PONS Medical Journal is a scientific, peer reviewed journal which publishes original results of experimental and clinical re-searches, examinations, specialized researches, case reports, elab-orations of scientific methods, book reviews, reports of scientific and specialized meetings, the health economy news, health in-formatics and management, medical history researches, analyses of social aspects of health care, medical ethics researches, letter to the editor, together with other appropriate contents in medical domain and other related fields. Submitted manuscripts are peer-reviewed by independent expert reviewers. PONS Medical Journal publishes researches written in Serbian or English language.
Akademija vaspitačko-medicinskih strukovnih studija, Kruševac
Breastfeeding is the best and most natural way of feeding newborns, but there are factors that make breastfeeding difficult or completely impossible for either the child or the mother. In those cases, adapted milk is used, which is the most similar to the composition of mother's milk in terms of quality and quantity of nutrients. The aim of this work is to examine the reasons for using and choosing adapted milk formulas. The choice of adapted milk formula depends on the age of the newborn, his health condition, as well as individual specifics. There is no universal way of choosing, but special attention should be paid to formulas, which are intended for newborns with different health conditions or nutritional challenges.
Copyright (c) 2026 PONS - medicinski časopis
Invasive pneumococcal disease in children - a case report of pneumonia with pleural effusion and septicemia
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Accent 6"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 6"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 6"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/> <w:LsdException Locked="false" Priority="19" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/> <w:LsdException Locked="false" Priority="21" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/> <w:LsdException Locked="false" Priority="31" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/> <w:LsdException Locked="false" Priority="32" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/> <w:LsdException Locked="false" Priority="33" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Book Title"/> <w:LsdException Locked="false" Priority="37" Name="Bibliography"/> <w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/> </w:LatentStyles> </xml><![endif]--><!-- [if gte mso 10]> <![endif]--> Slađana Pekmezović1,4, Svetlana Blagojević1, Bojan Jašović3,4, Vladimir Čotrić2,4, Janko Pejović4 , Slavica Mutavdžić Divac1 1. Pediatric Hospital, Clinical Center Zemun, 2. Radiology Department, Clinical Center Zemun, 3. Clinical Center Zvezdara, 4. Sanitary medical school of applied sciences “VISAN Pneumococcal disease (PD) represents a spectrum of infections caused by Streptococcus pneumoniae. Isolation of Streptococcus pneumoniae from normally sterile areas and fluids is a key diagnostic method for Invasive pneumococcal disease (IPD). Despite the availability of conjugate vaccines, infections caused by non-vaccine serotypes have increased serious and invasive infection incidence („serotype replacement“). Case report: We present a 20-month-old male admitted with a six-day history of fever and respiratory symptoms. Chest radiography and ultrasound confirmed pneumonia with pleural effusion. Laboratory findings revealed significant elevated inflammatory markers (CRP 317 mg/L, PCT 3.43 ng/ml). Streptococcus pneumoniae serotype 19A was isolated from both blood culture and nasopharyngeal aspirate. It was susceptible to penicillins and cephalosporins but resistant to macrolides and aminoglycosides. The patient was successfully treated with empirical dual antibiotic therapy, followed by ceftriaxone monotherapy, resulting in full clinical and radiological recovery. Considering the incomplete vaccination, complete vaccination with the 13-valent vaccine was recommended. Discussion: Early recognition is essential for improved outcome, but often poses a challenge in pediatric practice: the symptoms are nonspecific with good condition, there are no specifically sensitive laboratory parameters that would indicate the severity or cause of the infection and sampling of microbiological material from the respiratory tract is limited. Early initiation of antibiotic therapy ensures a favorable outcome and reduc complications. In this case report non-vaccine serotype 19A was confirmed, which is consistent with the occurrence of “serotype replacement”. Conclusion: This case report demonstrates that IPD remain diagnostic and therapeutic challenge. Can be develop in immunocompetent children with incomplete pneumococcal vaccination and the initial symptoms are nonspecific (fever, lethargy, mild to moderate respiratory distress). Initial empirical therapy according to defined and updated protocols is the cornerstone of treatment and vaccination remains the most effective method for its prevention. Continuous monitoring of pneumococcal serotype distribution and antibiotic resistance is essential, as well as planning public health strategies.
The risk of influenza infection in the elderly and the role of vaccination in the prevention and reduction of complications
Introduction The flu poses a serious threat to the elderly due to a weakened immune system and comorbidities. People over the age of 65 face an increased risk of complications, including hospitalizations, cardiovascular problems, pneumonia, and death. According to the World Health Organization (WHO), influenza causes between 250,000 and 500,000 deaths a year, of which 38,500 are estimated in Europe. Aim of the paper To investigate the risks posed by influenza to the elderly population, with a focus on comorbidities and the impact of vaccination in reducing these risks, as well as the benefits of new vaccines for this risk group. Discussion The risk of complications increases with age and concomitant diseases. Cardiovascular complications, including heart attacks and worsening heart failure, are often the result of influenza infection. Pneumonia is the leading cause of mortality, occurring in 10% of those infected. Although the immune response to vaccines may be weaker in the elderly, research shows that vaccination significantly reduces the risk of severe outcomes. A new generation of vaccines, such as high-dose and adjuvant vaccines, improve the immune response and protection. Conclusion Influenza vaccination provides significant protection for the elderly, reducing the severity of the disease and the mortality rate. Advances in the development of new vaccines improve outcomes in this risk group, making vaccination a key strategy in preventing complications of influenza. Keywords: influenza virus, influenza, vaccination, aging, complications, vaccine effectiveness
Presentation of a new instrument for assessment of nutritional status in elderly persons
International team of experts, Jelena Pavlović, PhD (Faculty of Medicine in Foča, University of East Sarajevo) i Maja Račić, PhD (The Ohio State University, Columbus, United States) constructed and validated a new instrument/tool ​​for nutritional risk assessment in older adults in Bosnia and Herzegovina (Nutrition risk assessment in older adults - NRA). The newly developed tool is comprehensive, has acceptable validity and internal consistency. It contains a total of 14 questions. The scoring of each question as well as the final score of the tool is designed in detail, and the maximum number of points is 21. The tool has three categories, and a lower score indicates a nutritional risk. The time required to complete the assessment ranged from 15 to 22 minutes. the new tool is the author's original contribution to science and practice. The new tool is protected and copyrighted, and can only be used with the author's permission.
