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Background/Aim. Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of surgery in newborns and young infants. Conservative treatment of IHPS is of great importance because it spares the newborn from stress caused by surgery and general anesthesia. The aim of this study was to evaluate the impact of various oral administration regimens of atropine on its efficacy in treating IHPS. Methods. The study included 45 patients with IHPS, conservatively treated by atropine sulfate in the period from 2006 to 2016. Clinical examination, laboratory analysis, and ultrasonography were performed on all patients on admission. The efficacy of treatment with different oral dosage regimens was analyzed and potential predictive factors of the negative outcome were defined. The evaluation of the success of the treatment was statistically analyzed by the method of the multivariate logistic regression model. Results. Out of 45 patients, 36 (80%) were successfully cured (p = 0.0008, without the need for surgery and without any complications. Gender prevalence, age, birth weight, body weight on admission, duration of symptoms, pyloric muscle thickness, and length had no statistically significant individual effect on the success of the atropine treatment. Patients who received a progressively increased dose of atropine had an 18 times higher risk of surgery, patients with hypochloremic alkalosis (HCA) had a 15 times higher risk, while others, with more than 5 vomitings within the first three days of the therapy, were 9 times more likely to be surgically treated. Conclusion. High success rate and no side effects represent an orally administered atropine treatment as a valid alternative choice for non-operative management of IHPS. Administration of initially high doses was shown to be more effective in relation to gradually increased oral doses of atropine sulfate. HCA and continued vomiting are considered as potential predictive factors of negative outcomes of the atropine treatment.

Background/Aim. Interatrial conduction time is early marker of disturbed impulse propagation in adult with elevated blood pressure. The aim of our study was to evaluate significance of noninvasive echocardiographic marker of slow sinus impulse propagation (atrial conduction time) for the identification of persons with slightly elevated blood pressure and hypertension in adults. Methods. One hundred and forty nine adults with normal and elevated blood pressure were studied: 46 normotensive adults (group 1), 28 adults with elevated blood pressure and hypertension stage 1 (group 2) and 75 adults with hypertension stage 2 (group 3), based on the Joint National Committee 8 (JNC-8) hypertension guidelines. We studied P wave dispersion, reservoir function of the left atrium (LA), total emptying volume of the LA and total emptying fraction of the LA (LATEF). The atrial conduction time (ACT) was evaluated by the pulsed tissue Doppler, and expressed as interatrial and intraatrial conduction time. Results. The LATEF decreased progressively from the group 3 (64.8 ± 4.4%) to the group 2 (59.8 ± 5.2%) and the group 1 (55.6 ± 7.3%) (p < 0.001). The P wave dispersion (55.1 ± 9.8 ms vs. 46.8 ± 3.1 ms vs. 43.1 ± 2.6 ms; p < 0.01) and intra ACT were significantly prolonged only in the group 3 compared to the other groups (22.7 ± 11.0 ms vs. 8.4 ± 4.7ms vs. 5.6 ± 2.4 ms, respectively; p < 0.001). Inter ACT significantly increased from the group 1 to the group 2 and the group 3 (15.6 ± 3.9 ms vs. 24.6 ± 5.7 ms vs. 50.4 ± 20 ms, respectively; p < 0.05). Using a cut-off level of 19.5 ms, inter ACT could separate adults in the group 2 from the group 1 with a sensitivity of 85%, and specificity of 89% [area under receiver operating characteristic (ROC) curve 0.911]. Conclusion. Prolonged ACT estimated with the tissue Doppler may be useful for identification persons with slighty elevated blood pressure, and hypertension stage 1.

