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We present a pilot study on the perception of noise and noise annoyance from various environmental sources after the COVID-19 lockdown in Serbia. We used an online platform to conduct an anonymous survey on about 190 respondents aged 15 to 75 years from all over the country. After the lockdown, there was a significant increase in the proportion of respondents who were highly annoyed by noise from the typical environmental sources, such as road traffic, air traffic, industrial facilities, and construction works on the streets, compared to the time during the lockdown. At the same time, the proportion of respondents who were highly annoyed by the sirens of ambulance vehicles decreased significantly. However, the most annoying environmental sound during and after the lockdown was that emitted by the ambulance vehicles, which respondents described as "unpleasant", "horrifying" and "irritating". The perception of the sounds of nature and church bells dropped significantly after the lockdown, whereas the perception of noise from the neighbors, household members, and indoor sources remained the same. In summary, after the lockdown, respondents perceive the new soundscape as louder, burdened with a cacophony of noises, and subsequently more annoying.

Objectives: Adults aged 65 years and older comprise one fifth of the Serbian population. Many of them have multiple, often diet-related comorbidities. We aimed to investigate their dietary habits by comparing them with younger adults' and to determine the relation of the differing ones to demographic, socioeconomic and health factors.Methods: We performed a secondary analysis of 2013 Serbian National Health Survey data on 14,082 adults. Binary logistic regression was used to determine dietary habits associated with older age (≥65 years) compared to younger age (18–64 years) and to assess their independent predictors in older adults.Results: Older adults more often reported everyday breakfast (OR = 2.085, 95%CI = 1.622–2.680) and brown/wholegrain bread consumption (OR = 1.681, 95% CI = 1.537–1.839), while using margarine (OR = 0.578, 95%CI = 0.397–0.839), discretionary salt (sometimes: OR = 0.648, 95%CI = 0.596–0.705, almost always: OR = 0.522, 95%CI = 0.445–0.614) and consuming fish (two or more times a week: OR = 0.465, 95%CI = 0.383–0.566) less frequently than younger adults. This was mainly positively related to urban environment, affluence, higher education and poor health.Conclusion: Using nationally representative data, we found that older adults reported healthier dietary habits compared to younger adults, which requires timely public health action.

Nutrition and health claims (NHCs) are a powerful tool that influence consumers’ final decision on the choice of food products. The purposes of this repeated cross-sectional study were to (i) assess the prevalence of pre-packaged food products containing nutrition and health claims among different food categories, (ii) to determine the type of NHCs labelled on the examined food products, and (iii) to evaluate the trend in the use of NHCs in comparison to the 2012 survey. The survey was conducted immediately before the full enforcement of the new national legislation on NHCs in 2020. It comprised 3141 pre-packaged food products from 10 product categories. In total, 21.2% of food products contained any claim (19.4% contained any nutrition claim, 8.2% contained any health claim). In comparison to the 2012 survey, we observed a rising trend in the presence of NHCs, the use of nutrition claims on food products increased three times and the use of health claims increased 1.3 times in the 2020 survey. Bearing in mind that NHCs are a powerful tool guiding consumers’ food purchase decisions, NHCs should be supported by precise legislation and strict surveillance by the public health authorities.

Soundscape is defined as the entire acoustic environment and the human responses to it. This review summarizes different human reactions to sound exposure, their development, prevalence, symptoms, comorbidities, methods for their assessment, and possible origins. The interpretation of sounds from the environment depends, not only on the characteristics of the sound itself, but also on the characteristics of the listener, their judgments, preferences, motivations, and emotional reactions to the sound or its source. Typical sound-related reactions are presented from two standpoints: population reactions, from the community perspective, and individual reactions, from the clinical perspective. Noise annoyance is a specific, unique, and typical psychological and physiological reaction to noise, which is assessed from the community perspective. Noise sensitivity, a stable personality trait, is at the basis of noise annoyance. Both noise annoyance and noise sensitivity play important roles in the development of other noise-related health disturbances. From the clinical perspective, hyperacusis and misophonia are the most distinctive individual responses to specific sounds. They may become so pronounced that they disturb one's physical and mental health, behavior, and functioning. Human reactions to sounds in the environment are widespread and well-investigated. This review goes beyond merely defining terminology in the domain of psychoacoustics; it may help health professionals understand human reactions to sound better. Further studies need to be directed towards developing methods for alleviating or treating the described reactions, but also towards creating a more pleasant acoustic environment for the purpose of protecting public health.

Lateralization is one of the central questions in neurology, neuropsychology, and other related scientific disciplines. There has been very little change in the proportion of left-handers since the Upper Paleolithic Age about 10,000 years ago and it is estimated to be around 10%. As the history of human thinking has developed from superstition to science, the explanation of left-handedness transformed from “devil’s work” to neurological specificity. This paper presents this very interesting historical change by analyzing the data on left-handedness and the attitudes towards it in human societies from prehistory to today. Even in a relatively open-minded society, parents and teachers may encourage a left-handed child to switch to right-handedness to make their lives easier in a largely right-handed world. On the other hand, left-handedness is increasingly seen as a special gift, and left-handed people have started to favor themselves as more competent in relation to the right-handed people. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 41020, Grant no. 175078 and Grant no. 175067]

Blood-pressure-to-height ratio is considered a simple, accurate, inexpensive and non-age-dependent index for screening high blood pressure in a clinical setting, but its suitability in epidemiological surveys was not taken into consideration. The aim of this study was to test the suitability of blood-pressure-to-height ratio against blood pressure for age percentiles for the identification of high blood pressure in an environmental study.The sample consisted of 2195 children, aged 3 to 15 years, whose blood pressure was measured as part of an environmental study in Belgrade, Serbia. High blood pressure was estimated using percentiles (gold standard) and blood-pressure-to-height ratios for systolic and diastolic pressures separately (proposed criterion). The optimal cut-offs of the blood-pressure-to-height ratio (BPHR) were selected based on Youden's index (sensitivity + specificity - 1) calculated from the receiver operator characteristic curve analysis.The proposed criterion identified five times more cases of high blood pressure in the investigated children of all age groups in comparison to the gold standard. The optimal cut-off values were selected based on the sensitivity and specificity values by age groups and gender.Blood-pressure-to-height ratio can be a reliable criterion for the estimation of high blood pressure in epidemiological studies. This is the first study on the applicability of blood-pressure-to-height ratio in Serbian children, but it may not be easily generalized to other populations due to small sample size across the examined age groups and potential diversities in risk factors for high blood pressure. Applied in epidemiological studies, BPHR would help researchers estimate the role of certain environmental factors on blood pressure in children.

