Browsing by Author "Paunović, Katarina (8412749700)"

The change in socio-economic status, drastic decrease in living standards, war, and the introduction of sanctions to our country were complicated in addition by a large number of internally displaced people from Kosovo, which culminated with the 1999 NATO bombing. The aim of this investigation was to estimate the influence of internal displacement on the adaptation and mental health of adolescents. The investigation was conducted on 238 adolescents, comprising a control group of 206 adolescents from Belgrade and 32 internally displaced adolescents from Kosovo. A specific questionnaire regarding habits, behaviour, and psychosomatic state was used, as well as the Cornell Medical Index and the Eysenck Personality Questionnaire. Internally displaced adolescents from Kosovo exhibited greater difficulties in adapting and had worse school records than adolescents from Belgrade, one year after the change in their location. Immediately after the NATO bombing, both groups reacted in the same way: they often talked about the events they had survived, they were afraid of the sounds of alarm sirens and of aeroplanes, and in addition had similar dreams (no statistical variation between the groups). Emotional disturbances, one year after the bombing, were not observed in 40.6% of adolescents from Kosovo, compared to the figure of 74.8% for adolescents from Belgrade. Adolescents from Belgrade consumed alcohol significantly more often: 75.7% compared to 56.3% for adolescents from Kosovo. In addition, 20.4% of adolescents from Belgrade consumed psychoactive substances compared to 6.3% of adolescents from Kosovo. There was no significant difference between the examined groups in the total scores on the scale for neuroticism. All in all, the girls from both examined groups displayed neurotic tendencies more frequently than the boys.

Aim. To investigate the connection between alcohol consumption and general and specific mortality in the Serbian population. Methods. Total of 286 healthy middle-aged participants of both genders enrolled in a prospective follow-up study in 1974. During the following 20 years, 80 deaths occurred. The data on underlying causes of death were obtained from official death certificates. Alcohol consumption was estimated from a multiple-choice questionnaire. According to the total daily alcohol intake, subjects were classified into 3 groups: none- or rare drinkers, moderate, and heavy drinkers. The relative risks (RR) adjusted for gender, smoking, body mass index, and blood pressure were calculated using non-drinkers as a reference category. Results. Heavy drinkers exhibited significantly higher adjusted ratios for all-cause mortality (RR = 1.970, 95% confidence interval [Cl] = 1.062-3.651; p = 0.031) and myocardial infarction (RR = 2.463, 95% Cl = 1.050-5.775; p = 0.038), and non-significantly higher risk for death from other causes. Moderate drinkers exhibited lower adjusted risk ratios for all-cause mortality, myocardial infarction and death from other causes, but this decrease did not reach the significance level. Further, overall probability of survival at every time point was the highest among moderate drinkers and lowest among heavy drinkers. Conclusion. Among Serbian middle-aged population moderate alcohol consumption reduced mortality from all causes, myocardial infarction and other causes of death, and increased the probability of survival in a twenty year follow-up period. Heavy drinking increased mortality rates from all causes and reduced the twenty year-survival probability in comparison with non-drinkers.

Background: The aim of this study was to assess the mortality rate and risk of death in relation to the blood pressure (BP) categories during 36 years of follow-up period. Methods: 265 healthy middle-aged participants were included in the follow up for 36 years; 136 deaths occurred during this time. Causes of death (myocardial infarction (MI), stroke and other causes) were obtained from the death certificates. Participants were divided into four groups according to their blood pressure measurements (normal blood pressure, prehypertension, stage I and stage II hypertension). Hazard ratios (HR) for mortality from all investigated causes of death were calculated using measurements of normal BP as a reference. Kaplan-Meier method was used to calculate probability of survival for each BP category. Results: Participants with prehypertension and stage I hypertension have shared similar all-cause mortality rates (15 deaths per 1000 person-years), and MI mortality rates (7 per 1000 person-years). Participants with stage II hypertension had the highest risk of all-cause mortality (HR 2.78, 95% confidence interval 1.16 to 6.66). Conclusion: Prehypertension and stage I hypertension induced similar rates of mortality due to myocardial infarction or all-causes. The survival probabilities were lower for participants with hypertension and prehypertension in comparison with those who had normal blood pressure. Participants with stage II hypertension had the highest mortality rates and the lowest probability of survival during a 36-year follow-up period. © 2013 Versita Warsaw and Springer-Verlag Berlin Heidelberg.

