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Translations of instruments for measuring quality of life developed in certain, mostly more developed, parts of the world usually do not cover regionally specific aspects of health-related quality of life, even after transcultural validation. The aim of this study was to develop and validate a reliable questionnaire in Serbian, Croatian, Bosnian, and Montenegrin languages suitable for measuring health-related quality of life in adults.

Introduction: The increasing resistance of Pseudomonas aeruginosa against cefepime requires a better understanding of hospital epidemiology in order to retain this drug as a therapeutic option. Aim: The aim of this study was to identify risk factors associated with healthcare associated infections (HAIs) caused by cefepime-resistant P. aeruginosa (CRPA), both in all patients with HAIs and in the subgroups of patients who died or who acquired infection with carbapenem-resistant P. aeruginosa. Methods: The academic study was designed as a combination of three nested case/ control studies within the cohort of patients with HAIs caused by P. aeruginosa regardless of localization, prospectively followed from January 2009 to December 2017 in a tertiary care hospital. The influence of risk factors on specific outcomes was estimated by adjusted odds ratios calculated from multivariate logistic regressions. Results: Our study showed that there are independent risk factors for CRPA infections: the existence of another HAI (p=0.001), hospitalization in ICU longer than one month (p=0.007), a longer stay in hospital prior to infection (p=0.004), longer use of mechanical ventilation (p=0.036), administration of antibiotics before infection (p

The overall experience of religious practice is significantly affected by the acoustical properties of temples. Divine service is the most important act in the Orthodox Church, which equally demands intelligibility of speech for preaching and as well as adequate acoustics for Byzantine chanting as a form of a song-prayer. In order to better understand and contribute to unlocking the role of sound in these historical sacral spaces, this paper explores the acoustics of two well-preserved Orthodox churches, from Ljubostinja and Naupara monastery, built in the last building period of medieval Serbia (1371–1459). These represent two types of the Morava architectural style – triconch combined with a developed and compressed inscribed cross, respectively. Using EASERA software, we measured the impulse response for two sound source positions – in the altar and in the southern chanting apse, as the main points from which the Orthodox service is carried out. Thus obtained acoustic parameters (RT, EDT, C50 and STI) were further analysed, pointing out the differences in experiencing sound between naos and narthex, as well as how the position of the sound source influenced the experience of sound. Finally, we compared the results with previous archaeoacoustic research of the churches from the same building period.

Introduction: Differentiating colonization from infection is not straightforward, and sometimes antibiotics are prescribed unnecessarily if a clinician relies only on susceptibility report from microbiology lab, further promoting antimicrobial resistance. Aim: The aim of our study was to investigate whether pandrug-resistant Pseudomonas aeruginosa (PA) isolated from qualitative endotracheal aspirates of ICU patients was primarily external colonization from environmental reservoirs. Subjects and Methods: An instrumental case study was conducted using qualitative research methodology. An ICU with level 2 or 3 of intensive care from Clinical Center Kragujevac, Serbia, was chosen for the case, and research questions were triangulated by direct observation, interviewing personnel of the ICU and by epidemiological survey. Results: Pandrug-resistant PA was present in environment of the ICU because hygiene was not stringently kept. It eventually arrived to respiratory circuits of mechanically ventilated patients and gradually descended to endotracheal tube and trachea. Reliance on qualitative endotracheal aspirate in patients with suspected respiratory tract infection led to diagnosing colonization as infection in 50% of cases with isolation of PA. Inadequate hygiene and avoidance of aseptic working techniques together with understaffing and insufficient funding of the ICUs leads to contamination of personnel and environment with Pseudomonas aeruginosa coming from ill patients. It is then cross-transferred to other patients, who are over-treated with reserve antibiotics due to low specificity of qualitative microbiological analyses and the fact that 50% of patients are only colonized. Conclusions: Pressure made by antimicrobial treatment of colonization creates at first multi drug-, and then pandrug-resistant clones of PA which gradually populate environment of the ICU, becoming serious threat for new patients. This vicious spiral could be broken by improvement of hygiene, provision of enough trained personnel and necessary materials, continuous control of personnel's compliance to working standards for ICUs and by introduction of quantitative microbiological analysis of samples.