This systematic review assesses the quality of the evidence across studies on the effect of environmental noise (road traffic noise, aircraft noise, railway noise, wind-turbine noise) on quality of life, wellbeing and mental health. Quantitative studies of noise effects on children and adults published from January 2005 up to October 2015 were reviewed. A total of 29 papers were identified. 90% of the papers were of cross-sectional design, with fewer studies of longitudinal or intervention design. Outcomes included depression and anxiety, medication use and childhood emotional problems. The quality of the evidence across the studies for each individual noise source was assessed using an adaptation of the GRADE methodology. Overall, given the predominance of cross-sectional studies, most evidence was rated as very low quality, with evidence of effects only being observed for some noise sources and outcomes. These ratings reflect inconsistent findings across studies, the small number of studies and a lack of methodological robustness within some domains. Overall, there are few studies of clinically significant mental health outcomes; few studies of railway noise exposure; and studies of large samples are needed. The lack of evidence for noise effects across studies for many of the quality of life, wellbeing and mental health domains examined does not necessarily mean that there are no effects: rather, that they have not yet been studied robustly for different noise sources.

Objectives: The aim was to assess the effects of lisinopril combined with hydrochlorthiazide on blood pressure of hypertensive women with normal weight, overweight and obesity. Methods: The study comprised 454 hypertensive women, aged 61.50±10.64 years. All patients were treated with fixed combination of 20 mg lisinopril and 12.5 mg hydrochlorthiazide. Body mass index (BMI) was calculated from body weight divided by squared body height. Normal weight was defined as BMI from 18.5 to 24.9 kg/m 2 , overweight as BMI from 25.0 to 29.9 kg/m 2 and obesity as BMI exceeding 30 kg/m 2 . Blood pressure (BP) was measured by an oscillometric device at the beginning of the study, and after three months of therapy. The differences between the groups were tested with one-way ANOVA. The differences from baseline values were tested with Student’s t test for paired samples. Results: At the beginning of the study 124 women (27.9%) had normal weight, 217 women (48.8%) were overweight, and 104 (23.4%) were obese. All three groups of women had similar systolic (SBP) and diastolic pressures (DBP) at the beginning of the study as well as at the end of the study. Mean BMI remained stable during three months of antihypertensive therapy. Mean SBP for all patients at the beginning of the study was 161.90±13.26 mmHg, mean DBP was 97.48±8.78 mmHg. After three months of therapy, all women reduced their SBP significantly (mean decrease from baseline = 28.48±12.67 mmHg), as well as their DBP (mean decrease from baseline = 15.48±8.84 mmHg). The average decrease in SBP and DBP during therapy was similar among women with normal weight, overweight and obesity. Women with normal weight reduced their SBP by 29.61±12.33 mmHg, in comparison to overweight women (28.42±11.89 mmHg), and to obese women (26.54±12.74 mmHg), but the difference was not statistically significant. Conclusion: Three-month therapy with lisinopril and hydrochlorthiazide is equally effective in hypertensive women with normal weight, overweight and obesity.

Non-auditory effects of noise on humans have been intensively studied in the last four decades. The International Commission on Biological Effects of Noise has been following scientific advances in this field by organizing international congresses from the first one in 1968 in Washington, DC, to the 11th congress in Nara, Japan, in 2014. There is already a large scientific body of evidence on the effects of noise on annoyance, communication, performance and behavior, mental health, sleep, and cardiovascular functions including relationship with hypertension and ischemic heart disease. In the last five years new issues in this field have been tackled. Large epidemiological studies on community noise have reported its relationship with breast cancer, stroke, type 2 diabetes, and obesity. It seems that noise-induced sleep disturbance may be one of the mediating factors in these effects. Given a large public health importance of the above-mentioned diseases, future studies should more thoroughly address the mechanisms underlying the reported association with community noise exposure. [Projekat Ministarstva nauke Republike Srbije, br. 175078]

Background Noise exposure increases blood pressure and peripheral vascular resistance in both genders in an experimental setting, as previously reported by the authors. Objectives The aim of this re-analysis was to present the minute-by-minute timeline of blood pressure changes and hemodynamic events provoked by traffic noise in the young and healthy adults. Methods The experiment consisted of three 10-min phases: rest in quiet conditions before noise (Leq = 40 dBA), exposure to recorded road-traffic noise (Leq = 89 dBA), and rest in quiet conditions after noise (Leq = 40 dBA). Participants’ blood pressure, heart rate, and hemodynamic parameters (cardiac index and total peripheral resistance index) were concurrently measured with a thoracic bioimpedance device. The raw beat-to-beat data were collected from 112 participants, i.e., 82 women and 30 men, aged 19–32 years. The timeline of events was created by splitting each experimental phase into ten one-minute intervals (30 intervals in total). Four statistical models were fitted to answer the six study questions what is happening from one minute to another during the experiment. Results Blood pressure decreased during quiet phase before noise, increased in the first minute of noise exposure and then decreased gradually toward the end of noise exposure, and continued to decline to baseline values after noise exposure. The cardiac index showed a gradual decrease throughout the experiment, whereas total vascular resistance increased steadily during and after noise exposure. Conclusions The timeline of events in this 30-min experiment provides insight into the hemodynamic processes underlying the changes of blood pressure before, during and after noise exposure.

