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Introduction: Hospitalized patients have an increased risk of developing infections caused by Clostridioides difficile. Due to the changing epidemiology of C. difficile, it is necessary to educate nurses about the implementation of prevention measures, but also about the criteria for obtaining a quality sample of feces in order to establish an etiological diagnosis in a timely manner. The aim of the study was to assess gaps and flaws in C. difficile infection (CDI) prevention policies and practices, and to determine whether a nurses knowledge about early identification and isolation of CDI patients improved after education. Methods: The research was conducted in a quasi-experimental study at the University Clinical Center of the Republka Srpska (UKC RS) in the period from May 2020 to December 2021 on a sample of 60 nurses. A survey questionnaire Centers for Disease Control and Prevention (CDC) was used as a research instrument and it was intended for the assessment of knowledge, attitudes and understanding about procedures for the prevention of infection with C. difficile. The applied strategy to prevent hospital CDI was based on the introduction of the concept of "package of care", which was based on scientific evidence. For the education of nurses, interactive educational modules were used that contained detailed prevention measures CDI in hospital conditions in accordance with the guidelines. Before and after the education, the participants completed a knowledge test about C. difficile and prevention CDI.The study was approved by the Ethics Committee of the UKC RS. Results: Only 5 (8.3%) respondents stated that they were informed about CDI prevention during the visit of a nurse from the infection control team. Most of the shortcomings during the assessment of CDI prevention at the observed clinics were related to the practice of sending feces samples for laboratory testing for C. difficile. Nurses showed highly statistically significant (p

Introduction: Unintentional falls are the leading cause of traumatic injuries, without fatal consequences, with significant morbidity in the population of children and adolescents. Goal: The main goal of this research was to analyze the manner of falling in relation to age and gender, and to assess the type of injury and the anatomical region of the body affected by the injury sustained during a fall in patients ≤19 years of age treated in the emergency medical services in the Republic of Srpska. Material and methods: A cross-section study with retrospective analysis of the national e-database WebMedic from 11 emergency medical services between January 2018 and December 2020 was conducted. Research included patients with diagnosis of unintentional injury caused by a fall, aged ≤19 years. Descriptive statistics and the Chi-square test were used for comparisons between groups. Results: During the observed period, 857 cases of unintentional falls were identified, where 87.5% were referred for hospitalization. The group of children aged 0 to 9 years (55.7%) was more often treated for falls (p

Background/Aim: Unintentional injuries among children and adolescents have become a common issue in public healthcare. The study objective was to analyse the characteristics and identify predictors associated with unintentional injuries in children and adolescents treated in emergency medical services (EMS) in the Republic of Srpska, Bosnia and Herzegovina. Methods: A cross-section study with retrospective analysis of WebMedic e-database from 14 EMS, in the period between January 2018 and December 2020 was conducted. Research included patients with unintentional injuries, aged ≤ 19 years, of both sexes. For comparison between groups, Chi-squared and multivariate logistic regression were used in risk factor analysis. Results: A total of 1,856 cases were identified, most injuries resulted from falls (46.7 %) and traffic injuries (26.9 %). Boys were significantly more affected by injuries than girls (p < 0.001). Falls were the major cause for reporting to EMS among age groups of children (0-9 years) and adolescents (10-14 years), whereas injuries in traffic were dominant in adolescents aged 15 to 19. The most common injuries were head injuries (35.7 %). Risk factors of unintentional injuries were age (p < 0.001), sex (p = 0.046), weekday (p = 0.016), winter (p = 0.014), body region (head, abdomen, lower and upper limbs (p < 0.001), thorax (p = 0.009)). Conclusions: There were significant differences in characteristics of unintentional injuries according to age and sex. Chances for occurrence of unintentional injuries among children increased with their age, especially for boys. These differences might indicate areas where preventive measures should be undertaken.

