Browsing by Author "Markovic-Denic, Ljiljana (55944510900)"

Background/Objectives: Data about the relationship between COVID-19 and healthcare-associated Clostridioides difficile infection (HA-CDI) occurrence are still controversial. This study examines antibiotics associated with CDI in patients with and without COVID-19 infection. Methods: A prospective cohort study was conducted at the University Clinical Center Belgrade, Serbia, from January 2019 to December 2021. Patients with the first episode of HA-CDI without and with COVID-19 were included. Results of bacteriology analyses, demographic and clinical data, and data on antibiotic usage and daily defined doses (DDD) were collected by the hospital Infection Control Team. Results: Out of 547 HA-CDI cases, 341 (62.3%) had COVID-19 infection. HA-CDI patients with COVID-19 were significantly younger (p = 0.017) with fewer comorbidities (<0.001). Two or more antibiotics in therapy were more frequently used by those patients (p = 0.03). COVID-19 patients were treated significantly more by third- and fourth-generation cephalosporins, fluoroquinolones (p < 0.001) and macrolides (p = 0.01). Ceftriaxone had a higher median DDD in COVID-19 patients (6.00, range 1.00–20.00) compared to non-COVID-19 patients (4.00, range 1.00–14.00), (p = 0.007). Conversely, meropenem showed a lower median DDD in COVID-19 patients. Multivariate analysis identified the use of fourth-generation cephalosporins and fluoroquinolones as independent risk factors for HA-CDI in COVID-19 patients. Conclusions: Patients with HA-CDI and COVID-19 more frequently received two or more antibiotics before the onset of HAI-CDI. The third and fourth generations of cephalosporins, fluoroquinolones and macrolides were administered significantly more often in these patients. More frequent administration of ceftriaxone was observed, but the lower DDD associated with meropenem needed additional analysis. © 2025 by the authors.

Background/Objectives: Data about the relationship between COVID-19 and healthcare-associated Clostridioides difficile infection (HA-CDI) occurrence are still controversial. This study examines antibiotics associated with CDI in patients with and without COVID-19 infection. Methods: A prospective cohort study was conducted at the University Clinical Center Belgrade, Serbia, from January 2019 to December 2021. Patients with the first episode of HA-CDI without and with COVID-19 were included. Results of bacteriology analyses, demographic and clinical data, and data on antibiotic usage and daily defined doses (DDD) were collected by the hospital Infection Control Team. Results: Out of 547 HA-CDI cases, 341 (62.3%) had COVID-19 infection. HA-CDI patients with COVID-19 were significantly younger (p = 0.017) with fewer comorbidities (<0.001). Two or more antibiotics in therapy were more frequently used by those patients (p = 0.03). COVID-19 patients were treated significantly more by third- and fourth-generation cephalosporins, fluoroquinolones (p < 0.001) and macrolides (p = 0.01). Ceftriaxone had a higher median DDD in COVID-19 patients (6.00, range 1.00–20.00) compared to non-COVID-19 patients (4.00, range 1.00–14.00), (p = 0.007). Conversely, meropenem showed a lower median DDD in COVID-19 patients. Multivariate analysis identified the use of fourth-generation cephalosporins and fluoroquinolones as independent risk factors for HA-CDI in COVID-19 patients. Conclusions: Patients with HA-CDI and COVID-19 more frequently received two or more antibiotics before the onset of HAI-CDI. The third and fourth generations of cephalosporins, fluoroquinolones and macrolides were administered significantly more often in these patients. More frequent administration of ceftriaxone was observed, but the lower DDD associated with meropenem needed additional analysis. © 2025 by the authors.

