Browsing by Author "Grgurevic, Anita (12780453700)"

The objective of the study was to investigate factors related to the occurrence of myelodysplatic syndromes (MDS) in the population of Belgrade (Serbia Montenegro). The case-control study was conducted during the period 2000-2003. The study group consisted of 80 newly diagnosed MDS patients and 160 sex- and age-matched hospital controls with nonmalignant and noninfectious diseases. The disease categories in the control group were circulatory (51 patients, 32%), gastrointestinal (53 patients, 33%), and ophthalmological (56 patients, 35%) disorders. Conditional univariate and multivariate logistic regression analyses were applied. Multivariate analysis showed the following factors to be significantly related to MDS: exposure to chemicals (OR=10.8, 95%CI 3.2-36.2, p=0.0001), viral upper respiratory tract infections (twice a year or more, OR=5.8, 95%CI 2.5-13.6, p=0.0001), exposure to insecticides, pesticides and herbicides (OR=5.2, 95%CI 1.8-15.1, p=0.003), coffee (OR=5.1, 95%CI 1.9-13.7, p=0.001), and alcohol consumption (OR=2.2, 95%CI 1.1-4.6, p=0.033). The findings support the hypotheses that exposure to chemical agents, pesticides, insecticides, and herbicides, certain lifestyle factors (alcohol and coffee consumption), and frequent viral infections may be involved in the etiology of MDS, but these results should be confirmed by further investigations. © Springer-Verlag 2006.

Objective: The relationship between smoking and onset of glaucoma has been inconsistent. However, there is a gap in understanding whether tobacco smoking is linked to a worse visual impairment in different glaucoma subtypes. The objective of this study was to examine the association between smoking behavior and vision-related disability in people who have different glaucoma subtypes. Methods: A total of 283 people with primary open-angle glaucoma (POAG), primary angle closure glaucoma (PACG), normal tension glaucoma (NTG), and pseudo-exfoliative (PEX) were included in this cross-sectional study. The recruitment of study participants was organized in one of two tertiary centers for eye diseases in Belgrade, Serbia, during their regular eye checks. Information about the duration and quantity of smoking was self-reported. Vision-related impairment was quantified using a validated Glaucoma Quality of Life-15 (GQL-15) questionnaire. Results: A series of multiple linear regression models adjusted for age, gender, severity of glaucoma, lifestyle, and mobility, intraocular pressure level, visual parameters, previous and current therapy, and chronic illnesses suggested that a higher quantity of cigarettes smoked per day was associated with poorer vision-related quality of life only among people with NTG subtypes. This association was absent when smoking duration was tested in the adjusted linear regression model. Conclusion: A higher number of cigarettes smoked daily was associated with poorer vision-related impairment among people who have NTG, but not other glaucoma subtypes. It is recommended that ophthalmologists and other health-care professionals work to improve their patients’ understanding of harmful effects of tobacco smoke and quit smoking. © 2023 Taylor & Francis Group, LLC.

The objective of this study is to estimate the burden of tuberculosis (TB) in Serbia in the period 1992-2002 based on incidence, mortality, and disability adjusted life years (DALY). The average age-adjusted TB incidence rate in the period 1992-2002 was 36.7/100,000 in males and 21.4/100,000 in females. During the period observed, TB incidence levelled of after a long period of decreasing trend during the preceding several decades. The incidence showed slightly increasing tendency in males and decreasing one in females. The average age-adjusted mortality rate was 4.1/100,000 in males and 1.3/100,000 in females. Mortality rates significantly decreased in both males (P = .0001) and females (P = .0001). The burden of TB (DALY) was 0.70/1000 for males and 0.26/1000 for females. DALY rates significantly decreased in both males (P = .009) and females (P = .008). TB incidence and mortality as well as DALY rates increased with aging. © 2006 Association for Professionals in Infection Control and Epidemiology, Inc.

The objective of this study was to establish the tuberculosis incidence and mortality in children in Serbia in the period 1992-2002. There were 280 reported cases. The average annual incidence rate was 1.79/100,000 (95% confidence interval, 0.92-3.13). The rate was higher in girls than in boys. Eleven children died. The average annual mortality rate was 0.10/100,000 (95% confidence interval, 0.01-0.56). The mortality rates for both boys and girls were higher in the age group 0-4 years than in older age group. © 2006 Lippincott Williams & Wilkins.