The aim of the study was to investigate the relationship between noise levels, traffic density and the presence of public transport and children's blood pressure. Another aim was to assess the applicability of public transport as a proxy indicator of noise exposure. A cross-sectional study involved 1113 children aged 7-11 years from a central municipality in Belgrade. Equivalent noise levels were measured in front of all schools and in the middle of all streets. Traffic density was defined as number of light and heavy vehicles per hour. The number of public transport vehicles was calculated from official timetables. Children's addresses were matched with noise levels and transport maps. A physician measured blood pressure with the sphygmomanometer. Children attending schools with public transport running nearby had by 1.3 mmHg higher systolic pressure than did children from schools without public transport. This relationship was independent from children's age, gender, and body mass index, family history of hypertension, some dwelling characteristics, and lifestyle habits. The association between diastolic pressure and public transport was statistically insignificant. The study indicated a possible positive association between the presence of public transport in the vicinity of schools with systolic blood pressure in 7-11 year-old schoolchildren. The presence of public transport may serve as an auxiliary indicator of noise exposure in undeveloped countries with limited capacities for noise measurement or modeling.

Lateralization is one of the central questions in neurology, neuropsychology, and other related scientific disciplines. There has been very little change in the proportion of left-handers since the Upper Paleolithic Age about 10,000 years ago and it is estimated to be around 10%. As the history of human thinking has developed from superstition to science, the explanation of left-handedness transformed from “devil’s work” to neurological specificity. This paper presents this very interesting historical change by analyzing the data on left-handedness and the attitudes towards it in human societies from prehistory to today. Even in a relatively open-minded society, parents and teachers may encourage a left-handed child to switch to right-handedness to make their lives easier in a largely right-handed world. On the other hand, left-handedness is increasingly seen as a special gift, and left-handed people have started to favor themselves as more competent in relation to the right-handed people. © 2019, Serbia Medical Society. All rights reserved.

To date, lateralization in living beings is a phenomenon almost mythologically unexplored. Scientists have proved that lateralization is not exclusively a human feature. Investigations in molecular biology, protein structure, mobility of bacteria, and intracellular lateralization in ciliates, shows important and universal nature of lateralization in living systems. Dominant lateralization implies the appearance of a dominant extremity, or a dominant sense during the performance of complex psychomotor activities. Hand dominance is usually defined as a tendency to use one hand rather than another to perform most activities and this is considered to be the most obvious example of cerebral lateralization and exclusive characteristic of humans. However, there are some exceptions in other species. The dominant hand is able to perform more complex and subtle manual tasks than the non-dominant hand, and this behavioral superiority is the absolute result of additional cerebral support. The asymmetry of brain organization was confirmed in rats, chimpanzees, dogs and birds, some fishes and lizards. The relationships between hand dominance with brain structure and function remain far from clear. For a long time, lateralization was considered unique to humans, but recently it has become clear that lateralization is a fundamental characteristic of the organization of brain and behavior in all vertebrates. It has been questioned to what extent lateralization in humans and other vertebrates may be comparable. © 2016. Srpski Arhiv za Celokupno Lekarstvo. All right reserved.

Objective - Left ventricular hypertrophy (LVH) is an independent predictor of cardiovascular and general mortality. Both arterial hypertension and obesity cause changes in structure and function of the left ventricle. Given the rising global epidemic of obesity, it is likely that adverse health consequences of excess adiposity will escalate in the future. The aim of this investigation was to assess the relation and predictive value of obesity on the occurrence of left ventricular hypertrophy in hypertensive middle-aged women. Methods and results - Investigation was conducted on a sample of 64 middle-aged women, diagnosed with arterial hypertension and treated longer than 10 years in the absence of other chronic diseases or heart failure. Based on anthropometric parameters, 14 women (21.9%) had a body mass index (BMI) within the normal range, 17 (26.6%) were overweight, and 33 (52.5%) were obese. Left ventricular hypertrophy was assessed by electrocardiographic and echocardiographic criteria. The influence of anthropometric parameters on left ventricular hypertrophy and patterns in left ventricular geometry was assessed using multivariate regression analyses. The prevalence of LV hypertrophy was 7.1% among normal-weight hypertensive women, 41.2% among overweight and 66.7% among obese women. Compared to normal-weight women, overweight and obese hypertensive subjects had higher mean values of all ECG and echo parameters. The strong correlation between anthropometric and left ventricular parameters was observed. Multivariate analysis showed that percent of body fat (OR = 1.226; 95% CI 1.011-1.486) was the only independent predictor of left ventricular hypertrophy. Being overweight was identified as predictor for the development of eccentric LV hypertrophy (OR = 31.824; 95%CI 1.225-826.850), and for concentric left ventricular remodelling (OR = 20.755; 95%CI 1.119-385.029). Conclusions - Heart abnormalities occurring in arterial hypertension in conjunction with overweight/obesity include left ventricular hypertrophy and structural changes in the left ventricle. These findings support weight control and the regulation of blood pressure for the prevention of left heart abnormalities.

