Browsing by Author "Maksimovic, M. (13613612200)"

Introduction: Burnout syndrome denotes undesirable stress reactions in one's professional sphere which reduce their work output and create dissatisfaction with their career. The last decade was characterized by intense research on this problem occurring in medical profession, highlighting the fact that the previous formative period of studying and specialization gives a significant contribution to burnout. Objective: This study was aimed at assessing the influence of stress during medical studies on the development of burnout syndrome in medical students by the end of clinical training. Methods: This cross-sectional study included all the fifth-year students from the Medical Faculty in Novi Sad and Belgrade in 2011, of whom 178 and 375, from the respective faculties, volunteered to fill in an anonymous questionnaire containing questions on selected socio-demographic data, length and accomplishments of previous courses, stress, various activities (including examinations, contact with patients, relationship with the teaching staff and other staff working at clinics). The 22- item Ma{cyrillic}sla{cyrillic}ch Burnout Inventory (MBI) was applied to assess the risk of developing burnout syndrome. Results: At the assessment of burnout syndrome the values of depersonalization were very high on the sub-scale MBI-DP in 73.1% of all respondents, whereas 52.7% of medical students from Novi Sad and 31.9% from Belgrade had high values for emotional exhaustion (MBI-EE). Examinations, as defined by half of all students, were the most stressful activity in both groups of students. Among the predictors of high risks of developing burnout syndrome, stressful effects of contact with patients were prominent for high MBI-EE: OR=1.59 (95%CI:1.15-2.21), and for high MBI-DP: OR=1.49 (95%CI: 1.00 -2.24) as well as stressfulness of examinations which significantly affects high MBI-EE: OR=1.33 (95%CI: 1.04 -1.70 Conclusion: The high prevalence of burnout among the medical students by the end of their clinical training underlines the necessity of modifying the existing curriculum so that it would prepare future doctors much better to overcome stress associated with the direct contact with patients. In addition, material to be covered for examinations should be reduced since examinations, besides contact with patients, represent the most stressful individual effect.

Aim. The aim of the present study was to investigate whether different levels of education are associated with different atherosclerotic disease risk factors. Methods. The cross-sectional study, involving 388 consecutive patients with verified peripheral arterial disease, was performed in Belgrade. Formal education level was used as a proxy for socioeconomic status. Anthropometric parameters and data on cardiovascular risk factors were analyzed in participants with different levels of education. In the analysis, univariate and multivariate logistic regressions were used. Results. Multivariate analysis showed that low education was significantly positively related to alcohol consumption (Odds Ratio - OR, 4.67; 95% confidence interval - CI, 1.80-12.12), increased triglycerides (OR, 2.73; 95% CI, 1.13-6.61), and physical activity during work (OR, 43.10; 95% CI 14.37-129.28), and negatively related to former smoking (OR, 0.11; 95% CI, 0.03-0.46) and sports and leisure - time physical activity (OR, 0.13; 95% CI, 0.04-0.41 and OR, 0.25; 95% CI, 0.11-0.57). Medium education was significantly positively related to increased triglycerides (OR, 1.74; 95% CI 1.01-2.98) and increased LDL-cholesterol (OR 2.37; 95% CI, 1.35-4.18), and to physical activity during work (OR, 2.22; 95% CI, 1.34-3.67), and negatively related to age (OR, 0.95; 95% CI, 0.92-0.98) and leisure - time physical activity (OR, 0.47; 95% CI, 0.30-0.74). Conclusions. It can be concluded that if there are differences in the risk of the occurrence of peripheral arterial disease by education status, they could be only partly explained by differences in the observed atherosclerotic disease risk factors.

Congenital vascular malformations (CVMs) are not rare disorders, with the overall incidence of 1.5%. Due to their complex embryology and various clinical presentations, there was a long lasting confusion among vascular specialists regarding the etiology, classification, basic principles of evaluation and treatment of these anomalies. The introduction of the Hamburg classification and its adoption by experts around the world made further studies of CVMs and comparison of results among different specialists possible. Precise diagnosis of the type and extent of the malformation is paramount for the choice of adequate treatment. In most instances this can be achieved with a detailed history, careful physical examination and a combination of appropriate non-invasive studies. Invasive tests should be reserved for confirmation of diagnosis and serve as a road map for treatment planning. Modern treatment of CVMs is based on a multidisciplinary team approach involving specialists in vascular surgery, interventional radiology, pediatrics, nuclear medicine, orthopedic surgery, plastic and reconstructive surgery and physical therapy. Surgical and endovascular techniques are used in conjunction to minimize morbidity and improve treatment outcomes.