Browsing by Author "Maksimović, Miloš (13613612200)"

Obesity due to increased body fatness has been recognized internationally as one of the leading factors affecting individual and public health. The aim of this study was to determine age-related differences in body fatness in a representative sample of women in Serbia. The study included 1937 Serbian females aged 20 to 69.9 years from all regions of the Republic of Serbia. The obesity and body fatness were analyzed using body mass index (BMI), body fat mass (BFM), percent of body fat (PBF), body fat mass index (BFMI), and visceral fat area (VFA). Multivariate analysis of variance with post hoc pairwise comparisons revealed the largest differences between the age categories in VFA followed by BFMI, PBF, and BMI. The prevalence of overweight, obese, and extremely obese subjects in the overall sample by BMI was 30.77, 1.32, and 1.40%, respectively. The prevalence was higher when calculated by PBF, with 37.84 and 20.11% for overweight and obese subjects. The prevalence of overweight and obesity, as calculated by BMI and PBF, was higher in older age groups of Serbian women. The prevalence of overweight women in the oldest group was 4.32 times higher, while the rate of obesity was 8.67 times higher than in the youngest group. Our results are a good basis for planning and implementing preventive health activities and monitoring changes in morphological parameters in Serbian women of different ages. © 2021 by the authors.

Obesity due to increased body fatness has been recognized internationally as one of the leading factors affecting individual and public health. The aim of this study was to determine age-related differences in body fatness in a representative sample of women in Serbia. The study included 1937 Serbian females aged 20 to 69.9 years from all regions of the Republic of Serbia. The obesity and body fatness were analyzed using body mass index (BMI), body fat mass (BFM), percent of body fat (PBF), body fat mass index (BFMI), and visceral fat area (VFA). Multivariate analysis of variance with post hoc pairwise comparisons revealed the largest differences between the age categories in VFA followed by BFMI, PBF, and BMI. The prevalence of overweight, obese, and extremely obese subjects in the overall sample by BMI was 30.77, 1.32, and 1.40%, respectively. The prevalence was higher when calculated by PBF, with 37.84 and 20.11% for overweight and obese subjects. The prevalence of overweight and obesity, as calculated by BMI and PBF, was higher in older age groups of Serbian women. The prevalence of overweight women in the oldest group was 4.32 times higher, while the rate of obesity was 8.67 times higher than in the youngest group. Our results are a good basis for planning and implementing preventive health activities and monitoring changes in morphological parameters in Serbian women of different ages. © 2021 by the authors.

Background: Undernutrition disorder is a prevalent comorbidity (up to 25%) in type 2 diabetes (T2D) patients which significantly compromises their health. We aimed to assess the association between single nucleotide poly-morphysms (SNPs) adiponectin (ADIPOQ) +276 (G/T) and resistin (RETN)-420 (C/G) with the risk of developing T2D and undernutrition in patients with T2D. Methods: The research was conducted as prospective case-control study among 106 patients with T2D and 106 healthy control individuals in the territory of the Bosnia and Herzegovina from Sep 1st 2022 to May 1st 2023. For assessing the nutritional status, the mini nutritional assessment (MNA) was used. DNA analysis was carried out by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) method. The data were analyzed using chi-square test, t-test for independent samples and binary multivariate logistic regression. Results: The research included 212 subjects of which 124 (58.5%) were male. The mean age of the subjects was 68.48±4,67 yr. Almost 20% of subjects were undernourished, significantly more T2D patients when compared to controls (33% vs. 6.6%; P<0.001). ADIPOQ +276 GT genotype was identified as significant predictor of T2D (OR: 3.454; 95% CI: 1.400-8.521; P=0.007) and undernutrition disorder (OR: 3.453; 95% CI: 1.331-8.961; P=0.011) in T2D population, while the presence of RETN-420 CG genotype had protective effect against occur-rence of T2D (OR: 0.353; 95% CI: 0.144-0.867; P=0.023). However, RETN genotypes were not associated with undernutrition disorder. Conclusion: ADIPOQ +276 gene polymorphism represent a significant predictor for development of T2D and undernutrition disorder in T2D population, while RETN-420 gene polymorphism was identified as a significant factor associated with a reduced risk for T2D, but was not associated with undernutrition. © 2025 Vuković et al.