Background/Aim. Hysteroscopy is one of the important methods in the endoscopic diagnosis and treatment of infertility, particularly at the examination of the morphology and function of the uterus. Uterine factor is present at 10% of infertile women, in which changes of the uterus can be congenital or acquired. The aim of this study was to estimate the significance of hysteroscopy in the diagnosis and treatment of congenital anomalies of the uterine cavity in patients in whom there was a reasonable suspicion for them based on prior clinical, ultrasound and hysterosalpingography (HSG) findings. The significance of hysteroscopy is considered in relation to the number of pregnancies achieved depending on the malformations in the 12 months period after the completion of the diagnostic or operational hysteroscopy. Methods. The study included 176 patients with congenital uterine anomalies, which had undergone hysteroscopy, diagnostic or operative, in the period from January 1, 2013 till January 1, 2016. Percentage of pregnancy was followed at all patients during the first 12 months after surgery. Patients were divided into two groups: the first group contained women who had pregnancy, and the second group included women who earlier were not pregnant. Their characteristics were compared, such as: age, duration of infertility, previous pregnancy and/or pregnancy loss, HSG and ultrasound findings, types of congenital anomalies, type of hysteroscopy, as well as the existence of associated pathology. Results. The mean age of patients tested in the study was 35 years. The group of patients with primary infertility had a total of 107 patients, while 69 patients were with secondary infertility. The average duration of infertility was 3 years in the studied patients. In the 12-months period, 39 of the examined women began pregnancy, which was completed with term delivery in 33 women. χ2 test showed a statistical significance difference (p < 0.05) between the groups of the patients with or without pregnancy after hysteroscopy in relation to infertility types as well as in relation to the number of previous miscarriages. Conclusion. Subseptus and septus uteri were the most common congenital uterine malformations in our patients. Very rare were uterus arquatus, uterus unicornis and uterus bicornis. In our study, 1/5 of examined women achieved pregnancy after hysteroscopy in the reporting period of 12 months, while the majority of these pregnancies ended with term delivery. The percentage of miscarriages in the examined women was reduced from 38% to 15% after hysteroscopy. In women who achieved pregnancy, uterine septum and subseptum were mostly diagnosed and in these patients hysteroscopic resection was successfully performed.

Background/Aim. Epileptogenic lesions carry intrinsic epileptogenicity or epileptogenic potential in their close vicinity. One third of patients with focal epilepsy have no epileptogenic lesions magnetic resonance imaging [MRI(-)]. The aim of this study was to determine the epileptogenic zone investigating electrical and clinical properties of MRI- patients. Methods. In 180 patients with focal epilepsy we analyzed 1,712 seizures for interictal and ictal electroencephalography (EEG) and seizure semiology. If multiple seizures occurred we took the best seen on video as an example, with secondary generalized tonic-clonic seizures (GTCS) if it occurred. Brain MRI was focused to investigate the zone of ictal EEG onset. Electroclinical properties of the MRIpatients were compared to lesion positive patients [MRI(+)]. Results. A single epileptogenic lesion was identified in 68.89% [hippocampal sclerosis (HS) in 58, focal cortical dysplasia (FCD) in 28 and other pathologies in 38 patients]. MRI(-) patients had significantly less interictal epileptiform abnormalities, and presented more often (p < 0.001) with secondary GTCS as the only seizure. Eye opening, hypermotor seizure, bilateral asymmetric clonic seizure, vocalization, and contralateral body turning occurred more frequently in the MRI- group compared to the MRI+ one. MRI- patients share some semiological features with FCD as opposed to HS patients. Conclusion. MRIepilepsy patients frequently present with electroclinical features seen in frontal lobe epilepsy or in epilepsy associated with FCD.

Background/Aim. Pulmonary exacerbations have negative impact on clinical course of cystic fibrosis (CF) lung disease being associated with a steeper decline in the lung function, unfavorable prognosis and impaired quality of life. The aim of this study was to determine whether an increased number of exacerbations had influence on the lung function in the patients with CF, as well as to estimate the nutritional status, gender, presence of comorbid conditions and bacterial colonization of airways as predictive factors for pulmonary exacerbations. Methods. This retrospective cohort study included 83 pediatric and adult patients, treated from 2011– 2015 in the Mother and Child Health Institute of Serbia „Dr Vukan Čupić”. The best result of forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in each year of follow-up was taken into account to calculate the five-year trend values of these indicators. The number of exacerbations per year of follow-up and its impact on the FEV1 decline was evaluated. Results. Mean annual decline of FEV1 and FVC were 2.4% and 1.7% respectively. The malnourished patients had the lower initial values of FEV1 and FVC, and more frequent exacerbations in comparison with the normal weight and overweight patients. The frequency of exacerbations was significantly higher in the patients chronically colonized with Burkholderia cepacia (p = 0.023). The increased number of exacerbation was proved to be the most important factor in a prediction of FEV1 decline over time (p = 0.013). Conclusion. Pulmonary exacerbations lead to the more progressive lung function decline in the patients with CF. Malnourishment and chronic airway colonization with Burkholderia cepacia result in more frequent pulmonary exacerbations.

