Srpski medicinski casopis Lekarske komore最新文献

{"title":"COOVID-19: What have we learned since the beginning of the epidemic until today?","authors":"I. Milošević, A. Vujovic","doi":"10.5937/smclk2-32959","DOIUrl":"https://doi.org/10.5937/smclk2-32959","url":null,"abstract":"In late December 2019, in the city of Wuhan, in China, the appearance of unknown viral pneumonia was recorded in a large number of patients. The cause of this infection was soon discovered - a new coronavirus, called SARS-CoV-2, due to its genetic similarity to the virus that causes severe acute respiratory syndrome (SARS-CoV). The infection then spread rapidly to other continents, and the pandemic is still ongoing. The clinical presentation varies from the asymptomatic form to symptoms of upper respiratory tract infection, and finally to pneumonia and acute respiratory distress syndrome (ARDS). The elderly, immunocompromised patients, and patients suffering from chronic, internal medicine diseases are at risk of the severe form of the COVID-19 disease. The virus enters cells via angiotensin converting enzyme 2 (ACE2) receptors, which are present in practically all tissues in the body. In addition to interstitial pneumonia, pathological changes are also found in other organ systems. The first case in Serbia was recorded on March 6, 2020. A large number of patients required the engagement of health workers of all profiles as well as the introduction of a large number of health institutions into the COVID system. The emergence of a new virus necessitated a new antiviral drug. Based on previous experience with the SARS-CoV virus, previously known antiviral drugs have been used, with varying degrees of success. The therapy changed in accordance with new knowledge, and since the beginning of the epidemic in Serbia, the National Protocol of the Republic of Serbia for the Treatment of the COVID-19 Infection has been established, which has kept apace with the recommendations of the world's leading institutions. The most significant event during the pandemic was the development of the vaccine against COVID-19, with vaccination in Serbia beginning in December 2020. How quickly the epidemic will end depends directly on the speed and efficiency of vaccination, along with other epidemiological measures.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"48 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":"121384833","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":"Complex regional pain syndrome: Literature review as a guide for the practicing clinician","authors":"E. Dubljanin-Raspopović, G. Tulić, U. Nedeljković, N. Ilić, Milica Aleksić, M. Kadija, Sanja Tomanović-Vujadinović","doi":"10.5937/smclk3-39589","DOIUrl":"https://doi.org/10.5937/smclk3-39589","url":null,"abstract":"Complex regional pain syndrome (CRPS) is a chronic complex disorder that significantly affects the quality of life of the people suffering from it. This syndrome affects the extremities after trauma or nerve injury. Hyperalgesia and allodynia of the extremities often accompany this condition. Diagnosing and treating this disease is very complex. The Budapest criteria are currently the most widely accepted diagnostic criteria. Early diagnosis and treatment are essential for a favorable outcome in CRPS. Therapeutic modalities available for the treatment of CRPS include physical therapy, pharmacotherapy, and interventional techniques. Additional high-quality studies are needed to determine the best therapeutic option.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"1 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":"127774153","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":"Diagnosis related group migration as an indicator of a potentially inefficient medical intervention","authors":"M. Topalović, M. Milošević, Z. Terzić-Šupić, J. Todorović, M. Šantrić-Milićević","doi":"10.5937/smclk3-35960","DOIUrl":"https://doi.org/10.5937/smclk3-35960","url":null,"abstract":"Introduction: Diagnosis related group migration (DRG) is a phenomenon in coding hospitalizations that indicates that a patient has been transferred from one group to a different, more costly group, after an episode of hospital treatment, solely because of complications or comorbidities that occurred during hospital treatment or medical intervention. Objective: The objective of the study was to examine the following: occurrence of DRG migrations, hospital costs, and length of hospitalization for colectomies. Methods: A retrospective secondary analysis of DRG data was conducted for a series of episodes of hospital treatment (n = 4,939) in patients aged 18 and above, who underwent colectomy in 49 hospitals in the Republic of Serbia, in the period between 2018 and 2020, and whose episodes of hospital treatment were grouped into three diagnosis related groups: the G02A group, a separate G02A group with T81-T88 diagnoses for surgical treatment complications, and the G02B group. Results: In the observed three-year period, the incidence of DRG migration was 7.4%. Inpatient treatment of patients classified in the diagnostic group G02A (T81-T88), which represents DRG migration, was statistically significantly more costly and these patients had a statistically significantly longer hospital stay. The total invoice amount for the diagnostic group G02A (T81-T88) was 509,651.7 dinars (approximately 4,320 euros), and the average length of an episode of hospital treatment was 23 days. In group G02B, the total invoice amount was 231,989.0 dinars (approximately 1,960 euros) with an average length of hospital stay of 11 days. Conclusion: Colectomies with complications prolong the length of hospitalization and imply a higher consumption of resources in the Republic of Serbia. Cost analysis related to DRG migration, per patient day and patient, may indicate the ineffectiveness of medical interventions.