This retrospective study provides an insight into the levels of radiation exposure of six nuclear medicine (NM) staff (four technologists and two nurses) performing routine diagnostic 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT) at the University Clinical Centre of the Republic of Srpska, Department of Nuclear Medicine and Thyroid Disorders, Banja Luka, Bosnia and Herzegovina. Data analysis included monthly staff exposure measured with personal thermoluminescent dosimeters (TLD) between June and December 2018, quantified in terms of normalised dose for the whole body [Hp(10)] and dominant hand [Hp(0.07)] and their comparison between each staff member and between the two groups (technologists and nurses). The study goal was to establish how our Department compared with reports from other PET/CT centres worldwide in terms of annual number of procedures and exposure limits and whether there could be room for further improvements in radiation protection. The number of procedures rose considerably from 208 in 2016 to 876 in 2019 and was 423 in the observed seven-month period. Mean individual whole-body exposure dose per GBq of injected 18F-FDG activity, [Hp(10)/A] was 18.55 μSv/GBq for the four technologists and 15.61 μSv/GBq for the two nurses. Mean dominant-hand exposure dose per GBq of injected 18F-FDG activity [Hp(0.07)/A] was 16.99 μSv/GBq and 25.44 μSv/GBq for the two groups, respectively. The average annual cumulative dose for all staff was (1.06±0.29) mSv for Hp(10) and (1.15±0.32) mSv for Hp(0.07). These results are comparable with those of similar studies. Staff doses were well below the annual limits. Nurses received slightly higher extremity doses than technologists. In view of the increasing trends in the number of PET/CT procedures, dose monitoring should be continued to identify exposure hotspots and maintain doses as low as possible.

Introduction/Objective. Myocardial perfusion imaging (MPI) is clinically useful for the evaluation of coronary artery disease in patients with diabetes mellitus. However, the prevalence of ischemia and its ability to predict future cardiac events is less clear. The aim was to determine the incidence of cardiac events in diabetic patients and the relationship between them and MPI findings. Methods. Two cohorts of patients, 98 diabetics and 100 non-diabetics, with medium- to high-risk of coronary artery disease without previous coronary revascularization, were studied prospectively. All of them were outpatients who underwent 99mTc-sestamibi MPI with dipyridamole. The data about cardiac events were collected during a follow-up period of two years. Results. Cardiac events occurred in 17.3% diabetics and in 8% non-diabetics (p = 0.048). Diabetics had shorter estimated event-free time of 24.7 months (95% CI 23.2–26.2) versus non-diabetics’ estimated event-free time of 28.5 months (95% CI 27.4–29.5) (p = 0.046). The independent predictors of cardiac events were male sex (p = 0.010), previous myocardial infarction (p < 0.001), presence of the symptoms of angina (p = 0.014), and all variables derived from MPI findings. After adjustment for variables derived from MPI findings, the significant predictors in diabetics were the size of stress perfusion defect (p = 0.022), summed stress score (p = 0.011), and summed difference score (p = 0.044). Conclusion. In diabetic patients, the cumulative rate of cardiac events was higher and the event-free survival was worse. MPI could help in prediction of cardiac events in diabetics and the most important predictors were size of stress perfusion defect, summed stress score, and summed difference score.

Introduction/Objective. Glaucoma is a chronic disease that impairs the optic nerve irreversibly and can lead to serious loss of vision and blindness. As the most frequent out of all, primary open-angle glaucoma has a worldwide incidence of 2.4 million. The objective of this article is to examine the characteristics of glaucoma hospitalization patterns in Central and West Serbia in the 2006–2017 period. Methods. This study was a retrospective analysis of glaucoma hospitalizations in the Kragujevac Clinical Center from 2006 to 2017 (n = 1,751). All hospitalizations were divided according to discharge diagnoses into the following three subgroups: primary open-angle glaucoma, the primary closure glaucoma, and secondary glaucoma and other glaucoma types. Results. The average hospitalization rate for glaucoma is 5/10,000 inhabitants. The lowest rate was recorded in 2013 (1.8/10,000) and the highest in 2015 (9.3/10,000). The rehospitalization rate ranged from 0.5/10,000 in 2013 to 6.9/10,000 in 2015, with an average of 2.4 patients per 10,000. The most common glaucoma was secondary glaucoma and other glaucoma types (44.6%), followed by primary open-angle glaucoma (37.9%) and primary closure glaucoma (17.5%). The average hospitalization length was 6.5 ± 4.9 days and it decreased from the average 9.7 ± 6.5 (2006) to 5.5 ± 3.7 days (2013) (p < 0.01) in all glaucoma types. Conclusion. There was a significant reduction of the hospitalization length in all glaucoma types in Central and West Serbia. The hospitalization rates varied with a significant increase since 2013, which is the consequence of the increase in rehospitalization rates.

