Browsing by Author "Nešić, Dejan (26023585700)"

Introduction/Objective Continuing Medical Education (CME) is a crucial element to keep the level of professionalism in the three key fields of medical education: pre-clinical, clinical, and public health. The profile of CME in Serbia has been analyzed for the 2011–2017 period. Methods Between 2011 and 2017, 11,557 courses of CME have been submitted for accreditation, de-scribed by 26 variables. Due to the predominance of nominal data, we employed a principal component analysis (PCA) using the nonlinear iterative partial least squares algorithm (PCA/PLS) to arrange the 16 variables with complete information in such a way that most influential factors could be displayed and ranked. The analysis was done with TIBCO Statistical Software. Results The Faculty of Medicine of Belgrade takes the top position among the medical faculties in Serbia with 569 courses or 47.9% (n = 1187; 2011–2017), whereas non-educational institutions with 86.2% of all courses (n = 11,514) are the most dominant providers. Clinical topics dominate the thematic spectrum with 59.7%. Between 2012 and 2017, the total number of courses offered diminished by 16.9%. A PCA of 16 potential determinants of CME reveals that the most relevant ones are duration, credit points, price, and number of lecturers. Conclusion For the last decade, a standstill or even a regression in the development can be observed. Especially the faculties of medicine in Serbia, as well as other major providers, should reconsider the entire structure of their administrative organization and initiate innovative development. © 2021, Serbia Medical Society. All rights reserved.

[No abstract available]

OBJECTIVES: Healthcare workers are the professional group at higher risk of burnout than others. It is the underlying reason for medical errors and the general decrease in quality of patient care and is related to poor patient-healthcare worker relationships. Healthcare workers who work with military personnel have specificities compared to healthcare workers who work only with civilians. METHODS: A cross-sectional study among 171 nurses at the Military Medical Academy was conducted. The questionnaire consisted of items regarding socio-demographic and socioeconomic characteristics, lifestyle characteristics, workplace environment, workplace stress, strategies of stress management, symptoms and signs of workplace-related stress, and the Serbian version of the Maslach Burnout Inventory. RESULTS: The prevalence of burnout was 46.2%. The multivariate logistic regression analysis showed that the burnout was associated with stating that they would not choose the same profession again (OR = 4.54, 95% CI: 1.53-14.50) and with not being interested in the work (OR = 4.86, 95% CI: 1.58-14.92). CONCLUSION: The prevalence of burnout is relatively high among nurses at the Medical Military Academy in Belgrade and is associated with factors in the work environment.

Changes in feeding regime represent serious stress, while ghrelin is considered a key player in energy balance. We investigated the effects of intracerebroventricular (ICV) ghrelin application on pituitary adrenocorticotropic (ACTH) cells in rats fed diets differing in energy content. Before the ICV treatment, male Wistar rats were subjected to three different feeding regimes for 4 weeks: normal-fed (NF), food-restricted (FR) or high-fed (HF) (n=3. ×. 14). At the age of 8 weeks, rats from each group were divided into two subgroups and given ICV, either ghrelin (G; 1. μg ghrelin/5. μl PBS, n=7) or solvent alone (5. μl PBS, n=7) every 24. h for 5 days. The immunohistochemical appearance and quantitative morphology of pituitary ACTH cells were evaluated, as well as peripheral ACTH and corticosterone levels. Central ghrelin administration increased (p<. 0.05) ACTH cell volumes in GNF, GFR and GHF rats by 8.1%, 11.8% and 9.1%, respectively, compared to the controls, while significant increases in ACTH cell volume density were observed in GNF and GHF rats. Circulating ACTH and corticosterone levels were elevated (p<. 0.05) in GNF and GFR rats by 72.8% and 80.8%, respectively, when compared to the corresponding controls. Thus, central ghrelin administration stimulated the pituitary-adrenal axis under preserved and negative energy balance states. © 2013 Elsevier GmbH.