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"23 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":"133455246","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":"Unmet dental health care needs in Serbia","authors":"J. Todorović, Nataša Popović, P. Piperac, Slavica Đurđević-Todorović, Z. Terzić-Šupić","doi":"10.5937/smclk2-32309","DOIUrl":"https://doi.org/10.5937/smclk2-32309","url":null,"abstract":"Aim: The aim of this study was the analysis of the social and health status characteristics of the population with unmet dental health care needs. Materials and methods: This cross-sectional study included 20,069 respondents from the Survey on Income and Living Conditions (SILC) in the Republic of Serbia in 2014. Results: Nearly every sixth citizen (16.1%) reported unmet dental health care needs. Participants between the ages of 27 and 44 years (OR: 1.48, 95% CI: 1.21 - 1.82), and between 45 and 64 years (OR: 1.49, 95% CI: 1.19 - 1.86), participants who assessed their health status as: good (OR: 1.91, 95% CI: 1.63 - 2.25), fair (OR: 3.16, 95% CI: 2.64 - 3.77), bad (OR: 3.65, 95% CI: 2.94 - 4.53), or very bad (OR: 4.22, 95% CI: 3.10 - 5.74), had a higher likelihood of reporting unmet dental health care needs. The most frequent reasons for unmet dental health care needs were financial obstacles to the accessibility of dental health care (66.6%) and fear or treatment (15.1%). Conclusion: The study found associations between unmet dental health care needs and social and health status characteristics. Health policy should adopt a multidimensional approach and eliminate barriers which restrict the accessibility of dental health care.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"104 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":"133025982","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":"Mortality of health workers during the COVID-19 pandemic","authors":"Milena Šantrić-Milićević","doi":"10.5937/smclk3-36614","DOIUrl":"https://doi.org/10.5937/smclk3-36614","url":null,"abstract":"","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"35 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":"114279222","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":"Thrombocytopenia and COVID-19: Differential diagnosis and therapy","authors":"M. Mitrović, N. Pantić","doi":"10.5937/smclk3-35382","DOIUrl":"https://doi.org/10.5937/smclk3-35382","url":null,"abstract":"Thrombocytopenia represents a common manifestation of COVID-19 with a prevalence of up to 35% in certain studies. A low platelet count is an unfavorable prognostic marker in SARS-CoV-2 infected patients. Despite a large number of publications dealing with the prognostic significance of thrombocytopenia in COVID-19, data regarding the differential diagnosis and therapy are scarce. The most common causes of thrombocytopenia in COVID-19 are shown in this review, namely: SARS-CoV-2-induced thrombocytopenia; disseminated intravascular coagulopathy (DIC); immune thrombocytopenia; drug-induced thrombocytopenia, with a special insight into heparin-induced thrombocytopenia (HIT). Although a majority of patients suffer from mild thrombocytopenia and do not require any particular treatment, there are some cases of severe thrombocytopenia which may cause life threatening bleeding. On the other hand, some forms of thrombocytopenia, such as DIC or HIT, carry a high risk of the development of thrombotic events, which is why anticoagulant prophylaxis is required in these patients. At the end of each section of this review, treatment recommendations are given for each aforementioned type of thrombocytopenia developing in COVID-19.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"213 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":"114844965","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":"Perioperative anaphylaxis caused by muscle relaxants: Do we know enough?","authors":"Danica Z. Marković, N. Vuković, Jelena Milenković, Bojana Z. Markovic-Zivkovic, I. Budic","doi":"10.5937/smclk3-40793","DOIUrl":"https://doi.org/10.5937/smclk3-40793","url":null,"abstract":"Perioperative anaphylaxis caused by muscle relaxants represents a relatively rare, albeit a serious complication during anesthesia. It can result in serious morbidity or even mortality. This reaction usually happens before or after intubation of a patient, that is, a few minutes after muscle relaxant administration. The beginning of the reaction can be missed, even by the most experienced anesthesiologist, since its recognition depends on the severity of the symptoms. There are no guidelines specific to the therapy of muscle relaxant anaphylaxis and therefore therapy is based simply on the general guidelines. Also, in many countries, there are no registries of the incidence of anaphylaxis caused by muscle relaxants. Therefore, this is an extremely important subject for anesthesiology practice, and it requires more attention.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"604 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":"116209179","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":"Association between sleep quality and depressive symptomatology in patients with multiple sclerosis","authors":"Isidora Semnic, Ksenija Gebauer-Bukurov","doi":"10.5937/smclk4-42962","DOIUrl":"https://doi.org/10.5937/smclk4-42962","url":null,"abstract":"Introduction: Sleep quality deterioration and depressive mood are common in patients with multiple sclerosis (MS). The pattern of sleep can be changed due to many psychological and physical symptoms, as well as sociodemographic characteristics occurring within MS. Aim: The study aim was to examine the frequency of changes in sleep quality, depression, anxiety and stress, in MS patients, using the following screening tools: the Pittsburgh Sleep Quality Index - PSQI test and the Depression, Anxiety, and Stress Scale - DASS test, whilst taking into account socio-demographic features, disease duration, as well as the score on the Expanded Disability Status Scale - EDSS score. The aim was also to determine the association between the global PSQI score and