Introduction: We aimed to report the distribution and resistance patterns of eight invasive clinically relevant bacteria surveyed in the Clinical Center of Serbia (CCS) in Belgrade. Methodology: A total of 477 clinical blood stream isolates of Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecium, Enterococcus faecalis, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter spp. were collected in the period from January to December 2013. Antimicrobial susceptibility testing was performed using standard methods and interpreted using the Clinical and Laboratory Standards Institute (CLSI) breakpoint criteria. Results: Acinetobacter spp. was the most prevalent bacteria encountered (37%), followed by K. pneumoniae (25.7%). Multidrug resistance was observed in 92.5% of all isolates. Out of 177 strains of Acinetobacter spp., 97.7% were resistant to fluoroquinolones and carbapenems. Resistance to aminoglycosides, fluoroquinolones, and third-generation cephalosporins was 97.1%, 95.4%, and 95.8% among K. pneumoniae and 21.4%, 21.7%, and 31% among E. coli isolates, respectively. In total, 65.1% of K. pneumoniae and 12.1% of E. coli isolates were determined to be extended-spectrum beta-lactamase (ESBL) positive. High-level aminoglycoside resistance of E. faecalis was 71.4%, and glycopeptide resistance of E. faecium was 95%. Out of 66 strains of S. aureus, 63.4% were methicillin resistant. Conclusions: The majority of bloodstream isolates of clinically relevant bacteria in CCS were multidrug resistant. The biggest concerns are carbapenem-resistant Acinetobacter spp., K. pneumoniae, and P. aeruginosa; third-generation cephalosporin-resistant E. coli; vancomycin-resistant E. faecium; and methicillin-resistant S. aureus. Stricter measures of infection control and antibiotic use are needed. © 2016 Djuric et al.

Introduction: We aimed to report the distribution and resistance patterns of eight invasive clinically relevant bacteria surveyed in the Clinical Center of Serbia (CCS) in Belgrade. Methodology: A total of 477 clinical blood stream isolates of Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecium, Enterococcus faecalis, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter spp. were collected in the period from January to December 2013. Antimicrobial susceptibility testing was performed using standard methods and interpreted using the Clinical and Laboratory Standards Institute (CLSI) breakpoint criteria. Results: Acinetobacter spp. was the most prevalent bacteria encountered (37%), followed by K. pneumoniae (25.7%). Multidrug resistance was observed in 92.5% of all isolates. Out of 177 strains of Acinetobacter spp., 97.7% were resistant to fluoroquinolones and carbapenems. Resistance to aminoglycosides, fluoroquinolones, and third-generation cephalosporins was 97.1%, 95.4%, and 95.8% among K. pneumoniae and 21.4%, 21.7%, and 31% among E. coli isolates, respectively. In total, 65.1% of K. pneumoniae and 12.1% of E. coli isolates were determined to be extended-spectrum beta-lactamase (ESBL) positive. High-level aminoglycoside resistance of E. faecalis was 71.4%, and glycopeptide resistance of E. faecium was 95%. Out of 66 strains of S. aureus, 63.4% were methicillin resistant. Conclusions: The majority of bloodstream isolates of clinically relevant bacteria in CCS were multidrug resistant. The biggest concerns are carbapenem-resistant Acinetobacter spp., K. pneumoniae, and P. aeruginosa; third-generation cephalosporin-resistant E. coli; vancomycin-resistant E. faecium; and methicillin-resistant S. aureus. Stricter measures of infection control and antibiotic use are needed. © 2016 Djuric et al.

Antimicrobial agents used to treat infections are lifesaving. Overuse may result in more frequent adverse effects and emergence of multidrug-resistant microorganisms. In 2016–17, we performed the second point-prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals. We included 1,209 hospitals and 310,755 patients in 28 of 31 European Union/European Economic Area (EU/EEA) countries. The weighted prevalence of antimicrobial use in the EU/EEA was 30.5% (95% CI: 29.2–31.9%). The most common indication for prescribing antimicrobials was treatment of a commu-nity-acquired infection, followed by treatment of HAI and surgical prophylaxis. Over half (54.2%) of antimicrobials for surgical prophylaxis were prescribed for more than 1 day. The most common infections treated by antimicrobials were respiratory tract infections and the most commonly prescribed antimicrobial agents were penicillins with beta-lactamase inhibitors. There was wide variation of patients on antimicrobials, in the selection of antimicrobial agents and in antimicrobial stewardship resources and activities across the participating countries. The results of the PPS provide detailed information on antimicrobial use in European acute care hospitals, enable comparisons between countries and hospitals, and highlight key areas for national and European action that will support efforts towards prudent use of antimicrobials. © 2018, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

