Browsing by Author "Belojevic, Goran (6603711924)"

There has been an abundance of different bioterrorist attack scenarios and consequently an unclear biodefense strategy so far. We present a framework for bioterrorism risk assessment that we believe would be useful for policymakers and understandable without needing to be an expert in this field. We retrieved the Medline database via PubMed (from January 1987 to January 2009) and cross-referenced and reviewed the terms biological weapons, biological attacks, bioterror, bio(defense), bio(strategy) and epidemiologic models, and risk assessment. Additionally, we conducted an internet search with the same terms and strategy. We divided bioterrorist attacks into 3 categories: strategical (large-scale), operational (middle-scale), and tactical (small-scale). A bioterrorist attack is presented as a 4-component chain model, including perpetrators, agents, means of delivery, and targets. For any of these 4 components, we propose quantitative and qualitative risk assessment parameters. Here we present a simple scoring system within our model applied to the 2001 U.S. anthrax attacks. 2009 © Mary Ann Liebert, Inc.

There has been an abundance of different bioterrorist attack scenarios and consequently an unclear biodefense strategy so far. We present a framework for bioterrorism risk assessment that we believe would be useful for policymakers and understandable without needing to be an expert in this field. We retrieved the Medline database via PubMed (from January 1987 to January 2009) and cross-referenced and reviewed the terms biological weapons, biological attacks, bioterror, bio(defense), bio(strategy) and epidemiologic models, and risk assessment. Additionally, we conducted an internet search with the same terms and strategy. We divided bioterrorist attacks into 3 categories: strategical (large-scale), operational (middle-scale), and tactical (small-scale). A bioterrorist attack is presented as a 4-component chain model, including perpetrators, agents, means of delivery, and targets. For any of these 4 components, we propose quantitative and qualitative risk assessment parameters. Here we present a simple scoring system within our model applied to the 2001 U.S. anthrax attacks. 2009 © Mary Ann Liebert, Inc.

Background: Health inequalities may begin during childhood. The aim of this study was to investigate the main effect of poverty and its interactive effect with gender on children's blood pressure. Methods: The study was performed in two elementary schools from a rural region near Podgorica, the capital of Montenegro. A questionnaire including questions on family monthly income, children's physical activity and the consumption of junk food was self-administered by parents of 434 children (223 boys and 211 girls) aged 6-13 years. Children's poverty level was assessed using the recommendations from the National Study on Poverty in Montenegro. Children's body weight and height were measured and body mass index-for-gender-and-age percentile was calculated. An oscillometric monitor was used for measurement of children's resting blood pressure in school. Results: A two-factorial analysis of variance with body mass index percentile, physical activity and junk food as covariates showed an interaction of gender and poverty on children's blood pressure, pointing to synergy between poverty and female gender, with statistical significance for raised diastolic pressure (F = 5.462; P = 0.021). Neither physical activity nor the consumption of junk food explained the interactive effect of poverty and gender on blood pressure. Conclusion: We show that poverty is linked to elevated blood pressure for girls but not boys, and this effect is statistically significant for diastolic pressure. The results are discussed in the light of gender differences in stress and coping that are endemic to poverty. © The Author 2013.

Background: The aim of this study was to investigate the effects of TV, magazines, radio, and internet following on body mass index (BMI) and obesity-related literacy among adults Methods: In this cross-sectional study, the subjects were recruited from an outpatient center in the city of Sombor, Serbia during Mar-Apr 2013. We collected data by a questionnaire from 657 (397 women; 59%) subjects, aged from 18 to 87 yr (Mean = 45; SD =14). The questionnaire consisted of personal data, body height and weight, frequency of television, radio, magazines and internet following and personal opinion on the impact of smoking, alcohol consumption, stress and physical inactivity on obesity. Results: Spearman’s rank correlation analysis showed that BMI increased with longer TV viewing with a very weak strength of the correlation (r=0.104; P=0.009) and decreased with more internet following with a weak strength of the correlation (r=-0.200: P<0.001). Multiple linear regression analysis revealed that only internet use had a significant independent effect on BMI. The frequency rise of internet following from “rare” to “often” and “every day” decreased BMI by 0.5 per each grade. Internet followers showed a significantly better knowledge of the importance of smoking (P = 0.003), alcohol consumption (P<0.001) and physical inactivity (P=0.004) for obesity in comparison to non-followers. Conclusion: Internet is the only media that independently and positively influence weight control and the literacy on obesity among adults. © 2018, Iranian Journal of Public Health. All rights reserved.

