HEALTH CARE
type: channel
description: Scientific journal Zdravstvena zaštita (journal Health care), which is published by the Chamber of health institution of Serbia since 1972, publishes unpublished original expert and scientific papers, review articles, short announcements, introductions, letters to the editor, meta – analysis, depictions of the patients, current topics, depictions of scientific books and conferences, among other things related to the field of medicine, stomatology, pharmacology, biochemistry and health management. In this way, the magazine contributes to promotion and development of science, as well as expertise and scientific and research work. Most preeminent experts of different profiles and with different scientific titles publish their scientific and research papers in the journal. By means of conveying the selected texts, the pages of Health care represent the testimony, of both the pioneering work of the Chamber, and a kind of history of health care in Serbia alike. Electronic publishing of the journal Health care has been conducted since January 2019, and it is available in the regime of open access since September 2019. Open access enables reading free of charge, downloading, saving, printing and using writings published in the journal to any user that has an internet access. All papers published in Health care can be downloaded for free on the journal’s website: www.komorazus.org.rs/jurnal. The journal is published four times a year. Prior to publishing in Health care, all writings are subject of an internal review (preliminary review of the writing by the editor and/or editorial board) as well as an external review (independent reviews by the experts form the given field, while respecting the anonymity of the author of the review and the author of the paper). Final decision on whether the paper is going to be published is reached on the basis of expertly, ethical, and statistical review. Control for plagiarism is performed before the paper is published, which implies compa…
publisher: KOMORA ZDRAVSTVENIH USTANOVA SRBIJE
language: en
publication name: HEALTH CARE
issn: 0350-3208
items: CRANIOFACIAL METASTASES OF GASTROINTESTINAL ADENOCARCINOMA: A DIAGNOSTIC CHALLENGE
items: ROLE OF MICROBIOLOGY AND INFLAMMATORY BIOMARKERS IN PLANNING RECONSTRUCTIVE TREATMENT OF CHRONIC WOUNDS: LITERATURE REVIEW
items: SPECIFICS OF NURSING CARE FOR PATIENTS WITH AFFECTIVE MOOD DISORDERS
items: ENDOCRINE AND IMMUNOLOGICAL ALTERATIONS IN SEVERE TRAUMA: CONTEMPORARY BIOMARKERS, PROGNOSTIC FACTORS, AND CLINICAL IMPLICATIONS
items: CHALLENGES IN MANAGING THE REPRODUCTIVE CELL DONATION PROGRAM PROCESS IN SERBIA
items: RISK FACTORS FOR ACUTE MYOCARDIAL INFARCTION IN THE REPUBLIC OF SERBIA
items: INCIDENCE OF ACUTE MYOCARDIAL INFARCTION IN THE REPUBLIC OF SERBIA FROM 2006 TO 2022
items: PREVENTION OF ISCHEMIC HEART DISEASE
items: EVALUATION OF PLANNING AND CONSUMPTION OF MEDICAL RESOURCES IN PRIMARY HEALTH CARE IN SERBIA
items: FUNCTIONAL PROFILE AND ASSOCIATED IMPAIRMENTS IN SCHOOL-AGED CHILDREN WITH CEREBRAL PALSY IN SERBIA
items: VOICE DISORDERS IN TRANSGENDER PERSONS: ETIOLOGY, CLINICAL PICTURE AND THERAPEUTIC APPROACHES
items: INCIDENTAL FINDING OF CONTRALATERAL BREAST CANCER IN CONTRALATERAL PROPHYLACTIC MASTECTOMY SPECIMEN: A CASE REPORT
items: PREOPERATIVE, INTRAOPERATIVE AND POSTOPERATIVE PREDICTORS ASSOCIATED WITH COMPLICATIONS AND SURVIVAL OF PATIENTS AFTER COLORECTAL RESECTION
items: LONG-TERM TREND OF BLADDER CANCER MORTALITY IN SERBIA, 1991-2024: A JOINPOINT REGRESSION ANALYSIS
items: PERIPHERAL NERVE SHEATH TUMORS: CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS – A RETROSPECTIVE CASE SERIES OF 46 PATIENTS
items: ATTITUDES AND KNOWLEDGE OF PARENTS OF SCHOOL CHILDREN ABOUT HPV INFECTION AND VACCINATION IN THE COUNTRIES OF THE FORMER YUGOSLAVIA: REVIEW
items: THE IMPACT OF BEHAVIORAL RISK FACTORS ON INFERTILITY
items: AGING AS AN INDICATOR OF CHANGES IN VOICE AND SPEECH QUALITY
items: SrpsEFIKASNOST HPV VAKCINE U PREVENCIJI RAKA GRLIĆA MATERICE I DRUGIH MALIGNOMAki
items: CHARACTERISTICS OF PATIENTS WITH GONORRHEA AND SYPHILIS TREATED AT THE CITY INSTITUTE FOR SKIN AND VENEREAL DISEASES IN BELGRADE IN 2016 AND 2024
items: MICROPHOTOGRAPHIC ATLAS OF NORMAL HISTOLOGY (1925) — PIONEERING CONTRIBUTION OF ALEXANDER Đ. KOSTIĆ TO MEDICAL EDUCATION
items: QUALITY OF LIFE OF PATIENTS ON CHRONIC HEMODIALYSIS PROGRAM IN THE CLINICAL CENTER OF MONTENEGRO
items: THE IMPORTANCE OF THE PASTEUR INSTITUTE IN NOVI SAD FOR THE PREVENTION AND CONTROL OF RABIES IN THE REPUBLIC OF SERBIA
items: THE ROLE OF THE SPEECH THERAPIST IN THE TREATMENT OF HEARING IMPAIRED CHILDREN - THE IMPORTANCE OF EARLY INTERVENTION
items: CHANGES IN THE VALUE OF QUALITY INDICATORS IN THE CAPITATION FORMULA FOR PRIMARY HEALTH CARE IN SERBIA DURING THE PANDEMIC
items: PREDICTORS OF INTENTION TO USE FUNCTIONAL APPLICATIONS FOR MOBILE HEALTH IN THE REPUBLIC OF SERBIA USING THE EXPANDED UTAUT2 METHOD
items: SCLEROSING LYMPHANGITIS OF THE PENIS – A CASE REPORT
items: ACUTE MASTOIDITIS: WHY MANDATORY IMMUNIZATION IS IMPORTANT?
items: mortalitet PREDICTORS OF TREATMENT OUTCOME OF SURGICAL PATIENTS IN THE INTENSIVE CARE UNIT: LITERATURE REVIEW
items: IS KNOWLEDGE OF DIABETES MELLITUS A PREREQUISITE FOR OPTIMAL SELF-CARE AND CONTROL OF THIS DISEASE?