Examination and analysis of modern scintigraphic methods with reference to diagnostic procedures that predict disease risks
Nuclear medicine is a specialized, relatively young branch of medicine that uses radioactive compounds for diagnostic and therapeutic purposes. The basis of the application of radiolabels and radiolabeled substances in nuclear/medical diagnostics is the ability to monitor physiological and pathophysiological processes in the body. Radiopharmaceuticals are radioactively labeled chemical compounds, consisting of a radioactive isotope and a carrier molecule, which has a high degree of specificity for the process under investigation. In diagnostics, 99mTc has been indisputable for decades, due to its excellent physical properties, high quality and easy availability, and the main source for obtaining it is chromatographic 99Mo/99mTc generators. Scintigraphy is an imaging diagnostic procedure that monitors and records the distribution of the radioactivity of the applied radiopharmaceutical, obtaining a scintigram, a two-dimensional image, while single photon emission computed tomography (SPECT) represents the circular motion of the detector around the body, along with a three-dimensional view of the organs. which can be observed in sections, in three planes (sagittal, frontal and transverse), where it is shown more clearly and precisely localizes any pathological process. In this work, we used a gamma camera Diacam - Siemens, penultimate generation, with extraordinary uniformity and resolution of the obtained diagnostic image. Based on the study reports of perfusion scintigraphy of the myocardium - mibi stress and scintigraphy of the parathyroid glands, made with 99mTc - sestamibi, we came to the images, which were studiously analyzed and processed with the help of a special computer program. We obtained a completely normal finding of the heart muscle, while the planar images of the neck and mediastinum were also disease-free, with a weakened display of radiopharmaceutical accumulation. From the perspective of the importance of scintigraphies performed, in the domain of image diagnostics, the paper shows the exceptional quality of the images obtained. Scintigraphy of the parathyroid glands is crucial in detecting disorders of the parathyroid glands, and also serves as a preoperative method. Nuclear medicine is the fastest growing medical field. It is extremely effective and with few side effects, allowing elderly patients to prolong and have a higher quality of life, compared to conventional treatments, such as chemotherapy. It is very versatile and is used in the treatment of various types of cancer.
Non-ionizing electromagnetic radiation - health aspects
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</xml><![endif]--><!-- [if gte mso 10]> <![endif]--> The accelerated development of mobile telecommunications, the widespread use of modern wireless technologies for the transmission of information and energy, as well as the growing use of electromagnetic devices in medical practice, have led to significant changes in the quality of the environment. Modern man is continuously exposed to non-ionizing electromagnetic radiation of various origins, which has raised concerns about the potential health effects of long-term exposure of the population to artificial sources of electromagnetic fields. Numerous studies have been aimed at examining the possible connection between the level of electromagnetic exposure and the frequency of certain health disorders. In order to assess the level of exposure of the population, measurements of electric, magnetic and electromagnetic fields were carried out in residential and working areas, in the frequency range from 0 Hz to 3.5 GHz. The measurements were carried out in areas identified as "hot spots", as well as in the immediate vicinity of sources of electromagnetic radiation, including power lines and wireless computer networks. The results obtained represent the basis for assessing the compliance of the measured values with applicable national and international regulations and recommendations, as well as for considering potential implications for public health.
Monitoring of drinking water quality in Mladenovac in the period 2021–2023
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Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Mention"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Smart Hyperlink"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Hashtag"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Unresolved Mention"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Smart Link"/> </w:LatentStyles> </xml><![endif]--><!-- [if gte mso 10]> <![endif]--> Introduction Water is of great importance for the entire living world. The World Health Organization classified water supply and drinking water quality among twelve basic indicators of the health status of a country's population. Aim The aim of the work is the analysis of physico-chemical and microbiological tests of drinking water in the territory of Mladenovac in a three-year period (2021-2023). Materials and methods The method of work is analytical-descriptive. For the analysis of the water quality in Mladenovac, data from the Annual Reports on the health control of drinking water from the water supply in Mladenovac for the years 2021, 2022 and 2023 were used. In the Laboratories of the City Public Health Institute of Belgrade, physico-chemical and microbiological tests of drinking water samples are carried out in the scope of Basic and Periodic analyzes according to the Rulebook on the hygienic suitability of drinking water ("Official Gazette of the FRY" No. 42/98 and 44/99 and "Official Gazette of the RS" No. 28/2019). Results The results of laboratory tests of water conducted in 2021 showed that out of a total of 362 tested samples, 292 (80.66%) were physically and chemically defective, while 51 (14.09%) were microbiologically defective. In 2022, a total of 368 samples were tested. From a physico-chemical point of view, 311 (84.51%) samples were unhealthy (unsafe), 50 (13.59%) were microbiologically unhealthy. Out of a total of 385 water samples tested in 2023, 273 (70.91%) were physico-chemically defective, and 43 (11.14%) were microbiologically defective. The causes of failure are physico-chemical parameters: turbidity, iron, manganese, ammonia and nitrites. In terms of microbiological water quality, the cause of malfunction is an increased total number of aerobic mesophilic bacteria in 1 ml of water, the presence of total coliform bacteria, Pseudomonas aeruginosa, faecal streptococci. Conclusion Analyzes indicate the need for urgent improvement of the water supply situation. Measures should be taken to reduce microbiological contamination and to reduce iron and manganese concentrations and water turbidity.