Objectives: The aim of this study was to assess the regulation of blood pressure after three months of antihypertensive therapy in persons with type 2 diabetes mellitus. Design and Methods: The study sample consisted of 398 persons with arterial hypertension and type 2 diabetes, aged 63.9±9.6 years. Hypertension was treated with 10 mg lisinopril (98 patients), 20 mg lisinopril (140 patients), or with fixed combination of 20 mg lisinopril and 12.5 mg hydrochlorothiazide (160 patients). Blood pressure (BP) was measured by an oscillometric device at the beginning of the study, one month later, and after three months of therapy. A ‘well-regulated’ blood pressure was defined as systolic BP less than 140 mmHg, and/or diastolic BP less than 90 mmHg one month and three months after the initiation of therapy. Logistic regression was used to predict good regulation of SBP and DBP after three months of therapy in relation to age, gender, smoking habits, body mass index, and regulation of blood pressure one month after the beginning of therapy. Results: At the beginning of the study, the average SBP was 159.4±12.7 mmHg, average DBP was 96.3±8.5 mmHg. After one month, average SBP was 140.5±18.6 mmHg, average DBP was 87.8±8.1 mmHg. At that stage, SPB was well-regulated in 127 persons (31.9% of the sample), whereas DBP was well-regulated in 189 persons (47.5% of the sample). After three months of therapy, average SBP was 132.4±9.0 mmHg, and average DBP was 81.6±6.0 mmHg. At that stage, SPB was well-regulated in 286 persons (71.9% of the sample), whereas DBP was well-regulated in 339 persons (85.2% of the sample). The only significant predictor for the good regulation of SBP after three months of therapy was good regulation of SBP one month after the beginning of therapy (Odds Ratio=2.44; 95% Confidence Interval =1.44-4.13). The only significant predictor for the good regulation of DBP after three months was good regulation of DBP one month after the beginning of therapy (OR=8.08; 95% CI =3.71-17.63). These prediction models were independent of age, gender, body mass index, smoking habits, and lisinopril treatment. Conclusion: The regulation of BP after three months of antihypertensive therapy with lisinopril depends on the good regulation of BP one month after the initiation of therapy.

This systematic review assesses the quality of the evidence across individual studies on the effect of environmental noise (road traffic, aircraft, and train and railway noise) on cognition. Quantitative non-experimental studies of the association between environmental noise exposure on child and adult cognitive performance published up to June 2015 were reviewed: no limit was placed on the start date for the search. A total of 34 papers were identified, all of which were of child populations. 82% of the papers were of cross-sectional design, with fewer studies of longitudinal or intervention design. A range of cognitive outcomes were examined. The quality of the evidence across the studies for each individual noise source and cognitive outcome was assessed using an adaptation of GRADE methodology. This review found, given the predominance of cross-sectional studies, that the quality of the evidence across studies ranged from being of moderate quality for an effect for some outcomes, e.g., aircraft noise effects on reading comprehension and on long-term memory, to no effect for other outcomes such as attention and executive function and for some noise sources such as road traffic noise and railway noise. The GRADE evaluation of low quality evidence across studies for some cognitive domains and for some noise sources does not necessarily mean that there are no effects: rather, that more robust and a greater number of studies are required.

Background The association between noise annoyance and public transport as a source of noise has not been studied previously. The aim was to study noise annoyance in an urban population due to the presence, the type and the number of public transport vehicles, in relation to other acoustical and non-acoustical parameters. Method The study sample comprised 5861 adults residing in 118 streets in the city center of Belgrade. The presence, the type and the number of public transport vehicles were assessed using official transport maps and matched with residential addresses. Noise annoyance was assessed by a questionnaire including a self-report five-graded scale. ‘High noise annoyance’ was defined by merging ‘very’ and ‘extremely’ annoyed answers. Results Significant predictors of high noise annoyance were the presence of public transport at daytime (yes vs. no) (odds ratio = 1.47, 95% confidence interval = 1.28–1.70), and at night (yes vs. no) (OR = 1.39, 95% CI = 1.20–1.61). Residing in the streets with more than 79 public transport vehicles per hour (3rd tercile vs. 1st tercile) predicted high noise annoyance at daytime (OR = 1.64, 95% CI = 1.18–2.27). Residing in the streets with buses and trams at night (‘bus and tram’ vs. no public transport) increased the risk of high noise annoyance (OR = 2.67, 95% CI = 1.78–4.09). These associations were independent from noise sensitivity, orientation of bedroom windows, floor level, and equivalent noise levels. Living in the apartment with bedroom windows facing the street was the strongest confounder for the association between noise annoyance, noise levels and public transport. Conclusion The study has identified the presence of public transport at daytime and at night as a significant and independent predictor of high noise annoyance. Future intervention measures should concern the presence, the type and the number of public transport vehicles in order to reduce noise annoyance reactions in urban areas.

Noise exposure increases blood pressure in both experimental and field studies. The underlying mechanisms may be evaluated by thoracic bioelectrical impedance. The aim of this experimental study was to assess changes in blood pressure, cardiac and hemodynamic parameters provoked by recorded traffic noise in young adults. The study included 130 participants (42 men and 88 women), aged 24.88±2.67 years. Thoracic electrical bioimpedance device was applied to monitor cardiac parameters, hemodynamic parameters, heart rate variability, blood pressure and heart rate. The testing procedure consisted of three phases. Participants were exposed to recorded road-traffic noise (Leq=89 dBA) for 10 min and relaxed in quiet conditions (Leq=40 dBA) before and after noise exposure. Listening to recorded noise resulted in significant decrease of stroke volume and cardiac output, and an increase of vascular resistance. Heart rate variability and the overall sympathovagal balance remained similar through all experimental conditions. During noise exposure, systolic pressure increased by 2 mmHg among women (95% confidence interval=0.97–2.73 mmHg), and by 4 mmHg among men (95% confidence interval=2.16–5.00 mmHg). Similarly, diastolic pressure increased by 2 mmHg among women (95% confidence interval=0.95–2.47 mmHg), and by 4 mmHg among men (95% confidence interval=2.46–5.28 mmHg). Once noise ceased, both pressures returned to pre-exposure levels. Experimental exposure to recorded road-traffic noise of 89 dBA for 10 min provoked significant hemodynamic changes in young adults, including vasoconstriction (increase of vascular resistance), and hypodynamics (decrease of global heart flow). The interaction of these effects resulted in the elevation of blood pressure during noise exposure.

