Browsing by Author "Šipetić, Sandra (6701802171)"

Angiokeratomas are papular vascular lesions characterized by marked ectasia of the superficial dermal blood vessels. Dermatological examination of angiokeratomas of Fordyce is characterized by papular keratotic lesions of erythematous-violet color. They are more common in the scrotum, and vulval involvement is rarely reported. This article reports the cases of angiokeratoma of Fordyce in a 25-year-old man and a 42-year-old woman. Diagnosis were made by history and physical examination. Dermoscopy has shown well-demarcated round dark lacunae in both patients. As the lesions were asymptomatic, the patients requested no further treatment. © Versita Sp. z o.o.

Background: The incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis of previous studies. Methods: Relevant studies published before January 2010 were identified from MEDLINE, Web of Science and EMBASE. Authors of studies provided individual patient data or conducted pre-specified analyses. Meta-analysis techniques were used to derive combined odds ratios (ORs), before and after adjustment for confounders, and investigate heterogeneity. Results: Data were available for 6 cohort and 25 case-control studies, including 11 955 cases of type 1 diabetes. Overall, there was no evidence of an association prior to adjustment for confounders. After adjustment for maternal age at birth and other confounders, a reduction in the risk of diabetes in second-or later born children became apparent [fully adjusted OR=0.90 95% confidence interval (CI) 0.83-0.98; P=0.02] but this association varied markedly between studies (I2=67%). An a priori subgroup analysis showed that the association was stronger and more consistent in children <5years of age (n=25 studies, maternal age adjusted OR=0.84 95% CI 0.75, 0.93; I2=23%). Conclusion: Although the association varied between studies, there was some evidence of a lower risk of childhood onset type 1 diabetes with increasing birth order, particularly in children aged <5 years. This finding could reflect increased exposure to infections in early life in later born children. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2010; all rights reserved.

At the beginning of a new millennium, syphilis incidence has been increasing worldwide, occurring primarily among men who have sex with men (MSM). The clinical features of primary syphilis among MSM is described, a case-note review of the primary syphilis (PS) patients who attended the Institute of Skin and Venereal Diseases. The diagnosis was assessed based upon the clinical features and positive syphilis serology tests. Among 25 patients with early syphilis referred during 2010, PS was diagnosed in a total of 13 cases. In all patients, unprotected oral sex was the only possible route of transmission, and two out of 13 patients had HIV co-infection. Overall, 77% of men presented with atypical penile manifestation. The VDRL test was positive with low titers. The numerous atypical clinical presentations of PS emphasize the importance of continuing education of non-experienced physicians, especially in countries with lower reported incidence of syphilis. © 2012 Elsevier Editora Ltda.

Objectives: This study investigated whether an infant diet is associated with the development of type 1 diabetes. Methods: A case-control study was conducted in Belgrade from 1994 to 1997. A total of 105 patients with recent onset diabetes (≤16 y old) were compared with 210 controls chosen among children with skin disease (first control group). Cases and controls were individually matched by age (±1 y), sex, and place of residence. Eighty-six children with diabetes were also compared with their siblings (second control group). Results: According to univariate logistic regression analysis, when cases were compared with the first control group, the risk of type 1 diabetes was greater for children who were breast fed less than 4 mo (odds ratio = 2.09, 95% confidence interval = 1.30 to 3.36) and who received cow's milk at younger than 5 mo (odds ratio = 3.39, 95% confidence interval = 2.04 to 5.66). According to univariate analysis, when cases were compared with their relatives, only early introduction of supplementary milk was associated with a higher risk for diabetes (odds ratio = 5.75, 95% confidence interval = 2.91 to 11.36). After adjusting for different confounding variables, infant diet was not independently associated with diabetes. Conclusions: The results obtained do not support the hypothesis that infant diet is related to the occurrence of type 1 diabetes. © 2005 Elsevier Inc. All rights reserved.