Introduction/Objective. The aim of this follow-up study was to determine the effects of topiramate therapy on cognitive functions in patients with pharmacoresistant focal epilepsy. Methods. The study sample comprised of 40 topiramate naive patients. The topiramate starting dose was 25 mg, with a fortnightly titration schedule of 25 mg. A wide range of cognitive functions was evaluated through extensive neuropsychological testing at baseline and six months after reaching the target dose (200 mg/day). Results. The most common side effects following the introduction of topiramate were cognitive impairments, reported by 45% of the participants. The neuropsychological scores on attention, executive function, verbal content recall, improved cognitive flexibility, as well as visuospatial ability and speech, obtained at six-month follow-up were significantly lower than at baseline. However, statistically significant correlation between neuropsychological scores and the number of antiepileptic drugs taken alongside topiramate could not be established. Similarly, no statistically significant differences were noted between the percentage of reduced neuropsychological scores at follow-up pertaining to patients with lower and higher baseline cognitive performance. Moreover, regression analysis indicates that the percentage change in the majority of cognitive scores is unrelated to the age at the epilepsy onset, epilepsy duration, presence of brain pathology on magnetic resonance imaging and percentage change in the depression scale score. Conclusion. Despite slow introduction and administration of a relatively small dose, topiramate exhibits adverse effects on a wide range of cognitive functions, which appear unrelated to the number of additional antiepileptic drugs, baseline cognitive functioning, age at the onset of epilepsy and its duration, presence of brain pathology and the extent of depressive symptoms.

Background/Aim. Tuberculosis in the second decade of the 21st century is an infectious disease with the highest mortality rate. In addition, in developed countries, pneumonia is the major couse of morbidity and mortality in adults. The aim of our study was to point out the differences and similarities between symptoms, laboratory parameters and clinical indicators in patients with pulmonary tuberculosis (PTB) and patients with pneumonia in the general population and in people belonging to the high risk groups for developing tuberculosis. Methods. This prospective study included patients with PTB (n = 70) and pneumonia (n = 75) treated at the Pulmonology Department of Clinical Hospital Center in Kosovska Mitrovica. Results. PTB was more frequent in men, 30–39 years of age (OR; 6:08), mainly from rural areas (p = 0.001), and with lower levels of education (p = 0.031). Pneumonia was more frequent in women older than 60 years of age (p = 0.0012). Night sweats (p = 0.001) and weight loss (p = 0.062) were significantly more frequent in patients with PTB, while chest pain (p = 0.001) and high temperature (p = 0.036) were more common in patients with pneumonia. X-ray changes in patients with PTB were located in the upper fields (p = 0.001), or appeared to be bilateral (p = 0.004). The strongest predictor associated with an increased risk of night sweats was diagnosed PTB (OR = 30.0). The chest pain was a predictor of pneumonia, unilateral changes (OR = 4.65) in the lower lung fields (OR = 0.08). Conclusion. Night sweats, weight loss and chest X-ray abnormalities in upper fields were significant indicators of PTB. Chest pain, fever and chest X-ray abnormalities in lower fields were significant indicators of pneumonia.