Background: Peripheral arterial disease (PAD) in the aortoiliac segment is found in nearly a half of patients with PAD. The aim of this study was to estimate the influence of obesity and fat distribution on the occurrence of aortoiliac PAD in middle-aged men. Methods: This case-control study included 204 middle-aged men (mean 58 ± 7 years; range 45-70 years): 102 patients with aortoiliac PAD and 102 healthy controls without PAD. Aortoiliac PAD was diagnosed by ankle-brachial index (ABI) and angiography. Body mass index (BMI) was categorized as: normal weight, overweight, and obese. Percents of body fat were grouped according to quartile distribution. The relationship between anthropometrics and aortoiliac PAD was estimated by multivariate logistic regression. Results: Patients with aortoiliac PAD had higher body mass index, waist circumference, waist-hip ratio and percent of body fat. A strong correlation between all anthropometric parameters and ABI index and mean angiographic score was shown among patients with PAD. Multivariate regression, adjusted for blood pressure and cholesterol level, identified being overweight, body fat over 26.5% and WHR over 1.02 as predictors for aortoiliac PAD. Body fat over 26.5% and WHR over 1.02 remained significant after further adjustment for blood pressure, cholesterol and body mass index. Conclusion: This study has identified the quantity of fat tissue (body fat over 26.5%) and its visceral distribution (waist-hip ratio over 1.02) as predictors of aortoiliac PAD in middle-aged men. Body mass index, a crude indicator of obesity, should be combined with these parameters when assessing the risk for aortoiliac PAD. © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Background: Precautionary allergen labels (PAL) should be used to indicate the possibility of allergen presence in the food. This study aimed to determine the prevalence and types of precautionary labeling statements on different pre-packaged food products in retail stores in Belgrade, Serbia, as well as to assess consumers’ attitudes and behavior towards PAL statements. Methods: This was a descriptive study. The following characteristics of 1404 pre-packaged foods were ana-lyzed: prevalence of PAL, listed food allergens on PAL, and the types of the advisory terminology. In the group of 275 participants (94 with food allergies, and 181 persons who purchasing food for a household member with food allergy) reading practice of PAL, purchasing practice based on PAL, and the opinion about PAL statements credibility were evaluated. Results: Overall, 33.9% of products had precautionary statements for one or more allergens. “Tree nuts” were the most common allergens listed in the PAL. The most common type of PAL was “May contain traces of x [allergen]” (52.7%). The PAL was always read by half of the participants. Less than half (43.3%) of the participants incorrectly believed that PAL is regulated by national law. A quarter of participants thought that the PAL statements are trustworthy. Conclusion: PAL statements frequently are not user-friendly and are not providing sufficient protection for food allergic patients. To gain buyers’ confidence, protect health and provide security, the necessity for the strategies that would regulate PAL by the law exists. © 2022 Davidović et al. Published by Tehran University of Medical Sciences.

