Browsing by Author "Marić, Gorica (56433592800)"

Background/Aim. The competence of healthcare workers (HCWs) to advocate the importance of immunization to persons who are hesitant about vaccines is extremely important. The aim of this study was to evaluate the final-year medical students’ competencies related to immunization challenges in their practice using their knowledge, attitudes, and study practices. Methods. The cross-sectional study was conducted among 442 final-year students of the Faculty of Medicine, University of Belgrade, Serbia. The instrument used for data collection was an anonymous questionnaire consisting of 38 questions. Hierarchical multiple regression analysis was conducted to identify the predictive value of different factors in immunization knowledge among medical students. Results. The median total knowledge score with the interquartile range was 7 ± 3.00 out of 13. There was a statistically significant positive correlation between the knowledge score and the grade point average (GPA) (r = 0.207, p < 0.001). Thirty-five percent of students felt moderately capable of conducting work regarding vaccination without supervision. Furthermore, 92.1% of students considered that additional training and information channels about immunization needed to be implemented in curricula for HCWs. The results of the hierarchical regression analysis showed that gender, age, GPA, study duration, self-confidence regarding immunization knowledge, the flu, and hepatitis B vaccination status explained a total of 36% of the variance in the immunization knowledge score. Less than two-thirds of students believed they had enough knowledge to reassure a person hesitant about immunization. Conclusion. The results of our study showed an average level of knowledge about immunization among final-year medical students. As less than two-thirds of students believe that they have enough knowledge to reassure a hesitant person, there is a need for a better understanding and improving the parts of the curricula of medical faculties regarding immunization. © 2023 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. Stroke remains one of the leading causes of death and disability worldwide. The aim of the study was to determine the nursing care-associated predictors of in-hospital mortality in the patients with acute ischemic stroke (AIS) who were hospitalized at the Department of Emergency Neurology. Methods. Prospective cohort study included 59 consecutive patients with AIS admitted to the Department of Emergency Neurology, Neurology Clinic, Clinical Center of Serbia, Belgrade. The patients were followed until discharge or death. For exploring a relationship between the outcome of patients with AIS and different groups of factors, the univariate and multivariate Cox proportionate hazard regression models were used. Results. There were 32 male and 27 female patients with AIS. The mean age was 62.5 ± 15.2 years. The average duration of hospitalization was 11.1 ± 9.6 days (median 8 days; range 1-54 days). Almost 80% of patients (47/59; 79.7%) were admitted to the stroke unit, while 12 (20.3%) patients were admitted to the intensive care unit. In the univariate Cox regression analysis the significant variables (p < 0.05) were the Morse score (p = 0.030) and the type of admission unit (p = 0.029). The multivariate predictive model revealed that the type of admission unit (stroke unit vs conventional unit) [hazard ratio (HR) = 0.16; p = 0.032] was the independent predictor of in-hospital mortality in the patients with AIS. Conclusion. The results of this study showed an important role of nursing staff in the recovery of the AIS patients, as well as that admission to the stroke units versus the conventional units is the independent predictor of decreased in-hospital mortality. © 2019, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background: Penile cancer (PC) is a highly aggressive disease, with a significant tendency for lymphatic spreading and subsequent development of distant metastases. The mutilating nature of PC surgical treatment has profound implications on the patient’s body integrity and self-image, sexual life and intimacy, voiding and mental health. The aim of our study was to comprehensively evaluate PC patients’ post-treatment quality of life (QoL), sexual activity, self-esteem, fatigue and fear of disease recurrence. (2) Methods: A cross-sectional study was conducted at the Clinic of Urology, University Clinical Centre of Serbia, and included 31 PC patients. Data were collected by means of a questionnaire. (3) Results: The average score on the Global health status scale was 67.2 out of 100 (ranging from 16.7 to 100), and the SD was 22.5. Hierarchical linear regression analysis showed that demographic characteristics, Hospital Anxiety and Depression scale (HADS) anxiety and depression scores, total Multidimensional Fatigue Inventory, Fear of cancer recurrence and Rosenberg scores and erectile function score explained a total of 78.2% of the variance in the global health status/QoL scale of PC patients. (4) Conclusions: Efforts should be made not only to increase the survival of PC patients after surgical treatment but also to enable the best possible level of QoL in the post-operative period. © 2023 by the authors.

