Browsing by Author "Marinković, Jelena M. (7004611210)"

Background: The aim of this study was to assess the knowledge and attitude of medical students in relation to cardiovascular disease (CVD) risk factors as well as to assess the impact of medical education on their knowledge and recognition of the importance of implementation of preventive measures. Methods: This cross-sectional study included 514 students in the second year of studying at the Faculty of Medicine in Belgrade, Serbia (younger students response rate 79.57%) and 511 students in the last year of education (older students response rate 90.21%). For data collection, an anonymous self-administered questionnaire was used, which included two types of questions about CVD risk factors and questions about the student’s attitude. Results: Older students knew significantly more about CVD risk factors than students who were at the beginning of their medical studies; however, more than half of the older students did not know the correct answers about CVD risk factors. The only exceptions were questions about “bad” and “good” cholesterol, metabolic syndrome (MSy) and lipid lowering therapy in high risk subjects. Physical inactivity, obesity, type 2 diabetes, smoking and hypertension were not ranked highly enough as important CVD risk factors. Compared groups of students did not significantly differ in attitude scores. The majority of them recognized CVD as the leading cause of death, had normal weight and knew their own blood pressure. Conclusion: Knowledge of medical students from Belgrade about CVD risk factors should be improved. © 2017, Springer-Verlag Wien.

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.

Objective The present study aimed to compare different indicators of obesity in the Serbian adult population. Design Cross-sectional study. A stratified, two-stage, national-representative random sampling approach was used for the selection of the survey sample. Data sources were questionnaires created according to the European Health Interview Survey questionnaire. Measurements of weight, height and waist circumference (WC) were performed using standard procedures. Anthropometric measures included BMI, WC and waist-to-height ratio (WHtR). Setting Data for the study were obtained from the 2013 National Health Survey, performed in line with the EUROSTAT recommendations for performance of the European Health Interview Survey. Subjects Adults aged ≥20 years. Results According to BMI, out of the whole studied population (12 460 adults of both sexes) 2·4 % were underweight, 36·4 % overweight and 22·4 % obese. Using WC and WHtR as measures of adiposity showed that 22·5 % and 42·8 % of participants were overweight and 39·8 % and 25·3 % were obese, respectively. Men and women differed significantly in all variables observed. Overweight was more frequent in men and obesity in women regardless of adiposity measure used. Conclusions In spite of strong correlations between BMI, WC and WHtR, substantial discrepancies between these three measures in the assessment of overweight and obesity were found, especially in some age groups. Which of these anthropometric measures should be used, or whether two or all three of them should be applied, depends on their associations with cardiovascular or some other disease of interest. Copyright © The Authors 2016.

Objective The present study aimed to compare different indicators of obesity in the Serbian adult population. Design Cross-sectional study. A stratified, two-stage, national-representative random sampling approach was used for the selection of the survey sample. Data sources were questionnaires created according to the European Health Interview Survey questionnaire. Measurements of weight, height and waist circumference (WC) were performed using standard procedures. Anthropometric measures included BMI, WC and waist-to-height ratio (WHtR). Setting Data for the study were obtained from the 2013 National Health Survey, performed in line with the EUROSTAT recommendations for performance of the European Health Interview Survey. Subjects Adults aged ≥20 years. Results According to BMI, out of the whole studied population (12 460 adults of both sexes) 2·4 % were underweight, 36·4 % overweight and 22·4 % obese. Using WC and WHtR as measures of adiposity showed that 22·5 % and 42·8 % of participants were overweight and 39·8 % and 25·3 % were obese, respectively. Men and women differed significantly in all variables observed. Overweight was more frequent in men and obesity in women regardless of adiposity measure used. Conclusions In spite of strong correlations between BMI, WC and WHtR, substantial discrepancies between these three measures in the assessment of overweight and obesity were found, especially in some age groups. Which of these anthropometric measures should be used, or whether two or all three of them should be applied, depends on their associations with cardiovascular or some other disease of interest. Copyright © The Authors 2016.