Antimicrobial agents used to treat infections are lifesaving. Overuse may result in more frequent adverse effects and emergence of multidrug-resistant microorganisms. In 2016–17, we performed the second point-prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals. We included 1,209 hospitals and 310,755 patients in 28 of 31 European Union/European Economic Area (EU/EEA) countries. The weighted prevalence of antimicrobial use in the EU/EEA was 30.5% (95% CI: 29.2–31.9%). The most common indication for prescribing antimicrobials was treatment of a commu-nity-acquired infection, followed by treatment of HAI and surgical prophylaxis. Over half (54.2%) of antimicrobials for surgical prophylaxis were prescribed for more than 1 day. The most common infections treated by antimicrobials were respiratory tract infections and the most commonly prescribed antimicrobial agents were penicillins with beta-lactamase inhibitors. There was wide variation of patients on antimicrobials, in the selection of antimicrobial agents and in antimicrobial stewardship resources and activities across the participating countries. The results of the PPS provide detailed information on antimicrobial use in European acute care hospitals, enable comparisons between countries and hospitals, and highlight key areas for national and European action that will support efforts towards prudent use of antimicrobials. © 2018, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

Antimicrobials are commonly prescribed and contribute to the development of antimicrobial resistance in long-term care facilities (LTCFs). In 2010, the European Centre for Disease Prevention and Control initiated point prevalence surveys (PPS) of healthcare-associated infections and antimicrobial use in European LTCFs, performed by external contractors as the Healthcare-Associated infections in Long-Term care facilities (HALT) projects. Here, we investigated prevalence and characteristics of antimicrobial use and antimicrobial stewardship indicators in European LTCFs in 2016–17. Twenty-four European Union/European Economic Area (EU/EEA) countries, the former Yugoslav Republic of Macedonia and Serbia participated in the third PPS in European LTCFs. Overall, 4.9% (95% confidence interval: 4.8–5.1) of LTCF residents in the EU/ EEA participating countries received at least one antimicrobial. The most commonly reported Anatomical Therapeutic Chemical (ATC) groups were beta-lactam antibacterials/penicillins (J01C), other antibacterials (J01X) (e.g. glycopeptide antibacterials, polymyxins), quinolones (J01M), sulfonamides and trimethoprim (J01E), and other beta-lactams (J01D). Urinary tract infections and respiratory tract infections were the main indications for antimicrobial prescription. This PPS provides updated and detailed information on antimicrobial use in LTCFs across the EU/EEA that can be used to identify targets for future interventions, follow-up of these interventions and promote prudent use of antimicrobials in European LTCFs. © 2018, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

Antimicrobials are commonly prescribed and contribute to the development of antimicrobial resistance in long-term care facilities (LTCFs). In 2010, the European Centre for Disease Prevention and Control initiated point prevalence surveys (PPS) of healthcare-associated infections and antimicrobial use in European LTCFs, performed by external contractors as the Healthcare-Associated infections in Long-Term care facilities (HALT) projects. Here, we investigated prevalence and characteristics of antimicrobial use and antimicrobial stewardship indicators in European LTCFs in 2016–17. Twenty-four European Union/European Economic Area (EU/EEA) countries, the former Yugoslav Republic of Macedonia and Serbia participated in the third PPS in European LTCFs. Overall, 4.9% (95% confidence interval: 4.8–5.1) of LTCF residents in the EU/ EEA participating countries received at least one antimicrobial. The most commonly reported Anatomical Therapeutic Chemical (ATC) groups were beta-lactam antibacterials/penicillins (J01C), other antibacterials (J01X) (e.g. glycopeptide antibacterials, polymyxins), quinolones (J01M), sulfonamides and trimethoprim (J01E), and other beta-lactams (J01D). Urinary tract infections and respiratory tract infections were the main indications for antimicrobial prescription. This PPS provides updated and detailed information on antimicrobial use in LTCFs across the EU/EEA that can be used to identify targets for future interventions, follow-up of these interventions and promote prudent use of antimicrobials in European LTCFs. © 2018, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