Changes in feeding regime represent serious stress, while ghrelin is considered a key player in energy balance. We investigated the effects of intracerebroventricular (ICV) ghrelin application on pituitary adrenocorticotropic (ACTH) cells in rats fed diets differing in energy content. Before the ICV treatment, male Wistar rats were subjected to three different feeding regimes for 4 weeks: normal-fed (NF), food-restricted (FR) or high-fed (HF) (n=3. ×. 14). At the age of 8 weeks, rats from each group were divided into two subgroups and given ICV, either ghrelin (G; 1. μg ghrelin/5. μl PBS, n=7) or solvent alone (5. μl PBS, n=7) every 24. h for 5 days. The immunohistochemical appearance and quantitative morphology of pituitary ACTH cells were evaluated, as well as peripheral ACTH and corticosterone levels. Central ghrelin administration increased (p<. 0.05) ACTH cell volumes in GNF, GFR and GHF rats by 8.1%, 11.8% and 9.1%, respectively, compared to the controls, while significant increases in ACTH cell volume density were observed in GNF and GHF rats. Circulating ACTH and corticosterone levels were elevated (p<. 0.05) in GNF and GFR rats by 72.8% and 80.8%, respectively, when compared to the corresponding controls. Thus, central ghrelin administration stimulated the pituitary-adrenal axis under preserved and negative energy balance states. © 2013 Elsevier GmbH.

Introduction Sleep disorders and psychological disturbances are common in end-stage renal disease (ESRD) patients. However, despite their frequency and importance, such conditions often go unnoticed, since all patients do not clearly manifest fully expressed symptoms.; Objective This study aimed to determine the prevalence of depression and poor sleep quality and to examine the association between these disorders and demographic, clinical and treatment-related characteristics of ESRD patients on hemodialysis (HD).; Methods The study included 222 patients (132 men and 90 women), mean age 57.3 ± 11.9 years, from 3 HD centers in Central Serbia, which provided us with biochemical parameters and demographic data. Sleep quality and depression were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), respectively.; Results The average BDI was 16.1 ± 11. 3. Depressed patients were significantly older (p=0.041), had a significantly lower dialysis adequacy (p=0.027) and a significantly worse quality of sleep (p<0.001), while they did not show significant difference as regarding sex, employment, marital status, comorbidities, dialysis type, dialysis vintage, shift and laboratory parameters. The average PSQI was 7.8 ± 4.5 and 64.2% of patients were poor sleepers. Poor sleepers were significantly older (p=0.002), they were more often females (p=0.027) and had a significantly higher BDI (p<0.001), while other investigated variables were not correlated with sleep quality. A statistically significant positive correlation was found between BDI and PSQI (r=0.604; p<0.001).; Conclusion Depression and poor sleep quality are frequent and interrelated among HD patients. © 2014, Srp Arh Celok Lek. All rights reserved.

Clinical presentation, course, and treatment for patients with isolated right ventricular (RV) hypoplasia (IRVH) depends on the degree of hypoplasia that is present—this is a spectrum from spontaneous maturation to Fontan circulation over time. An 8-month-old infant presented with IRVH; in the patient, a modified Blalock–Taussig (MBTS) shunt was closed percutaneously after spontaneous RV function recovery. A female newborn was diagnosed with differential cyanosis at birth. The echocardiography showed a hypertrophic RV with a small cavity, a right–left shunt on the atrial septal defect, an almost closed ductus arteriosus (DA), and a small tricuspid valve ring (Z-score-2) with mild regurgitation (pressure gradient 30 mmHg). On the 4th day of life, the patient showed deepened cyanosis and hyperlactatemia was registered. The echocardiography examination revealed a closed DA. Right ventriculography performed on the 5th day of life evidenced the presence of a small hypertrabeculated RV. The pressure in the RV increased. A right-side MBTS was created on the 6th day of life. Further echocardiographic findings indicated a gradual development of the RV and a decrease in RV pressure. MBTS occlusion was performed when the patient was 8 months old. Vital parameters were monitored invasively and noninvasively after the balloon occlusion of MBTS. Percutaneous MBTS occlusion was successfully performed using an Amplatzer vascular plug 2 (AVP2). During the follow-up period, the patient was found to have maintained a normal percutaneous oxyhaemoglobin blood saturation. © 2023 by the authors.