The aim of this study was to examine the effect of caffeine consumption during pregnancy on birth weight and its possible interaction with smoking. The sample included 1,011 women who were interviewed during their first 3 days after delivery in one of the hospitals of Belgrade, Yugoslavia. A significant reduction in birth weight was found to be associated with an average caffeine intake of ≤71 mg per day, after adjustment for gestational age, infant sex, parity, and maternal height and weight, but only in infants born to nonsmoking mothers.

Study objective - To determine the influence and the effect of the war in the former Yugoslavia and of the United Nations economic sanctions on mortality from infectious diseases. Design - This was a descriptive study analysing mortality data time series. Setting - Central Serbia, Yugoslavia. Participants - The population of central Serbia was the subject of the study (about six million inhabitants). Measurements - Mortality rates were standardised directly, using the 'European population') as the standard. Regression analysis and analysis of covariance were undertaken. Main results - During the period 1973-93, mortality from infectious diseases showed a decreasing trend. From 1987-90, and in both men and women, mortality from infectious diseases was significantly higher than expected on the basis of the trend for the preceding period (p = 0.020 and p = 0.000). In addition, there was a statistically significant departure from the preceding trend (p = 0.036) in men between 1991 and 1993 (the period of the war and UN sanctions) - the main effect being in younger age groups. Conclusion - The economic crisis in the former Yugoslavia during the 1980s followed by the outbreak of the war and the damaging effects of UN economic sanctions had a distinctly adverse effect on mortality from infectious diseases.

The elusive etiology and array of clinical presentations of psoriasis justify a myriad of therapeutic modalities designed to provide for the individual patient. Our purpose was to compare the clinical and histopathologic effectiveness of intralesional cyclosporine and dithranol in the treatment of plaque-type psoriasis. In a paired comparison study, 30 patients with psoriasis underwent treatment with cyclosporine intralesionally 3 times weekly in one lesion and dithranol daily in another for up to 4 weeks. Disease activity was assessed by a severity global score and histopathologic evaluations of biopsy specimens before and at the end of treatment. Twenty-five patients had complete clearance of one of the treated sites - in twenty-three, the cyclosporine, treated Site cleared first. The mean global score decreased from 14.7 ± 0.5 to 6.0 ±0.8 at the cyclosporine-treated site and 8.7 ± 0.6 at the dithranol-treated site after one week (p < 0.01). The statistically significant difference in favor of cyclosporine was maintained during the first three weeks. Epidermal thickness decreased from 0.39 ± 0.03 mm to 0.22 ± 0.02 at the cyclosporine- and to 0.30 ± 0.03 at the dithranol-treated site (p < 0.01). The degree of dermal infiltration was reduced from 1.77 ± 0.11 to 1.27 ± 0.09 with cyclosporine and to 1.53 ± 0.13 with dithranol (p < 0.01). Mean remission periods for cyclosporine- and to dithranol-treated sites were 316 ± 43 and 210 ± 40 days, respectively (p < 0.01). Intralesional cyclosporine proved clinically and histopathologically more effective than dithranol in the treatment of plaque-type psoriasis.

Background: This was a psychometric validation of the short Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-14) as quality of life (QOL) instrument for chronic venous disease (CVD) patients. Methods: Patients aged >18 years who had CVD in CEAP C stages C0s to C6 were included in the study. Diagnosis was made by general practitioners according to CVD symptoms and visual examination of the lower extremities. QOL was assessed with the self-administrated CIVIQ-14. The reliability, construct, and convergent validity of the CIVIQ-14 was estimated as well as QOL of CVD patients according to CEAP C stages. Results: The study comprised 2260 subjects who fully completed the CIVIQ-14. CIVIQ-14 had a high level of reliability, construct, and convergent validity, but the structure of its three dimensions (pain [P], physical [PHY], and psychological [PSY]) was suboptimal. After adjustment for age, body mass index, and number of CVD symptoms, CIVIQ -14 global, P, PHY, and PSY scores showed significant progressive reduction of QOL from CEAP class C0s to C6. These differences were present in both sexes. The progressive impairment of the QOL involved primarily the pain and the physical items. For all CEAP C classes, the P and PHY scores were lower than the PSY scores. Global scores for men and women were: 76.7 and 73.9 for C 0s; 75.5 and 70.6 for C1; 67.8 and 64.5 for C2; 68.3 and 61.6 for C3; 60.7 and 54.6 for C4; 49.5 and 50.2 for C5; and 41.3 and 46.7 for C6. Conclusions: CVD in the lower extremities has a substantial effect on both physical and psychologic aspects of QOL, the physical aspects of QOL (P and PHY items) being more important. CIVIQ-14 is valuable in assessing QOL in CVD patients. Further investigations are necessary to confirm the stability of its two dimensions. © 2013 Society for Vascular Surgery.© 2013 by the Society for Vascular Surgery.