Background: To compare breast cancer incidence and mortality trends in Central Serbia between males and females in the period 1999-2009. Materials and Methods: In this descriptive study, mortality data were obtained from the National Statistics Institute and morbidity data were derived from Institute of Public Health of Serbia for the period of interest. Results: Breast cancer is a leading cancer in the female population of Central Serbia, whereas in male population it is not on the list of 10 leading localizations, concerning both incidence as well as mortality. In the period 1999-2009 the average standardized incidence rates of breast cancer were 60.5/100,000 in women and 1.4/100,000 in men, while average standardized mortality rates were 20.4/100,000 and 0.4/100,000. The average standardized incidence and mortality rates were about 45 times higher in females than males. Male breast cancer comprises approximately 2.1% of all breast cancer cases. The average age-specific mortality and incidence rates increased with age in both sexes. In the observed period standardized mortality rates of breast cancer increased significantly only in men (y=0.320+0.0215×, p=0.044). Conclusions: The increase of breast cancer incidence in both sexes and mortality in men, indicate an urgent need for Serbian health professionals to apply existing cancer control and preventive measures. Male breast cancer is more present than in other world regions, with an outstanding increase of mortality, which demands a timely identification (screening) and adequate treatment. A national policy including mammography should be considered in the light of the newest findings.

Background: To compare breast cancer incidence and mortality trends in Central Serbia between males and females in the period 1999-2009. Materials and Methods: In this descriptive study, mortality data were obtained from the National Statistics Institute and morbidity data were derived from Institute of Public Health of Serbia for the period of interest. Results: Breast cancer is a leading cancer in the female population of Central Serbia, whereas in male population it is not on the list of 10 leading localizations, concerning both incidence as well as mortality. In the period 1999-2009 the average standardized incidence rates of breast cancer were 60.5/100,000 in women and 1.4/100,000 in men, while average standardized mortality rates were 20.4/100,000 and 0.4/100,000. The average standardized incidence and mortality rates were about 45 times higher in females than males. Male breast cancer comprises approximately 2.1% of all breast cancer cases. The average age-specific mortality and incidence rates increased with age in both sexes. In the observed period standardized mortality rates of breast cancer increased significantly only in men (y=0.320+0.0215×, p=0.044). Conclusions: The increase of breast cancer incidence in both sexes and mortality in men, indicate an urgent need for Serbian health professionals to apply existing cancer control and preventive measures. Male breast cancer is more present than in other world regions, with an outstanding increase of mortality, which demands a timely identification (screening) and adequate treatment. A national policy including mammography should be considered in the light of the newest findings.

Objective: Cross-cultural validation of the Serbian version of the Modified Falls Efficacy Scale (MFES). Methods: This cross-sectional study involved 257 women aged 65 years and above who were referred for dual-energy x-ray absorptiometry examination at the Railway Healthcare Institute in Belgrade, Serbia, between January and April 2016. Data collection comprised of a sociodemographic questionnaire and Geriatric Depression Scale-Short Form (GDS-SF) questionnaire, and data related to fractures, level of physical activity, use of medications that can increase the risk of falls, and frequency of falls in the past 12 months. None of the study participants had been previously treated for osteoporosis. The internal consistency of the questionnaire items was assessed via Cronbach's alpha, whereas the interclass correlation coefficient (ICC) was used to calculate test-retest reliability based on the sample of 257 women. We also evaluated concurrent, convergent, and construct validity. Results: Cronbach's alpha for the total assay score was 0.98. Correlations among the items ranged from 0.84 to 0.93. While ICC for the scale as a whole was 0.99 (95% confidence interval 0.98-0.99), ICC pertaining to individual items ranged from 0.82 to 0.99. Concurrent validity analysis revealed a significant positive correlation between MFES scores and the reported level of physical activity (ρ = 0.34; P < 0.01). Convergent validity was tested through the ratio of MFES and sociodemographic variables. The findings indicated presence of a significant negative correlation between the MFES scores and age (ρ = -0.32; P < 0.01), age of menopause onset (ρ = -0.16; P = 0.01), and GDS-SF scores (ρ = -0.12; P = 0.04), and positive correlation between MFES and the level of social activity (ρ = 0.22; P < 0.01). Significant differences were noted between the MFES scores of participants who had no history fractures and those who did (U = 5277.50; P < 0.01), and between scores of women who reported falling in the past 12 months and those who did not (U = 4968.50; P < 0.01). Similarly, significant differences (P < 0.01) in the scores pertaining to each MFES item were observed between women who had experienced falls in the past (n = 101) and those who had not (n = 156). Conclusion: The Serbian version of the MFES is a reliable and valid instrument that can be used in both clinical practice and research to describe and measure self-perceived fear of falling in older individuals. © 2017 by The North American Menopause Society.