Background: Penile cancer (PC) is a highly aggressive disease, with a significant tendency for lymphatic spreading and subsequent development of distant metastases. The mutilating nature of PC surgical treatment has profound implications on the patient’s body integrity and self-image, sexual life and intimacy, voiding and mental health. The aim of our study was to comprehensively evaluate PC patients’ post-treatment quality of life (QoL), sexual activity, self-esteem, fatigue and fear of disease recurrence. (2) Methods: A cross-sectional study was conducted at the Clinic of Urology, University Clinical Centre of Serbia, and included 31 PC patients. Data were collected by means of a questionnaire. (3) Results: The average score on the Global health status scale was 67.2 out of 100 (ranging from 16.7 to 100), and the SD was 22.5. Hierarchical linear regression analysis showed that demographic characteristics, Hospital Anxiety and Depression scale (HADS) anxiety and depression scores, total Multidimensional Fatigue Inventory, Fear of cancer recurrence and Rosenberg scores and erectile function score explained a total of 78.2% of the variance in the global health status/QoL scale of PC patients. (4) Conclusions: Efforts should be made not only to increase the survival of PC patients after surgical treatment but also to enable the best possible level of QoL in the post-operative period. © 2023 by the authors.

Objectives: The FACIT-CD (Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia) questionnaire is a disease-specific instrument for assessing the health-related quality of life (HRQoL) in women with cervical dysplasia. Our aim was to perform a cross-cultural adaptation and psychometric evaluation of the FACIT-CD scale in Serbian women with cervical squamous intraepithelial lesions (SIL). Study Design: Our study included women of reproductive age diagnosed with SIL in a single university-affiliated hospital. A total of 160 participants with histologically confirmed low-grade (LSIL) or high-grade (HSIL) squamous intraepithelial lesions responded to the Serbian version of the FACIT-CD instrument, the Short Form-36v2 questionnaire (SF-36v2), the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI). Women also participated in an interview regarding their socio-demographic data. We evaluated the validity and reliability of the Serbian version of FACIT-CD. Results: The Cronbach's alpha coefficient was 0.710 for the entire sample (0.702 for LSIL and 0.711 for HSIL). We found numerous correlations between the FACIT-CD scores and SF-36v2 scores, as well as between the BAI and BDI scores for both the total score and most of the domain scores. The mean FACIT-CD total score was high (114.47 ± 13.25 out of 136.00 which is the maximum score). There were no significant differences in the mean scores between the LSIL and HSIL groups. Conclusions: Our study demonstrated that the Serbian FACIT-CD has overall good psychometric properties in women with both LSIL and HSIL. We propose the use of the FACIT-CD questionnaire as an indicator for HRQoL in women with cervical dysplasia. © 2018