CRANIOFACIAL METASTASES OF GASTROINTESTINAL ADENOCARCINOMA: A DIAGNOSTIC CHALLENGE
type: item
description: Introduction/Aims: Adenocarcinomas of gastrointestinal origin rarely metastasize to the craniofacial region. Such manifestations, especially when associated with suspected leptomeningeal involvement, are characterized by high aggressiveness and a very poor prognosis. The aim of this paper is to present a rare case of a massive craniofacial metastasis from an adenocarcinoma with an atypical presentation and a fulminant clinical course. Case Report: A retrospective analysis of the medical records of a 74-year-old female patient was performed. The patient was admitted to the Emergency Center due to a sudden disturbance in the level of consciousness. Radiology revealed a massive frontoparietal lesion with extensive destruction of craniofacial bones and invasion of the orbit, sphenoid and temporal bones, and the infratemporal fossa. No primary intraparenchymal brain lesions were observed, but radiological findings suggested leptomeningeal involvement. Metastases were also detected in the liver and vertebral bodies (Th1, L1, L3). Histopathological and immunohistochemical analysis of the craniofacial mass biopsy confirmed an adenocarcinoma with an immunophenotype indicative of gastrointestinal origin. Despite intensive multidisciplinary treatment, the clinical course was fulminant, resulting in a lethal outcome on the fourth day of hospitalization. Conclusion: Craniofacial metastases of adenocarcinoma can be the first manifestation of an occult gastrointestinal malignancy. Extensive bone destruction and suspected leptomeningeal dissemination lead to an extremely unfavorable outcome. This case highlights the importance of rapid diagnosis and a high degree of clinical suspicion in patients presenting with atypical cranial bone lesions and acute neurological deterioration.
subject: Case report
  topic: section
subject: Array
  topic: keywords
creator: Dražen Radanović
creator: Dušan Micić
creator: Ana Drakul
creator: Marko Đurović
creator: Mihajlo Ćurčić
creator: Marija Rudić
creator: Vanja Mišić Mandić
creator: Sonja Giljača
creator: Emilija Manojlović Gačić
rights: Copyright (c) 2026 HEALTH CARE
date: 2026-03-06
publication date: 2026-03-06
doi: 10.5937/zdravzast54-63122

ROLE OF MICROBIOLOGY AND INFLAMMATORY BIOMARKERS IN PLANNING RECONSTRUCTIVE TREATMENT OF CHRONIC WOUNDS: LITERATURE REVIEW
type: item
description: Chronic wounds represent a significant clinical and public health burden, with increasing prevalence among elderly and patients with diabetes and vascular diseases. Proper planning of reconstructive treatment requires a comprehensive understanding of microbiological processes and inflammatory biomarkers reflecting wound status. The aim of this study was to analyze contemporary approaches to the diagnosis and planning of reconstructive treatment of chronic wounds, emphasizing the role of microbiology and inflammatory biomarkers. Review of 18 studies published between 2010 and 2025 was presented in the paper, focusing on microbial profiles, inflammatory markers, and reconstructive treatment modalities. The most common microorganisms are Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii. Elevated CRP and IL-6 levels correlate with infection and poor graft outcomes, while normalization indicates readiness for reconstruction. Epidemiological data show an 8–10% annual increase in chronic wound prevalence in Europe, alongside rising bacterial resistance. Microbiological evaluation and biomarker monitoring should be integral to reconstructive planning protocols in chronic wounds. This approach improves outcome prediction, reduces postoperative complications, and promotes rational therapy use.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Jelena Milović
creator: Dražen Radanović
creator: Mihajlo Ćurčić
creator: Vanja Misić Mandić
creator: Marija Rudić
creator: Saša Knežević
creator: Sonja Giljača
rights: Copyright (c) 2026 HEALTH CARE
date: 2026-01-28
publication date: 2026-01-28
doi: 10.5937/zdravzast54-62525

SPECIFICS OF NURSING CARE FOR PATIENTS WITH AFFECTIVE MOOD DISORDERS
type: item
description: Introduction/Aim: Affective mood disorders (AMD) are among the most common psychiatric illnesses of the modern era, with a growing prevalence among the younger population. Unipolar depression, as the most frequent form, represents one of the leading global causes of disease burden and suicide mortality. The aim of this paper is to analyze the specific aspects of nursing care and the role of the nurse in the therapeutic treatment of patients with AMD. Methods: The study applied the method of analyzing professional and scientific literature available in electronic databases (PubMed, NCBI, SCIndex, Google Scholar). The following keywords were used: "affective mood disorders", "nursing care", "nursing interventions", "nurse". The literature that was published in the period 2014-2024 was searched Results: The most prevalent forms of AMD are depressive and bipolar disorders. The etiology is complex, with psychosocial stressors and trauma playing a significant role. Nurses, through therapeutic communication and continuous monitoring, contribute crucially to patient stabilization and the implementation of the therapeutic plan. Conclusion: AMD is characterized by high prevalence and predominance of female gender. Improving the care process through a holistic approach and the standardization of interventions significantly contributes to the quality of treatment and the reduction of the risk of complications.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Isidora Joksimović
creator: Marijana Dabić
creator: Slavica Lazić
creator: Katarina Pavlović Jogović
creator: Vesna R. Jovanović
rights: Copyright (c) 2026 HEALTH CARE
date: 2026-01-26
publication date: 2026-01-26
doi: 10.5937/zdravzast54-62926

ENDOCRINE AND IMMUNOLOGICAL ALTERATIONS IN SEVERE TRAUMA: CONTEMPORARY BIOMARKERS, PROGNOSTIC FACTORS, AND CLINICAL IMPLICATIONS
type: item
description: Severe trauma triggers a complex and dynamic response of the organism that includes simultaneous endocrine, immunological and metabolic alterations with a direct impact on the clinical course and treatment outcome. Hypothalamic-Pituitary-Adrenal (HPA) axis activation, changes in the secretion of catecholamine, disorders of the thyroid function and imbalance of the inflammatory response are key components of the systemic response to traumatic stress. The aim of this review article was to systematize endocrine and immunological biomarkers that have prognostic relevance in patients with severe trauma based on contemporary literature, as well as to review their clinical implications in intensive care medicine. Relevant papers published in the period 2014 to 2025 were reviewed in order to analyze changes in cortisol and catecholamine concentrations, Critical Illness-related Corticosteroid Insufficiency (CIRCI) Syndrome, Non-Thyroid Illness Syndrome (NTIS), as well as inflammatory biomarkers such as Interleukin-6 and C-reactive protein. Special attention was paid to their role in predicting mortality, development of multiple organ dysfunction, respiratory deterioration and septic complications. Available data indicate that early disorders of endocrine axes, especially abnormal patterns of cortisol and thyroid reactions have a significant prognostic values, while inflammatory and transcriptomic biomarkers allow more precise risk stratification in the early stages of critical disease. The integration of endocrine, immunological and metabolic biomarkers with clinical parameters and demographic characteristics of patients is the basis of a modern, personalized approach in the treatment of severe trauma. Further research should be directed towards standardization of diagnostic criteria, optimal sampling time and evaluation of therapeutic interventions, with the aim of improving outcomes and reducing mortality in critically ill patients.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Filip Radović
creator: Mihajlo Ćurčić
creator: Marija Rudić
creator: Ana Drakul
creator: Dražen Radanović
creator: Vanja Misić Mandić
creator: Sonja Giljača
creator: Nikola Slijepčević
rights: Copyright (c) 2026 HEALTH CARE
date: 2026-01-28
publication date: 2026-01-28
doi: 10.5937/zdravzast54-63065