Research on the cardiovascular effects of noise in Serbia started in the year 2002, including experimental studies on humans and epidemiological studies on the adult and children population of Belgrade and Pancevo. Experimental exposure to noise [L eq = 89 dB (A)] had a hypodynamic effect, significantly lowering the cardiac index, cardiac work, and pump performance (P < 0.01). The vasoconstrictive effect of noise was shown through the significant elevation of after-load (P < 0.01). In a cross-sectional population study that was carried out on 2874 residents [1243 males and 1631 females] in Pancevo City, a significant odds ratio (adjusted for age, body mass index (BMI), and smoking habits) was found for self-reported hypertension (OR = 1.8, 95% CI = 1.0 - 2.4, P < 0.01) in men with a high level of noise annoyance compared to those with a low level of noise annoyance. In another study on 2503 residents (995 men and 1508 women) residents of Belgrade, the proportions of men with hypertension in the noisy [(L night , 8h > 45 dB (A)] and quiet areas [(L night , 8h ≤ 45 dB (A)] were 23.6% and 17.5%, respectively. The adjusted odds ratio (OR) for hypertension of the exposed group was 1.58 (95% CI = 1.03 - 2.42, P = 0.038), where men living in quiet streets were taken as a reference category. Associations between road traffic noise and blood pressure were also investigated in 328 preschool children in Belgrade. The systolic blood pressure was significantly higher among children from noisy residences and kindergartens, compared to children from both quiet environments (97.30 ± 8.15 and 92.33 ± 8.64 mmHg, respectively, P < 0.01). As a continuation of the study on preschool children, investigations were also carried out on 856 school children, aged between seven and eleven years, in Belgrade. It was found that systolic pressure was significantly higher among children from noisy schools and quiet residences, compared to children from both quiet environments (102.1 ± 9,3 and 100.4 ± 10.4 mmHg, respectively, P < 0.01).

Research on the cardiovascular effects of noise in Serbia started in the year 2002, including experimental studies on humans and epidemiological studies on the adult and children population of Belgrade and Pancevo. Experimental exposure to noise [L eq = 89 dB (A)] had a hypodynamic effect, significantly lowering the cardiac index, cardiac work, and pump performance (P < 0.01). The vasoconstrictive effect of noise was shown through the significant elevation of after-load (P < 0.01). In a cross-sectional population study that was carried out on 2874 residents [1243 males and 1631 females] in Pancevo City, a significant odds ratio (adjusted for age, body mass index (BMI), and smoking habits) was found for self-reported hypertension (OR = 1.8, 95% CI = 1.0 - 2.4, P < 0.01) in men with a high level of noise annoyance compared to those with a low level of noise annoyance. In another study on 2503 residents (995 men and 1508 women) residents of Belgrade, the proportions of men with hypertension in the noisy [(L night , 8h > 45 dB (A)] and quiet areas [(L night , 8h ≤ 45 dB (A)] were 23.6% and 17.5%, respectively. The adjusted odds ratio (OR) for hypertension of the exposed group was 1.58 (95% CI = 1.03 - 2.42, P = 0.038), where men living in quiet streets were taken as a reference category. Associations between road traffic noise and blood pressure were also investigated in 328 preschool children in Belgrade. The systolic blood pressure was significantly higher among children from noisy residences and kindergartens, compared to children from both quiet environments (97.30 ± 8.15 and 92.33 ± 8.64 mmHg, respectively, P < 0.01). As a continuation of the study on preschool children, investigations were also carried out on 856 school children, aged between seven and eleven years, in Belgrade. It was found that systolic pressure was significantly higher among children from noisy schools and quiet residences, compared to children from both quiet environments (102.1 ± 9,3 and 100.4 ± 10.4 mmHg, respectively, P < 0.01).

A bioterrorist attacks usually cause epidemics of panic in a targeted population. We have presented epidemiologic aspect of this phenomenon as a three-component model - host, information on an attack and social network. We have proposed a mathematical model of panic and counter-measures as the function of time in a population exposed to a bioterrorist attack. The model comprises ordinary differential equations and graphically presented combinations of the equations parameters. Clinically, we have presented a model through a sequence of psychic conditions and disorders initiated by an act of bioterrorism. This model might be helpful for an attacked community to timely and properly apply counter-measures and to minimize human mental suffering during a bioterrorist attack. © 2009 Elsevier Ltd. All rights reserved.