Background/Aim. Malignant gliomas represent a heterogenaus group of tumors. They occur in all age groups, predominatly in males in older age. The purpose of this case-control study was to examine the association between risk for developing glioma and family history of diseases. Methods. The case-control study included 100 pathologically confirmed cases of glioma at the Clinical Centre Kragujevac, Serbia, between 2015 and 2016, and 200 age- and sex-matched controls without glioma and other malignant diseases in personal and family history at the same institution. After signing the informed consent all the patients filled out an epidemiological questionnaire. Multivariate logistic regression analysies was used in statistical data processing. Results. Malignant diseases in family history were more common in the study group than in the control group [odds ratio (OR) = 1.821, 95% confidence interval (CI) 1.004–3.305; p = 0.049]. The most common malignant tumor in the study group were cancer of the uterus (7%) and colon cancer (6%), while in the control group the most common cancer were lung cancer (6%) and cancer of the uterus (7%). Diabetes mellitus in family history was more common among control individuals than among glioma patients (OR = 0.520, 95% CI = 0.271–0.995; p = 0.048). Also, our results showed that cardiovascular diseases in family history were more common in the control group than among patients of the study group (OR = 0.557, 95% CI = 0.325–0.953; p = 0.033). Conclusion. In this case-control study, we observed a statistically significant relation between family history of malignant diseases and glioma. Also, we found statistically significant inverse relation between family history of cardiovascular diseases and diabetes and glioma. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. Despite the availability of safe and effective vaccine since 1982, hepatitis B virus (HBV) infection still remains a major occupational disease among health care workers (HCWs) worldwide. The aim of this study was to estimate the level of knowledge regarding HBV among HCWs in Serbia. Methods. A random sample of 352 HCWs, stratified by occupation, was selected from the list of employees in the Clinical Centre of Serbia during December 2015. Anonymous questionnaire was used in data collection. Data were statistically assessed. Results. The mean HBV knowledge score was 22.9 ± 4.8 (out of maximum 30). Better knowledge score correlated with higher education attainment (= 0.377; p < 0.001), younger age (= -0.113; p = 0.034) and less working experience (-0.127; p = 0.017). We observed that those HCWs who were previously vaccinated against hepatitis B demonstrated statistically significantly higher knowledge level (t = 5.656, p < 0.001) compared to HCWs who were not vaccinated (23.9 ± 3.7 vs. 20.9 ± 5.8, respectively). Conclusion. We found poor level of knowledge on some aspects of HBV infection among HCWs in Serbia. Tailoring of education campaigns in this high-risk exposure group is necessary. Education intervention should focus on change of attitudes and behaviour modification to ensure safe and responsible health care environment. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Objective – To examine health-related quality of life (HRQoL) among Serbian students who study in the northern Kosovo province and to explore potential differences in HRQoL relative to students’ region of origin. Materials and Methods – This study was conducted from April to June 2015. A total of 514 students from the University of Priština temporarily settled in Kosovska Mitrovica were enrolled in the study. The students completed the socio-demographic and lifestyle questionnaire, Beck Depression Inventory (BDI) and the generic HRQoL questionnaire Short Form-36 (SF-36). The region of origin was classified based on the area in which the students were originally from: Republic of Serbia vs. North Kosovo vs. Southern enclaves. Results – The highest scores were observed for Physical Functioning and the lowest for Vitality. No difference in HRQoL was observed between students from the Republic of Serbia, North Kosovo and Southern enclaves. Compared to females, males scored better on Bodily Pain, General Health, Social Functioning and Mental Health. They also had better Physical and Mental Composite scores and Total HRQoL than females. Worse depressive symptoms were consistently associated with poorer HRQoL across all three groups of students. Conclusion – The HRQoL among Serbian students in the northern Kosovo province does not differ based on their region of origin. Health care services for university students should prioritize prevention, early recognition and treatment of depressive symptoms. © 2021 by the University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.

Purpose: The aim of this study is to measure retinal vessel density and flow rate area by optical coherence tomography angiography (OCTA) in patients with autoimmune diseases taking hydroxychloroquine (HCQ). Methods: The cross-sectional study included 98 patients divided into three groups. Group I included patients with the diagnosis of an autoimmune disease, for whom the introduction of HCQ was planned. Group II implied low-risk patients for retinal toxicity (≤5 years of HCQ use), whereas Group III implied patients that were at high-risk (>5 years of drug use). All patients underwent a computerized visual field, central macular thickness by optical coherence tomography, and OCTA measurements. Results: The vascular density was found to be statistically significantly decreased in the high-risk group compared to the control group in the superficial parafoveal zone (P = 0.030), whereas it was decreased compared to the low-risk and control groups in the deep layers whole (P = 0.006, P = 0.010, respectively) and perifoveal zones (P = 0.003, P = 0.010, respectively). The foveal avascular zone was significantly enlarged in the high-risk group compared to the control (P < 0.018). Retinal flow rates did not show statistically significant differences between the groups (P > 0.05). Conclusion: Patients treated with HCQ for more than 5 appear have a significant loss of vascular density in the parafoveal and perifoveal regions, and FAZ area is significantly increased compared to low-risk patients and controls. These findings indicate that OCTA may be beneficial for monitoring high-risk patients and may stratify their risk of further retinal damage. © 2023 Indian Journal of Ophthalmology.