CHALLENGES IN MANAGING THE REPRODUCTIVE CELL DONATION PROGRAM PROCESS IN SERBIA
type: item
description: Introduction/Aim: This study examines the governance challenges in Serbia's egg and sperm donation system. The necessity of donors importing donated reproductive cells requires coordination among clinics, regulatory agencies, and international tissue banks. The main objective is to analyse the roles, responsibilities of key institutions and stakeholders in the donation program, exploring opportunities for system improvement through clinical alignment and analysis of implementation in Fertility clinics. Methods: A descriptive statistical method was applied to the data collected using a questionnaire sent to IVF clinics, utilising the Resposinble, Accoutable, Consulted and Informed (RACI) matrix to define institutional roles, and conducting a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis based on the RACI matrix results. Results: RACI analysis revealed that the Ministry of Health bears the highest number of information responsibilities, confirming its leading, regulatory, and supervisory role. Based on the questionnaire, Clinical Embryologists handle most documentation tasks, including packaging and shipping (47.1%) and communication with tissue banks (58.8%). Most respondents (41.2%) reported that documentation errors rarely occur, while non-compliances from foreign banks were very uncommon (70.6%), and the Ministry's institutional support was viewed as limited. Conclusion: The results highlight a system with unclear and limited strategic communication, utilising the RACI matrix, which proved to be useful in clarifying institutional roles. The SWOT analysis emphasised both strengths (professional capacity) and threats, highlighting that excessive centralisation of roles can overload an institution and slow down processes. Future research should focus on quantitative analyses of clinical outcomes related to the origin and quality of donated material, as well as comparative evaluations of communication between institutions, banks and regulatory bodie…
subject: ORIGINAL ARTICLE
  topic: section
subject: Array
  topic: keywords
creator: Biljana Djordjević
creator: Lela Šurlan
creator: Ana Mitrović Jovanović
creator: Dejan Petrović
rights: Copyright (c) 2026 HEALTH CARE
date: 2026-01-26
publication date: 2026-01-26
doi: 10.5937/zdravzast54-61363

RISK FACTORS FOR ACUTE MYOCARDIAL INFARCTION IN THE REPUBLIC OF SERBIA
type: item
description: Background/Aim: Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality from cardiovascular diseases (CVD) globally. The development of the disease is strongly associated with the presence and interaction of multiple risk factors – non-modifiable (sex, age, family history) and modifiable (hypertension, dyslipidemia, smoking, obesity, physical inactivity, diabetes mellitus, stress). The aim of this study is to analyze the prevalence of key risk factors for AMI among patients with acute coronary syndrome (ACS) treated in coronary care units in the Republic of Serbia (2006–2011), as well as in the general population of Serbia (2012–2022). Furthermore, these findings are compared with European and global averages to better understand the burden of risk factors and provide additional insight into the need for improved national preventive interventions. Methods: A descriptive epidemiological study was conducted. Data on the prevalence of risk factors in hospitalized patients with acute coronary syndrome (ACS) for the period 2006–2011 were retrieved from the annual publications of the "Dr Milan Jovanović Batut" Institute of Public Health of Serbia – the National Registry for Acute Coronary Syndrome. The prevalence of the same risk factors in the general population of the Republic of Serbia for the period 2012–2022 was analyzed using national and international secondary data sources, including reports from the World Health Organization (WHO), the Global Adult Tobacco Survey (GATS), the Global Burden of Disease Study (GBD), the National Health Surveys from 2013 and 2019, and the European Health Interview Survey (EHIS). Risk factors were defined in accordance with the methodology of the data sources used and current international guidelines. Results: A high prevalence of all analyzed risk factors was recorded among patients with ACS hospitalized in coronary care units in the Republic of Serbia. In 2011, approximately 35% of patients were recorded as sm…
subject: ORIGINAL ARTICLE
  topic: section
subject: Array
  topic: keywords
creator: Marija Matić
rights: Copyright (c) 2026 HEALTH CARE
date: 2026-01-27
publication date: 2026-01-27
doi: 10.5937/zdravzast54-63252

INCIDENCE OF ACUTE MYOCARDIAL INFARCTION IN THE REPUBLIC OF SERBIA FROM 2006 TO 2022
type: item
description: Introduction/Aim: Cardiovascular diseases represent the leading cause of mortality worldwide and were responsible for more than 19.8 million deaths in 2022, accounting for 32% of all deaths according to World Health Organization data. Of all deaths due to cardiovascular diseases, as many as 85% were caused by acute myocardial infarction and stroke. The highest number of deaths occurs in countries with low and middle incomes. The aim of this study was to analyze trends in the incidence of acute myocardial infarction in the Republic of Serbia from 2006 to 2022. Methods: Data on newly diagnosed cases of acute myocardial infarction for the period 2006–2022 were obtained from the National Registry for Acute Coronary Syndrome, maintained by the Institute of Public Health of Serbia “Dr Milan Jovanović Batut”, as well as from official Health Statistical Yearbooks of the Republic of Serbia for the observed period. Crude incidence rates (CR) and age-standardized incidence rates adjusted to the European and world standard populations (ASR-E and ASR-W) were analyzed. Results: During the observed period, a decline in age-standardized incidence rates adjusted to the European standard population (ASR-E: 170.9 → 147.4) and to the world standard population (ASR-W: 118.2 → 101.8 per 100,000 population) was observed. Incidence rates varied over time, with the highest age-standardized incidence rate adjusted to the European standard population recorded in 2009 (183.7 per 100,000), and the lowest in 2017 (132.3 per 100,000) (Figure 1). The highest age-standardized incidence rate adjusted to the world standard population ranged from 126.1 per 100,000 in 2009 to 91.0 per 100,000 in 2017. Conclusion: The reduction in age-standardized incidence rates of acute myocardial infarction in the Republic of Serbia from 2006 to 2022 is likely the result of improved control of cardiovascular risk factors, including wider use of statins and modern antihypertensive therapies in primary and secondary pr…
subject: ORIGINAL ARTICLE
  topic: section
subject: Array
  topic: keywords
creator: Marija Matić
rights: Copyright (c) 2026 HEALTH CARE
date: 2026-01-26
publication date: 2026-01-26
doi: 10.5937/zdravzast54-63231

PREVENTION OF ISCHEMIC HEART DISEASE
type: item
description: Ischemic heart disease (IHD) is the leading cause of death globally, while in Serbia, it is responsible for more than 45% of all deaths, which is significantly above the average in the European Union. It occurs as a result of atherosclerosis of coronary arteries, and the main risk factors include smoking, hypertension, dyslipidemia, diabetes, obesity, physical inactivity, unhealthy diet and stress. Prevention as the foundation of public health and health policies of each country includes a range of measures and activities aimed at preserving and improving health, preventing the occurrence of diseases and complications, as well as reducing mortality and disability in the population at the primordial, primary, secondary and tertiary level. Key measures include the adoption of healthy lifestyle habits: balanced Mediterranean diet, regular physical activity (at least 150 minutes of moderate exercise per week), maintaining a healthy weight and quitting smoking. Controlling biological risk factors, such as hypertension, diabetes and high cholesterol, is also essential. A screening program within primary prevention plays an important role in the early detection of individuals at increased risk for IHD. Secondary prevention includes adequate treatment and measures to prevent further complications in patients who already suffer from IHD. This includes pharmacological therapy (antiaggregation drugs, beta-blockers, statins), invasive procedures such as coronary interventions or bypass surgery, as well as changing unhealthy habits. Tertiary prevention is aimed at patient rehabilitation, the reduction of complications and the improvement of the quality of life. Although recommendations for prevention are clearly defined, their implementation emerged as a challenge in Serbia. Better coordination, continuous education of the population and improvement of the health care system, especially in the field of post-hospital rehabilitation, are necessary. A comprehensive, integrated appr…
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Olivera Ninković
creator: Sandra Grujičić Šipetić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-12-02
publication date: 2025-12-02
doi: 10.5937/zdravzast54-61636