Arterial hypertension (AH) is the most common cardiovascular disease risk factor, affecting between 30 and 50% of the adult population in developed countries. A steady increase of the prevalence of AH by about 60% is expected by year 2025.Serbian Society of Hypertension conducted a prevalence study from February to May 2012 on a sample of 3878 adult respondents. The study included 2066 women (53.3%) and 1812 men (46.7%). Average age was 48.89 ± 17.48 years. Most participants resided in urban areas (2956 people, 76.2%), whereas 922 resided in rural areas (23.8%).The prevalence of AH in Serbia is 42.7%. Hypertension is more frequently diagnosed among women (53.3%), than among men (46.7%). One thousand, four hundred and twelve respondents were previously diagnosed and treated for hypertension. The estimated awareness of the presence of AH was 42.99% (i.e. 40.00% among male and 45.41% among female participants). Out of all diagnosed cases of hypertension, 390 persons (27.7%) have well regulated blood pressure values, whereas 1022 persons (72.3%) do not have their blood pressure under control.Serbia belongs to countries with a high prevalence of AH. A poor control of AH may be explained in view of socioeconomic problems. High prevalence of AH may indicate a remarkably high cardiovascular disease mortality in Serbia.

Background The aim of this study was to assess the mortality rate and risk of death in relation to the blood pressure (BP) categories during 36 years of follow-up period.

The systems of public complaints on environmental noise were reviewed in seven countries of Central and Eastern Europe (CEE), South-East Europe (SEE), and Newly Independent States (NIS). Public complaints remain an important issue due to differences in public sensitivity to noise and due to several cases where a measurement of noise intensity does not give a satisfying solution to the problem. The unresolved problem remaining in the residential neighborhoods is the noise from pubs and restaurants that are open until late in the night. In our review, we compiled information on the institutions responsible for the implementation of environmental noise legislation and organizations that are responsible for dealing with public complaints. Information on activities for increasing public awareness on hazards rising from environmental noise and the role of civil initiative was explored. In seven countries, and among them, Slovenia, Lithuania, Latvia, Slovakia, The Former Yugoslav Republic of Macedonia, Serbia, and Poland, the responsibilities and duties are shared among different institutions at national and regional levels, depending on the noise source. The problem of gathering information on complaints and using it for improving the wellbeing and health of citizens remains often difficult and unsolved.

Arsenic in drinking water presents a serious public health problem in Serbia, but its relationship with diabetes has not been studied previously. The aim of this study was to explore the association between exposure to arsenic in drinking water and the occurrence of type 2 diabetes in Middle Banat region, Serbia. This cross-sectional study comprised two populations. Exposed population in Middle Banat region consumes drinking water with arsenic (mean = 56 μg/L); unexposed population from six regions in Central Serbia consumes arsenic below detection limit (2 μg/L). Newly diagnosed cases of type 2 diabetes were obtained from the National Registry of Diabetes in 2008. The Registry included age, gender, family history of diabetes, presence of overweight, central obesity, cholesterol and triglyceride levels. In addition, the number of cases of diabetes reported in years 2006, 2007 and 2009 was used to calculate standardized incidence rates for both populations. Two populations were comparable by age, family history of diabetes and prevalence of overweight persons. Unexposed population was more likely to have central obesity, and high total cholesterol and triglycerides. Standardized incidence rates of type 2 diabetes were higher in exposed population. Odds ratios for type 2 diabetes were significantly higher for the exposed population, both men and women, in the period from 2006 to 2009, when compared with the unexposed population. The population from Middle Banat region, consuming drinking water with low levels of arsenic, was at higher risk for the occurrence of type 2 diabetes in comparison to the unexposed population in Central Serbia.

The highest arsenic concentrations in Serbia are measured in drinking water in the Middle Banat region within Vojvodina. The research was designed as a registry-based cross-sectional study comprising two separate populations in Serbia. Mean arsenic concentrations in drinking water from public water supply systems in 383 samples in Middle Banat region was 56.1 μg/L, Median value 38.0 μg/L, range 1.0–349.0 μg/L. This cross-sectional study showed that population from Middle Banat region in Serbia, exposed to low levels of arsenic in drinking water, was at higher risk for the occurrence of type 2 diabetes, in comparison to the unexposed population in Central Serbia. © 2016 Taylor & Francis Group, London. Arsenic Research and Global Sustainability - Proceedings of the 6th International Congress on Arseni

The objective of this study was to examine the relationships between noise and school children's executive functioning (EF). The study included 311 children (146 boys and 165 girls) aged 7–11 years, who lived in the center of Belgrade. Teachers rated children's EF on a standard scale evaluating their ability to work independently in a focused manner to achieve an end goal as well as children's ability to follow directions carefully. Residential noise exposure was estimated in three daytime intervals, one evening interval and two nighttime intervals in the middle of the streets where children lived. School noise exposure was measured on three different school days in front of children's schools. Socioeconomic status (mother's highest level of education and family income) was used as a statistical control. There were no significant main effects of ambient noise levels on EF, however, a significant interaction indicated adverse noise impacts on boy's EF. We discuss possible reasons for male EF vulnerability to noise.