A case-control study of 100 newly diagnosed patients with Graves' disease and the same numbers of controls matched with respect to sex, age (± 2 years) and type of residence (rural-urban) was carried out. According to the matched analysis (McNemar's test and t-test) seventeen variables recognized as risk factors were included into the model of multivariate conditional logistic regression. The following factors were significantly associated with the occurrence of Graves' disease: change in time spent on work - much overtime work, second job, much less work than usual (RR = 6.62; CI = 2.08-21.01), lack of readiness of relatives and friends to help the subject (RR = 1.48; 95% CI = 1.14-1.93), increased arguments with spouse (RR = 14.12; 95% CI = 1.63-121.87), unemployment for at least one month (RR = 9.80; 95% CI = 1.13-85.02), and family history of Graves disease in the first degree of relation (RR = 7.20; 95% Cl = 0.85-60.70).

A case-control study was conducted in order to assess possible relationships between life events and Graves' disease. The study included 100 newly diagnosed patients with Graves' disease and 100 controls matched with respect to sex, age (±2 years) and type of residence (rural, urban). Paykel's Interview for Recent Life Events (a semistructured research interview covering 61 life events) was administered to each subject. In comparison with controls, the patients claimed to have had significantly more life events in the 12 months preceding the diagnosis (p = 0.0001). The following eight life events were significantly more prevalent among patients than controls: change in time spent on work (much overtime work, second job, much less work than usual) (McNemar = 12.04; RR = 7.00; 95% CI = 2.35-20.80; p = 0.0001), unemployment for at least 1 month (McNemar = 4.00; RR = 8.00; 95% CI = 1.04-61.39; p = 0.039), arguments with one's superior at work or a coworker (McNemar = 4.50; RR = 3.50; 95% CI = 1.10-11.08; p = 0.031), change in the work conditions (new company division, new chief, large reorganization) (McNemar = 4.26; RR = 4.00; 95% CI = 1.07-14.92; p = 0.035), increased arguments with spouse (McNemar = 6.75; RR = 11.00; 95% CI = 1.82-66.44; p = 0.006), increased arguments with fiance/fiancee or a steady date (McNemar = 4.00; RR = 8.00; 95% CI = 1.04-61.39; p = 0.039), hospitalization of a family member for serious illness (McNemar = 3.76; RR = 3.25; 95% CI = 1.01-10.68; p = 0.049) and moderate financial difficulties (McNemar = 8.50; RR = 3.25; 95% CI = 1.47-7.16; p = 0.003). Our findings indicate that life events may be a risk factor for Graves' disease.