Objective Cross-cultural translation and validation of the Serbian version of the Retinopathy Treatment Satisfaction Questionnaire status version (RetTSQs). Design Cross-sectional study. Settings The study was conducted between June 2017 and June 2018 at tertiary care centre in Serbia, Belgrade. Participants A total of 101 patients with diabetic retinopathy (DR) were included. All subjects were evaluated in two consecutive visits, the first during the initial contact to the clinic, while the second 4-6 weeks later. Main outcome measures Validation of Serbian version of the RetTSQs was the major outcome. Results Cronbach alpha coefficient of the subscales ranged from 0.783 (positive scale) to 0.811 (negative scale) and for all domains it was excellent at α=0.829. The intraclass correlation coefficient was greater than 0.8 for all of the subscales. Univariable analyses revealed that age, gender, education, marital status and working status did not affect the RetTSQ scores, whereas participants with non-proliferative DR reported signi? cantly higher treatment satisfaction (TS) than those with proliferative retinopathy (p=0.001). The group who received laser treatment scored signi? cantly lower than the group without it (p=0.004) regardless of type of performed laser. Positive and statistically significant correlations were found between the RetTSQ score and most of the National Eye Institute Visual Functioning Questionnaire-25 subscales. Conclusion Translated Serbian adaptation of the RetTSQs showed adequate psychometric characteristics as an acceptable, reliable and valid questionnaire. It was well understood by Serbian diabetic patients and it promises to be used in daily clinical work as an instrument for the assessment of TS for patients with DR. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Purpose: The purpose of the study was to identify demographic risk factors associated with depression and suicidality among medical school students in Serbia, as well as to determine the prevalence of symptoms of depression and suicide attempts in the student population.; Method: This was a cross-sectional study conducted on the sample of 1,296 students recruited from the School of Medicine, University of Belgrade. Following questionnaires were assigned to participating subjects: PHQ-9, Suicide Behaviors Questionnaire, and Social-demographic survey.; Results: PHQ-9 scores in our sample ranged from 0 to 27, averaging at 6.21 (SD = 4.96). Symptoms of depression were associated with grade point average, age, relationship status, and gender. Reported history of suicide attempts was associated with PHQ-9 scores, grade point average, relationship status, gender, history of mental illness and drug use.; Conclusion: Our findings suggest that medical school students in Serbia may be considered an “at-risk” population. Preventative programs in the future should target symptoms of depression and should provide students with adequate mechanisms to cope successfully with school-related pressure. Alternative stress management strategies may also be useful, especially for younger students who seem to be at greater risk for depression and suicide. © 2014, Springer-Verlag Berlin Heidelberg.

Purpose: The purpose of the study was to identify demographic risk factors associated with depression and suicidality among medical school students in Serbia, as well as to determine the prevalence of symptoms of depression and suicide attempts in the student population.; Method: This was a cross-sectional study conducted on the sample of 1,296 students recruited from the School of Medicine, University of Belgrade. Following questionnaires were assigned to participating subjects: PHQ-9, Suicide Behaviors Questionnaire, and Social-demographic survey.; Results: PHQ-9 scores in our sample ranged from 0 to 27, averaging at 6.21 (SD = 4.96). Symptoms of depression were associated with grade point average, age, relationship status, and gender. Reported history of suicide attempts was associated with PHQ-9 scores, grade point average, relationship status, gender, history of mental illness and drug use.; Conclusion: Our findings suggest that medical school students in Serbia may be considered an “at-risk” population. Preventative programs in the future should target symptoms of depression and should provide students with adequate mechanisms to cope successfully with school-related pressure. Alternative stress management strategies may also be useful, especially for younger students who seem to be at greater risk for depression and suicide. © 2014, Springer-Verlag Berlin Heidelberg.