Background: In 2011, Germany was hit by one of its largest outbreaks of acute gastroenteritis and haemolytic uraemic syndrome caused by a new emerging enterohaemorrhagic Escherichia coli O104:H4 strain. The German Haemolytic Uraemic Syndrome/Enterohaemorrhagic E. coli (GHUSEC) outbreak had unusual microbiological, infectiological and epidemiological features and its origin is still only partially solved. The aim of this article is to contribute to the clarification of the origin of the epidemic. Methods: To retrospectively assess whether the GHUSEC outbreak was natural, accidental or a deliberate one, we analysed it according to three published scoring and differentiation models. Data for application of these models were obtained by literature review in the database Medline for the period 2011-13. Results: The analysis of the unusual GHUSEC outbreak shows that the present official assumption of its natural origin is questionable and pointed out to a probability that the pathogen could have also been introduced accidentally or intentionally in the food chain. Conclusion: The possibility of an accidental or deliberate epidemic should not be discarded. Further epidemiological, microbiological and forensic analyses are needed to clarify the GHUSEC outbreak. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The aim of this study was to investigate the relation between laterality and spine deformities in early adolescence, with special reference to sex differences. Interviews, anthropometric measurements and clinical examinations of body posture were carried out on a sample of 2546 schoolchildren, aged from 11 to 14 years, in seven elementary schools in the centre of Belgrade. Possible confounding factors (age, sex, body weight and body height) were controlled for. The overall prevalence of spine deformities (scoliosis and/or thoracic hyperkyphosis) in the investigated population was 11.8%, out of which there were 7.8% adolescents with scoliosis, 4.0% with thoracic hyperkyphosis, and 0.3% with both spine deformities. The prevalence of scoliosis was 2.7 times higher in girls compared to boys (11.7% vs. 4.3%) while the prevalence of thoracic hyperkyphosis was 1,6 higher among boys (5.0% vs. 3.2%). We found 7.6% of the schoolchildren examined to be left-handed. Left handedness was significantly related to scoliosis in girls (crude OR=1.60 and 95% confidence interval=1.01-2.54). Multivariate analysis showed that significant independent factors for scoliosis were female sex (p < 0.001), age (p=0.01) and left handedness (p=0.02). We did not find any appreciable relation between left handedness and thoracic hyperkyphosis in both sexes.

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The contradictory and confusing results in noise research on humans may partly be due to individual differences between the subjects participating in different studies. This review is based on a twelve year research on the role of neuroticism, extroversion and subjective noise sensitivity during mental work in noisy environment. Neurotic persons might show enhanced "arousability" i.e. their arousal level increases more in stress. Additional unfavorable factors for neurotics are worrying and anxiety, which might prevent them coping successfully with noise, or some other stressors during mental performance. In numerous experiments introverts have showed higher sensitivity to noise during mental performance compared to extroverts, while extroverts often cope with a boring task even by requesting short periods of noise during performance. Correlation analyses have regularly revealed a highly significant negative relation between extroversion and noise annoyance during mental processing. Numerous studies have shown that people with high noise sensitivity may be prevented from achieving the same work results as other people in noisy environment, thus leading to psychosomatic, neurotic or other difficulties. Positive relation between noise annoyance and subjective noise sensitivity might be very strong. Our results have shown, after matching with the results of other relevant studies, that more stable personality, with extroversive tendencies and with a relatively lower subjective noise sensitivity measured with standard questionnaires, may be expected to better adapt to noise during mental performance, compared to people with opposite personality traits.

The contradictory and confusing results in noise research on humans may partly be due to individual differences between the subjects participating in different studies. This review is based on a twelve year research on the role of neuroticism, extroversion and subjective noise sensitivity during mental work in noisy environment. Neurotic persons might show enhanced "arousability" i.e. their arousal level increases more in stress. Additional unfavorable factors for neurotics are worrying and anxiety, which might prevent them coping successfully with noise, or some other stressors during mental performance. In numerous experiments introverts have showed higher sensitivity to noise during mental performance compared to extroverts, while extroverts often cope with a boring task even by requesting short periods of noise during performance. Correlation analyses have regularly revealed a highly significant negative relation between extroversion and noise annoyance during mental processing. Numerous studies have shown that people with high noise sensitivity may be prevented from achieving the same work results as other people in noisy environment, thus leading to psychosomatic, neurotic or other difficulties. Positive relation between noise annoyance and subjective noise sensitivity might be very strong. Our results have shown, after matching with the results of other relevant studies, that more stable personality, with extroversive tendencies and with a relatively lower subjective noise sensitivity measured with standard questionnaires, may be expected to better adapt to noise during mental performance, compared to people with opposite personality traits.