socio-demographic characteristics, the EDSS score and illness duration, as well as to examine the relation between the global PSQI score and the DASS subscores. Materials and Methods: The study involved 53 patients, aged 19 - 56, with relapsing-remitting MS, treated with interferon beta. The PSQI index, which evaluates sleep quality, the DASS scale for assessing depression, anxiety, and stress, as well as the EDSS score, which evaluates the severity of the disease, were used. The data was interpreted in the SPSS (Statistical Package for the Social Sciences) statistical program (standard statistical methods, bivariate correlation, linear regression). Results: Sleep quality disorder was present in 44.4% of the examined sample. A positive correlation between the PSQI score and the DASS scale subcscores was established, and linear bivariate regression showed depression (p = 0.001), anxiety (p < 0.001), and stress (p <0.001) to be predictors of the deterioration of sleep quality. A statistically significant correlation between the age of the subjects and sleep quality was determined (p = 0.047). Conclusion: In MS patients with the relapsing-remitting form of the disease, who are treated with immunomodulatory therapy, a significant association between sleep quality and depression, anxiety, and stress, was detected. Of the sociodemographic characteristics, the only established association was the relation between age structure and sleep quality, measured with the PSQI index.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"89 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":"132423799","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":"Dual practice, factors and solutions for healthcare professionals","authors":"Marijana Milošević-Gačević","doi":"10.5937/smclk4-42557","DOIUrl":"https://doi.org/10.5937/smclk4-42557","url":null,"abstract":"Dual practice is a phenomenon found in most countries, but it is noticeably more frequent in low-income countries, such as ours. It has been gaining more and more importance lately due to the fact that it may contribute to reducing the already insufficient number of professional health workers in healthcare systems. The reasons that lead to dual practice have not been sufficiently studied. Research results mainly point to economic factors as predictors, but apart from these factors, it is necessary to investigate the prevalence, real consequences, managing this phenomenon, as well as the assessment of the impact of policy measures implemented in this area. Although dual practice is seen as a possible systemic solution to issues such as limited resources (and revenues) in the public sector, low regulatory capacity and the interaction between market forces and human resources, if poorly regulated, it can lead to a conflict of interest as well as resource drain from the public to the private sector. An optimal regulation of the situation and the mobility of health workforce depends on the exceptional circumstances of the country, government capabilities, and the improvement of the health system. At the international level, governments react differently to the phenomenon of dual practice. To recognize the role of dual practice and mobility in the health workforce market, experts advocate more data on dual practice of healthcare workers and the need to integrate these data into national health workforce accounts. The need to develop a national health policy for monitoring dual practice in our country and to develop strategies for mitigating negative effects was highlighted. This paper analyzes the available literature on dual practice, the factors that influence the emergence of this phenomenon, and possible solutions for health workers.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"36 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":"129005247","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":"Triage at a non-covid hospital during the COVID-19 pandemic","authors":"M. Đikić, Dušica Gujaničić, Ivana J. Milićević-Nešić, M. Ercegovac, Slobodan Dželebdžić, Ivanka Lukić, Budimir Andrić, Tijana Miladinović","doi":"10.5937/smclk2-32963","DOIUrl":"https://doi.org/10.5937/smclk2-32963","url":null,"abstract":"At the time of the COVID-19 pandemic, the Emergency Center of the University Clinical Center of Serbia (EC-UCCS), although a non-covid hospital, had to adapt to taking care of a large number of critically ill and, at the same time, potentially contagious patients. In this paper, we present the ways that the EC-UCCS has adjusted to the conditions of the pandemic, where no precise protocols had previously been established for acting in these types of situations. In March 2019, the Admissions Triage Facility of Emergency Medicine (ATFEM) was established. The main task of this facility was to separate patients with epidemiological risk (ER) from patients without risk and to carry out their further isolated care. ER assessment involves completing an epidemiological questionnaire, a targeted brief history, body temperature measurement, and assessment of the patient's respiratory status. The complete triage process, initial diagnosis, and treatment of patients with ER is the task and responsibility of emergency medicine specialists. Between March 15, 2020 and March 15, 2021, about 155,000 patients were examined in triage, of whom 9,519 had ER and were taken care of in the ATFEM. This triage method minimizes the spread of infection while taking care of all critically ill patients, regardless of ER. However, both patients with low and high risk of COVID-19, were all admitted to the same facility, due to the shortage of available space. Also, triage relates only to \"covid triage\" and not to triage according to the degree of urgency of the patients, which is the primary task of every modern emergency center.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"80 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":"128417381","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}