Internet is important resource of health-related information and health services. Factors associated with higher level of online health (eHealth) literacy among adolescence have been understudied. The aim of this study was to assess psychometric properties of the eHealth Literacy Scale (eHEALS) in Serbian language and to evaluate eHealth literacy among adolescents in Serbia. The study was carried out in four high schools in Belgrade, Serbia in the period December 2016 to January 2017. A total of 702 students comprised the study sample. The eHEALS was translated according to internationally accepted methodology and its psychometric properties were analyzed. The Cronbach's alpha coefficient for the entire eHEALS was 0.849. On exploratory factor analysis we obtained two-factorial structure. Our adolescents reported low confidence in knowing what health resources are available online. High confidence was observed for knowing how to use and how to find health information online. There was no difference in eHEALS score between genders or between school years. After adjustment for gender, type of school program, parental marital status, fathers' education level and household income, being female was associated with higher eHealth literacy (B = 1.12, 95% confidence interval 0.07-2.18; p = 0.036). Serbian version of the eHEALS is a valid instrument in assessment of online health literacy and can be further used in evaluation of eHealth literacy in other population groups in Serbian language. It is advised that some classes in school are dedicated to appraisal and use of online health websites. This could be achieved through peer-education. © 2018 The Author(s).

Internet is important resource of health-related information and health services. Factors associated with higher level of online health (eHealth) literacy among adolescence have been understudied. The aim of this study was to assess psychometric properties of the eHealth Literacy Scale (eHEALS) in Serbian language and to evaluate eHealth literacy among adolescents in Serbia. The study was carried out in four high schools in Belgrade, Serbia in the period December 2016 to January 2017. A total of 702 students comprised the study sample. The eHEALS was translated according to internationally accepted methodology and its psychometric properties were analyzed. The Cronbach's alpha coefficient for the entire eHEALS was 0.849. On exploratory factor analysis we obtained two-factorial structure. Our adolescents reported low confidence in knowing what health resources are available online. High confidence was observed for knowing how to use and how to find health information online. There was no difference in eHEALS score between genders or between school years. After adjustment for gender, type of school program, parental marital status, fathers' education level and household income, being female was associated with higher eHealth literacy (B = 1.12, 95% confidence interval 0.07-2.18; p = 0.036). Serbian version of the eHEALS is a valid instrument in assessment of online health literacy and can be further used in evaluation of eHealth literacy in other population groups in Serbian language. It is advised that some classes in school are dedicated to appraisal and use of online health websites. This could be achieved through peer-education. © 2018 The Author(s).

Background: Many adolescents believe that online health information is reliable, particularly when they are familiar with the source of information. Objective: To analyse the degree of influence of online health information on high school students' health decisions and examine whether socio-demographic characteristics, digital literacy, use of different websites and interest in specific health topics are associated with a stronger influence of online health information on adolescents' health-related decisions. Methods: Participants were students from four public high schools in Belgrade, Serbia. Socio-demographic and behavioural questionnaire as well as the e-health literacy scale (eHEALS) were used to collect data. Results: The study sample comprised 702 students. A total of 79.6% of students reported that online health information influenced their health decisions to a certain extent (from ‘a little’ to ‘a lot’). Being a boy, using the internet since younger age, better self-perceived e-health literacy, using health apps, Google, health forums, websites of health institutions, social media and YouTube, being interested in diet/nutrition, sexually transmitted infections and cigarettes were the characteristics associated with a stronger influence of online health information on students' health decisions. Conclusion: This study provides clues about how online health-related information can be used to adjust and enhance health promotion amongst adolescents. © 2022 Health Libraries Group.

