Srpski medicinski casopis Lekarske komore最新文献

{"title":"The HIV/AIDS epidemiological situation among men and women in Serbia in the period 2007-2017: Joinpoint regression analysis","authors":"A. Nikolić, A. Božič, D. Simić, S. Šipetić-Grujičić","doi":"10.5937/smclk2001022n","DOIUrl":"https://doi.org/10.5937/smclk2001022n","url":null,"abstract":"Introduction: Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) is a global major health problem. According to the data for 2018, there were 37.9 million people living with HIV/AIDS in the world, and the number of deaths related to AIDS was about 770,000. Aim: The aim of this study was to analyze the trend of newly diagnosed HIV-infected people, AIDS patients and AIDS-related deaths among men and women in Serbia, for the period 2007-2017. Materials and methods: Data on newly diagnosed HIV-infected people, AIDS patients and AIDS-related deaths were taken from the Report on Infectious Diseases in the Republic of Serbia. Age-specific and standardized mortality and incidence rates (standardized according to the world population) were calculated based on the data obtained. Joinpoint regression analysis was used to examine the trend. Results: The average standardized rates of newly diagnosed HIV-infected people (per 100,000) in Serbia, for the period 2007-2017, were 3.4 for men and 0.8 for women. There was a significant annual increase in standardized rates of newly diagnosed HIV-infected people; 7.0% for men and 21.1% for women. The average standardized rates (per 100,000) of AIDS incidence were 0.9 for men and 0.2 for women. There was a significant annual increase of 4.9% in the standardized incidence rate of AIDS in men, and a significant decrease of -12.2% in women. The average standardized mortality rates from AIDS (per 100,000) were 0.4 for men and 0.1 for women. During the observation period, there were no significant changes in the standardized mortality rates from AIDS in men, while in women there was a significant decline of -13.9% per year. The most common route of HIV transmission in men was sexual intercourse with men (69.0%), and in women it was heterosexual intercourse (75.7%). Conclusion: Further work is needed, primarily in advancing preventive measures, particularly by educating young people about transmission pathways and risks, but also in the early detection of HIV-infected persons and timely treatment.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127568479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How much has the COVID-19 pandemic changed us: The experience of the clinic for mental disorders \"Dr Laza Lazarević\"","authors":"I. Stašević-Karličić","doi":"10.5937/smclk2-33326","DOIUrl":"https://doi.org/10.5937/smclk2-33326","url":null,"abstract":"In order to preserve and improve public health, guided by the recommendations of the World Health Organization (WHO), the Clinic for Mental Disorders Dr Laza Lazarević, in cooperation with the Ministry of Health of the Republic of Serbia, developed a strategy for mental healthcare during the COVID-19 pandemic. This paper briefly presents some specific activities that the Clinic for Mental Disorders Dr Laza Lazarević has carried out during the current COVID-19 pandemic.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115568210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal uterine bleeding in women of reproductive age","authors":"R. Sparić, Đina Tomašević, Mladen Anđić, Svetlana Spremović-Rađenović","doi":"10.5937/smclk2-34990","DOIUrl":"https://doi.org/10.5937/smclk2-34990","url":null,"abstract":"Introduction: Abnormal uterine bleeding is one of the most common health disorders in women of reproductive age. In addition, it represents a significant public health problem. The aim of this paper is to present the modern classification, as well as the basis for diagnosis and treatment of abnormal uterine bleeding. Methods: This paper presents data from publications selected from the MEDLINE database using a combination of keywords: \"menstrual bleeding\", \"abnormal uterine bleeding\", \"PALM-COEIN classification\", \"leiomyoma\", \"endometrial polyp\", \"adenomyosis\", \"gynecological malignancies\", \"coagulopathy\", \"diagnostics of abnormal uterine bleeding\", and \"treatment of abnormal uterine bleeding\". The collected data from the selected studies were used and presented in this review paper. Conclusion: In order to achieve a unique classification of abnormal uterine bleeding, a classification was adopted under the name/acronym PALM-COEIN. The causes listed in the first part of the acronym (PALM) have a pathological/ anatomical cause in the reproductive organs that can be diagnosed using imaging techniques and/or histopathological examination. The causes listed in the second part of the acronym (COEIN) represent a group of dysfunctional disorders and they cannot be diagnosed using imaging techniques.