Background: Newly emerging Western style economic systems provide new opportunities to study the prevalence and predictors of childhood obesity. We also provide for the first time a national study of childhood obesity using all three international anthropometric criteria. Methods: The sample included 4097 Montenegrin children, 2076 boys (50.7%) and 2021 girls. Anthropometric measurements were performed in school. The questionnaire for parents included questions on 24 potential contributing factors for childhood obesity. Nutritional status was assessed according to World Health Organization, US Center for Disease Prevention and Control and International Obesity Task Force (IOTF) criteria. Results: Overall percentage of Montenegrin children who are overweight or obese (IOTF) is 22.9% of which 5.3% are obese (7.0% boys vs. 3.5% girls). We found 10 factors to be independently associated with child obesity. Positive relations [odds ratio (95% confidence interval)] were found with maternal obesity [2.05 (1.68-2.51)], paternal obesity [1.67 (1.32-2.10)], paternal employment [1.40 (1.12-1.74)], maternal smoking [1.32 (1.08-1.61)], obesity at birth [1.33 (1.04-1.70)] and computer game playing [per hour - 1.11 (1.00-1.24)]. Negative relations were found with female gender [0.64 (0.53-0.78)], the number of siblings [0.88 (0.78-0.98)], birth order [0.73 (0.64-0.83)] and age [0.92 (0.88-0.98)]. Conclusion: One out of four Montenegrin children is overweight, with two times more frequent obesity among boys compared with girls. Some previously salient predictors did not appear salient in this sample. To enable worldwide comparability, we propose the use of all three childhood obesity criteria in national studies. © 2015 The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

A cross-sectional study was performed on a 5% sample of the adult population of the city of Pancevo (3622 residents). The response rate was 79 % (2874), with 1243 interviewed males (43%) and 1631 females (57%). Noise annoyance was assessed on a five- grade verbal scale (Not at all; Slightly; Moderately; Very; Extremely). Arterial hypertension was defined by antihypertensive treatment, information on which was obtained from questionnaire. Myocardial infarction was also subjectively confirmed. Prevalence and odds ratios of arterial hypertension and myocardial infarction were computed for subjects who were very much and extremely annoyed by noise, or moderately annoyed, using residents who were slightly annoyed or not annoyed at all as a referent category. Significant odds ratios (adjusted for age, body mass index and smoking habits) were found for self-reported arterial hypertension [1,8 (1,0-2,4 - 95% confidence interval), P < 0,01] and myocardial infarction [1,7 (1,0-2,9), P < 0,05] in very much or extremely noise disturbed male subjects, compared to those who were not annoyed at all, or were slightly annoyed by noise. The respective odds ratios for females were lower and not statistically significant 1,1 (0,8-1,7) and 1 (0,4-2,0).

A cross-sectional study was performed on a 5% sample of the adult population of the city of Pancevo (3622 residents). The response rate was 79 % (2874), with 1243 interviewed males (43%) and 1631 females (57%). Noise annoyance was assessed on a five- grade verbal scale (Not at all; Slightly; Moderately; Very; Extremely). Arterial hypertension was defined by antihypertensive treatment, information on which was obtained from questionnaire. Myocardial infarction was also subjectively confirmed. Prevalence and odds ratios of arterial hypertension and myocardial infarction were computed for subjects who were very much and extremely annoyed by noise, or moderately annoyed, using residents who were slightly annoyed or not annoyed at all as a referent category. Significant odds ratios (adjusted for age, body mass index and smoking habits) were found for self-reported arterial hypertension [1,8 (1,0-2,4 - 95% confidence interval), P < 0,01] and myocardial infarction [1,7 (1,0-2,9), P < 0,05] in very much or extremely noise disturbed male subjects, compared to those who were not annoyed at all, or were slightly annoyed by noise. The respective odds ratios for females were lower and not statistically significant 1,1 (0,8-1,7) and 1 (0,4-2,0).

Aims and background. Bladder cancer (BC) is the most expensive cancer to treat. Its incidence and mortality have not decreased in the last three decades. Numerous uncertainties are still surrounding the etiology of BC. There is a need for a low-cost screening test for BC that would be applicable for early detection in asymptomatic persons, a test that would preferably be noninvasive and have satisfactory sensitivity and specificity. Methods and study design. The first part of this paper addresses critical issues in the research into BC etiology, which we classified as entrances, toxicity and metabolism, amounts, and duration of exposure to carcinogens in the bladder. In the second part, based on the proven risk factors for BC, we present a simple scoring system as part of a new BC screening method. Results. The heterogeneous results of studies on BC etiology are largely due to a lack of research into the compounds (and their mutual interactions) present in the urinary bladder, carcinogens absorbed through the skin and/or inhaled, and the daily dynamics of exposure to exogenous risk factors. We have calculated a score for BC screening which is an integral component of a new, four-level system of BC prevention. Conclusions. Interactions of carcinogens and their daily dynamics deserve more attention in further clarifying BC etiology. New attempts in BC screening should be focused on urine content analyses (carcinogens, antioxidants, vitamins, minerals) and not only on hematuria and currently used biomarkers. We propose a score for BC preevaluation and recruitment for screening and a new model of BC prevention.

