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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its resulting coronavirus disease 2019 (COVID-19) has caused a fast-moving pandemic. Diagnostic testing, aimed to identify patients infected with SARS-CoV-2, plays a key role in controlling the COVID-19 pandemic in different populations. (2) Methods: This retrospective cohort study aimed to investigate predictors associated with positive polymerase chain reaction (PCR) SARS-CoV-2 test results in hospitalized patients, healthcare workers (HCWs), and military personnel (MP) during 2020, before the widespread availability of COVID-19 vaccines. Persons with a positive test result were compared with persons with a negative test result in three cohorts during the study period. (3) Results: A total of 6912 respondents were tested, and 1334 (19.3%) of them had positive PCR SARS-CoV-2 test results. Contact with a known COVID-19 case within 14 days (p < 0.001; OR: 1.48; 95% CI: 1.25–1.76), fever (p < 0.001; OR: 3.66; 95% CI: 3.04–4.41), cough (p < 0.001; OR: 1.91; 95% CI: 1.59–2.30), headache (p = 0.028; OR: 1.24; 95% CI: 1.02–1.50), and myalgia/arthralgia (p < 0.001; OR: 1.99; 95% CI: 1.65–2.42) were independently associated with positive PCR SARS-CoV-2 test results in the cohort of MP. Furthermore, fever (p < 0.001; OR: 2.75; 95% CI: 1.83–4.13), cough (p < 0.001; OR: 2.04; 95% CI: 1.32–3.13), headache (p = 0.008; OR: 1.76; 95% CI: 1.15–2.68), and myalgia/arthralgia (p = 0.039; OR: 1.58; 95% CI: 1.02–2.45) were independently associated with positive PCR SARS-CoV-2 test results in the cohort of HCWs. Moreover, independent predictors of positive PCR SARS-CoV-2 test results in hospitalized patients were contact with a known COVID-19 case within 14 days (p < 0.001; OR: 2.56; 95% CI: 1.71–3.83), fever (p < 0.001; OR: 1.89; 95% CI: 1.38–2.59), pneumonia (p = 0.041; OR: 1.45; 95% CI: 1.01–2.09), and neurological diseases (p = 0.009; OR: 0.375; 95% CI: 0.18–0.78). (4) Conclusions: According to data gathered

Objectives: Many countries around the world have recognized the need for using an electronic health record (EHR) system. However, there is limited literature that could serve as a guide during a lengthy and challenging process of planning, development, and implementation of the e-Health system. Since the EHR system was recently introduced in Serbia, the purpose of this communication is to describe our experience and lessons learned along the way. Methods: The key personnel involved in the implementation of the EHR system in Serbia that began in 2015 conducted in 2019 a retrospective narrative review of the process and early outcomes. Results: An incremental approach in the planning, development, and implementation of the nationwide EHR system was taken. The process was split into phases with the gradual introduction of different regions of the country. The gradual shift from the existing to a new workflow for the prospective users was also implemented. The significant milestones were the achievement of quick legislative changes, the hiring of a professional team of experts in the field, the provision of timely and appropriate information and training to prospective users, the close collaboration between the implementation team and the Ministry of Health and mutual understanding of the aims and expectations, and the flexibility in accepting the evolving nature of the process, goals, and the system model. Conclusions: A successful implementation of the nationwide EHR system is feasible providing careful planning, the assembly of a multi-disciplinary team, the use of a stepwise approach, the early and continued involvement of the intended users, and the willingness to make adjustments along the way. The end-result sets the stage for the reform of the health care system itself., Ciljevi: Mnoge su zemlje diljem svijete prihvatile potrebu za uvođenjem elektroničkog sustava bilježenja zdravstvenih podataka. Cilj je ovog rada opisati nužne uvjete za početak razvitka i uvođenja sustava za e-Zdravlje u Srbiji te opis projekta koji je uveden u našoj zemlji. Metode: Opisali smo nužne uvjete za početak razvitka i uvođenja sustava e-Zdravlja i načina na koji je projekt uveden u našoj zemlji. Rezultati: Uvedena je metoda za postupni razvitak i uvođenje nacionalnog sustava elektroničkog bilježenja zdravstvenih podataka u Srbiji. Uvođenje je organizirano u fazama, postupnim uvođenjem regija pomoću funkcionalnih modula. Postepene promjene su također uvedene u rad medicinskih liječnika kao korisnika, od postojećih metoda prema planiranima. Najvažnije faze razvoja i uvođenja bile su: brze legislative promjene, pravovremeno i primjereno pružanje informacija korisnicima sustava, trening za primjereno korištenje sustava za sve korisnike, kolaboracija timova za implementaciju sustava i timova Ministarstva zdravstva, jasno razumijevanje ciljeva i očekivanja i od strane Ministarstva zdravstva i uvoditelja sustava, fleksibilnost u prihvaćanju promjena u ciljevima i primjerenim podešavanjem modela sustave te zapošljavanje primjerenog profesionalnog tima stručnjaka u tom polju. Zaključci: Elektronički sustav bilježenja zdravstvenih podataka smatrao se vrlo važnim alatom za uvođenje mnogih reformnih mjera u samom zdravstvenom sustavu.