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115649389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functioning, disability and exercise in the elderly","authors":"M. Kostadinović, S. Dedović, F. Milanović, N. Aksović, D. Nikolić","doi":"10.5937/smclk3-37528","DOIUrl":"https://doi.org/10.5937/smclk3-37528","url":null,"abstract":"The age of the population is increasing worldwide and is becoming an emerging problem in society. Maintaining physical as well as mental health, together with preventing and reducing disability, particularly in the older population, should be one of the most important aspects of successful aging. Thus, the goals of health programs should be the promotion of successful, active, and healthy aging. Elderly patients are usually associated with multiple medical conditions, which should be evaluated in a multidisciplinary fashion, bearing in mind the needs of this group of individuals. Even though it is assumed that aging is associated with a decline in functioning and, therefore, with reduced functional capacity in the elderly, it is important to identify the factors which play specific roles in healthy and active aging. Special consideration should be given to cognitive functioning. Furthermore, the elderly are at risk, due to habits characteristic of a sedentary lifestyle. Despite the positive effects of physical activity, particularly in the prevention and delay of chronic diseases and conditions, as well as in reducing the risk of premature death and in supporting positive mental health and healthy aging, the elderly population may face obstacles in terms of limited space for the safe execution of activities and the lack of proper knowledge on how to be active while taking into account one's physical limitations. When planning and implementing a physical activity, especially in the older population, the important factors that need to be considered include duration, frequency, intensity and mode. It should be stressed that exercise programs for the elderly should include aerobic, resistance, flexibility, and balance training.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124563697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of a multidisciplinary diagnostic and therapeutic approach to painful symphysis syndrome in athletes","authors":"Katarina Vukosavljević, Miloš Bojović, D. Drljačić, K. Vukušić","doi":"10.5937/smclk3-34160","DOIUrl":"https://doi.org/10.5937/smclk3-34160","url":null,"abstract":"Painful symphysis syndrome (pubalgia) in athletes is a particular injury, a painful condition, and dysfunction of the femoroinguinal region, which occurs due to the disproportion in strength between the abdominal wall muscles and the muscles of the lower extremities. This study aims to theoretically analyze the importance of a multidisciplinary diagnostic and therapeutic approach to painful symphysis syndrome in athletes. More than seventy causes of pubalgia have been presented in literature, most commonly linked to sports factors. Activities that include repetitive strong kicks, rotational movements, circumduction, and torsion, are risk factors. The syndrome was first registered in football players, and it mostly occurs in male athletes under the age of forty. Establishing a diagnosis is difficult, due to the complex anatomy and the overlapping of symptoms between different groin injuries. The therapeutic approach depends on the complexity of the injuries and the dynamics of the patient's recovery. It entails observing the principles of initiating treatment with minimally invasive modalities and reserving surgical treatment as the final therapeutic option, after which it is necessary to conduct an appropriate rehabilitation program, tailored to the pain and the dynamics of recovery. Most athletes resume their sports activities after two to three months, with no recurrence of pubalgia after surgical treatment. However, bearing in mind that the occurrence of pubalgia prevents the patients from engaging in sports activities over a prolonged period, special attention should be directed towards the prevention of this painful syndrome. Taking this into consideration, prevention should begin at the earliest age, through a daily program of exercises for strengthening the muscles of the anterior abdominal wall, with special emphasis on the oblique and transverse abdominal muscles.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117274044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advantages of point-of-care methods in perioperative bleeding control","authors":"N. Dimić, Milan Gojgić, J. Stanisavljević, Milica Karadžić-Kočica","doi":"10.5937/smclk2001076d","DOIUrl":"https://doi.org/10.5937/smclk2001076d","url":null,"abstract":"Perioperative bleeding management is a complex task which has significant impact on surgery outcome. Most hemostasis disorders occurring intraoperatively are acute, caused by massive bleeding, and can be explained by the principle of loss, compensation, and dilution of circulating blood volume. Disorders at the level of the hemostatic system can be assessed both by various standard laboratory tests, such as: prothrombin time, activated partial thromboplastin time, platelet count, coagulation factor concentrates, levels of antithrombin and D-dimer; or by point-of-care (POC) methods. Standard laboratory tests have their limitations. They do not detect increased intraoperative bleeding tendency, and it is recommended to use methods such as POC, which quickly and accurately assess the patient’s coagulation status, thus enabling the administration of the appropriate therapy, as soon