EVALUATION OF PLANNING AND CONSUMPTION OF MEDICAL RESOURCES IN PRIMARY HEALTH CARE IN SERBIA
type: item
description: Introduction/Aim: Efficient planning and consumption of medicines, medical and sanitary supplies, and laboratory reagents within the framework of Serbia's primary health care directly affect therapy availability, service quality, and the rational use of budgetary resources. Although a formal framework for centralized procurement exists, practice reveals significant discrepancies in criteria, procedures, and institutional approaches. The aim of this study was to examine how health care institutions plan their needs, what decision-making criteria they use, and the role of the Republic Health Insurance Fund (RHIF) in the evaluation and implementation of these plans. Methods: A quantitative study was conducted among 136 primary health care institutions and 26 RHIF branches, using a questionnaire designed in accordance with valid regulations and professional methodological guidelines. Data were analyzed in the Excel environment, using a binary matrix and thematic classification of responses. Results: Most institutions (84.6%) rely on historical consumption and RHIF guidelines, while only 8.8% use economic criteria. A multicriteria approach is used by just 5.1% of institutions. Internal evaluation is absent in 26.5% of cases, and information systems are mostly used for administrative purposes. A pattern of planning without analytical verification was observed, along with frequent shifting of responsibility to RHIF, which stated in its response that it did not perform evaluations nor apply analytical tools. Conclusion: Although the planning system formally meets regulatory requirements, it lacks an analytical foundation and functional evaluation. Establishing a standardized model based on clinical, economic, and epidemiological indicators, along with an active evaluative role of RHIF and two-way institutional feedback, represents a key step toward more rational and equitable management of health care resources.
subject: ORIGINAL ARTICLE
  topic: section
subject: Array
  topic: keywords
creator: Đorđe Jocić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-11-30
publication date: 2025-11-30
doi: 10.5937/zdravzast54-60283

FUNCTIONAL PROFILE AND ASSOCIATED IMPAIRMENTS IN SCHOOL-AGED CHILDREN WITH CEREBRAL PALSY IN SERBIA
type: item
description: Introduction/Aim: Cerebral palsy is a permanent and heterogeneous condition that requires continuous, comprehensive support from multiple service providers, including healthcare professionals. Information on functional characteristics of individuals with cerebral palsy is necessary for effective service planning and counselling families in a clinical context. However, no national database or register is available in Serbia. This descriptive and exploratory study aimed to examine functional characteristics and frequency of associated impairments in a sample of school-aged children with cerebral palsy in Serbia. Methods: A convenience sample of 117 children and adolescents with cerebral palsy (56.4% male), aged 7–18 years (M = 13.23, SD = 3.36), was analysed. Data on cerebral palsy type, gross motor function, fine manual and bimanual abilities, intellectual functioning, sensory impairments (visual, hearing), epilepsy, and general health problems were extracted from available medical, educational, and psychological records. Descriptive statistics were used for analysis. Results: Spastic cerebral palsy was the most common type (65.8%), frequently accompanied by intellectual disability (67.5%), visual impairment (33.3%), and epilepsy (24.7%). Nearly two-thirds (64.1%) of participants had two or more associated impairments. The majority exhibited limitations in ambulation, manual performance, and fine motor skills. Conclusion: The basic functional characteristics and frequency of associated impairments were generally in line with national and international reports, with some differences observed in comorbidity patterns. The high prevalence of multiple health and developmental challenges underscores the urgent need for a national cerebral palsy registry in Serbia.
subject: ORIGINAL ARTICLE
  topic: section
subject: Array
  topic: keywords
creator: Milena Milićević
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-11-30
publication date: 2025-11-30
doi: 10.5937/zdravzast54-60883

VOICE DISORDERS IN TRANSGENDER PERSONS: ETIOLOGY, CLINICAL PICTURE AND THERAPEUTIC APPROACHES
type: item
description: Voice disorders in transgender people represent a significant challenge in the process of gender affirmation, because the voice directly affects the perception of gender identity and psychosocial well-being. The aim of this paper is to provide a comprehensive overview of the etiology, clinical picture and therapeutic approaches of voice disorders in transgender people. Hormonal, anatomical and psychosocial factors influencing voice changes, typical symptoms and acoustic characteristics, as well as various treatment methods, including vocal therapy, phonosurgery and a multidisciplinary approach, were analyzed. Hormone therapy in trans men leads to significant voice changes, while in trans women it is often not enough to achieve the desired gender perception, and additional vocal therapy or phonosurgery is needed. Vocal therapy, when necessary, phonosurgery are effective methods for voice correction, and a multidisciplinary approach enables optimal outcomes and improvement of quality of life. However, the lack of standardized protocols and longitudinal studies highlights the need for further research and individualization of therapy. In conclusion, successful intervention in voice disorders in transgender persons requires the integration of medical, speech therapy and psychological methods, with the aim of achieving voice function that is consistent with gender identity and supporting psychosocial well-being.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Ivana Ilic Savic
creator: Mirjana Petrović-Lazić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-11-30
publication date: 2025-11-30
doi: 10.5937/zdravzast54-62243

INCIDENTAL FINDING OF CONTRALATERAL BREAST CANCER IN CONTRALATERAL PROPHYLACTIC MASTECTOMY SPECIMEN: A CASE REPORT
type: item
description: Introduction/Aim: Prophylactic mastectomy may be performed in women with high genetic or familial risk, or unilaterally alongside therapeutic mastectomy. Although malignancy is not expected in prophylactic specimens, incidental contralateral breast cancer (CBC) may alter management and prognosis. The aim of this study is to present a clinical case of the incidental finding of contralateral breast carcinoma (CBC) in a tissue specimen obtained through contralateral prophylactic mastectomy (CPM) in a 46-year-old patient who had been initially diagnosed with ductal carcinoma in situ (DCIS) in the opposite breast. Case report: We report a 46-year-old woman initially diagnosed with ductal carcinoma in situ (DCIS) of the right breast. After declining adjuvant radiotherapy, she opted for bilateral nipple-sparing mastectomy with direct-to-implant reconstruction. Histopathology confirmed DCIS with a focal invasive component in the right breast and unexpectedly revealed three microscopic focuses of DCIS in the contralateral breast, alongside fibrocystic changes and atypical ductal hyperplasia. Discussion: The annual incidence of CBC is estimated at 0.5-0.75%. Examination of contralateral prophylactic mastectomy (CPM) specimens may uncover high-risk lesions (ADH, ALH, LCIS) or, rarely, invasive carcinoma. Such findings highlight the diagnostic potential of CPM and the importance of multidisciplinary evaluation when selecting candidates for risk-reducing surgery. Conclusion: Although CPM does not consistently improve overall survival, it can contribute to individualized risk reduction, simplified surveillance, and reduced anxiety in selected patients. This case underscores its diagnostic value in detecting occult contralateral malignancy and reinforces the need for personalized surgical planning within a multidisciplinary framework.
subject: Case report
  topic: section
subject: Array
  topic: keywords
creator: Dimitrije Kosovac
creator: Branko Suđecki
creator: Olivera Kosovac
creator: Marko Jevtić
creator: Gordana Pupić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-11-06
publication date: 2025-11-06
doi: 10.5937/zdravzast54-62489