Study objective: Assessing knowledge and attitudes of parents towards human papillomavirus (HPV) vaccination of their children and estimating factors associated with parental positive attitude towards HPV immunization. Study design: Cross-sectional. Setting: Two Community Health Centers. A total of 282 adult parents of boys and/or girls who presented at the pediatrician's office with their child aged ≤18 years from December 2015 to May 2016. Main outcome measures: HPV vaccination coverage with one dose, knowledge and attitudes towards HPV vaccination. Parental knowledge was tested through a set of 10 items such as the infectious nature of HPV, mode of transmission, symptoms and its association with cervical cancer and circumstances surrounding HPV vaccine in Serbia. Answers were graded on a 5-point Likert scale from “strongly disagree” to “strongly agree”. Results: Coverage with one dose of HPV vaccine was 2.0%. Majority of parents knew that the vaccine existed (71.0%). One quarter of parents confirmed that their child should be vaccinated against HPV. Parents expressed highest level of agreement with the statement that HPV vaccination in Serbia is not sufficiently promoted (4.17 ± 1.21 points). Having female child and more knowledge on HPV were independently associated with positive attitude towards vaccination among parents of children aged <9 years. Having received recommendation for HPV vaccination from a pediatrician was independently associated with positive attitude towards HPV vaccination among parents of children aged ≥9 years. Conclusion: Coverage with one dose of HPV vaccine is low. Health-care authorities are urged to consider inclusion of HPV vaccination in immunization schedule. © 2018 Elsevier B.V.

Study objective: Assessing knowledge and attitudes of parents towards human papillomavirus (HPV) vaccination of their children and estimating factors associated with parental positive attitude towards HPV immunization. Study design: Cross-sectional. Setting: Two Community Health Centers. A total of 282 adult parents of boys and/or girls who presented at the pediatrician's office with their child aged ≤18 years from December 2015 to May 2016. Main outcome measures: HPV vaccination coverage with one dose, knowledge and attitudes towards HPV vaccination. Parental knowledge was tested through a set of 10 items such as the infectious nature of HPV, mode of transmission, symptoms and its association with cervical cancer and circumstances surrounding HPV vaccine in Serbia. Answers were graded on a 5-point Likert scale from “strongly disagree” to “strongly agree”. Results: Coverage with one dose of HPV vaccine was 2.0%. Majority of parents knew that the vaccine existed (71.0%). One quarter of parents confirmed that their child should be vaccinated against HPV. Parents expressed highest level of agreement with the statement that HPV vaccination in Serbia is not sufficiently promoted (4.17 ± 1.21 points). Having female child and more knowledge on HPV were independently associated with positive attitude towards vaccination among parents of children aged <9 years. Having received recommendation for HPV vaccination from a pediatrician was independently associated with positive attitude towards HPV vaccination among parents of children aged ≥9 years. Conclusion: Coverage with one dose of HPV vaccine is low. Health-care authorities are urged to consider inclusion of HPV vaccination in immunization schedule. © 2018 Elsevier B.V.

Self-perceived stress during undergraduate medical training could influence forthcoming career choices. The aim of this study was to explore the attitudes and potential differences between 1st and 6th year students regarding aspects of medical training and career plans. As many as 570 students in 1st and 400 in 6th year of studies at the Faculty of Medicine, University of Belgrade, were recruited on December 2-9, 2013. Data were acquired through a self-administered questionnaire. Students in both years rated “Helping other people” as the most important reason to study medicine. Freshmen rated statistically significantly higher ‘good incomes’ and ‘social status’ as reasons to study medicine (p=0.003 and p=0.037, respectively). The most desirable fields of specialization were surgery and internal medicine (36.4% and 18.7% for 1st year, and 26.3% and 36.6% for 6th year, respectively). Significantly more freshmen would prefer working abroad (χ2=3.891, p=0.029). In terms of careers abroad, students in both years expressed the highest interest in working in western and northern Europe. Desires for specialty training among medical students follow the pattern of the most frequent disciplines in the Serbian physician population, with gender differences comparable to other populations. A certain percentage of students would likely emigrate. © 2019, Klinicka Bolnica Sestre Milosrdnice. All rights reserved.