Background: Many adolescents believe that online health information is reliable, particularly when they are familiar with the source of information. Objective: To analyse the degree of influence of online health information on high school students' health decisions and examine whether socio-demographic characteristics, digital literacy, use of different websites and interest in specific health topics are associated with a stronger influence of online health information on adolescents' health-related decisions. Methods: Participants were students from four public high schools in Belgrade, Serbia. Socio-demographic and behavioural questionnaire as well as the e-health literacy scale (eHEALS) were used to collect data. Results: The study sample comprised 702 students. A total of 79.6% of students reported that online health information influenced their health decisions to a certain extent (from ‘a little’ to ‘a lot’). Being a boy, using the internet since younger age, better self-perceived e-health literacy, using health apps, Google, health forums, websites of health institutions, social media and YouTube, being interested in diet/nutrition, sexually transmitted infections and cigarettes were the characteristics associated with a stronger influence of online health information on students' health decisions. Conclusion: This study provides clues about how online health-related information can be used to adjust and enhance health promotion amongst adolescents. © 2022 Health Libraries Group.

Objective: Tracking of periods is recommended to adolescent girls because of their irregular menstrual cycle and longer cycle length compared to adult women. The purpose of this study was to examine the prevalence of use of apps to track menstrual cycle among high school girls from Belgrade, Serbia, as well as to define factors associated with their use. Methods: A study was carried out in December 2016 and January 2017. The study included 394 high school girls from Belgrade, Serbia, who used smartphones. The students were asked to fill in an anonymous questionnaire about socio-demographic characteristics, use of online platforms and smartphone apps as well as online health (e-health) literacy scale (eHEALS). Results: The prevalence of tracking menstrual cycle via smartphone apps was 29.7%. The multivariate logistic regression model showed that studying humanities-languages school program, using Wikipedia, websites run by physicians, health forums, but not YouTube were associated with use of menstrual cycle tracking apps. Girls who used fitness apps were more likely to use apps to track menstrual cycle. Conclusion: Approximately one third of girls in Belgrade highs schools who have smartphones used menstrual cycle tracking apps. Use of different digital media might influence the decision to track menstrual cycle via smartphone apps. © 2020 by the University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.

Background: There are many factors that affect smoking behavior. Objective: The aim of our study was to identify the most important risk factors related to smoking in the sample population of students at the University of Belgrade with a special emphasize on the family role. Methods: The cross-sectional study was conducted in a population of 2,000 students of the Belgrade University. Four faculties (Medicine, Geography, Economics, and Electrical Engineering) from which the students participating in this research were chosen by the method of random choice, conducted in the period April-June 2010. Results: Independent risk factors for smoking in students, assessed by multivariate logistic regression analysis, included: repeating a year (odds ratio (OR) = 1.67, p <.001), the number of hours spent in the rooms where others smoke (OR = 2.86, p <.001), brother smoker (OR = 1.88, p <.001), sister smoker (OR = 2.33, p <.001), knowledge about the association between smoking and lung cancer (OR = 0.31, p <.001), and depression (OR = 1.02, p =.013). Conclusion: Bearing in mind the influence of siblings, prevention, and intervention efforts should be focused more on family members than on the broader social environment. The results also indicate the need to develop a conscience on a healthy life style and to educate people to enhance and improve their health control. © 2016 Taylor & Francis Group, LLC.

Background: There are many factors that affect smoking behavior. Objective: The aim of our study was to identify the most important risk factors related to smoking in the sample population of students at the University of Belgrade with a special emphasize on the family role. Methods: The cross-sectional study was conducted in a population of 2,000 students of the Belgrade University. Four faculties (Medicine, Geography, Economics, and Electrical Engineering) from which the students participating in this research were chosen by the method of random choice, conducted in the period April-June 2010. Results: Independent risk factors for smoking in students, assessed by multivariate logistic regression analysis, included: repeating a year (odds ratio (OR) = 1.67, p <.001), the number of hours spent in the rooms where others smoke (OR = 2.86, p <.001), brother smoker (OR = 1.88, p <.001), sister smoker (OR = 2.33, p <.001), knowledge about the association between smoking and lung cancer (OR = 0.31, p <.001), and depression (OR = 1.02, p =.013). Conclusion: Bearing in mind the influence of siblings, prevention, and intervention efforts should be focused more on family members than on the broader social environment. The results also indicate the need to develop a conscience on a healthy life style and to educate people to enhance and improve their health control. © 2016 Taylor & Francis Group, LLC.

