Search

Background and Objectives : Human papillomavirus (HPV) infection and its etiological role in the development of cervical cancer are well established. The cervical cancer mortality rate in Serbia is one of the highest among European countries, and this cancer is the second-leading cause of death in Serbian women aged from 15 to 44. Materials and Methods : This retrospective study was conducted at the Institute of Public Health of Vojvodina. A total of 10,062 cervical specimens from Serbian women were collected and HPV tested in ten years. The study patients were divided into five age groups. HPV genotype testing was performed using a commercial kit to detect 14 high-risk (HR) HPV genotypes. Additionally, cervix cytology data have been available for patients tested in 2022 and 2023. Results : An overall positive rate was found in 43.3% of patients (4356/10,062). A single HPV infection (62.1%) was the main infection pattern. The most frequent HR HPV genotypes were HPV 16, 31, 52, 56, 39, and 51, comprising 62.3% of the detected genotypes, including multiple infections. A significant difference was noted in the HPV prevalence across the different age groups, with a bimodal distribution of HPV infection. The highest prevalence was recorded in the age group ≤ 30 and those after 61 years. Women diagnosed with high-grade squamous intraepithelial lesions (HSIL) were significantly older compared to others. HR HPV is the most prevalent in patients with HSIL cytological findings (76.5%). The most common type, according to age-specific distribution and cytological findings, was HR HPV 16. Conclusions : This study provides comprehensive data on HR HPV distribution among Serbian women, which can serve as a basis for subsequent monitoring of genotypic distribution. It is particularly significant considering they are missing in the updated ICO/IARC Report for Serbia, and the cervical cancer mortality rate in Serbia is one of the highest among European countries.

Provision of safe water, sanitation, and hygiene (WASH) services in health care facilities is a priority at the global, national, and local levels. To inform improvements planning, conditions of WASH, waste management, and environmental cleaning were assessed in 81 facilities in the Autonomous Province of Vojvodina, Serbia, as part of a nationally representative survey in 2019. The survey included on-site checks, structured interviews, and drinking-water quality analysis. WHO/UNICEF indicators for WASH service levels and an advanced service level defined at the national level were applied. The results showed that all investigated facilities provided basic water services; 94% of facilities provided basic hygiene and waste management services; 58 and 2%, respectively, provided basic cleaning and sanitation services. Only 1% of investigated facilities met the basic level for all five WASH dimensions. Advanced service levels were only met for hygiene, waste management, and/or cleaning in 15-38% of facilities. In 33% of health care facilities, drinking-water quality was not in compliance with the national standards. The results revealed that there is a need for increased awareness and efforts to ensure basic provisions for sanitation, environmental cleaning, and drinking-water safety.