Aim: To assess final year medical students' self-perception of their practical skills. Methods: The study was conducted at the Faculty of Medicine in Belgrade during compulsory practical sessions in the period December 2-9, 2013 and 390 students agreed to participate (response rate 77.8%). The questionnaire included questions on demographic characteristics, 21 questions on students' self-perception of their practical skills, and 1 question on students' self-perceived readiness to start working with patients. Results: Cronbach's α for the entire scale was 0.891. Students felt most confident about measuring arterial pulse and blood pressure and taking patients' history (average score 10 for all three skills) and least confident about placing a urinary catheter (average score 1) and suturing a wound (average score 2). They rated their readiness to work with patients with 5.0 out of 10.0 points. The total score did not correlate with students' average mark (Spearman's ρ = 0.039; P = 0.460) and the average mark did not correlate with the self-perceived readiness to work with patients (Spearman's ρ = -0.048; P = 0.365). Conclusion: Our study suggests that medical students lack confidence to perform various clinical procedures, particularly those related to surgical interventions. To improve students' confidence, clinical curriculum should include either more hours of practical work or ensure closer supervision of practical training in wards.

Histology and embryology are prerequisite for understanding the complexity of cell and tissue organization, function and development. The aim of this study was to examine the attitudes of medical students toward relevance of histology and embryology in their pre-clinical and clinical medical practice. The study sample consisted of 900 undergraduate students of 1st and 6th study year at the School of Medicine in Belgrade, Serbia. Data were collected using an anonymous questionnaire. Senior students reported the relevance of histology and embryology knowledge for learning pathology, dermatology, physiology, gynecology and obstetrics, pathophysiology and pediatrics. Examination of students’ attitudes revealed that 1st year participants more often acknowledged histology and embryology as being of great importance for their professional career. Analysis according to gender indicated that female students consider embryology as of greater importance for further medical education and future clinical practice than male students. Overall, study results suggest that medical students have a positive attitude toward histology and embryology undergraduate course. This evidence could be used as an additional motive for the development of histology and embryology courses, with special emphasis on practical application of knowledge in clinically-oriented setting. © 2016 Elsevier GmbH

Histology and embryology are prerequisite for understanding the complexity of cell and tissue organization, function and development. The aim of this study was to examine the attitudes of medical students toward relevance of histology and embryology in their pre-clinical and clinical medical practice. The study sample consisted of 900 undergraduate students of 1st and 6th study year at the School of Medicine in Belgrade, Serbia. Data were collected using an anonymous questionnaire. Senior students reported the relevance of histology and embryology knowledge for learning pathology, dermatology, physiology, gynecology and obstetrics, pathophysiology and pediatrics. Examination of students’ attitudes revealed that 1st year participants more often acknowledged histology and embryology as being of great importance for their professional career. Analysis according to gender indicated that female students consider embryology as of greater importance for further medical education and future clinical practice than male students. Overall, study results suggest that medical students have a positive attitude toward histology and embryology undergraduate course. This evidence could be used as an additional motive for the development of histology and embryology courses, with special emphasis on practical application of knowledge in clinically-oriented setting. © 2016 Elsevier GmbH