Objectives: This study investigated whether an infant diet is associated with the development of type 1 diabetes. Methods: A case-control study was conducted in Belgrade from 1994 to 1997. A total of 105 patients with recent onset diabetes (≤16 y old) were compared with 210 controls chosen among children with skin disease (first control group). Cases and controls were individually matched by age (±1 y), sex, and place of residence. Eighty-six children with diabetes were also compared with their siblings (second control group). Results: According to univariate logistic regression analysis, when cases were compared with the first control group, the risk of type 1 diabetes was greater for children who were breast fed less than 4 mo (odds ratio = 2.09, 95% confidence interval = 1.30 to 3.36) and who received cow's milk at younger than 5 mo (odds ratio = 3.39, 95% confidence interval = 2.04 to 5.66). According to univariate analysis, when cases were compared with their relatives, only early introduction of supplementary milk was associated with a higher risk for diabetes (odds ratio = 5.75, 95% confidence interval = 2.91 to 11.36). After adjusting for different confounding variables, infant diet was not independently associated with diabetes. Conclusions: The results obtained do not support the hypothesis that infant diet is related to the occurrence of type 1 diabetes. © 2005 Elsevier Inc. All rights reserved.

We present a case of early syphilis in a HIV negative bisexual man after an oral insertive intercourse with clinical overlap of primary and secondary stages, and laboratory and other criteria for syphilitic hepatitis. Moreover, we herein stress the importance of awareness of the high-risk behaviors and report syphilitic hepatitis without jaundice, a usually unrecognized clinical condition, emphasizing the clinical and therapeutic importance of its occurrence among syphilitic cases.

Background/Aim. Nasopharyngeal carcinoma (NPC) is a relatively rare malignant disease, of which 80 000 individuals become ill around the world annually, which amounts to 0.7% of all carcinomas. The aim of this descriptive study was to analyze NPC incidence in Belgrade (the capital city of Serbia, with about 1.6 milion inhabitants) during the period 1991-2005. Methods. In data analysis, crude rates age and sex specific rates, and standardized incidence rates were used. Standardization was performed by a direct method, using world population as the standard. Results. In Belgrade, during the observed 15-year-period, the number of new NPC patients totaled 118, of which 86 (72.9%) were male and 32 (27.1%) were female. The average standardized incidence rate for men was 0.52 per 100 000 and for women 0.16 per 100 000. In both sexes the incidence was very low before 40 years of age. In men, the greatest incidence rate of NPC was in the 50-59 years age group, and in women in those 60 and more years old. Furthermore, undifferentiated carcinoma of nasopharyngeal type was 3.6 times more often in comparison to squamous cell carcinoma. Conclusion. Belgrade belongs to a region with a low incidence rate of NPC. Further investigations are needed to explain higher frequency of undifferentiated carcinoma of nasopharyngeal type than squamous cell carcinoma.

Influenza is a major cause of morbidity and mortality worldwide, but is vaccine preventable. It is important to know the knowledge, attitudes and practices of medical students regarding influenza vaccination since these may influence their practice of medicine in the future. Therefore, in this study we aimed to determine the knowledge, attitudes and practices of Serbian medical students at the Faculty of Medicine, Belgrade, Serbia in order to inform the education curriculum at the study institution. This study was conducted during 5-23 December 2011. Study subjects were all fourth year medical students who were willing to participate in the study. Each student was asked to complete a self-administered anonymous questionnaire asking about their knowledge, attitudes and practices regarding influenza vaccination. A total of 413 subjects were included in the study (response rate of 83.6%). The mean [± standard deviation (SD)] age of study subjects was 22.7 (± 1.6) years; 63.9% females. Fourteen percent of subjects had previously received a vaccine to prevent against seasonal influenza and 4.8% had previously received a vaccine to prevent against pandemic influenza. Self-protection was the most commonly given reason for receiving influenza vaccination. Lack of time, forgetting to get the vaccine, not realizing their risk and belief the vaccine was ineffective were the main reasons for not receiving influenza vaccination. On multivariate regression analysis, belief that all medical students should be vaccinated against influenza [Odds Ratio (OR) = 2.93; 95% Confidence Interval (CI): 1.36-6.30] and receipt of pandemic influenza vaccine (OR = 16.74; 95%CI: 5.59-50.11) were factors significantly independently associated with receiving the seasonal influenza vaccine while receipt of annual seasonal influenza vaccination was significantly independently associated with receiving the pandemic influenza vaccination. To summarize, the percentage of subjects who had received influenza vaccination was low. In conclusion, subjects at the study institution need to be educated about their risk for contracting influenza and the efficacy of the vaccine. Receipt of the vaccine should be made more convenient so as not to take a long time to receive it and a vaccine should include coverage of both the pandemic strain and the seasonal strains in order to improve study subject uptake. © 2019, SEAMEO TROPMED Network. All rights reserved.