A cohort study was conducted to examine the association of an increased body mass index (BMI) with late adverse outcomes after a carotid endarterectomy (CEA). It comprised 1597 CEAs, performed in 1533 patients at the Vascular Surgery Clinic in Belgrade, from 1 January 2012 to 31 December 2017. The follow-up lasted four years after CEA. Data for late myocardial infarction and stroke were available for 1223 CEAs, data for death for 1305 CEAs, and data for restenosis for 1162 CEAs. Logistic and Cox regressions were used in the analysis. The CEAs in patients who were overweight and obese were separately compared with the CEAs in patients with a normal weight. Out of 1223 CEAs, 413 (33.8%) were performed in patients with a normal weight, 583 (47.7%) in patients who were overweight, and 220 (18.0%) in patients who were obese. According to the logistic regression analysis, the compared groups did not significantly differ in the frequency of myocardial infarction, stroke, and death, as late major adverse outcomes (MAOs), or in the frequency of restenosis. According to the Cox and logistic regression analyses, BMI was neither a predictor for late MAOs, analyzed separately or all together, nor for restenosis. In conclusion, being overweight and being obese were not related to the occurrence of late adverse outcomes after a carotid endarterectomy. © 2023 by the authors.

A cohort study was conducted to examine the association of an increased body mass index (BMI) with late adverse outcomes after a carotid endarterectomy (CEA). It comprised 1597 CEAs, performed in 1533 patients at the Vascular Surgery Clinic in Belgrade, from 1 January 2012 to 31 December 2017. The follow-up lasted four years after CEA. Data for late myocardial infarction and stroke were available for 1223 CEAs, data for death for 1305 CEAs, and data for restenosis for 1162 CEAs. Logistic and Cox regressions were used in the analysis. The CEAs in patients who were overweight and obese were separately compared with the CEAs in patients with a normal weight. Out of 1223 CEAs, 413 (33.8%) were performed in patients with a normal weight, 583 (47.7%) in patients who were overweight, and 220 (18.0%) in patients who were obese. According to the logistic regression analysis, the compared groups did not significantly differ in the frequency of myocardial infarction, stroke, and death, as late major adverse outcomes (MAOs), or in the frequency of restenosis. According to the Cox and logistic regression analyses, BMI was neither a predictor for late MAOs, analyzed separately or all together, nor for restenosis. In conclusion, being overweight and being obese were not related to the occurrence of late adverse outcomes after a carotid endarterectomy. © 2023 by the authors.

Aim: The aim of this study was to determine differences in psychosocial context of occurrence of cigarette smoking and alcohol and drugs use between adolescents living in foster homes and those living with parents. Methods: The study examined 58 adolescents (14-17 years) living in foster homes and 245 living with parents using an anonymous questionnaire. Findings: Consumption of tobacco and cannabis was more common in the group of children living in foster homes. They tried these substances earlier and used them more frequently. The most important predictor for current smoking was the number of peers who smoked. Another important predictor of current smoking was an expressed feeling of loneliness. The studied groups did not differ significantly in the occurrence of alcohol drinking. Conclusions: These results suggest that suitable prevention programmes with emphases on social groups living under adverse conditions are needed. Further research should be conducted to give more detailed insight into the reasons and psychosocial factors that precipitate the start and perpetuation of these habits in diverse environments. © 2006 Informa UK Ltd.

Aim: The aim of this study was to determine differences in psychosocial context of occurrence of cigarette smoking and alcohol and drugs use between adolescents living in foster homes and those living with parents. Methods: The study examined 58 adolescents (14-17 years) living in foster homes and 245 living with parents using an anonymous questionnaire. Findings: Consumption of tobacco and cannabis was more common in the group of children living in foster homes. They tried these substances earlier and used them more frequently. The most important predictor for current smoking was the number of peers who smoked. Another important predictor of current smoking was an expressed feeling of loneliness. The studied groups did not differ significantly in the occurrence of alcohol drinking. Conclusions: These results suggest that suitable prevention programmes with emphases on social groups living under adverse conditions are needed. Further research should be conducted to give more detailed insight into the reasons and psychosocial factors that precipitate the start and perpetuation of these habits in diverse environments. © 2006 Informa UK Ltd.