Objective. The aim of this study was to assess attitudes of the final year students of the Medical Faculty, University of Belgrade towards emigration after graduation. Methods. In January 2015 a cross-sectional study was conducted among final year students at the Medical Faculty in Belgrade. Statistical analysis was performed using descriptive and analytical statistics and chi-square test was used. Results. Among 180 students, 62.8% were females. After graduation, 16.1% medical students want to emigrate from Serbia, the majority of study population (65%) think about emigration, while 18.9% of students have an intention to stay and work as medical doctors in Serbia. Out of 29 medical students who would certainly emigrate from Serbia, 58.6% have remarkable success in studies (≥8.50, ranged 6-10). Also, 44.9% of students learn German as their first foreign language. Regarding the importance of career and professional development, higher wages, better life experience, higher standard than in Serbia and the lack of prospects in Serbia, we recorded higher scores among students who would certainly emigrate from Serbia as well as among students who think about emigration. 66.9% stated that they would like to work in Belgrade, if they stay in Serbia. Conclusion. Almost two-thirds of the final year students, at the Faculty of Medicine, University of Belgrade, expressed a conscious desire to leave the country after graduation in search of employment and professional development. © 2018, Serbian Medical Society. All rights reserved.

Purpose: Understanding target groups' awareness and knowledge regarding the human papillomavirus (HPV) and the HPV vaccine is essential for planning the screening and vaccination programs and attaining adequate vaccination coverage. The aim of this study was to estimate awareness and knowledge about HPV infection and the HPV vaccine and to assess factors associated with HPV awareness, HPV vaccine awareness and high HPV-related knowledge among women undergoing cervical cancer screening in Serbia. Methods: A cross-sectional study was conducted between January and June 2013 at the Obstetrics and Gynecology Clinic “Narodni Front” in Belgrade, Serbia. HPV awareness, HPV vaccine awareness, and HPV-related knowledge of women undergoing cervical cancer screening were estimated by the means of structured, self-administered questionnaire. Results: The median age of respondents was 36.0 years (range 18-65). Of 324 women participating in the study, 196 (60.5%) had heard of HPV while 95 (29.3%) had heard of the HPV vaccine. The median HPV-related knowledge score was 7 (interquartile range 4.8). Type of occupation and having an increasing number of lifetime sexual partners were associated with HPV awareness, while having no children was associated with HPV vaccine awareness. High HPV knowledge score was associated with younger age and type of occupation. Conclusions: Women undergoing cervical cancer screening in Serbia have moderate awareness of HPV infection and low awareness of HPV vaccine. However, it is promising that those who heard of HPV have high knowledge about it. © This work by JBUON is licensed under a Creative Commons Attribution 4.0 International License.

Purpose: Understanding target groups' awareness and knowledge regarding the human papillomavirus (HPV) and the HPV vaccine is essential for planning the screening and vaccination programs and attaining adequate vaccination coverage. The aim of this study was to estimate awareness and knowledge about HPV infection and the HPV vaccine and to assess factors associated with HPV awareness, HPV vaccine awareness and high HPV-related knowledge among women undergoing cervical cancer screening in Serbia. Methods: A cross-sectional study was conducted between January and June 2013 at the Obstetrics and Gynecology Clinic “Narodni Front” in Belgrade, Serbia. HPV awareness, HPV vaccine awareness, and HPV-related knowledge of women undergoing cervical cancer screening were estimated by the means of structured, self-administered questionnaire. Results: The median age of respondents was 36.0 years (range 18-65). Of 324 women participating in the study, 196 (60.5%) had heard of HPV while 95 (29.3%) had heard of the HPV vaccine. The median HPV-related knowledge score was 7 (interquartile range 4.8). Type of occupation and having an increasing number of lifetime sexual partners were associated with HPV awareness, while having no children was associated with HPV vaccine awareness. High HPV knowledge score was associated with younger age and type of occupation. Conclusions: Women undergoing cervical cancer screening in Serbia have moderate awareness of HPV infection and low awareness of HPV vaccine. However, it is promising that those who heard of HPV have high knowledge about it. © This work by JBUON is licensed under a Creative Commons Attribution 4.0 International License.