OBJECTIVE - The aim if the study was to investigate whether children born to older mothers have an increased risk of type 1 diabetes by performing a pooled analysis of previous studies using individual patient data to adjust for recognized confounders. RESEARCH DESIGN AND METHODS - Relevant studies published before June 2009 were identified from MEDLINE, Web of Science, and EMBASE. Authors of studies were contacted and asked to provide individual patient data or conduct prespecified analyses. Risk estimates of type 1 diabetes by maternal age were calculated for each study, before and after adjustment for potential confounders. Meta-analysis techniques were used to derive combined odds ratios and to investigate heterogeneity among studies. RESULTS - Data were available for 5 cohort and 25 case-control studies, including 14,724 cases of type 1 diabetes. Overall, there was, on average, a 5% (95% CI 2-9) increase in childhood type 1 diabetes odds per 5-year increase in maternal age (P = 0.006), but there was heterogeneity among studies (heterogeneity I2 = 70%). In studies with a low risk of bias, there was a more marked increase in diabetes odds of 10% per 5-year increase in maternal age. Adjustments for potential confounders little altered these estimates. CONCLUSIONS - There was evidence of a weak but significant linear increase in the risk of childhood type 1 diabetes across the range of maternal ages, but the magnitude of association varied between studies. A very small percentage of the increase in the incidence of childhood type 1 diabetes in recent years could be explained by increases in maternal age. © 2010 by the American Diabetes Association.

Introduction In most countries, cardiovascular diseases are the leading disorders, with ischemic heart diseases being the leading cause of death. According to WHO data, every year about 17 million people die of cardiovascular diseases, which is 30% of all deaths. Ischemic heart diseases contribute from one-third to one-half of all deaths due to cardiovascular diseases. Three point eight million men and 3.4 million women in the world die every year from ischemic heart diseases, and in Europe about 2 million. The highest mortality rate from ischemic heart diseases occurs in India, China and Russia. Objective The aim of this descriptive epidemiological study was to determine heart attack mortality in Belgrade population during the period 1990-2004. Method In the study, we conducted investigation of Belgrade population during the period 1990-2004. Mortality data were obtained from the city institution for statistics. The mortality rates were calculated based on the total Belgrade population obtained from the mean values for the last two register years (1991 and 2002). The mortality rates were standardized using the direct method of standardization according to the world (Segi) standard population. Results In the Belgrade population during the period 1990-2004, the participation of mortality rate due to heart attack among deaths from cardiovascular diseases was 17% in males and 10% in females. In Belgrade male population, mean standardized mortality rates (per 100,000 habitants) were 50.5 for heart attack, 8.3 for chronic ischemic heart diseases and 4.6 for angina pectoris, while in females the rates were 30.8, 6.7 and 4.2, respectively. Mortality from ischemic heart diseases and from heart attack was higher in males than in females. During the studied 15-year period, on average 755 males and 483 females died due to heart attack every year. Mean standardized mortality rates per 100,000 habitants were 50.0 in male and 31.1 in female population. Males died 1.6 times more frequently from heart attack than females. During the studied period, mean standardized mortality rates from heart attack, in the population aged over 30 increased with age both in male and female population. However, males tended to die from heart attack at an earlier age than females, with death rates for males approximately the same as those for women who were 10 years older. Conclusion In Belgrade during the period from 1990-2004, we found that there was an increasing trend in mortality rate due to cardiovascular diseases, while the trend of mortality rate from heart attack was constant with insignificant oscillations.