The process of patient education in nursing practice
Introduction. Due to the long duration of the disease, patients are faced with limited health resources, shorter hospitalizations, so they are forced to stay and carry out the treatment for the disease independently or with the help of other persons outside the health institutions. All this emphasizes the trend and the need to encourage a healthy lifestyle and train patients to take care of their own health. The aim of this review was to describe the process of patient education. Two aspects of health education are distinguished: content (what is learned) and process (how the material is learned). Education affects the behavior of patients, which changes knowledge, skills and attitudes, which is necessary in order to preserve and improve one's own health. The patient education process includes several steps: assessment of educational needs, setting educational goals, defining content, activities and learning aids (learning plan), conducting education and evaluating what has been learned. It is important to harmonize educational strategies with the patient's age, because there is a different approach to children, elderly people, people with special needs, etc. Educational activities in health care include three interrelated domains: cognitive (related to the acquisition of certain contents); affective (implies change of attitudes and development of abilities) and psychomotor (refers to the development of practical skills). A key component of the education process is the assessment of patient needs related to the area of ​​education. A nurse must be adequately qualified to assess educational needs, as this is a prerequisite for successful education. In Bosnia and Herzegovina, patient education is not carried out regularly and completely. Conclusion. Patient education has always been an integral part of the work of nurses, and in today's circumstances, the need for it is increasing. Graduated nurses are the main and responsible bearers of educational interventions. Keywords: education, patients, nurses, chronic diseases.
Copyright (c) 2025 PONS - medicinski časopis
20th YEARS MONICA PROJECT IN NOVI SAD - INFLUENCE OF SOCIOPOLITICAL AND ECONOMIC CIRCUMSTANCES ON STROKE EPIDEMIOLOGY
Objective. To measure trends in CVD, acute myocardial infarction (AMI), and MU morbidity and mortality, assessing the extent to which these trends are associated with changes in known risk factors (RF), daily lifestyle habits, health care, and major socioeconomic characteristics. Measurements were carried out at the same time in defined communities in different countries on several inhabited continents. Methods MONICA combined the old with the new, routine standardized measurements of epidemiological parameter’s, RF and medical care were combined with quality control and publication of results on the internet, hypothesis testing and publication of study results in prestigious scientific journals. The hypothesis couldn’t be tested only on one population and without cooperation with the WHO, and the main activities were recording the incidence of AMI and stroke, coronary care, analysis of population samples and implementation of the intervention program. Incidence, morbidity, lethality and mortality of stroke, sociopolitical and economic characteristics, as well as stroke RF in the area of Novi Sad were investigated from 1979-1983-2002. in order to establish and implement the aforementioned protocols. Results The levels and distribution of the main RF that determined the undertaking of preventive activities and the implementation of intervention programs to protect residents from CVD are presented. The results of the MONICA project in Novi Sad were achieved by reducing the epidemiological indicators of stroke in a period of favorable social, political and economic conditions, and by worsening them in the opposite circumstances in all expressed aspects of people's lives and state functioning. Conclusion The hypothesis has been proven that the social community achieves a successful final mission of reducing stroke rates of morbidity and mortality by undertaking prophylactic measures, so that despite the development of reperfusion therapies for patients with acute ischemic stroke, prevention remains the approach of choice for reducing the its risk.
Obesity is prevalent, complex chronic disease, which can lead to more than 200 diseases, including diabetes, cardiovascular and malignant diseases. Weight bias, stigmatization and discrimination are widespread and with serious consequences for people living with obesity. Approved methods for obesity treatment are: 1. Nutrition improvement; 2. Physical activity; 3. Psychotherapy; 4. Pharmacotherapy; and 5. Surgical therapy. Nutrition interventions and medical nutrition therapy are core treatment for obesity. Nutrition interventions that are safe, effective, nutritionally adequate, culturally acceptable and affordable for long-term adherence, should be considered for adults living with obesity. However, to date, no single best nutrition intervention has been shown to sustain weight loss long-term. Physical activity, psychotherapy, pharmacotherapy and surgical therapy can considerably improve results of treatment, but all together, treating of obesity is complex, expensive and with limited results. It has been suggested that primary prevention is the most cost-effective option for addressing obesity. Therefore, prevention of obesity and related health consequences should be a focus of every healthcare systems.
Copyright (c) 2024 PONS - medicinski časopis
OVERCOMING CULTURAL DIVERSITY IN THE PROFESSIONAL PRACTICE OF HEALTHCARE WORKERS
Cultural diversity, a characteristic of modern society, requires developed intercultural sensitivity and the application of acquired intercultural competencies in the daily practice of healthcare workers. Due to the nature of their activity, healthcare workers play a significant role in promoting multiculturalism. Thus, their professional actions should be based on ethical principles, empathy, respect for diversity, rejection of stereotypes and prejudices, and judgment of discrimination. Intending to raise the awareness of healthcare workers about the importance of intercultural competence in professional practice, the work sublimates the basic assumptions about prejudice, stereotypes and discrimination as potential sources of obstacles in intercultural communication within the healthcare system. Their impact on the quality of health care provided to patients is emphasised, as well as the necessary knowledge and skills of health workers to provide culturally competent care and treatment. According to the existing legal regulations, the authors present basic strategies and interventions for overcoming the mentioned obstacles. Social pluralism initiates the necessity of forming a solid value orientation of healthcare workers towards respect for universal human rights and values, developed through introspection, critical reflection and open dialogue.