Background and aim: The nutritive status has significant role in improving the quality of life of dialysis' patients. The aim of this study was to find out if there is any correlation of the anthropometric parameters and markers of nutrition with the adequacy of HD. Methods: The investigation was organized as a clinical, cross sectional study. Demographic characteristics, co-morbid conditions, smoking, dialysis duration and blood pressure were recorded. Serum total protein, albumin, ferritin and blood-lipids were measured as biochemical markers of nutritional status. One hundred and forty patients, 82 (58.6%) male, and 58 (41.4%) female, 55±12.59 years, were dividied into two groups. Group A consisted of 44 patients (14 women and 30 men) received the recommended hemodialysis dose (Kt/V ≥ 1.2), while the Group B consisted of 96 patients (69 males and 27 females) received non-adequate hemodialysis dose (Kt/V < 1.2). Results: Patients with adequate hemodialysis had been longer on dialysis in correlation with the group of patients with non-adequate hemodialysis (73 ± 56.4 vs. 44 ± 50.1 months; p: 0.004). Group A and group B presented significant differences in the number of leukocytes (p: 0.027), and hemoglobin (p: 0.047), potassium (p: 0.038) and C-reactive protein level (p: 0.048) as well as in serum total protein (69 ± 4.63 vs. 65 ± 5.74 g/L; p < 0.0001) and albumin (38 ± 2.99 vs. 29 ± 4.4 g/L; p: 0.047). Pearson's correlation of factors that may have impact on hemodialysis adequacy indicated a significant relation between serum total protein and the index of hemodialysis adequacy (r: 0.21; p: 0.0446). Conclusions: All investigated anthropometric parameters and protein status showed significantly higher values in patients with adequate hemodialysis quality (Group A). The Group B showed higher levels of CRP and lower values of hemoglobin. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the influence of IL-6, TNF-a and hs-CRP on insulin sensitivity during postoperative follow-up in patients with laparoscopic cholecystectomy (LC) or open hernia repair (OHR). Methods: 65 patients were studied: after laparoscopic cholecystectomy (LC; n=40) or open hernia repair (OHR; n = 25). Glucose, insulin, hs-CRP IL-6 and TNF-a were determined at day 0 (before the operation) and at days 1, 3 and 7 (after the operation). Results: There were no difference between LC and OHR groups concerning age, BMI, glucose, insulin, hs-CRP IL-6 and TNF-a at day 0. hs-CRP increased at day 1, 3 and 7 vs. day 0 (p

Introduction/Objective. Recently published studies have addressed the significant impairment of healthrelated quality of life (HRQoL) in patients suffering from gastroesophageal reflux disease (GERD) and functional dyspepsia (FD). To the best of our knowledge, none of the previously published studies have compared the impact of GERD and FD on HRQoL. The aim of the study was to determine the impact of GERD and FD on HRQoL. Methods. The current sample was extrapolated from a large cross-sectional population-based study conducted in primary health care facilities. Primary care physicians and general internists diagnosed GERD according to the Montreal definition for population-based studies. Also, primary care physicians and general internists diagnosed FD based on the Rome III criteria. The Serbian version of the generic self-administered Center for Disease Control and Prevention questionnaire was used. We used the propensity score method to match GERD and FD samples on variables such as age, gender, education, and adherence to therapy. Results. Regarding self-rated health, similar results were obtained from both groups. The Center for Disease Control and Prevention HRQoL questionnaire version 4 further revealed that functional dyspepsia led to greater disturbances of every-day functioning in regard to the criteria of physically healthy, mentally healthy, and activity limitation days. Conclusion. The results of the study have shown significant impairment of HRQoL in both groups, but, surprisingly, patients with FD experienced more limitations to their every-day functioning compared to patients with GERD.

Workplace violence is a serious and multidimensional problem that adversely affects professional and personal lives of employees. The aim of this study was to assess the prevalence and characteristics of verbal violence as a part of psychological violence among employees in primary health care in Belgrade, and to identify contributing factors of verbal violence in the workplace.