Background and Objectives: Studies on the effects of studying on a medical student’s quality of life are sparse. The World Health Organization Quality of Life (WHOQOL-BREF) questionnaire is a widely used scale that enables the assessment and international comparisons of the quality of life. The aim of this study was to evaluate psychometric properties of the WHOQOL-BREF questionnaire among Serbian medical students. Material and Methods: We conducted a crosssectional study that involved 760 medical students at a state medical faculty at the University of Kragujevac, Serbia. The reliability of the WHOQOL-BREF was evaluated using Cronbach’s alpha coefficient and test–retest analysis, and the validity was examined using principal component analysis, with Promax rotation method. Results: Cronbach’s alpha coefficient for the whole WHOQOL-BREF scale was 0.896. Internal reliability for all domains was above 0.70, except for the domain “Social Relationships” (0.533). The test–retest reliability for all domains was significant at p < 0.01 level, showing good stability of the scale. Principal component analysis with Promax rotation method indicated four main components that explained 49.5% of variance. Conclusion: The Serbian version of the WHOQOL-BREF scale showed satisfactory psychometric properties that facilitate estimation of the quality of life of medical students. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Summary Background: Lichen sclerosus (LS) is an inflammatory disease of the skin and mucous membranes. Its aetiology is still unknown. Objectives To determine risk factors for genital LS in men. Methods In a case-control study, 73 patients with LS, consecutively diagnosed at the City Dispensary for Skin and Venereal Diseases in Belgrade, were compared with 219 male patients visiting the same institution because of tinea cruris. Univariate and multivariate logistic regression analyses were used for analysis of data collected. Results According to multivariate logistic regression analysis, risk factors for male LS were as follows: a personal history of genital injury [odds ratio (OR) 28·1, 95% confidence interval (CI) 5·2-150·8], vitiligo (OR 23·1, 95% CI 2·2-240·2), alopecia areata (OR 8·8, 95% CI 1·1-68·5) and hypercholesterolaemia (OR 3·1, 95% CI 1·1-8·2), and a family history of alopecia areata (OR 24·3, 95% CI 2·1-280·7), diseases of the thyroid gland (OR 9·1, 95% CI 2·3-36·2) and other autoimmune diseases (OR 8·6, 95% CI 1·3-58·6). Conclusions The results of the present study are in line with the hypothesis that trauma of the penis is a possible trigger of symptoms in genetically predisposed individuals and that personal and family histories of autoimmune disorders are risk factors for male LS. © 2011 British Association of Dermatologists.

Introduction The incidence rate of nasopharyngeal carcinoma in Serbia is less than one per 100,000 citizens, which classifies it as a region with low incidence for this disease. Objective The aim of this study was to test some hypotheses of the risk factors for undifferentiated carcinoma of nasopharyngeal type (UCNT) in the low incidence population. Methods A case-control study was used for the research. The study included 45 cases with histopathological diagnosis of UCNT and 90 controls. Cases and the controls were individually matched by sex, age (±3 years), and place of residence (city-village). Data were gathered about sociodemographic characteristics, occupational exposure to harmful agents, habits, diet, personal history, and family history. In the analysis of the data, conditional univariate and multivariate logistic regression analyses were applied. Results According to the results of multivariate logistic regression analysis UCNT was significantly positively associated with "passive smoking" of tobacco in the family during childhood, frequent consumption of industrially manufactured food additives for enhancing flavour and frequent consumption of white bread. UCNT was significantly negatively associated with frequent consumption of margarine, olive oil and cornbread. Conclusion In our low incidence population, an independent risk factor for the occurrence of UCNT was "passive smoking" of tobacco in the family during childhood, use of industrially manufactured food with additives for enhancing flavour and consumption of white bread. Multicentric study enrolling a greater number of cases would be desirable.

Introduction: HIV in Serbia is most often transmitted through sexual contact, and therefore numerous prevention activities are geared towards sex workers (SW). Objective: To analyse the differences in knowledge, attitudes and risky behaviour between indoor and street SW in Belgrade; to examine the accessibility of health services to this vulnerable group. Methods: In this behavioural cross-sectional study, 113 street and 78 indoor SW were included. The sampling method used was snowball samples. Data were gathered through structured questionnaires. Results: Around 15% of respondents used drugs intravenously. Around 60% of SW used a condom during the last sexual intercourse with their private partner, and around 90% with a commercial partner. Indoor SW had lower levels of education more often than outdoor SW, and they used marijuana, sedatives and painkillers on a daily basis. A significantly higher number of indoor SW were informed about HIV, HBV and HCV testing, and that the risk for HIV infection is not lower if a condom is used exclusively for vaginal sex. Indoor SW reported using health services and testing and counselling for HIV, HBV and HCV more frequently than outdoor SW. Outdoor SW had significantly more sex partners in the previous month than indoor SW. Indoor SW recognized more frequently that providing sex services posed a higher risk for HIV infection. Conclusion: The results of this research study show that even though outdoor SW had higher levels of education than indoor SW, their level of knowledge about HIV transmission was lower and they reported more risky behaviour than indoor SW. Data show that both groups reported not taking care of their health.

We performed a prevalence study to compare some lifestyle habits between subjects with migraine and those with non-migraine primary headaches. We surveyed female students in randomly selected classes of the School of Medicine and the School of Pharmacy, Belgrade University. Among all observed students (1943 subjects), 245 had migraine and 1053 had non-migraine primary headache. According to multivariate logistic regression analysis, the following factors were associated with migraine: irregular eating (odds ratio (OR)=1.99; 95% confidence interval (95% CI), 1.69 to 2.34; p<0.01), sleep duration shorter than usual (OR=1.18; 95% CI 1.00 to 1.38; p=0.0449) and smoking >10 cigarettes per day (OR=1.18; 95% CI=1.00 to 1.39; p=0.0433). The results of the present study are in line with some other investigations suggesting that some lifestyle habits probably play a role as migraine precipitants.