BACKGROUND:: Arterial hypertension (AH) is the most common cardiovascular disease risk factor, affecting between 30 and 50% of the adult population in developed countries. A steady increase of the prevalence of AH by about 60% is expected by year 2025. METHODS:: Serbian Society of Hypertension conducted a prevalence study from February to May 2012 on a sample of 3878 adult respondents. The study included 2066 women (53.3%) and 1812 men (46.7%). Average age was 48.89 ±â€Š17.48 years. Most participants resided in urban areas (2956 people, 76.2%), whereas 922 resided in rural areas (23.8%). RESULTS:: The prevalence of AH in Serbia is 42.7%. Hypertension is more frequently diagnosed among women (53.3%), than among men (46.7%). One thousand, four hundred and twelve respondents were previously diagnosed and treated for hypertension. The estimated awareness of the presence of AH was 42.99% (i.e. 40.00% among male and 45.41% among female participants). Out of all diagnosed cases of hypertension, 390 persons (27.7%) have well regulated blood pressure values, whereas 1022 persons (72.3%) do not have their blood pressure under control. CONCLUSION:: Serbia belongs to countries with a high prevalence of AH. A poor control of AH may be explained in view of socioeconomic problems. High prevalence of AH may indicate a remarkably high cardiovascular disease mortality in Serbia. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.

BACKGROUND:: Arterial hypertension (AH) is the most common cardiovascular disease risk factor, affecting between 30 and 50% of the adult population in developed countries. A steady increase of the prevalence of AH by about 60% is expected by year 2025. METHODS:: Serbian Society of Hypertension conducted a prevalence study from February to May 2012 on a sample of 3878 adult respondents. The study included 2066 women (53.3%) and 1812 men (46.7%). Average age was 48.89 ±â€Š17.48 years. Most participants resided in urban areas (2956 people, 76.2%), whereas 922 resided in rural areas (23.8%). RESULTS:: The prevalence of AH in Serbia is 42.7%. Hypertension is more frequently diagnosed among women (53.3%), than among men (46.7%). One thousand, four hundred and twelve respondents were previously diagnosed and treated for hypertension. The estimated awareness of the presence of AH was 42.99% (i.e. 40.00% among male and 45.41% among female participants). Out of all diagnosed cases of hypertension, 390 persons (27.7%) have well regulated blood pressure values, whereas 1022 persons (72.3%) do not have their blood pressure under control. CONCLUSION:: Serbia belongs to countries with a high prevalence of AH. A poor control of AH may be explained in view of socioeconomic problems. High prevalence of AH may indicate a remarkably high cardiovascular disease mortality in Serbia. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Non-auditory effects of noise on humans have been intensively studied in the last four decades. The International Commission on Biological Effects of Noise has been following scientific advances in this field by organizing international congresses from the first one in 1968 in Washington, DC, to the 11th congress in Nara, Japan, in 2014. There is already a large scientific body of evidence on the effects of noise on annoyance, communication, performance and behavior, mental health, sleep, and cardiovascular functions including relationship with hypertension and ischemic heart disease. In the last five years new issues in this field have been tackled. Large epidemiological studies on community noise have reported its relationship with breast cancer, stroke, type 2 diabetes, and obesity. It seems that noise-induced sleep disturbance may be one of the mediating factors in these effects. Given a large public health importance of the above-mentioned diseases, future studies should more thoroughly address the mechanisms underlying the reported association with community noise exposure. © 2016, Serbia Medical Society. All rights reserved.

Aim: To explore the relationship between sleep disturbances caused by traffic noise and relevant personality traits, such as extroversion- introversion, neuroticism, and subjective noise sensitivity. Methods: A cross-sectional study was carried out from January to April 2005 in a central municipality of Belgrade, the capital of Serbia and Montenegro. Noise measurements were performed at 12 measurement sites three times at daytime and twice at night. On the basis of noise measurement results, three streets with the highest and three streets with the lowest values of equivalent sound pressure level (Leq) were chosen to represent noisy (>65 dB(A)) and quiet (<55dB(A)) areas, respectively. The respondents from both areas were asked to fill out the questionnaire on noise-related health problems. The final sample consisted of 310 respondents, 192 from noisy area and 118 from quiet area. Results: Respondents from noisy area reported having significantly more difficulties with falling asleep, being woken up by noise at night more often, and having more difficulties with falling back to sleep. They also complained of poorer sleep quality and tiredness after sleep and they slept by an open window in summer less often. Noise annoyance, subjective noise sensitivity, and neuroticism were significantly correlated with difficulties with falling asleep, time needed to fall asleep, poorer sleep quality, tiredness after sleep, and use of sleeping pills. After adjustment for potential modifying personality traits including subjective noise sensitivity, neuroticism, and extroversion, residence in noisy area was shown to be a significant predictor for difficulties with falling asleep (odds ratio [OR], 2.71; 95% confidence interval [CI], 1.27-5.80), difficulties with falling back to sleep (OR, 1.87; 1.02-3.40), waking up at night (OR, 2.60; 1.49-4.52), sleeping by closed windows (OR, 13.51; 5.84-31.25), having poor sleep quality (OR, 2.99; 1.13-7.89), and feeling tired after sleep (OR, 2.50; 1.11-5.63). Conclusion: Urban population living in noisy area was at higher risk for sleep disturbances than population living in the quiet area. Furthermore, sleep disturbances were significantly and positively related to personality traits of neuroticism, subjective noise sensitivity, and noise annoyance.