Background/Aim. Recent population based studies have proved that patients with functional dyspepsia (FD) have a significantly impaired health-related quality of life HRQoL as compared to general population. The aim of the study was to evaluate the impact of FD on (HRQoL) in patients treated in primary healthcare settings in Serbia. Methods. The study involved 1,448 patients with FD. The diagnosis was made by a general practice physician or gastroenterologist using the Rome III diagnostic criteria. The Serbian version of the questionnaire for the assessment of HRQoL of the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention (HRQoL-4 item CDC) was used for data collection, while descriptive statistical measurements were applied to calculate standard deviation, frequency as well as multiple logistic regression model. Results. Out of the total number of patients, 41.8% assessed their health condition as seriously disordered or poor. The mean values of health disorder duration over the last 30 days was 11.8 days, disordered physical health 7.2 days, mental disorder 6.3 days, and activity limitation 5.1 days. Also, 29.7%, 15.2%, 12.8% and 10.7% of the patients reported ≥ 14 unhealthy days, ≥ 14 physically unhealthy days, ≥ 14 mentally unhealthy days and ≥ 14 activity limitation days, respectively. Conclusion. From patients’ perspective, FD has a significant impact on HRQoL. In this study, 41.8% of the patients described their health status as fair or poor, and FD significantly affects all aspects of life, both mental and physical. The recognition of that impact is probably the most important step towards appropriate treatment and decreasing HRQoL impairment in patients with FD.

Validity shows the degree of concurrence between the results received by an actual measuring and that of what an instrument is supposed to measure. There are three main types of validity: content validity, criterion-related validity and construct validity. Factor validity is a special approach to constructive validity, tested by statistical analysis called factor analysis. Hamilton rating scale for depression and Montgomery-Asberg depression scale are the most widely used psychiatric instruments. The aim was to carry out a systematic review of the literature on factor structure of psychiatric scales reported in different times during longitudinal studies. The units of analysis were published papers obtained by searching the two bibliographic databases: MEDLINE and PsycINFO. Factor validity of the HAMD scale was reported in 6 (0.09%) of 6590 studies which used this scale, whereas the factor validity of the MADRS scale was reported in 4 (0.2%) of 2051 studies which used the MADRS scale. The difference between the first and the last measuring in relation to values was not statistically significant: median of the number of extracted factors of the HAMD scale (p=0.371), median of total explained factor variance of the HAMD scale (p=0.250), median of variance explained by the first factor of the HAMD scale (p=0.125). Factor validity of the MADRS scale in repeated measuring also did not have statistically significant difference for the following values: median of the number of extracted factors of the MADRS scale (p=0.174), median of variance explained by the first factor of the MADRS scale (p=0.125). Coefficients of concurrent validity of the HAMD i MADRS depression scales show the trend of increase in longitudinal studies and their values are for about a third higher at the end of studies than in their beginning. Low frequency of reporting the data about reliability and validity of applied rating scales is the main problem in using the meta-analytical methods effectively to study changes in adequacy of measures in longitudinal studies.

Planning cluster randomized studies requires special attention due to their specific design. To achieve balance on a cluster level as well as on individual level, it is necessary to apply randomization techniques which involve restricted randomization. Objective: Determine randomization techniques as well as their frequency in protocols for cluster randomized trials. Materials and method: Searching the MEDLINE bibliographic database, there were 1020 bibliographic units, the analysis included only the protocols for cluster randomized trials, which was a total of 169 trials. Data on randomization techniques, units of randomization and publication years of protocols were extracted. Results: The randomization technique with most frequency was stratification (35.9%). After stratification the most frequent was simple randomization (13.5%), followed by a combination of block and stratification (10%), block randomization (9.4%) and matching (9.4%). The most frequent units of randomization were health facilities (52%). The number of published protocols statistically increases during time (p

Backgraund/Aim. The northern part of Kosovo was one of the largest lead and zinc production industries in Europe. Special attention has been paid to the landfill sites of these metals remained after past industrial activities. The inhabitants of Roma camps in this area are collecting led waste they process by crushing and melting in their shacks in primitively organized working environments. Because of all the aforementioned it was necessary to examine the concentration of blood lead level (BLL) in the children aged less than 6 years inhabiting this area, especially taking care of blood analysis of children living in Roma camps. Methods. The study was conducted in the municipality of Leposavić, Province Kosovo and Metohija, Serbia. Totally 78 subjects participated in the study. All the subjects were divided into two groups: the group I consisting of 42 children who lived in the Romas camp, and the group II with 36 children from a city kindergarten. Based on the mathematical model WRPLOT we found out that both groups of patients were in the low risk zone for industrial contamination exposure. Blood analysis was done according to the protocol provided by ESA Lead Care. Results. The average age of participants in the study was 4.60 ± 1.63 years. The mean BBL in the children from the group 1 was 19.11 μg/dL and from the group 2 4.87 μg/dL. There was a statistically significant difference in the mean values of BBL between the groups (U = 39, p < 0.001). All of the children from the group 1 had BBL greater than 5 μg/dL in comparison to 38.9% of the children from the group 2 (χ2 = 35.75, p < 0.001). Conclusion. Although both groups were located outside the zone of direct spread of pollution, the results indicate high concentrations of lead in blood of all the examined children. The concentration was higher in the children who lived in the area in which illegal processing of lead waste took place. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. TR 37016]

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.