Association between depression screening and sick leave among employees in Serbia
Objective. The mental health of employees represents a key factor affecting absenteeism and productivity. This study aimed to examine the association between depressive symptoms and absenteeism among employees in Serbia and to identify demographic and socioeconomic factors influencing this relationship. Methods. A cross-sectional study was conducted using data from the National Health Survey, including a sample of 4,652 employees aged 18-65 years. Descriptive statistics and binary logistic regression, adjusted for demographic and socioeconomic factors, were used to analyze the association between depressive symptoms and absenteeism. Results. The prevalence of mild depressive symptoms was 2.3%, and depressive episodes were 0.6%. Women showed significantly higher prevalence of depressive symptoms compared to men (3.9% vs 2.1%, p=0.002). The most common symptoms were fatigue (2.1%) and sleep problems (1.6%). All depressive symptoms showed a statistically significant association with absenteeism (p<0.01). Absenteeism frequency increases with symptom severity: 1.6% in the absence of symptoms, 4.7% for mild symptoms, while long-term absenteeism with mild symptoms was 10.4%. Participants with mild depressive symptoms had twice the odds for absenteeism (OR=2.01), while those with depressive episodes had over three times higher odds (OR=3.20). Conclusion. The study confirms a significant association between the presence of depressive symptoms and absenteeism among employees in Serbia, with a clear risk gradation depending on symptom severity. Higher prevalence of depressive symptoms in women indicates the need for gender-adapted preventive approaches. Findings support the implementation of depression screening as an early strategy for reducing absenteeism in the working population.
Retrospektivna analiza padova kod obolelih od plućnih bolesti u hospitalnim uslovima
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UnhideWhenUsed="true" Name="Body Text First Indent 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Note Heading"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text Indent 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text Indent 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Block Text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Hyperlink"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="FollowedHyperlink"/> <w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/> <w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Document Map"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Plain Text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="E-mail Signature"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Top of Form"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Bottom of Form"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Normal (Web)"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Acronym"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Address"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Cite"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Code"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML 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Name="Table Colorful 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 5"/> <w:LsdException 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Name="Medium Grid 1"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/> <w:LsdException Locked="false" Priority="70" Name="Dark List"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/> <w:LsdException Locked="false" SemiHidden="true" Name="Revision"/> <w:LsdException Locked="false" Priority="34" QFormat="true" Name="List Paragraph"/> <w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/> <w:LsdException Locked="false" Priority="30" QFormat="true" Name="Intense Quote"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/> <w:LsdException 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<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/> 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Name="Grid Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/> 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Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> </xml><![endif]--><!-- [if gte mso 10]> <![endif]--> OBJECTIVE: Patient falls are categorized as the most common adverse events in hospital practice. Lung patients are elderly, multimorbidity, limited mobility and cognitive dysfunctions, which is why they may have an increased risk. The aim of this research is to analyze the risk factors of falls during hospitalization of patients with lung diseases, as well as their causes and consequences. METHOD: The study was designed as a retrospective - a pilot study on a sample of 37 patients with lung diseases, both sexes, aged from 43 to 90 years. Data were collected from medical records. The results are presented tabularly and graphically. RESULTS: The sample consisted of 51% male and 49% female respondents, 92% aged >60 years. Analysis of risk factors indicated the greatest degree of increased risk of falling: older age > 60 years 92%, respiratory insufficiency 89%, multimorbidity 97%, drugs with risk factors 97% and additional equipment 97%. The main causes of falls in 68% of patients are cognitive dysfunction, in 19% environmental factors, while in 13% the cause of the fall is unknown. In our sample, 54% of the respondents were without injuries. CONCLUSION: Based on this pilot study, we can conclude that there are a lot of associated risk factors that contribute to increased risk of falling in the studied population group, and in future research it is necessary to examine them in more detail in other lung diseases, not only in patients with COPD. KEYWORDS: falls, risk factors, assesment risk
The The Prevalence of Hard Ticks Infesting Humans in the South Bačka District: Association of Age and Infestation Localization with Tick Developmental Stages
ABSTRACT Objective. The aim of this study was to determine the prevalence of different tick species infesting humans, to assess the correlation between patient age and the body region affected by the infestation, as well as to analyze the number of human infestations during the period from January 1, 2023, to December 31, 2023. Methods. The study included patients residing in the South Bačka District who visited the Pasteur Institute with either a removed or attached tick. Patients were divided into eight age categories: 1–10 years, 11–20 years, 21–30 years, 31–40 years, 41–50 years, 51–60 years, 61–70 years, and 71–80 years. The study analyzed associations between age categories and the affected body regions (head and neck, upper extremities, lower extremities, torso, and genital area), the number of removed ticks, and the developmental stages of ticks (adult, nymph, larva). Results. A total of 502 ticks were collected during the study period. Six tick species were identified, with Ixodes ricinus being the most prevalent (460/502; 91.63%). Of the total ticks collected, 252 (50.19%) were nymphs, while 205 (40.83%) were adults. Regression analysis revealed a statistically significant correlation between the frequency of infestation of arms, legs, and the genital region and the age of participants. Risk analysis showed a statistically significant difference in the likelihood of nymph infestations compared to adults in patients aged 1–10 years, with the probability of nymph infestation being nearly 1.5 times higher. Conclusion. The results of this study highlight the dominance of Ixodes ricinus among ticks infesting humans in the South Bačka District, with nymphs being the most common developmental stage. A significant correlation was observed between the age of patients and the localization of infestations on the body, as well as an increased risk of nymph infestations in children aged 1–10 years. These findings provide valuable insights into the epidemiological characteristics of tick infestations, contributing to better planning of preventive measures and public education on tick-borne risks and protection.