PREOPERATIVE, INTRAOPERATIVE AND POSTOPERATIVE PREDICTORS ASSOCIATED WITH COMPLICATIONS AND SURVIVAL OF PATIENTS AFTER COLORECTAL RESECTION
type: item
description: Colorectal cancer is the third most commonly diagnosed form of all cancers, and the second deadliest cancer worldwide. The International Agency for Research on Cancer (IARC) estimates that the global burden of colorectal cancer on society will increase by 60%, representing more than 2.2 million new cases and 1.1 million deaths by the year 2030. The aim of this review paper is to show which predictors, at hat point in the course of the disease, and in what way they influence the occurrence of postoperative complications and the survival of patients with colorectal cancer. Elevated levels of inflammatory markers, poor nutritional status, a higher category of the ASA (American Society of Anesthesiologists) physical status classification, and poor lifestyle habits represent significant independent predictors of poor survival and increase the risk of developing postoperative complications after resection. Intraoperatively, longer duration of the operation and significant blood loss during surgery contribute to poor outcomes. Postoperative complications (anastomotic leakage, postoperative bleeding, intra-abdominal abscess, stoma complications, general complications) independently increase the risk of mortality after surgery.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Teodora Marković
creator: Sandra Grujičić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-11-30
publication date: 2025-11-30
doi: 10.5937/zdravzast54-61637

LONG-TERM TREND OF BLADDER CANCER MORTALITY IN SERBIA, 1991-2024: A JOINPOINT REGRESSION ANALYSIS
type: item
description: Introduction/Aim: Bladder cancer is among the main urological diseases. Bladder cancer mortality trends vary significantly worldwide. This research sought to assess temporal trends in deaths due to bladder cancer in Serbia. Methods: This was a population-based descriptive epidemiological study. Bladder cancer mortality data were obtained from an official database. Direct standardization with the World standard population was used to compute the age-standardized rates (ASRs) per 100,000. Joinpoint regression analysis was employed to assess temporal trends in bladder cancer mortality using the average annual percentage change (AAPC) alongside its 95% confidence interval (95% CI) over the 1991-2024 period. Results: During the period 1991-2024, almost 20,000 deaths due to bladder cancer (about 15,000 among men and 5,000 among women) occurred in Serbia. Average annual ASR of mortality from bladder cancer was notably higher among males than females (5.94 versus 3.87 per 100,000, respectively). Significant increases in bladder cancer mortality trends were recorded for both males (AAPC=0.6%; 95% CI=0.4 to 0.9) and females (AAPC=1.3%; 95% CI=1.0 to 1.5). The male and female trends were not parallel, as the final selected model rejected parallelism (p = 0.008). A significant increase in bladder cancer mortality in women was recorded in middle age (age groups 55 to 69 years), while in men a more pronounced increase was observed in older people (age groups 70 and older). Conclusion: An increase in bladder cancer mortality during more than three decades in Serbia implies that further analytical research is needed.
subject: ORIGINAL ARTICLE
  topic: section
subject: Array
  topic: keywords
creator: Irena Ilić
creator: Milena Ilić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-11-30
publication date: 2025-11-30
doi: 10.5937/zdravzast54-61834

PERIPHERAL NERVE SHEATH TUMORS: CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS – A RETROSPECTIVE CASE SERIES OF 46 PATIENTS
type: item
description: <!-- [if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> <w:LidThemeOther>HR</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> <w:SplitPgBreakAndParaMark/> <w:EnableOpenTypeKerning/> <w:DontFlipMirrorIndents/> <w:OverrideTableStyleHps/> </w:Compatibility> <m:mathPr> <m:mathFont m:val="Cambria Math"/> <m:brkBin m:val="before"/> <m:brkBinSub m:val="--"/> <m:smallFrac m:val="off"/> <m:dispDef/> <m:lMargin m:val="0"/> <m:rMargin m:val="0"/> <m:defJc m:val="centerGroup"/> <m:wrapIndent m:val="1440"/> <m:intLim m:val="subSup"/> <m:naryLim m:val="undOvr"/> </m:mathPr></w:WordDocument> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true" DefSemiHidden="true" DefQFormat="false" DefPriority="99" LatentStyleCount="267"> <w:LsdException Locked="false" Priority="0" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Normal"/> <w:LsdException Locked="false" Priority="9" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="heading 1"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name…
subject: Case series
  topic: section
subject: Array
  topic: keywords
creator: Mihajlo Ćurčić
creator: Dražen Radanović
creator: Andrija Savić
creator: Sonja Giljača
creator: Milutin Mrvaljević
creator: Vanja Misić Mandić
creator: Marija Rudić
creator: Lukas Rasulić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-08-29
publication date: 2025-08-29
doi: 10.5937/zdravzast54-60632

ATTITUDES AND KNOWLEDGE OF PARENTS OF SCHOOL CHILDREN ABOUT HPV INFECTION AND VACCINATION IN THE COUNTRIES OF THE FORMER YUGOSLAVIA: REVIEW
type: item
description: In 2022, cervical cancer was the fourth most common cancer among women worldwide, with over 660,000 new cases annually. It is caused by persistent infection with the human papillomavirus (HPV). The key measures for cervical cancer prevention are screening (Pap test) and the HPV vaccine. As of 2023, six types of HPV vaccines are available worldwide. According to the World Health Organization (WHO) strategy, if vaccination coverage of girls up to the age of 15 were to reach 90%, the disease could be eliminated. However, WHO member states have not yet exceeded a coverage rate of 55%, while the countries of the former Yugoslavia show significantly lower rates. The aim of this review paper is to analyze parents’ attitudes and knowledge regarding HPV vaccination of their children in the countries of the former Yugoslavia. Electronic databases (PubMed, Scopus, and Google Scholar) were searched using the following keywords in English: parental attitudes, vaccine acceptance, vaccine hesitancy, and HPV vaccine. Four articles meeting the inclusion criteria were identified. The analyzed studies showed that pediatricians’ recommendations have the greatest influence on parents’ acceptance of HPV vaccination. Studies conducted in Serbia found that girls are vaccinated more often than boys. Parents stated that HPV vaccination is insufficiently promoted, and that more attention should be dedicated to this issue in the future. It has been observed that parents are the target population for implementing educational interventions on HPV infection and vaccination in order to achieve higher coverage with this vaccine.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Katarina Pavić
creator: Nikola Savić
creator: Dušica Perović
creator: Goran Malenković
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-08-21
publication date: 2025-08-21
doi: 10.5937/zdravzast54-59331

THE IMPACT OF BEHAVIORAL RISK FACTORS ON INFERTILITY
type: item
description: Behavioral factors are modifiable risk factors that can significantly influence the development of various health conditions and diseases. Literature suggests that these factors may also have a detrimental effect on fertility. The aim of this review paper was to present the contribution of behavioral factors to the development of infertility in both sexes through the analysis of scientific literature, and to propose preventive measures. The following databases were searched: MEDLINE, PubMed, and KOBSON. Subsequently, an analysis was conducted on the collected data from clinical and other epidemiological studies published over the past 30 years. Research findings indicate that diets rich in dietary fiber, omega-3 fatty acids, plant-based proteins, vitamins, and minerals positively influence fertility in both men and women. Conversely, diets high in processed foods, trans fats, and refined carbohydrates have been shown to have a negative impact on fertility. Moderate physical activity plays a critical role in maintaining an optimal body mass index and improving ovarian function. However, intensive physical activity, due to its effect on the hypothalamic-pituitary axis, can lead to hypothalamic amenorrhea and subsequent infertility. Smoking, alcohol abuse, and the use of psychoactive substances adversely affect fertility in both sexes, as well as fetal development. A balanced and healthy diet, moderate physical activity, prevention of sexually transmitted infections, and the design and implementation of targeted infertility prevention strategies can significantly improve fertility outcomes and contribute to safe motherhood.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Kristina Stamenković
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-08-29
publication date: 2025-08-29
doi: 10.5937/zdravzast54-60875