A case-control study was conducted in order to assess possible relationships between life events and Graves' disease. The study included 100 newly diagnosed patients with Graves' disease and 100 controls matched with respect to sex, age (±2 years) and type of residence (rural, urban). Paykel's Interview for Recent Life Events (a semistructured research interview covering 61 life events) was administered to each subject. In comparison with controls, the patients claimed to have had significantly more life events in the 12 months preceding the diagnosis (p = 0.0001). The following eight life events were significantly more prevalent among patients than controls: change in time spent on work (much overtime work, second job, much less work than usual) (McNemar = 12.04; RR = 7.00; 95% CI = 2.35-20.80; p = 0.0001), unemployment for at least 1 month (McNemar = 4.00; RR = 8.00; 95% CI = 1.04-61.39; p = 0.039), arguments with one's superior at work or a coworker (McNemar = 4.50; RR = 3.50; 95% CI = 1.10-11.08; p = 0.031), change in the work conditions (new company division, new chief, large reorganization) (McNemar = 4.26; RR = 4.00; 95% CI = 1.07-14.92; p = 0.035), increased arguments with spouse (McNemar = 6.75; RR = 11.00; 95% CI = 1.82-66.44; p = 0.006), increased arguments with fiance/fiancee or a steady date (McNemar = 4.00; RR = 8.00; 95% CI = 1.04-61.39; p = 0.039), hospitalization of a family member for serious illness (McNemar = 3.76; RR = 3.25; 95% CI = 1.01-10.68; p = 0.049) and moderate financial difficulties (McNemar = 8.50; RR = 3.25; 95% CI = 1.47-7.16; p = 0.003). Our findings indicate that life events may be a risk factor for Graves' disease.

Background: The aim of this study was to evaluate some hypotheses about factors related to the development of type 1 diabetes mellitus. Methods: A case-control study was conducted in Belgrade during the period 1994-1997. A total of 105 recently onset diabetic and 210 control children, individually matched by age (± 1 year), sex and place of residence, were included in the study. Results: According to multivariate regression analysis, the following factors were related to type 1 diabetes: stressful events and symptoms of psychological dysfunction during the 12 months preceding the onset of the disease [odds ratio (OR) 3.48, 95% confidence interval (CI) 2.15-5.65; and OR 2.15, 95% CI 1.33-3.48], irregular vaccination (OR 16.98, 95% CI 1.38-208.92), infection during 6 months preceding the onset of the disease (OR 4.23, 95% CI 1.95-9.17), higher education of father (OR 1.50, 95% CI 1.05-2.14), mother's consumption of nitrosoamines-rich food during pregnancy (OR 4.33, 95% CI 1.95-9.61), alcohol consumption by father (OR 3.80, 95% CI 1.64-8.78), insulin-dependent and non-insulin-dependent diabetes mellitus in three generations of children's relatives (OR 20.04, 95% CI 4.73-84.81; and OR 5.52, 95% CI 2.45-12.46), and use of ultrasound diagnostic techniques during pregnancy (OR 0.42, 95% CI 0.17-1.00). Conclusions: Among non-genetic factors, those affecting the child during pregnancy are especially important because of their preventability. © The Author 2005. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Background Cardiovascular disease remains the major cause of mortality in the Western World. aims We aimed to assess the prevalence of polyvascular disease in patients with carotid artery disease and peripheral artery disease (PAD), and to determine the risk profile of patients with polyvascular disease. methods The study included 1045 consecutive patients presenting to our department with carotid disease or PAD. Demographic characteristics, anthropometric parameters, and data on cardiovascular risk factors were collected in all patients. On the basis of medical history, patients were classified into those who had only symptomatic carotid disease or symptomatic PAD and those who had symptomatic polyvascular disease. results Carotid disease alone was reported in 366 participants (35%), PAD alone, in 199 (19%), and polyvascular disease, in 480 (46%). Compared with carotid disease, PAD was more often a component of polyvascular disease (P = 0.002) and was combined with a higher number of other atherosclerotic diseases (P = 0.02). Compared with patients with symptomatic atherosclerotic disease in only 1 territory, patients with various types of polyvascular disease more often had hypertension (P from 0.03 to <0.001), dyslipidemia (P <0.001), high‑sensitivity C‑reactive protein levels of 3 mg/l or higher (P = 0.005), and more often were current smokers (P <0.001) or former smokers (P from 0.03 to 0.001). conclusions We showed a high prevalence of symptomatic polyvascular disease in patients with carotid disease or PAD. The risk profile was worse in patients with polyvascular disease than in those with a disease in a single vascular territory. Copyright by the Author(s), 2019