Background: Arsenic is constantly present in drinking water supply systems of Zrenjanin municipality across decades. It presents a great public health problem in Serbia, but its relationship with acute coronary syndrome (ACS) has not been studied previously. Objectives: The aims of this study were to assess the incidence of ACS in two areas from Zrenjanin municipality consuming different levels of arsenic in drinking water, and to explore the association between arsenic exposure and the probability of fatal outcome of ACS. Methods: The research was a registry-based ecological study of two populations consuming water with different arsenic levels, based on current guidelines (10 mu g/L). Median arsenic in the area above national standard was 80 mu g/L; median arsenic in the other area was 1 mu g/L. Newly diagnosed cases of ACS were obtained from the National Registry for Acute Coronary Syndrome from 2006 to 2010. Results: The two populations were comparable by age, gender, and prevalence of risk factors for ACS. Standardized incidence rates (SIR) of ACS were higher for people consuming arsenic above standard (average five-year SIR was 237.00 per 100.000: 95% CI=214.93-260.74), in comparison to people consuming arsenic within limits (average SIR=124.40 per 100.000; 95% CI=96.00-158.56). Exposure to arsenic above limits was insignificantly associated with fatal outcome of ACS for the whole population, men and women. Conclusions: Consumption of arsenic above national standards was associated with higher risk for the occurrence of acute coronary syndrome and with insignificantly higher probability of fatal outcome of ACS in Zrenjanin municipality. (C) 2012 Elsevier Inc. All rights reserved.

Objective: The goal of this review was to investigate methodological differences in studies on the effects of aircraft or road-traffic noise on blood pressure (BP) of urban children, emphasizing the similarities and differences in blood pressure measurements. Methods: A literature search has identified eight peer-reviewed studies, four conference proceedings and one PhD thesis on the effects of aircraft or road-traffic noise on children's blood pressure published in English in the last 30 years. Most of the studies were cross-sectional, and four studies were longitudinal, with follow-up period from one to three years. The studies were analyzed according to the following methodological issues: study design, children's characteristics, noise exposure assessment and blood pressure measurements. The effects of noise on systolic and diastolic pressure were presented in detail. Results: Studies on aircraft noise had more uniform methodology, indicating a slight tendency towards a positive relationship between aircraft noise exposure and BP in children. The studies on road-traffic noise were methodologically diverse, but compared to aircraft noise studies they showed a more uniform trend in the direction of a positive relationship with systolic BP. The time, place and number of BP measurements, as well as the devices and cuff sizes varied among the studies. Children's age, gender, body composition and ethnicity, and socio-economic status remain the greatest source of diversity in BP values. Conclusions: The reviewed studies were methodologically diverse concerning noise exposure assessment, BP measurement, study design and control for confounders. In spite of this, they indicate a tendency toward positive association between noise exposure and children's blood pressure. We recommended strategies that might help researchers adopt similar procedures when measuring BP in future field studies. Keywords: Epidemiological studies, Children, Environmental noise exposure, Blood pressure, Blood pressure measurement, Methodology

Background Peripheral arterial disease (PAD) in the aortoiliac segment is found in nearly a half of patients with PAD. The aim of this study was to estimate the influence of obesity and fat distribution on the occurrence of aortoiliac PAD in middle-aged men. Methods This case–control study included 204 middle-aged men (mean 58 ± 7 years; range 45–70 years): 102 patients with aortoiliac PAD and 102 healthy controls without PAD. Aortoiliac PAD was diagnosed by ankle–brachial index (ABI) and angiography. Body mass index (BMI) was categorized as: normal weight, overweight, and obese. Percents of body fat were grouped according to quartile distribution. The relationship between anthropometrics and aortoiliac PAD was estimated by multivariate logistic regression. Results Patients with aortoiliac PAD had higher body mass index, waist circumference, waist–hip ratio and percent of body fat. A strong correlation between all anthropometric parameters and ABI index and mean angiographic score was shown among patients with PAD. Multivariate regression, adjusted for blood pressure and cholesterol level, identified being overweight, body fat over 26.5% and WHR over 1.02 as predictors for aortoiliac PAD. Body fat over 26.5% and WHR over 1.02 remained significant after further adjustment for blood pressure, cholesterol and body mass index. Conclusion This study has identified the quantity of fat tissue (body fat over 26.5%) and its visceral distribution (waist–hip ratio over 1.02) as predictors of aortoiliac PAD in middle-aged men. Body mass index, a crude indicator of obesity, should be combined with these parameters when assessing the risk for aortoiliac PAD.

Vojvodina, a northern region of Serbia, belongs to the Pannonian Basin, whose aquifers contain high concentrations of arsenic. This study represents arsenic levels in drinking water in ten municipalities in Serbia. Around 63% of all water samples exceeded Serbian and European standards for arsenic in drinking water. Large variations in arsenic were observed among supply systems. Arsenic concentrations in public water supply systems in Vojvodina were much higher than in other countries in the Pannonian Basin.

Objectives Although noise annoyance is a major public health problem in urban areas, there is a lack of published data on predictors for noise annoyance in acoustically different urban environments. The aim of the study was to assess the predictive value of various factors on noise annoyance in noisy and quiet urban streets. Methods Equivalent noise levels [Leq (dBA)] were measured during day, evening and night times in all of the streets of a central Belgrade municipality. Based on 24-hour noise levels, the streets were denoted as noisy (24-hour Leq over 65 dBA), or quiet (24-hour Leq under 55 dBA). A cross-sectional study was performed on 1954 adult residents (768 men and 1186 women), aged 18–80 years. Noise annoyance was estimated using a self-report five-graded scale. In both areas, two multivariate logistic regression models were fitted: the first one with nighttime noise indicators and the other one with parameters for 24-hour noise exposure. Results In noisy streets, the relevant predictors of high annoyance were: the orientation of living room/bedroom toward the street, noise annoyance at workplace, and noise sensitivity. Significant acoustical factors for high noise annoyance were: nighttime noise level [OR = 1.02, 95%CI = 1.00–1.04 (per decibel)], nighttime heavy traffic [OR = 1.01, 95%CI = 1.00–1.02 (per vehicle)]; or day–evening–night noise level (Lden) [OR = 1.03, 95%CI = 1.00–1.07 (per decibel)]. In quiet streets, the significant predictors were: noise sensitivity, the time spent at home daily, light vehicles at nighttime or heavy vehicles at daytime. Conclusions Our study identified subjective noise sensitivity as a common annoyance predictor, regardless of noise exposure. Noise levels were important indicators of annoyance only in noisy streets, both for nighttime and 24-hour exposure. We propose that noise sensitivity is the most relevant personal trait for future studies and that nighttime noise levels might be as good as Lden in predicting annoyance in noisy urban areas.