AGING AS AN INDICATOR OF CHANGES IN VOICE AND SPEECH QUALITY
type: item
description: During the aging process, certain changes occur in the voice and speech. A person's voice changes during aging, becoming more unstable, less flexible, and hoarseness occurs. This study aims to analyze the effects of aging on voice frequency, voice intensity, and the rhythm and tempo of speech. The literature was studied using electronic databases, in particular Google Scholar Advanced Search and the Serbian Library Consortium for Coordinated Acquisition - KoBSON. The results show that there is a deterioration in the acoustic parameters of the voice (voice frequency and intensity) with age. It has also been observed that the aging process in the voice is more pronounced in women than in men. This can be explained by hormonal changes that are especially pronounced in women during menopause. After the age of sixty, the intensity of the voice becomes lower regardless of the person's gender. Depending on the person's age, the rhythm and tempo of speech also change. It was found that older subjects take longer to pronounce certain sounds, which is associated with a delay in the onset of phonation when pronouncing alveolar and bilabial sounds, which is most often attributed to jaw degradation. Studies show that voice and speech aging occurs gradually and as expected, with clearly expressed consequences for everyday life, which should be taken into account in clinical practice in order to improve the quality of life of older people.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Ivana Ilić Savić
creator: Mirjana Petrović-Lazić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-08-22
publication date: 2025-08-22
doi: 10.5937/zdravzast54-58451

SrpsEFIKASNOST HPV VAKCINE U PREVENCIJI RAKA GRLIĆA MATERICE I DRUGIH MALIGNOMAki
type: item
description: Human papillomavirus (HPV) infection is one of the most widespread sexually transmitted infections globally, responsible for a significant number of cases and deaths annually. It is one of the risk factors for cervical cancer, oral and pharyngeal cancer, vaginal cancer, vulvar cancer, penile cancer, and anal cancer, and it also causes genital warts. The introduction of licensed, globally recognized prophylactic HPV vaccines (e.g., Cervarix, Gardasil, Gardasil 9, Cecolin, Walrinvax, and Cervavac), based on virus-like particles (VLPs) made from viral protein components but without the virus's genetic material, has significantly contributed to reducing the number of cervical cancer cases, especially in highly developed countries where screening tests (Pap tests) are also used. Despite the introduction and implementation of these vaccines, HPV-related malignancies continue to be a global problem. The aim of this review is to analyze the effectiveness of the HPV vaccine in preventing cervical cancer and other malignant tumors.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Sara Simanić
creator: Sandra Grujičić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-08-22
publication date: 2025-08-22
doi: 10.5937/zdravzast54-59790

CHARACTERISTICS OF PATIENTS WITH GONORRHEA AND SYPHILIS TREATED AT THE CITY INSTITUTE FOR SKIN AND VENEREAL DISEASES IN BELGRADE IN 2016 AND 2024
type: item
description: Introduction/Aim: Gonorrhea and syphilis are common bacterial sexually transmitted infections, with a continuous increase being recorded worldwide. This rise is explained by the increase in risky sexual behaviors, meeting sexual partners through mobile applications, engaging in chemsex, as well as more frequent testing for these sexually transmitted infections among vulnerable groups. The aim of this study was to determine whether there are differences in the characteristics of patients with gonorrhea and syphilis treated at the City Institute for Skin and Venereal Diseases in Belgrade during 2016 and 2024, and to identify factors that influence the current epidemiological situation related to gonorrhea and syphilis. Methods: Data on basic demographic characteristics, sexual orientation, HIV status, and history of previous sexually transmitted infections among patients with gonorrhea and syphilis were collected from electronic medical records and partner notification forms of individuals diagnosed with these infections. The statistical analysis of the data was performed using the χ² test and Student's t-test. Results: Patients diagnosed with gonorrhea in 2024, compared to those diagnosed in 2016, were significantly more often male (p<0.001), unmarried (p<0.001), had a higher level of education (p<0.001), were employed (p<0.001), foreign citizens (p<0.001), with a homosexual orientation (p<0.001), had a history of both gonorrhea and syphilis in their personal medical records (p<0.001), and were more often diagnosed with gonorrhea through sampling from extra genital sites (p<0.001). Patients diagnosed with syphilis in 2024, compared to those from 2016, were significantly more often unmarried (p<0.001), had a higher level of education (p<0.05), were employed (p<0.001), foreign citizens (p=0.01), with a homosexual orientation (p=0.001), and had a history of both gonorrhea and syphilis in their personal medical records (p=0.01). Conclusion: More frequent testing for gono…
subject: ORIGINAL ARTICLE
  topic: section
subject: Array
  topic: keywords
creator: Milan Bjekić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-08-21
publication date: 2025-08-21
doi: 10.5937/zdravzast54-59641

MICROPHOTOGRAPHIC ATLAS OF NORMAL HISTOLOGY (1925) — PIONEERING CONTRIBUTION OF ALEXANDER Đ. KOSTIĆ TO MEDICAL EDUCATION
type: item
description: During its early years, the Faculty of Medicine faced numerous challenges, one of which was the lack of medical literature, especially in the Serbian language, which was particularly pronounced. In histology, an additional challenge was the presentation and identification of microscopic specimens during practical classes because it relied solely on drawings. An innovation in teaching was introduced in 1925 with the Microphotographic Atlas of Normal Histology, authored by Aleksandar Kostić. It was the first histological atlas intended for students of the Medical Faculty in Belgrade and one of the first in the world to contain complete microphotographs. Kostić prepared the set of microphotographs for the atlas in the Photography Department, established at the Institute in 1924. By publishing this atlas, Aleksandar Kostić established his scientific-photographic mission, making him a pioneer in medical photography both in Serbia and in the then Kingdom of Serbs, Croats, and Slovenes.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Nela Puškaš
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-08-23
publication date: 2025-08-23
doi: 10.5937/zdravzast54-59486

QUALITY OF LIFE OF PATIENTS ON CHRONIC HEMODIALYSIS PROGRAM IN THE CLINICAL CENTER OF MONTENEGRO
type: item
description: Introduction/Aim: Health-related quality of life (HRQoL) is one of the key predictors of mortality and hospitalization in patients undergoing hemodialysis (HD) due to terminal kidney failure. The aim of our study was to examine the HRQoL of individuals with terminal chronic kidney disease who are undergoing HD at the Hemodialysis Center of the Clinical Center of Montenegro (CCM). Methods: A cross-sectional study included 43 participants with terminal chronic kidney disease who were on HD during January 2025 at the Hemodialysis Center of CCM. Data were collected from participants using a general and standardized anonymous questionnaire, the Kidney Disease Quality of Life Short Form (KDQOL-SF™) (Serbian version). Pearson's correlation coefficient was used for data analysis. Results: There is a significant negative correlation between the perception of success and satisfaction with the impact of kidney disease on daily activities (r = -0.45; p < 0.001). Satisfaction with treatment in HD patients is lower when the impact of kidney disease on their lives is greater (r = -0.47; p < 0.001). Sexual functioning issues are more pronounced when the impact of the disease on mental health is greater (r = 0.54; p < 0.001), as well as when there is more preoccupation with the disease during daily activities (r = 0.67; p < 0.001) and when the impact of kidney disease on life is greater (r = 0.46; p < 0.001). Conclusion: Further research is needed in this area to assess the quality of life of individuals with chronic kidney disease undergoing HD in relation to demographic and clinical parameters, as well as to identify independent predictors of quality of life.
subject: ORIGINAL ARTICLE
  topic: section
subject: Array
  topic: keywords
creator: Damir Peličić
creator: Tanja Boljević,
creator: Milena Raspopović
creator: Mitar Saveljić
creator: Damira Murić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-04-01
publication date: 2025-04-01
doi: 10.5937/zdravzast54-56260