Introduction: We aimed to describe incidence, outcomes and antimicrobial resistance markers of causative agents of bacterial BSI in the intensive care unit (ICU) in a trauma center in Serbia. Methodology: Prospective surveillance was conducted from November 2014 to April 2016 in two trauma-surgical ICUs of the Emergency Department of Clinical center of Serbia. Bloodstream infections were diagnosed using the definitions of Center for Disease Control and Prevention. Results: Out of 406 trauma patients, 57 had at least one episode of BSI (cumulative incidence 14.0%). Overall 62 BSI episodes were diagnosed (incidence rate 11.8/1000 patient/days), of which 43 (69.4%) were primary BSI (13 catheter-related BSI and 30 of unknown origin) and 19 (30.6%) were secondary BSI. The most common isolated pathogen was Acinetobacter spp. [n = 24 (34.8%)], followed by Klebsiella spp. [n = 17 (24.6%)] and P. aeruginosa [n = 8 (1.6%)]. All S. aureus [n = 6 (100%)] and CoNS [n = 3 (100%)] isolates were methicillin resistant, while 4 (66%) of Enterococci isolates were vacomycin resistant. All isolates of Enterobacteriaceae were resistant to third-generation cephalosporins [n = 22 (100%)] while 7 (87.5%) of P. aeruginosa and 23 (95.8%) of Acinetobacter spp. isolates were resistant to carbapenems. All-cause mortality and sepsis were significantly higher in trauma patients with BSI compared to those without BSI (P < 0.001 each). Conclusions: BSI is a common healthcare-associated infection in trauma ICU and it is associated with worse outcome. Better adherence to infection control measures and guidelines for prevention of primary BSI must be achieved. © 2018 Djuric et al.

Introduction: We aimed to describe incidence, outcomes and antimicrobial resistance markers of causative agents of bacterial BSI in the intensive care unit (ICU) in a trauma center in Serbia. Methodology: Prospective surveillance was conducted from November 2014 to April 2016 in two trauma-surgical ICUs of the Emergency Department of Clinical center of Serbia. Bloodstream infections were diagnosed using the definitions of Center for Disease Control and Prevention. Results: Out of 406 trauma patients, 57 had at least one episode of BSI (cumulative incidence 14.0%). Overall 62 BSI episodes were diagnosed (incidence rate 11.8/1000 patient/days), of which 43 (69.4%) were primary BSI (13 catheter-related BSI and 30 of unknown origin) and 19 (30.6%) were secondary BSI. The most common isolated pathogen was Acinetobacter spp. [n = 24 (34.8%)], followed by Klebsiella spp. [n = 17 (24.6%)] and P. aeruginosa [n = 8 (1.6%)]. All S. aureus [n = 6 (100%)] and CoNS [n = 3 (100%)] isolates were methicillin resistant, while 4 (66%) of Enterococci isolates were vacomycin resistant. All isolates of Enterobacteriaceae were resistant to third-generation cephalosporins [n = 22 (100%)] while 7 (87.5%) of P. aeruginosa and 23 (95.8%) of Acinetobacter spp. isolates were resistant to carbapenems. All-cause mortality and sepsis were significantly higher in trauma patients with BSI compared to those without BSI (P < 0.001 each). Conclusions: BSI is a common healthcare-associated infection in trauma ICU and it is associated with worse outcome. Better adherence to infection control measures and guidelines for prevention of primary BSI must be achieved. © 2018 Djuric et al.

Purpose; Cancer is the one of the leading cause of death worldwide. The aim of this study was to examine cancer mortality trends in the population of central Serbia in the period from 2002 to 2011. Methods; The descriptive epidemiological method was used. The mortality from all malignant tumors (code C00-C96 of the International Disease Classification) was registered. The source of mortality data was the published material of the Cancer Registry of Serbia. The source of population data was the census of 2002 and 2011 and the estimates for inter-census years. Non-standardized, age-ad-justed and age-specific mortality rates were calculated. Age adjustment of mortality rates was performed by the direct method of standardization. Trend lines were estimated using linear regression. Results: During 2002-2011, cancer caused about 20% of all deaths each year in central Serbia. More men (56.9%) than women (43.1%) died of cancer. The average mortality rate for men was 1.3 times higher compared to women. A significant trend of increase of the age-adjusted mortality rates was recorded both for males (p<0.001 ) and for females (p=0.02). Except gastric cancer, the age-adjusted mortality rates in men were significantly increased for lung cancer (p=0.002), colorectal cancer (p<0.05), prostate cancer (p=0.001) and pancreatic cancer (p=0.001). Age-adjusted mortality rates for breast cancer infernales were remarkably increased (p=0.001), especially after 2007. Conclusions: In central Serbia during the period from 2002 to 2011, there was an increasing trend in mortality rates due to cancers in both sexes. Cancer mortality in males was 1.3-fold higher compared to females.