Clinical presentation, course, and treatment for patients with isolated right ventricular (RV) hypoplasia (IRVH) depends on the degree of hypoplasia that is present—this is a spectrum from spontaneous maturation to Fontan circulation over time. An 8-month-old infant presented with IRVH; in the patient, a modified Blalock–Taussig (MBTS) shunt was closed percutaneously after spontaneous RV function recovery. A female newborn was diagnosed with differential cyanosis at birth. The echocardiography showed a hypertrophic RV with a small cavity, a right–left shunt on the atrial septal defect, an almost closed ductus arteriosus (DA), and a small tricuspid valve ring (Z-score-2) with mild regurgitation (pressure gradient 30 mmHg). On the 4th day of life, the patient showed deepened cyanosis and hyperlactatemia was registered. The echocardiography examination revealed a closed DA. Right ventriculography performed on the 5th day of life evidenced the presence of a small hypertrabeculated RV. The pressure in the RV increased. A right-side MBTS was created on the 6th day of life. Further echocardiographic findings indicated a gradual development of the RV and a decrease in RV pressure. MBTS occlusion was performed when the patient was 8 months old. Vital parameters were monitored invasively and noninvasively after the balloon occlusion of MBTS. Percutaneous MBTS occlusion was successfully performed using an Amplatzer vascular plug 2 (AVP2). During the follow-up period, the patient was found to have maintained a normal percutaneous oxyhaemoglobin blood saturation. © 2023 by the authors.

Objective: Medical students usually do not meet the recommendations on the minimum level of physical activity, despite knowing the impact that physical activity has on the prevention and treatment of various diseases. Medical students are considered to be insufficiently physically active. The aim of this study is to determine the prevalence of physically active fifth-year medical students at five universities in Serbia, as well as to identify factors associated with insufficient physical activity of students. Methods: A cross-sectional study was performed in the population of fifth-year medical students from five different universities in Serbia. The research instrument was a questionnaire specially designed based on similar research. Descriptive and analytical statistics methods were used in statistical analysis. Results: The study included a total of 573 fifth-year medical students from five universities in Serbia: 311 (54.3%) Belgrade; 86 (15.0%) Kragujevac; 58 (10.1%) Nis; 66 (11.5%) Kosovska Mitrovica; 52 (9.1%) Novi Sad. Insufficient physical activity was statistically significantly associated with studying at the University of Kosovska Mitrovica (OR = 3.98, 95% CI: 1.83-8.57). There was a statistically significant difference in the frequency of anti-anxiety medications use in the last 12 months between students with sufficient and insufficient physical activity (p = 0.040) as well as in the average number of cigarettes smoked per day between students with sufficient and those with insufficient physical activity (2.82 ± 6.35 vs. 4.50 ± 8.29, p = 0.043). There was also a statistically significant difference in the average score on the Beck’s depression scale between students with sufficient and students with insufficient physical activity (6.51 ± 6.59 vs. 10.03 ± 9.37, p < 0.001) and in the average score on Zung’s anxiety scale (34.86 ± 8.18 vs. 38.07 ± 8.71, p = 0.003). Conclusion: A high percentage of medical faculty students (86.6%) are physically active. Differences in the level of physical activity were observed between students of these five universities as well as between students with different levels of physical activity. © 2024, Czech National Institute of Public Health. All rights reserved.

Introduction Specific morphological and functional characteristics of athletes have a significant role in determining athletes' sports results and can be also used to assess the athlete's individual potential. Objective The aim of the study was to compare anthropometric characteristics and cardiovascular parameters in trained subjects to those of untrained subjects. Methods A total number of 25 trained (17.30±}0.83 years) and 21 (18.52±}1.52 years) untrained male subjects participated in this study. Body weight and height were measured and these values were used to compute body mass index (BMI). The bioelectrical impedance analysis (BIA) method was used to estimate body fat percentage (%BF). Cardiovascular parameters were monitored in rest (rest heart rate, systolic and diastolic blood pressure) during ergospirometric testing (maximal oxygen consumption, maximal heart rate) and in recovery (heart rate in the first and third minute of recovery). Results Body mass, height and BMI (p<0.01) were significantly higher, although BF% was lower in trained group when compared to untrained, but the difference was not statistically significant. Heart rate in rest and recovery were significantly lower (p<0.05) in trained group when compared to untrained, although maximal oxygen consumption and maximal heart rate were significantly higher in trained group (p<0.01, p<0.05, respectevely). Conclusion Our results show that in trained subjects, water polo players, regular intense physical activity lead to adaptive changes of anthropometric parameters and adaptive changes on the cardiovascular system.