Commonly used daytime measurements in previous investigations on community noise and arterial hypertension (AH) may be a source of exposure bias, as urban residents spend most of their daytime hours out of the home on workdays. For this reason, we focused on the relation of nighttime noise and AH. A cross-sectional study was performed on a sample of 2,503 (995 men and 1,508 women) adult residents of a downtown Belgrade municipality. The inclusion criteria were a period of residence longer than 10 years and a bedroom oriented toward the street. The exclusion criteria were a high level of noise annoyance at work and diseases related to AH. Noise measurements were performed in all 70 streets of the municipality. The streets were grouped into noisy areas (equivalent noise level [Leq]45 dB(A)) and quiet areas (Leqor =45 dB(A)). The residents were interviewed in regard to antihypertensive therapy. Subjects who responded that they had not received such therapy were contacted for blood pressure measurements with mercury sphygmomanometer. Possible confounding factors: family history of AH, age, body mass index, smoking habits, physical activity and alcohol consumption were controlled for. The proportions of men with AH in the noisy and quiet areas were 23.6% and 17.5%, respectively. The adjusted odds ratio (OR) for AH was 1.58; the 95% confidence interval (CI) ranged from 1.03-2.42; and the probability value was 0.038, when men living in quiet streets were taken as a reference category. This relation was statistically insignificant for women: adjusted OR: 0.90; 95% CI: 0.59-1.38; p: 0.644. This cross-sectional study showed that nighttime urban road-traffic noise might be related to occurrence of AH in men.

Night time noise exposure has very rarely been used in previous studies on the relationship between community noise and children's blood pressure, although children spend a larger part of their night time sleeping at home than adults. For this reason, we focused on night time noise exposure at children's residences and daytime noise at kindergartens. The aim of this study was to investigate the effects of urban road-traffic noise on children's blood pressure and heart rate. A cross-sectional study was performed on 328 preschool children (174 boys and 154 girls) aged 3–7 years, who attended 10 public kindergartens in Belgrade. Equivalent noise levels (Leq) were measured during night in front of children's residences and during day in front of kindergartens. A residence was regarded noisy if Leq exceeded 45 dB (A) during night and quiet if the Leq was ≤45 dB (A). Noisy and quiet kindergartens were those with daily Leq>60 dB (A) and ≤60 dB (A), respectively. Children's blood pressure was measured with mercury sphygmomanometer. Heart rate was counted by radial artery palpitation for 1 min. The prevalence of children with hypertensive values of blood pressure was 3.96% (13 children, including 8 boys and 5 girls) with higher prevalence in children from noisy residences (5.70%), compared to children from quiet residences (1.48%). The difference was borderline significant (p=0.054). Systolic pressure was significantly higher (5 mm Hg on average) among children from noisy residences and kindergartens, compared to children from both quiet environments (p

Introduction Weight variations are a common phenomenon. Therefore, concern has been raised about the association between weight changes and weight variations and coronary heart disease (CHD). The aim of this study was to estimate the influence of weight change and weight variations as risk factors for coronary heart disease. Materials and methods The investigation was conducted as an observational cross-sectional study, including 102 participants of both genders: 61 patients with CHD and 41 healthy controls. All participants underwent anthropometric measurements and completed a questionnaire that included 1) weight changes in adulthood (maximum and minimum weight), 2) presence and number of weight variations in the 10 years prior to the onset of disease and 3) the size of weight change (weight gain or weight loss in kg). One weight variation was defined as weight loss followed by weight gain for more than 10% of body weight, or about 7 kg. Multivariant logistic regression was used for the estimation of significant predictors for the occurrence of coronary heart disease. Results Participants with CHD had higher values of body weight in adulthood compared to healthy controls, larger number of weight variations in the last 10 years, and more frequently reported weight gain and weight loss for more than 10 kg. The highest risk for the occurrence of coronary heart disease was observed for participants who had more than 3 weight variations for 10% (OR=2.13; 95%CI=0.98-5.48), those with weight loss over 10 kg (OR=2.16; 95%CI=1.71-2.72) and those with weight gain over 10 kg (OR=2.71; 95%CI=1.08-6.83), regardless of gender, age, smoking, body mass index and blood pressure. Discussion Several mechanisms are suggested to explain the relationship between weight changes and variations and coronary heart disease, including changes in plasma lipid levels, insulin levels, decrease of HDL cholesterol, increase of C-reactive protein and increase of blood pressure. Conclusion This study suggests that frequent and very intense weight changes can be considered important predictors for the occurrence of coronary heart disease.

To date, lateralization in living beings is a phenomenon almost mythologically unexplored. Scientists have proved that lateralization is not exclusively a human feature. Investigations in molecular biology, protein structure, mobility of bacteria, and intracellular lateralization in ciliates, shows important and universal nature of lateralization in living systems. Dominant lateralization implies the appearance of a dominant extremity, or a dominant sense during the performance of complex psychomotor activities. Hand dominance is usually defined as a tendency to use one hand rather than another to perform most activities and this is considered to be the most obvious example of cerebral lateralization and exclusive characteristic of humans. However, there are some exceptions in other species. The dominant hand is able to perform more complex and subtle manual tasks than the non-dominant hand, and this behavioral superiority is the absolute result of additional cerebral support. The asymmetry of brain organization was confirmed in rats, chimpanzees, dogs and birds, some fishes and lizards. The relationships between hand dominance with brain structure and function remain far from clear. For a long time, lateralization was considered unique to humans, but recently it has become clear that lateralization is a fundamental characteristic of the organization of brain and behavior in all vertebrates. It has been questioned to what extent lateralization in humans and other vertebrates may be comparable. [Projekat Ministarstva nauke Republike Srbije, br. 41020 i br. 175078]