Background: Blood-pressure-to-height ratio is considered a simple, accurate, inexpensive and non-age-dependent index for screening high blood pressure in a clinical setting, but its suitability in epidemiological surveys was not taken into consideration. The aim of this study was to test the suitability of blood-pressure-to-height ratio against blood pressure for age percentiles for the identification of high blood pressure in an environmental study. Methods: The sample consisted of 2195 children, aged 3 to 15 years, whose blood pressure was measured as part of an environmental study in Belgrade, Serbia. High blood pressure was estimated using percentiles (gold standard) and blood-pressure-to-height ratios for systolic and diastolic pressures separately (proposed criterion). The optimal cut-offs of the blood-pressure-to-height ratio (BPHR) were selected based on Youden’s index (sensitivity + specificity − 1) calculated from the receiver operator characteristic curve analysis. Results: The proposed criterion identified five times more cases of high blood pressure in the investigated children of all age groups in comparison to the gold standard. The optimal cut-off values were selected based on the sensitivity and specificity values by age groups and gender. Conclusion: Blood-pressure-to-height ratio can be a reliable criterion for the estimation of high blood pressure in epidemiological studies. This is the first study on the applicability of blood-pressure-to-height ratio in Serbian children, but it may not be easily generalized to other populations due to small sample size across the examined age groups and potential diversities in risk factors for high blood pressure. Applied in epidemiological studies, BPHR would help researchers estimate the role of certain environmental factors on blood pressure in children. © 2016 Informa UK Limited, trading as Taylor & Francis Group.

Provision of safe water, sanitation, and hygiene (WASH) services in health care facilities is a priority at the global, national, and local levels. To inform improvements planning, conditions of WASH, waste management, and environmental cleaning were assessed in 81 facilities in the Autonomous Province of Vojvodina, Serbia, as part of a nationally representative survey in 2019. The survey included on-site checks, structured interviews, and drinking-water quality analysis. WHO/UNICEF indicators for WASH service levels and an advanced service level defined at the national level were applied. The results showed that all investigated facilities provided basic water services; 94% of facilities provided basic hygiene and waste management services; 58 and 2%, respectively, provided basic cleaning and sanitation services. Only 1% of investigated facilities met the basic level for all five WASH dimensions. Advanced service levels were only met for hygiene, waste management, and/or cleaning in 15-38% of facilities. In 33% of health care facilities, drinking-water quality was not in compliance with the national standards. The results revealed that there is a need for increased awareness and efforts to ensure basic provisions for sanitation, environmental cleaning, and drinking-water safety. © World Health Organization 2022 Licensee IWA Publishing

Provision of safe water, sanitation, and hygiene (WASH) services in health care facilities is a priority at the global, national, and local levels. To inform improvements planning, conditions of WASH, waste management, and environmental cleaning were assessed in 81 facilities in the Autonomous Province of Vojvodina, Serbia, as part of a nationally representative survey in 2019. The survey included on-site checks, structured interviews, and drinking-water quality analysis. WHO/UNICEF indicators for WASH service levels and an advanced service level defined at the national level were applied. The results showed that all investigated facilities provided basic water services; 94% of facilities provided basic hygiene and waste management services; 58 and 2%, respectively, provided basic cleaning and sanitation services. Only 1% of investigated facilities met the basic level for all five WASH dimensions. Advanced service levels were only met for hygiene, waste management, and/or cleaning in 15-38% of facilities. In 33% of health care facilities, drinking-water quality was not in compliance with the national standards. The results revealed that there is a need for increased awareness and efforts to ensure basic provisions for sanitation, environmental cleaning, and drinking-water safety. © World Health Organization 2022 Licensee IWA Publishing