Aims and background. Bladder cancer (BC) is the most expensive cancer to treat. Its incidence and mortality have not decreased in the last three decades. Numerous uncertainties are still surrounding the etiology of BC. There is a need for a low-cost screening test for BC that would be applicable for early detection in asymptomatic persons, a test that would preferably be noninvasive and have satisfactory sensitivity and specificity. Methods and study design. The first part of this paper addresses critical issues in the research into BC etiology, which we classified as entrances, toxicity and metabolism, amounts, and duration of exposure to carcinogens in the bladder. In the second part, based on the proven risk factors for BC, we present a simple scoring system as part of a new BC screening method. Results. The heterogeneous results of studies on BC etiology are largely due to a lack of research into the compounds (and their mutual interactions) present in the urinary bladder, carcinogens absorbed through the skin and/or inhaled, and the daily dynamics of exposure to exogenous risk factors. We have calculated a score for BC screening which is an integral component of a new, four-level system of BC prevention. Conclusions. Interactions of carcinogens and their daily dynamics deserve more attention in further clarifying BC etiology. New attempts in BC screening should be focused on urine content analyses (carcinogens, antioxidants, vitamins, minerals) and not only on hematuria and currently used biomarkers. We propose a score for BC preevaluation and recruitment for screening and a new model of BC prevention.

Although tinnitus is a very common symptom, risk factors related to behavior and habits have not been sufficiently investigated. As no investigation on this problem has been performed in Serbia, the aim of our study was to establish the prevalence of tinnitus among Serbian adolescents and to investigate the relationship between their behavior and habits and tinnitus. This investigation was designed as a cross-sectional interview study among secondary school students in Belgrade, Serbia (277 boys and 494 girls). An anonymous questionnaire was self-administered at classes. The investigated variables were: The presence of tinnitus, sources of noise, night outs at noisy places, use of personal music players, smoking, second hand smoke (SHS), substance abuse, coffee and alcohol consumption. Spearman′s rank-order correlations and multiple logistic regressions were performed with variables related to behavior and habits as independent ones and tinnitus as a dichotomized dependent variable. Tinnitus was reported by 99 students (12.8%), more frequently among girls compared with boys (P = 0.009). Multivariate logistic regression analysis in boys revealed a significant independent effect of a regular drug abuse on the onset of tinnitus. The chances of tinnitus were 13 times higher among drug addicts compared with non-drug users (odds ratio [OR] and 95% confidence interval [CI] for tinnitus = 13.072; 1.335-127.946). In girls, the significant independent effect on tinnitus was found for daily duration of exposure to SHS (OR and 95% CI for tinnitus = 1.328; 1.073-1.644 /per 2 hours of exposure/).

Although tinnitus is a very common symptom, risk factors related to behavior and habits have not been sufficiently investigated. As no investigation on this problem has been performed in Serbia, the aim of our study was to establish the prevalence of tinnitus among Serbian adolescents and to investigate the relationship between their behavior and habits and tinnitus. This investigation was designed as a cross-sectional interview study among secondary school students in Belgrade, Serbia (277 boys and 494 girls). An anonymous questionnaire was self-administered at classes. The investigated variables were: The presence of tinnitus, sources of noise, night outs at noisy places, use of personal music players, smoking, second hand smoke (SHS), substance abuse, coffee and alcohol consumption. Spearman′s rank-order correlations and multiple logistic regressions were performed with variables related to behavior and habits as independent ones and tinnitus as a dichotomized dependent variable. Tinnitus was reported by 99 students (12.8%), more frequently among girls compared with boys (P = 0.009). Multivariate logistic regression analysis in boys revealed a significant independent effect of a regular drug abuse on the onset of tinnitus. The chances of tinnitus were 13 times higher among drug addicts compared with non-drug users (odds ratio [OR] and 95% confidence interval [CI] for tinnitus = 13.072; 1.335-127.946). In girls, the significant independent effect on tinnitus was found for daily duration of exposure to SHS (OR and 95% CI for tinnitus = 1.328; 1.073-1.644 /per 2 hours of exposure/).