[No abstract available]

Background: The educational process brings a considerable amount of stress to medical students that can influence mental health status and contribute to further professional burnout. The authors assessed the academic stress influences, mental health status and burnout syndrome, with the intent to find different patterns in female and male medical students. Subjects and methods: The applied cross sectional study was in the form of an anonymous questionnaire which included: sociodemographic data, self-reported health status and influence of studying activities on stress level in 755 medical students who attended two final years. Mental health status was explored by the General Health Questionnaire (GHQ-12), and Maslach Burnout Inventory (MBI). Results: Female students assessed their physical health status and general stress level as worse compared to males (p<0.001). Exams were described as a high stressor in about 50% of all examined students. However, this stressor was significantly more frequent in female students (p<0.001). Female students frequently declared high stressful effects of contacts with patients (p=0.009) and autopsy (p<0.001). The scores of the GHQ-12 questionnaire were above the threshold or high in 51.5% of all students, and also significantly higher in females (p=0.001). High scores were found among 52.6% of all examined students on MBI subscale of Depersonalization, and 33.6% on MBI subscale of Emotional exhaustion without gender difference. Conclusion: Measures for prevention of academic distress should be targeted at optimization of the educational process, development of the clinical skills and professionalism, with special concern to female students who manifested high vulnerability. © Medicinska naklada.

Introduction: The ability of airline pilots to maintain a good level of sleep goes a long way in ensuring operational effectiveness with regard to safety as well as personal health. The study assesses the risk factors for sleep quality of airline pilots in Serbia with the objective of determining those factors, both occupational and lifestyle that are paramount in assisting with sleep health. Methods: A cross-sectional study was conducted on a total of 66 Serbian commercial pilots, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess their sleep quality. Demographic, occupational, lifestyle, biological and psychological variables were obtained through validated questionnaires. Multivariate logistic regression was used to determine the predictors of poor sleep quality (PSQI ≥5). Results: Overall sleep quality was poor in 65.2% of the participants. Significant factors associated with poor sleep quality included years of experience (OR = 1.17, p = 0.007) and levels of stress (OR = 2.87, p = 0.004). Particular lifestyle variables, including factors such as coffee intake, had initial relationships with sleep quality but were not significant in the multivariate models. With regard to age, a significant univariate association was also revealed but was dropped in the final model because of collinearity with years of experience. Conclusion: Serbian commercial pilots have a relatively high risk of inadequate sleep associated with years of experience and levels of stress. There is a need to implement organization-wide changes such as stress management schemes in order to improve sleep quality among pilots, and foster prioritizing well-being. Copyright © 2025 Stojanović, Nesic, Maksimović, Terzić-Šupić, Todorović, Topalović, Vlaisavljević and Ilić Živojinović.

Background and aims: Silhouettes is self-reported measure of body image used as a method for estimating: current size, desired size and a discrepancy score, which is often used as a measure of body dissatisfaction. Several studies have looked at patients' perceptions of their weight and the accuracy of their impressions. The aim of the study was to find out if the discrepancies in silhouettes rating could be matched with weight loss goals projected by BMI, obtained both in patients and doctors. Methods: The silhouettes method was tested on 179 obese and overweight patients in out-patient dietetic unit and simultaneously in obese patients seeking treatment and their physicians. Results: The study has demonstrated that the magnitude of projected weight loss is very high, especially in female patients who expected their BMI after weight loss program to fit into normal range. Obese men projected their target BMI towards overweight cut-off point. Besides being very high in female patients, expected weight loss appeared to be much higher in patients in general in comparison to their physicians. Conclusion: The silhouette approach proved to be an accurate method for estimating nutritional status both when used by patients and physicians, and a useful easy-to-use tool during weight loss treatment. ©2010, Editrice Kurtis.

Introduction Obesity, particularly visceral obesity, is considered one of major risk factors for cardiovascular events. Objectives The aim of the present study was to investigate relationship between abdominal obesity and other cardiovascular risk factors. Methods The cross-sectional study involved 657 consecutive patients with verified carotid atherosclerosis. Carotid atherosclerosis was estimated by high resolution B-mode ultrasonography. Abdominal obesity was defined as waist circumference >102 cm in men and >88 cm in women. Results Abdominal obesity was present in 324 (49.3%) participants. Multivariate analyses showed that abdominal obesity was significantly positively associated with female sex, increased Baecke's Work Index of physical activity at work, years of school completed <12, metabolic syndrome, increased triglycerides, hyperglycemia and high serum uric acid. Smoking, alcohol consumption, physical inactivity, hypertension, increased total cholesterol, increased HDL and LDL cholesterols, increased high sensitive C-reactive protein, increased fibrinogen, anti-lipid therapy and anti-diabetic therapy were not significantly related to abdominal obesity. Conclusion Abdominal obesity among patients with symptomatic carotid disease is significantly related to other cardiovascular risk factors, especially metabolic syndrome, metabolic syndrome components and high level of serum uric acid.