Introduction. Obesity is a complex metabolic disorder and one of the most common modern health problems. Numerous studies indicate association between chronic low-grade inflammatory state and obesity. Myeloperoxidase (MPO) and its reactive oxidants participate in tissue damage in the course of inflammatory processes. The aim of this study was to examine MPO activity in the serum of obese participants with metabolic syndrome and its relationship with other indicators of inflammation. Material and Methods: Participants were divided into three groups according to the anthropometric parameters and biochemical indicators: normally fed ones (n=30), participants with abdominal obesity (n = 30) and participants with metabolic syndrome (n = 30). In the serum of patients was being determined chlorination activity of MPO by spectrophotometry. Results: Significant differences were found in MPO activity in all three groups of participants such as: the maximum activity was measured in patients with metabolic syndrome (p

Introduction: In over of 99% cases of cervical cancer its appearing is preceded by persistent cervical epithelium infection caused by high-risk oncogenic types of human papillomavirus (HPV). The aim of the study was to examine the distribution of high-risk oncogenic HPV types compared to patohistological diagnoses of cervical diseases in women. Materials and methods: The study included 56 women with suspected premalignant and malignant cervical lesions, due to suspected colposcopic and cytological findings (Papanicolaou test). The HPV typing by 'in situ' hybridization method on high-risk HPV types 16, 18, 31 and 33 was performed in all patients from cervical smear as well as cervical biopsy. Histological findings of cervical biopsy was a 'gold standard' in the analysis of materials. Results: Histologically detected premalignant or malignant changes of the cervix were found at 34 (60.7%) of all 56 examined women: 17 of them had LSIL, 13 of them had HSIL, while 4 had squamous cell carcinoma. A positive HPV test had a 47 (84%) of them with a prove of the presence of one or more types of HPV. The most common type of virus was HPV 16 and it was detected in 27 (48.2%) women, followed by HPV 31 that was detected in 26 (46.4%) women, HPV 18 in 18 (32.1%) of women and HPV 33 in 4 (7.1%) women. The infection caused by oncogenic type HPV16 was significantly more frequent in patients with HSIL and cervical cancer (p

Background/Aim. Immune system disorder, including inflammation, takes a significant place when considering still unclear etiology of schizophrenia. The aim of this study was to determine the blood levels of nonspecific inflammation markers in the first episode of schizophrenia and their relation to the therapy response. Methods. In this study we determined the blood levels of nonspecific inflammation markers: white blood cells count (WBC), C-reactive protein (CRP), erythrocytes sedimentation rate (ESR) and the elements of differential white blood cell counts (or the leukocyte formula): granulocytes (Gra), lymphocytes (Lym) and monocytes (Mon), in the first episode of schizofrenia, in 78 patients hospitalized at the Clinic for Psychiatric Disorders “Dr Laza Lazarević” in Belgrade. The levels were measured at admission to the clinic, as well as after 4 weeks of antipsychotic treatment. The Positive and negative syndrome scale for schizophrenia (PANSS) was applied to measure the severity of psychopathology and response to the treatment. Results. During the first episode of schizophrenia, before initiation of antipsychotic treatment, the frequency of abnormal values was high (≥ 25% of the patients) for the following non-specific inflammation markers: WBC, CRP, ESR and Gra, in the leukocyte formula, but dropped after 4 weeks of antipsychotic treatment at the level of high statistical significance for WBC and Gra (p < 0.001). The ESR remained unchanged in as many as 50% of the patients even after 4-week antipsychotic treatment, at the level of statistical significance in the non-responders compared to the responders (p = 0.045). Conclusion. The obtained results indicate that in the first episode of schizophrenia the blood levels of non-specific inflammation markers (WBS, CRP, ESR and Gra from the leukocyte formula) were high in the subpopulation of patients with the tendency towards normalization of inflammation parameters after a 4-week antipsychotic treatment.