The aim of this study was translating and exploring psychometric properties of Serbian Pittsburgh Sleep Quality Index (PSQI) in a sample of “good” and “bad” sleepers suffering from depression or obstructive sleep apnea (OSA). Formal translation and validation were performed on a sample of healthy controls, patients with untreated OSA, and with diagnosed major depressive disorder with evaluation of internal consistency, test–retest reliability, and construct and criterion validity. Controls and OSA subgroups were recruited from a larger sample of commercial drivers. One hundred and forty subjects, 84.3% male, 22–67 years old, were included. OSA subgroup had 59 subjects and depression subgroup had 40 subjects (22 females). Mean ± SD total PSQI was 3.5 ± 2.2 in controls, 4.9 ± 3.6 in OSA subjects, and 9.0 ± 4.9 in patients with depression. Cronbach’s α for total PSQI was 0.791. Subscale scores were significantly correlated to global PSQI in all subgroups. Intraclass correlation coefficient for global PSQI was 0.997 (p <.001). Epworth Sleepiness Scale score was significantly correlated to global PSQI (ρ = 0.333, p <.001). Three subgroups differed significantly in total PSQI and PSQI ≥ 5, even after adjustments for age and gender (p <.001). OSA patients had higher mean PSQI than controls but not significantly (p =.272). PSQI-reported sleep latency did not correlate with PSG-measured sleep latency (r =.130, p =.204). Total PSQI was significantly correlated to OSA severity (ρ = 0.261, p <.05). Serbian PSQI showed good internal consistency, test–retest reproducibility, and adequate construct and criterion validity, which supports further exploration of its use as a sleep quality screening tool in different target populations. © 2016, © The Author(s) 2016.

Objectives: The main aim has been to examine psychometric properties of STOP-Bang (snoring, tiredness, observed apnea, high blood pressure, body mass index (BMI), age, neck circumference, male gender) scoring model (Serbian translation), an obstructive sleep apnea (OSA) screening tool, in a sample of commercial drivers. Material and Methods: After formal translation, validation was performed on a sample of bus and truck drivers evaluating test-retest reliability, construct and criterion validity. Overnight polysomnography or cardiorespiratory polygraphy were used for OSA diagnosis purposes. Results: One hundred male participants, 24–62 years old, were included. STOP-Bang classified 69% as potential OSA patients. Polysomnography identified OSA in 57% of the sample. Test-retest reliability (Cohen’s κ = 0.89) was adequate. STOP-Bang score was significantly correlated to apnea-hypopnea index (AHI) and OSA severity. Sensitivity was 100% for AHI ≥ 15, highest specificity was 53.5% (AHI ≥ 5). Conclusions: STOP-Bang showed good measurement properties, supporting its further use in OSA screening of commercial drivers.

Introduction: It is very important to monitor levels of serum iron and other factors of iron metabolism and oxygen transport system as they play a very important role in functional ability of football players. A decrease in serum iron level can be the very first sign of development of iron deficiency anaemia, which seriously influences health and functional ability of an athlete and is a common problem in competitive sports. OBJECTIVE The aim of this study was to observe and evaluate changes in serum iron values during the competition season in relation to the training process. METHOD During four years, serum iron level was measured in 28-34 players of one of the top football clubs in Serbia, four times a year: at the beginning and at peak-point of both halfseasons. Differences between basic and control findings, relative and absolute changes in serum iron levels and statistical significance of the findings were than calculated. RESULTS There was a significant decrease in mean serum iron levels on each control test, compared to basic values. Mean value of control serum iron levels is significantly lower than mean of preseason values (20.64±6.58 vs. 16.38±5.51 μmol/l). Conclusion: A significant decrease in serum iron level among footballers during both half-seasons is most probably due to an increased loss and/or diminished absorption resulting from a high intensity training process. Because the decline in serum iron may be an early sign of iron store depletion and iron deficiency anaemia, it is very important to evaluate it regularly, along with other factors of iron metabolism and oxygen transport system.