Lung tumor discovered during the pre-employment medical check-up of a candidate for work abroad - case report
Abstract Introduction. Lung cancer is one of the most common and deadliest forms of cancer with a high mortality rate. Regular health check-ups play a crucial role in the early detection of malignant diseases, especially among employed individuals. Aim. The aim of the paper is to present a case of a diagnosed lung tumor in a person who underwent pre-employment medical check-up in order to obtain a work visa for the purpose of employment abroad. Case report. This paper presents the case of a 47-year-old architect who was diagnosed with a lung tumor during a preventive medical check-up for obtaining a work visa. The patient was a smoker without any health complaints. A chest X-ray revealed a well-defined shadow in the left lung field. Further diagnostic procedures (CT scan and bronchoscopy) confirmed the presence of a carcinoid (NET GR1). The tumor was successfully removed through surgery, and the patient received a positive opinion on work capability after a short rehabilitation period. Conclusion. This case highlights the importance of preventive medical examinations that enable early detection and timely intervention, significantly improving the chances of successful treatment. Early detection of malignant diseases reduces the need for invasive treatments, lowers treatment costs, and improves patients' quality of life. However, challenges include false positive and negative results, which can lead to unnecessary interventions or false security. The role of occupational medicine is crucial in early detection, providing a unique opportunity to identify malignant diseases through regular check-ups. A multidisciplinary approach, including collaboration among oncologists, surgeons, radiologists, and pulmonologists, is essential for optimal planning and execution of treatment, contributing to the best possible outcomes for patients. In conclusion, this paper emphasizes the need for continuous educational programs and raising awareness about the importance of early lung cancer detection. Public education and the implementation of preventive health programs can significantly reduce lung cancer mortality. This case serves as a reminder for all healthcare professionals about the importance of a careful and thorough approach to each patient, because every medical check-up can be an opportunity to save a life. Key words: tumor of the lungs, carcinoid, preventive medical check-up, occupational medicine
Abstract The aim of the paper is to show the structural changes in the form of microdeletion malformations and the mechanisms of the origin of these two microdeletion syndromes, especially Angelman syndrome. In addition to the molecular mechanisms of origin, some of the most well-known microdeletion syndromes, their clinical, genetic and phenotypic characteristics are included. In addition to the broader picture of numerous syndromes that arise as a result of microdeletion changes, Angelman and Prader-Willi syndromes are particularly presented. The work refers to findings from the literature that explain the specificities of these syndromes, both in genotype, phenotype and clinical picture, as well as in other aspects of the psychomotor, speech-language and general health course of children and adults. The methods of molecular genetics within prenatal diagnostics are presented as significant preventive measures within the framework of genetic counseling and the prevalence of the occurrence of these all-pervading severe forms of the syndrome. Also, an overview of modern methods and techniques used in differential diagnosis and improving genetic counseling is given. By monitoring significant delays in all modalities of development and problems with general health functioning, some of the types of therapeutic interventions of the holistic and pharmacological-symptomatic type are included. Key words: microdeletion syndromes, Angelman and Prader-Willi syndrome, multidisciplinary approach - prenatal counseling, pharmacological and defectological treatment
The Possibilities of Applying Ultrasound-Guided Percutaneous Electrolysis For Musculoskeletal Pain
Physical therapy is constantly evolving and adapting to new information and technologies in order to provide optimal care to patients with various musculoskeletal conditions. In this context, recent advances in technology and therapy methods has led to the introduction of new techniques, among which ultrasound-guided percutaneous electrolysis stands out. This technique, which combines the principle of electrotherapy (direct current) with percutaneous needle application, is becoming increasingly significant in the rehabilitation of patients with tendinopathies, myofascial pain syndromes, and other musculoskeletal conditions. The largest number of studies to date indicate its effectiveness, whether it is applied as an individual procedure, or in combination with other physical modalities and therapeutic exercises. The therapeutic effects were monitored in both the short and long term. The most adequate therapeutic protocols are still being sought after, considering that this technique has recently been introduced as a way of decreasing the symptoms and consequences of musculoskeletal pain. The aim of this research was to review the approaches and therapeutic protocols for the application of percutaneous electrolysis in the treatment of musculoskeletal pain. The research results indicate positive therapeutic effects, as well as the advantages of applying ultrasound-guided percutaneous electrolysis for musculoskeletal pain.
Personalized medicine and pharmacogenomics
Personalized medicine refers to any clinical approach that emphasizes the systematic use of preventive, diagnostic, and therapeutic interventions based on genomic and family history data to enhance health outcomes. In this sense, personalized treatment is frequently referred to as genomic medicine. Personalized medicine has several health strategies that rely on the identification of molecular-genetic markers, including molecular diagnosis, prognosis, and disease monitoring; predictive genetics and preventive medicine; pharmacogenomics; targeted molecular therapy, and gene-based therapy. This paper presents a summary of current pharmacogenomics findings, as well as the field's expected future progress. Pharmacogenomics is the study of how the entire genome influences an individual's response to a medicine. The clinical application of pharmacogenomics enables clinicians to predict a patient's response to a specific therapy based on information obtained from genetic tests, and to select the appropriate drug, drug dose, and duration of therapy in order to achieve the best possible therapeutic response in the patient while minimizing unwanted side effects. This necessitates objective and evidence-based guidelines, as well as an adequate infrastructure for accessing pharmacogenomic data, such as via the patient's electronic health record. Although medicine has always been essentially "personalized," or tailored to each patient, personalized medicine now employs cutting-edge technology and knowledge in the fields of molecular genetics and genomics, allowing for a greater degree of personalization and significant progress in clinical medicine.
