-sectional study has been conducted. The study was conducted in ten primary schools on 735 children, in 44 classrooms in Belgrade, Serbia. A standardized questionnaire was distributed to parents/caregivers, on child's respiratory health, socioeconomic status and parents' lifestyle habits, primarily cigarette smoking. Results. 78% of all exposed children have parents smoking up to 20 cigarettes/day, while more than 22% are exposed to parents' household second-hand smoke of more than 21 cigarettes per day (p lt 0.0001). Respiratory disorders appear in 45.9% of children exposed to domestic second-hand smoke (CI 1.04-1.89), asthmatic symptoms in 33.5% (CI 0.94-1.78), while the least incidence of disorders is reported for continuous cough, which have lasted for 3 months (3.3%, CI 0.44-2.36), wheezing after exercise (4.5%, CI 0.38-1.41) and being awaken by wheezing in last 12 months (7.4%, CI 0.89-3.28). Conclusion. Univariate logistic regression analysis proved that parental smoking exposure is a statistically significant predictor for childhood respiratory symptoms' manifestation., Cilj. Cilj ovog rada je uspostavljanje korelacije između izloženosti pasivnom pušenju u kućnom okruženju i pojave respiratornih simptoma kod dece koja pohađaju deset osnovnih škola u Beogradu, Srbija. Metod. Istraživanje je sprovedeno po tipu komparativne studije preseka, u deset osnovnih škola, na uzorku od 735 dece, u 44 učionice, u Beogradu, Srbija. Roditeljima/starateljima distribuiran je standardizovani upitnik, sa pitanjima o respiratornom zdravlju dece, socio-ekonomskom statusu i navikama roditelja, pre svega o pušenju cigareta. Rezultati. 78% dece koja su izložena duvanskom dimu ima roditelje koji puše do 20 cigareta/dan, dok je više od 22% izloženo duvanskom dimu od popušenih preko 21 cigareta/dan, od strane roditelja (p lt 0,0001). Respiratorni poremećaji prisutni su kod 45,9% dece izložene pasivnom pušenju u kućnom okruženju (CI 1.04-1.89), astmatični simptomi kod 33,5% (CI 0,94-1.,78), dok je najniža incidenca ovih poremećaja prijavljena u slučaju hroničnog kašlja, u trajanju od 3 meseca (3,3%, CI 0,44-2,36), vizinga nakon fizičke aktivnosti (4,5%, CI 0,38-1,41), kao i za slučaj buđenja usled viziga u poslednjih 12 meseci (7,4%, CI 0,89-3,28). Zaključak. Univarijantnom logističkom regresionom analizom dokazano je da je izloženost roditeljskom pušenju duvana statistički značajan prediktor za pojavu respiratornih simptoma kod dece.

Studenti se uglavnom smatraju zdravom grupacijom stanovništva, ali ipak oko 30% njih svake godine doživi neki problem iz oblasti mentalnog zdravlja. Mentalno zdravlje studenata sve više postaje sfera interesovanja na globalnom nivou, jer sučeljavanje sa brojnim životnim situacijama koje nosi ovaj period života ubrzava nastanak depresivnih i anksioznih poremećaja. Studija predstavlja jedno od najvećih istraživanja koje se bavi procenom mentalnog zdravlja kod studentske populacije na teritoriji Srbije. Istraživanje sugeriše na potrebe uvođenja skrininga na depresivnost i anksioznost kod studentske populacije, odnosno rano detektovanje neprepoznatih poremećaja zdravlja u presimptomatskoj fazi poremećaja. Ovakvo istraživanje bi moglo da pomogne u kreiranju preventivnih programa kod studentske populacije, kako na lokalnom tako i na naciopnalnom nivou, što bi rezultiralo sugestijama za dopune i izmene odgovarajućih zakonskih i podzakonskih akata u ovoj oblasti., Previously obtained data in Serbia showed that about 30% of university students population manifested signs of psychological distress and has mental problems. Mental health of university students is under increasing concern worldwide, because they face challenges which predispose them to depression and anxiety. This is one of the largest study examining mental disorders in a sample of university students in Serbia. AIM: to estimate the mental health and detection of depressive and anxiety symptoms among university students. The study was a cross-sectional survey of students attending University of Kragujevac. Our research instrument was standardized questionnaires (adapted to students), from the WHO research protocol of Health behavior. We randomly selected 1,940 students. Symptoms of depression were evaluated through the scale BDI-IA. Symptoms of anxiety were evaluated through the BAI scale. The prevalence of depressive symptoms in students was 23.6%, while the prevalence of anxiety symptoms was 33.5%. Female students, older students, students who reported low family economic situation, not owning the room, dissatisfaction with graduate education were more likely to show depressive symptoms. Female students, students who reported parents high expectations of academic success, students who reported environmental pressure of academic success were more likely to show anxiety symptoms. Questions from the questionnaire that were related to the presence of certain somatic symptoms in patients over the last six months, served as the basis for creating a new variable (the sum score of somatic symptoms) for assessing the risk of presence depressive or anxiety symptoms. By collecting responses, a new variable which sum the somatic symptoms might be indicate the presence of depressive or anxiety symptoms. Results show that the sum score of somatic symptoms might be a very good marker for the separation of students with depressive symptoms from students without which means tha