Archaeoacoustics is a multidisciplinary field of research focused on the history of the relatedness of the field of sound and architecture. The architectural history of Europe, from Antiquity to the modern period, is abundant in the findings of vessels, which are considered to have an acoustic purpose. This paper addresses these acoustic vessels embedded in the massive walls of sacred architecture in medieval Serbia (15 churches). We considered the wide context of current archaeoacoustic research, in order to argue that this practice can be regarded as an expression of a certain medieval musical tradition. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 177012: Society, spiritual and material culture and communication on the Balkans in prehistory and early history of Balkans and Grant no. 179048: Theory and practice of science in society: multidisciplinary, educational and intergenerational perspectives]

Introduction. Healthcare-acquired urinary tract infections (HAUTI) make up to 40% of all healthcareacquired infections and contribute significantly to hospital morbidity, mortality, and overall cost of treatment. Objective. The aim of our study was to investigate possible risk factors for development of HAUTI caused by multi-drug resistant pathogens. Methods. The prospective case-control study in a large tertiary-care hospital was conducted during a five-year period. The cases were patients with HAUTI caused by multi-drug resistant (MDR) pathogens, and the controls were patients with HAUTI caused by non-MDR pathogens. Results. There were 562 (62.6%) patients with MDR isolates and 336 (37.4%) patients with non-MDR isolates in the study. There were four significant predictors of HAUTI caused by MDR pathogens: hospitalization before insertion of urinary catheter for more than eight days (ORadjusted = 2.763; 95% CI = 1.352-5.647; p = 0.005), hospitalization for more than 15 days (ORadjusted = 2.144; 95% CI = 1.547-2.970; p < 0.001), previous stay in another department (intensive care units, other wards or hospitals) (ORadjusted = 2.147; 95% CI = 1.585-2.908; p < 0.001), and cancer of various localizations (ORadjusted = 2.313; 95% CI = 1.255-4.262; p = 0.007). Conclusion. Early removal of urinary catheter and reduction of time spent in a hospital or in an ICU could contribute to a decrease in the rate of HAUTI caused by MDR pathogens.

Background/Aim. Urinary tract infections (UTIs) are among the most common infections in outpatients. The aim of this study was to define the causative agents of urinary tract infections and their resistance to antimicrobial drugs in the urban area of central Serbia, as well as to evaluate eventual differences associated with age and gender of the patients. Methods. This retrospective study analysed data taken from routine, consecutively collected urine cultures of outpatients with symptomatic UTIs, collected from the Department of Microbiology, Institute of Public Health in Kragujevac, Serbia, from January 2009 to December 2013. Results. There were 71,905 urine cultures, and 24,713 (34.37%) of them were positive for bacterial pathogens. The most common pathogen was Escherichia coli (E. coli) (56.56%), followed by Klebsiella spp. (16.20%), Proteus spp. (14.68%), Enterococcus spp. (5.29%) and Pseudomonas aeruginosa (3.74%). E. coli and Enterococcus spp. isolation rates were lower in males ≥ 60 years old (23.71% and 4.87%, respectively), while Klebsiella spp. was more prevalent in this group (32.06%). The most common causative agents isolated from 15–29 years old male patients were Enterococcus spp. and Pseudomonas aeruginosa (13.28% each). Among women, the isolation rate of E.coli was high in all age groups (around 70%). Proteus spp. was frequently isolated from females ≤ 14 years old (13.27%), while Klebsiella spp. was the most frequent in the oldest age female group (10.99%). Conclusion. Choice of antibiotics for treatment of UTIs should be governed not only by the local resistance patterns, but also by gender and age of patients.

Introduction. Pseudomonas aeruginosa is a common cause of serious infections in hospitalized patients and is associated with high rates of hospital morbidity and mortality. Objective. The aim of this study was to identify the risk factors of nosocomial infections caused by piperacillin­tazobactam­ resistant P. aeruginosa (PT­RPA). Methods. A case­control study was conducted in the Clinical Centre Kragujevac from January 2010 to December 2011. Results. In the observed period, 79 (38.16%) patients had PT­ RPA infections, while 128 (61.84%) patients had infections caused by piperacillin­tazobactam­sensitive P. aeruginosa (PT­SPA). Pneumonia was more frequently found in the PT­RPA group (55.70%) (p

Religious practice in Serbia has taken place using both indoors and outdoors sacred sites ever since the adoption of Christianity in medieval times. However, previous archaeoacoustic research was focused on historic church acoustics, excluding the open-air soundscapes of sacred sites. The goal of this review paper is to shed light on the varieties of sacred soundscapes that have supported the various needs of Orthodox Christian practice in medieval Serbia. First, in relation to the acoustic requirements of the religious service, we compare the acoustic properties of masonry and wooden churches based on the published archaeoacoustic studies of medieval churches and musicological studies of the medieval art of chanting. Second, we provide an overview of the ethnological and historical studies that address the outdoor sacred soundscapes and investigate the religious sound markers of large percussion instruments, such as bells and semantra, the open-air litany procession that has been practiced during the annual celebration of a patron saint's day in rural areas, and the medieval assemblies that took place on the sacred sites. This paper finally points out that the archaeoacoustic studies of sacred soundscapes should not be limited to church acoustics but also include open-air sacred sites to provide a complete analysis of the aural environment of religious practice and thus contribute to understanding the acoustic intention of medieval builders, as well as the aural experience of both clergy and laity. [ABSTRACT FROM AUTHOR]