as possible. The most commonly used POC methods are the aggregometry methods (Multiplate, PFA-100, and Platelet Mapping Assay), used in perioperative platelet function evaluation, and viscoelastic tests (rotational thromboelastometry – ROTEM; thromboelastography – TEG), which provide a graphic representation of all hemostatic activity by measuring the time elapsed until the onset of clot formation, formation dynamics, as well as clot firmness and stability over time. The main advantages of the POC method are: the swift availability of results (up to 15 minutes) and the very small blood sample size (up to 5 ml) necessary for performing the test; while the main disadvantages are: their cost, which exceeds the cost of performing standard laboratory tests, and their inability to detect coagulopathies, resulting from the disturbance of the patient’s normal physiological state. POC methods are very important in reducing perioperative bleeding, reducing blood transfusions, and forming adequate therapeutic algorithms.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126151983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scope of preventive services provided by chosen doctors in primary health care, in the Republic of Serbia, in the period between 2013 and 2017","authors":"M. Milošević, M. Topalović, A. Jovic-Vranes","doi":"10.5937/smclk3-39707","DOIUrl":"https://doi.org/10.5937/smclk3-39707","url":null,"abstract":"Introduction: In the Republic of Serbia, the capitation formula was introduced in 2012, as a payment for performance model for chosen medical doctors based on the number of patients, number of visits, financial value of prescribed prescriptions, as well as on the basis of the number of preventive health services provided in public primary health care facilities. Aim: The aim of this paper is to analyze the scope of preventive health services provided, which is used to evaluate the performance and to pay selected doctors according to the capitation formula, in primary health care institutions, in the Republic of Serbia, in the period between 2013 and 2017. Methods: The available data of the Institute of Public Health of Serbia 'Dr Milan Jovanović - Batut' (IPHS 'Batut'), in terms of the coverage of certain populations with health services, were analyzed, namely twenty-three different indicators, i.e., preventive services provided by chosen medical doctors in the area of health services for adults, children, and women's healthcare, in 166 primary health care institutions to which the payment model based on the capitation formula is applied (158 primary healthcare centers, three institutes for the health care of university students, and five institutes for the health care of workers). The trend of coverage of the above-mentioned services, in the period between 2013 and 2017 was examined, as well as the increase in the volume of preventive services, with fixed-base and chain indices. Results: Three out of twenty-three different health services showed a declining trend, namely the coverage of infants with ultrasound examinations for early detection of hip dysplasia, coverage of schoolchildren with preventive examinations at the ages of 8, 10, 12, and 14 years, as well as coverage of the adult population (older than 35 years) with preventive services. All other services had a stable trend in terms of coverage of target populations in the period from 2013 to 2017. Conclusion: Although most of the observed preventive health services had a stable trend of population coverage, their coverage was far below the recommended level, in the observed period.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"128 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129998252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac magnetic resonance imaging in early diagnostics of myocardial inflammation after COVID-19: Case series and literature review","authors":"M. Zdravković, S. Klašnja, M. Popovic, Predrag Đuran, A. Manojlovic, Milica Brajkovic, O. Markovic, I. Jovanovic, M. Branković, V. Popadić","doi":"10.5937/smclk2-34913","DOIUrl":"https://doi.org/10.5937/smclk2-34913","url":null,"abstract":"Although, in the beginning, it was considered a respiratory infection with bilateral pneumonia as its main manifestation, COVID-19 is more of a multisystemic disease with various extrapulmonary manifestations. Cardiovascular manifestations are caused by direct viral involvement or by the effects of different cytokines on the myocardium and can occur during the acute phase of the disease or in the post-acute stadium. The most common cardiovascular symptoms in the post-acute COVID-19 stadium are fatigue, shortness of breath, chest pain, and palpitations. Routine cardiovascular diagnostics in these patients is usually without significant findings, although underlying myocardial inflammation may be present. Myocardial damage can also be the substrate for the worsening of heart failure and different potentially life-threatening arrhythmias, which is extremely important for further treatment and prognosis. Cardiac magnetic resonance imaging is a sophisticated, non-radiating imaging modality that can provide important information regarding left and right ventricle volumes and function, tissue characterization, and scar quantification. It is the golden standard in non-invasive diagnostics of myocarditis. In patients with prior COVID-19 infection and cardiovascular symptoms, typical signs of myocarditis, including myocardial edema, necrosis, and myocardial scarring, may be seen in cardiac magnetic resonance. Also, there are sophisticated cardiac magnetic resonance imaging modalities that can register subtle changes in the myocardium, in terms of myocardial inflammation, without visible signs in standard sequences. We present a case series of patients with different myocardial inflammation patterns, followed by a comprehensive review of potential pathophysiological mechanisms, complications, treatment and prognosis of patients with myocarditis or pericarditis after COVID-19.