Uvod: Nezadovoljna potreba za zaštitom zdravlja može se posmatrati kao spektar zdravstvenih potreba koje nisu optimalno zadovoljene. Cilj: Identifikacija faktora povezanih sa neostvarenim zdravstvenim potrebama u odrasloj populaciji Srbije. Metod: Istraživanje je sastavni deo Istraživanja zdravstvenog stanja stanovništva Srbije sprovedenog 2013. godine. U svrhu dobijanja rezultata za naše istraživanje upotrebljen je reprezentativni uzorak od 13 765 odraslog stanovništva starosne dobi od 20 i više godina. Upitnici koji su usklađeni sa upitnikom Evropskog istraživanja zdravlja, predstavljali su instrument istraživanja. Rezultati: Najveću prepreku za ostvarivanje zdravstvenih potreba kod odraslog stanovništva Srbije, činili su finansijski razlozi (19,9%), dugo čekanje na zakazanu posetu ili pregled (12,8%) i udaljenost odnosno problemi sa prevozom do mesta pružanja zdravstvene usluge (4,7%). Najteže se dolazilo do stomatološke (13,3%) i medicinske zdravstvene zaštite (12.9%), a zatim slede propisani lekovi (10,7%) i zaštita mentalnog zdravlja (2,4%). Zaključak: Istraživanje daje uvid u prediktore nejednakosti u korišćenju, pristupu i ostvarivanju zdravstvene zaštite sa ciljem skretanja pažnje donosiocima politike zdravstvene zaštite koje političke akcija treba preduzeti., Background: An unsatisfied need for health care can be viewed as a spectrum of health needs that are not optimally met. Aim: Identification of factors related to unmet health needs in the population of Serbia. Methods: The research is an integral part of the Health Survey of the Population of Serbia conducted in 2013 under the auspices of the Ministry of Health of the Republic of Serbia. For the purposes of this study, a representative sample of 13,765 adults aged 20 and over was used. Questionnaires, which were harmonized with the European Health Research Questionnaire, were a research instrument. Results: The biggest obstacle to meeting the health needs of the adult population of Serbia was financial reasons (19,9%), long waits for a scheduled visit or examination (12,8%) and distance or problems with transportation to the place of health care (4,7%). The most difficult were dental (13,3%) and medical health care (12,9%), followed by prescribed medication (10,7%) and mental health care (2,4%). Conclusion: The research provides insight into the predictors of inequality in the use, access and realization of health care in order to draw attention to health policy makers what policy action should be taken.

Sistemska trombolitička terapija, koja je u sadašnjim preporukama, metoda izbora kod pacijenata sa plućnom tromboembolijom (PTE) intermedijarno visokog rizika, nosi sa sobom značajan rizik od pojave velikih krvarenja. Cilj ovog istraživanja je poređenje rezultata lečenja ovih pacijenata ultrazvukom olakšanom kateterskom trombolizom (UZOKT) u odnosu na sistemsku trombolitičku terapiju i antikoagulantnu terapiju. Istraživanje je realizovano kao klinička opservaciona studija po tipu opservacione retrospektivne serije slučajeva, koje je obuhvatilo 237 pacijenata sa PTE intermedijarnog rizika, koji su lečeni na jedan od četiri načina, i to: 123 pacijenta je lečeno samo antikoagulantnom terapijom, odnosno bez trombolize, 44 pacijenta je bilo na sporoj infuziji streptokinazom (sistemskom primenom spore infuzije streptokinaze), 38 pacijenata je lečeno sporim tPA (tkivni Plazminogenski Aktivator) sistemskim protokolom (sporom sistemskom infuzijom redukovane doze tPA), a 32 pacijenta lečeno je UZOKT. Protokoli lečenja sprovedeni su u skladu sa važećim preporukama, pre svega Evropskog udruženja kardiologa (European Society of Cardiology - ESC). Naše istraživanje je pokazalo, da je UZOKT jednako bezbedan za primenu kao i ostala tri načina lečenja, uz veću efikasnost u smislu smanjenja smrtnog ishoda i hemodinamske dekompenzacije. Ovi rezulatati naročito dobijaju na značaju, ako se ima na umu, da je upravo UZOKT grupa imala hemodinamski najveće opterećenje, (sistolni pritisak desne komore (SPDK) je kod pacijenata lečenih UZOKT bio najviši), i samim tim i najveći rizik za razvijanje dekompenzacije tj.smrtni ishod, a da su u ovoj grupi, ako se ima u vidu preživljavanje i pojava dekompenzacije, postignuti najznačajniji rezultati. Rezultati ove studije doprineće utvrđivanju značaja UZOKT u odnosu na antikoagulantnu terapiju, sporu infuziju streptokinaze i spori tPA sistemski protokol, kod pacijenata sa akutnom intermedijarnom rizičnom grupom PTE. Ključne reči: plućna tromboembolija, Systemic thrombolytic therapy, which is currently, the method of choice in patients with intermediate-risk pulmonary thromboembolism (PTE), carries with it a significant risk of major bleeding. The aim of this study was to compare the results of treatment of these patients with ultrasound assisted catheter thrombolysis (USACT) in relation to systemic thrombolytic therapy and anticoagulant therapy. The study was conducted as a clinical observational study on the type of observational retrospective series of cases, that included 237 patients with intermediate-risk PTE, who were treated in one of four ways, namely: 123 patients were treated with anticoagulant therapy alone, ie without thrombolysis, 44 patients were treated with slow infusion of streptokinase (systemic administration of a slow infusion of streptokinase), 38 patients were treated with a slow tPA (tissue Plasminogen Activator) systemic protocol (slow systemic infusion of reduced dose tPA), and 32 patients were treated with USACT. Treatment protocols were implemented in accordance with current recommendations, primarily European Society of Cardiology (ESC). Our research has shown that USACT is just as safe to use as the other three treatments with greater efficiency in terms of reduced mortality and hemodynamic decompensation. These results are especially important, if we keep in mind that the USACT group had the highest hemodynamically load (right ventricular systolic pressure (RVSP) was the highest in patients treated with USACT), and thus the highest risk for the development of decompensation, ie death, and that in this group, if we take into account the survival and the occurrence of decompensation, the most significant results have been achieved. The results of this study will contribute to the determination of the significance of USACT in relation to anticoagulant therapy, slow streptokinase infusion and slow tPA systemic protocol, in patients with acute intermediate-risk group PTE.