Introduction. Urinary tract infections are the most frequent hospital infections and account for about 40% of total hospital infections. The main risk factor for their development is the use of catheters. Objective. Assessment of basic epidemiological and etiological characteristics of nosocomial urinary tract infections (NUTIs) and investigation of differences in risk factors among the patients with NUTIs with and without the urinary catheter. Methods. The study comprised patients treated in chosen units/ of the Clinical Center in Kragujevac, in whom NUTI was registered during 2009. Differences in risk factors for NUTIs between the catheterized and uncatheterized patients were tested by the logistic regression analysis. Results. NUTIs was registered in 162 patients whose average age was 66.2±13.5 years with approximately equal gender participation (51.2% men and 48.8% women). Almost three quarters of the patients with NUITs had indwelling urinary catheter, 12.0±7.7 days on average (from 1 to 39 days). In the patients with urinary catheter, the risk for NUITs was significantly positively associated with emergency admission to hospital treatment (p=0.0185). The uncatheterized patients had a significant frequency of malignant tumours comparing to the patients with a urinary catheter (p=0.039). The compared groups did not differ in other risk factors. The most frequently isolated microbial agents was Klebsiella spp (37.3%), then Pseudomonas aeruginosa (14.1%) and Proteus mirabilis (11.9%). Most of the bacteria showed a great level of resistance to frequently used antibacterial drugs, even up to 100%. Conclusion. It is necessary to define national recommendations for the prevention and control of NUTIs in the future.

Introduction. Acute respiratory distress syndrome (ARDS) is a significant complication in patients with type A influenza (H1N1) due to the severity of the disease and adverse outcome. Objective. The aim of the study was to identify risk factors for the development of ARDS in patients with type A influenza (H1N1) and outcome of ARDS. Methods. The research was conducted as a case series study, and included patients admitted at the Clinical Center in Kragujevac during the 2009 and 2010 flu season. Data for the study were obtained from patients’ medical records, inclusion criteria having been determined in accordance with recommendations of the Expert Methodological Guide for Controlling Spread of Pandemic Influenza in the Republic of Serbia. Primary data analysis was performed using descriptive statistics and a statistical method for testing hypotheses. Dependence analysis was performed using simple logistic regression. The statistical hypotheses were tested at the 0.05 level of significance. Results. The case group consisted of 14 patients who developed ARDS, while the control group was composed of 34 patients with influenza but without ARDS (group alignment performed by age). Simple logistic regression analysis identified the following risk factors for the development of ARDS: diabetes mellitus type 1 or 2 (p=0.028), high levels of C-reactive protein (p=0.004), aspartate-aminotransferase (p=0.006), urea (p=0.028), creatine kinase (p=0.001), lactate-dehydrogenase (p=0.005) and longer time elapsed from disease symptoms onset to the administration of specific antiviral therapy administration (p=0.021). Conclusion. The research showed that diabetes, late initiation of antiviral therapy and some laboratory tests are risk factors for ARDS development in patients with type A influenza (H1N1).

Introduction. Pneumonia is the most frequent nosocomial infection in intensive care units. The reported frequency varies with definition, the type of hospital or intensive care units and the population of patients. The incidence ranges from 6.8-27%. Objective. The objective of this study was to determine the frequency, risk factors and mortality of nosocomial pneumonia in intensive care patients. Methods. We analyzed retrospectively and prospectively the collected data of 180 patients with central nervous system infections who needed to stay in the intensive care unit for more than 48 hours. This study was conducted from 2003 to 2009 at the Clinical Centre of Kragujevac. Results. During the study period, 54 (30%) patients developed nosocomial pneumonia. The time to develop pneumonia was 10±6 days. We found that the following risk factors for the development of nosocomial pneumonia were statistically significant: age, Glasgow Coma Scale (GCS) score

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The objective of this research was to analyze the varicella patients' data in order to determine the following: general frequency of pneumopathies and types of lung changes according to X-ray presentation and the changes on the computed tomography. It examined 101 patients with the clinical presentation of varicella and some of the X-ray entities of varicella pneumopathies. Radiological techniques included chest X-ray and CT scans. Familiarity with clinical, laboratory and radiological characteristics of the disease may be of utmost importance for early recognition. [ABSTRACT FROM AUTHOR]