Purpose; Cancer is the one of the leading cause of death worldwide. The aim of this study was to examine cancer mortality trends in the population of central Serbia in the period from 2002 to 2011. Methods; The descriptive epidemiological method was used. The mortality from all malignant tumors (code C00-C96 of the International Disease Classification) was registered. The source of mortality data was the published material of the Cancer Registry of Serbia. The source of population data was the census of 2002 and 2011 and the estimates for inter-census years. Non-standardized, age-ad-justed and age-specific mortality rates were calculated. Age adjustment of mortality rates was performed by the direct method of standardization. Trend lines were estimated using linear regression. Results: During 2002-2011, cancer caused about 20% of all deaths each year in central Serbia. More men (56.9%) than women (43.1%) died of cancer. The average mortality rate for men was 1.3 times higher compared to women. A significant trend of increase of the age-adjusted mortality rates was recorded both for males (p<0.001 ) and for females (p=0.02). Except gastric cancer, the age-adjusted mortality rates in men were significantly increased for lung cancer (p=0.002), colorectal cancer (p<0.05), prostate cancer (p=0.001) and pancreatic cancer (p=0.001). Age-adjusted mortality rates for breast cancer infernales were remarkably increased (p=0.001), especially after 2007. Conclusions: In central Serbia during the period from 2002 to 2011, there was an increasing trend in mortality rates due to cancers in both sexes. Cancer mortality in males was 1.3-fold higher compared to females.

Background: It is unclear whether the heart is affected in pediatric patients with milder forms of spinal muscular atrophy (SMA). Therefore, we aimed to determine the presence of any cardiac abnormalities in these patients. Methods: We conducted a cross-sectional study of children and adolescents with SMA types 2 and 3 between July 2018 and July 2019. All patients underwent a comprehensive cardiac evaluation, including history-taking, physical examination, electrocardiography, echocardiography, measurement of cardiac biomarkers (cardiac troponin T [cTnT] and N-terminal pro–brain natriuretic peptide [NT-proBNP]), and 24-hour Holter monitoring. Results: In total, 42 patients were enrolled (27 and 15 with SMA type 2 and 3, respectively). No patient had structural heart disease, except for one with mitral valve prolapse. None had signs of ventricular dysfunction on echocardiography. Both cTnT and NT-proBNP levels were normal in all patients. Electrocardiography showed sinus tachycardia in seven patients (16.7%), and prolonged P-R interval in one (2.4%). Holter monitoring detected benign ventricular arrhythmias in two patients (4.8%), and rare supraventricular premature beats in one. The mean 24-hour heart rate was elevated in six patients (14.3%), whereas both the minimum 24-hour heart rate and the maximum R-R interval were increased in 23 (54.8%). Discussion: The prevalence of cardiac disease in pediatric patients with SMA types 2 and 3 is low; however, these patients may have increased resting heart rates. A complete cardiac history and physical examination are a useful screen. Additional cardiac investigations may be performed as needed. © 2020 Wiley Periodicals LLC

Background: It is unclear whether the heart is affected in pediatric patients with milder forms of spinal muscular atrophy (SMA). Therefore, we aimed to determine the presence of any cardiac abnormalities in these patients. Methods: We conducted a cross-sectional study of children and adolescents with SMA types 2 and 3 between July 2018 and July 2019. All patients underwent a comprehensive cardiac evaluation, including history-taking, physical examination, electrocardiography, echocardiography, measurement of cardiac biomarkers (cardiac troponin T [cTnT] and N-terminal pro–brain natriuretic peptide [NT-proBNP]), and 24-hour Holter monitoring. Results: In total, 42 patients were enrolled (27 and 15 with SMA type 2 and 3, respectively). No patient had structural heart disease, except for one with mitral valve prolapse. None had signs of ventricular dysfunction on echocardiography. Both cTnT and NT-proBNP levels were normal in all patients. Electrocardiography showed sinus tachycardia in seven patients (16.7%), and prolonged P-R interval in one (2.4%). Holter monitoring detected benign ventricular arrhythmias in two patients (4.8%), and rare supraventricular premature beats in one. The mean 24-hour heart rate was elevated in six patients (14.3%), whereas both the minimum 24-hour heart rate and the maximum R-R interval were increased in 23 (54.8%). Discussion: The prevalence of cardiac disease in pediatric patients with SMA types 2 and 3 is low; however, these patients may have increased resting heart rates. A complete cardiac history and physical examination are a useful screen. Additional cardiac investigations may be performed as needed. © 2020 Wiley Periodicals LLC