Background/Aim. Non-communicable diseases (NCDs) are a major public health challenge worldwide. Although they are preventable, NCDs are the major global causes of morbidity and mortality, absenteeism, disability and premature death. The aim of this study was to examine socioeconomic inequalities in the prevalence of non-communicable diseases in Serbia. Methods. Data from the 2013 National Health Survey of the population of Serbia was used in this study. There were 13,765 adults interviewed, aged ≥ 20 years. We used multivariate logistic regression analyses with demographic and socioeconomic determinants of health as independent variables and prevalence of non-communicable diseases as a dependent variable. The minimum level of significance was p < 0.05. Results. Hypertension was the most prevalent NCDs (36.1%). The prevalence of multimorbidity was 47.1%. Multivariate logistic regression analysis showed that gender, age, place of residence, employment status and education were associated with the presence of NCDs. The odds ratio (OR) for age was 1.074 [95% confidence interval (CI) : 1.070–1.077). Women were at a higher risk of NCDs by 58.9% when compared to men (OR = 1.589; 95% 95% CI : 1.467–1.726). Respondents who lived in the rural areas were at a higher risk for NCDs by 14.1% compared to those who lived in urban areas (OR = 1.141; 95% CI : 1.047– 1.244). Odds ratio for unemployment was 1.227 (95% CI: 1.118–1.346). Respondents with primary education were at a higher risk for chronic diseases by 47.1% (OR = 1.471; 95% CI : 1.281–1.687) while those with secondary school were at a higher risk by 27.7% (OR = 1.277; 95% CI : 1.142–1.428) compared to respondents who had higher education. When it comes to Wealth Index, univariate logistic regression analysis showed that respondents who belonged to the poor and middle classes were at a higher risk for NCDs (OR = 2.031; 95% CI : 1.819–2.267; OR = 1.473; 95% CI : 1.343– 1.615) compared to respondents who belonged to the rich class. Multivariate logistic regression analysis did not show statistically significant correlations between the Wealth index and NCDs. Conclusion. Socioeconomic inequalities in health status are the major challenge and should be a target of national health policy in Serbia, not only because they represent social injustice but also because solving the health problems of underprivileged groups of the population can influence improvement of health status of the population as a whole.

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Background/Aim. Sudden sensorineural hearing loss is manifested by the loss of hearing for more than 30 dB at three consecutive frequencies in the timeframe of 72 h. It is of unclear etiology and pathogenesis, which leads to the use of different therapeutic methods. Treatment protocols are not compliant, making it difficult to objectively quantify their impact. The aim of this study was to show the effect of hyperbaric oxygen therapy as the only method for the treatment of sudden sensorineural hearing loss. Methods. This retrospective study included 20 patients treated for sudden sensorineural hearing loss with hyperbaric oxygenation (HBO) in the period from 2004 to 2014. The study was conducted in the specialized medical clinic for hyperbaric and underwater medicine, HBO Medical Center in Belgrade. The patients were treated according to the following protocol: a session of 60 min at the pressure of 2 bars (2ATA) two times a day, a total of 30 sessions. Assessment of the therapy effects was performed by observing the change in the hearing threshold at the frequencies of 500, 1,000, 2,000 and 4,000 Hz at the end of the treatment. Results. After the completion of treatment according to the protocol, a full hearing recovery (total improvement of hearing damage or achieving final hearing threshold above 25 dB) was found in 11 (55%) of the patients. A partial recovery (hearing improvement of up to 15 dB, and a final hearing threshold below 45 dB) occurred in 4 (20%) of the patients. In 5 (25%) of the patients, improvement was not verified (there was no recovery or it was less than 5 dB). The average absolute hearing recovery was 24.94 dB. The mean relative hearing recovery was 65.45%. Conclusion. Because of the unclear multifactorial etiopathogenesis of this disease, there are many therapeutic protocols. Based on the results of our study HBO therapy could be recommended primarily as the treatment for sudden sensorineural hearing loss.