Objective: To assess the effect of age on mechanisms of exercise tolerance., Methods: Prospective observational study recruited 71 healthy individuals divided into two groups according to their age i.e. younger (≤40 years of age, N = 43); and older (≥55 years of age, N = 28). All participants underwent maximal graded cardiopulmonary exercise stress testing using cycle ergometer with simultaneous non-invasive gas-exchange and central haemodynamic measurements. Using the Fick equation, arteriovenous O 2 difference was calculated as the ratio between measured O 2 consumption and cardiac output., Results: The mean age of younger and older participants was 26.0 ± 5.7 years, and 65.1 ± 6.6 years respectively. Peak O 2 consumption was significantly lower in older compared to the younger age group (18.8 ± 5.2 vs 34.4 ± 9.8 mL/kg/min, p < 0.01). Peak exercise cardiac output and cardiac index were not significantly different between the younger and older age groups (22.7 ± 5.0 vs 22.1 ± 3.9 L/min, p = 0.59; and 12.4 ± 2.9 vs 11.8 ± 1.9 L/min/m 2 , p = 0.29). Despite demonstrating significantly lower peak heart rate by 33 beats/min (129 ± 18.3 vs 162 ± 19.9, p < 0.01), older participants demonstrated significantly higher stroke volume and stroke volume index compared to the younger age group (173 ± 41.5 vs 142 ± 34.9 mL/min, p < 0.01; and 92.1 ± 18.1 vs 78.3 ± 19.5 mL/m 2 , p < 0.01). Arteriovenous O 2 difference was significantly lower in older compared to younger age group participants (9.01 ± 3.0 vs 15.8 ± 4.3 mlO 2 /100 mL blood, p < 0.01)., Conclusion: Ability of skeletal muscles to extract delivered oxygen represented by reduced arteriovenous O 2 difference at peak exercise appears to be the key determinant of exercise tolerance in healthy older individuals., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objectives: The objective of this research is to determine the change in outdoor air quality during the COVID‑19 related state of emergency resulting in a lockdown and the potential health benefits for the urban population., Material and Methods: During 53 days of the COVID‑19 related state of emergency with a lockdown (March 15-May 6, 2020) in the Republic of Serbia, as well as in the corresponding periods of 2018 and 2019, data on the daily sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2), ground-level ozone (O 3 ) and particulate matter (PM 10 and PM 2.5 ) concentrations were analyzed. The total mortality data were analyzed to estimate the impact of the COVID‑19 related lockdown measures on the burden of health in a given population, attributed to the outdoor air quality in the City of Novi Sad, using AirQ+ software., Results: The average daily concentrations of PM 2.5 , NO 2 , PM 10 and SO 2 were reduced by 35%, 34%, 23% and 18%, respectively. In contrast, the average daily concentration of O 3 increased by 8%, even if the primary precursors were reducing, thus representing a challenge for air quality management. In the City of Novi Sad, a reduction in the average daily PM 2.5 concentration of 11.23 μg/m³ was significant, which resulted in a quantified number of avoided deaths., Conclusions: Air pollution in the City of Novi Sad had a chance to be improved due to some preventive measures related to the infectious disease (the COVID‑19 related lockdown), which in turn was the mitigation measure to air pollution with positive public health effects. The confirmed positive effects of the improved air quality on public health could also include raising collective resistance to mass non-communicable and infectious diseases such as COVID‑19 and reducing economic costs. Int J Occup Med Environ Health. 2021;34(2):223-37., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background/aim: It had been suggested that elevated body mass index (BMI) is a beneficial and preventive factor when it comes to the outcome for patients undergoing coronary artery bypass grafting (CABG). At the same time, obesity is strongly associated with coronary artery disease development. The aim of this study was to determine the significance of the obesity paradox in patients referred for CABG and to examine if a relationship exists between obesity and early coronary surgery outcome., Methods: This study comparised 791 patients who had undergone isolated CABG over one year period (year 2010). The average age of patients was 62.33 +/- 8.12 years and involved 568 (71.8%) male and 223 (28.2%) female patients, while the mean logistic EuroSCORE was 3.42%. The patients were categorized into three distinct groups based on their BMI: I - BMI < 24.9 kg/m2; II - BMI 25-30 kg/m2; III - BMI > 30 kg/m2. Regression analysis was conducted to determine whether BMI was an independent predictor of early mortality after CABG., Results: The majority of the cohort could be categorized as overweight (490/o) or obese (30%). There was no association between BMI and gender (p = 0.398). The overall early mortality was 2.15% (1.85% in the group I, 2.06% in the group II and 2.51% in the group III; p = 0.869). Univariate analysis showed that obesity cannot be regarded as an independent risk factor for early mortality following CABG (odds ratio 1.021, 95% confidence interval 0.910-1.145, p = 0.724). Duration of in-hospital period following the surgery was comparable within the BMI groups (p = 0.502)., Conclusion: Compared to non-obese patients, overweight and obese individuals have similar early mortality rate following CABG. This study can substantiate the presence of obesity paradox only in terms that elevated BMI patients have comparable outcome with non-obese. Further research is needed to delineate potential underlying mechanisms that set off obesity to protective factor for coronary surgery.

Certain lifestyle and environmental factors play an important role on breast cancer (BC) risk, but data on the influence of nutritional factors are still conflicting. Migrational data have pointed to nutrition as one of the more relevant external factors involved. So far, the only well established nutrition-related risk factors for BC are obesity and alcohol consumption. The evidence that body fatness is a cause of postmenopausal breast cancer is convincing as is the evidence that alcoholic drinks are a cause of BC in all ages. On the other hand, body fatness probably protects against BC diagnosed premenopause. It is more likely that the BC risk is related to life-long dietary habits. The general preventive recommendation often includes a reduction of alcohol, red meat and total dietary fat, and increase in vegetable and fruit consumption. The purpose of this work was to summarize and present current opinions on the influence of diet and nutrition on BC etiology and to suggest possible preventive measures.