Background/Objectives: Certain aspects of retinal thickness assessed by optical coherence tomography (OCT) in patients with Parkinson’s disease (PD) require additional clarification. It is supposed that attributing reduced retinal thickness in PD to dopaminergic loss may not be acceptable as it also happens in diseases where dopaminergic loss does not occur. The objective of our study is to compare the ganglion cell/inner plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (pRNFL), and macular thickness of PD and dopa responsive dystonia (DRD) patients with healthy controls (HC), to investigate whether DRD patients, as a distinctive model of genetically induced dopamine deficiency, have reduced retinal thickness in comparison with PD, and to analyze correlation between retinal thickness and various PD clinical parameters. Methods: We analyzed 86 patients with PD, 10 patients with DRD, and 96 age- and sex-matched HC. Results: GCIPL, pRNFL, and central macula thickness (CMT) are statistically significantly thinner in PD patients compared to HC (p < 0.001, all). GCIPL and CMT are also statistically significantly thinner in DRD patients compared to HC (p = 0.012, p = 0.001, respectively). GCIPL thickness correlates positively with the daily dose of levodopa (r = 0.244, p < 0.01). The thickness of GCIPL and pRNFL correlate negatively with current age (r = −0.219; p < 0.01 and r = −0.358; p < 0.05, respectively). All retinal parameters are statistically significantly thinner in females than in males (p < 0.05). Conclusions: Patients with PD and DRD did not differ in GCIPL and pRNFL thickness when compared to one another. These results, supported by positive correlation of levodopa dose and GCIPL thickness in PD patients, emphasize the importance of dopamine in maintaining retinal thickness. © 2025 by the authors.

Aim To validate and cross-culturally adapt Croatian and Serbian versions of composite autonomic symptom score- 31 (COMPASS-31) for the detection of dysautonomia in patients with multiple sclerosis (MS). Methods A total of 179 patients, 67 with clinically isolated syndrome (CIS) and 112 with MS, completed the COMPASS- 31 at two MS centers in Zagreb and Belgrade between April 1 and October 31, 2016. Demographic and clinical data including age, gender, MS phenotypes, and the Expanded Disability Status Scale (EDSS) score were collected. Results The Cronbach's alpha coefficient of COMPASS-31 total score was 0.844 for the Croatian MS sample and 0.779 for the Serbian MS sample. A joint analysis yielded Cronbach's alpha coefficients ranging from 0.394 to 0.796, with values in four domains higher than 0.700. In Croatian and Serbian samples and the total study sample, the Cronbach's alpha coefficient of COMPASS-31 was 0.785. Reproducibility measured by intra-class correlation coefficient (ICC) was acceptable (ICC = 0.795). With regard to the clinical validity, significant correlation was found between EDSS and the COMPASS-31 total score (P < 0.001). Furthermore, significant differences between MS phenotypes were detected for bladder and gastrointestinal domains and for the COMPASS-31 total score (P < 0.001, P = 0.005, and P = 0.027, respectively). Finally, significant differences between MS phenotypes in patients with score > 0, which implies the existence of at least one of the symptoms investigated in each domain, were detected for secretomotor and bladder domains (P = 0.015 and P < 0.001, respectively). Conclusion COMPASS-31 represents a valid and acceptable self-assessment instrument for the detection of dysautonomia in MS patients.

Cognitive impairment is one of the most frequently reported symptoms in persons with multiple sclerosis (MS). The Brief International Cognitive Assessment for Multiple Sclerosis (BI-CAMS) has been recommended as a standardized international screening and monitoring tool for brief cognitive assessment.The aim of our study was to assess the reliability and validity of the Serbian version of the BICAMS. A total of 500 relapsing-remitting MS (RRMS) patients and 69 age-, gender-and educa-tion-matched healthy control (HC) subjects were examined. All participants performed the BICAMS test battery, which includes the oral version of the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test second edition (CVLT-II), and Brief Visuospatial Memory Test Revised (BVMTR). A ran-domly selected subset of patients were retested one to three weeks after baseline. Statistically significant dif-ferences between patients and HCs were evident on the SDMT and BVMTR (p<0.001). HCs had higher CVLT-II scores but this difference did not reach statistical significance (p=0.063). Cognitive impairment, defined as an abnormal test score on ≥1 subtest, was found in 62.9% of MS patients.There were statistically significant correlations between BICAMS scores and age, education, EDSS and disease duration in patient sample. Test-retest reliability was confirmed with Pearson correlation coefficient of 0.70 in all measures. This study supported the reliability and validity of the Serbian BICAMS, although the CVLT-II version tested here lacked sensitivity to detect MS compared to healthy volunteers. © 2022, Dr. Mladen Stojanovic University Hospital. All rights reserved.