Introduction. By the year 2020, if current trends for demographic and epidemiological transition continue, the burden of depression will have increased to 5.7% of the total burden of disease, thus becoming the second leading cause of disability-adjusted life year (DALY) lost. Early detection of people at risk of developing any mental disorder is extremely important in the prevention of all mental disorders. Objective. The objective of the study was to determine depression predictors among adult residents in four Kosovo and Metohia municipalities predominantly inhabited by Serbian population. Methods. This cross-sectional study included the representative sample of adults in Leposavić, North Kosovska Mitrovica, Gnjilane and Priština and was performed in October/November of 2009. The sample was selected from the list of citizens older than 18, received in the above mentioned municipalities. The Goldberg General Health Questionnaire (GHQ-28) was used as a research instrument. The methods of statistical analysis included descriptive statistics, simple and multiple logistic regression analysis, and analysis of variance, with a significance level of 0.05. Results. Problems with depression have been significantly associated with female sex (OR=2.24), older age (OR=1.01), lower levels of education (OR=0.50), unemployment (OR=1.09), poor financial situation (OR=0.45), abuse (OR=0.08) and assessment of the future political and security situation as a highly risky one (OR=3.01). Conclusion. To determine risk groups being in greater risk to suffer from depression is important for planning, enhancing, promoting and implementing the prevention strategies for this disease.

Introduction. Recent data from the studies conducted in the Western countries have proved that patients with gastroesophageal reflux disease have significantly impaired health-related quality of life compared to general population. Objective. The study is aimed at evaluating the burden of reflux symptoms on patients’ health-related quality of life. Methods. The study involved 1,593 patients with diagnosed gastroesophageal reflux disease. The Serbian version of a generic self-administered Centers for Disease Control and Prevention questionnaire was used. Statistical analyses included descriptive statistics, Pearson chi-square test and a multiple regression model. Results. Among all participants, 43.9% reported fair or poor health. Mean value of unhealthy days during the past 30 days was 10.4 days, physically unhealthy days 6.4 days, mentally unhealthy days 5.3 days and activity limitation days 4.3 days. Furthermore, 24.8% participants reported having ≥14 unhealthy days, 14.9% had ≥14 physically unhealthy days, 11.8% reported ≥14 mentally unhealthy days, and 9.4% had ≥14 activity limitation days. Conclusion. This study addressed complex relationships between reflux symptoms and patients’ impaired everyday lives.

Background/Aim. Urinary tract infections are still the most frequent complications in patients with spinal cord injury (SCI). The aim of this study was to analyze the factors influencing development of urinary tract infections during rehabilitation in patients with SCI. Methods. This retrospective case/control study including 540 patients with SCI which were rehabilitated in the Clinic for Rehabilitation “Dr Miroslav Zotović” between January 2000 and December 2009. We used patient files and other avail-able medical documentation for obtaining information contained in this study, such as the manner of bladder emptying, the type of neurological disorder of the bladder, the neurological level and completeness of a lesion, the injury etiology, treatment method, secondary complications and associated injuries, kidney and bladder calculosis, age and sex. Results. Out of the total number of patients included in the study, 152 (28.1%) were without urinary tract infections, whereas 388 (71.9%) had urinary tract infections. There were 389 (72%) male and 151 (28%) female patients. The average age of patients without urinary tract infections was 51.0 ± 15.4 years, whereas the mean age of patients with urinary tract infections was 44.3 ± 16.9 years. The results of our study showed that the occurrence of urinary tract infections during rehabilitation in patients with SCIs was associated with the following factors: combined injuries (OR = 3.5), anemia (OR = 5.67), type of the bladder functional disorder (OR = 40-60) and crystals in urine (OR = 7.54). Conclusion. The physicians should take precautions and try to make the early diagnosis and rapid appropriate treatment of urinary tract infections in patients with SCI who also have functional bladder disorder, combined spinal injuries, anemia or urine crystals.