Introduction. Work in pharmaceutical-chemical industry is characterized by exposure to numerous hazards, both physical (microclimate, illumination, noise) and chemical (organic solvents). Organic solvents can cause damage to many organic systems and have carcinogenic, teratogenic and mutagenic effects. Objective. The aim of this study was to analyze patterns of chronic morbidity of workers employed in pharmaceuticalchemical industry during 2002. Method. The study was conducted in the pharmaceutical- chemical industry "Zdravlje" Leskovac in 2002. A total of 143 workers in workplaces with special working conditions - exposed to chemical hazards as well as 40 workers from control group took part in the study. The physical examinations of the participants were performed at the Department of Occupational Health in Health Center, Leskovac. Results. Heart diseases were the most frequent both among exposed workers (17.8%) and in control group (33.3%). Respiratory diseases were at the second place (16.9% in the exposed group, and 7.4% in control group). Arterial hypertension was diagnosed in 14.7% workers occupationally exposed to hazards, and in 12.5% workers from control group (p>0.05). Chronic bronchitis was diagnosed in 17.5% of the exposed workers and in only 5.0% of controls (p>0.05). The highest prevalence of diseases in both groups was observed among workers aged 40-49 years, with 20-29 years of exposure working time. 73.4% of the exposed workers and 85% of control workers were capable of work (p>0.05). Conclusion. Workers occupationally exposed to hazards in pharmaceutical-chemical industry have higher prevalence of various diseases compared to non-exposed workers, which can be the result of work, working conditions and work activity. Preventive measures should be directed towards the decrease of occupational hazards and unfavorable working conditions and increase of work protection. Regular physical examinations of workers are of prime importance for the prevention of occupational morbidity, traumatism and invalidity. .

Objective - Left ventricular hypertrophy (LVH) is an independent predictor of cardiovascular and general mortality. Both arterial hypertension and obesity cause changes in structure and function of the left ventricle. Given the rising global epidemic of obesity, it is likely that adverse health consequences of excess adiposity will escalate in the future. The aim of this investigation was to assess the relation and predictive value of obesity on the occurrence of left ventricular hypertrophy in hypertensive middle-aged women. Methods and results - Investigation was conducted on a sample of 64 middle-aged women, diagnosed with arterial hypertension and treated longer than 10 years in the absence of other chronic diseases or heart failure. Based on anthropometric parameters, 14 women (21.9%) had a body mass index (BMI) within the normal range, 17 (26.6%) were overweight, and 33 (52.5%) were obese. Left ventricular hypertrophy was assessed by electrocardiographic and echocardiographic criteria.The influence of anthropometric parameters on left ventricular hypertrophy and patterns in left ventricular geometry was assessed using multivariate regression analyses. The prevalence of LV hypertrophy was 7.1% among normal-weight hypertensive women, 41.2% among overweight and 66.7% among obese women. Compared to normal-weight women, overweight and obese hypertensive subjects had higher mean values of all ECG and echo parameters. The strong correlation between anthropometric and left ventricular parameters was observed. Multivariate analysis showed that percent of body fat (OR = 1.226; 95% Cl 1.011 -1.486) was the only independent predictor of left ventricular hypertrophy. Being overweight was identified as predictor for the development of eccentric LV hypertrophy (OR = 31.824; 95%Cl 1.225-826.850), and for concentric left ventricular remodelling (OR = 20.755; 95%Cl 1.119-385.029). Conclusions - Heart abnormalities occurring in arterial hypertension in conjunction with overweight/obesity include left ventricular hypertrophy and structural changes in the left ventricle.These findings support weight control and the regulation of blood pressure for the prevention of left heart abnormalities.

Arterijska hipertenzija je veoma rasprostranjena kardiovaskularna bolest i predstavlja zna ajan faktor rizika za nastanak kardiovaskularnih, cerebrovaskularnih i renovaskularnih oboljenja (1). Blagovremena dijagnoza i pravilna terapija kod hipertenzije su od izuzetnog zna aja za smanjenje rizika od kardiovaskularnih komplikacija. Za pravilno le enje od arterijske hipertenzije zna ajno je poznavanje osnovnih hemodinamskih parametara koji u estvuju u formiranju arterijskog krvnog pritiska (AKP). Arterijski krvni pritisak je proizvod minutnog volumena srca i veli ine perifernog otpora uglavnom u arteriolama (2). To je pogonska sila potrebna za kretanje krvi kroz sistem krvnih sudova. Ovu silu daje leva komora svojom kontrakcijom (sistolom). Istisnuta krv iz komore siri aortu i velike arterije, pa se tako deo energije, tj. sile, prenosi na elasti na vlakna u zidovima krvnih sudova koja se istežu. Do sirenja krvnih sudova i istezanja elasti nih vlakana u njihovim zidovima dolazi zbog delovanja jos jednog zna ajnog inioca – otpora u arteriolama (vaskularna rezistencija). Ovaj otpor omogu ava da se sila rada leve komore prenese na elasti na vlakna u sistoli, ali istovremeno omogu ava kretanje krvi i u dijastoli. U dijastoli leva komora miruje, ali se elasti na vlakna u zidovima velikih krvnih sudova skra uju, tj. vra aju se na prvobitnu dužinu, smanjuju promer krvnog suda i na taj na in dalje istiskuju krv koju su aorta i arterije primile tokom sistole leve komore. Ovo je mehanizam koji silom istiskivanja krvi i otporom u arteriolama omogu ava potpuno pražnjenje krvnih sudova i neprekidan tok krvi u sistoli i dijastoli (3, 4). Odre ivanje ovih hemodinamskih parametara je znatno olaksano primenom toraksne bioelektri ne impedanse (5). Toraksna bioelektri na impedansa (TBI) je nov neinvazivni hemodinamski metod pomo u kojeg smo u mogu nosti da na jednostavan na in do emo do hemodinamskih parametara koji su klju ni u formiranju arterijskog krvnog pritiska, tj. koli ine te nosti koja cirkulise, kontraktilnosti sr anog misi a i perifernog otpora. Na osnovu parametra koji je poreme en možemo da odredimo adekvatnu terapiju i da pratimo njen hemodinamski efekat. Nyboer je 1959. godine prvi primenio bioelektri nu impedansu za odre ivanje udarnog volumena leve komore. Modifikaciju Nyboerove jedna ine uradili su Kubicek i saradnici 1966. godine, a 1981. godine Quail i saradnici su u originalnu jedna inu uveli tzv. faktor rezistentnosti. Sramek i saradnici su 1983. godine nasli da konusni oblik grudnog kosa ima uticaja na postavljanje elektroda i merenje toraksne bioimpedanse.