Background: In 2009, an improved influenza surveillance system was implemented and weekly reporting to the World Health Organization on influenza-like illness (ILI) began. The goals of the surveillance system are to monitor and analyse the intensity of influenza activity, to provide timely information about circulating strains and to help in establishing preventive and control measures. In addition, the system is useful for comparative analysis of influenza data from Montenegro with other countries. Aim: We aimed to evaluate the performance and usefulness of the Moving Epidemic Method (MEM), for use in the influenza surveillance system in Montenegro. Methods: Historical ILI data from 2010/11 to 2017/18 influenza seasons were modelled with MEM. Epidemic threshold for Montenegro 2017/18 season was calculated using incidence rates from 2010/11–2016/17 influenza seasons. Results: Pre-epidemic ILI threshold per 100,000 population was 19.23, while the post-epidemic threshold was 17.55. Using MEM, we identified an epidemic of 10 weeks’ duration. The sensitivity of the MEM epidemic threshold in Montenegro was 89% and the warning signal specificity was 99%. Conclusions: Our study marks the first attempt to determine the pre/post-epidemic threshold values for the epidemic period in Montenegro. The findings will allow a more detailed examination of the influenza-related epidemiological situation, timely detection of epidemic and contribute to the development of more efficient measures for disease prevention and control aimed at reducing the influenza-associated morbidity and mortality. © 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

Background: In 2009, an improved influenza surveillance system was implemented and weekly reporting to the World Health Organization on influenza-like illness (ILI) began. The goals of the surveillance system are to monitor and analyse the intensity of influenza activity, to provide timely information about circulating strains and to help in establishing preventive and control measures. In addition, the system is useful for comparative analysis of influenza data from Montenegro with other countries. Aim: We aimed to evaluate the performance and usefulness of the Moving Epidemic Method (MEM), for use in the influenza surveillance system in Montenegro. Methods: Historical ILI data from 2010/11 to 2017/18 influenza seasons were modelled with MEM. Epidemic threshold for Montenegro 2017/18 season was calculated using incidence rates from 2010/11–2016/17 influenza seasons. Results: Pre-epidemic ILI threshold per 100,000 population was 19.23, while the post-epidemic threshold was 17.55. Using MEM, we identified an epidemic of 10 weeks’ duration. The sensitivity of the MEM epidemic threshold in Montenegro was 89% and the warning signal specificity was 99%. Conclusions: Our study marks the first attempt to determine the pre/post-epidemic threshold values for the epidemic period in Montenegro. The findings will allow a more detailed examination of the influenza-related epidemiological situation, timely detection of epidemic and contribute to the development of more efficient measures for disease prevention and control aimed at reducing the influenza-associated morbidity and mortality. © 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

Background: The screening for intestinal carriage of vancomycin-resistant Enterococcus spp. (VRE) among high risk patients in the Balkan region and molecular epidemiology of VRE is insufficiently investigated, yet it could be of key importance in infection control. The aim of this study was to provide baseline data on VRE intestinal carriage among high-risk patients in Serbian university hospitals, to determine the phenotypic/genotypic profiles of the isolated VRE, to obtain knowledge of local resistance patterns and bridge the gaps in current VRE surveillance. Methods: The VRE reservoir was investigated using stool samples from 268 inpatients. Characterization of isolated VRE stains consisted of BD Phoenix system, genotypic identification, glycopeptide and quinupristin–dalfopristin (Q–D) resistance probing, virulence gene (esp, hyl, efaA, asa1, gelE, cpd) detection and MLVA. Biofilm formation was evaluated by the microtiter plate method. Results: VRE carriage prevalence among at-risk patients was 28.7%. All VRE strains were vanA positive multidrug-resistant Enterococcus faecium (VRfm), harboring ermB-1 (38.9%), esp (84%), efaA (71.2%), hyl (54.5%), asa1 (23.4%), gelE and cpd (11.6%) each. Ability of biofilm production was detected in 20.8%. Genetic relatedness of the isolates revealed 13 clusters, heterogeneous picture and 25 unique MTs profiles. Conclusion: The obtained prevalence of VRE intestinal carriage among high-risk inpatients in Serbia is higher than the European average, with high percentage of multidrug resistance. The emergence of resistance to Q–D is of particular concern. Close monitoring of pattern of resistance and strict adherence to specific guidelines are urgently needed in Serbia. © 2021, The Author(s).