The influence of breast volume and age on the occurrence of severe forms of radiation dermatitis as a complication of postoperative 3D-conformal radiotherapy of the breast - one center experience
Introduction/goal. In the world, the incidence of breast cancer is constantly increasing, and according to the results of GLOBOCAN 2022, in the population of women, breast cancer is in the first place in terms of incidence and in the second place in terms of mortality. The modern approach to breast cancer treatment is multidisciplinary. Surgery, drugs and radiotherapy, as well as their combinations, are applied in the order that depends on the stage of the disease, general condition, comorbidities. The results of previous studies have proven that in selected patients with early breast cancer there is no statistically significant difference in overall survival between partial resection followed by radiation therapy and mastectomy, which rapidly increased the number of breast conserving surgery. In this regard, it is a challenge to carry out postoperative radiotherapy of the breast with as few consequences as possible for the surrounding organs (heart and lungs), but also to minimize early and late reactions of the skin as well as the breast itself and, accordingly, radiation dermatitis (RD) is the most common complication that occurs in patients treated with radiotherapy. The aim of the study was to determine whether breast volume and age have an influence on the occurrence of more severe forms of acute skin toxicity. Methods. The research was conducted at the Radiotherapy Department of the Radiology Institute of the Military Medical Academy in Belgrade, and the study had a retrospective-prospective character. The study included data analysis of 42 patients who were diagnosed with early breast cancer. After a breast conserving surgery was performed on them, with or without adjuvant chemotherapy, they were advised to undergo further treatment with postoperative radiation therapy. Results. All patients (100%) had a skin reaction. As treatment progressed and RD appeared or worsened, there was a tendency to increase in intensity of signs and symptoms. The percentage of mild forms of RD (gr I) was 52.4%, moderate (gr II) 35.7%, medium severe (gr III ) 11.9%, while there were no severe forms in the form of necrosis and ulceration. The average breast volume in RD grade I was 1542ml, grade II 1698ml, grade III 1988ml. The average age of subjects with acute RD grade I is 66 years, grade II 64 years and grade III 58 years. Conclusion. Using the 3D conformal technique, in local postoperative radiation therapy of the breast in the standard mode of fractionation in the supination position, breast volume and age have no statistical significance on the degree of acute skin toxicity.
Contemporary approach to prevention and therapy of the no-reflow phenomenon
No-reflow phenomenon is defined as a state of inadequate (incomplete) myocardial perfusion through a certain segment of the coronary circulation, in the absence of mechanical obstruction of the epicardial coronary artery, i.e. without the presence of significant residual stenosis, spasm, occlusive dissection or intracoronary thrombosis. The development of the no-reflow phenomenon in patients with acute myocardial infarction with ST elevation increases the risk of early clinical complications and mortality many times over. Early intrahospital complications are manifested in the form of hemodynamic instability, acute heart failure including cardiogenic shock, myocardial rupture, and arise as a result of the extension of the area of myocardial necrosis, malignant cardiac arrhythmias, conduction disorders and acute pulmonary edema. The aim of this review is to present the modern aspects of prevention and therapeutic possibilities in patients with the developed no-reflow phenomenon. Prevention involves the application of various strategies before the complete reopening of the occluded infarcted coronary artery, with the aim of preparing the coronary microcirculation for reperfusion. Preventive measures should be directed towards different pathophysiological mechanisms of the no-reflow phenomenon in order to be effective, from the reduction of the total ischemic time, to the application of various pharmacological and non-pharmacological measures. Application of therapeutic measures is necessary in case of unsuccessful prevention and development of no-reflow phenomenon. In this context, therapeutic agents should be effective during current and progressive myocardial circulation damage, and the modern method of primary percutaneous coronary intervention provides the possibility of delivering high local doses of pharmacological agents directly to the infarcted coronary artery, unlike traditional treatment using fibrinolytic therapy.
Risk factors associated with cognitive dysfunction in patients on peritoneal dialysis
Introduction: Cognitive impairments represent a significant global issue, as they deteriorate patients' quality of life, increase mortality and the number of hospitalizations, burden the healthcare system, and raise treatment costs. Aim of procedure: The aim of this research is to determine the prevalence of cognitive dysfunction in patients undergoing peritoneal dialysis. Material and Methods: A cross-sectional study was conducted in May 2024, at the University Clinical Center of Vojvodina, at the Clinic for <nephrology and clinical immunology. The study included 30 patients undergoing peritoneal dialysis. The Montreal Cognitive Assessment (MoCA) was used as the instrument for assessing cognitive dysfunction. The maximum score is 30, and a result of <25 was considered indicative of cognitive dysfunction. Results: Of the 30 patients, 55.2% were male. The most represented age category was ≥60 years, comprising 43.5%. Among comorbidities, hypertension was the most prevalent at 33.3%. Cognitive dysfunction was confirmed in 34% of the patients. A logistic regression model was applied to identify predictors of cognitive dysfunction, revealing that female patients and those over 60 years of age were at a higher risk for cognitive dysfunction. A positive correlation between the MMSE score and the total dialysis adequacy index Kt/V was also identified. Conclusion: Significant predictors of cognitive dysfunction in patients on peritoneal dialysis were female gender, age category (above 60 years), glucose levels, daily and weekly doses of vitamin D, and the dialysis adequacy index Kt/V. Key words: cognitive dysfunction, peritoneal dialysis, risk factors
MODERN APPROACHES IN THE TREATMENT OF OSTEOARTHRITIS OF THE KNEE