Thoracic electrical bioimpedance is a new non-invasive technique for obtaining haemodynamic parameters. The method involves the passing of low amperage, high frequency current through the thorax. The current induces a change of resistance within the thorax, which is registered by electrodes. The overall impedance of the thorax is a measure of the electrical resistance of the thorax to this high frequency, low amplitude current. In clinical practice, thoracic electrical bioimpedance has been applied in diagnostic, therapeutic, and prognostic use in patients with heart failure and hypertension, patients with pacemakers, within the scope of early diagnosis of implant rejection following heart transplantation, as well as in patients with kidney disorders, before and after dialysis. However, one of its most important applications is in the determination of antihypertensive therapy, because it provides the parameters that reflect the genesis of arterial blood pressure, in assessing these parameters, optimal therapy adjusted to the haemodynamic status of each patient can be prescribed.

The change in socio-economic status, drastic decrease in living standards, war, and the introduction of sanctions to our country were complicated in addition by a large number of internally displaced people from Kosovo, which culminated with the 1999 NATO bombing. The aim of this investigation was to estimate the influence of internal displacement on the adaptation and mental health of adolescents. The investigation was conducted on 238 adolescents, comprising a control group of 206 adolescents from Belgrade and 32 internally displaced adolescents from Kosovo. A specific questionnaire regarding habits, behavior, and psychosomatic state was used, as well as the Cornell Medical Index and the Eysenck Personality Questionnaire. Internally displaced adolescents from Kosovo exhibited greater difficulties in adapting and had worse school records than adolescents from Belgrade, one year after the change in their location. Immediately after the NATO bombing, both groups reacted in the same way: they often talked about the events they had survived, they were afraid of the sounds of alarm sirens and of airplanes, and in addition had similar dreams (no statistical variation between the groups). Emotional disturbances, one year after the bombing, were not observed in 40.6% of adolescents from Kosovo, compared to the figure of 74.8% for adolescents from Belgrade. Adolescents from Belgrade consumed alcohol significantly more often: 75.7% compared to 56.3% for adolescents from Kosovo. In addition, 20.4% of adolescents from Belgrade consumed psychoactive substances compared to 6.3% of adolescents from Kosovo. There was no significant difference between the examined groups in the total scores on the scale for neuroticism. All in all, the girls from both examined groups displayed neurotic tendencies more frequently than the boys.

Ketogena dijeta je dijeta sa precizno određenim odnosom sadržaja masti u visokom procentu prema sadržaju ugljenih hidrata i proteina koja se primenjuje kod dece sa epilepsijom refrakternom na konvencionalne antiepileptike. Uvođenjem ketogene dijete indukuje ce stvaranje ketonskihtela za koje se pretpostavlja da imaju terapijski efekat u smanjivanju epilepticnih napada kod neke dece sa epilepsijom. Poslednjih decenija zapaža se rezistencija epilepticnih napada i na novije antiepilepticne medikamente. Uvodi ce pojam refrakterne ili intraktabilne epilepsije, koji je definisan kao neadekvatna kontrola epilepticnih napada uprkos optimalnom lecenju konvencionalnom terapijom, sto podrazumeva da se pokusalo s lecenjem sa najmanje dva antiepileptika. S obzirom na to da je losa kontrola epilepticnih napada udružena sa vecom stopom mortaliteta i ostecenjem psihomotornih funkcija, kao i zbog zapažanja brojnih stetnih nusefekata novijih antiepileptika, ponovo raste interesovanje za ispitivanje efikasnosti ketogene dijete, objasnjenje mehanizma njenog dejstva, kao i mogucnosti njene sire primene.

Background. Arterial hypertension is a multicausal chronic disease often accompanied by obesity. The aim of this investigation was to examine the effect of diet therapy in the treatment of obese hypertensives with and without antihypertensive therapy. Methods. The investigation was conducted at the Department of Nutrition on a sample of 110 obese hypertensive patients on diet therapy. Subjects were divided into two groups: the group on diet therapy with antihypertensive drugs E1 (n=78), and the group on diet therapy without pharmacotherapy E2 (n=32). Nourishment state i.e., obesity level was assessed by body mass index (BMI). All the patients belonged to the obese group - BMI > 30 kg/m2. Besides blood pressure values, the following parameters were monitored: serum cholesterol, trygliceride levels and BMI. Results. The obtained results in the group with diet therapy combined with antihypertensive therapy showed highly significant decrease of anthropometrical parameters: body weight (99.14 kg vs. 90.16 kg) (p

The aim of this pilot study was to calculate the disability-adjusted life years (DALY) as a quantification of the burden of myocardial infarction (MI) attributable to road-traffic noise in Belgrade, Serbia. Exposure to road-traffic noise was estimated on a sample of almost 6000 adult inhabitants living in the central municipality Stari Grad in Belgrade, Serbia. Each participant was assigned to daytime noise levels for 16 h exposure measured on the street of current residence. Population-attributable fraction of MI due to road-traffic noise was calculated based on the distribution of the population in different noise exposure categories and the respective relative risk of MI compared to the reference level. DALYs due to noise-related MI were calculated as the sum of years of life lost and years with disability. The contribution of road traffic noise to the occurrence of MI for the population of the municipality Stari Grad in Belgrade equals 2.518%. Total DALY for MI due to road-traffic noise results in 176 years, that is, 115 years for men and 61 years for women. When adjusted for the present size of the population in Belgrade, total DALY due to road-traffic noise equals 107 years/million inhabitants that is, 70/million inhabitants for men and 37/million inhabitants for women. The burden of disease due to road-traffic noise in Belgrade is relatively small but noteworthy from the public health point of view.