Atrial arrhythmias are an often and common problem in patients with arterial hypertension. Some recent studies have shown that the electrical pulse delay estimated by echocardiography is prolonged in patients with paroxysmal atrial fibrillation compared to healthy persons. To assess the electromechanical function of the left atrium in patients with various degrees of hypertension compared to healthy persons. The study has included 103 patients with artery hypertension, who were divided into four groups according to the degree of arterial hypertension and 46 healthy persons as a control. The volumes of the left atrium were measured by echocardiography using the disk, active and passive emptying volumes of left atrium and the fractions were calculated. Electrical delay within the left atrium and between the two atria were measured using the tissue Doppler. The values of passive left atrial emptying fraction were highest in patients in the control group and in patients with prehypertension they have significantly declined with the increased degree of hypertension (12.8 vs 12.6 vs 11.2 vs .10.2 vs 9.9%, p

Background/Aim. Mental health disorders lead to disorder of effective functioning of people and deterioration of quality of life. Early detection of individuals at risk of mental health disorders is extremely important from the aspect of mental health disorders prevention. The aim of the research was to determine the frequency of mental health problems among adult residents of northern Kosovska Mitrovica and to examine the association between frequency of mental health problems and socio-demographic and other characteristics of the population obtained by the questionnaire. Methods. The cross-sectional study on the representative sample of adult residents of northern Kosovska Mitrovica was performed in October 2009. To obtain information about the characteristics of mental health the Goldberg’s General Health Questionnaire (GHQ-28) was used. For performing survey at site the method of rapid epidemiological assessment was chosen. Statistical analysis included the methods of descriptive statistics, multivariate regression analysis and calculation of the Cronbach’s alpha coefficient of internal consistency of the questionnaire. Results. Mental health problems (total score) were present in almost half of the respondents (49.2%). Psychosomatic problems were present in more than half of the respondents (55.4%), while anxiety and insomnia were present in almost half of the respondents (49.2%). Social dysfunction had more than three fifths of the respondents (63.1%) and depression more than a quarter of the respondents (28.5%). More positive responses in the questionnaire were statistically significantly associated with older age, poor financial situation, abuse and assessing of the current political-security situation as high risk. The value of Cronbach’s alpha coefficient was 0.705. Conclusions. Almost half of the respondents (49.2%) of North Kosovska Mitrovica had mental health problems. Mental health problems were associated with older age, poor financial situation, abuse and considering the current political security situation as high-risk factor.

Background/Aim. Adipose tissue secrets a number of hormonal active substances that play an important role in the development of various metabolic diseases. The aim of this study was to determine the resistin significance in patients with various forms of metabolic diseases. Methods. The survey was conducted in a hospital in Laplje Selo, and included 102 patients suffering from diabetes mellitus, cardiovascular disease and renal insufficiency. All patients were verified and anthropometric characteristics and the basic hematological and biochemical analysis and resistin level were controlled. Results. The average age of the patients, 69 (67.6%) men and 33 (32.4%) women, was 55 ± 9.3 years. It was about two-thirds of smokers. The values of mean arterial blood pressure suggested that our patients had expressed hypertension, body mass index (28.5 ± 3.4 kg/m2) pointed to excessive well-fed, the circumference of hips (100 ± 10.8 cm), waist circumference (110 ± 17.4 cm) and the ratio of hip/waist circumference (1.05 ± 0.14) indicated a significant intra-abdominal distribution of fat tissue. More than one third of our patients had a certain form of cardiovascular diseases, renal failure was present almost in a fifth of patients, while diabetes mellitus was verified in 44.1% of the studied population. Significantly higher values of resistin concentrations were determined in patients with renal insufficiency and diabetes mellitus. In relation to the level of resistin, according to the number of metabolic diseases per patient, a statistically significant difference was achieved (F = 11.80, DF = 4.61, p < 0.001). Spearman correlation (r = 0.66, p < 0.001) found a statistically significant correlation between the number of diseases in one subject and the levels of resistin. Conclusion. In patients with diabetes mellitus and renal failure higher concentrations of resistin were recorded.