Introduction: Peripheral arterial disease (PAD) is a severe atherosclerotic condition. The relationship between various risk factors and severity of PAD, measured by Ankle Brachial Index (ABI), has been the subject of a relatively small number of studies. Objective: The aim of the present study was to investigate whether there was any relationship between severity of PAD, expressed as ABI, and anthropometric, clinical and biochemical characteristics of patients, including inflammatory markers. Methods: The cross-sectional study, involving 388 consecutive patients with verified PAD, was performed at the Dedinje Vascular Surgery Clinic in Belgrade. The diagnosis of PAD was defined by Doppler sonography as ABI<0.9, and by symptoms. Data on cardiovascular risk factors, anthropometric parameters, clinical and biochemical characteristics were collected for all participants. In the analysis, χ2 test, t-test and multivariate logistic regressions were used. Results: According to the results of multivariate analysis (the model of which included age, percentage of body fat, average value of uric acid, high sensitivity C-reactive protein - hsCRP ≥3 mg/L, fibrinogen ≥4 g/L, Baecke index of physical activity at work and Baecke index of leisure-time physical activity), the patients with more severe form of peripheral arterial disease (ABI≤0.40) had more frequently increased high sensitivity C-reactive protein (p=0.002), lower Baecke index of physical activity at work (p=0.050) and lower Baecke index of leisure-time physical activity (p=0.024). Average value of body fat was significantly higher in the patients with a less severe form of disease (p=0.006). Conclusion: According to the results obtained, the increased values of hsCRP and physical inactivity are associated with a more severe form of PAD (ABI≤0.40).

BACKGROUND: Socioeconomic status is a well-known risk factor for obesity. The aim of this study was to assess the relationship between socioeconomic and nutritional status in the Serbian adult population. DESIGN AND SETTING: Cross-sectional study on data from the 2013 National Health Survey performed in Serbia. METHODS: The study population consisted of adults aged ≥ 20 years. Face-to-face interviews and anthropometric measurements were conducted by trained staff. Associations between body mass index and sociodemographic variables were analyzed using multivariable logistic regression analyses. RESULTS: Out of 12,461 subjects of both sexes, 36.4% were overweight and 22.4% were obese. The prev-alences of overweight and obesity differed significantly between the sexes, regarding all sociodemographic characteristics. Among women, educational attainment was associated with lower risk of being overweight (odds ratio, OR = 0.82; 95% confidence interval, CI: 0.69-0.98 for medium-level and OR = 0.77; CI: 0.62-0.97 for higher education) or obese (OR = 0.68; CI: 0.57-0.82 for medium-level and OR = 0.41; CI: 0.31-0.54 for higher education). In contrast, medium-level (OR = 1.28; CI: 1.08-1.52) and highly educated men (OR = 1.39; CI: 1.11-1.74) were more frequently overweight than were those with low education. Among men, grade I obesity was positively related to the richest wealth index group (OR = 1.27), while the opposite was true for grade II obesity among women (OR = 0.61). CONCLUSION: This study showed significant socioeconomic inequalities in nutritional status between men and women. Continuous monitoring of socioeconomic patterns relating to weight is important, especially with further exploration of the link between education and obesity. © 2018, Associacao Paulista de Medicina. All rights reserved.

Introduction Cardiovascular diseases, especially heart disease and stroke are the cause of more than a half of the total number of deaths in Serbia. Objectives The aim of the present study was to determine sex differences of atherosclerotic risk factors in patients with symptomatic carotid disease. Methods The cross-sectional study, involving 657 consecutive patients with verified carotid atherosclerotic disease, was performed in Belgrade, Serbia. Sex differences of anthropometric parameters and atherosclerotic risk factors were analyzed by means of the univariate logistic regression. Results In comparison with men, lower education and physical inactivity were significantly more frequent in women, and the frequency of metabolic syndrome (MetS), lower high-density cholesterol, abdominal obesity, body mass index ≥30.0 kg/m2, hypercholesterolemia and depression were also significantly higher in women. Smoking and high serum uric acid level were significantly more frequent in men than in women. Women had significantly higher number of MetS components per person, but there were no significant sex differences in the number of other risk factors. Out of all observed risk factors, including MetS components, physical inactivity and hypertension were most frequent in both sexes followed by ever smoking and low education in men and low education and dyslipidemia in women. Conclusion There were significant sex differences in the distribution of some atherosclerotic risk factors, but not in their number per person. Only the number of MetS components was significantly higher in women.