Background: Despite the knowledge that they have high blood pressure, which can be controlled with medicines, one portion of the patients still ignores doctor's advice. The aim of the research was to examine the impact of socio-demographic factors for treatment of hypertension among adults in Serbia. Subjects and methods: In the study, we used data from the National Health Survey of the Republic of Serbia in 2013. The sample consisted of respondents who had diagnosed hypertension, 5073 of them. The dependent variable in the study was binary (treatment, or no treatment of hypertension) and independent was socio-demographic characteristics of respondents. Logistic regression was used to determine sociodemographic predictors associated with blood pressure control. Results: From a total of 5073 diagnosed hypertensive patients, 91.3% of them cures high blood pressure. Women, older, medium rich patients, those who follow health topics on television and those who do not follow them on the Internet, who, in the past year, have been hospitalized or used the services of daily care significantly more often treat hypertension. The results of binary logistic regression in which the dependent variable is the treatment of high blood pressure, showed that a statistically significantly predictors are: age, gender, the wealth index and monitoring topics related to health through television and the Internet. In the treatment of hypertension, the strongest predictor was the index of well-being. Thus, people who are medium rich are almost three times more likely to treat high blood pressure compared to the richest (OR=2.94, 95%CI=1.54-5.59). A statistically significant difference in treatment is not recorded between the richest and the poorest (p> 0.05). Men are 1.5 times more likely to treat their tension as compared to women (OR=1.54, 95%CI=1.02-2.32). People following itopics related to the health via the internet are1.7 times more likely to treat hypertension in comparison to subjects who do not follow these topics via the Internet (OR=1.72, 95%CI=1.07-2.76). Conclusion: Analysis of the impact of sociodemographic characteristics on the awareness of patients about the importance of treatment of hypertension is an important step in defining the strategies for treatment of patients.

Introduction/Aim. Reproductive health and cervical cancer screeaning are public health priorities. The aim of the study was to asses the sexual behavior and prevalence of cervical cancer screening use in the Šumadija District, Serbia. Methods. The research was conducted as a cross-sectional study. The study population consisted of 510 females aged 18 - 49 years, living on the territory of the Šumadija District. An anonymous standardised questionnaire was used as a research tool based on the research protocol entitled "The World Health organization, STEPwise Approach to Noncommunicable Disease Risk Factor Surveillance (STEPS)". Results. During the first sexual intercourse, 60.1% of the surveyed population used some of the contraceptives, whereas during the last sexual intercourse, 72.5% of the female respondents reported not having used any of these. Out of the total number of female respondents, every fifth respondent reported not having had a single Pap smear in her lifetime performed (22.8%), i. e. 85.0% of the female respondents aged 19 - 29 years (p < 0.001), every third female respondent who had completed elementary school (28.4%) p = 0.009, and every third respondent who was not married (33.3%) (p = 0.01). Conclusion. All the activities should be directed towards increasing the levels of accessibility and availability of the institutions and cervical cancer screening services provided there. In addition, resource capacities should be enhanced as well (medical staff, rooms, equipment). [ABSTRACT FROM AUTHOR]

Background/Aim. Admission diagnosis represents the diagnosis of an illness, injury or condition due to which a patient is referred to hospital to be admitted. Discharge diagnosis represents the main reason of illness or condition due to which a patient is admitted. The aim of this study was to analyze the agreement between admission diagnostic groups and discharge diagnostic groups of patients in the Clinical Center Kragujevac in the period from January 1, 2006 to December 31, 2013 on the basis of the hospitalization report. Methods. From the basic set of reports, 5% of random samples were singled out and they contained 20,422 reports. Out of the given number of reports, 18,173 hospitalization reports were complete and then further analyzed in the paper. Admission diagnostic groups given by the primary care doctor were compared with discharge diagnostic groups filled out by the practicing physician in the hospital ward from which a patient was discharged. The agreement of these two diagnostic groups was an indication of the high-quality performance of the primary care doctor. Agreement analysis was conducted using Cohen’s Kappa statistics. Results. Agreement analysis showed that the values of the Kappa coefficient for the five leading admission diagnostic groups were in the range of κ = 0.61 to κ = 0.94. The values of the Kappa coefficient for the five most common discharge diagnostic groups were in the range of κ = 0.55 to κ = 0.81. Conclusion. Hospitalization report is a reliable individual report on inpatient care, so it could be used in determining the degree of agreement between admission diagnostic groups and discharge diagnostic groups.