Introduction In the last two decades there has been an increase in the prevalence of type 2 diabetes in both developed and in developing countries. Objective To determine whether personal habits like smoking, alcohol and coffee consumption or physical inactivity are different between genders in patients with type 2 diabetes. Methods The study was conducted in Belgrade, during the period 2007-2008, and included newly diagnosed patients with type 2 diabetes. We included 80 men and 99 women diagnosed with diabetes mellitus type 2, referred to the Primary Health Care Centre "Savski venac". A questionnaire was used to collect data on demographic and anthropometric characteristics, as well as data on healthy habits. The X2 test and two-tailed t-test were used for data analysis. Results The men were significantly more engaged in industry and crafts, while the women worked significantly more frequently in administrative jobs. The men were married significantly more frequently than the women (p<0.05) and had a higher level of education (p<0.05). Regarding to the level of implementation of nutritional and physical activity, there were no significant differences between the genders (p>0.05). The women consumed coffee significantly more frequently than the men (p<0.05), but drank less alcohol (p<0.05). The men were former smokers significantly more frequently (p<0.05) than the women. Conclusion These results indicate the role of certain personal habits in the development of type 2 diabetes.

[No abstract available]

A case-control study was conducted in Belgrade (about 320 000 inhabitants 0-16 years old) during the period 1994-97, comprising 68 diabetic children (cases) and 68 controls chosen from the siblings of the cases. Analysis using multivariable logistic regression analysis indicated the following independent risk factors for Type 1 diabetes: higher birth order, infections during the 6 months preceding the onset of the disease and stressful events. Out of individual stressful and psychological factors, 'other' stressful events (severe accident or hospitalisation or death of a close friend, conflict with a teacher, death of a pet, failure in competition, quarrel between parents, punishment, physical attack, war in republics of former Yugoslavia and near drowning in the pool) and learning problems were independent risk factor for Type 1 diabetes. The results obtained in this study of siblings supports the hypothesis that environmental factors play a role in the development of Type 1 diabetes. ©2006 Blackwell Publishing Ltd.

PURPOSE: The aim of this study was to investigate whether individual infections or combination of infections or vaccination affect the risk of developing diabetes in childhood. METHODS: A case-control study was conducted in Belgrade during the period between 1994 and 1997. A total of 105 recent onset diabetics were compared with 210 controls chosen among children with skin disease (the first control group). Cases and controls were individually matched by age (±1 year), sex, and place of residence. Eighty-six diabetic children were also compared with their brothers/sisters (the second control group). RESULTS: After adjustment for confounding variables, independent association with diabetes was found for infections during the 6 months preceding the onset of the disease, when cases were compared with both the first control group (OR = 4.23, 95% CI, 1.95-9.17, p<0.001) and the second control group (OR = 4.68, 95% CI, 2.09-10.47, p<0.001), and for regular vaccination when cases were compared with the first control group (OR = 0.08, 95% CI, 0.01-0.50, p = 0.03). CONCLUSION: The results obtained support the hypotheses that infections play a role in the development of type 1 diabetes and that regular vaccination has a preventive effect. © 2003 Elsevier Inc. All rights reserved.

The aim of this study was to investigate whether prenatal and social factors are associated with the development of type 1 diabetes. A case-control study was conducted in Belgrade during the period 1994-97. A total of 105 children ≤16 years old with recently onset of diabetes and 210 control children, individually matched by age (± 1 year), sex and place of residence, were included in the study. In the analysis using multivariable logistic regression, the following factors were significantly related to type 1 diabetes: poor socio-economic status (Odds ratio = 4.18, 95% confidence interval [2.01, 8.72]); higher education of father (1.53, [1.16, 2.03]); complications during pregnancy (3.39, [1.64, 7.00]); ultrasound scan during pregnancy (0.40, [0.20, 0.79]); gestational age > 41 weeks (11.11, [1.80, 68.52]); mother's consumption of foods containing nitrosamines during pregnancy (3.14, [1.68, 5.87]); and consumption of alcohol by father (4.54, [2.34, 8.79]).