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

Cilj ove studije je bio da se proceni uticaj pola i komedikacije na izloženost takrolimusu uz pomoć odnosa koncentracije i doze takrolimusa (C/D odnos) kod bolesnika sa transplantiranim bubregom. Korišćena je prospektivna serija slučajeva (54 pacijenta), gde je jedinica posmatranja bio kontrolni ambulantni pregled (1872) bolesnika sa transplantiranim bubregom. Bolesnici su praćeni od 2010. do 2014. godine, a ono je započeto mesec dana nakon transplantacije. Minimalna koncentracija takrolimusa u krvi (TTC) merena je uz pomoć hemiluminiscentnog mikročestičnog imunoeseja. TTC i C/D odnos su bili značajno niži kod žena u poređenju sa muškarcima. Za razliku od muškaraca, u žena je nađeno značajno povećanje dnevne doze takrolimusa (TDD) po kg telesne težine i TTC, zajedno sa povećanjem kortikosteroidne doze, koji nije bio praćen nikakvim značajnim promenama C/D odnosa. Bolesnici koji su upotrebljavali inhibitore protonske pumpe imali su značajno viši TDD po kg telesne težine i TTC, dok je C/D odnos bio značajno niži u poređenju sa bolesnicima bez ovog tretmana. Kod bolesnika koji su upotrebljavali kalcijumske blokatore TDD po kg telesne težine je bio značajno niži, dok je C/D odnos bio značajno viši u poređenju sa bolesnicima bez ovog tretmana. Kod žena je pokazano niže izlaganje takrolimusu u odnosu na muškarace. Kada su posmatrane polne razlike u odnosu na različite doze kortikosteroida, viđeno je brže eliminisanje takrolimusa kod žena, sa izuzetkom kada je doza bila > 0,25 mg/kg. Izloženost takrolimusu u prisustvu pantoprazola bila je značajno manje izražena u poređenju sa bolesnicima koji nisu bili lečeni ovim lekom., The aim of the study was to estimate the use of tacrolimus C/D ratio for the assessment of the influence of gender differences and comedication on tacrolimus exposure in renal transplant recipients. The study was designed as a prospective case series study (54 patients), in which the unit of monitoring was outpatient examination (1872) of the renal transplant patients. The patients were monitored in the period 2010- 2014, starting one month after the transplantation. Tacrolimus trough concentrations (TTC) were measured by chemiluminescence microparticles immunoassay. TTC and tacrolimus C/D ratio were significantly lower in females comparing with males. Contrary to males, in females, a significant increase of tacrolimus daily dose (TDD) per body weight and TTC, along with the corticosteroid dose increase, was not accompanied by any significant changes in tacrolimus C/D ratio. In the patients treated with proton pump inhibitors, TDD per body weight and TTC were significantly higher, while tacrolimus C/D ratio was significantly lower compared to the patients without this treatment. In the patients treated with calcium channel blockers, TDD per body weight was significantly lower, while tacrolimus C/D ratio was higher compared to the patients not treated with them. A lower tacrolimus exposure was detected in females in comparison to males. When gender differences were considered in the context of different corticosteroid doses, faster elimination of tacrolimus in females was also seen, with the exception of the doses > 0.25mg/kg. Tacrolimus exposure in pantoprazole-treated patients was significantly less expressed in comparison with the patients not treated with them.