THE IMPORTANCE OF THE PASTEUR INSTITUTE IN NOVI SAD FOR THE PREVENTION AND CONTROL OF RABIES IN THE REPUBLIC OF SERBIA
type: item
description: Rabies is a deadly zoonotic disease that occurs in more than 150 countries and represents a public health issue for over three billion people worldwide. In Europe, rabies in animals is present in Ukraine, Belarus, Poland, Moldova, Russia, and Romania, with isolated cases reported in other countries as well. The highest number of human rabies cases is found in Asia and Africa. The aim of this review paper is to present the significance of the Pasteur Institute in Novi Sad in the control and prevention of rabies in the Republic of Serbia. Data for this paper were collected from various databases (Web of Science, PubMed, Google Scholar), bulletins, etc. The Pasteur Institute in Novi Sad is the National Reference Health Institution for rabies in the Republic of Serbia. All activities necessary in the fight against rabies are covered within this institution: providing anti-rabies protection to people at risk of rabies through the administration of cell culture rabies vaccines and human rabies immunoglobulin (HRIG); preventive immunization of high-risk populations; providing expert methodological assistance and professional supervision of the work of 27 anti-rabies stations (ARS) in the Republic of Serbia; supplying HRIG and rabies vaccines to all ARS; establishing doctrinal and professional medical guidelines in the field of anti-rabies protection; monitoring the occurrence of rabies; preparing reports and informing ARS and government authorities about every registered case of rabies in the country; proposing and implementing measures for its control; diagnosing rabies within the national reference laboratory for rabies; and controlling the achieved immunity following the immunization of people and animals. The regional project of oral vaccination of foxes against rabies has been implemented in the territory of the Republic of Serbia since 2010, and monitoring of vaccination effectiveness has been conducted since 2011. In the Republic of Serbia, urban rabies was eliminat…
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Dragana Gazibara
creator: Marko Ključar
creator: Verica Simin
creator: Ivana Bogdan
creator: Dragana Mijatović
creator: Andrea Stojšić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-03-31
publication date: 2025-03-31
doi: 10.5937/zdravzast54-56980

THE ROLE OF THE SPEECH THERAPIST IN THE TREATMENT OF HEARING IMPAIRED CHILDREN - THE IMPORTANCE OF EARLY INTERVENTION
type: item
description: The aim of this review is to present the relationship between early intervention in speech rehabilitation and the success of speech therapists in speech habilitation in hearing impaired children. Proper hearing is one of the most important prerequisites for the proper development of speech, because speech is learned by listening. It is necessary for parents to turn to a speech therapist for help if the child's vocalization is absent or stops suddenly, if he does not respond to sounds from the environment, if he does not turn to the call of the interlocutor who is not in his field of vision, if he does not respond to simple verbal commands, if during the conversation he focuses strongly on the face of another person, if he approaches the sound source or tries to amplify the sound, as well as if there is a lack of socialization with to family members. Early treatment of children with hearing impairment involves a series of stimulating activities aimed at improving the child's development, especially the development of speech and auditory attention. The modern approach to speech and language habilitation places great emphasis on the development of verbal communication, which is crucial for the common life of children with hearing impairments and hearing children, especially in the period when children want to socialize with their peers. Early intervention is critical because a child's brain develops faster from conception to age three than at any time later in life. Children who are involved in the process of installing a cochlear implant before the age of one have a greater chance of achieving their full potential compared to children who are implanted around the age of three.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Ivana Ilić Savić
creator: Mirjana Petrović-Lazić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-03-31
publication date: 2025-03-31
doi: 10.5937/zdravzast54-56645

CHANGES IN THE VALUE OF QUALITY INDICATORS IN THE CAPITATION FORMULA FOR PRIMARY HEALTH CARE IN SERBIA DURING THE PANDEMIC
type: item
description: Introduction/Aim. The COVID-19 pandemic created new challenges and assignments for primary care, affecting routine health services. This study aimed to measure the changes in the values of the performance indicators that are part of the capitation formula in Serbia using data obtained from the National Health Insurance Fund. Methods. Data were analyzed at the national level. The indicator change was measured as the absolute difference in the indicator’s values between 2020 and 2019. Results. In the healthcare services for adults, the values of three indicators related to lifestyle advice increased in 2020 between 3.0% and 3.8%, while the values of indicators related to diabetes, arterial hypertension, and among patients with previous myocardial infarction have decreased in the range of 0.5% to 2.4%. The values of indicators associated with counseling obese children, the adequate number of check-ups of newborns, and services related to early detection and counseling among pregnant women increased by 1.2% to 10.2 %. The other indicators recorded a decline in their value up to 9.9%. Conclusion. Despite the obstacles faced during the COVID-19 pandemic, primary healthcare has played and continues to play a substantial role in preserving and improving the population’s health.
subject: ORIGINAL ARTICLE
  topic: section
subject: Array
  topic: keywords
creator: Aleksandar Medarević
creator: Olivera Ninković
creator: Periša Simonović
creator: Milena Vasić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-04-02
publication date: 2025-04-02
doi: 10.5937/zdravzast54-56863

PREDICTORS OF INTENTION TO USE FUNCTIONAL APPLICATIONS FOR MOBILE HEALTH IN THE REPUBLIC OF SERBIA USING THE EXPANDED UTAUT2 METHOD
type: item
description: Introduction/Aim: Health mobile applications provide an opportunity for each user to proactively monitor and manage their health. The mHealth mobile application uses the latest technology with the aim of making healthcare more accessible and affordable to more users. The aim of this paper was to identify factors, defined according to the expanded UTAUT2 (Unified Theory of Acceptance and Use of Technology) model, which have an impact on the intention to use mobile health applications (mHealth) in the Republic of Serbia. Methods: The cross-sectional study included 64 respondents (opportunity sample), former students, teachers and associates of the Academy of Vocational Studies in Western Serbia, who filled out an online questionnaire in the period May - November 2024. Cronbach's coefficient α, Pearson correlation coefficient and regression analysis were used in the data analysis. Results: Five of the 7 elements (Performance Expectancy - PE, Effort Expectancy - EE, Social Influence - SI, Price Value - PV and Facilitating Conditions - FC) of the UTAUT2 model are significant predictors of respondents' intention to accept and use mHealth mobile application services. Habit (H) elements and hedonic motivation (HM) have no significant effect on the use of mHealth mobile applications. Correlation analysis indicates that behavioral intention (BI) correlates significantly strongly positively with EE, facilitating conditions - FC and PE, and significantly positively but weakly with SI and PV. No significant correlation was found with HM and H. Conclusion: Further research in this area is necessary, especially research related to the testing and use of a specific mobile application for mHealth according to the elements of the UTAUT2 model.
subject: ORIGINAL ARTICLE
  topic: section
subject: Array
  topic: keywords
creator: Miloš Mijić
creator: Branko Ćebić
creator: Slobodanka Bogdanović Vasić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-04-01
publication date: 2025-04-01
doi: 10.5937/zdravzast54-57136