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122368885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rate of the occurrence of adverse events in preschool children after vaccination at the Health Care Center in Inđija","authors":"Tanja Mitrović-Rožek, Vesna Petrović, Danilo Višnjevac","doi":"10.5937/SMCLK2002122R","DOIUrl":"https://doi.org/10.5937/SMCLK2002122R","url":null,"abstract":"Introduction: An adverse event following immunization is any undesirable medical occurrence that follows immunization, and which does not necessarily have a causal relationship with the usage of the vaccine. The aim of this study was to determine the rate of occurrence of adverse events in preschool children, after vaccination at the Primary Health Care Center in Inđija. Material and methods: Data were used from the medical and administrative documentation of the Pediatrics Department in Inđija. The study covered a period of 11 years and during this period 4,273 children were vaccinated, and 70,558 doses of vaccines were administered. Results: 13 cases of severe adverse reactions to a vaccine were registered, with a rate of 18.4:100,000 vaccine doses. There were 6 severe adverse reactions to the DTP vaccine per 8,180 administered doses of this vaccine, which was a rate of 73.3:100,000 doses of the DTP vaccine. There were 7 cases of severe adverse reactions to the MMR vaccine per 8,505 administered doses of the MMR vaccine, which was a rate of 82.3:100,000 doses of MMR vaccine. The overall rate of adverse reactions in the form of mumps was 47.0:100,000 doses of the MMR vaccine, in the form of rubella rash it was 11.7:100,000 doses of the MMR vaccine and the rate of adverse allergic reactions to the MMR vaccine was 23.5:100,000 doses of the MMR vaccine. According to our results, there were two cases of adverse reactions in the form of allergic reaction, to all vaccines administered, which was the rate of 3:100,000. Conclusion: This study confirms the very rare occurrence of severe adverse reactions to vaccination and speaks in favor of a far greater benefit from vaccination as compared to the risk of an adverse reaction to vaccination.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"242 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121330489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stabilization of Neer IIB type distal clavicle fracture using the Tightrope system: Case report","authors":"Dejan Aleksandric, Lazar Mičeta, Bojana Aleksić, Uroš Dabetić, Jovana Grupković","doi":"10.5937/smclk4-41228","DOIUrl":"https://doi.org/10.5937/smclk4-41228","url":null,"abstract":"Introduction: Fractures of the distal end of the clavicle account for 10% - 30% of all fractures of this bone, however, they account for as many as 50% of nonunions and malunions in clavicle fractures. Of all distal clavicle fractures, the highest percentage of complications appertain to Neer type IIB fractures. The aim of this paper is to describe the case of a female patient with a Neer type IIB clavicle fracture treated by fracture reduction and flexible stabilization of the coracoclavicular joint using the TightRope system. Case report: A 48-year-old female patient, injured in a traffic accident while driving a car, suffered a Neer type IIB fracture of the distal edge of the left clavicle. Three days after the injury, the patient underwent indirect stabilization surgery of the coracoclavicular joint by fixation, with the application of the TightRope system. Rehabilitation began on the first postoperative day and was completed three months after surgery, with the achievement of full range of motion in the left shoulder, return of muscle tone and strength of the shoulder muscles, followed by a return to everyday life and work activities, as before the injury. Conclusion: Although no gold standard exists in the operative treatment of the above-described injuries, the indirect method of stabilization and flexible fixation of the coracoclavicular joint, using different types of sutures, achieves good to excellent results. Comparing this method with other described techniques indicates that it has a better functional result, which is achieved faster with a lower complication rate. Our patient's functional results contribute to literature data and yet again demonstrate the effectiveness of this type of treatment for these complex injuries.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121696795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}