Copyright of Archives of Industrial Hygiene & Toxicology / Arhiv za Higijenu Rada I Toksikologiju is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medical Journal / Medicinski Časopis is the property of Serbian Medical Society, Section Kragujevac and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Uvod: U Kliničkom zavodu za nuklearnu medicinu i bolesti štitne žlijezde UKC RS od 2006. godine postoji Terapijski blok u kojem se hospitalizuju pacijenti nakon operativno odstranjene štitne žlijezde i patohistološki verifikovanog karcinoma štitne žlijezde radi provođenja terapije radioaktivnim I131. U terapijskom bloku Kliničkog zavoda za nuklearnu medicinu i bolesti štitne žlijezde postoji mogućnost praćenja pacijenata pri aplikaciji I131 i mjerenja preostale aktivnosti pri otpuštanju pacijenta sa liječenja. Od 2007. godine u BiH postoji regulatorna agencija za atomsku energiju na državnom nivou. Prema novom Pravilniku, predviđeno je da se ambulantna administracija I131 može vršiti do 800 MBq, a primjena većih doza I131 zahtjeva hospitalizaciju pacijenta. Cilj rada: 1. Prikazati preostalu radioaktivnost I131 pri otpustu pacijenta i uporediti je sa primljenom dozom I131. 2. Prikazati količinu preostale aktivnosti I131 i uporediti je sa evropskim standardima i preporukama IAEA. Metodologija rada: Godišnje u terapijskom bloku KZZNM hospitalizuje se 150 pacijenata. U ovom radu prikazani su pacijenti koji su hospitalizovani u toku 2018. godine sa dijagnozom Ca papillare i Ca folicullare. Pri analizi uzeli smo u obzir primljene doze radioaktivnog I131, broj dana ležanja u bolnici, te izmjerene doze na udaljenosti od 1m pri otpuštanju pacijenta iz terapijskog bloka. Rezultati: Analizirano je 130 pacijenata u toku 2018. godine. Od ukupnog broja analiziranih 125 pacijenata ima dijagnozu Ca papillare. Sve aplikovane doze su bile preko 1.850 MBq. Sve izmjerene doze pri otpustu su u skladu sa evropskim standardima. Zaključak: Standardnim postupcima u terapijskom bloku KZZNM postiže se da preostala radioaktivnost kod pacijenta bude u skladu sa preporukama Evropske komisije. [ABSTRACT FROM AUTHOR]

Copyright of Medical Gazette / Medicinski Glasnik is the property of Specijalna bolnica za bolesti stitaste zlezde i bolesti metabolizma Zlatibor and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The inhabitants of the Dinaric Alps (former Yugoslavia and Albania) have long been known as people of impressive body height, but after World War II, there was a critical lack of data related to this phenomenon. This anthropological synthesis includes the measurements of 47,158 individuals (24,642 males and 22,516 females) from the period 2010−2018 and describes detailed regional differences in male stature in the Western Balkans. According to these data, young men from Montenegro (182.9 cm) are currently the tallest 18-year-olds in the world, surpassing their Dutch peers (182.4 cm), and 18-year-old boys from Dalmatia are even taller (183.7 cm) at a regional level. A continuous belt of extraordinary height means (>184 cm) stretches from the Adriatic coast of Dalmatia through Herzegovina to the central part of Montenegro. This article summarizes all the key socio-economic, nutritional, and genetic data, and offers possible explanations for this anthropological phenomenon. Since the remarkable height of the Dinaric populations cannot be connected with any commonly known environmental factor, the most probable hypothesis is genetic and links these physical characteristics with the local founder effect of Y haplogroup I-M170. Furthermore, given that both the level of socio-economic development and dietary protein quality are still sub-optimal, the local upward trend in body height has the potential to continue in the future.