SCLEROSING LYMPHANGITIS OF THE PENIS – A CASE REPORT
type: item
description: Background/Aim: Sclerosing lymphangitis of the penis is a rare non-infectious condition that most commonly occurs in young sexually active individuals. It is characterized by the sudden appearance of a painless, band-like thickening in the area of the coronal sulcus, which is preceded by intense sexual intercourse or masturbation. The aim of this paper was to present a patient with the characteristic clinical picture of non-venereal sclerosing lymphangitis of the penis and to remind healthcare professionals, particularly dermatologists and urologists, of this rare condition. Case report: A 32-year-old male in good general health presented to a dermatologist with a painless thickening on the shaft of the penis that appeared after intense sexual intercourse. Clinical examination revealed the presence of a painless, translucent, thick, band-like structure with a cartilaginous consistency behind the corona of the glans, without enlargement of regional lymph nodes. Serological tests for syphilis did not indicate recent infection. The patient was advised to refrain from sexual activity, and after four weeks, the changes had resolved. Conclusion: Sclerosing lymphangitis of the penis is a rare benign, non-infectious condition that occurs in younger sexually active individuals and often causes concern. It can present a diagnostic challenge for healthcare providers due to its clinical similarity to superficial penile vein thrombophlebitis or atypical early syphilitic penile lesions. Therefore, it is important that urologists and dermatologists do not overlook it in their daily practice.
subject: Case report
  topic: section
subject: Array
  topic: keywords
creator: Milan Bjekić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-03-31
publication date: 2025-03-31
doi: 10.5937/zdravzast54-57565

ACUTE MASTOIDITIS: WHY MANDATORY IMMUNIZATION IS IMPORTANT?
type: item
description: Introduction/Aim. Acute mastoiditis (AM) is a serious bacterial infection of the mastoid bone that occurs as a consequence of acute otitis media (AOM). Although mastoiditis can occur at any age, the majority of patients are less than two years of age, with a median age of 12 months. The infection is most often caused by Streptococcus pneumoniae. After antibiotics and pneumococcal vaccination, 0,002% of children with AOM progress too acute coalescent mastoiditis. The aim of this study is to present the case of a four-year-old girl with AM who was found not vaccinated by pneumococcal conjugated vaccine according to the mandatory immunization schedule of the Republic of Serbia. Case report. We describe the case of a four-year-old girl with AM, where we found that she was not regularly vaccinated by pneumococcal conjugated vaccine. The girl was presenting with irritability, fussiness, fever, ear pain, red and swollen retroauricular skin. The inflammatory markers were elevated. Due to the suspicion of acute mastoiditis, a CT scan of the endocranium was performed, which confirmed the diagnosis. Timely initiation of parenteral antimicrobial therapy with surgical retroauricular incision and drainage of the periosteal abscess, mastoidectomy and myringotomy perfomed on the girl led to an improvement in the general condition, and Streptococcus pneumoniae was isolated in the drained contents. Conclusion. By presenting the case of an unvaccinated child who suffered from acute mastoiditis caused by a vaccine preventable disease we once again wanted to draw attention to the importance of timely immunization.
subject: Case report
  topic: section
subject: Array
  topic: keywords
creator: Mirjana Makević Đurić
creator: Milivoje Djurić
creator: Biljana Rakovic
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-03-31
publication date: 2025-03-31
doi: 10.5937/zdravzast54-56283

mortalitet PREDICTORS OF TREATMENT OUTCOME OF SURGICAL PATIENTS IN THE INTENSIVE CARE UNIT: LITERATURE REVIEW
type: item
description: Intensive care involves the care of life-threatening patients, i.e. care of critically ill patients who need intensive monitoring, treatment and care in order to maintain hemodynamic and respiratory balance, in order to reduce the number of complications and deaths. The aging of the population, the increased complexity of care, as well as the increasingly diverse pathology and symptomatology of certain diseases and conditions, influence the increase in the need for intensive care services in all branches of medicine, primarily in surgery. The aim of this review is to identify predictors of treatment outcomes for surgical patients in intensive care units (ICUs). Data were collected by searching several databases: PubMed, Google Scholar, Web of Science and Embase. A search was conducted for the past twenty years using the following keywords: intensive care unit, surgery, predictors, and treatment outcome. Included in our analysis were papers that analyzed the clinical outcomes of surgical patients who stayed in the ICU. It is observed that the predictors of the outcome of the treatment of surgical patients in ICU are: the severity of the patient's clinical picture before hospitalization, the type and scope of the operation, age, obesity, number of comorbidities, postoperative complications, but also the degree of organization of the health service and the competence of the health staff. Therefore, at the local, regional and global level, continuous monitoring and evaluation of predictors of treatment outcomes for surgical patients in the ICU should be developed, bearing in mind that life-threatening patients are hospitalized and that there is a high risk of complications and death. By identifying the predictors of the outcome of the treatment of surgical patients in the ICU, it will contribute to the adoption of strategies to improve the treatment of these patients.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Slobodanka Bogdanović Vasić
creator: Dragan Joković
creator: Katarina Pavić
creator: Roland Antonić
creator: Branimirka Arandjelović
creator: Nikola Savić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-01-27
publication date: 2025-01-27
doi: 10.5937/zdravzast53-53575

IS KNOWLEDGE OF DIABETES MELLITUS A PREREQUISITE FOR OPTIMAL SELF-CARE AND CONTROL OF THIS DISEASE?
type: item
description: Diabetes mellitus (DM) is the most common endocrinological disease of the modern era of pandemic proportions. People with DM have an increased risk of premature death caused by cardiovascular and other diseases compared to the general population. Patients' knowledge about DM includes a series of beliefs about different aspects of the disease that patients have accumulated during their lifetime, before and after diagnosis. This knowledge represents a significant cognitive factor that can influence a person's adaptation to the disease, the course of the disease and its treatment. In this review, it was examined whether knowledge about DM is a prerequisite for optimal self-care and control of this disease. The literature search was conducted using the following key words: diabetes mellitus, self-management, knowledge and education in PubMed, Emabase, Scopus, SCIndex and Hrčak for the period from 2001 to 2024. The largest number of studies on DM patients' knowledge used the Diabetes Knowledge Questionnaire (DKQ) with 24 items. In patients with DM type 1 and DM type 2 who participated in these studies, ubiquitous, deficient knowledge about DM was observed, which the authors link to suboptimal blood glucose values, high morbidity and mortality of the patients. Family history of DM, younger age and college education were independent predictors of optimal knowledge of patients with DM in most studies. Routine assessment of the level of knowledge of patients with DM through standardized questionnaires, accompanying identification of vulnerable groups and their education would enable the improvement of the knowledge of patients and the acquisition of skills necessary for self-menagement.
subject: Review article
  topic: section
subject: Array
  topic: keywords
creator: Marijana Jandrić-Kočić
rights: Copyright (c) 2025 HEALTH CARE
date: 2025-01-27
publication date: 2025-01-27
doi: 10.5937/zdravzast53-53040