The epidemic control approach was based on non-pharmacological measures in the first year of the COVID-19 pandemic, followed by vaccine uptake in the second year. Vaccine uptake depends on the individual attitude toward vaccination. The aim was to assess the changes in attitudes regarding COVID-19 vaccine protection during the pandemic and to determine the vaccination uptake concerning these attitudes. A panel study on COVID-19 vaccine attitudes and vaccination against COVID-19 was conducted in Belgrade, Serbia. The first survey was carried out in May–June 2020, and the second survey was organized in August–September 2021. During the baseline testing performed in 2020, 64.4% of respondents believed that the future vaccine against COVID-19 could protect against the COVID-19 disease, while 9.7% thought that it could not, and 25.9% were unsure. One year later, in the second survey, the percentage of participants with positive attitudes was slightly lower (64.7% vs. 62.5%). However, negative attitudes turned positive in 34% of cases, and 28.9% became unsure about vaccine protection (p < 0.001). Out of the 390 participants included in the study, 79.7% were vaccinated against COVID-19 until follow-up. There is a statistically significant difference in vaccination uptake compared to the baseline attitude about the protection of the COVID-19 vaccine. The main finding of our study is that the majority of participants who were vaccine hesitant during the baseline testing changed their opinion during the follow-up period. Additionally, the baseline attitude about the protection of the COVID-19 vaccine has been shown to be a potential determinant of vaccination uptake. © 2023 by the authors.

The epidemic control approach was based on non-pharmacological measures in the first year of the COVID-19 pandemic, followed by vaccine uptake in the second year. Vaccine uptake depends on the individual attitude toward vaccination. The aim was to assess the changes in attitudes regarding COVID-19 vaccine protection during the pandemic and to determine the vaccination uptake concerning these attitudes. A panel study on COVID-19 vaccine attitudes and vaccination against COVID-19 was conducted in Belgrade, Serbia. The first survey was carried out in May–June 2020, and the second survey was organized in August–September 2021. During the baseline testing performed in 2020, 64.4% of respondents believed that the future vaccine against COVID-19 could protect against the COVID-19 disease, while 9.7% thought that it could not, and 25.9% were unsure. One year later, in the second survey, the percentage of participants with positive attitudes was slightly lower (64.7% vs. 62.5%). However, negative attitudes turned positive in 34% of cases, and 28.9% became unsure about vaccine protection (p < 0.001). Out of the 390 participants included in the study, 79.7% were vaccinated against COVID-19 until follow-up. There is a statistically significant difference in vaccination uptake compared to the baseline attitude about the protection of the COVID-19 vaccine. The main finding of our study is that the majority of participants who were vaccine hesitant during the baseline testing changed their opinion during the follow-up period. Additionally, the baseline attitude about the protection of the COVID-19 vaccine has been shown to be a potential determinant of vaccination uptake. © 2023 by the authors.

SETTING: Republic of Serbia, excluding Kosovo. OBJECTIVE: To estimate the clinical and epidemiological pattern of tuberculosis (TB) in Serbia during the period 1990-2004. DESIGN: A retrospective analysis of clinical and epidemiological data on TB patients registered in annual TB reports. RESULTS: During the 15-year period, TB incidence levelled off in Serbia. The slightly decreasing trend occurred in both total pulmonary TB (PTB) and laboratory confirmed PTB (PTB+) incidence (P > 0.05), while the trend of extra-pulmonary TB (EPTB) incidence increased slightly (P > 0.05). During the same period, TB mortality showed a significantly decreasing trend (P < 0.05). The mean annual proportion of PTB+ cases among newly reported PTB cases was 62.7%. The mean proportion of EPTB cases among total TB cases was 6.1%. The mean percentage of cases with resistance to at least one anti-tuberculosis drug was 4.8%. CONCLUSION: Thanks to the good organisation and efficient work of anti-tuberculosis dispensaries in Serbia, as well as to the low incidence of AIDS and low frequency of Mycobacterium tuberculosis resistant strains, TB incidence did not increase during the period observed and TB mortality significantly decreased, despite markedly deteriorated socio-economic conditions during the 1990s. © 2007 The Union.