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.

Introduction Medical studies bring many stressful activities to students. Prolonged stress can make adverse effects to mental health and lead to further professional burnout. Objective The aim of this study was to assess the association of stress impact and adverse effects of medical studies with psychological distress among medical students. Methods The cross sectional study was conducted on 367 fourth-year medical students of the Faculty of Medicine in Belgrade, by means of the anonymous questionnaire, containing: socio-demographic data, self-reported health status and stressful influences of studying activities. Mental health status was estimated by General Health Questionnaire (GHQ-12). Results More than 50% of students perceive frequent feeling of psychic tension, and one third has problems with insomnia. Nearly one-half of students assessed their general stress level as moderate or high. Exams were estimated as high stressor in 63.1% of all students. Stressful effects of communication with teaching staff were reported by one quarter of the examinees. The scores of GHQ-12 were above the threshold in 55.6% of all students. Mental health problems among students were most significantly associated with stressful experience during exams and contacts with teaching staff. Conclusion Academic stress makes great influence on mental health of medical students. Reduction of stress effects should be directed to optimization of the examination process and improvement of communication skills.

Introduction: Deep vein thrombosis (DVT) is present in 10.6% patients after operative treatment for ovarian malignancy. We undertook the present study to find the risk factors for venous thromboembolism (VTE) after surgical treatment for ovarian cancer and to clarify the prognostic value of D-dimer and a positive PTP test (Wells score) in these patients. Material and Methods: A total of 31 consecutive patients with histologically confirmed ovarian cancer after surgery, clinically suspicious for DVT were followed from January 2006 to December 2008. All patients were operatively treated at the Clinical Center of Serbia. Study variables included age, cardiovascular disease, FIGO stage, histology, BMI, presence of massive ascites and tumor size, D-dimer level and Wells score. All patients were postoperatively administered anticoagulant therapy. Results: DVT was found in nine of 31 patients (29.0%). High BMI and presence of massive ascites were significantly associated with DVT D-dimer (DD) levels were high in 27 of out 31 patients (87.1%). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 100, 18.2, 33.3 and 100%. Results of the PTP test (according to Wells score) was positive in 20 out of 31 patients (64.5%). PTP score was not significantly different in patients with or without VTE (p = 0.606). Sensitivity, specificity, PPV and NPV were 66.7, 36.4, 30.0 and 72.7%, respectively. Conclusion: Incidence of VTE after gynecological operations for ovarian cancer in our study was similar to other investigators. Obesity and the massive ascites are statistically significant risk factors. Measurement of DD level and ultrasonography could become the standard in predicting VTE in ovarian cancer surgery. The use of Wells score is not satisfying in these patients. Prediction of VTE after gynecological surgery needs further confirmation in randomized controlled trials.

The aim of the study was to determine changes in body mass index (BMI) and in the prevalence of overweight and obesity in Serbian adult population. Data for this study were obtained from three National Health Interview Surveys, carried out as cross-sectional, nationally representative surveys in 2000, 2006 and 2013. The values of p for trends of sociodemographic and health related behavioral characteristics, of BMI distribution, and of overweight and obesity prevalence were determined by univariate and multivariate linear and logistic regression analyses, with year of survey as a continuous variable. The mean values of BMI and standard deviations in surveys were 26.09±3.92, 26.28±4.02 and 26.87±4.33 in men, and 25.91±5.25, 25.77±5.22 and 26.35±5.58 in women, respectively (trend p<0.001 both). The prevalence of obesity was 14.3%, 16.5% and 21.4% in men, and 20.0%, 19.7% and 23.3% in women, respectively (trend p<0.001 both). The prevalence of overweight did not change significantly during the observed period. In conclusion, the prevalence of obesity showed an increasing trend in both men and women, demanding targeted public health interventions. © 2023, Dr. Mladen Stojanovic University Hospital. All rights reserved.