Introduction. Arthrosis is a common, primarily non-inflammatory, chronic, slowly progressing disease of the joints, with the most common localization in the knee joint, which is the main cause of chronic disability. As there is still no treatment that can stop the process of joint degeneration, we can only come up with measures to reduce pain and improve the functionality and quality of life of the patient. The aim of this study is to present recommendations for the treatment of gonarthrosis, with special reference to procedures applied at the level of primary health care. Method and material. The research was designed as a review paper. Based on keywords, various databases were reviewed, as well as recommendations from domestic and international rheumatology societies. Results and discussion. According to the Brussels Declaration on Rheumatic and Musculoskeletal Diseases (RMD), these diseases affect more than a quarter of people in Europe. The frequency increases with age, especially in black and yellow females, but it does not have to be an inevitable consequence of aging. The treatment plan for patients with osteoarthritis involves the application of mutually complementary individual measures. The best indicator of the severity of the disease is the presence of pain, so pain treatment is the most important part of the therapy. Treatment can be non-surgical or surgical. Non-surgical is divided into non-pharmacological and pharmacological treatment. Weight loss is the main therapeutic goal. Education includes group counseling which encompasses coping with the disease, self-control, self-help, and a structured exercise program. Pharmacological measures include the use of analgesics and antirheumatic drugs. Protheses, orthotics and a walking stick are recommended aids. Physical procedures: ultrasound, kinesiotherapy, interference currents... Biological therapy is applied according to special protocols. Total arthroplasty is the last therapeutic option. Conclusion. In addition to the prevention of osteoarthritis of the knee, the most important is the application of basic non-pharmacological measures with an emphasis on educating patients and their family members about the disease, self-help, dosage, regular physical exercise and weight reduction. What is most realistically possible to implement in primary health care is to increase the use of non-pharmacological forms of treatment such as weight reduction and regular exercise. The task of the entire society is to raise awareness of degenerative joint diseases and their public health significance, as well as the promotion of healthy lifestyles.
KNOWLEDGE AND ATTITUDES OF STUDENTS ON FIRST AID, CARDIOPULMONARY RESUSCITATION AND AUTOMATED EXTERNAL DEFIBRILLATOR
Cardiac arrest is the leading cause of death in Europe with around 700,000 cases per year. With the use of modern technology, the mortality rate has decreased, but the general population's lack of education about cardiopulmonary resuscitation (CPR) and the use of an automatic external defibrillator (AED) is still a problem. During their academic education, students of the College of Health Sciences Prijedor meet in theoretical and practical classes with CPR and the use of AEDs from various subjects. Aim: The aim of the research is to examine the knowledge and attitudes of students about providing first aid, resuscitation and proper use of AED. Respondents and methods: The research was conducted in 2023 using an anonymous questionnaire taken from author Mikac Lee, which was culturally adapted. Eighty six in-class students of the College of Health Sciences Prijedor participated in the research. The questionnaire consists of sociodemographic data, knowledge of first aid and CPR, as well as the use of AED. The results were processed using SPSS V26 and presented tabularly and graphically. Results: The results showed that most students of all study programs would properly approach a vulnerable person. There was no statistically significant difference in knowledge of the examined items between students of different study programs. Students were divided on the claim that every person is legally obliged to provide first aid to an injured person. Conclusion: It is important to focus attention on the education of other non-medical students, because cardiac arrest can happen anywhere and to anyone, and the environment of the person at risk is a key factor in the survival rate of the person at risk. A high level of education of the population in the field of first aid, resuscitation and the use of AEDs is one of the biggest goals of all health workers.
The influence of physical activity on cognitive functions in the elderly population
It is known that during the aging process, the likelihood of disturbance in cognitive psychic functions such as thinking and memory is increased. Dementia is the basis of age-dependent brain organosynthesis, which today present a serious public health problem. Some authors believe that regular exercise throughout life plays an important role in the prevention of dementia in old age, as well as the general improvement in cognitive abilities. Physical activity is a potential modulator of noradrenaline, serotonin and dopamine transmissions, both in the brain cortex and subcortical structures. It is possible, in this way, that regular physical activity indirectly influences the preservation and normal functioning of a brain cholinergic system that is vital to normal thinking, learning and memory. Also, aerobic muscle activity and exercise may potentially also affect other mental functions such as attention, perception, and emotions, or mood. Some physicians in primary and secondary health care often recommend exercising and practicing sports not only for the prevention of dementia, but also as an ancillary therapeutic agent for most organic and inorganic mental disorders. However, despite numerous studies, some aspects of the effects of physical activity on cognitive functions are still unknown. Molecular and cellular processes occurring in the limbic system during exercise are not sufficiently studied. Also, it is unclear whether and to what extent there are morphological changes in synapses and neuronal organization during physical activity, as well as whether these changes can prevent the development of dementia. The goal of research is to show the impact of physical activity and exercise on cognitive functions during the aging process, as well as the potential importance of exercise in the prevention of cognitive deficits in old age. The paper is written as a review paper. The database in which the search was performed was Medline, PubMed, Cobson. A review of the literature indicated the different views of the authors, as well as their agreement in the field, as well as the positive effects of regular exercise on the health of the elderly, including reduced mortality, reduced risk of falls and improved quality of life.
HEALTH LITERACY OF STUDENTS OF PROFESSIONAL STUDIES IN HEALTH ORIENTATION
According to the definition of the World Health Organization, health literacy includes the cognitive and social skills and capacities needed to access, understand and use information in a way that promotes and protects good health. Reproductive health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and its functions and processes. Objective: The main objective of this research was to determine whether and to what extent the level of health literacy affects the reproductive health of young people. Material and methods: The research belongs to the group of epidemiological studies, conducted according to the type of cross-sectional study. It was carried out in the period from 01. To 17.06.2019. A total of 230 students of professional health studies participated in the research. The questionnaire, in addition to demographic data, contained the S-TOFHLA health literacy test and specially designed questions about reproductive health. Results: Our research showed that six respondents (2.61%) had inadequate health literacy, 80 (34.78%) had marginal health literacy, and 144 (62.61%) had adequate health literacy. literacy. Greater health literacy is associated with sexual activity, number of partners, use of anti-baby pills. Discussion: Health literacy is influenced by many factors, including knowledge of reproductive health, age, gender, sociodemographic factors, economic status, level of education, and more. Insufficient promotion of sexual education in our society, potential mistrust in the official education system and the desire of respondents to independently research this area. Conclusion: More than two thirds of students show the adequate level of health literacy. Students who are older in terms of age and years of study have a higher level of health literacy. This research can serve as a starting point for the creation of new programs on reproductive health and health literacy, especially those aimed at the population of health professionals.
Understanding the influence of digital technology on adolescent mental health and violent behavior
The aim: Examine the degree and nature of digital violence among adolescents. Method: The research was carried out on a sample of adolescents with an average age of 16.07 years who attend the medical school in Ćuprija. The research process was conducted using the survey method and questionnaire technique on a sample of 109 respondents. A range of statistical tests, such as frequency analysis, reliability analysis, t test, and ANOVA test were utilized. The conclusion was reached at the 0.05 level of statistical significance. Results: A total of 11.2% of respondents experienced some form of violence on the Internet, 20.2% received disturbing content or an offensive message, 13.8% were the subject of unwanted filming and sending recorded material to others and 13.8% were harassed by phone. On the other hand, 7.3% of adolescents committed violence against others via the Internet, 9.2% sent disturbing content or an offensive message, 10.1% recorded others on the phone and sent the content to others, 4.6% disturbed others on the phone. No statistically significant differences were identified in the frequency of digital violence depending on the gender and age of adolescents. Conclusion: The use of digital technology to commit violence among adolescents is present, and the most common forms of violence are sending inaccurate and false information to friends and family members, creating and sending false information via chat, spreading rumors, as well as the use of sexual symbols in communication. Key words: digital violence, cyberbullying, adolescents, digital technology
The significance of the correlation between the cell proliferative index KI-67 and the human epidermal growth factor HER2 in breast cancer patients who received neoadjuvant therapy.
Objective. Evaluation of the value of HER2 and Ki-67 expression and determination of their mutual correlation within two-factor analysis models in patients with a pathohistologically confirmed diagnosis of breast cancer, who received neoadjuvant therapy. Methods. The retrospective study includes all breast cancer patients who underwent neoadjuvant and surgical therapy at Serbia's Institute of Oncology and Radiology between 2017 and 2019. HER2 positive status was defined either as a value of 3+ by immunohistochemical analysis or as an amplification of the HER2 gene by in situ hybridization, for values ​​of 2+. Relevant statistical methods were used to test statistical differences: chi-square test, Mann-Whitney U test, and Kruskall Wallis H-test. Results. In the analyzed group of patients, the most frequently determined value of HER2 expression is 1+. By testing the correlation of the Ki-67 cell proliferative index value with HER2 and testing the differences between groups by post hoc analysis on the material obtained by preoperative, core needle biopsy, a statistically significant difference was determined (H=9.020, p=0.029), especially between the HER2 groups (1+) and (3+) (highly statistically significant difference (U=863.5, p=0.005)) and HER2 (2+) and (3+) (statistically significant difference (U=907, p=.036)). Conclusion. The results of our study indicate that the degree of HER2 expression is in a statistically significant and positive correlation with the values ​​of the cell proliferative index Ki-67, which correlates with the results of previous studies and oncological practice, which confirmed that excessive amplification or expression of HER2 is associated with the degree of malignancy and poor prognosis of breast cancer.
Palliative care of patients with Parkinson's disease
Parkinson's disease is a chronic, progressive, neurodegenerative disease that most often affects elderly people. The disease is characterized by a wide range of motor and non-motor symptoms, which, as the disease progresses, lead to significant disability, dependence on other people, and impaired quality of life. Currently, there is no medicine that can cure or stop the progression of the disease. With palliative care with a holistic approach and the involvement of a multidisciplinary team, most symptoms can be kept under control and provide support to caregivers, which significantly contributes to a better quality of life for both patients and their families, i.e., caregivers.
The Role of Breastfeeding in Preserving the Health of Mother and Child
Breastfeeding is the cornerstone of infant and young child survival, nutrition and development and maternal health. Many studies have shown thant women who breastfeed their children have ovarian or breastcarcinoma, cardiovascular diseases and diabetes type 2 rarely. Also, breastffeding is protective factor for postpartal depression, leads to faster weight loss after giving birth, faster return of the uterus, reduces possibility of postpartal hemorrhage. Breastfed children are more intelligent, less likely to develop autistic spectrum, less tendency to develop obesity and allergies, better immunity. At the time of the pandemic Covid 19, center of gravity of health systems of all countries was put on prevention and combat against new infective disease. Family care is neglected. The World Health Organization recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond. According data of World Health organization, in 2015-2021, the percent of infants under six months of age, exclusively breastfed reached 48%, ten percentage points higher than a decade earlier and close to the WHO target of 50% by 2025. The global target for 2030, however, is to reach 70%. Statistical data on the proportion of breastfed children and monitoring of breastfeeding rates in the Republic of Serbia still cannot be obtained from routine health statistics, although they are much needed. To compare and monitor breastfeeding rates, as well as for planning activities related to breastfeeding promotion, data is most often used from MISC, Multiple Indicator Cluster Survey. According to the latest data MISC-a, in the Republic of Serbia 90,4 % children were started breastfeeding, but only 12 % of children are exclusively breastfed unil the age of 6 months.